Tag Archives: asthma

Is Kentucky’s Fall Allergy Culprit Impacting You?


Louisville’s pollen count 9/12-9/14.

If you’ve seen the weather forecast this week, you may have noticed the high ragweed pollen level alerts. This is problematic for many, as it is estimated 15-20% of Americans suffer from ragweed allergy. This green flowering weed (17 different varieties, not to be confused with Goldenrod, Kentucky’s state flower) makes millions of us miserable with runny noses, itchy throats and burning eyes.screen-shot-2016-09-12-at-8-15-22-am

A single ragweed plant can produce one billion pollen grains per season, and the lightweight pollen grains can be carried up to 400 miles in the wind! Ragweed is very hardy and can be found in vacant lots, the side of the roads, parks and fields; it can thrive in poor soil conditions. In our area, the ragweed pollination ends around the time of the first frost.

Also, some people with ragweed allergy experience an itchy throat or mouth after eating some common fresh fruits and vegetables. The condition is called oral allergy syndrome and an allergist can help you diagnose and manage your symptoms.

What can you do?

  • See an allergist to determine the culprit of your allergies.
  • There are over-the-counter and prescription medications which can help reduce pollen allergy symptoms including nasal sprays, antihistimines and decongestants.
  • If these medicines do not provide relief, you may be a candidate for immunotherapy (allergy shots).
  • Avoidance can help lessen symptoms. Keep windows closed and use a HEPA filter. Early mornings are the best time to get outside since ragweed is a late-morning pollinator.

Call our office today at (502) 882-2063 to schedule an appointment to help you figure out your allergies and come up with a treatment plan that works for you.





May is National Asthma and Allergy Awareness Month #1in5

May is National Asthma and Allergy Awareness Month. There is no cure for asthma, but asthma can be managed with proper prevention and treatment. Asthma affects 24 million Americans, and 6.3 million children under the age of 18 suffer from asthma. More than 50 million Americans have allergies – pollen, skin, latex and more, and the rate of allergies and asthma is climbing. Please join us in raising awareness for these common diseases.


If you experience allergic and/or asthma symptoms or have questions, call our team at (502) 882-2063 to learn more about finding relief.



“My Nose is Running Faster Than My Feet!”

One month from today is the KDF mini-marathon! If your spring allergies are getting in the way of your training, you may find relief by trying the following:

  1. ANTIHISTAMINES: Consider taking an oral or nasal antihistamine. (Be sure to hydrate, as antihistamines can have a drying effect and leave you feeling dehydrated sooner than usual.)
  2. WEATHER: Avoid running at peak pollen times. Check your local allergen forecast online (Pollen.com, AAAAI.org, Weather.com) or use an allergy app on your smartphone. Also, it is better to run after a rain, as opposed to clear, windy days, as there is often less pollen in the air.
  3. CLOTHING: After running, immediately launder your clothing, take a shower and wash your hair to help minimize your exposure to outdoor pollen.
  4. SALINE: Try using a saline spray or a neti pot to clear your nasal passages.
  5. AIR POLLUTION: It is best to run indoors when an ozone alert is issued. Common air pollutants can make it difficult to breath, especially for those suffering with asthma and severe allergies.
  6. LONG-TERM: Seeing a board-certified allergist can prove helpful in the long run, as he/she can decipher what allergens trigger your symptoms and develop a plan to help  your symptoms and needs.

Call us at (502) 882-2063 to schedule an appointment with Dr. Damin and his team at Allergy Partners.Layout 1


Pollen! What is it and Why Does it Make Me Miserable?

The pollen count

3/22/16: The pollen count is already in the “HIGH” range.

Pollen is one of the most common causes of allergies in the United States. You’ve seen it coating your car, wafting through the air and saturating your sidewalk—-the very fine, powdery, yellowish dusting which thrives in the Kentuckiana area. Our region is known to have prolific amounts of pollen which wreaks havoc and causes an adverse immune response in many of us.

Pollen is produced by trees, grasses, weeds and flowers. It fertilizes plants of the same species. Our immune system is an amazing protector, defending the body from harmful invaders and can prevents sickness. For those with pollen allergies, the immune system mistakenly targets the pollen as unhealthy and produces chemicals in your body to fight the pollen. The pollen has now become an “allergen” and the manifested fight is known as an “allergic reaction,” “hay fever” or “allergic rhinitis.”

Do you suffer in the spring? March and April allergies are almost always due to tree pollen. (It is important to start treatment before pollen season begins.)

Do you suffer around Derby time? Your are likely allergic to grass pollen. Sufferers in the late summer and fall can be allergic to ragweed. Pollen is wind-driven, can travel hundreds of miles and survive a mild winter. (Did you know the ragweed season has increased four additional weeks in the last 10-15 years–some say due to global warming.)

Some suffer pollen allergies year-round. Symptoms include: sinus pressure, facial pain, nasal congestion, cough, scratchy throat, watery/itchy eyes, runny nose, dark circles under the eyes and a decreased taste/smell sensation.

Using Neti pots, vacuuming regularly with a HEPA filter vacuum, frequent and immediate washing of clothes that have been worn outside, closing windows, using the air conditioner in your car and home, using HEPA filters and frequent changing of your home air filters can provide some sufferers relief.

Over-the-counter and/or prescription nasal sprays, antihistamines and decongestants can provide relief for many.

If those do not work, immunotherapy (allergy shots) is shown to reduce symptoms long-term in most children and adults. Call us at (502) 882-2063 to find out your options before the pollen season is upon us!




Disclaimer: This blog is not intended to create a doctor-patient relationship with any reader. If you need personalized medical advice, contact your primary care physician or other physician in your community.

To Vape or Not to Vape


E-cigarettes can look like a traditional tobacco cigarette. The battery heats “e-liquid” which is released in aerosol form. (Photo courtesy of Ecig Click, vapour.co.uk.)

Did you know cigarette smoke contains more than 7,000 chemicals? Smoking is the leading cause of preventable, premature mortality, and it is harmful to allergic and asthmatic children and adults.

A February 2016 article in the Annals of Allergy, Asthma and Immunology examines the use of electronic cigarettes as an option for harm reduction in asthmatic patients who are existing smokers and are unable to quit using other smoking cessation tools. The article recognized that e-cigarettes could be safer than conventional cigarettes, but, as Dr. Fred Hsieh with the Cleveland Clinic’s Allergy and Immunology Respiratory Institute points out, they are not altogether safe. Check out just a few of the components included in every puff of this vaporized aerosol:

  • propylene glycol (airway irritant associated with decreased lung function)
  • vegetable glycerin
  • flavorings and other unregulated addititves
  • nicotine
  • formaldehyde (potentially carcinogenic in humans)

Other scary facts:

  • According to the CDC, e-cigarette usage by children ages 11-17 increased from 1.5% to 13.4% between 2011 to 2014. An estimated 2.4 million minors are vaping.
  • The e-cigarette is not federally regulated meaning that chemical additives, nicotine content and other components do not have the same safety oversight and quality controls as do regulated drugs.
  • There is still second-hand and third-hand exposure from e-cigarettes.
  • Use of e-cigarettes has prompted a “significant increase” in calls to poison control centers, and over 50% of them involve children.

If smoking cessation is your goal, randomized clinical trials comparing e-cigarettes to nicotine patches did not suggest an advantage of the e-cigarette over the nicotine patch.

E-cigarettes have only been around since 2007, so the data is still too new to fully assess the short- and long-term consequences. Therefore, given what we do know combined with what we are yet to learn, consumers should be wary of e-cigarettes as a safe alternate to cigarettes or as an effective tool in their smoking cessation quest. And if you are looking for one more reason to give pause, check out this CNN article posted Feb. 25, 2016 about an Owensboro, KY man’s pants catching on fire from his electronic cigarette battery. 



Asthma News: An App that can Record Inhaler Doses and Provide Reminders!

SmartTouch Dulera (2) Remembering to take medications every day can be difficult for many people. For asthma patients, forgetting to take daily controller inhalers can lead to more asthma exacerbations. New technology, however, may help asthmatics remember their medications and keep asthma under better control.

On June 3rd, 2014, a New Zealand company, Nexus6, announced it received marketing clearance for SmartTouch, an inhaler monitoring device. In the recent December issue of the Journal of Allergy and Clinical Immunology a study was published titled Inhaler reminders improve adherence with controller treatment in primary care patients with asthma by Foster et al. It used the SmartTouch device to measure asthma medication adherence. The device, which can connect to the internet via smart phones and other devices, records doses and provides reminders for missed doses. At six months, adherence in the reminder group was double (60%) that of the non-reminder group (29%) whose adherence data was collected covertly. The reminder group also had a statistically significant reduction in severe exacerbations (11% versus 28%) compared to the non-reminder group. Such data will help health care providers distinguish patients that are refractory to treatment versus treatment failures due to non-compliance. A similar device appears on their website for nasal sprays.

Further adherence data in children was recently published January 20, 2015 online in the journal Lancet titled The effect of an electronic monitoring device with audiovisual reminder function on adherence to inhaled corticosteroids and school attendance in children with asthma: a randomised controlled trial. The group with the audio visual reminder function turned on had an 84% adherence rate compared to 30% in the control group.

Per the company website, the SmartinhalerAppTM is available on iPad, iPhone and Android devices although it was not found in the iTunes App Store as of March 2. It appears the SmartTouch device is preparing for U.S. markets given the product section of the  company website has a color matching device for most American branded inhaler products available.

The availability of a “Smart Inhaler” should benefit both patients and physicians. We may eventually see devices that can alert pharmacies when your inhaler is running low. The physician can be alerted if rescue inhaler usage has exceeded the recommended amount. Can’t recall if you took your scheduled controller last night? Check the log. No more over or under reporting of medication use based on what a patient thinks the physician wants to hear. Patient reminders and accurate adherence records will help improve asthma control as we continue to become further connected electronically.

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Disclaimer: This blog is not intended to create a doctor-patient relationship with any reader. If you need personalized medical advice, contact your primary care physician or other physician in your community.



2014 Allergy Year in Review

Untitled-3The new year has arrived and it’s often a time to reflect on trends and highlights from the previous year. Below is my list of the highlights in the world of allergy in 2014. Enjoy and may you have a healthy and happy 2015!

  1. Allergy Partners of Louisville Opens: On January 2, 2014, I opened my own solo allergy practice with a wonderful staff and team. The office moved to its permanent location next to Wild Eggs in the Landis Lakes Shopping Center in June. The new office is even more patient-friendly with large HD monitors in every exam room with multiple viewing options, fewer “pokes” with allergy testing and shorter conventional allergy shot build-up schedules without having to pre-medicate with steroids.
  2. Nasal steroids moved to become available over-the-counter (OTC): Nasacort was approved for the switch from prescription to OTC and became available as such in February 2014. Steroid nasal sprays are considered first line treatment for moderate to severe allergic rhinitis. Look for others to follow suit in 2015. Flonase is expected to be on retail shelves in early 2015.
  3. Asthma inhalers continue to shift toward emphasizing smaller particle sizes: Aerospan became available in the US after Meda Pharmaceuticals bought Acton in late 2013. Better, deeper lung deposition is thought to be the benefit of inhalers with smaller particle size. Look for specialists to increase their use of Aerospan, Alvesco and Qvar, the three inhalers with the smallest particle sizes in 2015.
  4. FDA-approved sublingual immunotherapy (SLIT) becomes available in the US: Look for the products Grastek, Ragwitek and Oralair to be marketed heavily in 2015 and directly to consumers. You too have probably seen Grastek’s countdown to grass season whole page ads  in the Courier-Journal and other publications. The main benefit is home administration. Barriers include cost, potential side effects, need for an injectable epinephrine device and the requirements of receiving the 1st dose in the physician’s office. Better discount programs should improve usage in 2015.
  5. The end of Maxair: Under the Montreal Protocol, all CFC-containing, ozone-depleting inhalers were phased out by the FDA as of December 31, 2013. Maxair could not be made or sold after December 31, 2013. This means any Maxair still in your drawers or purses should be properly disposed of, as they are expired and no longer compliant. If you’re still carrying Maxair or the old CFC version of Combivent, see your doctor to discuss alternatives. If you are still carrying an old white generic albuterol inhaler made by Wallace or Warrick, you may need to go through your medications more often!
  6. Xolair receives indication for Chronic Idiopathic Urticaria (CIU): Omalizumab or Xolair is a biologic antibody that has been available since 2003 for the treatment of allergic asthma. Xolair was approved for CIU in 2014 and will provide another step in the treatment options for hives sufferers before having to consider medications with more significant side effect profiles.
  7. Affordable Care Act to further drive consumer awareness of the cost of health care: As my family compared health insurance options for 2015, the changes brought on by the ACA were noticeable. Look for premiums and deductibles to rise. Shorter build-up shot schedules and smaller test panels without sacrificing quality will position Allergy Partners of Louisville as one of the most cost-conscious allergy choices in the Louisville market.
  8. Component Food Allergy Testing: More and more allergists are using component resolved diagnostic testing to aid in clinical decision making for food allergy sufferers. Component food allergy testing uses allergy specific blood testing to look at the components of specific foods like peanut, egg and milk. Knowing if a patient is allergic to casein or ovomucoid in milk and egg, respectively, can help a family know if they will tolerate cooked milk and egg in products. Knowing a patient’s Ara h2 level for peanut allergy is much more precise in knowing whether a patient will tolerate an oral peanut challenge. Look for component resolved diagnostics to become standard of care in making decisions for reintroduction of known food allergens.

That summarizes my year-end reflections on the ever-changing world of allergy. Thanks to each of you for a rewarding 2014 and going with me on this amazing journey in relationships and providing better health to patients. Best wishes and God bless in the New Year!

Derek Damin, MD