environmental allergy testing Archives

To Your Health With Dr. Jim Morrow: Episode 23, Childhood Asthma

December 18, 2019 by John Ray

North Fulton Studio

To Your Health With Dr. Jim Morrow: Episode 23, Childhood Asthma

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To Your Health With Dr. Jim Morrow: Episode 23, Childhood Asthma

On this edition of “To Your Health with Dr. Jim Morrow,” Dr. Morrow childhood asthma: the symptoms to look for, the testing necessary for diagnosis, and prevention of environmental allergies which can cause this ailment. “To Your Health” is brought to you by Morrow Family Medicine, which brings the CARE back to healthcare.

About Morrow Family Medicine and Dr. Jim Morrow

Morrow Family Medicine is an award-winning, state-of-the-art family practice with offices in Cumming and Milton, Georgia. The practice combines healthcare information technology with old-fashioned care to provide the type of care that many are in search of today. Two physicians, three physician assistants and two nurse practitioners are supported by a knowledgeable and friendly staff to make your visit to Morrow Family Medicine one that will remind you of the way healthcare should be. At Morrow Family Medicine, we like to say we are “bringing the care back to healthcare!” Morrow Family Medicine has been named the “Best of Forsyth” in Family Medicine in all five years of the award, is a three-time consecutive winner of the “Best of North Atlanta” by readers of Appen Media, and the 2019 winner of “Best of Life” in North Fulton County.

Dr. Jim Morrow, Morrow Family Medicine, and Host of “To Your Health With Dr. Jim Morrow”

Dr. Jim Morrow is the founder and CEO of Morrow Family Medicine. He has been a trailblazer and evangelist in the area of healthcare information technology, was named Physician IT Leader of the Year by HIMSS, a HIMSS Davies Award Winner, the Cumming-Forsyth Chamber of Commerce Steve Bloom Award Winner as Entrepreneur of the Year and he received a Phoenix Award as Community Leader of the Year from the Metro Atlanta Chamber of Commerce. He is married to Peggie Morrow and together they founded the Forsyth BYOT Benefit, a charity in Forsyth County to support students in need of technology and devices. They have two Goldendoodles, a gaggle of grandchildren and enjoy life on and around Lake Lanier.

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

The complete show archive of “To Your Health with Dr. Jim Morrow” addresses a wide range of health and wellness topics, and can be found at www.toyourhealthradio.com.

Dr. Morrow’s Show Notes

What is Childhood Asthma?

Asthma is a chronic disease that affects your airways.
- Your airways are tubes that carry air in and out of your lungs. If you have asthma, the inside walls of your airways become sore and swollen.
- In the United States, about 20 million people have asthma.
  - Nearly 9 million of them are children.
  - Children have smaller airways than adults, which makes asthma especially serious for them.
  - Children with asthma may experience wheezing, coughing, chest tightness, and trouble breathing, especially early in the morning or at night.
  - Many things can cause asthma, including
    - Allergens – mold, pollen, animals
    - Irritants – cigarette smoke, air pollution
    - Weather – cold air, changes in weather
    - Exercise
    - Infections – flu, common cold
  - When asthma symptoms become worse than usual, it is called an asthma attack.
  - Asthma is treated with two kinds of medicines:
    - quick-relief medicines to stop asthma symptoms and
    - long-term control medicines to prevent symptoms.

Symptoms of Childhood Asthma

Diagnosing asthma in children can be difficult.
- Many children will go symptom-free for long periods of time before having an asthma attack.
- The symptoms of asthma can be confused with those of other respiratory diseases.
- And depending on your child’s age, it may be difficult for him or her to explain his or her symptoms.
Children with asthma may show the same symptoms as adults with asthma,
- coughing,
- wheezing and shortness of breath.
- In some children, chronic cough may be the only symptom.
If your child has one or more of these common symptoms, make an appointment with an allergist / immunologist:
- Coughing that is constant or made worse by viral infections, happens while your child is asleep or is triggered by exercise or cold air
- Wheezing or whistling sound when your child exhales
- Shortness of breath or rapid breathing, which may be associated with exercise
- Chest tightness (a young child may say that his chest “hurts” or “feels funny”)
- Fatigue (your child slows down or stops playing)
- Problems feeding or grunting during feeding (infants)
- Avoiding sports or social activities
- Problems sleeping due to coughing or difficulty breathing
Asthma symptoms or flare-ups are most commonly caused by allergies.
- Exposure to dust mites,
- dander from dogs or cats,
- pollen and other environmental allergens can trigger an asthma attack.
- In some children, asthma can be caused by non-allergic triggers such as
  - cold air,
  - pollution or
- Patterns in asthma symptoms are important and can help your doctor make a diagnosis.
  - Pay attention to when symptoms occur:
    - At night or early morning
    - During or after exercise
    - During certain seasons
    - After laughing or crying
    - When exposed to common asthma triggers

Diagnosing Asthma

It is often difficult, especially in young children, to be entirely certain that asthma is the diagnosis. After a careful physical examination, your pediatrician will need to ask you specific questions about your child’s health.
- The information you give your pediatrician will help determine if your child has asthma.
- Your pediatrician will need information about
  - Your child’s symptoms, such as wheezing, coughing, and shortness of breath
  - What triggers the symptoms or when the symptoms get worse
  - Medications that were tried and if they helped
  - Any family history of allergies or asthma
- It is very important that your pediatrician test your child’s airway function.
  - Spirometry is the most common lung function test done.
  - It measures how much air is moved in and out of the lungs and how fast the air moves.
  - To get the best results, your child will be asked to follow very specific instructions.
  - Most children can do spirometry by age 6, though some preschoolers are able to perform the test at a younger age.
  - Your child will be asked to wear a nose clip to keep him or her from breathing through his or her nose during the test.
    - Your child will then be asked to take in a deep breath and to blow the air out into a mouthpiece that is connected to a computer.
    - The computer measures how much and how fast the air is blown out.
    - Your child will repeat the test at least two times to get their best, most consistent result.
    - This test can take up to 30 minutes to complete.
  - One of the tests measured during spirometry is your child’s peak flow.
    - The peak flow requires your child to blow out as hard and as fast as they can.
    - Sometimes it takes several visits to the office or lab to practice the test before your child can complete the test.
      - Coughing during the test is to be expected.
      - Tell your child that they may rest between blowing into the machine, in order to catch his or her breath.
      - Sometimes this test is repeated after your child inhales medication.
      - This test is called a post- bronchodilator or bronchodilator response test.
    - How can I help to make the breathing test less stressful for my child and me?
      - Be patient with your child during the test.
      - Explain to your child that the test does not hurt.
      - Explain to your child that the breathing test is being done to find out how to make their breathing better.
      - Schedule the test at a time of day that your child is usually not tired or hungry.
      - The staff will explain the test to you and your child. If you or your child does not understand, ask the staff to repeat the instructions.
      - If your child has a cold, sinus infection, or other reason that makes them unable to take the test, let your provider and the office or lab know as soon as possible. They can decide whether the test should be performed or rescheduled.
    - Some children do not find relief from their symptoms even after using medications.
      - If that is your child, your pediatrician may want to test your child for other conditions that can make asthma worse.
      - These conditions include
        allergic rhinitis (hayfever),
        sinusitis (sinus infection), and
        gastroesophageal reflux disease (the process that causes heartburn).
      - It is important to remember that asthma is a complicated disease to diagnose, and the results of airway function testing may be normal even if your child has asthma.
        Also keep in mind that not all children with repeated episodes of wheezing have asthma.
        Some children are born with small lungs, and their air passages may get blocked by infections.
        As their lungs grow they no longer wheeze after an infection. This type of wheezing usually occurs in children without a family history of asthma and in children whose mothers smoked during pregnancy.

Preventing Environmental Allergies and Asthma

Dust Mites
- Since some airborne substances may trigger allergy or asthma symptoms, reducing contact with these substances early in life may delay or prevent allergy or asthma symptoms.
- Research for this is clearest with dust mites.
- If your child is at high risk of developing allergies, there are steps you can take to control dust mites.
  - Use zippered, “allergen-impermeable” covers on pillows and mattresses and wash bedding in hot water weekly.
  - Indoor humidity should be kept below 50%.
    - Mold in homes is often due to excessive moisture indoors, which can result from water damage due to flooding, leaky roofs, leaking pipes, or excessive humidity.
    - Repair any sources of water leakage.
    - Control indoor humidity by using exhaust fans in the bathrooms and kitchen, and adding a dehumidifier in areas with naturally high humidity.
    - Clean existing mold contamination with detergent and water.
    - Sometimes porous materials such as wallboards with mold contamination have to be replaced.
  - If possible, carpets and upholstered furniture should be removed from your infant’s bedroom.
- Pets and Other Animals
  - The relationship between early life exposure to animals and the development of allergies and asthma is somewhat confusing and there are many factors to consider.
  - Previous evidence suggested that children exposed to animals early in life are more likely to develop allergies and asthma.
    - More recent research seems to show that early exposure to animals (cats and dogs in particular) may actually protect children from developing these diseases.
    - Newer research also suggests children raised on farms develop fewer allergies and asthma.
  - Tobacco Smoke
    - It is very important not to expose your children to tobacco smoke before or after birth.
    - Smoking during pregnancy increases the chance of your child wheezing during infancy.
    - Exposing children to secondhand smoke has also been shown to increase the development of asthma and other chronic respiratory illnesses.

When is Asthma an Emergency?

As a parent of a child with asthma, you want to avoid the emergency room (ER) as much as possible.
- But it’s also important to know when going to the ER is the right choice.
Sometimes, kids with asthma need medical care very quickly.
- If any of these symptoms happen, see your doctor immediately, go to the ER, or call an ambulance:
  - Your child has constant wheezing.
  - Your child uses quick-relief medicines (also called rescue or fast-acting medicines) repeatedly for severe flare-up symptoms that don’t go away after 15–20 minutes or return again quickly.
  - Your child has a lasting cough that doesn’t respond to inhaled quick-relief medicine.
  - There are changes in your child’s color, like bluish or gray lips and fingernails.
  - Your child has trouble talking and can’t speak in full sentences.
  - The areas below the ribs, between the ribs, and in the neck visibly pull in during inhalation (called retractions).

In Summary

Asthma is a chronic illness, but it doesn’t have to be a progressively debilitating disease.
An accurate diagnosis and an asthma action plan could mean the difference between your child sitting on the sidelines or fully participating in activities with family and friends. You, your child and your allergist / immunologist can work together to ensure that asthma doesn’t take control of your child’s quality of life.

Source: familydoctor.org

To Your Health With Dr. Jim Morrow: Episode 7, Allergies

April 24, 2019 by John Ray

North Fulton Studio

To Your Health With Dr. Jim Morrow: Episode 7, Allergies

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**Dr. Jim Morrow, Host of “To Your Health With Dr. Jim Morrow”**

Episode 7, Allergies

Allergies affect almost 50 million people in the United States alone. On this episode of “To Your Heath,” Dr. Jim Morrow, an allergy sufferer himself, takes them all on: food, plants, drug, environmental, and contact allergies. Dr. Morrow also talks about Forsyth BYOT, a non-profit established by Dr. Jim and Peggie Morrow to support technology initiatives in Forsyth County Schools.

Dr. Morrow’s Show Notes on Allergies

Allergies

When you hear someone talk about having allergies, usually they mean rhinitis or upper respiratory symptoms (runny nose, watery eyes, itching eyes and ears and nose, sneezing).
Allergies also can be due to food, medications, animal dander or plants.

Allergic Rhinitis

The diagnosis of allergic rhinitis (AR) should be made when history and physical findings are consistent with an allergic cause (e.g., clear rhinorrhea, pale discoloration of nasal mucosa, and red and watery eyes) and one or more of the following symptoms: nasal congestion, runny nose, itchy nose, or sneezing.
Individuals with allergic rhinitis should be assessed for the presence of associated conditions such as asthma, atopic dermatitis, sleep-disordered breathing, conjunctivitis, rhinosinusitis, and otitis media.
Specific testing (blood or skin) should be performed for patients with a clinical diagnosis of allergic rhinitis who do not respond to empiric treatment, or when diagnosis is uncertain, or when determination of specific target allergen is needed.
Sinus imaging should not routinely be performed in patients presenting with symptoms consistent with allergic rhinitis.
Intranasal steroids should be prescribed for patients with allergic rhinitis whose symptoms affect quality of life.
Oral second-generation/less sedating antihistamines should be prescribed for patients with allergic rhinitis and primary complaints of sneezing and itching.
Intranasal antihistamines may be prescribed for patients with seasonal, perennial, or episodic AR.
Oral leukotriene receptor antagonists should not be prescribed as primary therapy for patients with AR.
Combination pharmacologic therapy may be prescribed for patients with allergic rhinitis who have inadequate response to monotherapy. The most effective combination therapy is an intranasal steroid and an intranasal antihistamine.
Immunotherapy should be prescribed for patients with allergic rhinitis who have inadequate response to pharmacologic therapy
Avoidance of known allergens or environmental control may be considered in patients with allergic rhinitis who have identified allergens that correlate with their clinical symptoms.
Inferior turbinate reduction may be considered for patients with allergic rhinitis with nasal airway obstruction and enlarged inferior turbinates who have failed medical management.

Allergy Testing

Many types of allergies: environmental, foods, drug, contact.
An estimated 10% to 30% of the global population has an allergic disease.
Clinical presentations of allergic diseases, respiratory infections, and autoimmune conditions have similar features.
Allergy and immunologic testing can help clarify the diagnosis and guide treatment. Immediate immunoglobulin E (IgE) and delayed T cell–mediated reactions are the main types of allergic responses.
The allergens suspected in an immediate IgE-mediated response are identified through serum IgE-specific antibody or skin testing.
For patients with an inhalant allergy, skin or IgE-specific antibody testing is preferred.
In patients with food allergies, eliminating the suspected allergenic food from the diet is the initial treatment.
If this is ineffective, IgE-specific antibody or skin testing can exclude allergens.
An oral food challenge should be performed to confirm the diagnosis. Results of laboratory testing for food-specific IgE are generally poor, even less helpful than those for percutaneous skin testing.
Patients with an anaphylactic reaction to an insect sting should undergo specific antibody or skin testing.
Skin testing for penicillin has a high negative predictive value and can help when penicillin administration is indicated and there are limited alternatives. Testing for other drug allergies has less well-determined sensitivity and specificity, but can guide the diagnosis.
Patch testing can help identify the allergen responsible for contact dermatitis.

Food Allergies

Patients with suspected food allergies are commonly seen in clinical practice.
Although up to 15 percent of parents believe their children have food allergies, these allergies have been confirmed in only 1 to 3 percent of all Americans.
Family physicians must be able to separate true food allergies from food intolerance, food dislikes, and other conditions that mimic food allergy.
The most common foods that produce allergic symptoms are milk, eggs, seafood, peanuts, and tree nuts.
Although skin testing and in vitro serum immunoglobulin E assays may help in the evaluation of suspected food allergies, they should not be performed unless the clinical history suggests a specific food allergen to which testing can be targeted.
Furthermore, these tests do not confirm food allergy. Confirmation requires a positive food challenge or a clear history of an allergic reaction to a food and resolution of symptoms after eliminating that food from the diet.
More than 70 percent of children will outgrow milk and egg allergies by early adolescence, whereas peanut allergies usually remain throughout life.
The most serious allergic response to food allergy is anaphylaxis. It requires emergency care that should be initiated by the patient or family using an epinephrine auto-injector, which should be carried by anyone with a diagnosed food allergy.
There are no recommended medications to prevent IgE- or non–IgE-mediated allergic reactions to food. Allergen-specific immunotherapy or immunotherapy with cross-reacting allergens is not recommended to treat food allergy.
Some environmental allergens cross-react with foods, such as:
- Birch pollen: Carrots, celery, fresh fruit (e.g., apples, cherries, nectarines, peaches, pears), hazelnuts, parsnips, potatoes
- Grass pollen: Kiwi, tomatoes
- Ragweed pollen: Bananas, melons (e.g., cantaloupe, honeydew, watermelon)

Nonallergic Rhinitis

Chronic nonallergic rhinitis encompasses a group of rhinitis subtypes without allergic or infectious etiologies.
Although chronic nonallergic rhinitis represents about one-fourth of rhinitis cases and impacts 20 to 30 million patients in the United States, its pathophysiology is unclear and diagnostic testing is not available.
Characteristics such as no evidence of allergy or defined triggers help define clinical subtypes.
There are several subtypes with overlapping presentations, including:
- nonallergic rhinopathy,
- nonallergic rhinitis with nasal eosinophilia syndrome,
- atrophic rhinitis,
- senile or geriatric rhinitis,
- gustatory rhinitis,
- drug-induced rhinitis,
- hormonal rhinitis, and
- occupational rhinitis.
Treatment is symptom-driven and similar to that of allergic rhinitis. Patients should avoid known triggers when possible.
First-line therapies include intranasal corticosteroids, intranasal antihistamines, and intranasal ipratropium.
Combination therapy with decongestants and first-generation antihistamines can be considered if monotherapy does not adequately control symptoms.
Nasal irrigation and intranasal capsaicin may be helpful but need further investigation.

Hives (Urticaria)

Hives are typically large, raised areas on the skin that can itch and spread and coalesce into huge areas of swelling
They can be caused by many things, including:
- Colds
- Bladder infections or other types of infection
- Allergies to food, particles in the air, or things that touch your skin
- Insect stings or bites
- Medicines
- Heat, cold, or pressure
- Exercise
- A serious disease, but this is uncommon In many cases, no specific cause is found.

About Morrow Family Medicine and Dr. Jim Morrow

**Dr. Jim Morrow, Morrow Family Medicine**

Facebook: https://www.facebook.com/MorrowFamMed/

LinkedIn: https://www.linkedin.com/company/7788088/admin/

Twitter: https://twitter.com/toyourhealthMD

Forsyth BYOT

In 2013, Dr. Jim and Peggie Morrow found that hundreds of students in Forsyth County did not have the technology necessary to succeed in the highly technical environment that school is today. The county relies on online work a great deal and so many students were having to go to the library or a Starbucks to access assignments because they did not have internet in their homes. Additionally, many did not and do not have internet capable devices that make this work possible either.

So, the Morrows made it their mission to bridge this gap and help these students try to break the cycle of generational poverty that so many of them are born to.

In the last five years, over $300,000 has been raised and donated by Forsyth BYOT to the Forsyth County Schools for this purpose. Forsyth BYOT seeks to raise awareness of the problem and find sponsors to donate or raise money outright through two yearly fundraisers, the BYOT Golf Tournament in May and the iRUN for BYOT 5K & FunRun in October. Donated funds are given to the school district, which has staff in place to first determine which students are in need and then to purchase and distribute internet hotspots or devices to that family.

BEST OF HEALTH with Arizona HealthNow Expo 2018

February 27, 2018 by Karen

Best Of Health

BEST OF HEALTH with Arizona HealthNow Expo 2018

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BEST OF HEALTH with Arizona HealthNow Expo 2018

You are invited to attend the HealthNow 2018 Healthcare Expo located in Scottsdale, AZ to learn about health, wellness and senior services available in the community.

This is your opportunity to receive education, ask questions on the latest in health and wellness products and medical services for living a healthier life at ANY age.

Free health seminars
Free blood pressure checks
Give-aways and raffles

Come meet TOP Scottsdale/Phoenix Physicians and Medical Facilities specializing in integrative medicine, pain management, family medicine, hormone replacement and more!

When: Saturday, March 3rd from 11:00am – 3:00pm
Event located at Venue 8600
8600 E. Anderson Drive, Scottsdale 85255
(easy access from Scottsdale 101 freeway, with plenty of free parking)

www.HealthNow2018.com
Facebook.com/healthnow2018/

Jodi Towns, Founder and Marketing Mixologist for Towns Consulting LLC. My business background is a bit of a puzzle, with all points back to “I love people!” I’ve been called by many friends and colleagues a “connector” and one of my favorite quotes that reads something like this, “A room full of strangers are just friends I haven’t yet met.” Professionally, I’ve worked mostly in the financial and healthcare industry, held positions like Director of Marketing, Training & Development Director, and CEO of a staffing/recruiting firm.

Towns Consulting LLC offers go-to market strategies mostly in the healthcare space. I teach and coach physicians and their staff on how to organically market and promote their medical practices to draw in their perfect patient. Jodi offers consulting services to help businesses (mostly physicians and other medical practitioners, including cosmetic and aesthetic service providers) create marketing strategies to launch or re-launch their business products or services to the world. Jodi has spent the past 7 plus years in healthcare, specifically Concierge Medicine (membership based medicine) aesthetics and nutrition as a Marketing Director and knows what it takes to make a medical practice stand out from the rest, attract your ideal patient, build physician referral partnerships and create a practice you can be proud of!

Founded in 2017, Jodi Towns has organized Networking for Healthcare Mix and Mingle events bi-monthly growing her group to 200 plus members. This group is comprised of physicians, practitioners, medical marketers/promoters and is an opportunity to build connections and relationships to support others in the medical community. She is the organizer and event coordinator for HealthNow Expo coming to Scottsdale, March 2018.

Jodi is called on to speak at events, webinars, and conferences to share advice and educate on various topics around business, healthcare marketing and networking.

Jodi has consulted for a broad spectrum of clients including:

Recovia
Health and Wellness Care, Geralyn Jones FNP
King Integrative Primary Care
Smooth Contour
Medmetrics Compounding Pharmacy
Goddess Fit
Accurate Care Pain Relief
Integrative Orthopedics of Arizona

www.JodiTowns.com
www.NetworkingForHealthcare.com
www.HealthNow2018.com
joditowns@gmail.com

Towns Consulting LLC
11445 E. Via Linda Suite 2-414 Scottsdale, AZ 85259
602-741-3190

https://www.facebook.com/jodi.riostowns
https://twitter.com/JodiTowns
https://www.instagram.com/wave1jodi/
https://www.linkedin.com/in/joditowns/

Eva Savageau CNMT, LMT, Infant Massage Instructor, Public Speaker, Author and Owner of NeuroMuscular Pain and Wellness Center in Old Town Scottsdale

Diana Fischer, Marketing Operations Director for HealthSouth Rehabilitation Hospital

WHY BEST OF HEALTH?

I am a Physician Assistant who has been caring for patients for over 20 years and Family Practice (cradle to grave) is my specialty.

Following the footsteps of three generations of family practice physicians (my father, grandfather and great grandfather) this was a natural and genetic calling that I do not regret.

Given this, I have a unique perspective and it’s time to share that perspective through Ask the PA. As a health care provider, teacher, business owner, patient, and advocate for my family and friends throughout the years, it has been painfully apparent there are disconnects within the current state of health care in the US and throughout the world. It can be confusing and frankly very scary.

It is my goal though this series, Best of Health, to bring people together that are passionate about their roles in the business of health care… and yes, whether or not you want to hear that it’s a business, it is — and that’s the fact. I will introduce to you great, dedicated practitioners and people with a passion for getting the word out about their personal journeys and causes. I will provide information about navigating through a confusing system, asking the right questions and share ways for saving money and time along the way.

It’s time to create change by partnering, empowering, and focusing on the patient, their families and their providers of care. It’s time for you to take the driver’s seat rather than leave your health care solely in the hands of entities such as insurance companies and the pharmaceutical industry.

Stay tuned. Here’s to your Best of Health.

~ Barb

ABOUT BARB

Barb is a Physician Assistant (PA) and a primary care provider with a passion for education and advocacy. Prior to becoming a Physician Assistant (PA), Barb was an accomplished musician and teacher. In 1992, Barb made the conscious decision to leave teaching and her musical career in pursuit of a career in medicine. She graduated from AT Still University’s first PA class in 1997 with a Masters of Science in Physician Assistant Studies.

Barb has spent several years working in clinics and family practices. Currently, Barb works for Premise Health at Insight Enterprises in Tempe, AZ as a solo practitioner providing primary care to employees and families on campus. She was also a partner in Renaissance Medical Group and Renaissance Medical Properties in Chandler and Maricopa, AZ and had a dual role of Chief Operations Officer and practicing PA for 14 years.

Along with being a PA, Barb is the author of the book Surviving the “Business” of Healthcare, Knowledge is Power! She is a certified Medical Professional Legal Consultant and Patient Advocate, speaker and influencer for change in healthcare for the patient, provider and family members. Barb is also certified by the National Commission of Certification of Physician Assistants and is an active member of the American Academy of Physician Assistants.

In her spare time, she loves to travel, maintaining an active lifestyle that includes running, biking, swimming. She loves to spend time outdoors with her family and friends, whether it’s walking on the beach or hiking in the desert.

For more information about Ask the PA and to connect with Barb:

Askthepa.com

Facebook: Ask the PA

LinkedIn: Barb Regis, M.S.,PA-C