Tag Archives: anaphylaxis

What You Must Know About X-Ray Safety

November 7, 2018General Health and Wellness, Health Prevention844-SMA-TALK, anaphylaxis, Behind the Curtain, contrast media, radiation, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Introduction

X-ray safety is as important as using x-rays for proper evaluation.

Let’s start by getting this off the table: x-rays are safe when used appropriately and with care during each case. Radiologists and x-ray technologists are trained to toe the line between inadequate production of x-rays and overexposure such that patients are placed at risk. Additionally, your physicians consider the risk-benefit ratio with each study ordered. This is why instances exist when your physician (especially emergency physicians) may advise against having x-rays done.

What exactly are the risks of x-rays and other medical imaging studies?

It’s about the risks of radiation and the potential contribution to cancer. You accept these risks everyday. Some of you tan, play golf, surf and otherwise expose yourself to the sun. It’s the cumulative exposure that poses risks, and these risks are miniscule. That said, there are circumstances in which the risks become pronounced, such as irradiation during pregnancy, in children or due to dye materials (called contrast media) such as barium or iodine used to enhance development of the film during special x-ray studies.
In some people, the injection of a contrast medium can cause the following side effects:

A feeling of warmth or flushing
A metallic taste in the mouth
Hives
Itching
light-headedness
Nausea
Severely low blood pressure and shock (anaphylaxis, due to an allergic reaction)
Cardiac arrest

How much radiation is involved in these studies?

The radiation exposure from one chest x-ray is roughly equivalent to the amount of radiation exposure you obtain from natural surroundings in 10 days.

Aren’t x-rays dangerous during pregnancy?

One of the rules of emergency medicine is we don’t focus on potential side effects when confronted with a defined life threat. The issue of the effect of x-rays on an unborn fetus is secondary to the need to treat the mother. In other words, the best way to protect the fetus is to protect the mother. Even so, the theoretical risk exists, and your physician will take steps to minimize the risk if possible. This may occur by choosing another test (such as an ultrasound) that doesn’t involve radiation. The vast majority of medical x-rays do not pose a critical risk to a developing child. In fact, x-rays of the head, arms, legs and chest do not usually expose the baby directly to radiation.
Regarding standard x-ray examinations of the abdomen, they are not likely to pose a serious risk to the child. Some abdominal and pelvic studies such as CT, nuclear medicine scans and interventional radiologic studies deliver greater amounts of radiation to a developing pregnancy.

What can I do to minimize risks and ensure x-ray safety?

I’ll offer two simple recommendations that will help reduce your risk. In both of these instances, alternative evaluation and treatment options might be available that can provide the desired level of care.

Work with your physician in obtaining x-rays. The instances when you receive x-rays when your physician suggests they are not necessary are not in your best interest.
Inform the radiologist that you are or might be pregnant.

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Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Straight, No Chaser: What Would You Do If Your Tongue Suddenly Swelled? Learn About Angioedema

June 11, 2018Endocrine/Metabolic, Head/Eyes/Ears/Nose/Throat, Skin/Dermatology844-SMA-TALK, anaphylaxis, angioedema, Behind the Curtain, Conditions and Diseases, epinephrine, epipen, hypersensitivity reaction, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

Here at Straight, No Chaser, we want you to know how to prevent disease and injury because that’s a lot easier than the alternative. However, if and when the time comes, you should also have a few tools in your arsenal to stave off a life-threatening situation. One of the more scary examples of needing help is acute swelling of your tongue, sometimes so much so that your airway appears as if it will be blocked.
The most common cause of acute tongue, lip or throat swelling is called angioedema. This is an allergic reaction and occurs in two varieties.

A life-threatening allergic reaction (anaphylaxis) sometimes occurs shortly after an exposure to substance such as medicine, bee or other insect stings or food. It can throw your entire body into a state of shock, including involvement of multiple parts of the body. This can include massive tongue swelling, wheezing, low blood pressure resulting in blackouts and, of course, the rash typified by hives (urticaria).
Sometimes lip, tongue and/or throat swelling may be the only symptoms. This is more typical of a delayed reaction to certain medications, such as types of blood pressure medications (ACE inhibitors and calcium channel blockers), estrogen and the class of pain medication called NSAIDs (non-steroidal anti-inflammatory drugs, such as ibuprofen)

If the swelling is (or assumed to be) due to any form of medication, symptoms will improve a few days after stopping it. If the swelling in this instance becomes severe enough, treatment may resemble that of the life-threatening variety.
There are few things better than cheating death. If you’re at risk, carry that injectable epinephrine (e.g. an Epi-pen). If you’re affected, take some Benadryl and/or steroids if you’ve been taught what dose to take, and most importantly, don’t wait to see if things improve. Get evaluated, get treated and get better!
I welcome your questions and comments.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Food Allergies

May 19, 2018Diet and Nutrition, Endocrine/Metabolic, Hematology & Oncology/Blood Disorders/Cancer844-SMA-TALK, Allergies, anaphylaxis, Behind the Curtain, food allergies, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

I often say whatever you put in your mouth either helps or harms you. Today, we discuss food allergies, which sounds like a cruel trick or something out of a horror movie, but unfortunately, they’re all too real. Let’s address questions on the topic.

Why do I get allergies anyway?
Food and other types of allergies result from your body mistaking harmless substances for potential threats. The resulting immune response is an attempt to defeat that threat. You are caught in the crossfire, and you exhibit symptoms as a result.
Why do I get allergies to foods I’ve eaten before without a problem?
In many instances, the first time you’re exposed to a certain new food, your body is only primed, and you won’t experience symptoms. A subsequent exposure will prompt the full allergic response.
Is there a way to know if I’m at risk?
Food allergies are more likely in those who have a family history of allergies, asthma or eczema. Take a minute today and ask your parents if they have any allergies to foods or medicines. It’s good to be aware.
How do I know my symptoms are an allergic reaction?
We’ll discuss symptoms shortly, but one big clue is the timing of symptoms. Allergic reactions due to food take place within minutes to a few hours after exposure. It’s not as important for you to know the symptoms as to realize that you’re not well and that evaluation is needed.

So what are the symptoms?
Let’s start with the life-threatening considerations. If you have any shortness of breath, mental status changes (e.g. confusion, severe dizziness) or sensation that your throat is closing, get to an emergency room as soon as possible. Other symptoms may include the following.

Itching or swelling of your mouth or the tissues between your mouth and throat
Hives, wheals, or an eruption of your eczema
Abdominal pain or cramping
Nausea, vomiting or diarrhea
Drop in your blood pressure

Can you get food allergies from touching foods?
Yes. As an example, those with peanut allergies can have an allergic reaction from breathing in peanut residue, touching peanuts or using skin products that contain peanuts.

Which foods are most likely to cause allergies?
Here is a partial list of foods commonly causing food allergies.

Cow’s mik
Eggs
Fish/shellfish
Peanuts/tree nuts
Soy
Wheat

Cow’s milk? Is that the same as lactose intolerance?
No. That’s a different consideration and an upcoming post.
What about treatment?
That’s tomorrow’s post. Obviously knowledge and avoidance are key.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: X-Ray Safety

November 9, 2017General Health and Wellness, Health Prevention844-SMA-TALK, anaphylaxis, Behind the Curtain, contrast media, radiation, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

After the question of “Can I get an x-ray,” the next most common question I get (which should be the first) regarding x-rays is “Do I need this x-ray?” The answer is not just based on the presence or absence of a medical indication but the medical indication relative to the risk. I’ll provide examples of that consideration shortly. The point of this Straight, No Chaser is to get you to more frequently think of the risks of irradiating your body parts. After all, inappropriate doses of radiation have a much greater chance of contributing to cancer than turning you into a superhero.
Let’s start by getting this off the table: x-rays are safe when used appropriately and with care during each case. Radiologists and x-ray technologists are trained to toe the line between inadequate production of x-rays and overexposure such that patients are placed at risk. Additionally, your physicians consider the risk-benefit ratio with each study ordered. This is why instances exist when your physician (especially emergency physicians) may advise against having x-rays done.

What exactly are the risks of x-rays and other medical imaging studies?
It’s about the risks of radiation and the potential contribution to cancer. You accept these risks everyday. Some of you tan, play golf, surf and otherwise expose yourself to the sun. It’s the cumulative exposure that poses risks, and these risks are miniscule. That said, there are circumstances in which the risks become pronounced, such as irradiation during pregnancy, in children or due to dye materials (called contrast media) such as barium or iodine used to enhance development of the film during special x-ray studies.
In some people, the injection of a contrast medium can cause the following side effects:

A feeling of warmth or flushing
A metallic taste in the mouth
Hives
Itching
light-headedness
Nausea
Severely low blood pressure and shock (anaphylaxis, due to an allergic reaction)
Cardiac arrest

How much radiation is involved in these studies?
The radiation exposure from one chest x-ray is roughly equivalent to the amount of radiation exposure you obtain from natural surroundings in 10 days.

Aren’t x-rays dangerous during pregnancy?
One of the rules of emergency medicine is we don’t focus on potential side effects when confronted with a defined life threat. The issue of the effect of x-rays on an unborn fetus is secondary to the need to treat the mother. In other words, the best way to protect the fetus is to protect the mother. Even so, the theoretical risk exists, and your physician will take steps to minimize the risk if possible. This may occur by choosing another test (such as an ultrasound) that doesn’t involve radiation. The vast majority of medical x-rays do not pose a critical risk to a developing child. In fact, x-rays of the head, arms, legs and chest do not usually expose the baby directly to radiation.
Regarding standard x-ray examinations of the abdomen, they are not likely to pose a serious risk to the child. Some abdominal and pelvic studies such as CT, nuclear medicine scans and interventional radiologic studies deliver greater amounts of radiation to a developing pregnancy.

What can I do to minimize risks?
I’ll offer two simple recommendations that will help reduce your risk. In both of these instances, alternative evaluation and treatment options might be available that can provide the desired level of care.

Work with your physician in obtaining x-rays. The instances when you receive x-rays when your physician suggests they are not necessary are not in your best interest.
Inform the radiologist that you are or might be pregnant.

Feel free to ask your SMA expert consultant any questions you may have on this topic.Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Food Allergies

May 12, 2017Diet and Nutrition, Endocrine/Metabolic, Hematology & Oncology/Blood Disorders/Cancer844-SMA-TALK, Allergies, anaphylaxis, Behind the Curtain, food allergies, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, There are 72 Hours in a DayJeffrey Sterling, MD

I often say whatever you put in your mouth either helps or harms you. Today, we discuss food allergies, which sound like a cruel trick or something out of a horror movie, but unfortunately, they’re all too real. Let’s address questions on the topic.

Itching or swelling of your mouth or the tissues between your mouth and throat
Hives, wheals, or an eruption of your eczema
Abdominal pain or cramping
Nausea, vomiting or diarrhea
Drop in your blood pressure

Which foods are most likely to cause allergies?
Here is a partial list of foods commonly causing food allergies.

Cow’s mik
Eggs
Fish/shellfish
Peanuts/tree nuts
Soy
Wheat

Cow’s milk? Is that the same as lactose intolerance?
No. That’s a different consideration and an upcoming post.
What about treatment?
That’s tomorrow’s post. Obviously knowledge and avoidance are key.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Food Allergies

May 12, 2016Diet and Nutrition, Endocrine/Metabolic, Environmental, Hematology & Oncology/Blood Disorders/Cancer844-SMA-TALK, Allergies, anaphylaxis, Behind the Curtain, food allergies, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Itching or swelling of your mouth or the tissues between your mouth and throat
Hives, wheals, or an eruption of your eczema
Abdominal pain or cramping
Nausea, vomiting or diarrhea
Drop in your blood pressure

Which foods are most likely to cause allergies?
Here is a partial list of foods commonly causing food allergies.

Cow’s mik
Eggs
Fish/shellfish
Peanuts/tree nuts
Soy
Wheat

Cow’s milk? Is that the same as lactose intolerance?
No. That’s a different consideration and an upcoming post.
What about treatment?
That’s tomorrow’s post. Obviously knowledge and avoidance are key.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Food Allergies

December 7, 2015Diet and Nutrition, Endocrine/Metabolic, Environmental, Hematology & Oncology/Blood Disorders/Cancer844-SMA-TALK, Allergies, anaphylaxis, Behind the Curtain, food allergies, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This week’s Straight, No Chaser posts will focus on your food. Today, we begin with food allergies, which sound like a cruel trick or something out of a horror movie, but unfortunately, they’re all too real. We’ve discussed seasonal allergies and allergic reactions before, but food allergies warrant addressing additional questions you’ve had.

Itching or swelling of your mouth or the tissues between your mouth and throat
Hives, wheals, or an eruption of your eczema
Abdominal pain or cramping
Nausea, vomiting or diarrhea
Drop in your blood pressure

Which foods are most likely to cause allergies?
Here is a partial list of foods commonly causing food allergies.

Cow’s mik
Eggs
Fish/shellfish
Peanuts/tree nuts
Soy
Wheat

Cow’s milk? Is that the same as lactose intolerance?
No. That’s a different consideration and an upcoming post.
What about treatment?
That’s tomorrow’s post. Obviously knowledge and avoidance are key.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: X-Ray Safety

November 25, 2015General Health and Wellness, Health Prevention844-SMA-TALK, anaphylaxis, Behind the Curtain, contrast media, radiation, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

A feeling of warmth or flushing
A metallic taste in the mouth
Hives
Itching
Lightheadedness
Nausea
Severely low blood pressure and shock (anaphylaxis, due to an allergic reaction)
Cardiac arrest

Work with your physician in obtaining x-rays. The instances when you receive x-rays when your physician suggests they are not necessary are not in your best interest.
Inform the radiologist that you are or might be pregnant.

Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: X-Ray Safety

July 5, 2014General Health and Wellness844-SMA-TALK, anaphylaxis, contrast media, radiation, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

A feeling of warmth or flushing
A metallic taste in the mouth
Hives
Itching
Lightheadedness
Nausea
Severely low blood pressure and shock (anaphylaxis, due to an allergic reaction)
Cardiac arrest

Work with your physician in obtaining x-rays. The instances when you receive x-rays when your physician suggests they are not necessary are not in your best interest.
Inform the radiologist that you are or might be pregnant.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Food Allergies

June 26, 2014Environmental, Hematology & Oncology/Blood Disorders/Cancer844-SMA-TALK, Allergies, anaphylaxis, food allergies, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Food allergies sound like a cruel trick or something out of a horror movie, but unfortunately, they’re all too real. We’ve discussed seasonal allergies and allergic reactions before, but food allergies warrant addressing additional questions you’ve had.

Itching or swelling of your mouth or the tissues between your mouth and throat
Hives, wheals, or an eruption of your eczema
Abdominal pain or cramping
Nausea, vomiting or diarrhea
Drop in your blood pressure

Which foods are most likely to cause allergies?
Here is a partial list of foods commonly causing food allergies.

Cow’s mik
Eggs
Fish/shellfish
Peanuts/tree nuts
Soy
Wheat

Cow’s milk? Is that the same as lactose intolerance?
No. That’s a different consideration.
What about treatment?
That’s a different post. Obviously knowledge and avoidance are key.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: What Would You Do If Your Tongue Suddenly Swelled? Learn About Angioedema

June 3, 2014Endocrine/Metabolic, Head/Eyes/Ears/Nose/Throat, Skin/Dermatology844-SMA-TALK, anaphylaxis, angioedema, Conditions and Diseases, epinephrine, epipen, hypersensitivity reaction, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, urticariaJeffrey Sterling, MD

A life-threatening allergic reaction (anaphylaxis) sometimes occurs shortly after an exposure to substance such as medicine, bee or other insect stings or food. It can throw your entire body into a state of shock, including involvement of multiple parts of the body. This can include massive tongue swelling, wheezing, low blood pressure resulting in blackouts and, of course, the rash typified by hives (urticaria).
Sometimes lip, tongue and/or throat swelling may be the only symptoms. This is more typical of a delayed reaction to certain medications, such as types of blood pressure medications (ACE inhibitors and calcium channel blockers), estrogen and the class of pain medication called NSAIDs (non-steroidal anti-inflammatory drugs, such as ibuprofen)

Straight, No Chaser: Allergies – Friend or Foe?

April 23, 2014General Health and Wellness844-SMA-TALK, Allergies, anaphylaxis, Benadryl, diphenhydramine, Sterling Medical Advice, SterlingMedicalAdvice.com, steroids, Straight No ChaserJeffrey Sterling, MD

Bee stings. Medication reactions. Food allergies. Latex. Animals. Dust. Cosmetics. What do these things have in common? You get allergic to them, and in differing degrees they make you come to the emergency room or your physician’s office huffing and puffing and puffy and sometimes thinking about not breathing anymore.

The basis of allergies is that your body is trying to defend you from infections. Sometimes our defense mechanisms are “indiscriminate,” and the body overreacts to what normally might be harmless substances by producing a system wide reaction, producing antibodies to certain triggers (allergens). This overreaction amounts to our bodies fighting a war that doesn’t need to be fought. That manifests itself clinically by some subset of itchy rashes (called wheals, urticaria or angioedema), shortness of breath, nausea, vomiting and other body-wide systems. Again, it’s important to note that this can be both a systemic overreaction or just a local reaction.
One question I commonly get asked is “Why am I allergic to this now?” In other words, sometimes allergies occur after the initial exposure to seafood or peanuts, or maybe you had been stung by a bee in the past without incident. That occurs because the first allergic exposure doesn’t always cause a visible reaction. However, it will sensitize the body such that you’re mobilized for subsequent exposures and will be prepared to “unload both barrels” if it’s needed. Unfortunately, this reaction can be life-threatening. This life-threatening response is called anaphylaxis, and you’ll know it because more than one organ system of your body will be affected. For example, you may have pounding or racing heartbeats, breathing difficulties, intestinal upset, itchy skin rashes and/or dizziness as your body goes into shock.

Although allergic reactions are more likely to occur in those with conditions like asthma, eczema, allergic rhinitis, seasonal allergies, and sleep apnea, to be clear, the acute allergic reaction is a different animal than seasonal allergies. If you have any sensation that you’re short of breath, your throat feels like it’s closing, you have any dizziness or altered mental status, palpitations, or if the rash is diffuse and spreading, please get to your closest emergency room. I wouldn’t be upset if you took the recommended dose of Benadryl (generic name: diphenhydramine) along the way.
Final tip: Those of you who’ve suffered any type of allergic reaction to medication, food, animals, etc., should ask your physician about the utility of carrying an epipen, benadryl or steroids to be taken in the event of an emergency. If your risk profile warrants it, any or all of these could prove life saving. However, these medicines aren’t without risk, so you shouldn’t take any of them unless recommended by your physician.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Straight, No Chaser: What Would You Do If Your Tongue Suddenly Swelled? Learn About Angioedema

October 7, 2013Head/Eyes/Ears/Nose/Throat, Health Preventionanaphylactic reaction, anaphylaxis, angioedema, Conditions and Diseases, Disease, health, Limited liability company, Pharmaceutical drug, Straight No Chaser (composition), United States, urticaria, WordPressJeffrey Sterling, MD

Here at Straight, No Chaser, we want you to know how to prevent disease and injury because that’s a lot easier than the alternative. However, if and when the time comes, you should also have a few tools in your arsenal to stave off a life-threatening situation. One of the more scary examples of needing help is acute swelling of your tongue, sometimes so much so that your airway appears as if it will be blocked.
The most common cause of acute tongue, lip or throat swelling is called angioedema. This is an allergic reaction and occurs in two varieties.

A life-threatening allergic reaction (anaphylaxis) sometimes occurs shortly after an exposure to substance such as medicine, bee or other insect stings or food. It can throw your entire body into a state of shock, including involvement of multiple parts of the body. This can include massive tongue swelling, wheezing, low blood pressure resulting in blackouts and, of course, the rash typified by hives (urticaria).
Sometimes lip, tongue and/or throat swelling may be the only symptoms. This is more typical of a delayed reaction to certain medications, such as types of blood pressure medications (ACE inhibitors and calcium channel blockers), estrogen and the class of pain medication called NSAIDs (non-steroidal anti-inflammatory drugs, such as ibuprofen)

With any luck, you would already know you’re at risk for this condition, and your physician may have prompted you to wear a medical alert bracelet or necklace. In these cases, your physician may have also given you medicines and instruction on how to take them in the event you feel as if your tongue is swelling and/or your throat is closing. These medicines would include epinephrine for injection, steroids and antihistamines such as Benadryl. As you dial 911 (my recommendation) or make your way to the nearest hospital, taking any or all of these medications could be life-saving. By the way, those are the among the same medicines you’ll be treated with upon arrival to the emergency room. In severe cases, you may need to be intubated (i.e. have a breathing tube placed) to maintain some opening of the airway.
If the swelling is (or assumed to be) due to any form of medication, symptoms will improve a few days after stopping it. If the swelling in this instance becomes severe enough, treatment may resemble that of the life-threatening variety.
There are few things better than cheating death. If you’re at risk, carry that injectable epinephrine (e.g. an Epi-pen). If you’re affected, take some Benadryl and/or steroids if you’ve been taught what dose to take, and most importantly, don’t wait to see if things improve. Get evaluated, get treated and get better!
I welcome your questions and comments.
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Straight, No Chaser: When Allergies Strike

August 14, 2013Medical Treatment, Skin/Dermatology, Health PreventionAllergen, Allergies, Allergy, anaphylaxis, angioedema, Benadryl, Conditions and Diseases, health, House dust mite, Latex, United States, urticariaJeffrey Sterling, MD

Bee stings. Medication reactions. Food allergies. Latex. Animals. Dust. Cosmetics. What do these things have in common? You get allergic to them, and in differing degrees, they make you come to me huffing and puffing and puffy and thinking about not breathing anymore.
The basis of allergies is that your body is trying to defend you from infections. Sometimes our defense mechanisms are ‘inaccurate’, and the body overreacts to what normally might be harmless substances by producing a system wide reaction (antibodies) to certain triggers (allergens). This overreaction leads to our bodies fighting a war that isn’t meant to be fought. That manifests itself clinically by some subset of itchy rashes (wheals, urticaria or angioedema), shortness of breath, nausea, vomiting and other systemic systems. Again, it’s important to note that this can be both a systemic overreaction or just a local reaction.
One question I commonly get asked is “Why I am allergic to this now?” In other words, sometimes allergies occur after the initial exposure to seafood or peanuts, or maybe you had been stung by a bee in the past. That occurs because the first allergic exposure doesn’t always cause a visible reaction. However, it will sensitize the body such that you’re mobilized for subsequent exposures and will be prepared to ‘unload both barrels’ if it’s needed. Unfortunately, this reaction can be itself life-threatening. This life-threatening response is called anaphylaxis, and you’ll know it because more than one organ system of your body (heart palpations, breathing difficulties, gastric upset, itchy skin rashes, dizziness as your body goes into shock, etc.).
Although allergic reactions are more likely to occur in those with conditions like asthma, eczema, allergic rhinitis, seasonal allergies, and sleep apnea, to be clear, the acute allergic reaction is a different animal than seasonal allergies. If you have any sensation that you’re short of breath, your throat feels like it’s closing, you have any dizziness or altered mental status, palpitations, or if the rash is diffuse and spreading, please get to your closest emergency room. I wouldn’t be upset if you took the recommended dose of Benadryl along the way.
Final tip: Those of you who’ve suffered any type of allergic reaction to medication, food, animals, etc. should ask your physician about the utility of carrying an epipen, benadryl or steroids in the event of an emergency. If your risk profile warrants it, any or all of these could prove life saving. However, these medicines aren’t without risk, so you shouldn’t take any of them unless recommended by your physician.