Allergy Aphorisms...

 

The discovery of IgE was the best thing—and the worst thing—for the field of allergy…


 IgE can be a cruel taskmaster… 

The greatest modern tragedy in the field of allergy is the abdication of the role of the allergist in treating all allergically-responsive organ systems…

 An allergist who only treats asthma is like a musician who only plays one song… 

The field of allergy—unlike pulmonology and otolaryngology—is not an anatomically demarcated specialty, although most modern allergists (“asthma doctors”) would like to have us think so… 

The single best “allergy test” is a thorough clinical history taken by an experienced allergist… 

Compassion is like money: you can never have enough of it, and the allergist is far richer for having the former than the latter…

 Once an allergen…always a potential allergen… 

When a patient asks the age-old question, “Could this-or-that be caused by allergies?”, it is the wise allergist who abides by the maxim, “never say never”… 

The typical allergist likes his immunology lectures to be complex, but his patients to be simple… 

Recurrent infections and chronic fatigue…the “sed rate” of patient status in the complex allergic patient…

 A negative skin test or RAST test should be the beginning—not the end—of critical thinking for the allergist…

 Mold sensitivity, food yeast sensitivity, and Candida sensitivity: the great “allergic triad” seldom appreciated by the practicing allergist… 

Wisdom, technical expertise, compassion: the “Holy Trinity” of the superior allergist…

 Patients avoiding a food allergen often find they are “losing their best friend”, and typically go thru the five stages of grief: denial, anger, bargaining, depression, and finally acceptance. The wise allergist would take note….
  
There is an art to the practice of allergy...unfortunately, most of us are more adept at measuring a wheal than using a crayola...
  
Keep your eye on the target...the allergen is our target, the body organ manifestation is secondary...
 ---
 In a previously treated (and stable) allergy patient, if they present with new, confusing symptoms, they are having a drug reaction until proven otherwise...
 ---
 Food avoidance is a short-term solution frought with long-term problems...
---
When it comes to immunotherapy, frequent low doses can often trump infrequent high doses
---
The allergist who only observes a skin test for 10 or 15 minutes is like the viewer who watches a television show for only 10 or 15 minutes...and then turns it off.  Much is missed.  Sometimes the most important parts. 
--
A patient with chronic sinus congestion and depression has a mold allergy until proven otherwise...
--
The child with allergies often unknowingly presents with patriotic colors--red ears, bluish allergic shiners, and whitish, pale skin...the "red, white and blue" of the allergic child...
--
Viral gastroenteritis is a bad illness for everyone, but for the food allergic patient it is disastrous...often resulting in heightened food sensitivities due to increased intestinal permeability...
--
Having "only a little bit of allergy" is somewhat like being "only a little bit pregnant"--the implications are enormous...
--
Repetition is may be the best thing for an aspiring musician, but it is the worst thing for an allergy patient aspiring to get well...
--
The best diagnostic tool an allergiest can wield is not the skin test needle between his fingers, but the grey matter between his ears...
--
When an established allergy patient returns with new, puzzling symptoms they haven't had before, they are having a drug reaction until proven otherwise...
--
The true incidence of food allergy is unknowable...
--
The atopic patient of today, (if left untreated with immunotherapy), is the Chronic Fatigue Patient of tomorrow...
--
We are fond of the mantra "one respiratory tract" when dealing with allergy in the upper and lower airways.  However, in looking at a patient with multiple symptoms in multiple organ systems, the mantra of the Allergist should be..."one mucosal membrane"
--
The allergy patient with troublesome reflux (GERD) has a food allergy until proven otherwise...
--
The allergy patient with confirmed celiac disease who is having problems is dairy and corn sensitive until proven otherwise...
--
We are physicians, first--and allergists, second.  Never forget that order...
--
The overweight, dieting patient is lettuce allergic until proven otherwise... (Theron Randolph)
--
The true Renaissance Allergist is more concerned about achieving "Peak Life" in his patients than just "Peak Flow".  Often, the two are not synonymous...
--
The Total Load Theory--For the allergist, never has so much been explained by so little
--
The single quality which separates the superior allergist from the ordinary one is simply Curiosity
--
The Researcher in Allergy writes in notebooks; the Clinician in Allergy writes in his patients Hearts...
--
What the scalpel is to the surgeon, immunotherapy is to the allergist...it defines who we are, and what we can do.  Never think otherwise....
--
Delayed food allergy--the patient who fails to learn about this is uninformed, but the patient who seeks help from an allergist about this becomes misinformed...
--
The hayfever patient who presents with recurrent yeast vaginal infections has allergic vaginitis until proven otherwise. 
--
The patient who inconsistently reacts to the same allergen ("sometimes I react to it and sometimes I don't") is usually a victim of The Total Allergy Load
--
They say that a dermatologist's interest in their patient is only skin deep, but often an allergist's interest in their patient doesn't extend beyond the length of their skin prick needle... 
--
Food allergy component testing--consider it when you think the whole food is not telling the whole story....