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The most common antibiotic allergy is penicillin.  About 10 years after a true allergy reaction, the chances are 1 person in 10 will still be sensitive.

The challenge will determine if there is a problem still.  Nevertheless, these persons can be desensitized.  For other antibiotics or medications the person can be built up to a dose of the medication that will allow the medication to be used until the treatment is finished.  If another similar need for the medication arises, the process must be started anew. In the case of Aspirin, the person is also given successfully higher doses of the medication and the reaction is treated as they arise.  Once the person has been given 325 mg. of Aspirin they are required to take that dose daily from then on to continue to use the product safely. More information is available at www.ACAAI.org and www.worldallergy.org


When metal parts are put into a person there is a risk of becoming sensitive to the metal.

This is especially true if the person is sensitive to poison oak, poison ivy and nickel if is commonly recommended to have patch testing with the material before it is used.  This requires putting a small sample of the product on the skin, covering it up and keeping it dry for 5 or 7 days.  It the area become itchy, red, painful or swollen there is a problem.  This means the metal containing graft cannot be used. Unfortunately, we find this out after the graft is in place and surgery is required to remove the offending material.  Obviously we prefer to see you before a graft is used.  We will work with your medical team to work out a solution.


With this condition you can have swelling of the face, hands, throat, and gastrointestinal tract.

When it is not responding to simple measures, a medication called Xolair or Omalizumab is available. This wondrous medication requires an injection once a month.  Recently the FDA has approved this medication for this condition.  We do have to petition your health insurance for coverage, but we have excellent responses. I recommend going to www.xolair.com for more detailed information.


This is a serious life-threatening problem, which formerly required medications that can impair the response to infections.

Xolair or Omalizumab is available for this condition and it can truly change the future for these people.  It is given by injection once or twice a month.  It has an excellent safety profile and we have used this for a number of people. I recommend going to www.xolair.com for more detailed information.


These children and adults present with severe pain with swallowing.

In infants and young children this can severely impair growth and development.  In adults, difficulty swallowing is noted and is the most common reason people seek the help of a Gastroenterologist.

The diagnosis is made by doing a biopsy of the esophagus to see if there is a dramatic number of Eosinophil in the tissue.  The Eosinophil is designed to destroy parasites that may be eaten; it releases very potent chemicals that will kill any worm or parasite as such they are very nasty cells to have in abundance.  Traditionally corticosteroids are needed to control the problem, but for many persons food sensitivity underlies the problem.  To cure the problem requires tests to check food sensitivity and avoiding the products entirely from that point on.  Skin and blood studies can identify the culprit in many cases. For more information I recommend going to www.acaai.org for good information about this subject.


Some forms of immune deficiency are as common as 1 in 100,000.

These can occur from birth, but can be acquired later in life. Most commonly a person suffers more frequent and severe infections requiring antibiotics and hospitalizations.

After a thorough history and physical, blood studies are required to clarify the nature of the problem and propose a treatment plan. Common Variable Immune Deficiency is the most common problem and there is help to correct the problem. Some other immune deficiencies will require referral to a regional medical center for evaluation and therapy. For detailed information about Immune Deficiency Disorders I recommend www.primaryimmune.org for details.


This condition can occur a birth with a genetic defect or acquired later in life.

It occurs in 1 person in 10,000 to 50,000 so it is not that rare. These people will have episodes of severe swelling of the throat, hands or feet or severe swelling of the intestines.  It can be lethal and in the hereditary version a family may have a history of relatives suddenly dying for no apparent reason.  In almost every case, simple blood studies can determine if you have the problem and now there are excellent medications available to treat and even prevent these episodes for occurring.  In many cases the person will require training to give the necessary medication at the onset of the problem to decrease the severity of the reaction; it is truly life saving medication. Go to www.haea.org for more information.