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.

Hair Dye and Allergy to Beauty Products

As a result of the ladies fashion of having their hair dyed, my number of patients for hair dye allergy has grown exponentially; I probably have a few hundreds of such patients.

The reason of hair dye allergy is basically due to the chemicals to make the hair dye. There are very few cases of such allergy when using henna hair dyes but which young lady (or man) wants to use henna dyes these days?

As a result, I literally have hundreds of antidotes each for a particular patient. Don't forget that hair dyes remains on your head for a period of months. However, most hair dye allergy do not manifeast immediately. Indeed, most of them start to cause itchy rash around the face and neck only a few months later.

Cosmetics (Beauty products) are also a major problem causing rash around the face and it may not be itchy but present as acne-like lesions. Look at your cosmetic bottle and see how many chemicals are shown as ingredients (and note that the company does not need to show all the ingredients!). I find the major problem of cosmetic allrgy arises when one changes ones cosmetic to another type, typically someone one who want to upgrade to more expensive ones.

One example is a patient, as a ressult of her husband doing very well, decided to change to a very expensive brand. Unfortunately she became sensitive to these and have to give up and I advised her to go back to her old range.

Lesson: DONT CHANGE YOUR COSMETICS AND HAIR OR SKIN PRODUCTS IF THEY ARE SERVING YOU WELL

My learning continues...

Yeast Allergy in Foods

I've a substantial number of patients with yeast allergy.

The obvious question would be what to avoid. The basic thing would be to avoid most kind of bread or products containing bread like croutons and fried food with bread crumbs. Any alcohol drink will have yeast as its ingredients and must be avoided. Less common known products that contains small amount of yeast include instant noodles, pau (chinese steamed buns) and other buns, over-ripe grapes and raisins and for those who are very sensitive to yeast, yogurt products and even vinegar. Soya sauces can also cause reactions.

With my patients I tell them to bring the products for muscle testing to see if they can consume them or not.

In most cultures, we have got so accustomed to eating bread and drinking some alcohol that abstaining from these become not such an easy task.

Lesson: AVOIDANCE OF YEAST IN FOOD REQUIRES DETERMINATION AND PLANNING

and my learning continues...

Egg Allergy and Avoidance

Lets say you (or your child) has been diagnosed with egg allergy and you have been told to totally avoid eggs, as ingestion of eggs will cause your allergy to worsen.

It is very easy to say, "avoid eggs at all cost" but in practice, it takes a lot of effort to do so.

Lets examine what type of food has eggs:

• All fried food that contains batters (flour with eggs added) e.g. goreng pisang (banana fritters)
• Most pastries and bread contains eggs
• Most types of biscuits in its content or they are glazed with eggs
• Mee noodles (egg noodles - the yellow ones) especially those instant ones
• Ice cream, chocolates, cakes and the list goes on and on

I am still learning from my patients which foods contain eggs and which do not. Reading labels on the food packet usually does not help (as there is no law on strict labelling in Malaysia, but your country may have it) and as such imported food need not state all the ingredients. So if you are unsure whether a particular food has egg or not, avoid it!

Lession: FOOD AVOIDANCE IS NO EASY TASK BUT ABSOLUTELY NECESSARY

and my learning continues...

Rubber Allergy

Many years ago, one of my dance instructors showed me her feet - it was scaly around her toes and sole.

"Aha", my first thought was a fungal infection, but tests showed it was not. Muscle testing revealed that she was sensitive to rubber products, particularly her socks. She was wearing '100% cotton' socks but since it was stretchable, I was sure it had rubber components in it. She cleverly went to hunt for a pair of socks that did not have rubber but was made of cotton spandex and simply enough, her allergy was cured.

The big problem of rubber allergy is when the rash is at your undergarment areas such as your bra region. Boxer shorts help but even that some still gets the rash and i have advised for these to go back to the 'good-old-days' undies that my dad used i.e. those which you need to tie with strings and these are specially sown. Not especially cool or fashionable, but it will help tremendously in the long run.

Lesson: The simple key to contact-based allergy is avoidance.

My learning continues...

Multiple Allergies and Growing Up

This young man first saw me at the age of 12 with very severe eczema and he was feeling terrible and really, who can blame him?

He was first diagnosed to have house dust mite, egg and milk allery and later with the help of his mum and himself, we gradually realised that he also had chrome, nickel, alcohol, detergent and mint allergy. That's quite a number.

His condition improved with time but he was not happy as he was the smallest boy in class and by 15 had not attained puberty. I assured him that with the elimination of his allergies, he would grow. Of course, being the awkward age of 15, I wasn't sure if he believed me.

Imagine my pride that he is now grown and training for a triathron! In fact when I met him at the park where I have my weekly walks, he challenged me for a race (with handicap of course... I'm past my prime) with the bet that if he won, further medical fees would be waived. Clever boy.

Because he was getting better in the course of his treatment, he also mentioned that he wanted me to stay alive as long as he lives so that he would always be well. What a compliment, I thought.

Allergies May Have Multiple Causes. Doctor and Patient Detective Collaboration Helps.

My learning continues.