Relapses of Allergy

Recently, the wife of a very good friend of mine came to see me again after she had a relapse of her abdominal bloatedness. She had the problem after her uterus was removed. It was obvious to me that after her operation, she was given a powerful dose of antibiotics and although that killed the bad bacteria that could cause problems, that also killed most of her good gut bacteria and promoted the growth of candida.

She was also found to have soya allergy and was asked to avoid yeast and sugar as they promote the growth of candida. Along with probiotics and her strict adherence to my instructions, her results were amazing.

She remained well for a number of years but unfortunately she had a very bad chest infection and she was given antibiotic and the whole problem started again. She is doing well again and hopefully will remain so.

Another similar case I saw a few weeks ago is a former military attache to the Singapore government. He had severe abdominal symptoms and went to see many gastroenterologists but he was not getting better. I tested him and found him to have yeast allergy as well as candidiasis. 

This guy has a really a very sweet tooth, so I duly advised him to refrain from sugars and yeast and guess what, I met him last night at a common good friends dinner and he is doing very well. 

This begs the question, "How long must one be on the drops or probiotics?" The answer is, it is difficult to know but if one is exposed to the allergen too quickly after 'getting better', the allergy returns.

Another case will illustrate my point:

A lady lawyer whom I saw many years ago with rather severe multiple allergies, loves cats and she has a number of them in her home. Her allergy has improved with treatment but she continues seeing me for her drops, antidotes for her cat allergy and though she has an occasional rash, it is never severe. 

                                                                                        

Allergy can relapse if the causes are activated.

And my learning continues..... 

The Extremes of Allergies

An allergy can present as two extreme manifestations; I had two cases today to demonstrate my point.

One young man came to see me for a patch of thickened skin rash at the back of his neck, about the size of a ten-cent coin. He was diagnosed to have chromium allergy (i.e. allergy to chrome). It was due to a chain he was wearing for some time, a gift from his girlfriend.

The other patient had seen me 5 years ago and was diagnosed as having egg allergy and has actually got well after treatment by me. This time, he had a scaly rash all over his scalp, his face and his whole body. His condition is known as exfoliative dermatitis, a severe allergic reaction. His present severe manifestation is in contrast with what he experienced 5 years ago - only a mild skin rash. This illustrates the unpredictability of allergy.

I can remember some other cases I've had of extreme allergic manifestations.

Many years ago, one patient of mine had an allergy to yellow dye additive (as found in certain foods) and was admitted to a hospital for an anaphylactic reaction (i.e. allergic shock) in Sydney after taking some butter for breakfast. After that incident, she kept an Epipen (Epinephrine Auto-Injector) with her. She had another attack in Kuala Lumpur when she was back in Malaysia but after I prescribed her with probiotic, she has never had another attack since. 

Another patient is the daughter of a squash buddy of mine who had peanut-induced anaphylactic shock, which can cause death very rapidly, like 5 minutes. He brought her to see me, and after treatment, she has not had an attack since.

Allergy can range from the very mild to very life treatening

My learning continues...

Running Noses

Many people have been suffering from a running or stuffy nose for a very, very long time and have been on antihistamine or nasal sprays. A lot of sufferers have resigned themselves to the fact that they have to suffer such symptoms forever. 

They do not have to.

There are two main categories of causes:

1. Temperature changes 
2. Allergens in the atmosphere.

The culprits are usually due to house dust mites, moulds (airborne spores), pet dander, dust particles, smoke/smog, grass and plant pollen (the grass pollen in the east differ from those which cause seasonal rhinitis/runny nose in the west) and in my part of the world (Malaysia) I have found that joss sticks, mosquito repellents (coils or electric) can also cause this problem.          

Unlike food, airborne allergens are difficult to avoid totally. It is possible to desensitise the sufferer ageist the allergen by producing holistic drops which neutralise the effect of the allergen, thereby decreasing the sensitvity to the allergen.

There are also patients who get running nose by consuming coffee or tea, exposure to perfumes and even seafood but these causes are less common.

Most nasal allergy are caused by airborne allergens

My learning continues.......

Why Treatment Sometimes Fails

When I was a young houseman working in Johor Bahru, I would always remember what my boss Datuk Lim Kee Jin often said: 

"When medical treatment fails, remember the dictum that either the diagnosis was wrong, or the drug used was wrong, or the dosage was wrong, or the time for treatment was wrong, or some other complications or other medical conditions have been missed out."  

Applying this principle to why allergy treatment sometimes 'fails' in my practice, the diagnosis may not be allergy but a fungal or parasitic infection or the wrong dose was prescribed, meaning that the neutralising dose of the treatment may be wrong. 

It is often the expectation of patients to get well quickly but most of the time in treating the cause of allergies, it takes considerable time and effort. 

Here's an example: let's say we have diagnosed the offending allergen to be yeast. Now, the cornerstone of treatment would be total avoidance of the foods with yeast. It's not as easy as it sounds, as avoiding yeast means avoiding bread, most biscuits, 'pau' (Chinese pastry), certain roti canai (Indian breads), alcohol and most vitamins (many of them are manufactured from yeast) can be a daunting task for a lot of patients. 

The period of abstinence can be very long i.e. I prescribe a period of one year after the condition completely heals. It may seem a long and daunting task but there are many, many out there who have done that. And achieving a cure is worth the effort.       

In some cases there may be more than one substance that is causing the allergy. I have always advocated that a food log be kept and if there is a breakout, one can then suspect the allergen and then discuss with me. I often learn from my patients as to what to avoid and this helps me to pass the information to newer patients.

Failure of allergy treatment needs further investigaion by Doctor and Patient

And my learning continues.

Blame The Salons

For the last couple of years, hairstylists have created a deluge of allergic cases, mainly because women love having their hair dyed.

With the exception of henna (which is popular with the Indian community and also the older generation), the chemical ingredients in hair dyes are highly allergic in nature. Hence the great number of such cases. Typically, the allergies present themselves as rashes around the neck, behind the ears, face and even further down the body. When the patient showers, the water flows down and creates the rash. 

Usually at the initial stages when the hair is dyed there is no adverse reaction but after a period of time, the allergy sets in and the person with the allergy has to endure a few months until the hair dye disappears. Once a diagnosis is established, I teach patients how not to allow the hair to come in contact with the skin as well how to shower so that the dye does not contact the body. I also prepare an antidote for the specific hair dye. If the patient wants to dye her hair again, she has to bring the dye for me to test before she proceeds to use. There are also the dyes used to highlight the hair which also causes allergy.

I classify such allergies as chemical allergy mainly because they are due to the chemicals found in these daily substances. Toothpastes can also cause allergy as a result of the mint or the whitening contents. Hair shampoos can cause hair itch and rashes and soaps with chemical ingredients are notoriously common causes of allergy. In fact i have always been against the use of such soaps and the fact that many people use them because they are advertised to kill bacteria.

I will write about cosmetics in another post.

Lesson: We use too many chemicals daily; use those with the least chemicals