Allergy in Piety

I had an interesting case of a middle age Malay lady who came to see me because of an extremely itchy thickened lesions at both of her knees and some parts of her ankle. My investigative skills were challenged, but I finally solved it.

Turns out, her allergy was due to her prayer mat which she use to kneel and the cause of the allergy was due to the new detergent she uses to wash her mat. Asking her to revert back to her old detergent solved her problem.

You never know where allergy can pop up!

My learning continues....

*Cough* *Cough*

Chronic cough can be caused by allergy, but it's not always the case.

Recently I saw a young man who had a chronic cough. I did a chest X-ray, and it showed a tumor that was eventually diagnosed as germinal cell cancer. Luckily for him, this tumor is very treatable.

Another case was a middle age man who was diagnosed with tuberculosis from the chest X-ray. In another case, a man with a prolonged runny nose turned out to have a cancer of his throat.

The lesson is to do at least some simple tests to rule out other conditions before thinking of allergy.

My learning continues

More Work-related Allergies

Imagine that you are a masonry worker and if you have developed contact dermatitis due to cement, you would have to choose between continuing with your work or to be extremely careful to avoid contact with cement. That is a difficult thing to do.

There are many such work related allergies, each with it's dilemma. One teacher patient of mine had hand allergy due to the use of chalk (I thought we dont use chalk in the classroom anymore!) and another young school girl had allergic conjunctivitis (itchy red eyes) who was also allergic to chalk. She got much better when she went to university. I suppose they don't use chalk there anymore.

Grass pollen allergies are common in farmers and are difficult to manage.

There are also many work-related allergies occuring in factories such as chrome allery of hands (especially in cement factories), work dust allergy (for work that have a lot of dust), paint and turpentine allergy (common in furniture workers) and the list goes on and on.

Lesson: IT IS NOT UNCOMMON FOR YOUR WORK TO CAUSE YOU ALLEGIES

My learning continues.

Work-related Allergies

I saw a patient many years ago with allergy of his hands and discovered his allergy was due to the chemical he was using to soak his bean sprouts in. Asking him to use gloves stopped his allergy. That one was simple enough.

Another interesting case was a farmer who had a cough for months and had seen many doctors including a respiratory doctor but he did not get any better.

I asked him to bring to my clinic all the pesticides and fungicides that he used on his vegetables and watermelon and lo and behold, he was found to be allergic to a number of these. I advised him to avoid going to the farm and so his son went instead and eventually, his cough disappeared.I advised him to wear a particular mask if he ever wants to go the farm.

I have kept the pesticide and fungicide solutions but interestingly, except for a few patients, most were not allergic to them.

Lesson: BEWARE OF PESTICIDES AND FUNGICIDES

and my learning continues...

Chinese Herbs and Jaundice

Today, I want to highlight two quite similar and extremely interesting cases.

First was a patient who was referred to me by her brother-in-law who is a close friend of mine and another the father of one of my dance instructors. Both came to see me rather ill with severe jaundice, meaning their livers were not functioning and their skins were as yellow as pumpkins.

Both of them were admitted to private hospitals and the doctors were puzzled as to the cause of their condition as the blood tests showed their liver was inflammed but the cause was not known (most these cases are due to hepatitis A or B).

Their problems were quickly resolved when I asked them whether they were taking any chinese herbs or medicine. The lady was taking a kind of Chinese pill for a long time for her knee pain, and the old man was taking a Chinese herb for general good health. I tested them against their respective Chinese herbs and true enough, they sensitivity to the herbs proved positive. I then made them antidotes and within a week, their jaundice disappeared and they were smiling when they came back to see me, not yellow anymore.

Lesson: BEWARE OF THE DANGERS OF CHINESE HERBS AND MEDICINE

My learning continues.

Hives (Urticaria)

When you suddenly develop extreme itchiness together with swelling of your body in patches or lumps, chances are you have hives (or in medical terms, urticaria).

This condition can progress further to swelling of the eyes and face and worse still, go to a very dangerous condition of the patient collapsing within minutes with difficulty in breathing. This is called anaphylaxis or allergic shock.

Fortunately for most patients, they only have transient hives but unfortunately, most do not know the cause.

Generally, most hives are caused by various drug reactions but some are caused by food, in particular seafoods of various kinds, colour additives and eggs.

There is also a kind of hives caused by PHYSICAL means, such as cold, heat or even physical contact. This condition is called Physical Urticaria.

The treatment of urticaria includes the avoidance of the causative factors and the treatment of a superficial fungus which causing the condition.

Lesson: HIVES TREATMENT INCLUDES TREATMENT OF A SUPERFICIAL FUNGAL INFECTION

And my learning continues.

Yellow Yellow Allergic Fellow

One of the most difficult food substance to avoid in food allergy is those connected with yellow color additive (E110: Sunset Yellow and E102: Tartrazine).

These additives have caused untold misery to countless patients of mine. One is a lady from my hometown whose allergy to colour additive manifested as eczema all over her body.

I have learned a lot of what type of food to avoid from my consultation with her:

• Most junk food contains these additives and therefore they are no-no
• Cooking oils are also a major problem as a lot of them contains these addictives (hence the 'golden yellow' look)
• Olive and sunflowerseed oils generally do not contain them
• Most butter and margarines have these additives and therefore pastries and cakes made with these ingredients must be avoided.
• So is local Malaysian coffee (as most are roasted with margarine) and tea as they may contain yellow additives
• Most of the commercial prepared yellow mee (egg noodles) have the E102 and E110 additives

This lady now cooks with lard (to avoid the colour additives) and she goes to a particular restaurant which cooks for her specially using the oil she places at the restaurant for her food. She also told me that the task is difficult but the reward is satisfying as she made a complete recovery even though it took her some time and a number of relapses.

Lesson: E110 AND E102 ARE YELLOW COLOR ADDITIVES AND VERY COMMON FOOD ALLERGENS

My learning continues.