From: kja@cbnewsf.cb.att.com (krista.j.anderson)
Subject: Re: Severe Allergies
Organization: AT&T
Date: Fri, 11 Sep 1992 23:05:49 GMT

In article <1992Sep10.182606.3776@lambda.msfc.nasa.gov>, cfar@lambda.msfc.nasa.gov (Carol Farquhar) writes:
> This is being posted for a co-worker who suffers from asthma and 
> severe allergies.  
> 
> Her first asthma attack was at 3 weeks of age and re-occured 2 to
> 3 times a month until age 19.  Since then the frequency has decreased
> to 2 or 3 severe attacks a year.
> 
> She is allergic to:
> 
>   	cats
> 	dogs
> 	horses
> 	anything with hair
> 	strawberries
> 	milk	
> 	bacon
> 	eggs
> 	bee stings
> 	tomato sauce
> 	dilaudid
> 	penicillin (sp?)
> 	compazine
> 	codiene
> 
> and seems to acquire more allergies over the years.  She has been
> to countless specialists in Birmingham and Atlanta to no avail.
> Please post or e-mail any information that might help.  

While I sympathize with your friend's problem, there's a limit to
what modern medicine can do for allergies and allergic symptoms.
Desensitization by injection is not as effective against animal
dander as it is against other inhalants, and doesn't work at all
for food allergies. 

So, animals and hides should be avoided if possible.  There is
something called sodium cromoglycate (SCG) that is used in food
allergies to inhibit mediators (e.g. histamine, prostaglandins,
leukotrienes) from being released from mast cells.  But giving up
the foods that cause the greatest reactions is still recommended.

I can imagine the horror of developing new sensitivities; a
rotation diet is sometimes used to prevent that.  I don't know if
it works, but the premise is that by not eating a food several
times in a row, a sensitivity will not build up.  Hence, the diet
is set up so that no food is repeated for about a week.

Exploring new ethnic cuisines is suggested by some as a way to find 
new foods to which a sensitivity has not developed.

Some foods are histamine releasers and may push a person over the
edge if already suffering some degree of a reaction, although I'm
not sure if this is relevant to asthma.  The histamine releasing
foods include strawberries, egg white, shellfish, tomatoes, fish,
pork, chocolate, pineapple, papaya, and alcoholic beverages.

The effects of the histamine releasers tend to lessen with age, and
so do allergies in general and food sensitivities in particular.
However, allergies can go away and then come back at a later age,
or stay with a person for life, and sometimes new allergies can
development throughout adulthood.

For asthma, theophylline is effective.  For rhinitis and hives,
antihistimines and decongestants (catecholamines) are effective.
Some catecholamines may also help asthma since they relax the lungs
if they are beta-2-adrenergic agents.  Alpha-adrenergic agents
narrow blood vessels and are more for rhinitis, I think.  (But do
they prevent inflammation responses in general?)
Alpha only catecholamines are phenylephrine, pseudoephedrine,
phenylephedrine, and phenylpropanolamine.
Beta only catcholamines are isoproterenol, terbutaline,
and albuterol (aka salbuterol).
Alpha and beta catecholamines are epinephrine and ephedrine.

(I'm not familiar with asthma remedies/preventatives, so I can't
say too much about the above.  My daughter and I mainly take things
for rhinitis and conjunctivitis; this was her first year with
full-blown symptoms and she was thrilled to be diagnosed with
allergies just like mom and dad.  1/2 :-)  1/2 :-( )

For bee stings, there is a kit with an injection of epinephrine
that will prevent anaphylactic shock.  Apparently bees and wasps
have different venum, and the bee venum is worse.  Injections
against bee and/or wasp stings is effective now that pure venum is
available.

Certain other factors may aggravate some allergic symptoms,
especially asthma.  These include cold air, changes in temperature,
changes in barametric pressure, changes in the endocrine system,
smoke, fumes and exercise.  The role of stress is subject to
debate; it probably aggravates some asthma (possibly other symptoms?)

For women, there are obvious monthly changes in the endocrine
system; the pill or other estrogen may keep things a little more
level.  I choose to take it for my comfort; others may not.

Finally, one note on the allergies to medicines is for your friend
to tell her doctors about them, of course, but also to check with
the pharmacist whenever she gets a prescription.  That way she gets
2 chances to avoid becoming a horror story.  Allergy to penicillin
is the most common cause of anaphylactic shock.