The Allergist - Oklahoma Allergy and Asthma Clinic
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The Allergist
A newsletter from the Oklahoma Allergy & Asthma Clinic Winter 2018
Cedar Pollen Strike Again Dr. Warren
Sneezing, itchy eyes, runny noses…and
it is winter? What is going on? Filley Retires
Mountain cedar is a very important tree
allergen in Oklahoma. Sometimes called
the Christmas allergy, mountain ce-
dar pollinates typically from November
through March. One cone on a mountain
cedar tree can have hundreds of thou-
sands pollen grains making it a potent
allergen. Mountain cedar pollen can
travel for hundreds of miles, and some
of the pollen detected in Oklahoma actu-
ally comes from Texas. The dry weather Mountain cedar wreaks allergy havoc
conditions can potentially contribute to each winter in Oklahoma.
making pollen-related allergies worse. help pollen from blowing into your car.
“The back and forth temperatures, cold Any way you can lessen exposure your
to warm to and warm to cold, can create pollen should be of utmost importance After more than 35 years as an allergist
the perfect atmosphere for pollination,” to your overall well being.” at OAAC, Dr. Warren Filley retired De-
said OAAC Allergist Dr. Laura Chong.” If you have dogs and cats that go out- cember 31, 2017. “It has been a great
“Here are steps you can take to keep pol- doors, they will get covered with pollen honor and privilege to serve the clinic
len out of your life and ease your symp- as well. Bathing your pets constantly is and our patients over those years. Very
toms.” probably not very realistic, at the least, enjoyable and fulfilling,” said Dr. Fil-
Starting at home, keeping windows keep pets off of your bed and out of your ley of his years at the clinic. Originally
closed will help keep pollen out. Change bedroom. from Kansas, he first came to Oklahoma
your air filters monthly on your heat- in 1976 for an Internal Medicine resi-
Using a sinus irrigation, nasal spray and
ing and cooling unit. When you’ve been dency at OUHSC. Leaving in 1979 for
antihistamines can help. If you use a si-
outside, your clothing and hair can be The Mayo Clinic to take a Fellowship in
nus irrigation, distilled water rather than
coated with pollen. Take a quick shower Allergy/Immunology Dr. Filley eventu-
tap water is recommended.
and wash your clothes to keep your liv- ally returned to Oklahoma in 1982 as a
ing areas as pollen free as possible. Wear Depending on the severity of the symp- clinic physician.
close-fitting sunglasses to protect your toms, several medications are available.
Board certified in Internal Medicine
eyes from pollen. Artificial tears eye “We recommend you visit with your phy- and Allergy/Immunology, he served the
drops can help wash the pollen out of sician or OAAC allergist to determine the clinic twice as its President and taught
eyes. No one loves to do house chores best plan of action,” said Dr. Chong. at the Oklahoma University Medical
but dusting should be left to the person If your allergies are still bothering you Center in Oklahoma City as a Clinical
who is not allergic, if possible. despite medication management, aller- Professor of Medicine. He served on
“When driving to work, keep your win- gen immunotherapy might be the next the Oklahoma Health Center Founda-
dows closed,” Dr. Chong said. “This will step. tion board of directors and is currently
President of The Robert M. Bird Soci-
“Immunotherapy or allergy shots can
Brought to you by ety/Friends of the University of Okla-
help your body build tolerance to spe-
homa Health Sciences Center (OUHSC)
cific allergens,” Dr. Chong said. “Through
Library. After retirement Dr. Filley plans
an allergy test, we can identify exactly
to continue his involvement with the
what is causing your symptoms. Allergy
university as well as pursue joint aca-
shots contain extracts of the allergen
demic research interests with the clinic.
you are allergic to help build your im-
@okallergyasthma mune system to those allergens. (continued on page 3)
Flu Epidemic Hits Oklahoma Hard
This year's flu season has become an
epidemic. Influenza is widespread
across every state except for Hawaii.
More than 22 million people have the
flu. In Oklahoma, 2,200 have been hos-
pitalized and 74 people have died. The
flu has caused schools to be closed due
to students, teachers, or a combination
of both, who are sick.
Droplets from sneezes can be found as
far as 26 feet away. The flu virus can
live on some hard surfaces for up to
24 hours. You can be contagious a day
before you even experience symptoms
and up to a week after getting sick. The
flu season typically runs from October
through May.
For those who have asthma, the flu
can be very dangerous, even if their
Flu shots (made with inactivated (killed) • Follow this plan for daily treatment
asthma is mild or their symptoms are
flu virus) are approved for use in peo- to control asthma long-term and
well-controlled by medication. This is
ple 6 months and older regardless of to handle worsening asthma, or at-
because people with asthma have swol-
whether or not they have asthma or tacks.
len and sensitive airways and influenza
other health conditions. The flu shot • If your child has asthma, make sure
can cause further inflammation of the
has a long established safety record in that his or her up-to-date written
airways and lungs. Influenza infection
people with asthma. Asthma Action Plan is on file at
in the lungs can trigger asthma attacks
and a worsening of asthma symptoms. Take everyday preventive actions to school or at the daycare center. Be
It also can lead to pneumonia and oth- stop the spread of flu: sure that the plan and medication(s)
er acute respiratory diseases. In fact, • Stay home when you are sick, ex- are easy to get to when needed.
adults and children with asthma are cept to get medical care. Stay away If you do get sick with flu symptoms,
more likely to develop pneumonia af- from other people who are sick. call your doctor early in illness because
ter getting sick with the flu than people prompt treatment is recommended for
• Cover your nose and mouth with a
who do not have asthma. people who are at high risk of serious
tissue when coughing or sneezing
Asthma is the most common medical and throw the tissue away. If you do flu complications and who have influ-
condition among children hospitalized not have a tissue, cough or sneeze enza infection or suspected influenza
with the flu and one of the more com- into your elbow or shoulder not infection.
mon medical conditions among hospi- your bare hands; Treatment should begin as soon as pos-
talized adults. sible because antiviral drug treatment
• Wash your hands often with soap
If You Have Asthma, You Need to Take and water, especially after coughing works best when started early (within
Steps to Fight the Flu or sneezing; 48 hours after symptoms start).
Everyone with asthma who is six • Avoid touching your eyes, nose, or Antiviral drugs can make your flu illness
months and older should get a flu vac- mouth (germs are spread that way); milder and make you feel better faster.
cine to protect against getting the flu. and They may also prevent serious health
Vaccines are available to OAAC patients. problems that can result from flu ill-
• Clean and disinfect frequently ness.
Vaccination is the first and most impor- touched surfaces at home, work or
tant step in protecting against influen- school, especially when someone is Oseltamivir (available as a generic ver-
za. Even if you don’t have a regular doc- ill. sion or under the trade name Tamiflu®)
tor or nurse, you can get a flu vaccine. or peramivir (trade name Rapivab®)
• Follow an updated, written Asthma are the two antiviral drugs that can be
Free flu vaccines are available through
Action Plan developed with your
county health departments. (continued on page 4)
doctor.
2
Skin Patch Testing Can Reveal The Cause
If you are experiencing a skin irrita- at the testing site.
tion that has lasted for weeks, maybe Patch testing is painless and doesn’t
even into years, you might need a involve needless of any kind. How-
skin patch test. Those itchy red little ever, a reaction could be uncomfort-
bumps can drive anyone crazy. able but usually the reaction is mild.
OAAC Allergist Dr. Greg Metz recom- A positive test could show redness,
mends a skin patch for those with swelling, bumps and can even form
a chronic rash, especially if the rash a small blister at the site where the
involves the hands and around the substance was placed. After the test-
eyes. Patch tests evaluate for a con- ing is complete, a topical steroid can
tact allergy. ” be used to soothe the itching and
A “contact allergy” is actually the rash.
immune system’s response to cer- “Common reactions are to nickel and
tain types of substances. The external fragrance,” Dr. Metz said. “The patch
stimulus causes the skin to break out test reveals what ingredients you
in a hypersensitive reaction. are reacting to and then you can be
With patch testing, a tiny droplet of armed with that knowledge.”
different substances is placed on the He added, “Just because a product
skin and covered with a patch for 48 like shampoo says hypo-allergenic, Patch testing is painless and doesn’t
hours. Before undergoing the patch doesn’t mean you won’t react to it. involve needless of any kind.
test, your allergist may ask you to re- You will need to check the ingredi-
frain from taking certain medications. ents list to know what is in each
Also, the patch will need to remain product you use.”
dry, showers, baths and excessive In the long run, Dr. Metz says testing
sweating, should be avoided during can save consumers time and money
the patch testing. After removing the instead of trying product after prod-
patches, the patient returns 1-2 days uct to see what doesn’t cause a re-
later to see if there are any reactions action.
“Treatment for allergic contact der-
“The Allergist” is published quarterly by the
matitis is avoidance and the rash is
Oklahoma Allergy & Asthma Clinic. Contents
are not intended to provide personal medical not treated with allergy shots,” said
Dr. Metz. “Patch testing is a great
advice, which should be obtained directly from
a physician. way to get more information.” Dr. Filley...
(continued from page 1)
“The Allergist” welcomes your letters,
comments or suggestions for future issues. He continues to review articles for pub-
Send to:
lication in both The Annals and JACI.
The Allergist
750 NE 13th Street Dr. Filley’s interest in horticulture runs
Oklahoma City, OK 73104-5051 deep having gardened since childhood.
Phone: 405-235-0040 Social Media Also Used for
www.oklahomaallergy.com Currently serving on the Myriad Gar-
Important Announcements dens board of directors he is a past
Oklahoma Allergy & Asthma Clinic Remember to Follow OAAC on President of the Oklahoma Horticultural
Editorial Advisory Board Facebook and Twitter Society. “Retirement will give me more
Dean A. Atkinson, M.D.
Laura K. Chong, M.D. In addition to posting pollen and time to enjoy horticulture and share it
Scott B. Dennis, MHA mold counts each day, OAAC also with my children who also have the in-
Richard T. Hatch, M.D. uses social media to post announce- terest as well as my grandchildren,” said
Bret R. Haymore, M.D.
ments or educational allergy news Dr. Filley.
Gregory M. Metz, M.D.
Patricia I. Overhulser, M.D. updates. Follow us on Facebook at He and his wife, Karen, are looking for-
Shahan A. Stutes, M.D. ward to spending more free time to-
Karen Gregory, DNP
https://www.facebook.com/oklaho-
Stefanie Rollins, APRN-CNP maallergyasthmaclinic/ and on Twit- gether doing all the things they love to
Elisa Thompson, APRN-CNP ter @ okallergyasthma do as long as they can. The staff wishes
Dr. Filley a wonderful retirement!
3
New Epinephrine Auto-Injector Available
for Infants and Children
The first and only epinephrine auto- epinephrine auto-injector in the event
injector (EAI) for infants and small chil- of an allergic emergency.”
dren weighing 16.5 to 33 pounds has Inventors of the AUVI-Q are identical
been approved by the U.S. Food and twin brothers, Evan and Eric Edwards,
Drug Administration (FDA) and is now who are both allergy patients and par-
available. AUVI-Q is a compact epineph- ents of food allergic children. Their goal
rine auto-injector with industry first was to develop an epinephrine auto-
features – a voice prompt system that injector that contained innovative fea-
guides a user with step by step instruc- tures such as a voice-instruction system
tions through the delivery process and that helps guide patients and caregivers
a needle that automatically retracts fol- step-by-step through the injection pro-
lowing administration. cess.
The new .01 mg-dose epinephrine au- “Until now, healthcare practitioners and
to-injector has a shorter needle length caregivers to infants and small children
and a lower dose of epinephrine than have not had an epinephrine auto-in-
the current FDA approved 0.15 mg and jector with an appropriate dose of epi-
0.3 mg epinephrine auto-injectors.
Children are increasingly being treated Study Reveals
for anaphylaxis. Over the last ten years, nephrine available to them, potentially
there was a 129.8 percent increase in Indoor Allergens causing some delay in the administra-
emergency room anaphylaxis among Indoor allergens are important risk fac- tion of epinephrine in a life-threatening
children four years old and younger. tors for those with asthma and respira- allergic emergency,” said Dr. Vivian Her-
According to a study published in Al- tory allergies. nandez-Trujillo, a pediatric allergist and
lergy, Asthma & Clinical Immunology, fellow of the American Academy of Al-
According to the largest and most com-
43 percent of children weighing 16.5 lergy, Asthma and Immunology, Ameri-
prehensive indoor-allergy study ever
pounds to 33 pounds treated with a can College of Allergy, Asthma and Im-
done in the United States, the 2005-
standard epinephrine needle length are munology, and the American Academy
2006 National Health and Nutritional
at risk of having the needle strike the of Pediatrics specifically designed for
Examination Survey, if you are experi-
bone. Therefore, this could potentially infants and small children should help
encing allergies when pollen is nonexis-
impact the administration of epineph- alleviate concerns around hitting the
tent, your home may be the trigger.
rine during a life-threatening emergen- bone or injecting too much epineph-
More than 90 percent of homes studied rine.”
cy. The needle length in the new AUV-Q
had more than three or more allergens
injector was specifically designed for For more information, visit the website
present. They also found that 73 per-
use with infants and small children to at https://www.auvi-q.com/getting-
cent of homes had one allergen at el-
help mitigate this safety concern. auvi-q/.
evated levels. The presence of pets and
“The approval of an epinephrine auto-
injector specifically designed for infants
pests contributed strongly to increased
allergen levels.
Flu...
(continued from page 2)
and small children is timely, especially
The most common indoor allergens used in people with asthma. People
given the recent changes to guidelines
were cat, dog (dander); cockroach, with asthma should not use zanamivir
recommending that certain high-risk
mouse, rat (dander or droppings); and (trade name Relenza®), a different anti-
infants as young as four to six months
two types of dust mites. viral drug, because there is a risk it may
old be introduced to peanut-containing
foods,” said Eleanor Garrow-Holding, The study measured dust collected from cause wheezing in people with asthma
president and CEO of the Food Al- survey participants’ bedrooms. Higher or other lung problems.
lergy & Anaphylaxis Connection Team levels of cat and dust mite allergens For you to get an antiviral drug, a doc-
(FAACT). “We are pleased that the pedi- were found in rural areas compared to tor needs to write a prescription. These
atric allergy healthcare community and urban settings. medicines fight against the flu by keep-
parents of infants and small children This report shows that residential expo- ing flu viruses from making more virus-
with life-threatening allergies will have sure to multiple allergens is common in es in your body.
the ability to obtain an FDA-approved most U.S. homes. Source: CDC
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