Speaker 1 0:03

Welcome to the healthy matters podcast with Dr. David Hilton, primary care physician and acute care hospitalist at Hennepin healthcare in downtown Minneapolis, where we cover the latest in health healthcare, and what matters to you. And now here's your host, Dr. David Hilton.

Speaker 2 0:20

Hey Dr. Hilton here, pollen cats, dust mites, peanuts. What do these all have in common today? On episode 12 of the healthy matters podcast, we're gonna talk about allergies and to help us out. I've brought an old friend and colleague Dr. John Sweet, who is an allergist at Henne healthcare. John, welcome to the show. Glad to be here. Good to have you start us off. Why do we have allergies?

Speaker 3 0:44

Good question. Well, not all of us

Speaker 2 0:46

To keep you in, in, in work. Is that why we haven't?

Speaker 3 0:48

<laugh> it, uh, it's, it's a never ending supply of patients these days, but it's not. Everyone does not everyone. Everyone thinks, oh, everyone's allergic to something that's not true anywhere. It's about anywhere between 10 to 30% of people have it. Depending what age group you belong to. So not everyone has'em, but if you do, you know, it's one of those things that it can manifest in different ways or show up. You can have allergic rhinitis, allergic conjunctivitis, meaning itchy water eyes, just in the nose. You can have food allergies. You can have, uh, eczema, atopic dermatitis, a asthma allergies can affect people in a whole bunch of different ways. But the most common way, when people say they have allergies, they usually mean the nose and they have stuffy nose, nasal congestion. Post-nasal drip. That sort of thing

Speaker 2 1:31

Is, is it your immune system isn't working well enough or what's going on?

Speaker 3 1:34

It's working too well.

Speaker 2 1:35

It's working too well.

Speaker 3 1:36

It's uh, I, as I often say to my patients, you, you got a very healthy, well nourished immune system. That's bored. It's looking for something to do they,

Speaker 2 1:44

Okay. So it's overactive

Speaker 3 1:46

Overactive it's, it's, it's reacting to things that should ignore. And I explain to them like you have friends without allergies, they're exposed to the exact same thing. You are, their body sees it and ignores it. They see tree pollen, they see grass pollen. They see pet dander. Nothing happens to them, but you, my patient, unfortunately your immune system sees it as a threat and it's trying to get rid of it. So think of that sneeze, that postnasal drip, that drainage as a way of your body, trying to get it out instead of ignoring it, it's trying to remove it. And that, that leads to a lot of symptoms that it can be pretty uncomfortable.

Speaker 2 2:18

I'm allergic to a variety of things, dust mites, and molds, and Lord knows what else I'm, I'm allergic to. Yeah. I seem to know quite a few people who this time of year it is may when we're recording this episode, this time of year, things are getting worse. If people are getting worse in may with seasonal things, what are they reacting to? Why springtime? Right.

Speaker 3 2:36

Well, here in the upper Midwest, it's been a slow thaw. And I admittedly a lot of the pollen counts aren't as high as they typically are and previous years, but when the first snow melt, usually in the upper Midwest, it's gonna be mid-February mid-March, you're gonna start getting the molds released from the, from the ground or snow mold. That's a commonly caused those, get picked up into the air and people start looking around. There's nothing green outside, but they're starting to get that runny nose every time they're outdoors or that, uh, itchy eyes and such. When you start seeing the first changes in the trees, those little buds on the trees, you start seeing tree pollens will start coming out here. We got Ash Birch, uh, pollen is, is on definitely on the rise. Yeah, that,

Speaker 2 3:15

That would be, uh, I can see it on, on the, the trees out in our front yard. They got little teeny buds. So does that mean that allergies come earlier in, you know, in other parts of the country? So we have listeners all over the place. I have, I have listener friends in West Virginia and in the south of the United and the Southwest, I suppose it varies then absolutely

Speaker 3 3:32

For them, seasonal allergies are year round down in the south in Texas, have up Cedar fever and Cedar fever, Cedar fever, Cedar pollen is gonna be raging at that point. You know, grass, pollens and weed pollens will never go away. And it says ebbs and flows, at least in the Northern climate at, for now, we have frost that kills off everything that

Speaker 2 3:52

Nothing survives in Minnesota for six months of the year, except the people. But that's cuz we kind of hibernate<laugh> so the molds and the pollens and all that, they're literally just frozen to death and that's what happens

Speaker 3 4:03

Vast majority. But then people ask, well, as an allergies, what do you got to do in the wintertime? He said that's indoor allergy season with all those heat systems, um, moving dust and pet dander through the air. Or if you have other contaminants in the home or allergens can cause a lot of symptoms during the winter season as

Speaker 2 4:18

Well. Yeah. I, one time went to your office. I think it was your office, your clinic office. You had a poster on the wall of like an allergy friendly bedroom. And I gotta tell you, John, I love you and everything, but that bedroom looked like a pretty sterile office. It had, you know, it didn't have any, any like coziness. I

Speaker 3 4:34

Often say you want your bedroom to look like it came from Ikea.

Speaker 2 4:36

Oh God

Speaker 3 4:37

Hard angular services, nothing soft in there except maybe a pillow.

Speaker 2 4:41

Oh, come on. Yeah.

Speaker 3 4:43

It's hard. Don't

Speaker 2 4:44

I bet you're real popular with your patients. Okay. Here's what you have to do. You have to get rid of your pillows and your blankets and your curtains and your carpets and everything. Is that what you have to do?

Speaker 3 4:51

Well, you know, I say that a lot of patients already know that they already know to take the carpet outta the bedroom. They already know to not have things in the bedroom that serve as an allergen magnet where the dander or dust mites can accrue quite easily. But even though, even with that, those they'll still have symptoms because they're just things you can't escape. Like dust mites, you know, dust mites are microscopic. Can't see'em with a naked eye, but one dust mite, uh, lays 200 eggs in three months. Okay? And you're are, if you have that allergy, you're allergic to the living ones, the dead ones and all their waste.

Speaker 2 5:23

This is kind of gruesome. It is it's gross. So the dust mites are in our homes

Speaker 3 5:28

Just about everywhere. You can find them and they, they eat our dead skin. They thrive in the micro climate of our bed where there's enough humidity from our perspiration and such. We give'em food, we give'em water and in a perfect temperature and they just thrive in our bedding. Wow. And so you can get rid of'em, but you can't get rid of the eggs, eggs remain. They're very sticky. They keep growing. And so that can cause a lot of symptoms throughout the, uh, every night during sleep, you wake up, gotta blow your nose. Every morning, patients are sometimes surprised. Like doesn't everyone do that? It's like, no,<laugh> no, that is not a, a common thing for people to have. Uh, unless you have allergies,

Speaker 2 6:00

What do you recommend people do when they're experiencing their, their inevitable annual allergy symptoms? Yeah.

Speaker 3 6:08

Good question. The, uh, the whole is if you know, you have allergies and you know that spring is your season, you know, the thing is to get ahead of it. All the allergy, me medications, you can get over the counter best work preventively. They don't work as well. If you already have the symptoms. But if you know your pollen season is coming, start your antihistamine, start your steroid nasal spray a week or two before the onset of your symptoms. And you're end up having fewer symptoms or, or less severe symptoms if you do. And the other thing, if you know, you have an allergen trigger, you know, you're allergic at pollen, that pollen you're allergic to the air. I tell my patients seriously,

Speaker 2 6:41

You can't avoid that. Can you? Yeah. Well,

Speaker 3 6:43

If you have to go out and who doesn't wanna go out when you got, uh,

Speaker 2 6:46

Beautiful spring day and a lot of us need to breathe, John.

Speaker 3 6:49

Yeah.<laugh> absolutely go outside. But your hair acts like a giant pollen collector, you know, wear a hat. And if you come in, you know, take a shower before you go bed at night, two minute rinse, get that pollen off you.

Speaker 2 7:00

Okay? Say that again. Your hair is a giant. It's like a big net. It's a

Speaker 3 7:04

Big net. That pollen is sticky. It sticks to you, sticks to your face, sticks to your, your hair. Get that off you before you go to sleep at night. If you know you have outdoor allergens, don't bring it in the house.

Speaker 2 7:13

I haven't thought about that. You know, you're literally out there collecting pollen on your hair. And then what you do is you go lie in your pillow.

Speaker 3 7:19

Yeah. Just think about that. You come out. If you park your car outside, you come outside and it's coated with pollen from the tree. That's that's on you too when you're outside. So you don't want that indoor. Great

Speaker 2 7:27

Tip. Wash your hair. When you come back inside, don't get it all over your house. Or you could, uh, wear a B font hair net there. That works too. That, that I'd look

Speaker 3 7:35

Good in that. And cut down on the Aquanet.

Speaker 2 7:37

<laugh> I cut down. Exactly. Exactly. Or maybe embrace your hair loss.

Speaker 3 7:42

<laugh> exactly. Yeah.

Speaker 2 7:44

Don't be so worried guys. You're losing your hair. What you're doing is you're losing pollen. Collectors.

Speaker 3 7:49

Yeah. You're losing pollen count gaining face. Okay,

Speaker 2 7:53

Good. Perfect. Perfect. Okay. So that's one good tip. Yeah, but it is hard. I, I get it. You know, there pollen's floating around and for much of the year, and like you said, in the south of, of the country for the entirety of the year, it's hard to avoid it entirely. Mm-hmm<affirmative> and you got your windows open. It's probably blowing in your windows.

Speaker 3 8:08

Yeah. That's and even though it could be tempting, you know, you get nice spring weather, open the windows, tell my patients, you know, keep the windows closed. And if you half open the windows, you must have put a fan in the window, but blowing outwards don't don't bring the cool air and the pollen in exhaust the warm air outta your

Speaker 2 8:25

House. Another good tip. And you said, get ahead of it with your medications. Mm-hmm<affirmative> what, what if, what do you do if you just, is there anything you can do once you're sneezing and itching and it's just all hell broke

Speaker 3 8:34

Loose. You know that that's when it get stuff, if your allergies are so strong and that you're using, I say, think of your allergies as a fire. And you're that medicine is like barely affecting. As you're putting a cup of water on a bonfire, it's not gonna work. That's when you, you consider getting assessed, you know, figure out what's causing this. Cuz there are a lot of effective treatments besides the overcoming medications that can do this first IO say to conquer your enemy, you gotta first gotta know your enemy. And if you know what you're allergic to, we can help avoid for that. But then there's, if the medicines aren't helping or if your goal is to have reduce your medicine that you need, and sometimes even get you off. Often we, we offer allergy shots or desensitization and, and the word shot is often people can be apprehensive, particularly in children. They don't like the idea of getting an injection and a needle, but the needles are very small. The size, my pinky fingernail, they just go under the skin if we need to. And the whole idea is that we've already established that immune system is overreacting to something should ignore. This is way of training the immune system to ignore what you're allergic to

Speaker 2 9:33

For that's what allergy shots

Speaker 3 9:33

Are doing. Exactly. Yes. We take all the things we know you're allergic to purify them, to loop them down to a level or water them down to level so low. You better can barely perceive what they are. We introduce'em to the body and uh, and we watch it and make sure you have no reaction or adverse response. Great. You go. And every time you come back to the clinic, we slowly increase the dose slowly, build up the dose on the inside, uh, of your body, build up your tolerance. And we build up the dose that to a high enough level that should be effective in decreasing your, your body's response. Teaching your immune system, not, uh, respond to these things when you're exposed to them and they can be quite effective, very effective and in reducing symptoms. So you don't need as much medications, very possibly no medications.

Speaker 2 10:15

I can vouch for that. I know many, many, many people who have come to your clinic to get their immunotherapy shots for allergies. And they're it's life. It's life changing for the better for them. They, they don't react to stuff as much. It's so that's an interesting way, but you're teaching your body to ignore these things that it was formerly pretty angry about.

Speaker 3 10:32

Yeah. I've been through allergy shots and that's what I, I can preach what I, what I've lived. There can be great reward from it so much can get better. If you treat your allergies, it's less fatigue, less sprain fog that you have fewer allergi allergy symptoms. Obviously patients tell me less frequent headaches. Some patients tell me that they have less frequent migraines that they used to have me chronically weekly or monthly benefits can be enormous. It helps with asthma. It can help people with eczema. It can be life changer for a lot of folks.

Speaker 2 11:00

I wanna revisit what you said a few minutes ago. You said in order to conquer your enemy, you have to know your enemy mm-hmm<affirmative>. So that gets down to skin testing or how, or, or explain for us, how do you find out what I'm allergic to? I'm your patient? There's zillion things floating around there. And I got cats. I got dogs. I got, you know, how do you find out? Well,

Speaker 3 11:18

First, you know, try to get a good history, you know, and try to understand how do allergies affect you. And I'm when do you have the symptoms? Are the symptoms present in the morning? Uh, uh, throughout the year. Okay. That suggests to me. Okay. There might be something inside the house. Okay. Do you have pets? Do you have an apartment that unfortunately may have cockroaches coming in from the neighbor or you have problems with mice? Do you have a damp basement? Is your bedroom in the basement where the moisture level tends to be high and dust might thrive? Okay. All these things can help me triangulate around what possibly could be, uh, affecting you. Some people that are house cleaners, uh, or domestic cleaners in, in hotels, enormous dust might exposures, you know? And so they, and that they're allergic to their job and they they're exposed to dust all day long and then vacuuming and changing bedding and so forth. So all these things help me figure out what you're allergic to. And so that helps me focus on what we should try to explore. Do we have animal and such molds trees, grasses, weeds. Do you travel to the Southwest? And you're uh, are you a snowbird? Are you symptom free when you're there, but you come back home and things get worse. That helps me figure things out.

Speaker 2 12:24

So that FA that history of when it's really bad, um, kind of narrows down what you actually have to test for mm-hmm<affirmative>. So I walk into your clinic and you do testing, you do skin testing or pinprick testing or whatever. That sounds a little bit ISY for, for people. What is it? Yeah,

Speaker 3 12:39

Very, very, very easy. And, and it's often I have the, um, uh, people quite apprehensive or fearful of it, but, you know, I have toddlers who do it without a single tier. And so really?

Speaker 2 12:50

Yeah. So I

Speaker 3 12:50

Try to reassure'em that this can

Speaker 2 12:51

Be, I think, I think I made it through with it with just one or two tears.

Speaker 3 12:55

<laugh> I, I saw you biting your lip there.

Speaker 2 12:57

<laugh>

Speaker 3 12:58

Yeah, it's a tiny, tiny scratch. And I say there, these tests can be done without any shedding of blood at all. It's a quick scratch of the skin, uh, where we take the, the allergen at a certain concentration that, and wait, we see, does your body have a allergic response? Does it have an urticarial reaction on the skin? What's aria? I'm sorry. Yeah. Like a hive, like reaction, like I, a little mosquito bite and we, we wait 15 minutes, we take a measurement. Did your body respond, uh, in a significant level? And so that helps me figure out what can be contributing to your symptoms.

Speaker 2 13:27

Where do you do it? What part of the body you do it like right in the forehead.

Speaker 3 13:30

<laugh> that would be

Speaker 2 13:32

Something I know you don't. Yeah.

Speaker 3 13:34

Yeah. The back, uh, tends to be a great place to do. It's a nice, even lot of real estate, we say a lot of flat area. We can do it. Some we'll do it on the arms. Sometimes the forearms, depending where at some patients come in with a lot of ink, we'll say a lot of

Speaker 2 13:46

Tattoos, a lot of tattoos. Oh, that would make it harder. Yeah. We

Speaker 3 13:49

Gotta, we gotta be selective where we choose. Yeah. We gotta be selective sometimes, but yeah, we can usually figure it out.

Speaker 2 13:54

What are, what are people most allergic to?

Speaker 3 13:56

I would say, uh, easily indoors or dust mites, dust mites. We're talking because that's the one thing you can't escape unless you live on a tippy top of a mountain or where that's super dry, there's no humidity. Uh, you're gonna be exposed to dust mites just about everywhere you go. And so that would probably the number one allergen, if you haven't and now it's not, I'm not saying you're allergic to dust. Anyone can sneeze when they're onto dust, but having dust mites that alle, that would be,

Speaker 2 14:21

Um, so it's the, I mean, not to get too gruesome here, but it's the critter that, that you are allergic to. The little thing that under microscope looks like a little monster.

Speaker 3 14:29

Yeah. They're they're descendants of spiders and rack it. Yeah. Dust might themselves as well as, uh, their fecal pellets and they just so you know, interesting fact, they poop about 40 times a day.

Speaker 2 14:40

Yeah. Great. Yeah. So every single person listening to this podcast is looking for their vacuum cleaner, right about now

Speaker 3 14:46

Vacuum cleaner with a HEPA

Speaker 2 14:48

Filter. I hope. Oh, it has to have a HEPA filter. Yeah.

Speaker 3 14:50

Otherwise you're just it up and passing it right through the back.

Speaker 2 14:52

So this is a plug for cleaning your house, but in, in all seriousness does cleaning your house help or are they coming right back? You can, you gotta

Speaker 3 14:59

Re you can reduce them, but you gotta be consistent about it. Okay. The, these things, the, the, the allergen, and at least in the dust might is about three microns wide. Okay. That's one 30th of the width of a hair follicle. And so it's tiny, tiny, tiny. So allergen covers that are woven so tightly that the dust might can't get through or pet. Those are ideal cover up the mattress, cover up the pillows. And I tell my patients anything above those allergen covers wash. You gotta wash. And if you can't wash something, put in the dryer and high heat, uh, kill the dust mite with a high heat. But unfortunately you're not gonna kill the eggs very

Speaker 2 15:33

Well. Right. Very specific question. How often should you launder your linens, your bed, linens your towels?

Speaker 3 15:40

The rule of thumb is once a week, but I say you, if you, if you have a dust, my use your nose as a barometer. If you're waking up in the morning with congestion, that feels like your allergies, that's assigned to do your, uh, do your

Speaker 2 15:51

Wash, do your laundry. Yeah.

Speaker 3 15:53

Oh, that's a good tip. I used to have a terrible dust. My allergy before I did my, uh, allergy shots. And I know exactly what that feels like deep, clean, wake up breathing. Well,

Speaker 2 16:01

Next day is a little bit better.

Speaker 3 16:03

Yeah. And then 3, 5, 7 days, depending how sensitive you are, symptoms can be back. That's how often should be tackling the begging.

Speaker 2 16:10

Julie and I, Julie, my wife, Julie, that you know, well, I've had a conversation about the ceiling fan in our bedroom. Yeah. Now mm-hmm,<affirmative>, we're, we're not slobs, but we're also not. Our bedroom does not look like an Ikea showroom. There's, there's a rug and there's linens in there and there's a ceiling fan. I maintain that. That's like blowing all the junk all over the room when you are running a ceiling fan at night, and my allergies are thus worse. And that's why I'm like all sniffly at nighttime. She doesn't think it's a ceiling fan thoughts,

Speaker 3 16:38

Dave, I'm gonna side with you. Okay. Thank

Speaker 2 16:41

You. You're

Speaker 3 16:42

Happy you

Speaker 2 16:42

Are. She won't be happy.

Speaker 3 16:44

You, you can be stirring up, uh, the dust. Right. But if that's case, um, one, I think get a HEPA filter in, in the bedroom. Suck that dust outta air. So it doesn't go into,

Speaker 2 16:53

I don't even know what a HEPA filter looks like. Is it, you know, a little thing you put on the side of the room, what are you talking about? Room,

Speaker 3 16:58

Air cleaner. That's gonna filter the air that want to get one that's large enough for the cubic feet or the size of your room that can reci at the air, you know, three, five times an hour to pull that dust out. Uh, so it's not landing on you or into your bedding. All

Speaker 2 17:12

Right. Okay. It's a

Speaker 3 17:13

Good tip. You spend a third of your day, a third of your life of sleep. You know, I think that deserves a

Speaker 2 17:17

Little attention. All right. All right. Okay. Well, we're talking to Dr. John Sweet, an allergist at Hennepin healthcare with me. And when we come back from a short break, I wanna talk to you about pets and allergies. Stay with us.

Speaker 1 17:29

You're listening to the healthy matters podcast with Dr. David Hilton, have a question or a comment for the doctor become a part of our show by reaching out to us@healthymattersathcmed.org. Or give us a call at six one two eight seven three talk that's 6 1 2 8 7 3 8 2 5 5.

Speaker 3 17:50

And now let's get back to more healthy

Speaker 2 17:51

Conversation. Hey, we're back. I'm talking with Dr. John Sweet allergist at henna put healthcare pets. John, a lot of people are allergic to dogs and cats and all that. And, uh, what's to be done about that. What if you're allergic to your own cat?

Speaker 3 18:09

Ah, yes. The patients will come to me with complaints of chronic symptoms and you know, immediately I said, I tell'em I gonna test them for their cat or cats or dog or dogs a lot. And they, uh, they immediately they're back stiffens a little bit. I'm not getting anything my pet. And I said,

Speaker 2 18:25

They're not getting rid

Speaker 3 18:26

Of Fido. No, never.

Speaker 2 18:29

Have you ever had to do that? Have you ever to tell, tell patient, okay. I did skin testing. You're allergic to Fido

Speaker 3 18:33

It's<laugh> in my early career. I told the mother that yes, the child was literally catch. She said, okay, I'm taking out back this afternoon.

Speaker 2 18:44

The dad

Speaker 3 18:45

<laugh>,

Speaker 2 18:47

The mother really was gonna say, okay, I'm I'm gonna take care of this animal. And

Speaker 3 18:50

I was, I was harp I'm, I'm an animal lover. I could have been a vet. I mean, I never ever advocat to get rid of pet because rarely it is just the pet. If you have an allergy to pet, you usually have allergies to other things also, which require medications, which require certain changes at home. So I try to work around that. Okay. So the, the old way of saying was that you gotta get rid of the pet and that never happened is I I've said that before. They they'll get rid of the allergist before they get rid of the pet.

Speaker 2 19:20

Seriously. Yeah. They're gonna get rid of you. It

Speaker 3 19:22

Won't, it never works. You try to, even the negotiation, don't let the pet into your bedroom where you're, you're sleeping. That rarely happens, you know, so aggressive, all abatement, reducing the allergen as best you can, you know? And then, well, can't, I wash my pet and well, it works for about three days, you know? Yeah. And so then the dander comes back to level to affect you

Speaker 2 19:43

Are some pets, less allergenic are some, you breeds,

Speaker 3 19:47

Uh, first question. Yes. Not by breed,

Speaker 2 19:49

Not by breed. Oh,

Speaker 3 19:51

You've never been proven that this, uh, labradoodle, this poodle, this bean is, uh, a breed is less allergen on and it's extremely controversial cuz it's out there and then people believe it and they say, yeah, if

Speaker 2 20:02

You're allergic to your lab, then go ahead and get a poodle and you're gonna be better. That's not a thing.

Speaker 3 20:06

No, not the case at all. None. It's not proven are some individual, uh, pets, less allergen than others. Absolutely. Are, is there there's new genetically engineered cat that is less allergenic than yeah. That you, yeah, that, that exists, but not in general. Um, uh, availability to most folks. And so yes, individual pets, heart, well, patients will often tell me, well, not my pet, but when I go to my friend's house, but the, with a, with the same cat or dog, I reacted them. And I said, well, hold on, let's back up on the symptoms you told me, you told me you have chronic nasal congestion, chronic post nasal drainage. And you, you have that throughout the year. Okay. And so I often explain to'em there are two stages to an allergic reaction. There's the immediate, there's the delayed, the immediate everyone can identify. It looks like every antihistamine commercial we ever see itch sneeze, watery eyes. Okay. That's what happens when, uh, in the immune response, when first encounters, uh, a novel allergen, then there's the delayed response. That's about an hour or two later. That's the inflammatory response. That's the, the sinus congestion, the pressure, the slow drainage down the throat, the chronic eczema, let's say that's the delayed allergic response. That's about an hour or two later. And it can last up to a, a day or even more when you live with something you're allergic to that immediate response diminishes, that goes way low. You don't itch and sneeze anymore, but you have the chronic symptoms, the pressure and congestion. And so a good example, again, back to our friendly dust mite, you're crawling to beds with millions of dust mites every, every night. If, if you have that allergy, you don't itch and sneeze, but you wake up congested every morning. Mm-hmm<affirmative> that you have the delayed allergic spine. Mm-hmm<affirmative> same thing with your pet. If you are allergic to it, that contributes to the symptoms. So the whole idea is yes, the pets can cause the symptoms. Yeah. We can treat that. Allergy desensitization can be marvelously effective. Unfortunately, the patients start feeling so good.<laugh> in my practice. They often add a second or third pet after,

Speaker 2 22:04

After the looking better sore, like adding on more fuel to the fire, if you will. Yeah. A

Speaker 3 22:09

Couple physicians who have done that. And then they say, you, they tell me their shots stopped working. I said, okay.<laugh>

Speaker 2 22:16

But you became a dog breeder. In the meantime,

Speaker 3 22:19

You took care of my cirrhosis of the liver, but I drank more. And it's your

Speaker 2 22:23

<laugh>. Yeah, exactly. So my that's a good way to put it. That's a way you're gonna a good way

Speaker 3 22:26

To put it. Yeah. But no, we can out and handle all

Speaker 2 22:29

That. Okay. Sounds good. So you don't have to get rid of, uh, your, your cat and get fish necessarily. Right. But you might have to manage it. Right. I say get fish because I bet people aren't as quite allergic to fish.

Speaker 3 22:40

<laugh> only if they eat'em I guess

Speaker 2 22:42

Only if they eat'em. Yeah. Before we close off, I gotta ask you a question that I get from patients and listeners a lot. Um, it's about peanut allergies. Mm-hmm<affirmative> and so many people. I mean, for, I, I remember when, like, I think it was Delta airlines, which is based in Georgia, which is like the peanut capital of the world was the only airline still giving peanuts because we were so worried about people with allergies. In other words, it was pretty prevalent. People were really worried about peanut allergies. I remember you telling me not too long ago that what should parents of kids do babies do to prevent peanut allergies? Good. Is there a thing they can do?

Speaker 3 23:16

Absolutely. Now there are, there are risk factors for developing a food allergy, particularly peanut. They have found that children at with moderate to severe eczema, uh, meaning red scaly skin during infancy at, um, are at risk for it or children that have known egg allergy that causes highs or anaphylaxis or strong allergic reactions. Those children have higher risk for having peanut allergy. We know that and the fascinating study based on incidental observation of in Israel, it was very common for infants to receive a snack called Baba snack. It's like Baba, Baba, B a M B a. And it's very common culturally to feed the children, infants. This it's like this peanut flavored, uh, Cheeto. It's a peanut puff. And it was very common to give that then. And they realized in the Israeli children population, the rate of penology was much lower than the same sort of genetic comparison population they had in Britain. And they said, could it possibly be that they're actually inducing tolerance at an early age for these high risk patients? And sure enough, there was a study called leap learning early about peanut and could introducing peanut, uh, early in life actually build a tolerance to peanut, make it less likely for a child to be diagnosed with peanut alga. And sure enough, they found by feeding about six grams of peanut. That's about several teaspoons of peanut butter over a week's time consistently starting to any age from anywhere six months to 11 months, if both children, these high risk children were fed peanut at age five, they're 80% less chance of having a peanut alga versus the children. When in our way of doing things in the early two thousands before it was restrict,

Speaker 2 25:01

Avoid, avoid, avoid,

Speaker 3 25:02

Keep it away from the kid. That way they can't develop an allergy. Actually they were inducing algae. They were hiding the food from the immune system. So it couldn't develop a tolerance to it. And so, yeah, so actually feeding the, these high risk children, peanut at a very early age can do it. And they, the, the theory is it can work well possibly with other foods. We just haven't figured out the right dose or the right form that it should work for others, but you can see it. Now you get these prepackaged forms of like, of, of egg and wheat and peanut protein tree up protein, uh, to feed these kids in infas with the goal of trying to train the immune system early on that these are benign things. Don't react.

Speaker 2 25:38

That's fascinating, you know, don't, don't, you know, don't restrict it from your immune system, introduce it, but at safe doses. So what do you tell a parent, a new mom, a new dad of a, okay. They're kids starting to get into solid foods. They're six months old. They're 10 months old. Yeah. How do they do that? Can't like open a can of peanut butter and say, here you go,

Speaker 3 25:57

Right? Yeah. There's a choking hazard. Exactly. Uh there's there is the, the peanut flavored cereal. There is the, the, uh, the peanut puff snacks that we talked about or dissolving the peanut butter into the, into their food, stirring it in, mixing it in introducing the small waste. And I've got in, this is kind of out there. I have parents do it already. Unfortunately it works 80% of the time. I still have parents who are very aggressive, very thoughtful about these things. They try to do it, but the kid end up having allergic reactions to this very preventive treatment. And that's unfortunately the way it works, sometimes the genie is outta the bottle. Yeah. The kid's been dealt a genetic hand. That's just prone to develop this. Yeah.

Speaker 2 26:36

On a related note, should kids eat dirt?

Speaker 3 26:39

<laugh> yes. Yeah. The hygiene hypothesis. Yeah. Uh, let them eat dirt. And the whole idea is the hygiene hypothesis is, are we living in two cleaner environment? Is the body missing the chance for, uh, uh, learning what the natural world is? Is it too often? Use of, of antibiotics is actually vaccination. I am pro vaccination, sorry, anyone out there, but it's, it's a good thing. But could that possibly be in our Western society that we're actually preventing some common infections that help strengthen the immune system to target the right things? Mm-hmm<affirmative> is that, uh, cesarean births that is associated with increased risk of allergic disease, cuz you're not getting

Speaker 2 27:20

Crean birth.

Speaker 3 27:21

Interesting. Yeah. Uh, because you're not getting colonized, uh, with right bacteria. You're bypassing that. Yep. Yep. And

Speaker 2 27:27

So the birth canal. Yeah.

Speaker 3 27:27

Birth canal. And so all these things are, are risks, right? Again, with the genetic tendency, if you got, uh, both parents have allergy about 80% chance. Well, me allergy in some form, never not saying the severity, but of some form, one parent has, can be 40% chance approximately, but we tend to see that perhaps more later in life and to the question of algae, start later in life. We often see that in my own history, like people coming to me in their thirties, their forties, fifties. Why now it's I asked one of your parents have sinus problems, warrior parents clearing their throat all the time. Folks. Yeah.

Speaker 2 28:00

Well, we've been talking to Dr. John Sweet all just at Hennepin healthcare, a long time friend and colleague of mine. Um, John, do you have time for a couple questions from listeners?

Speaker 3 28:08

Absolutely.

Speaker 1 28:09

Okay. Tina from Ellie, Minnesota says, I can't remember where, but I once heard sore muscles could be attributed to allergies. Is that true? And what are some of the more rare manifestations of allergies that you've seen?

Speaker 3 28:22

All right. That's a good question. I, I wouldn't say directly sore muscles, but absolutely fatigue. Fatigue is a huge factor that patients will complain about a difficulty concentrating children's test scores. And during peak pollen season event, uh, with allergies tend to go down muscle aches. I wouldn't be able to say directly that's the case, but definitely feeling achy, feeling, run down cuz your immune system is inflamed. Your immune system is trying to fight off the world. And so yeah, people can feel run down. What about

Speaker 2 28:51

That brain? You've talked about concentration. I've had people say that when their allergies were treated, they felt sharper, you know, is there, is there like a brain fog or a concentration issue or are they just, are they indirectly

Speaker 3 29:02

Related? Allergies can affect quality of sleep. Absolutely. Um, taking over counter antihistamines can be sedating. You take away those things and definitely that can improve concentration, but also too, people just feel miserable and it's hard to focus when you're, uh, when you're you feel well when you got allergies.

Speaker 2 29:18

Thanks for that question. Tina

Speaker 1 29:20

And Jeff in Chicago was wondering, is there anything to be particularly concerned about if you decide just to take over the counter treatments for your allergies?

Speaker 3 29:28

Good question. Uh, over the counter medications, the antihistamines, the, the second generation antihistamine like Satine, Zac Veo, Allegra Orine Claratin, those things are relatively safe. The first generation antihistamine are, have a stronger anticholinergic effect like Benadryl and such are chlorpheniramine and

Speaker 2 29:47

They knock

Speaker 3 29:47

You out. They knock you out and there's a question, do they, or do not have increased the risk for, uh, dementia in elderly really after prolonged use it's it's questionable, but the questions being raised. And so we'll often find that if you get by with a, a single dose of the second generation of antihistamines and well controlled, great, or using stir nasal spray or using nasal lavages, those can be very effective. But if you find that you're, um, cheating and up dosing, as we say, uh, chasing your symptoms with higher and higher amounts or using, uh, large amounts of, uh, decon oral decongestants, increased risk for, uh, high blood pressure, insomnia and such or increased anxiety, all these things can be signed. Like your allergies are getting outta control and it's it's worth getting assessed and you know, talking about treatment options

Speaker 1 30:36

And my own question, Netty pots, good, bad. What's the word on those

Speaker 3 30:41

Netty pots done correctly? Uh, absolutely can help. You're helping your body wash out the allergen, wash out those, um, perhaps thick secretions outta your sinuses, uh, that can definitely improve.

Speaker 2 30:52

I've done a Netty pot. It's like a radiator flush for your nose, but you feel like an idiot doing

Speaker 3 30:57

It. Yeah. You know, do it over sink, do it in the shower, you know, get that allergen out. I often advocate that if you're spending the afternoon or evening outside, get that allergen out, but it can help. The whole idea is if you gotta have the right concentration of the salt, you don't want it to burn too much. People will do it with just playing tap water, which is the wrong thing to do because why,

Speaker 2 31:17

Why? Okay. Guilty.

Speaker 3 31:19

Okay. One that's not it's uh, it's not isotonic. So you're gonna, it is gonna feel burn. It's not at the same. No,

Speaker 2 31:24

But I, I take tap water from good old Mississippi river water out of the Minneapolis tap. And then I put a little, the salt packet in there and I stick the genie bottle in my nose. Okay. Okay. You're laughing at me. Am I not, am I not doing it correctly?

Speaker 3 31:38

<laugh> I cannot endorse that.<laugh> uh, in that, uh,

Speaker 2 31:42

There, there is. Uh, and you've been a pain in the neck for 25 years. John I'm telling you<laugh>

Speaker 3 31:47

There is, uh, there is the rare, uh, chance of, of that water could be unfiltered to the point where it has a meas in it and you could get a severe, uh, um, infection. I've heard

Speaker 2 32:00

That

Speaker 3 32:00

Actually. Yeah. Within 24 hours it could be life 30. So for that rare chance, you're having unfiltered water that has possibly contaminated. We say don't uh, just filter water, bottled water, um, distilled

Speaker 2 32:12

Or filtered, all that kinda stuff.

Speaker 3 32:13

Okay. Yeah. That's ideal.

Speaker 2 32:14

But so the point is that it literally just kinda washes the allergens, the pollen and the stuff that's sitting inside your nasal passages to just washes it

Speaker 3 32:21

Out. Yeah. And the hard part is to get people to do it. I mean, people, they absolutely refuse. They, they, I, I think it's great if you can do it right. You can tolerate it and you can be very effective, but uh, there's some people just don't find it comfortable.

Speaker 2 32:34

Okay, good tip. Do it the correct way would do it safely. Don't do it like I do. And I won't do it that way anymore. And

Speaker 3 32:40

<laugh> and if you can't tolerate the nasal lavage sinus, for instance, we say, get some saline, nasal spray, do 6, 8, 10 squirts into the nose, something mild or smaller, at least that will help get some of that allergen out. Terrific.

Speaker 2 32:52

We have been talking to John Sweet allergist at Hennepin healthcare. If you want an allergist and you live in the upper Midwest, I can't recommend anybody more strongly than John. So go to Dr. Sweet at Hennepin, check him out at 6 1 2 8 7 3, my MD, or for more information, go to Hennepin healthcare.org. John, thanks for being with us today. It's been a great conversation. I could talk to you forever about this stuff. Thank you. Thanks

Speaker 3 33:14

Dave. I was glad to

Speaker 2 33:15

Be here. It's great to have you on the show, John, and I hope to get you on a future episode. So thanks for listening today. I hope you'll tune in for our next episode and in the meantime, be healthy and be well.

Speaker 1 33:27

Thanks for listening to the healthy matters podcast with Dr. David Hilton. For more information on healthy matters or to browse the archive, visit our website@healthymatters.org. And if you have a question or comment for the doctor, email us@healthymattersathcmed.org, or give us a call at six one two eight seven three. Talk. The healthy matters podcast is made possible by Hennepin healthcare in Minneapolis, Minnesota, and engineered by John Lucas at highball executive producers are Jonathan Kato and Christine Hill. Please remember we can only give general medical advice during this program. And every case is unique. We urge you to consult with your personal physician. If you have more serious or pressing health concerns until next time, be healthy and be well.