oh good evening.

>> I'm Jennifer Blomqvist and welcome to HealthLine.

I have the privilege of hosting the program tonight.

I'm so glad you joined us.

We have a wonderful guest here tonight.

She's a local physician who specializes as an allergist and immunologist and she is here to answer your questions.

Nothing in life is free.

I'm sure most of you know that by now.

But this show is totally free.

You get your answer questions answered for free and free help.

So take advantage of that.

That's why we keep that phone number up at the bottom of the screen throughout the show.

>> So it's (969) 27 two zero if you're outside of Fort Wayne put 866- in front of there.

That makes it a toll free call when you call in if you have a question for our doctor, you have two options.

My favorite option is that you call five because if you do that you can talk to the doctor.

She might need to get more information from you to give you a better answer to your question.

So that's a great option.

But if you'd prefer not to do that, go ahead and call in and you'll talk to a call screener and then that person can take your question and I'll answer I'll ask the doctor the question for you.

So two ways to go about it either way you get your question answered.

So let me go and introduce you to our guest tonight.

She's brand new.

She's never done it before but she's going to be great.

I can tell already.

This is Dr. Vanessa Chavira.

And Doctor, you specialize as an allergist and immunologist.

Good evening, Jennifer.

Thank you for the invitation.

Yes, I specialize as an allergist immunologist and I have kids and adults.

>> Wonderful.

And I'm so glad she came to join us tonight.

I have to just put this in.

She is new to this region and she moved here from Florida which is her why but so this is her first winter here.

>> So we were chitchatting all about the cold and everything like that.

But you know, speaking of weather, I always think that weather impacts allergy allergies.

You know, it seems like like right now my husband if it's in the spring he's taking allergy medicine around the clock but people with those kinds of allergies kind of get a break.

The seasonal ones I feel like in the winter they get a little bit of a break.

>> Would you agree because of the cold?

It kind of yeah, of course.

Is it better?

Exactly.

So when we are in the spring in the summer and fall we have different Polings out that are the major responsibles of those people suffering from allergies are in that time.

>> Right.

But once we get the first four hours of the year in the fall after everything dies so the people that are allergic to those are specific pollens get a break like you're saying.

Right.

But of course and other things to started like the respiratory infections like in kids that have already allergies or persons with allergies that can be a little bit more you know, like it's hard for them to oh sure.

Sure.

You know and we hear so much about allergies today.

I mean I'm in my fifties and I feel like when I was growing up I mean like my brother and my dad we get the seasonal allergies but I never heard of the other kinds of of allergies like the peanut allergies, all these allergies to certain kinds of food, you know, dairy or things like that that seems to be so much more prevalent.

So do you think that is it is it because we live differently or you know, maybe we have different diets now compared to many years ago or did those problems exist before but we just didn't really know it?

Well, definitely what you're mentioning is something that we have noticed in the world.

Allergies are becoming much more prevalent to the point that we're calling them epidemic.

>> Yes, of course we wonder why this is going on and we can say, you know, as much as there are genetic factors, you know, like when there is family history of having allergies also there is very important the environmental factors like what you were mentioning.

There are many things around and in fact I feel like in these days are the ones that are impacting more because having a genetic change takes much more time.

But it seems like this came as a burden.

So they I support right now and the environmental factors yes they have been lately many studies trying to you know, to see what are the reasons why this is happening.

>> So for example, we know that when you are exposed early in life to smoke that predisposes you to have allergies later in life .

>> For example, we know that kids that are born and they you know, they suffer from a specific viral infections or infections or encounters with germs and pathogens they can that can put them on a higher risk of developing allergies.

Right.

Another factors like for example, breastfeeding breastfeeding could be a little bit protective right before the kids didn't have it then they have a little bit of that disadvantage and an exposure to antibiotics early on in life can also be related to have an increased risk of developing allergies and it's you know, it's a challenge.

It really is because it doesn't just impact that child.

But you know, once they go to school I know my daughter when she was in fourth grade there was a child who couldn't be couldn't have peanuts like even if it was in the room it didn't have to be that he ingested it or touched it.

But nobody in the room could have any peanut products or he could have an issue.

And I just thought holy cow, that's all that that impacted how they ran the classroom.

They banned snacks that year.

They were just too afraid that some child might forget and bring something with peanuts in it.

So I mean it does have a big impact not just on the child but just other people they interact absolutely.

Well, yeah, restricting a specific food has an impact on everybody because those are kids that are not allergic then they cannot use that protein.

For example, in the case of peanuts it's an excellent protein but if you've had allergic in the class and it's man like you said then everybody gets the disadvantage of not eating that.

>> So it seems like a little unfair sometimes.

You know, and we in general as allergist we want everybody to be prepared for the worst case scenario.

>> Has it been a phrase where they have to be all to identify not so much about banning foods is mostly like just be ready in case something happens.

>> Do you find that some kids outgrow some of these food allergies?

Is that common or you know, because I've heard of some kids do I don't know if it would be really like an experiment but they'll do something like I knew a boy who had a peanut allergy growing up and now he's in college and I was just talking to his grandma the other day and she said he's been starting to do like eating just a few nuts every day under a super under a doctor's supervision.

Well, yes.

Going with the first part of your question.

Yes, there are so many allergies that kids can grow and that's what food allergies is very strong when you are taking care of pediatric patients.

There's allergens like milk, egg, wheat that you can definitely outgrow by the time that you're eight .

Hopefully you're grown.

>> That's the natural history although now we're seeing some especially cases that continue to have the allergy but that's not the common norm.

>> But there is other allergens like for example, peanut and shellfish and we also tend to stay with you if you have them by the time that you're in puberty years probably that's what it's going to be for life and what you were mentioning yes, there is now oral allergy immunotherapy which we can offer for some patients is like a process.

It's not for everybody is just allowing patients to eat a specific amount of the allergen so that way they can feel feel more confident when they go out and they've encountered Trace's so they probably are protected to that.

Right.

So that's something that coming in in the later years but it's not curative and it once again is for specific patients.

Not everybody will benefit from it.

All right.

I just want to remind everybody that they can call and ask a question because we haven't had any calls yet in the phone lines are open.

We'd love to hear from you if you have anything allergy related or immunology you related that you'd like to ask Dr. Chavira, please call again.

There's a number at the bottom of the screen.

It's (969) 27 two zero.

It's still the toll free call if you put in 866- in front of there and again our time is limited.

We only have Dr. Chavira for about another twenty minutes so call sooner rather than later.

In the meantime, we're going to keep talking about this.

What do you advise people to do if they're maybe you have a relative who has an allergy or some type of issue and then for people starting to have their own families, their own children, are there precautions you need to take or just things that you need to watch for because you mentioned it can be you know, the hereditary factor can be yeah.

>> Well, it's always, you know, important to just know the history of the family.

You know, if somebody of the parents or siblings have definitely the risk of that kid, then it's going to be born.

It's a little higher and I think what you have to do is just pay attention, you know, like we were I think a very interesting concept to like just let everybody know right now we talk a lot of what is the topic march which is just a sequence of these topic conditions and how they present over a span of life in childhood.

Right.

It's a is it a topic march atopic march.

Yeah, it's just the sequence like we don't know exactly what is the cause of the other of the it's just you know one comes and then the other is independently coming but the most evidence that it's out there no like it's eczema probably the first one appearing and exactly.

>> And that's a sign that you for example have to pay attention if you have this family history and a child to start developing a rash.

>> I you know, they are very similar is Smilde can definitely be addressed by the general practitioners.

But if that eczema becomes a little bit more severe or there is other components of your topic marriage like for example, you know, concerns for food allergies, reactions to foods or even wheezing or respiratory issues.

So that kid definitely has to be evaluated by an allergist.

Uh huh uh and those are the things that we have to pay attention for .

Yeah, I was going to I was going to ask you like what if you have a child who has a peanut allergy and then you're having another baby?

I mean should you just not let that baby have peanuts or it could you maybe give them just do maybe just at the doctor's office try and do it or I would be terrified, you know, not know or is there testing that you do at a certain absolutely.

>> Yeah definitely the parents come with that question.

It's very common in general we will not you know, like tell a kid not to eat peanuts just based on the brother or sibling not having not having having that allergy.

OK in the past, you know, some trend was about like testing them before but no we don't we do not advocate for that anymore.

What we will do is assess the risk.

Right.

Definitely genetically they have it.

But if this kid you could, you know, do some testing and kind of evaluate the risk and in order for try to introduce the food in a safely way.

Right.

That's what I would advice.

>> Right.

All right.

Yeah, it is it is a frightening thing for a lot of parents, especially when you have to send your child to school and you're not there to supervise all the time.

So that can be I would imagine they'd be pretty stressful.

So again, I just want to remind everybody we have the phone lines open and Dr. Chavira is here to answer any questions you may have.

I know I meet a lot of grandparents who this is kind of a new thing having a grandchild maybe their children didn't have any of these allergies but now they have grandchildren with allergies so recovery is your source for great information.

If you want to call and give a gift, ask her a question again.

She's only here until a little before eight o'clock.

>> So what would you recommend that people do as far as preparing just to be prepared wherever you go?

>> Do you always have to have medicine with you or I mean I'm just thinking you go to a restaurant.

>> Do you just I don't even know how hard I guess I've never really paid attention to if they mentioned like a menu some of the oils or things because there could be peanut oil.

You know what what do you always recommend to your patients to keep themselves safe just when they're out and about?

Yeah, of course when somebody has a food allergy I guess that's the patient that of course we have to be careful .

These patients of course have to have you know, have to be evaluated by an allergist and they have to have what we call an action plan which is you know, this patient has his medication, epinephrine and other medications like Stemmons in case they have there's two different types of reactions.

You can have a mild exposure just you like to just we're having to try but not necessarily ingested and you can manage that been an antihistamine.

But if you have a reaction then that's why you have an epinephrine that you know and the plan is should be clear enough to, you know, educate the family and a patient who went to administer the medication now if you are going out, of course we will recommend that you have to take your epinephrine with you wherever you go because we know that they are not purposely ingest the food.

>> All this is preparation for any thing that happens like that's an accident.

Right.

So when you go to restaurants we always advise our patients to try to pick his heart especially shellfish and fish and it's always something that it's mixed.

You don't know exactly what's happening in the kitchen.

So in general I recommend my patients if you're going let's say you're allergic to fish but not to shellfish or vice versa because that that can happen.

You don't have to be allergic to both of them are different.

>> Just please if you like the other food that you are not allergic to try eating at home and you cook it yourself or your family or exactly.

You don't know about the cross contamination in the restaurant and think about how busy a kitchen would be and the you know, they may not be able to avoid exactly.

Even if they tell you I always you know and once again be prepared you have your epinephrine would you if you are going out you just have to be prepared all right.

Smart idea.

We actually have a gentleman who is waiting to ask you a question.

So Steve, take it away.

>> You have a question for Dr. Navarro?

Yes.

I'd like to know about the connection between itching and primary sclerosing cholangitis.

>> OK, so this is well, this condition is not a deconditioning is sclerosing cholangitis but as a doctor of course it can bring a little bit of reference that each illness that you have in this condition is secondary to increasing some of the liver enzymes in our body so that each illness is a different way is not necessarily has to do with antihistamine what ISTOMIN So this will be a different type of patients, not necessarily an allergic patient.

>> OK, I don't know if Steve.

>> Steve are you still on the line.

Yeah.

Oh did you want to ask did you have anything else you understructure Chavira or did you need more information.

>> No I was just trying to determine whether or not there is a connection between the two conditions the skin itching and and oh yeah like I said I would definitely recommend that you get an evaluation by your primary care to determine but most of the time unless there is something else in the history you know you may have also allergies.

These type of itchiness on the skin is a for a different reason.

>> All right.

Thank you so much for calling.

I appreciate the question.

Whilst while you were answering that we did get somebody else who called in a woman named Sarah but she wanted me to ask the question for her.

>> So Dr. Chavira Sarah is asking when it comes to dust and mold is that usually when you hear about people struggling with those kinds of allergens is a healthy children or adults and then she wanted to know how you would get tested to determine that.

>> Yeah.

So of course adults and kids can be affected by mold allergy and it's quite common and definitely if you are evaluated by an allergist, part of the regular I would say is skin testing that we do in our face or that any allergies do in the office include fungal spores which we commonly called mold and yes, you you can be tested.

That allergy can be identified and treated with medications or even allergy immunotherapy which is specific to animals.

>> You know, years ago I know they used to do the testing on the back.

>> They would like draw a grid on your back then just use the different little prongs.

>> Is that how they still do it?

Yes, the tests still do it the same way.

>> What things that I can change is better minimalize like how you do break the breaks but the the basics and you know the principle of the test is the same.

Basically we expose the patients to that allergen and they immunology cells which are on the skin react to that which give us an answer very fast and is the best way in the world that we all prefer to evaluate our patients.

>> And I used to growing up I used to hear about people getting allergy shots, kids and adults, regular and I didn't know how common that was or if there are other ways besides just having shots regularly that you could manage severe allergies.

Yeah, definitely.

That's again one method that has been there many, many years but we still use it is so good you know, so solid immunotherapy and is very effective, you know, controlling symptoms.

It also resets our body in that tolerant state.

So hopefully you won't get you will not get more new allergies and it also improves an asthma and asthma isolating.

>> So it's definitely a therapy that we you know, allergy is one of our big guns and we rely on and that we used to treat daily our patients.

>> OK, interesting.

We have another person to called and wanted me to ask the question for them.

So James called and wanted to know can you grow out what you were talking about asthma?

Can you grow out of asthma like you can with some of these other food allergies you were talking about?

Yes, absolutely.

You can you can grow and it's exactly what I said.

You know, we don't know who exactly is of course you're going to grow typically the majority of kids you know that they are Weezer's when they are little and you know they will eventually grow.

Yes, there is some that will continue with the condition or some that will be worse.

But in general the majority of them will grow.

Is that you must you probably do a lot of interaction with your patients maybe over time you know as well because it's it's something that if it's an issue you're dealing with, you're going to have to I like how regular life like how regularly if you have a severe allergy do you need to go see a doctor every month or do you manage your symptoms on your own for a while or I just wonder like how much care require exactly.

>> So when you have do you suspect of allergies of course you always have your general physician you like you can be treated with medications but when that's not you know, you don't have a solution to your symptoms.

I we you know, we recommend that you are evaluated by an allergist to determine in the first place it's allergies right.

>> Which will probably be the most common cause but that that you can just say after and evaluation OK. >> All right.

And we have another person wanted me to ask the question for them so thank you for calling and he wanted to know when it comes to allergies would you recommend a nasal spray versus oral medication?

And if you let's see if you take both can you overmedicate and think about that?

>> So is there one that's better than the other the spray versus taking something orally?

>> Yeah.

So both of them are helpful.

The nasal sprays are of course our favorite said they go directly to the mucosa and they take care mostly inflammation they antihistamines may deal more with the symptoms for example runny nose or dripping so both of them have the specifics but yes, most of the time we we prescribe both of them together and if you are using it correctly as your doctor is indicating them to you, you should not have problems so that risk about overmedicating is is is minimal is is going to be basically if you don't do it following the instructions you know and I I just know a lot of people who have allergies that I had never really heard of this until recent years but a lot of them say it's not like a medicated spray but just a sailin type of like they'll say like oh if I rinse my nose out with this saline spray it just they I they tell me that it feels better or at least if they feel like they've kind of cleaned out their nose better I don't know if that's a common practice or not but so I guess yes to clarify it's good I guess it I was talking more about a nasal spray that is a steroids study but there is yes there is other ways that you can clean that or that part of the airway the nose which also helps also helps and there are other mechanisms to clean the nose and the sinuses but that will be like typically just to clear from secretions or some like sort of the breeze or anything in there which also helps in the management of allergies sort of chronic illness of the cities.

But it's not you know, it's different different than the steroids.

All right.

Well, I think a couple of minutes left so I mean we could probably squeeze in a real quick question.

Just want to let you know that if you want to call it give us a call real quickly at (969) 27 two zero.

And Dr. COVID , answer your question for you.

I was just wondering you know, I know it's hard to think about it now, but spring isn't that far away depending on I guess the what Punxsutawney Phil, Pennsylvania said we have six more weeks of winter.

Our local groundhog I think his name is Charlie.

He said that we're going to have six weeks until spring.

So either way the change of season is coming up.

What are some things that people can do if you if you suffer from springtime allergies?

A lot of people just dread it.

Are there things you can do now that would help you to maybe make make it a little easier of a transition going from winter to spring?

>> Well, just you know, if you know that you have allergies to Tripoli, which is the first one coming OK, it's the first time coming just your average medications or have a planned withdrawal of U.S. urologists around that some weeks before.

>> Yeah.

Just to make sure that you have all your prescriptions filled and I don't know if you have discussable doing something else maybe you know, considering the allergy therapy the shots generally known as shots, that's something that also you know, I will be ahead on the setting even before the season if you if you start doing shots, is it you know, there are some medications you know, I'm just thinking like for for like other specialties like a heart issue.

There's some medications where once you take it it's like you take it for the rest of your life .

But if you do the shots I mean and you don't like it or it's not working, is it a big is it a commitment you committed to do you have to stay with that or could you stop?

>> I don't know how that worked so allergy shots are a big commitment from the patient like you said and it takes time to build you know, to build you to the dose that we want you to be and to have the full effect.

So yes, it's a full commitment.

You have to be weeks, months building up and then OK and then maybe years on menos between three to five that's the recommendations.

>> So usually they are pretty good but they are not working for you.

>> Of course it is always a consideration about stopping the treatment but every time I'm going to start one of those things any of my patients like you know we said seriously we said this is your time so we need to make it worth.

>> Yeah it is it is a commitment you know.

Yeah.

When you're saying that I mean I guess if if you get to the point where it's bad enough that you just want out you're willing to do anything to get relief, I guess it's it would be an easy commitment but yeah.

>> All right.

Good stuff to know.

So we appreciate you coming on.

>> Dr. Chavira was our first time ever doing this show and I told you of your pro you did a great job.

>> Thank you so much and many thanks to all of you who called in tonight.

Great questions.

Really appreciate that.

So take care.

Have a good rest of your week.

We have another HealthLine coming up next week.

Mark Evans will be hosting that one.

They're going to be talking about cardiac rehab and therapies that are available for cardiac patients.

So it is Heart Health Month.

So join us next week, next Tuesday evening.

In the meantime, take care.

>> Have a good night.

Bye bye.