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Dr.-Inderpal-Randhawa-with-FM-Bank-President-Henry-Walker

Dr. Randhawa (R) with F&M Bank President Henry Walker (L)

Long Beach, California. (November 2, 2017).    At the 7th Annual “People You Can Bank On” Luncheon held today in Long Beach, California, Farmers & Merchants Bank (F&M) presented Dr. Inderpal Randhawa with the 2017 “Dedication” Award.  The Awards are hosted by the bank each year to honor the virtues and characteristics that F&M values in it customers – Honesty, Faith, Loyalty, Integrity, Dedication, Gratitude, Humility, Dependability, Compassion, and Service Above Self.

Dr. Randhawa is a board-certified physician in allergy, immunology, pulmonology, pediatrics and internal medicine.  Early in his career he began to question conventional protocols for the treatment of life-threatening food allergies.   By studying a vast number of genetic and environmental factors, he developed a comprehensive, multi-system approach resulting in individualized, data-driven treatment regimens for allergic patients.   Utilizing this model, over the past 10 years he has successfully treated more than 2,000 patients at a near-perfect success rate, offering food-allergic children the freedom to safely eat foods to which they were once deathly allergic.  This unprecedented model of success led him to found TPIRC, an unconventional clinic and research center where precision medicine and data-analytics drive the treatment of not only food allergy, but also a series of rare and orphan diseases.

When introducing Randhawa, F&M Bank President, Henry Walker, commented, “Many years ago, Dr. Randhawa had the courage to question the status quo.   It is his dedication and ability to think critically to find elusive answers which enables thousands of children across the country with so-called ‘orphan diseases’ . . . to access cutting edge treatment and a better quality of life.”

“I tried to analyze what I was doing that was so different,” Randhawa shared, “. . . it was all data-driven . . . gathering hundreds and hundreds of biomarkers and data points per patient and utilizing that information to drive treatment in a comprehensive, multi-system approach.  It actually was nothing short of remarkable.  Once it was done correctly it saw success after success. . . this is becoming something that I think Long Beach can be very proud of.”

Dr. Randhawa went on to exhort the audience, stating, “Change comes from the people . . . when you look at our communities and society and you question things, remember that change is possible.”

About Dr. Inderpal Randhawa

Dr. Randhawa is a board-certified physician in adult medicine and pediatrics. In addition, he has board certifications in clinical immunology, allergy and pulmonary medicine. He currently serves as the director of the Food Allergy & Intolerance Center at Long Beach Memorial Hospital, the chief physician at Southern California Allergy, Asthma & Pulmonary Specialists, and Associate Director of the Division of Pediatric Pulmonology at Miller Children’s Hospital.  He also acts as the program director and research coordinator in two fellowship programs at the David Geffen UCLA School of Medicine and UCI-Miller Children’s Hospital. In addition to Associate Professor appointments at these two institutions, Dr. Randhawa practices clinical medicine in pulmonary diseases, immune deficiencies, allergy, and transplant medicine. Dr. Randhawa received his medical degree from the Feinberg Northwestern University School of Medicine.  After completing a combined Internal Medicine/Pediatrics residency, he completed training in Clinical Immunology & Allergy at UCLA. He finished his studies in pediatric and adult pulmonology at UC Irvine – Miller Children’s Hospital.  Dr. Randhawa has authored over 100 peer reviewed abstracts and research publications.  He serves on several scientific and clinical advisory boards for national health and disease organizations.  His clinical and research focus on rare and orphan diseases spearheaded the development of TPIRC.

About TPIRC

TPIRC is a non-profit clinical care and research center that focuses on the development of cutting-edge, individualized treatment protocols for rare and orphan diseases utilizing comprehensive diagnostic tools and patient-driven research.  The mission is two-fold – to advance treatment discovery at a pace which helps patients today, while building a scalable model of success to accelerate the rate of research discovery for all diseases.  For more information about TPIRC, please visit the website at www.tpirc.org.

About Farmers & Merchants Bank

Founded in Long Beach in 1907 by C.J. Walker, Farmers & Merchants Bank has 24 branches across Orange County, Long Beach and the South Bay. The Bank specializes in commercial and small business banking, business loan programs, home loans, and a robust offering of consumer retail banking products, including checking, savings and youth accounts. Farmers & Merchants Bank is a California state chartered bank with deposits insured by the Federal Deposit Insurance Corporation (Member FDIC) and an Equal Housing Lender. For more information about F&M, please visit the website at www.fmb.com.

 
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oit_predictors

After treating nearly 700 food allergy OIT patients, a common theme during initial office visits surrounds not just safety but the “risk of reactions” during OIT. Many parents state their child has not had anaphylaxis for years. Others will say reactions occur regularly. Some parents say their children’s allergy testing done at an outside allergist’s office labels them as “high risk” for reactions. This leaves a lot of uncertainty in the discussion.

My discussion with patients and families focuses on the TPIRC model of OIT. The comprehensive nature of analysis not only involves elaborate allergy testing. It also involves a clear evaluation of all allergic systems of the body.   These systems involve the skin, the blood vessels, the lungs, the heart, the liver, and more. It is most important to evaluate all these systems due to the involvement of these systems during different types of allergic reactions. But while all systems are critical, the lungs are one of the most important.

As a board certified pulmonologist, my bias toward excellent lung function prior to starting OIT is based on evidence. A large Australian study published in 2014 brought to light the risk factors of reactions during allergic food exposure. The study, entitled: Safety and clinical predictors of reacting to extensively heated cow’s milk challenge in cow’s milk-allergic children., sought to define the clinical “risk factors” of children allergic to milk who were about to undergo a baked milk challenge. 71 children with confirmed milk protein allergy were set to undergo a baked milk food challenge. Keep in mind the baked milk challenge is not done all at once. It is done in a graded, staged fashion over hours of time with small incremental dose increases. Of the 71 children tested, most passed (51 total, 73%). Of the 27% who did not pass, 4 children actually needed an epinephrine injection to rescue them.

This Australian group studied these 27% who did not pass by comparing them to those who passed and discovered the top “risk factors” associated with having an allergic reaction during food dosing:

  • Any history of asthma, especially asthma requiring preventer therapy (inhaled steroids, singulair)
  • IgE-mediated clinical reactions to more than 3 food groups (separate groups ie nuts, milk, peanut)
  • A history of cow’s milk reactions consistent with severe anaphylaxis

What is the take away message?

If you are considering OIT and your child has the “risk factors” mentioned above, do everything possible to control the lungs before and during treatment. The TPIRC model not only deploys state of the art lung function testing including complete body plethysmography, forced oscillation testing, exhaled nitric oxide and lung clearance index testing. The TPIRC model of OIT ensures patients undergoing OIT are maintained at a normal to super normal level of lung function.

The questions brought forth by this study need to be studied clearly in OIT patients. TPIRC and its OIT model is actively studying these clinical questions and looks forward to publishing its data in 2016.

 

Inderpal Randhawa, MD

 

Reference:

Ann Allergy Asthma Immunol. 2014 Oct;113(4):425-9. doi: 10.1016/j.anai.2014.06.023. Epub 2014 Jul 22.

 
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The Patch vs. TPIRC OIT Model: The Difference is Clear

Patch vs TPIRC OIT (2)
Phase IIB VIPES (Viaskin Peanut’s Efficacy and Safety) trial was conducted in 221 peanut allergy patients (6-55 years with 113 children, 73 adolescents and 35 adults).  The goal of the trial was to see if after 12 months of a “patch” placed on the skin daily, the patient would be able to eat more than 1000 mg of peanut protein or 10 times their baseline dose which made them have anaphylaxis.  The patch started at 50 micrograms then increased to 100 micrograms and finally 250 micrograms.  50% of the patients utilizing the highest dose patch reached the “goal” compared to 25% in the placebo group.  6% of patients dropped out.  No major adverse events were reported.  No epinephrine was used during patch treatment.

To the credit of the company, the study was conducted safely.  However, taking a closer look at the numbers, the graph above shows out of 221 patients in treatment, only half actually reached any benefit.  Of the half who reached a benefit, only a total of 28 patients were able to actually tolerate over 1000 mg of peanut protein.  The Phase III study is planned.

The arguments for the patch:

  • It is on the skin and poses little risk
  • It can be used at a young age
  • It has some effect on the immune system’s “view” of peanut protein

The arguments against the patch:

  • One year of treatment is lengthy
  • Only half the patients receive any kind of “safety” benefit.
  • Even the half who receive the safety benefit, many of them cannot eat over 1000 mg of peanut protein (or 4-5 peanuts)
  • What happens when they stop using the patch? Will just eating a certain “amount” of  peanut continue to help with protection?
  • Is there any long term immune system benefit toward tolerance?

While it looks promising, the details provide the real specifics.  Oral immunotherapy (OIT) utilizes much higher doses of peanut protein.  In fact, unique from any other model of OIT, the TPIRC model is able to treat peanut allergy patients and eventually achieve a very high dose of protein (15,000 to 30,000 mg dose) by mouth safely.  Instead of receiving treatment for one year, patients here receive treatment over 6-12 weeks.  The TPIRC model of food allergy OIT allows the ultimate dose to be safely eaten intermittently typically once every week to monthly.  By achieving these doses, the immune system food allergy profile of each patient shows dramatic shifts toward long term desensitization, clear safety, and free eating of peanuts.

 

The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. We expressly disclaim responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.

 
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Exercise Induced Anaphylaxis:  What To Know?

by Dr. Inderpal Randhawa, M.D.

Screenshot_2015-10-02-13-19-01 (2)Anaphylaxis from all causes impacts over 3 million Americans annually.  The most common cause of anaphylaxis involves the most common food triggers- milk, egg, wheat, soy, tree nuts, peanut, fish and shellfish.  Other triggers include medications, contrast dye, non-steroid anti-inflammatory drugs (NSAIDs), and other causes.  A very rare but interesting form of anaphylaxis is termed exercise induced anaphylaxis.

Exercise induced anaphylaxis has been described for decades.  It involves a patient eating foods like wheat or celery and typically one hour after ingestion with moderate exercise resulting in anaphylaxis symptoms.  The symptoms can be as mild as fatigue, red skin, lightheadedness, and throat tightening.  Symptoms can progress to life threatening anaphylaxis.  The causal relationship of the reaction is unclear.  The reaction is likely related to histamine release from mast cells and basophils primed by the food allergen exposure.

When should a parent be concerned about exercise induced anaphylaxis?  If a child, especially a teenager, notices a reduction in exercise tolerance after a new food exposure, it is worth a discussion with your primary care doctor.  It may be appropriate to perform food allergy testing and an exercise cardiopulmonary challenge to make the diagnosis.

An important note for OIT patients:  the reason most clinicians recommend a rest period after food dosing is due to the risk of a similar reaction described above.

 

 

 

The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. We expressly disclaim responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.

 
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Our OIT Superhero

by Pujal Patel

Aanya Photo 2Aanya was born with a milk allergy. Barely a day old in the NICU, a nurse fed her cow based formula and she started projectile vomiting.  She was JUST A NEWBORN! It took us a few days to figure out that the issue was milk, not overeating! We came home with a newborn and advice to breast feed only, no milk based formula.

At 9 months old, our pediatrician asked us to ‘try’ some yogurt.  One lick resulted in full body hives, severe GI upset and fussiness for days. After being referred to an allergist, she tested positive for milk and nut allergies (we were already avoiding nuts due to her older sister who had multiple nut anaphylaxis).  We were sent home with epi pens and advice to avoid her allergens (which were everywhere!!!).

Aanya was two years old when, at the touch of chickpea chutney, she went into anaphylaxis. She had major GI distress, hives all over her tiny body, facial swelling and was struggling to breathe. I will never forget her frantically clawing at her chest with her tiny little hands. An EpiPen saved her life!

That night I knew we couldn’t keep our kids alive just by avoiding their allergens; danger lurked around every corner no matter how hard we tried. That was the darkest night but fortunately a light came on in the form of Dr. Inderpal Randhawa. I was full of hope for the first time when I walked out of our consultation appointment. After running comprehensive tests, Dr. Randhawa put Aanya on SLIT (Sublingual Immunotherapy) which greatly helped as she also had a history of asthma attacks every 3-4 weeks. Her asthma usually ended up in nebulization, steroids and lots of urgent care and doctor visits.

We then embarked on our OIT journey with milk, followed by almonds, pine nuts, pistachio, cashew, macadamia, and pecans. We will soon be working on the remaining tree nuts, peanuts and chickpeas!!

We cannot thank Dr. Randhawa enough! We were barely surviving and now we have this new life, full of freedom, just like childhood should be!! He is our SUPERHERO!!!

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It’s National Peanut Day:  Time to Understand the Anatomy of Peanuts

Why is it important in general to understand the inner “workings” of various nuts?

All nuts are composed of many components or subparts.  The most common parts are fats, carbohydrates, vitamins, minerals, water and protein.  When it comes to peanut food allergy, the protein is the most important part.

Why is knowing the subparts very important in OIT?

It is very important to know the subparts of peanuts in OIT to better understand dosing.  When a patient is able to eat one peanut, what does that really mean?  It means how much actual “food allergy molecule protein” is that child now eating.  This is particularly important when understanding the concept of safety.

For example, if a patient can tolerate 8 peanuts daily after being treated with OIT, can the patient safely eat more than 8 peanuts at any time?  The answer lies in that patient’s immune system response to OIT.  If the patient has demonstrated improved clinical markers of sensitization and clinical evidence of tolerating high doses of peanut, the question of safety is answered more scientifically.

What are the different types of peanuts?

Peanut Comparison

There are several types of “typical” peanuts in the United States.  Please keep in mind species of peanuts in China, India and Africa have different protein structures and weights than US based peanut products.  The most common US peanut is the runner peanut.  It is available at any grocery store.  Since each type has different weights, it is important to discuss the properties of these peanuts with your allergist when deciding how much of which peanut to consume during maintenance.

How much protein is in one peanut?

On average, 10 grams of peanuts are used to pass a food challenge in any standard allergy practice office.  This is deemed a “pass” for non-allergic patients.  10 grams of runner peanuts equals 18-20 peanuts daily.  However, this is the total weight of the peanuts.  How much actual protein is in the 18-20 peanuts?  It depends on whether the peanuts are heavily roasted or not roasted at all.  If it is unroasted, the protein count ranges from 5-6 grams.  If it is heavily roasted, it can range from 4-6 grams.

Of greater interest is what amount of protein actually contains the high anaphylaxis risk epitope sequences of Ara h1, Ara h2 and Ara h3.  Early experiments to purify this protein resulted in some approximations of the dosing.  However, an exact amount of how much of these epitopes is unclear.  The likely percentage ranges from 5-15% of the total protein is comprised of the high risk sequences.

Why do the number of maintenance peanuts matter?

Based on the last question’s response, everyone’s immune system responds to peanut protein differently.  Some may respond very quickly to OIT and their maintenance dose can be 20 grams every month in order to successfully maintain a “sensitized” immune system.  However, others may need to eat 10 grams every day to maintain the same sensitization.

Again, the anatomy of the peanut is important.  It contains complex subparts of which the protein is most important.  Specific epitopes of the protein are of even greater importance for food allergy dosing and safety.  One goal of research at The Translational Pulmonary & Immunology Research Center (TPIRC) is to better study and define the anatomy of peanut protein responsiveness in order to fine tune each patient’s maintenance dose to ensure maximal safety and simultaneously ensure maximal long term benefit.

Inderpal Randhawa, MD

Chief Medical Officer, TPIRC

 

References:

U.S. Department of Agriculture, Agricultural Research Service. 2013. USDA National Nutrient Database for Standard Reference, Release 25.

10.4049/​jimmunol.169.2.882.  The Journal of Immunology July 15, 2002.  vol. 169  no. 2  882-887

 

The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.

We expressly disclaim responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.

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Back to School on Oral Immunotherapy:  Prevention is Key!

by Dr. Inderpal Randhawa, M.D.

Food Allergy FullSizeRender

After treating nearly 600 patients with oral immunotherapy for nearly a decade, I am often asked what worries me the most.  From a parent’s standpoint, I would imagine the anticipated response will be a severe anaphylactic reaction during a visit updose/challenge or a severe reaction at home.  However, I believe in security during OIT.  Hence, the hospital based therapy and food challenges.  Similarly, the dosing protocols which limit the risk of a significant reaction to under 1 percent.  So what worries me the most with OIT?  The month of September.

September is back to school month.  After a predictable summer, the children on OIT now return to a bastion of bacteria, viruses, pollutants and more.  This is fodder for the immune system to react to.  It is most common, in my experience, to see a surge of mild reactions during home based therapy in September.  My advice is the same every year.  Prevent what you can and notify your physician prior to any OIT dosing if you see any signs of infection or increased inflammation.

The most common illnesses in September include:

  • Viruses (simple to complex colds)
  • Wheezing/Bronchitis
  • Sinusitis
  • Pharyngitis (strep throat)
  • Otitis media (ear infections)
  • Skin infections (pustules)
  • Gastroenteritis (diarrhea/vomiting)
  • Conjunctivitis (eye/eyelid infection)

What can you do to prevent a difficult September for your child?

  1. Lots of handwashing
  2. Use a safe nasal washing system after school daily
  3. Talk to the school teacher about sanitizers, wipes, and handwashing for all children
  4. Enforce the sick child policy (so sick children are sent home)
  5. Obtain a lung function test prior to school starting to ensure maximum lung function
  6. Monitor and limit activity on high pollution days
  7. Ensure your child’s technique for inhalers and nasal sprays is correct
  8. Avoid unnecessary visits to high risk areas (busy grocery stores, daycares, etc.)
  9. Apply the wash and change routine to all children and adults in the home. Many studies show the most common carrier of viral and bacterial pathogens are adults and older children.  The first thing to do when you get home?  Change clothes and wash down (hands, arms, neck, and face) with soap and water.
  10. Ensure a healthy classroom (refer to the American Lung Association healthy classroom checklist).

As always, if your child is ill during OIT, notify your doctor immediately PRIOR to dosing. 

Hopefully this September will be a smooth transition for all OIT patients.  Stay healthy!

 
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The LEAP Study – New Discoveries in Peanut Allergy

By Dr. Christopher Parrish

Peanut allergy has become an increasing issue for many children over the past several decades. Investigators of the LEAP (Learning Early APeanuts for Postbout Peanut Allergy) Study Team suggest that early introduction of peanut into the diet of children at high risk for peanut allergy may prevent development of peanut allergy. These findings were in the February 26, 2015 issue of the New England Journal of Medicine. What lessons should parents take home from this?

In 2000, the American Academy of Pediatrics (AAP) recommended avoidance of foods commonly linked to allergies (such as peanuts and seafood) for high-risk children and their mothers during pregnancy and lactation. Further research showed no benefit of such strategies, and the number of children with food allergies continued to rise. In 2008, the AAP withdrew the recommendations for avoidance. The LEAP study investigators then noted a 10-fold difference in the rates of peanut allergy among Jewish children in the UK versus otherwise similar children in Israel. The age at which peanut was introduced to children in Israel was much younger, and this led to the idea that introducing peanut early may reduce the risk of becoming allergic to peanut.

The LEAP study investigators decided to test this hypothesis. The children in the study were considered to have a high risk of developing peanut allergy (they had severe eczema and/or egg allergy). If they had a clearly positive (>4mm) skin test to peanut they were not included in the study (this makes sense because the investigators were trying to see if peanut allergy could be prevented, not whether it could be treated).  The children were randomly assigned to avoid or consume peanut. The group that consumed peanut mostly ate a snack food called Bamba (https://en.wikipedia.org/wiki/Bamba_(snack)). They ate peanut at least 3 times per week for a total of at least 6 grams of peanut protein per week. This is equivalent to about 24 peanuts per week. The results were astounding – the children who consumed peanut had a reduction of at least 70% in the rate of peanut allergy compared to the children who avoided peanut.

What does this mean for parents concerned about peanut allergy in their children? Numerous physician societies including the American Academy of Pediatrics (AAP), American Academy of Asthma, Allergy and Immunology (AAAAI), American College of Asthma, Allergy, and Immunology (ACAAI), and World Allergy Organization (WAO) released a joint statement after the study above was published. They suggested that doctors recommend introduction of peanut to “high-risk” infants between 4 and 11 months of age. They also suggest that babies with problems such as severe eczema or egg allergy by age 4 or 6 months should be evaluated by an allergist. The allergist evaluation may include skin testing and/or observation of the child after eating peanut in clinic.

While the findings of the LEAP study are very encouraging, there is still a lot we don’t know. Would eating smaller amounts of peanut produce similar benefits? What if peanut was eaten inconsistently on an on/off basis? Further studies are under way to hopefully provide clarity with regard to these and other questions. In the meantime, TPIRC will continue to support these studies to determine whether the old adage “an ounce of prevention is worth a pound of cure” may apply to peanut allergy as well.

 

The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. We expressly disclaim responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.

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Today is National Oyster Day!

by Dr. Inderpal Randhawa, M.D.

Remember a food allergy to shellfish does not mean you are allergic to all shellfish.  In fact, a patient allergic to one shellfish has a 50% chance of being allergic to another shellfish.  It is important to know the difference between shellfish (called Crustacea) and mollusks (see the table below).

Shellfish Info

 

 

If you are allergic to one shellfish, what is the chance of being allergic to another?  Around 75%.  Shellfish allergy is the most prevalent adult food allergy in the US population.

If you are allergic to shellfish or mollusks, what is the chance of being allergic to fish?  Around 5-10%.

If you are allergic to shellfish, does that increase risk of an allergy to iodine or to radiocontrast used in studies like CT scans?  This is a common misperception.  Shellfish allergy does not increase risk to either.

Take away message:

Get tested for all types of shellfish, mollusk and fish allergy!  Don’t assume if you are allergic to one you will be allergic to others.

 

 

 

 

The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. We expressly disclaim responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.  

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JUST DON’T EAT IT!

by Leah Roffman

We have all seen the stereotypical portrayal of the allergy and asthma nerd. While I am proud to call myself a nerd, I take issue with the often weak, unpopular and uncoordinated caricature of the allergic and asthmatic child. I have carried the diagnosis of Food Allergies, severe Asthma, and Inflammatory Disorders my entire life. Contrary to the usual portrayal, I believe that the trials and tribulations of navigating a poisonous world has made me stronger.

Many of the less empathetic (let’s call these people “insensitives”) insist that severe food allergies are the same as the Pollen sniffles they get every spring. Much of the world remains misinformed about the dangers of anaphylactic allergies. As a result of this ignorance, insensitive people refuse to limit their consumption of airborne allergens in public places. Consequently, while advocacy and food allergy awareness remain near and dear to my heart, I realize that it is equally important to move swiftly toward the eradication or at least suppression of life threatening allergies.

Many people in my life would actually advise me …so if you’re allergic to it, just don’t eat it and you should be fine – those people completely ignoring the literature proving that many food allergies are airborne.  Once the allergens reached my body, whether through my mouth, my skin, or my nose, they caused a cascade of systemic reactions. The inflammation caused by my intense reaction to these microscopic molecules of destruction caused my body to be rapidly overwhelmed by itching, swelling, sneezing, coughing and worse.

After many emergency room visits, steroids, prolonged school absences and accompanying social consequences, my medication list kept growing.  One night, in middle school, I went to see the Harry Potter Midnight Premiere with a friend at which time something in the theater caused a severe allergic reaction.  The emergency room took a CT scan of my lungs which showed some nodular changes.  At that time my family decided that I could never recover in Michigan with the allergens and severe weather changes.  We picked up and moved to California in time for my first year of high school.

Unfortunately, things got so bad with my asthma that my immune system was beat. I was hospitalized with H1N1 my first week of high school. I was on IV Steroids and oxygen for a week and continued steroids for the better part of my first semester of school.  The steroid weight gain caused problems with my confidence as I had been a physically fit dancer up to that point.

I was allergic to Eggs, Nuts (peanuts and tree nuts and every cousin of legumes such as beans) and Fish (finned fish and shellfish). I was airborne. I couldn’t be within 10 feet of Nuts or Fish or I was at risk of anaphylaxis. The enemy was literally everywhere.  

By way of example:

– I went to Epcot with my family one year when they had Walnut trees on the grounds.  I broke out into hives 5 minutes inside the park.

– When I went to the movies we used to bring a towel for me to sit on so my skin never touched the seat.

– I’ve never been to a baseball game.

– I sat at a special table at lunch accompanied by a recess monitor to make sure I was safe-every single day of elementary school.  

– I was not allowed to play outside at recess during most of the winter due to my asthma.

– My first boyfriend had to give me a rundown of every food and beverage he consumed for the day if he intended to kiss me.

– I could only go to a few restaurants after the menu was checked out and with the clear understanding that they would cook in areas that were not cross contaminated.

– I could not get my hair washed or styled in a salon since we didn’t know if there were nut oils in the products. (Or manicures)

– My teachers had to physically carry a hip pack with EpiPen, liquid Benadryl, and inhaler– from room to room since I couldn’t have it too far away.

– My parents donated massive quantities of wipes to the school so that after lunch all hands could be wiped under supervision.

– My only camp experience was at an air conditioned dance camp. They went out of their way to keep allergens away from the camp. Nevertheless, my parents brought every single piece of food that I ate for the week

– I never got to ride the bus to field trips with the rest of the children. It was too much risk that someone would have an allergen aboard and there was no adult available to medicate me.

– My favorite game in high school was “Never Have I Ever” because of all the things I couldn’t eat or do.

Eventually, my body got so hyper-allergic to everything that I actually developed an allergy to cockroaches, which are often found in public high schools in California. I would develop a sandpaper rash as soon as I entered my high school campus.  I started an online program for my last two years of high school because I couldn’t stay in a public school with cockroaches and peanut dust.

The treatment was often isolating. I had recurrent pancreatitis from so much steroid use.  I was in such a dark place at that time. My illnesses were a source of stress at school, in dance class, and in my social life. I was depressed, I felt alone.

When I was 16, I was seeing a neurologist for severe migraines. A mother of another patient referred my mother to a specialist by the name of  Dr. Randhawa. We didn’t know it then, but that little business card was the start of the rest of my life.

When my parents took me to Dr. Randhawa, I was angry, depressed, and very skeptical. Every so called “specialist” I’d seen in California had failed me.  I was hostile and not very nice to him the first visit.

In spite of my negativity, the doc immediately started trying out different treatments and ordering tests. As we started to focus my issues, the doc started me on a new drug that he thought would help with the pain and help me get back out into the world.  I started sublingual immunotherapy (SLIT) for the environmental allergens.  As I started to improve, we realized my asthma was still causing more problems.  Dr. Randhawa suggested an injected drug that would help the allergic asthma…adding that it might also be helpful in reducing many of my allergies. I thought he was crazy.  Nevertheless, I agreed to the injections and improved dramatically.  With that success, Dr. Randhawa started to educate my family on the options of Oral Immunotherapy.  

Initially I refused, explaining that he previously described my food allergies as “off the charts” and “some of the highest test results he had seen”, and now he wanted to start feeding me the things I was allergic to? I wasn’t going to let that happen, and neither was my mom. He patiently explained in more detail his procedure (for more information on OIT treatment click here). We decided to try it.  I am so happy about that decision.

Fast forward 4 years:

– I’m a Sophomore in college (I got a 4.0 last semester).   

– I’m on the speech and debate team.   

– I feel free to go where I need to and do what I need to without the constant fear of death by lunch.

– I’m eating as many eggs daily as I please, a peanut butter and jelly sandwich every night, and every type of nut out there is A-OK.

– I can go to restaurants and Disneyland and Comic Con all by myself without worrying that something terrible will happen.

My world has completely changed from the young, fear-filled, little girl I was my entire life. I’m not ruled by my illness. The world is out there and I am ready to embrace it.

 

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