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Allergen Immunotherapy

Purpose

Your individualized course of allergy shots (immunotherapy) is designed to decrease your allergic sensitivities. The vast majority of allergic patients (80-90%) will experience substantial reductions in their symptoms over time (months to years). Many also reduce or eliminate the need for other medications. Together with avoidance of offending allergens and medication allergy shots represent one of the recommended treatments for allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. Allergy shots are not useful for food/drug allergies or non-allergic conditions like infections.

Treatment Duration

The length of a treatment course varies on a case by case basis but in general a course requires 3 to 5 years of maintenance treatment for completion. Initially there is a build-up phase where the injections are given more frequently but as the High Dose, or maintenance dose, is reached the frequency of injections may be adjusted. The total duration of therapy can vary considerably from patient to patient. During your treatment you will be re-evaluated frequently by your physician. These visits will occur at least annually.

Schedule of Administration

Your series of injections begins at a low dose selected by your physician based on your skin test results and history. Over time the shots build gradually until you reach your High Dose. This High Dose is called the maintenance dose and you will stay on it for the duration of your treatment course unless it is changed by your physician. Maintenance therapy can be continued if you are pregnant BUT notify your OAAC physician when you become pregnant.

The build-up phase of the allergy shots can occur in different formats. Your physician will help you decide which is right for you. Most common is the weekly building schedule. Various accelerated schedules include: 2 or 3 time a week shots, clusters of several shots given on the same day and finally RUSH therapy where many injections are given on one day and then weekly shots follow until you are at your High Dose. RUSH therapy is associated with significantly more side effects (see below) and is not for every patient. However, it does bring you to the High Dose level in a month rather than slowly over many months. This is an advantage for some patients.

Safety

All allergy shots carry some risks for severe anaphylactic reactions. Therefore the injections need to be administered in a medical facility under medical supervision on a regular basis. Weekly or twice weekly shots from our clinic carry a risk of anaphylaxis of 0.015 to 0.02% of injections compared to nationally published risks of 0.1 to 0.3% of injections. RUSH therapy carries a nationally published risk of almost 40% of shots whereas our RUSH risk is closer to 10% of injections. This marked increase in risk however makes RUSH therapy unacceptable for many patients.

Recent News

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Making Halloween Fun for Everyone

When a child has a food allergy, holidays can be especially tough for both the child and the child’s family, says Oklahoma Asthma & Allergy Clinic’s Board-Certified Allergist Dr. Maya Gharfeh.

“Holidays are such an important and fun part of childhood,” said Gharfeh. “One of the most important things of raising a child with a food allergy is to not let him or her feel different or isolated because of the food allergy. Instead, we adapt and still let the holiday be as fun as possible.”

The Teal Pumpkin project is an initiative created by the Food Allergy Research and Education (FARE) network to promote a safe Halloween for all including those with a food allergy. It encourages families to place a teal pumpkin on their doorstep to let families know they have non-food treats available for kids with food allergies. Those who wish to participate can register their home address on the FARE website so families can pre-plan their trick or treating.

Any food allergy is potentially life threatening. An accidental exposure through ingestion of a food allergen may quickly lead to a life-threatening situation where a child would need emergency medication – like epinephrine – for survival.

As the mother of a child with a food allergy, Gharfeh has first-hand knowledge. She suggested ideas they’ve done to make a happier Halloween for their daughter.

“We have a rule of no eating or snacking on candy while trick or treating. We go house to house and collect treats as normal. Once we get home, we dump them out and I sort the candies into safe and non-safe, specific for my daughter,” Gharfeh said.

She always keeps safe treats at home for a swap out for those unsafe ones.

“No one wants a half-full Halloween basket,” she said.

Non-food items for those swap outs could include stickers, glow in the dark bracelets and necklaces, Halloween pencils, spider rings, etc.

“Since my daughter has a nut allergy, we try to stay away from most of the chocolate candies and stick with sugar candies such as Skittles or Jolly Ranchers,” Gharfeh added. “We always carry our emergency epinephrine device with us while trick or treating to be ready for an emergency.”

Other ideas for making Halloween safer, Gharfeh says, includes hosting your own Halloween party with allergy safe food treats and non-food items as treats. She encourages families to educate their neighbors and friends about the Teal Pumpkin project. Volunteer for school positions to allow more involvement in choosing snacks/treats for holidays such as Halloween.

“Kids love painting pumpkins,” Gharfeh said. “By inviting your neighbors to participate, you have provided an opportunity to ensure some safe stops for your food allergic littles in your neighborhood.”

FARE recommends has these ideas to celebrate the teal pumpkin project:

  • Decorate your front door. Grab some teal plastic pumpkins (available at local retailers), festive decorations and transform your door. Get your whole neighborhood involved.
  • Host a virtual Halloween party. Staying inside this year? Plan a virtual party so kids can dress up and show off their costumes. Make the party even more interactive by playing fun games online like bingo or trivia.
  • Set up a craft and activity station and let the kids loose! From coloring sheets to word matches, FARE has printable resources for getting kids excited about Halloween.
  • Halloween Scavenger Hunt – get your kids outside and moving. Take a walk or drive around to try and spot sooky sights. Bonus points for spotting teal pumpkins.
  • Stay in for a scary movie night. Invite your friends and neighbors over to watch your favorite Halloween movie.
  • For food allergy friendly recipes, check out the FARE website www.foodallergy.org

If families suspect their child might have a food allergy, Gharfeh says, “Come see a board-certified allergist. We want to help not only diagnose but also to help you, your child, and your family know what a food allergy means and the steps to ensure a safe, healthy and fun childhood, even with a diagnosis of a food allergy.”Teal Pumpkin Campaign

 

The post Making Halloween Fun for Everyone appeared first on Oklahoma Allergy and Asthma Clinic.

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