The Itch: Allergies, Asthma, Eczema & Immunology

#56 - Biologic Therapies for Asthma

Part of the series: Allergy, Asthma & Immunology Innovations Podcast

This podcast was made in partnership with Allergy & Asthma Network, with funding support from AstraZeneca.

In this episode, we explore a new form of asthma treatment, Biologics. These innovative treatments offer targeted relief by addressing the underlying causes of asthma, leading to improved symptom control and a better quality of life. Dr. G and Kortney discuss the current biologics on the market for asthma treatment. 

As this is a true deep dive, we have provided some more information about the Biologics discussed to help you build a better understanding. We have included images and graphs you can use when listening to the episode. 

What we cover in this episode:

• A background on how Biologic treatments work.
• The Biologics available for asthma - discuss who is a candidate, how they each work, how they are taken and some side effects. 
  • Omalizumab (Xolair)
  • Mepolizumab
  • Reslizumab
  • Benralizumab
  • Dupilumab
  • Tezepelumab

Helpful links:

Images and graphs discussed in this episode: www.itchpodcast.com/episodes/56-asthma-biologics

A look at biologics in more depth: www.biologicmeds.org

More about type 2 inflammation: https://allergyasthmanetwork.org/news/when-asthma-more-than-asthma-type-inflammation/

#55 - What is a venom allergy?

Breaking down the facts behind a bee sting allergy and more!

In this episode, we delve into the world of venom allergies, focusing on allergic reactions caused by flying insects and fire ants. Our hosts are joined by Dr. Farah Khan, who shares her valuable expertise, in explaining the underlying mechanisms of allergic reactions to venom allergies. 

What we cover in this episode:

• What types of insects can cause a venom allergy and lead to anaphylaxis; honey bees, bumble bees, wasps, hornets, yellow jackets and fire ants.
• Why mosquitos are not a concern for anaphylaxis.
• What a normal versus an allergic reaction to venom looks like.Local versus systemic reactions. What is the difference, and when do you need to worry that you will potentially have an anaphylaxic reaction.
• When should you see a doctor regarding your insect bite.
• Why testing is not straightforward for insect stings (venom allergy): insect sting allergies are rare, and we do not want to over-test. What happens after you have reacted a venom and how to work with your allergist.
• Only test people who have had an allergic reaction to a sting. Types of tests that would be used once you have reacted to venom. 
• How to determine whether you are a candidate for immunotherapy. 
• Why allergist test for systemic mastocytosis when talking about venom allergies.
• What to do when you get stung and the best medications to take.
• How to best prepare yourself to avoid getting stung.
• Advice to someone afraid of a stinging insect.

More information about this episode can be found here: www.itchpodcast.com/episodes/55-venom-allergy

#54 - Early Introduction of Allergens in Babies

What is early allergen introduction for babies?

Are you still confused about when to feed your baby allergens? Over the past few decades, there has been quite a shift in thinking about the early introduction of food allergens for babies, so your confusion is wholly justified. Dr. G dives into this exact topic and talks to two professionals, Meenal Lele and Dr. Katie Marks-Cogan, in the field of early introduction. She explores why the guidelines for introducing allergens have changed and how to introduce allergens safely and consistently. 

What we cover in this podcast about the early introduction of food allergens:

What inspired Meenal and Katie to develop products to help parents with early allergen introduction?

What is early food introduction? Why are we no longer avoiding food allergens in babies? 

What studies have shaped the protocol change around introducing allergens to babies? How does this impact 'high-risk' children?

The challenges for the studies and compliance hurdles parents faced.  

Why do babies develop food allergies? What hypotheses point to the increase in food allergies in children over the past three decades?

The guidelines for early introduction of allergens. How to feed allergens to infants safely?

Why do you want to consider the early introduction of allergens with your babies? 

The role of food allergies in a baby's eczema: if your baby has eczema, will they develop food allergies? When to see an allergist for your baby?

What is the best practice for diagnosing a baby's allergies, and why is testing not always appropriate? How to work with your medical team and rely on something other than online information. 

Fundamental studies about the early introduction of allergens: The LEAP study, EAT study, PETIT study

Guest Bios

Meenal Lele is the founder of Lil Mixins, an allergy prevention company for babies. With experience as a food allergy parent and clinical knowledge, she created the company to provide options for parents introducing allergenic foods to their babies. Meenal holds an engineering and business degree from the University of Pennsylvania. She is the author of The Baby and the Biome, a book exploring the connection between a child's microbiome and their health.

Dr. Katie Marks-Cogan, MD, FAAAAI, FACAAI, specializes in allergies, asthma, and sinus disease. She is the head allergist at Ready.Set.Food and provides top-notch care to both kids and adults at Clear Allergy in Downtown Culver City, CA. As a mom of two, Dr. Marks-Cogan was inspired to work with Ready.Set.Food. Originally from Cleveland, OH, she graduated with honors from the University of Maryland School of Medicine after earning a Bachelor of Science Degree in Physiology and Neurobiology from the University of Maryland College Park.

#53 - Shared Decision Making for Atopic Dermatitis & Your Health Care Team

Tips on how to make the best of your atopic dermatitis management and care plan.

 

Atopic dermatitis is not a diagnosis that you should go at alone. Your care team can consist of multiple health care professionals, from your GP to a nurse, a therapist, and even your pharmacist. Additionally, you should be an active member in creating your healthcare plan since you are the one who needs to follow through with it day in and day out. 

In this final episode of our Atopic Dermatitis in Skin of Color series, Dr. G and Kortney talk to Tonya Winders, the president of Allergy Asthma Network, to discuss the nurse's role in AD management and shared decision-making. Tonya also shares her experiences of having a daughter with atopic dermatitis and the psychological toll the disease can have on patients. 

 

What we cover in this episode:

- Who can all be a part of your healthcare team

- Telehealth for atopic dermatitis

- Why decision aids are essential to use

 

Interview with Tonya Winters: 

- Nurses in an outpatient setting - understanding their role in patients with atopic dermatitis.

- Nurse versus a nurse practitioner

- Developing an atopic dermatitis plan - asking what your goals are.

- Allergy and Asthma Network is working to help more nurses and physician assistants to become certified in managing atopic dermatitis.

- Shared decision making - what is it, and how can you be sure you are practicing this with your healthcare team

- How to talk to your doctor about your financial situation when making your treatment plan

- Using shared decision aids to help with shared decision making and as a guide to talking with your care team.

- The importance of addressing psychological health for people with atopic dermatitis

 

Helpful Links:

The role of the nurse in the care and management of patients with atopic dermatitis - Paper co-authored by Tonya: https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-020-00494-y

Shared Decision Making Aids: www.ithcpodcast.com

#52 - Medications for treating atopic dermatitis in all skin colors

You have been diagnosed with atopic dermatitis or you are experiencing an eczema flare, now what can you do to treat it? 

In the fourth part of the series on atopic dermatitis in skin of color, Dr. G and Kortney discuss all medications available to treat AD, from topicals (creams) to oral medication and injections. 

They also discuss how other strategies to treat AD that is more budget-conscious if your insurance does not cover certain medications. 

What we cover in this atopic dermatitis in skin of color episode:

- Topical steroids: what are they, how to use them and their side effects

- Topical steroid withdrawal

- Other topicals that do not contain steroids

- Oral medication that may be prescribed for atopic dermatitis: oral steroids, antibiotics and antihistamines

- Biologics: what are they and their side effects

- Wet wrapping

- Phototherapy

From Shiv

- How to wet wrap and why she likes this form of treatment

Helpful atopic dermatitis in skin of color resources:

Non-Steroidal Topicals

1. Calcineurin inhibitors - tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel)
2. Phosphodiesterase 4 inhibitor - crisaborole (Eucrisa)
3. JAK inhibitors. 

Bleach bath recipe from the American Academy of Allergy, Asthma and Immunology (AAAAI)

• Add ¼ - ½ cup of common 5% household bleach to a bathtub full of water (40 gallons). 
• Soak your torso or just the affected part of your skin for about 10 minutes
• Limit diluted bleach baths to no more than twice a week. 

 

More information about AD in skin of color: https://eczemainskinofcolor.org/eczema-diagnosis-skin-of-color/

#51 - Skincare strategies and lifestyle changes for atopic dermatitis in all skin colors

Practical tips about skin care maintenance for atopic dermatitis

In the third part of our 5 part series in collaboration with the Allergy & Asthma Network on atopic dermatitis in skin of color we are talking all about taking care of your skin and how to make your living environment more atopic dermatitis friendly.

 

Dr. G and Kortney the importance of skin hydration; the best ways to moisturize and shower. They also share ways to ensure your living environment is optimized for good skin conditions, from cleaning products to carpets. Finally, they go over the psychological side of atopic dermatitis and how to maintain balance in the body and the mind. 

 

What we cover in this atopic dermatitis in skin of color episode:

Understanding the importance of keeping atopic skin hydrated.

How to break the itch-scratch-rash cycle.

Skincare: bathing and moisturizing - the preferred types of cleansers and moisturizers to use.

How to make your living environment atopic dermatitis friendly.

Sleep hygiene for atopic dermatitis.

Managing stress to help control eczema - some things that can help you.

Strategies to stop scratching.

 

From Shiv

How moving helped her flares.

Seeking therapy was important to her mental health and skin healing.

 

Helpful atopic dermatitis in skin of color resources:

Resource for AD in skin of color:  https://eczemainskinofcolor.org/eczema-diagnosis-skin-of-color/

Dr G and Kortney discuss yoga for asthma - many of the tips can also apply to atopic dermatitis:https://allergyasthmanetwork.org/news/does-yoga-benefit-asthma/ 

More eczema episodes: https://www.itchpodcast.com/eczema

Yoga for asthma podcast: https://www.itchpodcast.com/episodes/48-yoga-asthma

Meet Shiv on Instagram: https://www.instagram.com/shivaika/ 

#50 - Diagnosing AD in patients with skin of color

How do doctors diagnose atopic dermatitis in skin of color?

In the second part of our 5 part series in collaboration with the Allergy & Asthma Network  on atopic dermatitis in skin of color we are talking about diagnosis!

Dr. G and Kortney discuss all of the tests involved in diagnosing atopic dermatitis (AD) in people with skin color. They also cover all of the skin conditions that are ruled out when a doctor is making a diagnosis and the importance of patient history in diagnosis. 

 

What we cover in this episode:

• A quick overview of what AD looks like in skin of color

• Skin conditions that may look like atopic dermatitis and common misdiagnosis

• The symptoms doctors look for when diagnosing atopic dermatitis

• Explanations of the  tests doctors use to diagnose atopic dermatitis- IgE blood test, component blood test, skin prick test, patch testing,and  skin biopsy

• How to diagnose eczema in babies and the link to food allergies

• The other factors that doctors take into account when diagnosing AD - the importance of patient history

 

From Shiv:

• Shiv shares her experiences with being diagnosed with atopic dermatitis and her experiences with different doctors.

 

Helpful Links:

• Link to images of AD in skin of color: https://eczemainskinofcolor.org/image-library/

• “What is eczema” from Allergy & Asthma Network: https://allergyasthmanetwork.org/what-is-eczema/

• More about Shiv: https://www.instagram.com/shivaika/

#49 - Understanding Atopic Dermatitis in Skin of Color

This is the first episode of our 5 part series in collaboration with the Allergy & Asthma Network about atopic dermatitis in skin of color. 

In the first episode, we are going to talk about atopic dermatitis (AD) in people with skin of color. Atopic dermatitis affects everyone differently, which means it does not look the same on everyone or in every skin color. It is important to recognize this and to raise awareness on how AD impacts certain populations differently than others. 

Along with Kortney, Dr. G will be sharing her expertise as an allergist and will be overviewing the basics of AD. Special guest Shiv Sewlal shares her personal experiences with atopic dermatitis. 

 

What we cover in this episode

• Why are we doing a podcast series about atopic dermatitis (AD) in people with skin of color?

• What is atopic dermatitis?

• Is eczema the same thing as atopic dermatitis?

• What is the difference between child onset versus adult-onset atopic dermatitis? Can you develop AD as an adult?

• Why is atopic dermatitis more prominent in people with skin of color?

• How can housing impact your skin? 

• Why air conditioning can be helpful for people with atopic dermatitis.

• Why is atopic dermatitis underdiagnosed in patients with skin of color?

• What are the symptoms of AD in different skin colors?

• What are triggers? How do these make atopic dermatitis worse?

• How does mental health impact atopic dermatitis?

• What is the itch-scratch cycle?

• Who should you see if you think you have atopic dermatitis?

 

From Shiv

• Shiv shares what her atopic dermatitis looks like

• Shiv and her mom’s experience with therapy to help with her skincare

 

Helpful Resources

•  All our past atopic dermatitis episodes: https://www.itchpodcast.com/eczema

• More about Shiv: https://www.instagram.com/shivaika/

• "What is eczema" from Allergy & Asthma Network: https://allergyasthmanetwork.org/what-is-eczema/

#48 - Yoga for asthma

Can yoga help with asthma management and control?

We are releasing the ‘Yoga breathing exercises for asthma’ panel discussion that Dr. G and Kortney had in the late fall of 2021. This was one of 3 Living Well with Asthma Virtual Events organized by Allergy & Asthma Network and sponsored by GSK.

What we cover in this climate change episode:

- The benefits of yoga for your breath, asthma and overall health. 

- How yoga gives you more body awareness that helps with asthma management. 

- How to choose which form of yoga to do.

- When to use an albuterol inhaler before yoga.

- How to prepare for your first yoga class and what to look for. 

- The difference between doing yoga at home vs doing yoga in a studio.

 

Q&A section:

- Can yoga help with vocal chord dysfunction?

- How about going to a studio during the pandemic?

- Do you need to modify your yoga practice due to age?

- Are there any medical conditions that would stop you from doing yoga?

 

Helpful resources:

- Kortney’s yoga tips: https://thezestfull.com/yoga-for-asthma/

- Watch the panel discussion here: https://allergyasthmanetwork.org/news/does-yoga-benefit-asthma/

#47 - The impacts of climate change on human health

What are the impacts of climate change on human health?

Climate change is a large public health threat, it impacts all aspects of human health from physical to mental. Dr. Neelu Tummala joins us to discuss how we are seeing the direct effects of climate change on human health. She also shares ways that both patients and doctors can take action to help combat climate change. 

The face of climate change is no longer the polar bear, it is your son, your grandma, your neighbour, and even you!

What we cover in this climate change episode:

• How is climate change impacting our health? 

• Why are doctors are concerned about the increased length of pollen allergy season? 

• What can doctors and patients do to make a difference with climate change?

  • Understanding what changes the government can do such as the Build Back Better Act

  • Supporting local organizations 

  • Energy efficiency home

• Building awareness: if you are living with a condition that is affected by climate change and your environment - talk about it!

• How climate change is impacting lower-income communities more than wealthy communities?

• Dr. Tummala explains why you want to talk about climate change with your doctor

• The importance of being aware of the air quality index

• How much impact does an individual have versus a government or big company?

• Plant-based diet - what if you love eating steak?

• Is recycling actually worth it?

Helpful resources:

More about Dr. Neelu Tammula

• Dr. Neelu Tummala is a board-certified physician, surgeon, writer and climate advocate who has a special interest in education and advocacy concerning the health effects of climate change and environmental injustice. 

• She is on the Steering Committee for Virginia Clinicians for Climate Action and is a trained Climate Reality Leader. She has worked with the American Lung Association, Union of Concerned Scientists, The Medical Society Consortium on Climate and Health, and Environment Virginia as a volunteer activist and educator.

• Follow Dr. Tummala on social media:

  • https://www.instagram.com/neelutummala/

  • https://www.linkedin.com/in/neelu-tummala-55600196/

  • https://twitter.com/neelutummala