I often find that the terms "food allergy" and "food intolerance" are used interchangeably. But really….... they are not the same thing. Food Allergies  A true food allergy results when one's immune system overreacts to an ordinarily harmless food. This is caused by an antibody called Immunoglobulin E (IgE).  After production, IgE binds to allergy cells and waits to be activated by this offending food. Once these cells are stimulated, many chemicals and mediators are released (ex. Histamine) This sequence of events leads to an allergic reaction. What causes food intolerance? A food intolerance is an abnormal response to a food that is not an allergic reaction.  In fact, it does not even involve the immune system. It is usually the result of an enzymatic effect defect in the body. An example of this is with milk intolerance in adults in which the body has a defect in the lactase enzyme and therefore cannot break down lactose, which is a sugar. This inability to digest this sugar can lead to uncomfortable GI symptoms such as abdominal pain, bloating, gas and diarrhea. Examples of Types of Food Intolerances: a) Lactose Intolerance- absence of an enzyme needed to fully digest the food b) Irritable Bowel Syndrome: This chronic condition can cause cramping, constipation and c) Sensitivity to Food Additives: An example can include sulfites in wine which can trigger asthma in some individuals. d) Recurring stress of psychological factors e) Celiac disease -The immune system damages the small intestine when gluten protein found in wheat, rye, or barley is ingested. Life Impact of Food Allergies vs. Food Intolerance Food allergies occur in 1-2% of adults and <10% of children. They are far less common than food intolerances. Food intolerance can significantly affect your quality of life, but it is not life-threatening like a food allergy can be. The severity spectrum for food allergies can vary from mild symptoms to a severe anaphylactic episode.  Anaphylactic symptoms may include hives, lip swelling, vomiting, diarrhea, urticaria, angioedema, coughing, wheezing, and even cardiac arrest. This is why it is important for these patients to carry...

Mountain cedar, also known by its Latin name Juniperus ashei, is a drought tolerant native evergreen tree that causes winter/spring allergen in Texas. Although it is common in Mexico, in the USA, it is primarily found in Texas. The name Mountain Cedar originated from its highest density in the Hill Country area.  Its name is somewhat of a misnomer since it is a juniper and not cedar and Central Texas is hardly mountainous.   Most of the country is frozen in the winter without blooming plants, which gives people a break from allergies. Texas is unique in that it has a wintertime allergen, mountain cedar, which explodes in the cold winter months. Juniperus ashei is related to Juniperus virginiana that pollinates in the spring. Therefore, January till March is the peak season. The plant's part that causes allergies is the pollen, which is part of the plant's reproductive cycle. Did you know that trees can be male and female? The male cedar trees become covered with small brown cones that burst open on dry, windy days to release pollen. The pollen is often seen blowing in large clouds in the Central Texas area in January, often mistaken for wildfire due to the large and intense pollen clouds. The winds will carry the pollen for many miles, well into Oklahoma. Mountain Cedar is often referred to as “cedar fever” by the locals.  Although ironic, cedar fever does not produce a fever. Instead, it causes our wintertime misery of sneezing, runny nose, sore throat, itchy watery eyes, asthma, and cough. Sadly, each winter, I hear many people say that they assumed that living in Texas means you suffer from allergies, and little can be done about it.  No one should suffer from allergies with our excellent treatment options.  First, over the counter antihistamines and nasal steroid sprays, and nasal irrigation are an excellent start. Second, prescription antihistamine nasal sprays can be added.  If this treatment fails, immunotherapy by injections or drops is excellent.  Immunotherapy prevents symptoms and is the only treatment option that can be curative in many patients. Dr. James Holman...

Did you know that 6 million children have food allergies in the US? 1 in 13 children are affected. Given the standard classroom size, that is two children per class! These statistics are alarming but very accurate! So how did we get here? The truth is, we don't have one answer to explain this. The answer is likely multifactorial. We think that our rapid lifestyle change has contributed to this rise in food allergies over the past few decades. Being a native of West Africa, my mother grew up in a country where roasted peanut protein is everywhere in the culture and is integrated very early on into the infant diet. So whenever my mother reads such statistics, she almost always mutters, "We never had food allergies when we were growing up." She is exceedingly perplexed when she thinks about the fact that she has two grandchildren with severe food allergies. As a food allergy parent, you may be interested in knowing where food allergies come from. For me personally, I wanted to know if there was something I could have done to prevent food allergies in my children. Could I have eaten different foods? Should I have avoided specific foods during pregnancy, and the list goes on and on...….. Could I have done something to prevent this? This is a tough question that I know every food allergy mama has asked at one point in time. There have been excellent studies to confirm that eating allergenic food during pregnancy or avoiding allergenic food does not play a role in whether your newborn child develops food allergies. Furthermore, there is substantial evidence that our diet during breastfeeding does not increase the likelihood of food allergies, and mothers are free to consume varied diets without limitations. Moms, know that we are not at fault. We have all done the best with the knowledge that was available at each point in time. What are the current theories around the Food Allergy Epidemic? 1. Hygiene Hypothesis: "We Live Clean." You may already be familiar with the "hygiene hypothesis." Over the years, this...

It’s not too late to get your flu shot! Y’all it’s 2020! It is understandable that this time of year I would be writing a blog for FAAC patients about the importance of getting a flu shot.  I’ve been asking everyone since about mid-August: “Have you had your flu shot or are you planning to get one? “ When I ask this question, I usually receive one of the following responses: Yes, I have already had one or I am planning to get one because I get one every year or my work requires me to have one every year. No, I have not had it. I do not usually get a flu shot.  What do you think Dr. Hudelson?  I have never really had the flu. No, I have not. I do not get flu shots because I always get the flu when I do. No, I have not. They do not make sense to me because they are based on last year’s flu. No, I do not like to get vaccines because I am worried about side effects No, I cannot get the flu shot. I am allergic to eggs. Most of you know me well enough to know that my response tends to be: “Well it is my job to remind you to get your flu shot. I hope you will get one.” But I rarely preach. When I am asked my opinion, I always speak affirmatively about flu shots. I insist on flu shots for the staff at FAAC and for all high risk patients. Yet, I am re-thinking my approach in 2020!  Really y’all – it is 2020. And this year will go down in the history books as a hum dinger! The goal of this blog is to briefly speak to each of the patient responses given above as a reason to not get a flu shot.  Most of you will have already heard these reasons and for the most part have already decided whether you will or will not get a flu shot. This blog is my personal reason why I believe...

POLLEN COUNT ALERT: There are VERY HIGH concentrations of Weeds (Ragweed, Sage, Wormwood, Goosefoot, Lamb's Quarters, Pigweed, Amaranth, Saltbush, Russian Thistle). Visit the website to get the full report. CLICK HERE

    It is tough enough on those with food allergies during this anticipated tradition of Halloween.  But.. this year, we all need to juggle managing our child’s food allergies, Halloween festivities and the “real boogeyman this year”-The COVID-19 pandemic. This year we have ghosts, the boogeyman, food allergies and the virus to juggle.  So, what do you think? Are we going to have Halloween this year?  We think that the children do need some sort of normalcy and with careful planning and thoughtful precautions, we can have a safe successful Halloween.  Here are few tips and tricks to help you and your family have a safe Halloween. Trick or Treating will need to be re-imagined this year. We will need to be disciplined and really plan to make sure we “mask up” and keep social distancing at the forefront of our minds.  Pre-Halloween Hype and Tips:     1.  Let's talk with our children beforehand about what it will "look like" and “feel like” to have a fun and safe Halloween this year. We want to emphasize being "careful" rather than being fearful. Also emphasizing, that our goal is to keep others safe. You will want to have this discussion with your  child several weeks prior to the Halloween events.     2. Decorate your home for Halloween and paint your pumpkin teal blue to educate, gain support,          and create awareness about Food Allergies during the Halloween season. Support the Teal Pumpkin  Project to create awareness about food allergy in your community. This may        encourage your neighbors to have non-food Halloween treats.     3. If you decide to skip out on Trick or Treating this year due to the pandemic, you can still have a lot of fun. One idea is planning a Halloween Egg Scavenger hunt in your backyard with safe treats inside the eggs for your children to find.     4. Typically children grab their candy out of a bowl. This year avoid using any grab bowls in order to reduce the risk of virus transmission. Instead, consider individually wrapped Non-candy...

Its time again to vote for Best of Denton County! We are honored that so many of you have taken the time to nominate our office, thank you! The providers and our amazing staff are committed to continue to provide you with compassionate quality care.  Thank you so much for trusting us to take care of yourself and your families!  We love our patients! https://bestofdentoncounty.com/medical-health/  

The COVID-19 pandemic is scary for all people, but for those with asthma there is great fear that they will have a worse outcome or be more likely to get the virus that causes COVID-19. It is important to know that currently there is no evidence of increased infection rates in those with asthma. And although the Centers for Disease Control and Prevention states that patients with moderate-severe asthma could be at greater risk for more severe disease, there are no published data to support this at this time. There has been one report suggesting that asthma may increase the risk of hospitalization from COVID-19 in 18-49 year old adults; however, this is based on a small number of patients. And in the opposite direction are data from New York where asthma was under-represented (so possibly protective) in those who died from COVID-19. It is important to remember we are dealing with an evolving pandemic and new information could change the situation in the future.   Early reports suggested that steroids were not recommended in patients with COVID-19 disease, although there have been some indications that steroids are useful in severe COVID-19 disease. Given the varying opinions on the use of steroids and COVID-19, many are wondering what to do if their controller medication is a steroid (inhaled or oral). The short answer is continue taking your controller medications and do not stop them. The data suggesting that steroids might increase the shedding of SARS-CoV-2 comes from treating hospitalized patients with systemic steroids just for the viral illness. The use of inhaled or oral steroids for treating other diseases (like asthma) was not studied. However, people with asthma are placed on controller medications to keep their asthma under control. In the current pandemic, the best thing a person with asthma can do (with respect to asthma) is to get and keep their asthma under control. Stopping a controller medication will put the person at risk for developing an asthma exacerbation. In the current pandemic, treatment of an exacerbation will likely require going to the emergency department or urgent care,...

Dear patients, FAAC strives to be a source of accurate, helpful information for our community. To that end, we would like to share the following information with our patients. In the spirit of caring for our community and assisting our healthcare colleagues on the front-lines of the current pandemic, FAAC is committed to staying available to you, our patients. We are here for you, wherever you are.  While you are at home, we have Telemedicine up and running.  We are also seeing patients in the clinic with added protections. These policies are updated often based on current evidence. Current protections include: Disinfection of all surfaces every 2 hours and between patients. All staff wear masks at all times and are screened daily for fevers. In-person appointments are only scheduled at your Physician or Physician Assistant’s discretion after you are seen through a telemedicine visit. When a provider feels that their patient should be seen in person, the patient is pre-screened, checked for fever, and wears a mask while in the clinic. Appointment times are spaced out to allow adequate physical distancing. Only well patients enter through the front of the clinic.   The symptoms of the novel coronavirus can overlap with allergies and asthma. We want all of our patients to stay as healthy as possible, which is why we are continuing immunotherapy with added protections. Currently: All immunotherapy patients are pre-screened by a nurse at the door. The number of patients in shot waiting room is strictly controlled. If there are more than 10 patients waiting, you may be asked to wait in your car until you are able to receive your injection. All patients must still remain in the clinic during the post-injection wait period in case of allergic reaction. The post-injection wait period has been shortened to 20 minutes for patients with no asthma or history of systemic reactions in order to reduce the amount of time that patients are in the clinic. Patients older than 60 years on immunotherapy are encouraged to come in the morning to minimize their exposure to others. We request that all patients wear...

Coronavirus or Allergies? The spring pollen season is upon us!  Our FAAC pollen counters are reporting record high tree pollen and the grasses are starting to bloom as well. (www.faaccares.com/pollen).  All the visible yellow pollen on cars, driveways and trashcans is causing the usual spring miseries of sneezing, runny nose, itchy eyes and coughing.  Currently, the COVID-19 pandemic is making these symptoms particularly worrisome to the more than 50 million allergy sufferers in the U.S. because of the overlap of symptoms seen with ordinary allergies and COVID-19.  An otherwise annoying spring sneeze or cough now has the potential to cause fear and anxiety. Although cough is a common symptom in both the pandemic and seasonal allergies, there are several differences in symptoms between the two diseases. Allergy symptoms include sneezing, runny nose, itchy eyes, and occasionally cough. On the other hand, COVID-19 causes fever, shortness of breath, and body aches in addition to cough. Runny nose is rarely a symptom of the novel coronavirus. COVID-19 tips for spring allergy sufferers. Your allergy symptoms may lead to the feeling of constantly needing to scratch your eyes, nose, or face, but this behavior makes it easier to spread the virus. Here’s what you can do to help: Wash your hands frequently. Use tissues as much as possible to cover your sneezes. Throw the tissue away after use into a closed container. Continue to take your routine allergy medications consistently, including nasal sprays, decongestants, and antihistamines. Remove clothes you've worn outside and shower to rinse pollen from your skin and hair. Close doors and windows at night and on days when pollen counts are high. Avoid outdoor activity in the early morning when pollen counts are highest. Remember, the best way to give yourself peace of mind about whether your symptoms are a result of allergies or COVID-19 is to take your allergy medications consistently. If your symptoms go away after taking allergy medications and you don’t have other coronavirus symptoms, it is likely that you are dealing with allergies, not COVID-19.