Allergy shots?

[ny biker]

I haven't been to the allergist in a while. The one I used to see has retired, so I went to a new one today. Really just wanted to establish as a patient and ask a couple of questions. I have asthma, which has been treated for years by a pulmonologist who I really like, chronic idiopathic hives and pollen allergies. The latter two conditions are really what I want the allergist to help with, though they always ask about the asthma. Everything is currently pretty well controlled by medication, much of it available over the counter. I was slammed by pollen a couple of weeks ago when it exploded earlier than usual with the warm winter we've been having, but the allergic reaction is now under control.

I chose the new doctor because she's also an immunologist (helpful for the chronic hives), she's on my insurance plan and the location is reasonable. The practice is owned by a larger company that seems to have bought up most of the allergy practices around here. It's clear from their website that they give a lot of allergy shots. There's a big sign on the door giving the hours for allergy shots. Most of the other people in the waiting room were there for allergy shots. While I was talking to the doctor, she recommended allergy shots.

Do allergy shots actually work?

It felt very much like a profit center for them, the way they pushed the shots. I honestly don't see why I need them. It seems like a lot of time and money spent in a year-round effort to make things a little better during the 4-6 weeks that pollen really kicks up. My insurance essentially doesn't cover them -- there's a high deductible and a limit of six treatments per year, so it's entirely possible that I'd hit the 7th treatment before I maxed out the deductible.

I also don't understand them in the context of my layperson's knowledge of allergies, which is that you will always have at least one exposure to something without a reaction and then develop the allergy, and the reaction can get worse with repeated exposure. The recommendations to manage allergies always involve avoiding exposure to the allergens -- like removing rugs from your home if you're allergic to dust or washing your hair and changing your clothes when you come inside if you're allergic to pollen. So I don't see have frequent exposure to increasing amounts injected into to you would be a good thing to do, let alone an effective treatment.

The other things we discussed during my visit, like dosages for antihistamines and a different type of drug that's available for the hives, were reasonable, and the doctor moved on from the shot recommendation pretty quickly when I said I'd think about it. So I'm willing to see her again. I just don't get understand the shots.

[Pax]

I took them for four years, they accomplished absolutely nothing other than a huge ongoing expense and I probably messed with my immune system. They push them because they are a HUGE moneymaker that work for some people, but speaking anecdotally, not for anyone I've ever met.

[emily_in_nc]

I had them as a child, many, many years ago, so I have no idea if they work as an adult. I know they helped with some of my allergies (wool, feather pillows...) but couldn't do anything for my cat allergy. It's possible I might have grown out of some of my allergies anyway. But I was sick all the time, which is why my parents had me tested at Duke, and I suppose they did help a little with that. But giving away our house cat to a friend was probably the #1 thing that helped me have a life again!

[Crankin]

I took them as a kid around age 7-8 and then again in HS for 2 years and in my 30s, when I developed asthma, new food allergies, hives, and a general chemical sensitivity, which has since gone away.
I know I am allergic to mold, dust, and peanuts. I have always done the environmental things. The shots as a kid didn't do much, but I think the ones I took as an adult helped get me out of a very terrible cycle I was in. But, I stopped because I always had a weird reaction afterwards. Not quite an asthma attack, but feeling weird. I think it may have been the preservative used. But, my older son was deathly ill with chronic bronchial stuff and he was allergic to Bermuda grass, which in AZ is everywhere. He also had something (a deficiency, I can't remember) with IgA, one of the histamines in the body. It really helped him. He took them for about 2 years. Of course when we moved, both he and I became 100% healthier. The dust in the desert was not good for either of us. I put away my nebulizer for good.
I like allergists better than pulmonary docs. I had been going to one for about a year when the asthma stuff started in the 80s and all he did was give me prednisone. The allergists I saw understood the issues better.
I think you could keep going, using meds, but you have had a lot of stuff, some of which might be helped by the shots.

[ny biker]

For me, the hives can be triggered by something that causes the histamines to increase in my system, but they don't appear to be an allergic reaction to anything specific. And the asthma is mostly not allergic. Pollen that I am definitely allergic to is high right now but I kicked a$$ on the lung function test they gave me today -- the nurse was actually impressed by the results. The only allergies that really cause consistent problems for me are seasonal. So I don't feel like shots would be worth the expense.

I know people who get them, so I suppose they find them helpful.

Asthma treatment has improved significantly since the 80s. But some cases are more allergy-based than others, and of course some doctors in any specialty are just not very good.

[Crankin]

Oh, I know how asthma treatment has changed. My son's allergist in Tempe is the person who actually invented that first combination inhaler that is often prescribed (the name is escaping me, but I know Emily used to take it!) as a preventative. Weirdly, his brother and family live in Acton and in the past were sort of part of my social circle. I have never been diagnosed with pollen allergies, but it seems like I've developed them. I am sensitive to changing weather conditions, though.
I would not do shots now, though. My hives are definitely stress related, but there is an underlying allergy component. The only times I've had them in the recent past has been related to wearing wool. I was never sensitive to it before, and it's usually around this time of year, after a couple of months of merino. My mom had hives on and off for years and she also had asthma, so it's genetic. I remember her taking oatmeal baths for the hives .
It just sucks to live with this stuff, though. I have weird reactions to all sorts of things, which makes people think I am a complainer! I had a couple of years where I could not even walk through a department store, due to the perfume smells.
Of course you aced the lung function test!

[emily_in_nc]

Oh, I know how asthma treatment has changed. My son's allergist in Tempe is the person who actually invented that first combination inhaler that is often prescribed (the name is escaping me, but I know Emily used to take it!) as a preventative.

LOL...I'll have to think on that as I can't recall now either! I remember that it came in a purple plastic disk, and the reason I stopped it was because it was found to (possibly) cause osteoporosis. As a petite, white female (high risk group for osteoporosis anyway), that wasn't something I wanted to mess around with. Now I just use my rescue inhaler (albuterol) if I am having a wheezy day. Fortunately, a couple of inhalers gets me through a year or more. Have not had to use it much here in Florida at all. Some places and some times of year, it gets a bit more usage.

[Crankin]

Yup, a lot my asthma treatment surely hastened the development of osteoporosis.
I also have an Albuterol inhaler and I rarely get it refilled more than once in a year, usually have just one. I use pre-ride, on hot days, or when there's an air quality issue. Before, I would avoid riding in those conditions, but given how hot it's been the past 2 years, I can't avoid it.

[ny biker]

It's Advair. Still in use, but not the first course of treatment because one of the two medicines in it can have serious side effects. I am currently using Flovent, also a purple disk, from the same company, with just one active ingredient (which happens to be the same active ingredient in Flonase nasal spray, which I recently started taking to relieve the effects of the early pollen explosion). I have ridiculously dense bones, so am not at as high a risk for osteoporosis.

I also rarely use the Albuterol. I would probably need it more without the antihistamines and Flovent/nase.

[Pax]

My wife has awful osteoporosis from inhaled corticosteroids, but the alternative is not breathing so she still uses one. The best thing for her though was us living in Florida, she had so few asthma issues she had weaned off her inhalers and was only using the singulair pill.

For me, I'm a big woman with big dense bones, I could live to be 150 before I ended up with osteoporosis from my inhaler.

[ny biker]

What a shame that the good place for her allergies was such a bad place for yours!

My father has been on inhalers for years and also has to take meds for his bone density. But thin bones run in his side of the family -- his mother had bird bones, as does one of my sisters. My mother has dense bones, though, which I assume is where I got them.

[Crankin]

I had to stop Flonase and start taking Nasacort because the Flonase made my nose bleed after a couple of months. I remember taking Flovent at one point, and since it's been a long time since I was treated for asthma, that med must have been around for awhile.
I have been taking a Claritin almost daily for years. I stopped taking it for about a week and my symptoms got much worse. I have had issues with my right eye for about 2-3 years, itching, red. So much, that I've ripped a lot of contact lenses. It's not my contacts initially, but taking it out eventually makes it better. I've been using antihistamine eye drops for about a year, but it's not helping. I've changed eye make up remover, mascara, cleaning my eye makeup brushes religiously and nothing helps. It seems to get worse after exercising outside in the cold or wind. Even the wind of my hair blower, or heat from my flat iron sets it off. But sometimes it just starts out of nothing! I hate wearing my glasses to work, but it's happened a few times recently. My eye doctor says there is nothing wrong with my eye.
Unless I am allergic to life, I can't try much more...

[Pax]

What a shame that the good place for her allergies was such a bad place for yours!

We are going to have some HVAC work done when we go back, install a UV system and some additional air filtration. If I can keep things clean and stable at home, I do much better trying to brave the outdoors.

I had to stop Flonase and start taking Nasacort because the Flonase made my nose bleed after a couple of months. I remember taking Flovent at one point, and since it's been a long time since I was treated for asthma, that med must have been around for awhile.

My doc just DC'd my flonase script. It was destroying my sense of smell and taste along with nosebleeds, she's worried if I continue it those changes will be permanent.

[ny biker]

My plan for the Flonase is to use it short term when pollen is really affecting me. With the forecast calling for a week of January-like cold, I was actually planning to stop taking it as of today. But then I decided to try wearing contact lenses for the first time in several weeks, and I put them in before using the antihistamine eye drops, and didn't feel like taking them out again for the drops. So one more day of Flonase, then I will try going without it. So far I may be experiencing one side effect from it -- I'm getting headaches at the gym. Hopefully I won't have any other problems with it, especially if I only use it for a few weeks out of the year.

Pax, I hope the changes in Florida work for you.

Crankin, does your eye itch when you're not wearing contacts? Or is it just that the contact lens makes it worse?

[Crankin]

It generally starts when my contacts are in. But now, it doesn't resolve right away when I take them out. I do my hair and take a shower without my contacts in, and I have been taking them out as soon as I get home. The past few weeks have been better, then all of a sudden, it's returned with a vegenance. I have had issues with my right eye, ever since I switched from the old, old version of Accuvues. I am now on my 3d brand for my right eye, since then.No eye doctor believes me. Basically, I used start having my right eye tear like crazy when the temperature was less than 40 or so, while skiing or riding. That threshold has gone up to about 50 or higher and I spend half my time hiking or skiing wiping my eye and taking my sunglasses on and off. I was told this is age. Well, I am not sure of that. My left eye has an astigmatism and after I finally found a lens for that that I could tolerate, the right eye started up. I used to have very poor vision in my left eye, with my contacts, because I chose not to wear a lens with the astigmatism correction.
Any suggestions?