WHAT MAKES A BETTER OPTION FOR AN ATTORNEY?
Welcome to the trusted podcast. I am your host Blake Johnson. Uh, today we’re going to be talking about allergies and I’ve got my good friend, dr. David reader, who is an allergy specialist, and he’s going to be giving us all the information. So, Dave, thanks for joining us today for us as the best Trusts Attorney Las Vegas.
Hey, absolutely. It’s great to be here.
All right, Dave, just gives us a little bit background about yourself, uh, and your office, and what makes you guys the trusted experts in your field?
Yeah, so, um, my name is dr. Dave Reeder. I was born and raised in Mesa. Arizona went to school for undergrad at BYU and graduated in exercise science. For those of you that don’t know BYU is Brigham young university to enjoy a better level of Trusts Attorney Las Vegas services. I went to medical school at the University of Arizona College of Medicine in Phoenix, uh, completed residency and, uh, Mount Auburn Hospital in Cambridge, Massachusetts. And I finished fellowship, uh, actually just the summer in Irvine, California. And, uh, I’m not practicing the real world now. It feels great. Um, I just joined a practice called Arizona allergy associates and we have five locations. Um, one is in central Phoenix and all the other ones are in the East Valley of Phoenix. Um, yeah, that’s briefly about me,
I think has been, um, you know, a little humble there. And when you mean means he was in Massachusetts, he was doing his residency under Harvard. So, you know, definitely don’t want him to pass that over.
It was part of, it was one of the Harvard teaching hospitals, but it wasn’t like their flagship. It wasn’t Brigham, it wasn’t Brigham and women’s hospital, but yeah, it was, it was a really fun time in Massachusetts, a chance for my wife and me to have an adventure. Um, and we, we loved all the places we’ve trained out, all the people we’ve been with.
We’ve done a lot of schools and a lot of hands-on learning in different hospitals. So, um, I think you definitely have the credentials there, so what’s, let’s dive right in. What are the most common forms of allergies that you see and, um, talk about whether they’re preventable or curable for the best Trusts Attorney Las Vegas?
So, um, when you talk about allergies, um, what you’re really talking about is a situation where your body has mounting an immune response against something that otherwise isn’t inherently dangerous. Um, so when you take allergies that affect the nose as an example, something like Birch pollen, isn’t inherently dangerous in and of itself, but your body, for some reason, targets, uh, some portions of Birch pollen, protein, and, uh, somehow convinces itself that it’s dangerous. And it decides to mount an immune response against it. It creates inflammation and then all of the symptoms of, uh, that inflammation, uh, become known to the patient is going to be the great Trusts Attorney Las Vegas. So when we’re talking about just the nose, you see things like a stuffy nose, runny nose down the lip, that’s called rhinorrhea, runny nose down the back of the throat. That’s called postnasal drip. Um, that postnasal drip can cause sore and scratchy throat frequent throat clearing.
Um, I hear patients sneeze all the time. Um, so there’s, there’s a host of changes that start to happen in the nose. And then because of the dripping aspect of the nose also in the throat, um, that same kind of process, if the Birch pollen comes into contact with the eyes can cause eye symptoms. So watery eyes, itchy eyes, red eyes, um, and if it’s inhaled into the lungs, um, it can actually, uh, precipitate something like an asthma flare asthma attack, asthma itself with amazing Trusts Attorney Las Vegas. And so you’ll, um, have patients complaining about shortness of breath, wheezing, cough, chest tightness, um, as an allergist, I help manage all these things, but interestingly, there’s also nonallergic triggers for all of these things too. So, um, I know for me, I’ve, I’ve had those symptoms in the nose, my entire life, and it’s not just allergies. That’s causing him when I walked by strong perfumes or colognes.
Um, it triggers my nose as well. Um, strong deodorants can do it, um, cleaning supplies. And I tell my wife all the time, I can’t clean that it’s going to trigger my nose symptoms. Um, it doesn’t really work. Um, but sometimes if it’s especially bad, she lets me off the hook. Um, let’s see, we take care of other stuff. We take care of eczema. Um, that’s a dry itchy rash on the skin. We tear care of highs. We take care of it. Um, let’s see, we can tinker with the immune system if there are immune deficiencies. So I’m not just an allergist, I’m also an immunologist for the best Trusts Attorney Las Vegas around. Um, if someone’s having recurrent or severe infections, we can actually help too, um, replace part of the immune system. That’s nonfunctional in certain circumstances. Um, there are very limited roles for this, but sometimes we can actually change someone’s, uh, genes it’s called gene therapy or gene editing, and we can replace for them with their body isn’t making itself. Um, so there’s some really slick therapies that are kind of, uh, hot off the press. Some of them are still being developed and it’s really fun to be part of this field because I’m making a difference in patient’s lives, helping them breathe better. Um, it’s, it’s fun to, uh, be a doctor
Let’s talk about, uh, you know, there’s obviously treatment the different things that you can do. So if with these treatments, is it more of just managing symptoms or can they eventually become to where they stop having that allergic reaction to the Birch pollen or whatever it is?
Yeah, that’s a great question. Um, so we have several different approaches to helping patients that complain of these symptoms. And sometimes it is caused by allergies. Sometimes it’s caused by the non-allergic triggers, um, as it pertains to the allergies and the non-allergic triggers, we can always suggest therapies that are intended to alleviate symptoms. And so we can give you therapies that will stop the nose from being so darn stuffy and it can dry the nose out and we can prevent phenomena with, um, the allergy specific inflammation called priming or less and less of the allergen is required for your body to mount an immune response. Um, there are immune-modulating therapies and that’s a complicated word. What it means is that I can actually change, um, some aspect of the disease itself rather than, um, cover up the symptoms with the bandaid and those immune-modulating therapies come from something like allergy shots.
Um, so with the allergy shots, um, we actually intend on introducing you to very small amounts of the substance you are allergic to. And over time we build up that, uh, threshold that dose for you. And we get you to a point where your body is becoming so accustomed to seeing this, uh, allergen that it effectively raises its own triggering threshold for how much you need to be exposed to in order for your body to Mount a particular immune response. But also we’re changing the immune responses that your body makes. Um, we’re changing it from a particular antibody called IgE to different types of antibodies like IgG one and IgG four. We can get really into the minutia Blake. I don’t, I don’t think you’re that far into it. Um, but, uh, yeah, essentially we can change, uh, the way that your body responds to allergens in a way that effectively takes away, um, that allergic response at normal exposures to allergens. So, um, in 85% of patients, they report that their symptoms are either blunted or in some cases taken away by, um, allergy shots. And that helps with the nose, the eyes, it helps with the breathing. Um, we have a recent indication even for eczema, um, particularly with house dust mite, which is, um, a really interesting allergen. So that was a great question. Right.
Okay. So what about, uh, you know, if I’m at home and I constantly expose myself to whatever I feel is making me allergic, am I going to have the same type of response as the allergy shot by giving the exposure that way? Or is there something else with allergy shots or is there anything I can do at home to help expand my migraine,
Um, at home, it really, the only studied, um, therapies for how to effectively induce those kinds of, um, immune-modulating, uh, therapies it’s allergy shots. Um, in Europe, they do a little more with sublingual therapy, sublingual meeting under the tongue. Um, and they’ve put a lot of stock into, um, trying that as a, um, alternative. Um, but here in the States, we, we prefer the allergy shots because they do, they do tend to be more effective as we’ve studied them. And so the literature tends to be on the side of the States when it when it comes to that particular argument. I’m sure if you asked the doctor in Europe, they’d say that the studies we’ve done on their sublingual therapy they’re under the tongue therapy were, um, not entirely fair. Um, but that’s, that’s a debate among allergists, I suppose. Um, in the US there are actually, um, four different under the tongue FDA approved therapies.
I don’t find myself reaching for them often, but I suppose if you’re started in a doctor’s office, um, there’s no reason you couldn’t continue that therapy at home with our great Trusts Attorney Las Vegas. And so, um, when you’re talking about being exposed to, um, let’s, let’s take a few kinds of grass as an example, if you’re allergic to only one or a handful of grasses, theoretically, you could have the same kind of beneficial response, um, with those FDA approved particular allergens. Um, if you take that under the tongue therapy, as opposed to going into an allergist office and getting those shots, um, but in general, the answer to that question is, um, notes. It’s really something you need to see a specialist for and see them forward on a regular basis.
What, uh, what are the biggest mistakes you see people make when they get allergies?
Um, I guess it talks about it depends on what type of allergy we’re referring to. I think the biggest mistakes I’ve seen actually pertain to food allergies. Um, and I’ll tell you why. Um, it’s not uncommon for, uh, allergists to get referrals from primary care physicians, pediatricians, um, family physicians, um, internal medicine docs. And, um, the, the common complaint is, um, my doctor just told me that I have a food allergy. Um, and as the story goes, the patient’s been complaining of some type of, um, like gastrointestinal problems, bloating, um, maybe some bowel changes and they ask their physician to order like food allergy testing, um, and the physician orders, the food allergy testing, a few things come back as high. And then they’re told to keep those things out of the diet for a time in Memorial. And, uh, in some cases they’re asked to see us at or around the same time.
Um, the problem with that, um, involves a few different issues. Now, if their children, especially, um, you’ve run into a few problems, if you’re telling a child that they have something might cow’s milk allergy, and they actually don’t, um, you’re really taking out, um, uh, a wealth of nutrient-dense, uh, foods that should sustain the child and health and shell grow. And so you’re limiting their options for nutrient-dense food. The other problem is that, um, if a child has an antibody made against a particular food, and that’s really what the test is measuring, then the child can develop a food allergy. That is a clinically significant food allergy. So, um, we’re getting a little in the weeds again, but what the test, um, the blood test, or the skin test that we do is actually looking for is an antibody against something. Um, it’s called sensitization for great Trusts Attorney Las Vegas.
Now, when you talk about food allergy, it’s not really diagnosed by a test, it’s diagnosed by a patient. And so the best test I have for food allergy is, are you, Blake. So if you drink cow’s milk or eat butter, that’s made from cow’s milk or ice cream, or yogurt or cheese, any one of a number of things. If you have something like a life-threatening reaction, every time you have calcium-based products, that’s the best test I have in your history. Um, if you get, um, a little bit of bloating and you get some bowel habit changes when you have, um, let’s say a milkshake at Denny’s or wherever you’d like to get milkshakes, um, that isn’t the classic kind of food allergy to see why we are here to help you. That’s the life-threatening kind, the kind that is, um, assisted by antibodies. That could be something more like lactose intolerance. Um, the only blood test we have, that’s a reliable blood test, um, is the crime that tests for the life-threatening kind of food allergies.
Um, and I’m, I’m making some generalizations here just to keep it simple. Um, but so we have these parents coming in, asking for a wide net to be cast, and then they pull back all these foods and they see what comes back. And so a few different things pop up and the story often goes that the child was drinking cow’s milk on a very regular basis, not having any reactions. And then they stopped having the cow’s milk for six months to a year. Um, if they stopped that nutrient-dense food, again, the problem is that they were missing out on those crucial nutrients. But another problem is that they could have developed food allergy because they weren’t eating or drinking milk-based products. Um, and then that raises a whole host of different questions that I have, and we ended up having to, um, retest them and potentially challenged them in the office with something like a swallow challenge to cow’s milk product for a better level of Trusts Attorney Las Vegas. So, um, that’s one of the problems. Uh, I see, um, people encountering, um, and these are problems that are in part coming from other physicians. So, um, it’s, it’s a problem in communication. It’s a problem in misunderstanding what the test results mean. Um, and, uh, I wish that weren’t the case, but I’m happy to get involved when those patients come cause I can really help. Yeah.
And I know we’ve talked extensively about peanut allergies and how, um, we’ve seen a spike in that over the last, you know, 10 to 15 years. Um, do you want to speak to that at all? And what’s your, do you think is the result?
Yeah, so I love peanut allergy. Um, it’s a really fascinating topic. Um, so the recommendations from the medical community used to be that you should avoid peanut products until the age of two or three. And, um, a few years back, um, some allergists colleagues in England, um, we’re talking to their allergist colleagues in Israel and they said, Hey, like, what do you guys think about this peanut problem what’s going on? And the allergists in Israel were like, what are you talking about for more levels of Trusts Attorney Las Vegas? There is no peanut problem. Um, and come to find out in Israel, there’s something like a peanut Shito that kids are exposed to at a very young age. And they’re knowing on these peanut Cheetos all the time. Um, they’re enjoying the peanut Cheetos and, uh, the, um, the incidence of peanut allergy. That means how, um, how often it affects and population in a certain amount of time.
It was just drastically lower than that in England and suddenly designed to study. Um, and this study was looking at the early introduction of peanut versus the late introduction of peanut. And if that was associated with the development of peanut allergy, they did the study, it was called the leap trial. And then they did a subsequent study called the leap on trial. Um, and you can look this up, it’s really fascinating stuff. But what they found was that early introduction of peanut actually is protective against the development of peanut allergy. Um, and there are particular groups that are, um, at risk for developing peanut allergy, those that have eczema, and those that have an egg allergy, um, are among those at-risk populations. Um, so peanut allergy prevalence was definitely increasing in part because of the advice that the medical community was giving. It was just advice. Um, and so we’ve since reversed our instructions, we’ve asked, um, patients and families to start introducing peanut at an earlier age. Um, and we hope that that will change the trends. Food allergy in general is increasing nationwide. Um, and we don’t exactly know why that’s the case. We have several thoughts or ideas. Um, but one of the reasons why peanut allergy, in particular, was increasing is because we were giving, um, bomb advice. So I’m glad that we’ve changed that we’ve done the studies it’s convincing, uh, results. And so that’s a chance that you’ve probably seen.
Yeah. I remember when, when we first had our son he’s eight, now it was, yeah, don’t give them, don’t expose them to peanuts or anything like that. And, um, he did it accidentally at like, you know, seven or eight months or whatever, and had a smaller action, but that was it. And then the next time we exposed it to him, didn’t have a reaction. And, and that was our experience. It was like, Oh yeah, they, they, it’s going to shock their system cause it’s something new, but the body learns how to handle that. And I think, um, I mean, I have no basis or medical authority for this at all, but I think in general, our allergies are increasing just from the same standpoint. If we’re inside more, we’re not exposed to nature. We’re not out in, in those elements. And so our bodies just are not used to, to handling them all.
Yeah. Um, there’s something called the hygiene hypothesis, um, in the allergy world. And it basically says the same thing. Um, we’ve observed that um, patients who come from third world countries or environments, they don’t really have problems with allergic disease. Um, and, uh, something of the same results has actually come from more rural areas of the United States and other developed countries. If you’re exposed to microbes from things like, um, it’s kinda gross, but pet feces or a lot of different, um, like farm products, uh, your chance or risk of developing allergies is less than that for a new solution of Trusts Attorney Las Vegas, of the developed urban world. Um, it’s, it’s again, just a hypothesis and it’s probably one of the reasons why the incidence and prevalence of allergic diseases increasing. Um, but I think there’s really good weight behind it. It makes sense.
Alright. So when for sure, does someone need to seek out a specialist like yourself with an allergy? They start barely starting having symptoms or, you know, how far down the road should they be?
I think there are disease-specific instructions for when that ought to happen. Um, you can take a kid who’s wheezing, for example, um, every child who raises it doesn’t need to see an allergist within the week. Um, but if a child is wheezing to the extent that they’re being brought to an urgent care center or emergency departments on, on gosh, anything resembling a regular basis, um, I, I think that’s when a primary care physician ought to say, you know what, I’m not doing you a service by continuing to try to manage this on my own. Let’s get someone else involved who can be part of our team, so that can manage this better together. Um, there’s nothing inherently dangerous about, um, allergies affecting the nose, but it does affect things like let’s say workplace productivity. We, we, um, developed a validated inventory that looked at workplace productivity and found that those who have, um, how would you is affecting the nos are 28 to 40% less effective when they’re being, uh, when they’re symptomatic with those nose symptoms.
And so would you like to be more effective at work if that’s the case and you’re not getting the kind of relief that you want from over the counter therapies, come see an allergist. Um, if you have eczema that is, um, really poorly controlled, if it’s keeping you or your child up at night, because, um, the itch is so valued, you just can’t help it, scratch it, come see an allergist. Um, it’s, uh, it’s, it’s hard to come up with hard and fast principles for when someone needs to come to see an allergist, but if you feel like it’s a problem, that’s always, that’s always an indication in and of itself for the top Trusts Attorney Las Vegas. Um, but especially if it’s a problem that will get worse and potentially be life-threatening like food allergy or asthma, um, you, you should definitely come in and be seen. And the interesting thing about excellent to Blake, um, excellent predisposes to the development of allergies and the nose and eyes and also predisposes to asthma.
Um, uh, an interesting thing that, um, I wasn’t anticipating on talking about, um, is that in a way you can help to change, not just your own, um, allergy profile, but if you get something like allergy shots, you can actually change the risk of your children, developing allergies and asthma. Um, we’ve done a few studies on that and the literature looks, looks to be more towards the convincing side that it’s helpful in that regard, your kids will have a lower chance of developing those kinds of problems. If you go through that disease-modifying therapy, interesting stuff for a better level of Trusts Attorney Las Vegas.
It all comes back to modifying the genes and obviously, those genes get passed on your kids. So, yeah, it makes sense that would help.
I don’t know if you’re changing the genes, but there is something called epigenetics where you’re changing gene expression. And that maybe, that may be where the magic is happening there.
Fascinating stuff. Um, all right. We’re running out of time. So how can someone find a good allergist? Um, if they think they need to see what are, what are the key things they should be looking for with an allergist? What are the red flags they should stay away from?
Sure, sure. So, um, there are plenty of practices that, um, will tout, uh, their capacity to manage allergies. Um, many of them are board or board eligible allergists, and I’m trying not to step on colleague’s toes. Um, some practices are not, some practices are run by, um, specialists that come from other disciplines. Um, so I, I, I always hold, um, hard and fast to the traditional approach, um, which is that I only want to practice stuff. That’s really in the scope of my practice as the best Trusts Attorney Las Vegas around. So as an allergist, I manage allergies. If you’re going to a doctor who didn’t specialize in the management of allergies and wasn’t trained, I’m not sure that I would, I’m not sure that I would really choose them as an allergist. So you don’t want to see, um, a joint specialist, and be treated for allergies because they weren’t trained on how to manage allergies. And, um, you, you, you may not receive the standard therapy. Um, if you go there and so you’re running a risk. So what you’re looking for as an important certified or board eligible allergist,
That was like the same thing with the practice of law. Like we have family law specialists. Do you have criminal law specialists? Those don’t overlap. They definitely overlap with estate planning, which is why I don’t do any of those litigation areas or anything like that. Cause it’s, this is my field. This is what I’m comfortable with. I know that I’m do all my continuing education. And it’s the same thing with you. You, you learn and you focus and you know how to deal with allergies, you don’t,
And nor would I want to be. I see some people trying to practice within my scope of practice and they’re not trained on how to do it. And sometimes I find myself correcting their mistakes. Um, and I would never pretend to be a heart surgeon for a more solid level of Trusts Attorney Las Vegas. I would be doing patients a disservice if I opened up their chest and starting to look around because I, I, I wouldn’t know what I’m doing. Like, um, so I think finding a board-eligible or board-certified allergist is really the way to go.
Okay. Uh, any red flags, uh, other than that, then the, just look at their credentials. I may dwell, let’s say, is there a place where they can look to verify their credential?
Sure. Um, there are different, um, certifying institutions that have running lists of, um, uh, certified or eligible, um, practitioners of allergy immunology. Um, I think one of them is, uh, you can look up the website. I think it’s, um, quad AI an I, and there’s like a, find an allergist, um, a search bar that you could, uh, that you could enter.
Okay. I like it. Um, all right, well, thanks, Dave. Uh, anything else, particularly with, to allergies that we missed that we need to cover?
I don’t think so. Um, yeah, I, I speak for the practice in general, but we love what we do. I hope you can see that when you come and try and get help from an allergist, most of us have allergies ourselves. And so we know where you’re coming from. And, uh, that’s why we ended up in this with our top Trusts Attorney Las Vegas. We’re passionate about helping to manage symptoms and helping to manage the disease itself. Hopefully, we can take the edge off of the, of the symptoms or get rid of them.
Awesome. Well, how can people get in touch with you at your office if they’re in Arizona and want to come to see you?
Um, yeah, you can, uh, you can come by. We’ve got actually a really small wait time. Um, part of it’s the time of year right now, but part of it is also coronavirus. Um, you can call any one of our referral centers, and, um, I, I don’t know the number off the top of my head. Um, but if you just search up Arizona allergy associates, um, give us a call and I’d be surprised if you couldn’t be seen within the week. Um, in some cases you’ll need a referral from your primary care physician to experience the best Trusts Attorney Las Vegas. Um, it depends on your insurance. Um, in some cases you can just show up and we’ll, and we’ll take care of you.
Perfect. Well, thanks, David, appreciate you being on the show and, uh, you know, explaining so much and not putting it too far over my head.
Blake, it’s always a pleasure.
Yeah. And to our listeners, thanks for joining us today as always, please like, and subscribe. So you get the latest content for the trusted podcast and also reach out, let me know, uh, what, uh, what guests we should have on here next time. And with that, uh, we’ll sign it off for now. So thank you, Dave. We’ll talk to listeners next time.