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What is Eosinophilic Asthma?

Eosinophils are a type of white blood cell in our body that helps fight off parasitic infections and cancers. They also play a role in allergic reactions. They make up a small fraction of our white blood cells, and the number of eosinophils in our blood can vary over time. If the number of eosinophils in your bloodstream or organs are elevated, you may have an eosinophil-associated disease.

Although many diseases are caused by an increasing number of eosinophils in your body, we will focus on what is, and the background behind eosinophilic asthma.

What is Eosinophilic Asthma (e-asthma)?

Eosinophilic asthma is a subtype of asthma that is normally seen in adults ranging from 35-50 years of age, although it can occur in children and young adults as well. If you have asthma, the number of eosinophils are high in your blood, lung tissue, or mucus and coughed up from your respiratory tract, you likely have e-asthma.

Unfortunately, the cause for e-asthma remains unknown. However, those with e-asthma do not usually have any disease-related allergies that provoke asthma symptoms. There are many ongoing clinical trials that center around therapies to control e-asthma symptoms.

Symptoms

Eosinophilic asthma has similar symptoms to classic asthma. However, the symptoms are more severe and constant. These include:

Shortness of breath
Wheezing
Coughing
Airflow obstruction
Chronic rhinitis with nasal polyps
Inflamed nasal mucous membrane

Diagnosis

If you have severe asthma, levels of eosinophils by analyzing your blood, sputum, saliva, or conducting a bronchial biopsy (tiny forceps passed through a channel of the bronchoscope into your lungs).

Treatments

Although e-asthma has been established for many years, there are now new treatments that can reduce eosinophils.

Biologic therapies that target eosinophils may be prescribed to treat eosinophilic asthma.

Biologics that are currently approved for use in the U.S. include the following

Benralizumab: antibody that binds Interleukin-5 (IL-5) receptors. 12 years and older
Dupilumab: Interleukin-4 (IL-4) and Interleukin-13 (IL-13) inhibitor and binds to the IL-4 alpha receptor. 12 years and older
Mepolizumab: an antibody that recognizes and blocks Interleukin-5 (IL-5). 6 years and older
Reslizumab: an antibody that recognizes and blocks Interleukin-5 (IL-5). 18 years and older

Many treatments and therapies are underway to improve the lives of many with eosinophilic asthma.

If you or someone you know suffer from severe asthma, our board-certified providers are ready to help you find the right treatment for you. Call 210-616-0882 to schedule your appointment today.

May 26, 2021/by Kayla Gomez

English, Health

10 Asthma Myth Busters

Asthma is an extremely common lung condition in the United States- approximately 26 million children and adults suffer from it. With so many people having this condition, there are bound to be rumors and myths that come with it. Today, we will fact-check some of these myths to create more safety and awareness for those with asthma.

Myth: Children can outgrow asthma.1

Truth: Asthma can go into periods of remission or may be so well controlled that symptoms are not experienced for long periods. Once you have asthma, you’ll always have asthma.

Myth: Asthma is difficult to control. 3

Truth: It can be well-controlled with the right treatment options available to you.

Myth: You can stop medication during the seasons that you don’t have any exposure to your asthma triggers.1

Truth: It’s important for you to continue your asthma action plan and take your medication to keep control of your asthma. Your doctor may tell you to reduce your medication if it is well under control, however, it is very dangerous to stop without supervision.

Myth: Pregnant women with asthma should not take the flu shot.1

Truth: Pregnant women should get the flu shot when it’s available. Getting the vaccine is protecting them, and via the placenta, giving the baby some flu immunity, too.

Myth: Asthma medication is dangerous and can be addicting.4

Truth: No asthma medication used in the U.S. is habit-forming or addicting. Although some medications are inhaled corticosteroids, these are not related to the steroids used for muscle growth (for athletes).

Myth: Asthma can’t be fatal.5

Truth: It is rare, but fatalities can happen. The rate of death due to asthma has been decreasing since 2001

Myth: My child has asthma and shouldn’t be allowed to play outside or play any sports.7

Truth: All kids need to exercise and be healthy. As long as a child with controlled asthma takes their medication before they play outside or join a sport, they should be able to keep up. If the child has uncontrolled asthma, they may develop symptoms as they play.

Myth: Asthma symptoms are the same for everyone.2

Truth: Asthma affects each person differently. One person might show several symptoms and others may just cough.

Myth: Asthma is all in your mind.2

Truth: Asthma is hard to predict but can be very serious. There can be underlying inflammation in the airways in people with asthma. Asthma doesn’t just go away when symptoms are gone.

Myth: Asthma medication becomes less effective over time.6

Truth: If you have an asthma attack, it may not be that your medication has stopped working- it may just be the air quality or you are being exposed to a new environmental trigger. Although if it is noticeable that you’re having a difficult time controlling your asthma, contact your doctor and find ways to better manage or change your medication.

If you have any questions about how to maintain your asthma, please give us a call and schedule an appointment with one of our board-certified providers to help you find the best ways to help. 210-616-0882.

Allergyasthmanetwork.com
https://health.utah.gov/asthma/pdfs/factsheets/myths_facts_asthma.pdf
https://www.amestrib.com/news/20180514/myth-busting-5-facts-about-allergic-asthma-that-may-surprise-you
health.usnews.com/health-care/for-better/articles/2018-12-04/common-myths-about-asthma
https://www.pulmonologyadvisor.com/home/topics/asthma/asthma-myths-5-misconceptions-your-patients-might-have/
https://www.childrens.com/health-wellness/busting-6-asthma-myths
https://www.chop.edu/news/asthma-myths-and-facts

May 4, 2021/by Kayla Gomez

Allergies, English, Health

What You Need to Know About Palforzia

AllergySA is the first clinic in San Antonio to introduce Palforzia. We have, since, been named second in the nation to have a patient reach maintenance phase.

Since Palforzia has been successful, many parents are interested in this treatment and might have several questions about it. Let’s explore the need-to-know information to understand what Palforzia really is.

What is Palforzia?

Palforzia is an oral immunotherapy treatment for children of ages 4-17, with peanut allergy to help reduce the severity of allergic reactions and anaphylaxis. It is a defatted peanut protein powder that is carefully measured in capsules or a sachet, depending on how large the dosage is. It is the first FDA approved oral immunotherapy for a food allergy.

Your child can face a severe reaction to exposure to peanuts, and this treatment can help reduce the likeliness of a reaction.

How effective is Palforzia?

Effectiveness is proven as long as your child is on Palforzia. Recent studies have shown that children with long-term daily dosing treatments have had the greatest strides in reaching maintenance in desensitization to their peanut allergy.

Just after 2 years of taking Palforzia, more than 80% of children demonstrated desensitization to 2000 mg of peanut protein (which is equivalent to 6 peanut kernels).

How is Palforzia taken?

Palforzia is a powder to be mixed in soft, room temperature food such as pudding, applesauce, or anything else that is tolerated by the child.

Open capsule or sachet and mix in food
Wash hands after mixing
Medication can be refrigerated between 2-8⁰C

What are the side effects?

Side effects include:

Stomach pain
Vomiting
Feeling sick
Itching or burning in the mouth
Throat irritation
Cough
Runny rose
Sneezing
Itchy skin
Hives

Most side effects are mild and resolve within 40 minutes of taking Palforzia. More severe reactions include the risk of anaphylaxis and developing Eosinophilic Esophagitis (EoE).

How do I start my child on Palforzia?

All children must first be enrolled in the Palforzia Risk Evaluation and Mitigation Strategy program (REMS). This is a safety program that manages the risk of anaphylaxis associated with Palforzia and is required by the FDA to ensure the benefits outweigh the risks.

If your doctor prescribes your child to Palforzia, they will send the prescription to a specialty pharmacy. If your insurance is eligible the pharmacy will reach out to you to confirm the shipment details of Palforzia.

Patients with no insurance or with commercial insurance who have been denied coverage can be put in the Palforzia Pathway Patient Assistance Program and are eligible to receive Palforzia at no cost.

If you think that Palforzia is something that your child may need, schedule an appointment with us at 210-616-0882 today to learn more.

April 19, 2021/by Kayla Gomez

Allergies, English, Health

15 Allergy Friendly & Affordable Easter Candy

Easter is right around the corner and we want to make sure that you are fully aware of what your children will eat this weekend. We have made a list of 15 affordable Easter treats that exclude some of the most common allergens so you can have a fun and safe Easter weekend!

Amanda’s Own Confections: Jelly Beans

This product is dairy-free, nut-free, peanut-free, gluten-free, wheat-free, soy-free, egg-free, sesame-free, mustard-free, shellfish-free and crustacean-free. NOT vegan.
Price: ranges from $7.25 – $8.25

Chocolate Emporium: Chocolate bunnies

This product is dairy-free, gluten-free, vegan and parve.
Price: $4.85 each

Double Bubble: Egg shaped gumballs

This product is nut-free gluten-free, shellfish-free, egg-free and kosher.
Price: $1.00

Evolved: Chocolate bars

This product is gluten-free, dairy-free, cane sugar-free, soy-free and vegan. Check website for more flavors and ingredient listings.
Price: $4.99

free2b Foods: Chocolate butter cups

This product is gluten-free, egg-free, fish-free, peanut-free, shellfish-free, soy-free, tree nut-free and wheat-free. Check website for more flavors and ingredient listings.
Price: $2.50

No Whey Foods: Chocolate lollipops

This product is dairy-free, milk-free, lactose-free, peanut-free, tree nut-free, egg-free, soy-free, wheat-free, gluten-free and vegan.
Price: $3.95 each

Spangler: Dumdum fruity bunny pops

This product is dairy-free, gluten-free, tree nut-free, peanut-free, egg-free, soy-free, and fat-free.
Price: $2.99

Jelly Belly Candy Company: Sunkist fruit gems

This product is fat-free, peanut-free, gluten-free, kosher and vegan.
Price: $7.59

Tootsie Roll: Easter Midgees

This product is egg-free, tree nut-free, coconut-free, sesame-free, gluten free, wheat-free, shellfish-free and kosher.
Price: $9.99

Vermont Nut Free Chocolates: Marshmallow on a stick

This product is peanut-free, tree nut-free, coconut-free, sesame-free, fish-free, shellfish-free and kosher.
Price: $3.95 each

YumEarth: Licorice

This product is peanut-free, gluten-free, tree nut-free, milk-free, egg-free, fish-free, shellfish-free, soy-free and vegan. Check website for more flavors and ingredient listings.

Enjoy Life Foods: Chocolate Minis

This product is wheat-free, dairy-free, soy-free, sulfate-free, lupin-free, fish-free, crustaceans-free, peanut-free, tree nut-free, casein-free, egg-free, sesame-free, mustard-free and shellfish-free. Check website for more flavors and ingredient listings.
Price: $4.99

Skip’s Candies: Marsh Pops

This product is peanut-free, tree nut-free, and coconut-free.
Price: $3.25

Bo & Ty: Gummy worms

This product is nut-free and gluten-free.
Price: $6.14

Smarties (American): anything!

All of their product is gluten-free, milk-free, egg-free, fish-free, shellfish-free, tree nut-free, peanut-free, wheat-free, soy-free and vegan.
Price: starting at $2.89

We hope that you stay safe this weekend and enjoy all of the sweets and always remember to look at ingredients label before you consume your candy.

If you believe that your child has food allergies, please call AllergySA to schedule an appointment with one of our providers at 210-616-0882.

Happy Easter!

March 31, 2021/by Kayla Gomez

English, Health

Johnson & Johnson’s Janssen COVID-19 Vaccine Issued for Emergency Use Authorization

UPDATE 4/13/21: The Texas Department of State Health Services is asking vaccine providers in Texas to pause all administration of the Johnson & Johnson/Janssen COVID-19 vaccine following the CDC’s recommendation as it investigates six reported U.S. cases of a rare blood clot. For more information, see the DSHS Statement on Johnson & Johnson Vaccine here.

As of February 27, 2021, the U.S. Food and Drug Administration (FDA) has issued Emergency Use Authorization (EUA) for the third COVID-19 vaccine.

Johnson & Johnson’s Janssen COVID-19 Vaccine has properly met the required FDA criteria and will be provided in the United States for individuals 18 years and older. While the Pfizer-BioNTech and Moderna vaccines are still to be distributed, J&J plans to deliver over 20 million doses in March and 100 million doses within the first half of 2021.

What’s So Different About J&J’s Vaccine?

Pfizer and Moderna vaccines both have similar studies, effectiveness rates, vaccine types, etc. to prevent COVID-19 and have proven effectiveness. Johnson & Johnson’s Janssen vaccine shows various differences that are still effective and will prevent contracting COVID-19.

While Pfizer and Moderna are both mRNA (messenger RNA) vaccines, Johnson & Johnson developed a harmless adenovirus vector vaccine. This means the vaccine uses a harmless adenovirus to introduce COVID-19 spike protein information to the body, and helps us develop antibodies and immune cells to fight COVID-19 infection. Johnson & Johnson used this approach with their Ebola vaccine in July of 2020, which authorized by the European Medicines Agency.

The Janssen COVID-19 vaccine is a single-shot vaccine as opposed to the two-shot strategy that Pfizer and Moderna have developed. It is 66% effective in preventing the disease and 85% effective in preventing severe disease. These percentages are shown to be effective 28 days after vaccination. This vaccine is a useful tool in fighting the pandemic and combating the continuous high number of cases.

What Should I Do After Receiving the COVID-19 Vaccine?

Continue to wear your mask, practice social distancing, wash your hands frequently and all other practical guidelines that the CDC has provided us. As of right now, the vaccine is not quite yet out for the general public, so there are many without the vaccine that are still at risk of acquiring COVID-19.

Please continue to be cautious around those at high risk and the elderly.

It is recommended that once an individual is vaccinated, they are to be monitored 30 minutes after. If you are someone with a medication, food and/or vaccine allergy, it is advised that you keep your EpiPen alongside you at all times- before, during and after your COVID-19 vaccine.

However, medication, food and/or other vaccine allergies are NOT a contraindication for the COVID-19 vaccine.

Allergy SA will keep you updated with the latest, and will let our patients now as soon as we have the vaccine available in our clinics. To stay updated, please visit our page www.allergysa.com/covid19vaccine or call us for any questions you may have at 210-616-0882.

March 3, 2021/by Kayla Gomez

Health

COVID-19 Vaccine

AllergySA continues to monitor the approval of COVID-19 Vaccinations in the United States and the distribution/availability within our San Antonio community. We will continue to update our patients with information as we receive it.

Who Can Get the COVID-19 Vaccine?

As of Tuesday, November 2, 2021, everyone 5 years old and older is now eligible to receive a COVID-19 vaccine in Texas.

Children 5-11 are only eligible to receive the Pfizer-BioNTech vaccine. This vaccine for children has the same ingredients as the adults and adolescent vaccines. It is, however, an age-appropriate dose of one-third of the adult and adolescent doses and smaller needles designed for children.

The state’s Expert Vaccine Allocation Panel recommended opening vaccination to everyone who falls under the current Food and Drug Administration emergency use authorizations. All vaccines are authorized for people 18 years old and older. The Pfizer vaccine is authorized for people 12 years old and older.

For more details on the DSHS phases visit: https://www.dshs.state.tx.us/coronavirus/immunize/vaccine.aspx

Please call our offices at 210-616-0882 to schedule.

We continue to monitor vaccine locations throughout our community and will update this section as the information is received.

MetroHealth/Alamodome: MetroHealth continues to offer vaccine appointments per week dependent on supply. Appointments are required and can be made at covid19.sanantonio.gov/vaccine, by calling 311 (option 8) or 210-207-6000 (option 8).
WellMed’s Vaccine Locations are currently making appointments by phone only. Call 833-968-1745 to schedule.
University Health Vaccination Clinic (4522 Fredericksburg Road): For more information and to scheduled visit wecandoitsa.com
UT Health San Antonio has opened vaccine appointments to the general public. Appointments can be made by visiting: schedule.utmedicinesa.com
H-E-B Pharmacies are continually opening appointment slots as they receive supply. For more information and to view availability visit vaccine.heb.com
Walmart Pharmacies are administering vaccines at select locations. To view availability and to schedule visit walmart.com/covidvaccine
CVS Pharmacies are administering vaccines at select locations. Appointments are required and can be made by visiting: cvs.com/immunizations/covid-19-vaccine

Should I Get the COVID-19 Vaccination?

At this time we recommend everyone to get the vaccine, including those who have already recovered from COVID-19.

Some benefits include:

It is effective at preventing COVID-19 infection and may also protect those people living and working with you.
- Pfizer-BioNTech: 95% effective 7 days after fully vaccinated
- Moderna: 94.1% effective 14 days after fully vaccinated
- Johnson & Johnson’s Janssen: 66% effective 28 days after vaccination
Getting COVID-19 may offer some natural protection but if you are infected, there is no way to know how it will affect you. Vaccination will be a safer way to build protection.
Vaccination will be an important tool to help stop the pandemic.

What is Johnson & Johnson’s COVID-19 Vaccine and Will It Work?

On February 27, 2021, Johnson & Johnson’s Janssen COVID-19 vaccine is issued to be the third Emergency Use Authorization COVID-19 vaccine in the United States.

Harmless adenovirus vector vaccine that helps our body develop antibodies and immune cells to fight the infection
Available to ages of 18 years and older
Single-shot vaccine has proven 66% effectiveness in fighting the pandemic

Visit our most recent blog post to learn everything you need to now about the new Janssen COVID-19 vaccine.

We continue to monitor and learn more daily and will update our patients as more information becomes available.

For more information, watch Dr. Lukena Karkhanis answer your most common questions about the vaccine and vaccine reactions during these recent Facebook LIVE events.

January 8, 2021/by Kayla Gomez

Allergies, English, Health, Illness

Is It Mountain Cedar Allergies or COVID-19?

Venn Diagram of COVID and Seasonal Allergy Symptoms

Content source: National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases

Are you feeling a slight sniffle, cough or headache? This winter brings an extra layer of worry for mountain cedar sufferers as they try to decipher the difference between mountain cedar allergies and COVID-19.

The CDC has shared this helpful Venn diagram showing the differences and similarities of seasonal allergies to COVID-19. The biggest difference is that COVID-19 may cause: fever, chills, body aches, loss of taste or smell, nausea or vomiting, and diarrhea while seasonal allergies will not.

If you are experiencing a mixture of these symptoms it could be possible that you have contracted the COVID-19 virus while also being affected by mountain cedar pollen in the air. The only way to know for sure is by getting a COVID-19 test.

Taking extra precaution to wear a mask and social distance this winter is advised. If you believe that you may have COVID-19, be sure to get tested and quarantine to avoid spreading the virus to others. If you are having trouble breathing, or other emergency warning signs, seek emergency medical care immediately.

AllergySA is not a current testing site for COVID-19. For a list of testing locations please visit: https://covid19.sanantonio.gov/What-YOU-Can-Do/Testing#TestingLocation

A COVID-19 Vaccine is days away from approval. For up to date information on the vaccination, visit our COVID-19 Information page at: https://allergysa.com/covid19/#COVID-Vaccination

December 10, 2020/by Kayla Gomez

Allergies, English, Health

First Patient Reaches Maintenance Phase of Palforzia® – New FDA Approved Peanut Allergy Treatment

Congratulations to Claire for being our first peanut allergy patient to reach the maintenance phase of Palforzia®.

Palforzia® is the first and only standardized oral immunotherapy treatment approved by the U.S. Food and Drug Administration to minimize the incidence and severity of an allergic reaction from accidental exposure to peanuts.

Early this year, AllergySA was the first to introduce Palforzia® to the San Antonio area and is now the second in the nation to have a patient reach the maintenance phase. The treatment involves an up-dosing phase first administered in an allergist’s office every 2 weeks for about 6 months. Once up-dosing has been completed, the patient will continue taking the maintenance dose at home daily.

To start treatment, the patient needs to be between the ages of 4 and 17 with a confirmed diagnosis of peanut allergy. In the event of accidental peanut exposure, Palforzia® can help reduce the risk of a severe allergic reaction, including anaphylaxis.

Palforzia® is covered by all major insurances including Medicaid. To find out if Palforzia® is right for your family, schedule an appointment with AllergySA at 210-616-0882.

November 9, 2020/by Kayla Gomez

English, Health, News

COVID-19 creates new dilemma for parents with asthmatic children

AllergySA’s Medical Director, Dr. Joseph Diaz, was recently interviewed about how COVID-19 creates a dilemma for parents when your child has been diagnosed with asthma. While you may be ready to return back to work, finding childcare is difficult as your child is considered high-risk.

“If a child has asthma in the middle of COVID it’s a little more tricky. As you start to open up these daycares and you start to see people going back to work there is a dilemma,” Diaz said.

View the full story at news4sanantonio.com.

For an in depth look at Asthma and COVID-19, view our COVID-19 page including Dr. Diaz’s Facebook Live discussion: https://allergysa.com/covid19/

May 28, 2020/by Kayla Gomez

English, Health, Illness, YouTube

Information on Coronavirus (COVID-19)

As we continue to see the impact of Coronavirus (COVID-19), we feel it is important to share with you what AllergySA is doing to help slow the spread while continuing to provide critical care to our patients.

What is Eosinophilic Asthma?

10 Asthma Myth Busters

What You Need to Know About Palforzia

15 Allergy Friendly & Affordable Easter Candy

Johnson & Johnson’s Janssen COVID-19 Vaccine Issued for Emergency Use Authorization

COVID-19 Vaccine

Is It Mountain Cedar Allergies or COVID-19?

First Patient Reaches Maintenance Phase of Palforzia® – New FDA Approved Peanut Allergy Treatment

COVID-19 creates new dilemma for parents with asthmatic children

Information on Coronavirus (COVID-19)

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