For most of those in the Midwest, ragweed season is here! It actually started last week, will peak around Labor Day Weekend, and gradually decline for the rest of September. There is no detectable ragweed by the time October rolls around.

Tips to decrease exposure to ragweed:

Stay indoors

Keep windows closed

Wash your hair/bathe nightly

Please refer to our previous posts regarding recommendations for use of OTC allergy medications.

This link is a detailed post about ragweed previously posted last year. https://www.parkallergy.com/ragweed-facts-you-need-to-know/


All allergy injections for environmental allergies will resume on Monday May 4.

New Shot Hours starting Monday May 4: 8:30am – 4pm Monday through Thursday

  • Please review our recent policy changes regarding social distancing, screening, and required facial masks as those policies will remain in effect.
  • The total number of patients/visitors in the building will be capped.
  • PLEASE EXPECT LONGER THAN USUAL WAIT TIMES.

Effective immediately, ALL patients entering Park Allergy Center, whether for an appointment, treatment, or allergy injection, will be required to wear a facial mask (cloth facial coverings acceptable). All patients are asked to bring and use their own mask as our supply is almost exhausted. Following is a link to the latest CDC recommendation regarding the use of cloth facial masks in public. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html

As always, thank you for your understanding and trust in Park Allergy Center.

Park Allergy Center now screens all patients and visitors before they enter the office.

If you have had recent fever, cough, or shortness of breath, or exposure to anyone that has or is suspected of having SARS-CoV2 (COVID-19) and are coming for your allergy injection, PLEASE STAY HOME, as you will be turned away.

If you have any of the above symptoms/exposures and are here for a non-urgent appointment, PLEASE STAY HOME, as you will be turned away.

If you have any of the above symptoms/exposures and are here for an urgent appointment, you will be asked to wear a mask and taken directly to your room.

Thank you for your understanding.

Photo by Kelly Sikkema on Unsplash

Assume you have the virus and act accordingly. Most people act defensively, trying to not to get infected. On the other hand, acting as if you already have the virus and doing your best to prevent infecting others is another step up in prevention. The number of times you clean you hands will go up significantly.

Do not let your respiratory droplets land on someone else.  Obvious sources of respiratory droplets are sneezing and coughing, but one important source that can’t be overlooked is talking.  All of us spit a little, some more than others, while we talk.  Make sure you are at least 3 feet away when talking to someone, even loved ones (yes 6 feet is even better). 

Keep your hands clean, as they are a primary source of spreading respiratory droplets.  Lick your finger? Clean your hands. Touch your face? Clean your hands. Touch your hair? Clean your hands. Eat something? Clean your hands.  Reach for another slice of pizza?  Clean your hands before grabbing another slice.  Drink something?  Small droplets of saliva can land on you hands, contaminating them.  Clean your hands. 

Further, be aggressive with your defenses.  Open or close a public door?  Clean your hands.  Pump gas into your car?  Clean your hands.  Light switch. Clean your hands.  Keyboard/mouse?  Clean your hands.  Pencil?  Clean your hands.  Get the picture?

On 1/31/20, Palforzia became the first FDA approved treatment for peanut allergy.

Here are my initial thoughts about this new product.

First of all, Palforzia isn’t really a drug at all.  Palforzia is simply peanut powder placed in capsules at specific doses ranging from 0.5mg to 300mg.  The capsule is not consumed, rather the powder is mixed with another food like apple sauce, then consumed.  

The first day is done at the doctor’s office, consisting of 5 separate doses starting at 0.5mg and ending at 6mg.

The patient then goes home and consumes 3mg once a day for 2 weeks.

Photo by Tom Hermans

Every 2 weeks, the dose is increased with the first higher dose given at the doctor’s office.

If all goes well the build up schedule is completed in 22 weeks and the patient then takes a daily maintenance dose of 300mg.  If you miss 3 days or more, you need to reduce the dose or perhaps even start all over.

Just in case you’re wondering, the average peanut contains about 200mg of peanut protein.  So the maintenance dose of 300mg is equal to about 1.5 peanuts.

Palforzia is not a cure for peanut allergy.  It decreases the chance of having an allergic reaction to a small ingestion of peanut (1-2 peanuts).

In the studies for Palforzia, the rate of anaphylaxis during the build up phase was 9.4%.

The rate of anaphylaxis during the maintenance phase was 8.7%

Other reactions like abdominal pain were as high as 67% in the build up phase, 30% in the maintenance phase.

And remember, the vast majority of the doses are given at home.

So, as you can see, Palforzia is not the “cure” we have been hoping for.

If offers some protection against accidental reactions – but acquiring that protection comes with risk.

Further, in similar desensitization studies previously done using peanut powder, the dropout rate in patients who successfully reached maintenance dose was 50% after the 1st year.  It turns out, it’s not easy to consume a maintenance dose of peanuts every single day.

In summary, I do not think the risk is worth the reward for most people when it comes to Palforzia.  

The best treatment advice for most peanut allergic patients remains strict avoidance and to have injectable epinephrine readily available in case of accidental ingestion and reaction.

However, for parents and patients who want to take the risk, Palforzia offers a convenient way to obtain precise doses of peanut protein to attempt desensitization.

Michael Park, MD

With the arrival of winter, there are several things to consider if you have allergies.  First, if you haven’t done it already, now is a good time to change the filter on your furnace.  Dust has likely accumulated in your furnace for 6 months and old filters, burdened with a large dust load, do not filter as well as new, clean ones. 

Outdoor allergies resolve in the winter but indoor allergies usually worsen.  The most common indoor allergies are cat, dog and other furry animals.  Dust mite allergy also tends to worsen in the winter.

Humidity is something that tends to confuse most people.  I often see patients who use a steamer or humidifier thinking it will decrease their “allergies.”  But if cat and dog are the main indoor allergens, how will a humidifier improve pet allergies?  The answer is they won’t.  Do they help dust mite allergy?  No, just the opposite.  One of the ways to control dust mite population is to keep the humidity low, not high.  Two things that are helped by using a humidifier in the winter are dry nasal passages and dry skin.  Many patients with allergies also have eczema.  Dry skin usually results in a flare of eczema.  So, using a humidifier in the winter can help eczema.  It can also help a dry nose.  Using a water based lubricant for the nasal passages is another way to improve dry nostrils in the winter.  A good rule of thumb is to keep the humidity below 50%, whether it is summer or winter.

During the holiday season, many people get live Christmas trees.  Unfortunately, these trees tend to have a lot of mold on them.  Since Christmas trees do not pollinate in the winter, and definitely do not pollinate in your living room, the increase in symptoms that occur once the Christmas tree is put up and decorated is usually caused by the mold.  If you have significant mold allergies, it would be best to use an artificial Christmas tree.

Michael Park, MD

There are many different types of inhaled medications these days, ranging from the old style inhalers in a pressured canister, to powders, to mists. The following instructions pertain to old style metered dose inhalers (MDI), the traditional asthma inhaler used for the past 50 years. Before you begin, a brand new MDI should be primed by puffing 4 doses into the air, as the first several doses do not contain proper amounts of the medication. This does not have to be done before each use, just when it is new.

Image by Bob Williams from Pixabay

First, shake the inhaler and exhale fully.

Second, close your lips around the mouthpiece making sure your teeth do not block the way.

Third, puff the inhaler and start your inhalation at the SAME time. The inhalation should be SLOW, not fast, and should last 5 SECONDS.

Fourth, hold your breath for 10 seconds.

That’s it. You may run across minor variations to these instruction, but I have found these guidelines to be the easiest, most reliable way to teach patients how to properly use an MDI. The most common error is inhaling too quickly. A slow inhalation delivers more medication to the lungs compared to a fast one. Further, holding your breath for 10 seconds at the end is important, as this is when the medication spreads to the periphery of the lungs.

Michael Park, MD

Ragweed season starts in mid-August and ends at the end of September.

Often, people in the Midwestern United States who suffer from seasonal allergies complain of symptoms in the spring and “in the fall.” However, when asked to specify what part of the fall, they usually mean late August and all of September, not late October when the leaves are on the ground. So, it is more accurate to say “late summer” or “early fall,” when describing this second allergy season of the year. The main allergen responsible for symptoms this time of the year is ragweed. Ragweed is a common weed that grows in many parts of the North America and Central America. Although native to this continent, it has spread to Europe, probably starting in the 1900s during WWI. Unfortunately, for those of us with allergies, it is also a potent allergen.

In Southwest Michigan, ragweed starts to pollinate in mid-August, peaks around Labor Day weekend, and continues till the end of September. There is no detectable ragweed by October 1. As a potent allergen, it is responsible for most of the itchy eyes, running nose, nasal stuffiness and sneezing this time of year. Ragweed pollen levels tend to peak midday and can literally fly for hundreds of miles. So, it doesn’t matter that your yard is a perfectly manicured model of Midwestern grass. You can’t escape ragweed pollen.

Treatment for ragweed is basically the same as for most environmental allergies. The triad of avoidance, medications, and immunotherapy are the hallmark of treatment. Avoidance involves staying indoors, keeping the windows closed, and bathing every night before going to bed (you need to wash that ragweed out of your hair…). I am often asked if there is someplace one could move to avoid ragweed. The short answer is no – unless you’d like to move to Antarctica. However, spending ragweed season on an ocean or large lake (eg. Lake Michigan) shoreline can be helpful. Medications involve allergy eye drops, oral antihistamines, and allergy nasal sprays. Please refer to the previous posts detailing use of OTC allergy medications. Finally, immunotherapy, either via allergy injections or allergy oral drops, probably offers the most effective treatment available.

Michael Park, MD

Honey bee collecting nectar and pollen

Eating local honey has been considered a natural way to treat one’s seasonal allergies for many years. The rationale is since local honey is made with the local pollens from the area, eating the honey on a regular basis will naturally desensitize you to those pollens. Sounds nice, but does this really work?

The short answer is no. First of all, honey bees do not use the pollen to make honey. It is the nectar they collect from flowers that is transformed to honey. Honey bees do collect pollen but they consume both the pollen and honey for food. The bottom line is there is virtually no pollen or plant antigen in honey.

Further, the pollen from flowers do not significantly cross react with the various trees, grass, and weeds that cause seasonal allergies. So even if honey contained pollen, it wouldn’t do much good. Even allergy injections with flower extracts will not help those with tree or ragweed allergies.

Honey

Honey is a delicious, natural sweetener, but nothing more. When it comes to treating your allergies, best to leave the bees out of it.