ASTHMA: ALLERGY – THE GREAT MASQUERADERAs we have seen, most, if not all, asthmatics are also allergic; indeed, their asthma is an allergic reaction. But allergies can also cause lots of other reactions. Unless you happen to be sneezing all the time, your friends will give you funny looks if you say you are allergic. And even if you do show the common signs and symptoms of allergies, you may not get much sympathy. That’s because, to those lucky people who haven’t got any, allergies are very simple. If it’s not quite seen as a moral weakness — the way we used to see alcoholism — then there’s a strong suspicion that the allergic person is just, well, a bit peculiar and might be a great deal less sick if people, especially mothers, didn’t make such a fuss. Then there’d be much less of this sneezing and wheezing and breaking out in rashes every time the victim drinks milk or walks past a privet bush.This popular idea of allergy and the substances which cause it is wrong. Times have changed, and while it’s true that wheezing, sneezing and rashes are still the commonest symptoms, and that parental attitudes can be a factor, it’s now known that many other symptoms can arise from many more triggers than eggs, privet, milk or cats. What’s worse, most of these symptoms are things that even medically trained people will, nine times out of ten, attribute to something else.We have seen that, apart from causing asthma, an allergy can make you tense, give you a tired, washed-out feeling, make you constipated, give you diarrhoea, keep you awake at night, cause depression, give you burning, ulcer-like pains in the stomach, headaches, feelings of confusion and forgetfulness, high blood pressure, diabetes (after the age of thirty-five), pains in the joints and muscles, and even make you fat.It’s not surprising, then, that so many patients who turn up at the doctor’s complaining of any of these things simply don’t get well. They are referred to psychiatrists, given tranquillisers or anti-depressants and pull-yourself-together talks, advised to take a holiday or to change their jobs, or are relieved of tonsils, appendixes, uteruses or gallbladders.Hardly any attention is ever paid to what the patient is eating; and unless one is clearly working in an environment now known to be hazardous, such as an asbestos plant, not much attention is paid to environment either. And even less environmental scrutiny is given to women than to men, especially to housewives, who are assumed to be perfectly safe at home within their own four walls. As we have seen, the kitchen, and the house and garden generally, may be the most dangerous places of all.I remember the case of a girl of seven who was found one morning lying in a pool of blood, from a severe nosebleed, in her bed. Doctors looked frantically for the cause and eventually discovered that it was an allergy to the pillow on which she had been sleeping. When a pillow with a different filling was used, the girl’s nosebleeds stopped.A man suffered for ten years from small itching blisters on the palms of his hands and the soles of his feet. When he eventually saw an allergist who diagnosed his allergy to mould, the man insisted there was no mould in his house until, during rebuilding some months later, the wooden foundations were found to be impregnated with mould.You can discover mould for yourself when you move into a house and decide to make some small improvements, such as knocking out a panel to create a cupboard under the stairs. You may notice very extraordinary smells, which could be mould, or one of the pesticides or chemicals often used by renovators of old houses. Stripping back old exterior paintwork from the days before lead-free paint is a special hazard.Many years ago I treated a child for the behavioural disorder formerly known as ‘hyperactivity’. After getting no improvement with diet, I discovered an allergy to the father’s aftershave lotion. How often would a simple thing like this be considered worthy of attention when there are so many exciting psychological avenues to explore — including the fashionable idea that children need more intimate contact with their fathers? In this particular case, it would have been disastrous.One of the secretaries in a medical centre where I sometimes work as a consultant is an asthmatic. I cannot wear even the smallest amount of after-shave lotion when I work there. The moment I entered the office she used to give me a piercing look, ‘And just what are we wearing today, Dr Vayda?’ she would ask in a bellow that could be heard in every waiting room of every office in the building. After a few times of this treatment I gave up putting anything on my face after shaving.Another patient, a young married woman, had emotional disturbances and severe physical symptoms that just didn’t add up to any recognisable pattern on which a label could be hung. Again nutritional changes brought no improvement, but we did discover that whenever she went away for a camping holiday, the troubles all cleared up. Eventually, the cause was found. The couple had moved into a freshly painted house and the woman was so sensitive to paint that even six months later she was still reacting.Allergenic substances lurk everywhere in the home: gas stoves, heaters, aerosol sprays, paint, lacquer, room freshener, hair spray, oven cleaner, floor polishes, waxes, bleaches, cosmetics. Any one of these can cause an adverse reaction in susceptible people. And once outside your front door, the list is endless. This means that an allergic child is at risk almost from the moment it’s born, but because allergy is the great masquerader, children as well as adults can be misdiagnosed if their symptoms are not the good old familiar ones like rashes or sneezing.*19\145\2*
The prevention of bee stings can be achieved by teaching the child to:
a. Avoid food that is discarded in outside garbage cans.
b. Avoid gardens (because flowers attract bees and vines conceal their nests).
c. Avoid clothes with bright, flowery prints, for they, too, attract bees.
d. Wear shoes when outdoors.
e. Take vitamin Bl during the summer (it gives an odor to the body which bees avoid).
Children who are known to be allergic to bees should be desensitized with a mixture of bee, wasp, hornet, and yellow jacket antigens
Other insects such as the ant, mosquito, bedbug, flea, spider, tick, mite, and scorpion may cause allergic reactions. They can be avoided with house screens, or discouraged with repellents. The U.S. Department of Agriculture, Bureau of Entomology, Washington, D.C., is ready to give advice on the eradication of any one of these insects.
The eradication of bee hives from an area has to be done by a professional exterminator who should inspect the premises at weekly intervals during the spring and summer to detect budding hives. Wasps build hives in almost any protected place, and their nests can be destroyed by hosing them or knocking them down with a stick or broom handle. Spraying tie area with an insecticide discourages them from rebuilding in the same place. Yellow jackets build hives in the ground and emerge through a small hole which should be marked, it dust (after all the insects have returned for tie night), gasoline, which need not be lighted, should be poured down the hole. Hornets build nests in the branches of tall shrubs or trees.
Allergic children going to camp should carry an emergency kit containing 10 mg. Isuprel tablets, an adrenalin aerosol (for inhalation), a tourniquet, a pair of tweezers (for the removal of the stinger and venom sac), and an antiseptic towel.
The child should be taught to immediately remove the bee stinger and its sac with the tweezers (particularly in a sting by a honey bee, instant removal of the stinger and sac may help prevent the poison from being absorbed into the blood); to suck one tablet of Isuprel under the tongue; to use the adrenalin inhaler if there is difficulty in breathing; to apply a tourniquet on the arm above the sting site; to clean the sting site with an antiseptic towel; to apply a cold pack to the sting area; to take an antihistamine by mouth; and to contact the nearest doctor or hospital as soon as possible.
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One important dietary component, that can have a powerful effect on both mind and body, is caffeine. This drug is found in coffee and tea, and, in lesser amounts, in chocolate, Coca-cola, Pepsi-cola and other cola drinks. Some experts advise a maximum dose of 350-500 mg per day, but according to others, a dose of 250 mg a day is potentially toxic. Two to six cups of coffee (depending on its strength), three to seven cups of tea, or seven cans of cola supply this amount. Children are more susceptible to caffeine than adults and should probably not drink more than one or two colas a day. Some individuals are far more sensitive than others and should not consume caffeine at all.
Taking excess caffeine can produce anxiety, mood swings, tremors, insomnia, abnormal heart rhythms (palpitations), sweating and weight loss. Hyperventilation sometimes accompanies these symptoms, producing breathlessness, chest pains, tingling in the toes and fingers, dizziness and fainting. Some patients who drink too much caffeine show none of these symptoms, but vomit violently instead – this is particularly common with tea drinkers. Abdominal pain and diarrhoea can also be produced by too much caffeine, and in children it can produce hyperactive behaviour.
Those who drink large amounts of coffee during work hours may suffer from caffeine withdrawal at weekends, or if they miss their morning cup of coffee. They may be irritable, lethargic, depressed, drowsy or nervous. Nausea, sneezing and a runny or congested nose are other possible symptoms, and a headache may follow. Some cases of ‘weekend migraine’ may be due to caffeine withdrawal.
Another symptom that has been attributed to excess caffeine is the restless legs syndrome. Extreme discomfort in the legs, and sometimes the arms, leads sufferers to constantly move their legs around in bed, resulting in insomnia for themselves and anyone unfortunate enough to have to share a bed with them. Although not all doctors would agree that restless legs are attributable to caffeine, anyone suffering this condition should try avoiding caffeine for a while to see if it makes any difference. The amount of caffeine should be reduced gradually, over a period of two to three weeks, to minimize withdrawal reactions. Remember that some painkillers contain caffeine (eg Ana-din) and cut these out as well.
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