CONTACT ALLERGIES: ‘WHY ME?’

Some people can practically swim in poison ivy and suffer hardly an itch. Others break out after merely handling exposed clothing or animal fur. That’s because sensitivity depends on several factors – and many of them are within our control

First and foremost, how long and how frequently you come in contact with the offending substance makes a great deal of difference. Similarly, pressing or rubbing against it increases the intensity of contact and may prolong the reaction.

The health of your skin is also a factor. Infected, inflamed, burned or otherwise irritated skin is in no condition to defend itself against an allergic contact, skin that’s overly dry or too alkaline’ (from washing with alkaline soaps) is also vulnerable. So is skin that’s already in the processor reacting.

Perspiration can also fuel a reaction because it dissolve and spreads allergic and irritating substances such as nickel and clothing dyes in fact, some people break out only when they

Certain drugs such as antihistamines and antibiotics increase your sensitivity to sunlight, making you more easily sunburned and susceptible to an allergic reaction. Some topical salves and lotions can also cause reactions in the presence of sunlight. Antiseptics in some soaps, for instance, are allergenic only under sunlight.

Contact allergy most often erupts during or after middle age; eczema in children and younger adults is more apt to be triggered by food and inhalants. Many older people, in fact, are taken by surprise by a sudden allergy to something they’ve been using safely all their lives. Skin allergies also tend to be more stubborn and resistant to control the older you get. Part of the reason is that as we age, we tend to have drier skin. So we use more bath oils and lanolin-containing lotions to relieve dryness. Using more lotions, however, means we’re exposing ourselves to more chemicals with allergic potential. So the older you are, the more tender loving care your skin needs, including blander lotions and soaps.

Not only does our sensitivity change as we age, but also the way we react. While itching is as bad as ever, older people experience less inflammation and fewer blisters. Instead, the skin tends to thicken and grow scaly – from the allergic process itself, from the drier skin of old age and from constant scratching.

Your hobby or occupation may also habitually expose you to chemicals and other substances. Many materials used in gardening, carpentry, painting, ceramics and sculpture are potent allergy triggers. Gardening usually demands handling weeds and applying fertilizer or insecticides, organic or chemical. Both organic pesticides (like pyrethrum) and chemicals (like malathion) are potential causes of skin allergy. The turpentine, epoxy resins, glues and adhesives of carpentry can trigger a skin reaction. Cashiers and sales clerks, waiters and waitresses may find that they react to the nickel in coins. Nurses, doctors and dentists are subject to allergic skin reactions from penicillin, antibiotics, antiseptics, metals and the like.

We’re not saying you should abandon your hobby or quit your job. Just keep all your regular activities in mind when looking for clues to an unexplained skin rash.

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MANAGING DRUG ALLERGY

Recognizing a drug allergy for what it really is can be easy . . . or difficult. It’s easy if:

– you show symptoms while you take the drug or a few days after you stop;

– symptoms disappear a few days after the drug is discontinued;

– your symptoms resemble those experienced by others who are allergic to the drug; or

– you’ve reacted to the same drug before in the same way.

It can be difficult to diagnose drug allergy, however, if:

– you have previously taken the drug in question with no difficulty;

- your symptoms resemble the symptoms of your disease (for instance, drug-induced wheezing and bronchospasms may resemble respiratory problems from asthma);

– you are taking several drugs at the same time;

- the reaction persists for weeks or months after you stop taking the drug, as is the case with drugs that the body eliminates slowly, like Depo-Testosterone and other time-release hormones; or

- you’re unknowingly exposed to unsuspected sources of the drug (for example, penicillin in milk, or aspirin in over-the-counter remedies).

Overcoming these difficulties with skin tests to uncover the allergy is not really an option. For one thing, skin testing for drugs is risky because of the danger of anaphylaxis. For another, they don’t offer accurate clues (except for the skin test for penicillin we mentioned earlier in this chapter).

The biggest ‘difficulty’ is the first on our list: drug reactions that get lost among the symptoms of a basic, underlying illness. For instance, say you’re given streptomycin for a virus and develop an allergic fever. The fever may be misinterpreted as a symptom of the virus, when in fact it is a reaction to streptomycin. And that could be dangerous.

‘A minor drug reaction may progress, if unrecognized, to more severe, even fatal, reactions,’ writes allergist Dr Richard D. DeSwarte, an assistant professor at Northwestern University Medical School in Chicago.

Common sense, then, says that if you’re taking drugs of any kind you should immediately report any unusual reactions to your doctor, even if you stopped taking the medication a few days before. That’s not only for your personal benefit, but it also helps doctors to keep track of reactions so that drugs can be used more safely and wisely.

For mild drug reactions, stopping the drug is all that’s usually needed. For widespread skin eruptions, tepid colloidal baths can soothe and relieve the itch. For systemic reactions, like asthma, your doctor may prescribe a short course of antihistamines or corticosteroids to get things under control. By staying away from a drug for a few years, many people lose their allergic sensitivity to it and are once again able to take it if they have to.

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UNDERSTANDING ALLERGY: PERSONAL OASIS AGAINST CHEMICALS

Creating a refuge against chemicals makes it easier for highly sensitive people to tolerate exposure to the rest of the chemical-ridden world. What’s more, a personal oasis shores you up psychologically as well as physically, giving you confidence to venture out.

Dr McGovern tells his chemically sensitive patients: ‘Select any bedroom in the house and make it “chemically clean”. It’s not hard to do. Remove the pictures from the walls. Take down all the curtains. Take out the rugs and carpeting. If there’s hardwood flooring under the carpeting, so much the better. If not, it’s best to cover the floor with ceramic tile. If ceramic tile is not available or too expensive, you may also use very inexpensive, hard vinyl tiles.’

The inexpensive ones?

‘The least expensive, self-sticking tiles tend to be harder and less toxic than the more expensive products. Take my word for it,’ says Dr McGovern.

‘Next,’ he adds, ‘you take out all the furniture. Use an aluminum bed with springs – a folding cot – to sleep on. Instead of a mattress, use several 100 per cent plain cotton blankets. Wash them six or seven times in baking soda to remove any chemical treatment. Layer them to serve as a mattress.’ For a pillow, Dr McGovern recommends cotton T-shirts, rolled up and stuffed into a washed, cotton pillowcase.

A pretty Spartan sleeping arrangement. But Dr McGovern has a good reason to recommend it as some mattresses contain flame-retardant chemicals. Formaldehyde and pesticides are also employed in their manufacture and if chemically sensitive people sleep on such a mattress, they’ll never get better.

For other furniture, Dr McGovern recommends nothing more extravagant than going to a second-hand shop. Finished furniture is okay, as long as it’s a few years old and the fumes from paint or stain have had time to dissipate. And be sure to ask if it’s been sprayed with pesticides. If it has been, don’t buy it. If not, you’re safe.

Do people actually make these kinds of changes in their homes?

‘Nearly 400 of our patients are sleeping on metal beds,’ says Dr McGovern, ‘and making nice recoveries.’

‘I’ve had 3,500 patients get rid of their gas stoves,’ says Dr Randolph.

Dr William J. Rea, of Dallas, Texas, who has treated thousands of environmentally allergic people, adds, ‘We don’t recommend anything people won’t do. It would be a waste of time.’

Taking the gas stove out of the kitchen and ripping out the carpeting at home are pretty much within our control. But what about going to work? Or travelling? Again, there’s more you can do about these situations than you might think.

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UNDERSTANDING ALLERGY: DUST CONTROL TIPS

The type of vacuum cleaner you use can also make a great deal of difference in dust control. Most conventional air-bag-equipped vacuum cleaners work against you: they vent dust out of the exhaust hatch – and into the air again – while you zealously go after every last nook and cranny with the front end. And there’s hardly a housekeeper alive who hasn’t nearly choked on the cloud of dust stirred up every time the bag is changed – an utter disaster if you’re allergic.

In contrast, central vacuum cleaning systems get rid of dust for good – as long as the exhaust is vented well away from living quarters. A more convenient and affordable solution — especially for people who rent their house or flat or move frequently – is a water-trap vacuum cleaner. This model collects dust in water instead of an awkward air bag, so dust isn’t continually re-circulated into the air you breathe. An added advantage: water-trap vacuum cleaners don’t lose power the way bag-equipped models do when the pouch begins to fill up. Without that power loss, you can pick up more dust in the first place.

‘They really do the job – and they do help allergies,’ says Robert W. Boxer, an allergist in Chicago who recommends water-trap vacuum cleaners to his patients. ‘We’ve had one in our house for about fourteen years and it’s very effective,’ he adds.

A bonus to the chemically sensitive is that water-trap vacuum cleaners offer attachments that allow you to shampoo rugs and upholstery with nontoxic cleaning products, rather than having to hire professional cleaners who use strong chemicals.

Here are a few additional dust control tips to make your life as easy and dust-free as possible.

• Purchase only stuffed toys that can be easily laundered.

• Avoid furniture, pillows, cushions, quilts and sleeping bags stuffed with kapok.

(Check labels.)

• Wear a dampened cotton surgical mask over your nose and mouth while dusting,

vacuuming or mopping.

• To cut down on dust accumulation in wardrobes, hang clothing in zippered garment

bags. Use the compartmentalized ones for shoes and sweaters.

• If your house has baseboard heat, detach the front and side panels (if they’re

removable) for vacuuming. ‘Fried dust’ can be very allergenic.

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WHAT YOUR PULSE CAN TELL YOU ABOUT ALLERGY

In some people, eating troublesome food will speed up their pulse. First noticed by Arthur F. Coca, an allergist and immunologist, that phenomenon was described at length in his book, The Pulse Test (Lyle Stuart). According to Dr Coca, taking your pulse after meals helps to identify allergy-causing foods.

Say you have a hunch you’re allergic to wheat. Take your pulse when you first get up in the morning. Lightly press two or three fingers of one hand over the artery just inside the wrist of the opposite hand, below the thumb. (Don’t try to feel your pulse with the thumb – it’s got a pulse of its own.) Count the beats felt in exactly one minute and write it down. (The average is about 60 to 80 per minute.)

Take your pulse again just before eating a single serving of the wheat alone (or any other suspected food). Then take it again 30 minutes and 60 minutes after the test serving. An abnormal increase in pulse- unrelated to infection, exercise or stress, that is – presumably indicates an allergy.

Sounds pretty remarkable. But William J. Rea, a cardiovascular (heart) doctor in Dallas, told us that the pulse test doesn’t work for everyone. ‘In about one-third of the people, the pulse will go up/ he says. ‘In another third, it will go down. And in another third, it stays the same. And some people will experience any one of those changes at different times, depending on what they eat.

‘So it’s only good if there’s a definite, consistent change in the individual/ he continued. ‘For example, I have one secretary who, anytime she has a food reaction, also has a ten-point or higher elevation in pulse. Every time. No question about it. So for her, it works.

‘We do use the pulse test routinely’, Dr Rea told us, ‘because it’s one objective measure. But we don’t rely on the pulse test alone. After all, no test is 100 per cent reliable.’

In other words, the pulse test is a tool that may be helpful if used along with a food diary and elimination-and-challenge diets.

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