No matter if your child is attending school online, in-person, or hybrid of both – returning to school is looking different for everyone this year. In addition to navigating the changes due to Covid-19, allergy and asthma families may have additional challenges or concerns this year. Here are some tips and thoughts if your child is back in the classroom this fall:
Stay home if sick, especially if you have a fever. Most schools have their own protocols in place regarding this. It’s important to keep your child home, monitor symptoms, and follow up with your doctor if needed.
While wearing a mask can prevent COVID transmission, a mask will not prevent allergies or asthma. Please be sure that allergy and asthma medications are continued as directed by your provider and if you feel your asthma is worse because of the mask, it’s a good idea to discuss with your provider.
Get your annual flu vaccine to keep your child healthy.
Many schools are having lunch time in the classroom, instead of the cafeteria. If your child has food allergy, remind them not to trade foods with other students. Consider meeting with the teacher to discuss any unique challenges your child may face with food in the classroom. Continue to educate your child on the importance of hand-washing to prevent the spread of germs, both in and out of the classroom.
Finally, make sure your food allergy and asthma action plans are up to date. Now is a great time to get into your allergy provider to discuss your food allergy action plans and asthma action plans and get up-to-date forms for schools. If you need your new forms completed, call our office. Some patients may need an appointment in order for their doctor or physician assistant to complete their forms.
Vocal Cord Dysfunction (VCD), also known as Paradoxical Vocal Fold Movement (PVFM) occurs when the vocal cords do not move or open properly. Sometimes, VCD can be confused with asthma because their symptoms and triggers are very similar. Symptoms of VCD can include shortness of breath, chronic cough, throat clearing, wheezing, loud whistling sound with breathing in, difficult getting a good breath in, frequent yawning, throat tightness, or hoarse voice. VCD can be triggered during stressful or anxious events, or with exercise. Triggers also include airborne dust, pollens and irritants, or colds and viruses. VCD can affect patients of all ages and conditioning level, and is commonly seen in elite athletes or runners. Acid reflux, seen with gastroesophageal reflux disease (GERD) and post nasal drainage seen with allergies or sinus disease, can also trigger VCD.
Diagnosing VCD can be a challenge. Often times we rely on the patient’s history, symptoms, and the timing of symptom onset. Sometimes, how a patient responds to different inhaled medications can be a clue. Spirometry, a test often used for asthma diagnosis and monitoring, can sometimes show features of vocal cord irritation. The most definitive way to diagnosis VCD is with laryngoscopy with visualization of the vocal cords.
Treatment for VCD depends on the underlying cause and is different for everyone. It involves treating the underlying cause and controlling triggers, as well as speech therapy or special breathing exercises to relax the throat muscles. The providers at AAAI can help determine if you have VCD or asthma (or both) and help find the right treatment program for you.
In eczema, or atopic dermatitis, the skin is dry, irritable, sensitive and prone to inflammation and infection. The natural course of eczema is to see periodic flares in symptoms – whether there is an identifiable trigger or not. Because of this, it can be very tricky to determine if a food is causing the eczema flares. Most of the time, the food does not cause the eczema, despite someone having a strong suspicion. People with eczema are at risk for food allergies, but when the food is ingested, there will typically be an immediate allergic reaction (with hives or wheezing, for example), rather than an eczema flare. Finally, it is not common for foods that were previously eaten without problems to become the allergic trigger. If you cannot get your eczema under control and have concerns about a food trigger, it’s important to discuss with your allergist. In the meantime, here are some tips:
1. Don’t assume the rash is result of a food allergy. Eczema is due to a barrier dysfunction and inflammation in the skin. A good skin care regimen or eczema care plan can help minimize flares and keep skin under control. The most important part of a skin care regimen is moisturizing (especially after bathing) and avoiding known triggers (chemicals, certain fabrics, etc).
2. If you see typical food allergy symptoms (such as hives, wheezing, vomiting) in addition to the eczema flare, it makes it much more likely that a food could be a trigger. Treat any reactions, take note of food ingredients, and talk to your allergist.
3. Do not remove foods from the diet on your own when a relationship is not clear. Removing foods can cause social and nutritional problems, and potentially cause more issues down the road.
4. Come to your allergist appointment ready to give details. Keep a good history about the foods eaten, how symptoms started and timing of symptoms. The history is the best “test” to determine if there is a food allergy, and way more informative than any blood or skin tests. Random testing for several foods can be inaccurate and misleading, but a good “history”, or details of what happened, is the most accurate test.
Managing food allergy and eczema is complicated. If you continue to have problems controlling your eczema, make an appointment with your allergist to discuss.