I am very excited to have the oppourtunity to have Dr. John Weiner as a guest blogger today!! I had some questions for him regarding allergies and luckily he was thrilled to answer! You can check out his blog http://www.allergynet.com.au . Here is a brief description about him :) Enjoy!
Dr John Weiner is a medical doctor specializing in Allergy and Clinical Immunology in Melbourne, Australia. He is a part-time PhD student at Monash University in Melbourne, studying e-Professionalism. John maintains AllergyNet Australia, the longest continuous medical blog in the world, which was launched in January 1998, was recently archived by the National Library of Australia. John microblogs on Twitter @AllergyNet.
1. How did you become interested/ involved in allergies?
My initial love was Pathology, and I specialized in a branch called Anatomical Pathology. That involved a lot of time looking down a microscope. I was fortunate enough to obtain a Fellowship at the Armed Forces Institute of Pathology in Washington DC. I sub-specialized in Eye, Ear, Nose and Throat Pathology, and after two years returned to Melbourne as a hospital pathologist. Allergy often involves the eyes and nose, so I learnt a lot about allergy. After six years I hankered to treat live people again, so I became a Fellow once more, this time in Allergy and Clinical Immunology. After two more years, I opened my clinic. That was 24 years ago!
2. Do you have any allergies?
Just one. In 1972 I was a 24-year-old intern. I spent three months in a country hospital that was 4 hours drive from Melbourne. A patient there gave me a large bunch of Protea flowers. These grow well in Australia, but are South African, and in fact the King Protea is the national flower of that country. By the time I walked the half-mile back to my quarters, with the large bunch slung over my shoulder, I was covered in hives.
Of course, I have blamed the Protea for the last 42 years. It could have been something I ate, a tablet I may have taken, the exercise itself, or something else. But I never bothered to see an allergist. As the great physician Sir William Osler said over a hundred years ago, “the doctor who treats himself has a fool for a patient”!
3. What do you think is the biggest challenge that people with allergies face? How should they overcome this?
OK, up to about 15 years ago the greatest challenge was acceptance. The public then considered all allergies as trivial.
Now the greatest challenge, I believe, is delineation. By that I mean a separation between true, important allergies, and dietary or other changes as a lifestyle choice. When an adult goes to the restaurant and says “no dairy please”, we should remember that the owner hears this request say 50 times a week. Maybe one in 200 such (adult) customers have a true cow’s milk allergy that is potentially anaphylactic. This can downgrade the potential importance of these allergies in the mind of the owner. A clued-up food seller would ask “Are you anaphylactic?” and “Do you carry an epinephrine (adrenaline) injector?” The allergy sufferer then knows immediately that the food seller is in the zone. Both the seller and the customer can then have an intelligent and informed discussion about the food or meal.
How can this challenge be overcome? Put simply, by education. From schools, associations, food regulatory bodies, and governments. And, yes, from you and me through social media. Remember, it’s the squeaky wheel that gets the oil.
4. Do you believe that one day we will have a cure for allergies?
Absolutely. A proper vaccine for food allergy, I believe, will be available inside 15 years. By “proper” I mean a short course of treatment resulting in a cure.
There are already reasonably good immunotherapy treatments for hay fever and asthma (allergy shots). Most of the world, apart from the USA, has also used oral immunotherapy for 15 years, again for hay fever and asthma, and it is hoped that the FDA will approve such treatment in 2014.
5. Have you any advice for newly diagnosed people?
Well, it depends a bit on the diagnosis. There are protocols in all countries on advice regarding anaphylaxis, asthma, upper airway disease, eczema, hives and so on. Philosophically though, the best advice is a thorough explanation from a caring allergist, even if a cause cannot be found. Most people will accept that approach and this helps them plan their life.
More practically, seeking a list of available resources through national allergy bodies is also most helpful, and Twitter is replete with excellent resources.
6. Why do feel there is an increase of allergies in the last 10 years?
As your readers are aware, there are many theories, but no proven reasons. These include the hygiene hypothesis, delayed infant feeding, pollutants, diet, and vitamin D. I favor the “hygiene hypothesis” – a combination of the allergy genes together with reduced infection in early life. There are a lot of epidemiological studies to support that view. I feel that epidemiology (the statistical study of the causes and effects of health and disease) is a most valuable discipline. Of course, it is statistical, but then so is most of medicine! UCLA Health has a nice poster on the hygiene theory http://fooddrugallergy.ucla.edu/body.cfm?id=40
7. Anything else you may want to add?
As a 65-year-old man, I am so impressed with young men and women (like yourself, Sydney) who have used social media to educate and inform. Way back, we were hampered by both personal privacy, and the restrictions of pen and paper. Now, the culture and technology have changed. We can blog away our innermost and pressing problems, and receive support on a global scale. For those with allergies, this has been a godsend. To all those who take the time to share their experiences, keep up the good work! And thank you for allowing me to be a guest on your terrific blog.
** Thank you Dr. John Weiner for your answers and insight. It was a pleasure having you on my blog!