The Itch: Allergies, Asthma, Eczema & Immunology

If you treat patients with asthma, this episode is for you. Not just allergists, but GPs, pediatricians, family medicine doctors, urgent care providers, and anyone who sees a patient with asthma in their practice.

Dr. Cherie Zachary, current president of the American College of Allergy, Asthma and Immunology, joins Kortney and Dr. Payel Gupta to talk about why uncontrolled asthma remains a serious and largely preventable problem, and what providers can do differently starting with their next patient visit.

What we cover in this episode about uncontrolled asthma

The data behind the problem. ER visits, hospitalizations, and asthma deaths have not improved in years, and Dr. Zachary explains why that should concern every provider who treats asthma patients.

An ER visit is a treatment failure. Dr. Zachary makes the case that any asthma patient who ends up in urgent care or the emergency room should trigger an immediate reassessment of their treatment plan, not just a course of steroids and a send-home.

Five questions every provider should be asking. The episode walks through a standardized set of control questions designed to help providers catch uncontrolled asthma before it becomes a crisis, covering steroid use, ER visits, rescue inhaler use, nighttime waking, and daily activity limitations.

Why patients normalize their symptoms. Providers hear what controlled asthma should actually look like, and why patients often don't volunteer the information needed to catch a problem.

Who is most at risk. Dr. Zachary shares which patient populations are most likely to have uncontrolled asthma and least likely to be identified, and what providers can do to close that gap.

More resources about uncontrolled asthma

ControlYourAsthma.org 

Free AAN Asthma Coach Program

Find an allergist

Understanding Oral Corticosteroid Overuse in Asthma

Made in partnership with The Allergy & Asthma Network.

Thanks to Sanofi-Regeneron for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Food allergy bullying is more common than most parents realize, and most kids never bring it up on their own. Research shows it affects up to 1 in 3 children with food allergies, and the signs can be easy to miss: a lunchbox that keeps coming home full, a sudden reluctance to go to school, or quietly backing off from safe food habits to avoid standing out.

In this episode, psychologist Dr. Amanda Whitehouse joins Kortney and Dr. Payel Gupta to talk about what food allergy bullying actually looks like, how to start a conversation with your child without shutting them down, and when and how to bring the school into it.

What we cover in this episode about food allergy bullying

What food allergy bullying looks like. From verbal teasing and social exclusion to threats involving allergens, and how it differs from everyday teasing.

Signs your child may be being bullied. Behavioral shifts to watch for include school avoidance, changes in eating habits, and withdrawal from activities they used to love.

How to start the conversation. Why open-ended questions and connection before action are key to getting your child to open up.

When and how to involve the school. How to approach teachers and administrators, know your child's rights, and document what's happening.

Building resilience after bullying. How involving your child in the solution, rather than swooping in to fix it, helps them feel empowered rather than powerless.

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Made in partnership with The Allergy & Asthma Network.

Thanks to Genentech and Kaléo for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Kortney and Dr. Payel Gupta sit down with Nissa Shaffi, MS, Director of Advocacy at the Allergy & Asthma Network, to talk about what patient advocacy really means, how the healthcare system works as a whole, and how everyday people with allergies, asthma, and related conditions can learn to use their voice to push for real change.

What we cover in this episode is patient advocacy for allergy and asthma

Anyone can be an advocate. Advocacy is not just for politicians or lawyers. It is for anyone who sees a problem and wants to do something about it, from patients, caregivers, doctors, and everyday people alike.

Forms of advocacy, from social media to Capitol Hill. You do not have to fly to Washington to make a difference. Advocacy starts with education, storytelling, and showing up in whatever way you can.

How the healthcare system actually works. No single insurance company, hospital, or drug maker is to blame for everything. Understanding the whole system is what makes advocacy effective.

Why your story can change a law. Personal experience is one of the most powerful tools in advocacy. Real patient stories have driven landmark legislation and saved lives.

PALI, the Patient Advocacy Leadership Initiative. A free monthly program from the Allergy & Asthma Network that teaches patients the language, tools, and knowledge they need to advocate confidently at any level.

More resources

PALI (Patient Advocacy Leadership Initiative): 

Allergy & Asthma Day on Capitol Hill (AADCH)

AAN Advocacy Center, take action today! 

Bills Allergy & Asthma Network is prioritizing this year:

Safe Step Act

EPIPEN Act

HELP Copays Act 

One School One Nurse Act

See all the bills on the Network’s Advocacy page

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Made in partnership with The Allergy & Asthma Network.

If you have ever taken an antihistamine labeled "non-drowsy" and still ended up foggy and tired, you are not imagining it. Allergists have a lot to say about that label and about the foggy feeling that comes with allergy season in general.

In part two of our live recordings from the AAAAI conference in Philadelphia, Kortney and Dr. Payel Gupta talk to allergists from across the US about what they actually think about antihistamines.

What we cover in this episode about antihistamines:

Non-drowsy does not mean the same thing for every antihistamine. Zyrtec, Claritin, and Allegra are all labeled non-drowsy, but some are more likely to make you sleepy than others.

Why allergists have moved away from Benadryl. First-generation antihistamines cross into the brain more easily, causing drowsiness and a range of other side effects that are far less common with newer antihistamines.

The foggy feeling might not be your medication. Congestion from untreated allergies disrupts your sleep, and poor sleep creates its own fog. Sometimes it is the disease, not the drug.

Timing your antihistamine makes a real difference. Taking it before you head out gives it the best chance to work. And if it makes you drowsy, switching to a nighttime dose is a simple fix.

Not all second-generation antihistamines are approved for pilots. Fexofenadine has the lowest penetration into the brain of any antihistamine tested, which is why the FAA cleared it as the only option pilots can take while flying.

Second-generation antihistamines (non-sedating or minimally sedating)

Cetirizine — Zyrtec

Loratadine — Claritin, Alavert

Fexofenadine — Allegra

Levocetirizine — Xyzal

Desloratadine — Clarinex (prescription only)

First-generation antihistamines (sedating)

Diphenhydramine — Benadryl, ZzzQuil, Unisom

Chlorpheniramine — Chlor-Trimeton

Brompheniramine — Dimetapp

Dimenhydrinate — Dramamine

Hydroxyzine — Atarax, Vistaril (prescription only)

Thank you to our allergists

A huge thank you to every allergist who stopped what they were doing at the AAAAI conference to talk to us. We could not make this episode without you.

Dr. Mansi Kotwal, Instagram

Dr. Lauren Davidson, Instagram

Dr. Joel Brooks, LinkedIn

Dr. Pratibha Vakharia, allergyv.com

Dr. Rathika Gupta

Dr. David Wertheim

Thanks to Opella for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.

Ep. 150: What Allergists Really Think About Your Allergy Nasal Spray
If you have ever grabbed a nasal spray off the pharmacy shelf, used it for a few days, and given up because nothing seemed to be happening, you are not alone. And according to the allergists we spoke to at the AAAAI conference in Philadelphia, that is not uncommon.

In this episode, Kortney and Dr. Payel Gupta share real conversations with allergists from across the US about what they actually think about allergy nasal sprays.

What we cover in this episode about allergy nasal sprays

Why allergists love nasal steroid sprays. They work at the source of the problem by calming swelling inside the nose before your symptoms have a chance to take hold, and you can pick them up at the grocery store without a prescription.

You may not feel the nasal spray work right away. Nasal steroid sprays need about two weeks of consistent daily use before you feel a difference. The medication is working, you just cannot feel it yet. Do not give up early.

When to start before allergy season. Starting your spray a couple of weeks before your season hits means you go in with as little swelling inside your nose as possible, giving the medication the best chance to work.

Why so many patients stop using their spray. Incorrect technique causes irritation and nosebleeds, and means the medication is not landing where it needs to.

Not all nasal sprays smell or feel the same. If the smell or taste of your spray puts you off, there are options without it, and that is worth a conversation with your allergist or pharmacist.

Thank you to our allergists

A huge thank you to every allergist who stopped what they were doing at the AAAAI conference to talk to us. We could not make this episode without you.

Dr. Jessica Hui, Instagram | LinkedIn

Dr. Jamie Rutland, Instagram | Instagram: The Health Exchange Podcast

Dr. Juan Carlos Murillo, Instagram | LinkedIn

Dr. Tobi Olayiwola 

Dr. Jake Rosenblum, LinkedIn

Dr. David Wertheim

Dr. Sonali Majmudar, Instagram | LinkedIn

Thanks to Opella for sponsoring today’s episode. 

This podcast is for informational purposes only and does not substitute professional medical advice. Always consult with your healthcare provider for any medical concerns.