Transcript: Allergies | May 19, 2000

(music plays)

The opening sequence shows a wooden table with a small lit candle as several words fly by: Nutrition, medicine, prevention, treatment, health.

Fast clips show different sets of hands performing activities on the table such as pulling petals from a daisy, drawing a big red heart, tuning a violin, flipping through the pages of a book, cooking, and pouring a glass of red wine.

In animation, the title appears inside the shape of a house: “More to life.”


Maureen Taylor sits in a studio with yellow walls and a small TV set in the background, which reads “More to life.”



Maureen is in her late thirties, with wavy blond hair in a bob. She’s wearing a black blazer over a bright yellow shirt.

She says HELLO.
I'M MAUREEN TAYLOR.
THIS IS “MORE TO LIFE.”
BY NOW, MOST OF US UNDERSTAND
THAT SOME PEOPLE ARE BORN WITH
OR DEVELOP ANAPHALATIC
ALLERGIESS TO PEANUTS.
THE MOST SEVERE AND DEADLY OF
ALL FOOD ALLERGIES.
BUT DOCTORS WONDERED IF A
PERSON COULD OUT GROW A PEANUT
ALLERGY THE WAY A PERSON CAN
OUT GROW AN EGG OR MILK
ALLERGY.
OR MAYBE THE PERSON WAS SHOWING
A SENSITIVITY AND NOT AN
ALLERGY IN THE FIRST PLACE.
IN ANY EVENT, YOU WANT TO BE
CAREFUL BEFORE YOU TEST THIS
THEORY AND THAT'S WHY SOME
HOSPITALS VERSUS DEVELOPED THE
PEANUT CHALLENGE.

In a short clip, a woman in her thirties with curly blonde hair sits on a bed and reads to her young daughter.

Maureen narrates IT'S THE STUFF OF NIGHTMARES
TO HAVE A CHILD DIAGNOSED WITH
A PEANUT ALLERGY.
ROMA'S DAUGHTER HAD HER FIRST
REACTION WHEN SHE WAS 2 YEARS
OLD.

The caption changes to “Roma Blecher.”

She says I WAS HOLDING HER IN ONE
ARM, AND I WAS ACTUALLY
HOLDING, AH, A BOWL OF NUTS IN
THE OTHER HAND.
AND I WAS EATING NUTS FROM THE
BOWL.
SHE JUST PUTER HAND IN TO-- TO
TOUCH THE NUTS, AND, UM, SHE
ACTUALLY DEVELOPED HIVES UPS
HER ARM.

A girl in her twenties with long brown hair eats at a fast food restaurant.

Maureen continues LINDSAY TAYLOR WAS SENSITIVE
TO MANY FOODS, BUT THE FIRST
DANGEROUS TO PEANUTS HAPPENED
AT A AGE 12.

The caption changes to “Lindsay Taylor.”

She says I LOOKED AT THE WHITE AND
THE RED.
MY CHEST WAS TIGHT.
I STARTED TO SHAKE.
IMMEDIATELY THEY HAD TO TAKE ME
INTO THE OFFICE, AND DOCTORS
WERE CALLED.
AND I HAD TO GO, YOU KNOW, GET
AN ECG AND GET TESTED RUN.
AND, LIKE, TO FIND OUT THAT I
WAS ALLERGIC TO PEANUTS AND
COULD HAVE CONTRIBUTE TODAY MY
REACTION.
I JUST REMEMBER BEING SO
SCARED, YOU KNOW?

The caption changes to “Janet Taylor.” She's in her fifties with short white hair.

She says WE WERE SENT TO DR. GOLD.
ANOTHER SCRATCH TEST WAS
PERFORMED AT THAT POINT.
UM, AND AMONG OTHER THINGS,
PEANUT WAS, UM, LOUD AND CLEAR
AS AN ALLERGY.

Maureen continues BECAUSE A PEANUT ALLERGY CAN
BE FATAL, EVERYONE WHO HAS A
POSITIVE SKIN TEST IS TOLD TO
AVOID PEANUTS COMPLETELY.
BUT THAT'S NOT EASY.
AND THE STRESS IS ENORMOUS.

Janet shops around a grocery store.

She says INITIALLY, THE FEAR OF, UM,
LINDSAY DYING OR GOING INTO
ANAPHALATIC SHOCK WAS ALL
CONSUMING FOR ME.

Lindsay says A PEANUT ALLERGY IS A BIG
PART OF MY LIFE.
CONSTANTLY ON MY MIND, I'M
THINKING CAN I EAT THIS?
CAN I INGEST THIS?

Roma says THE EXTENT TO WHICH YOUR
LIFE CHANGES IS ACTUALLY VERY
HARD TO-- TO IMAGINE.
BECAUSE YOU GO FROM BEING
CAREFUL AND WORRYING ABOUT THE
NORMAL THINGS THAT MOTHERS
WORRY ABOUT, YOU KNOW, YOUR
CHILD HAS A COUGH OR A COLD AND
YOU RUN OFF TO THE DETERIORATE
AND HOPEFULLY GET IT DEALT
WITH.
BUT SUDDENLY-- GO TO THE DOCTOR
AND HOPEFULLY GET IT DEALT
WITH.
BUT SUDDENLY IT'S THE FEAR OF
THE UNKNOWN.

Lindsay has her samples of her arm skin taken by a doctor.

Maureen continues UNTIL RECENTLY, A SCRATCH
TEST WAS THE ONLY WAY TO TEST
FOR PEANUT ALLERGY.
THE PROBLEM IS THAT THE SCRATCH
TEST ISN'T CONCLUSIVE.

The caption changes to “Dr. Milton Gold. Allergist.” He's in his 6ties, clean-shaven, with short brown hair.

He says THE SKIN TEST IS A RATHER
OLD METHOD ALMOST 50, 60 YEARS
OLD AND IT'S HELPED US TO SOME
EXTENT BUT BASICALLY HAS
LIMITATIONS.
IF THIS CHILD HAS A NEGATIVE
SKIN TEST, PROBABLY A 95 PERCENT
PROBABILITY THAT IT'S A TRUE
NEGATIVE AND IT HELPS US IN
THAT WAY.
BUT IF IT'S POSITIVE, IT'S ONLY
ABOUT 50 PERCENT, 60 PERCENT PROBABILITY.

Maureen continues DOCTORS NEEDED TO FIND A WAY
TO DETERMINE WHETHER A CHILD
HAS A SEVERE PEANUT ALLERGY HAS
OUTGROWN IT OR SIMPLY HAS A
SKIN REACTION TO PEANUT SYRUP.
DR. MILTON GOLD IS AN ALLERGIST
AT TORONTO'S HOSPITAL FOR SICK
CHILDREN.

Dr. Milton says BECAUSE THE SKIN TEST ONLY
ALLOWS US TO GO TO A CERTAIN
LEVEL OF INVESTIGATION, WE FEEL
WE NEED THE CHALLENGE TO BE
ANOTHER PART OF THE
INVESTIGATION PROCESS.
AH, UM, THIS ALLOWS US TO TAKE
PATIENT WAS MILDER REACTIONS OR
WHO HAD A POSITIVE SKIN TEST
WITH NO HISTORY OF REACTION AND
THEN SEE IF THEY REALLY DO HAVE
THE ALLERGY.

Maureen continues IT SEEMS UNTHINKABLE TO
DELIBERATELY GIVE A
PEANUT-ALLERGIC CHILD THE VERY
SUBSTANCE THAT COULD TRIGGER A
REACTION.
BUT THAT'S WHAT THE PEANUT TEST
DOES.

Roma says I CAN CERTAINLY REALITY TO
PEOPLE THAT WANT TO UNDERGO A
PEANUT ALLERGY CHALLENGES.
UM, ON THE OTHER HAND, I THINK
IT'S A VERY TOUGH DECISION FOR
PARENTS TO MAKE ON BEHALF OF
THEIR CHILDREN.
BECAUSE THE TRUTH IS IT'S A
VERY RISKY PROCEDURE.

Roma hands her daughter an epipen.

Maureen continues DR. GOLD AGREES THERE ARE
SOME PEOPLE WHO SHOULD NOT BE
PUT THROUGH THE CHALLENGE.

Dr. Milton says INDIVIDUALS WHO HAVE HAD A
SIGNIFICANT, UM, REACTION IN
THE SENT THAT-- THAT IT'S BEEN,
UM, A VERY SEVERE SKIN REACTION
PLUS AN INTERNAL TYPE OF
REACTION, WHETHER THEY'VE HAD
SOME DIFFICULTY BREATHING, THEY
MAY HAVE HAD SOME VOMITING,
DIARRHEA, ALONG WITH IT.
OR, UM, EVEN CHILDREN THAT MAY
OBVIOUSLY GO INTO A MORE
SIGNIFICANT REACTION, WHETHER
FAINTING OR COLLAPSING.
AND, UM, AND-- AND NEED TO, AH,
NEED TO HAVE INTENSIVE TYPE OF
THERAPY IN THE HOSPITAL.
THOSE CERTAINLY SHOULDN'T BE
CONSIDERING, UM, A CHALLENGE.

Maureen continues LORI WAS TOO HIGH RISK
BECAUSE OF HER HISTORY.
BUT DR. GOLD THOUGHT LINDSAY
WOULD BE A GOOD CANDIDATE.

Janet says THE DECISION TO PUT LINDSAY
THROUGH A PEANUT CHALLENGE, UM,
NUMBER ONE, HAS TO COME FROM
LINDSAY.
IT HAS INITIALLY.
I THINK THAT-- THAT-- FROM A
MOTHER'S POINT OF VIEW, LONG
AFTER GONE, LINDSAY NEEDS TO
KNOW WHAT SHE'S UP AGAINST FOR
THE REST OF HER LIFE.

Lindsay says I DECIDED TO TAKE THE PEANUT
CHALLENGE BECAUSE I WANT TO
FIND OUT IF I'M ACTUALLY AS
ALLERGIC AS EVERYONE'S TELLING
ME.
I'M PRETTY MUCH HOPING,
DREAMING THAT-- THAT WHEN I
COME OUT OF THIS TEST, THAT
THEY'RE GOING TO TELL ME IT'S
NOT AS BIG A DEAL AS EVERYONE'S
MAKING IT OUT TO BE.
MAYBE I'M NOT GOING TO HAVE TO
READ LABELS ANYMORE.
MAYBE I'LL BE ABLE TO TAKE, YOU
KNOW, THAT CRACKER HAS TRACE OF
NUTS BECAUSE I WON'T HAVE A
REACTION.

Maureen continues JANET AND LINDSAY DECIDE TO
RISK IT.
BUT IT'S OBVIOUSLY THEY'RE
NERVOUS ON THE KAY OF THE-- ON
THE DAY OF THE K458ENING.

Lindsay sits on a hospital bed with her mother Janet by her side. Dr. Milton walks in and greets them.

Janet says BREATHE.
REMEMBER TO BREATH-- ON THE DAY
OF THE CHALLENGE.

Dr. Milton says IN TERMS OF WHO WE WOULD
CONSIDER AS A CANDIDATE FOR
THIS TYPE OF TEST CHALLENGING,
UM, WE'RE LOOKING BASICALLY AT
INDIVIDUALS WHO MAY HAVE HAD A
MILD HISTORY OF A REACTION TO
THE PEANUT.
UM, AND HAVE A POSITIVE SKIN
TEST.
UM, AND-- AND THERE'S A
CONCERN, OF COURSE, THAT IT
COULD BECOME WORSE.
BUT IN MOST CASES, UM, WE HAVE
EVIDENCE THAT SHOWS THAT SOME
OF THESE PATIENTS DO SEEM TO
LOSE IT.
AND, UM, THE ONLY OTHER TYPE OF
TEST WE HAVE OVER AND ABOVE THE
SKIN TEST IS THIS TYPE OF
CHALLENGE.
SO AS LONG AS IT'S DONE IN A
HOSPITAL SETTING, UNDER, UM,
CLOSE OBSERVATION, WE'RE, UM,
PROCEEDING WITH THIS KIND OF
INVESTIGATION.

A female nurse hands Lindsay a small clear tube attached to a machine and Lindsay puts it in her mouth.

The nurse says JUST PUT IT UNDER YOUR
TONGUE.
CLOSE YOUR MOUTH.
WILL YOU HOLD THAT FOR ME?

Dr. Milton continues WE'RE SETUP WHERE WE HAVE A
NURSE MONITORING THE PATIENT
CONSTANTLY.
UM, TAKING VITAL SIGNS IN TERMS
OF BLOOD PRESSURE AND PULSE AND
SEEING IF THERE-- THERE'S ANY
CHANGES ON THE SKIN.
THE BREATHING OF THE CHILD SO
THIS IS ALL BEING CLOSELY
WATCHED.
AND, UM, BASICALLY IF THERE'S
ANY PROBLEM, WE HAVE DRUGS AT
THE BED SIDE THAT WE CAN
ADMINISTRATE.

Maureen says AFTER A BASIC CHECK UP,
LINDSAY IS HOOKED TO AN IV AND
GIVEN THE STANDARD SKIN TEST.
THEN THEY WAIT 15 MINUTES.
THEN, DR. GOLD AND HIS COLLEAGUE
COLLEAGUE, DR. ATKINSON, COME
IN TO CHECK ON THE SKIN TEST.

The doctors examine Lindsay's arm.

Maureen continues LINDSAY IS SHOWING A
POSITIVE REACTION TO THE SKIN
TEST.
BUT ALMOST 50 PERCENT OF PATIENTS WHO
DO REACT MAY NOT ACTUALLY BE
ALLERGIC.

Dr. Milton says SO THIS JUST MEANS THAT ON
THE SKIN TEST, IT'S STILL
PERSISTENT.
BUT THE QUESTION IS WHETHER OR
NOT IT WILL PERSIST IF WE FEED
IT TO HER.

Maureen continues DR. GOLD DECIDES TO
CONTINUE.

A woman in her forties with long blonde hair walks into the hospital room and talks with Lindsay.

She says SO WHAT WE'RE GOING TO DO--
NOW START WITH THE LIPS.
SO ON THE INSIDE OF YOUR BOTTOM
LIP RIGHT HERE, I'LL JUST SMEAR
A LITTLE BIT OF PEANUT BUTTER.
TRY NOT TO LICK IT WITH YOUR
TONGUE OR ANYTHING LIKE THAT,
OKAY?
IF YOU FEEL ANY TINGLING, OR
ITCHING LIKE YOU KIND OF WANT
TO SCRATCH IT, YOU NEED TO LET
US KNOW ABOUT THAT.
AND WE'LL BE DOING VERY CAREFUL
MONITORING AS WELL.
OKAY.

Maureen continues SHE PLACES A SMALL AMOUNT OF
PEANUT BUTTER ON LINDSAY'S
LOWER LIP.
BY INTRODUCING PEANUT BUTTER IN
SMALL STEPS, THEY CAN MONITOR
HER REACTION.

Dr. Milton says BY VIRTUE OF TAKING, UM,
A-- THE JUST-- JUST A LITTLE
BIT IN TERMS OF DOSE AGES, AND
THE MAJORITY OF CASES WHERE THE
STUDIES HAVE BEEN DONE THIS
WAY, THE CHILDREN SEEM TO HAVE
SORT OF MILD REACTIONS AT THE
BEGINNING.
THAT KIND OF INDICATE TO US
THAT THERE MAY BE A PROBLEM.
WE'RE ABLE TO STOP ANY FURTHER
PROGRESSION AND STOP IT FROM A
SEVERE REACTION.

The blonde nurse examines the inside of Lindsay's mouth.

She says NOT-- AND ON THE LIPS, IT'S
LIKE A WHITE-- THAT LOOKS FINE.
OKAY.
LET'S-- LET'S PERSEVERE.

Maureen continues SO FAR, LINDSAY IS PASSING
THE PEANUT CHALLENGE.
BUT SHE HASN'T SWALLOWED THE
PEEB YOU THE BUTTER YET-- BUT
SHE HASN'T SWALLOWED THE PEANUT
BUTTER YET.

Dr. Milton says WE CERTAINLY WOULDN'T LIKE A
PARENT TO BE TRYING THIS
PARTICULAR CHALLENGE AT HOME.
UM, THE-- THE MONITORING SHOULD
BE DONE BY SOMEONE, OBVIOUSLY,
THAT IS TRAINED TO-- TO LOOK
FOR THESE KINDS OF SIGNS AND TO
KNOW WHAT THEY'RE LOOKING FOR.
AND, UM, AND SOMETIMES, THE
SUBTLE SIGNS ARE WHAT SOMEONE
WHO'S PROFESSIONAL AT IT CAN BE
ON TOP OF.
AND THAT'S WHY WE'RE CONCERNED
THAT A PARENT SHOULDN'T BE DOCK
THIS AT HOME.
UM,-- SHOULDN'T BE DOING THIS
AT HOME.
UM, BECAUSE THE SMALL SIGNS CAN
COME OUT AND BE MISSED.

The blonde purse shows Lindsay a spoon with peanut butter and says A QUARTER OF A TEASPOON.
HALF AND THEN A FULL TEASPOON.
SO THE MOUTH IS GUMMY.

Maureen says THAT'S LINDSAY'S FIRST TASTE
OF PEANUT BUTTER IN YEARS.

Janet says I'M STILL FEELING VERY
ANXIOUS.
I'M WAITING FOR-- FOR THAT
FEELING TO DISPERSE A LITTLE
BIT.
BUT, UM, IT'S NOT GOING AWAY
FOR ME YET.
WE'RE AT THE LAST STAGE.
WHERE WE'RE ABOUT TO INGEST--
WE ARE ABOUT TO INGEST PEANUT
BUTTER ON TOAST.
BUT, UM, I'M NOT AS COMFORTABLE
AS I THOUGHT I WOULD BE .

Maureen continues AFTER ANOTHER 15 MINUTES,
AND-- AND ANOTHER CHECK UP,
LINDSAY IS READY FOR THE FINAL
TEST.
PEANUT BUTTER ON TOAST.
AFTER WAITING AN HOUR, LINDSAY
CAN GO HOME.
SHE'S PASSED THE PEANUT
CHALLENGE.

Janet says THE FEELING OF RELIEF THAT--
THAT I KNOW THAT LINDSAY DID--
CAN GO ANYWHERE AND EAT
ANYTHING OR BE SOMEWHERE,
BEYOND BY CONTROL AND INGEST
PEANUTS, SAFELY, IS A GREAT
RELIEF.

Lindsay says IT'S LIKE, MY DREAMS SORT OF
COME TRUE.
I CAN GO AND NOT HAVE TO READ
LABEL AND I CAN EAT STUFF.

The clip ends.

Back in the studio, Maureen says AGAIN, WE WANT TO STRESS
THAT THAT TYPE OF CHALLENGE
SHOULD ONLY BE DONE BY AN ALL
ALLERGY SPECIALIST IN A HOSPITAL
SETTING.
THIS IS A COAUTHOR OF THE
CANADIAN ALLERGY AND ASTHMA
HANDBOOK.

Dr. Zimmerman's book “The Canadian Allergy and Asthma Handbook” appears on screen.

Maureen continues IF YOU HAVE ANY QUESTIONS ABOUT
ALLERGIES FROM FOOD TO RAG WEED
OR ABOUT ASTHMA TREATMENT, GIVE
US A CALL: IN TORONTO DIAL 416-484-2727.

CALL LONG DISTANCE TO 1-888-411-1234.
DR. ZIMMERMAN, WELCOME BACK.
HI.

Dr. Zimmerman's in his sixties and with white hair and a white beard. He's wearing glasses and a dark black suit with a purple tie.

Maureen says WHAT IS YOUR THEORY ABOUT
WHY CAITLAN IN THERE IS NO
LONGER ALLERGIC TO PEANUTS?

The caption changes to “Dr. Barry Zimmerman. Allergist.”

He says SHE HAS THE SKIN-- WE DON'T
ALWAYS UNDERSTAND IT.
SO THERE WERE A-- THERE ARE A
CERTAIN PERCENTAGE OF CHILDREN
THAT LOSE THE SKIN TEST.
THOSE I CAN DO IN THE OFFICE.
I CAN CHALLENGE WHAT WE DO IN
THE OFFICE, BECAUSE I JUST
COMPLETED A STUDY IN 1999, 96
KIDS CAME BACK TO ME WHO
PREVIOUSLY TESTED POSITIVE FOR
PEANUT.
OF THAT 96, 10 OF THEM LOST THE
POSITIVE.
SO WE TESTED A COUPLE OF
PREPARATION OF PEANUT.
WE USE PEANUT BUTTER ITSELF.
WE USE A BLOOD TEST.
WHEN EVERYTHING IS NEGATIVE,
THOSE KIND I CAN GO AHEAD WITH.
AND I WAS TRYING TO CONFIRM
SOMETHING SAID LEFT IN THE
BRITISH LITERATURE, THEY ARE
LESS ALLERGIC-- THEY HAVE FEW
POSITIVE SKIN TESTS THAN OTHER
THINGS AND LESS ASTHMATIC AND
LESS POSITIVE TO NUTS.
AND EVERYTHING ABOUT IT.
THEY LOSE THE POSITIVE AND THEN
GO AHEAD.
WITHIN THE GROUP THAT RETAIN
THE POSITIVE, THERE ARE ALSO
SOME WHO HAVEN'T LOST THE
POSITIVE SKIN TEST.
BUT HAVE LOST THE CLINICAL
SENSITIVITY.
AND I AM DELIGHTED THAT-- THAT
SICK KIDS IS DOING THIS NOW.
BECAUSE IT'S WHAT WE NEED IN
PRACTICE.
AND-- AND MILT GOLD IS DOING A
SUPERB JOB AT SETTING THE
PROGRAM UP.
BECAUSE THERE WERE-- THERE WILL
BE A FAIR PERCENTAGE OF THEM
THAT WON'T HAVE THE REACTION AND
WE CAN UNLOAD THE WHOLE THING
ABOUT--

Maureen says BUT YOU'RE CONVINCED AT ONE
TIME THEY WERE ALLERGIC AND
THEY LOST IT.

Dr. Zimmerman says WELL, THE KIDS THAT I
ACTUALLY DID IN MY OFFICE WERE
ONES WHO I PREVIOUSLY TESTED
POSITIVE.
MINIMUM OF A COUPLE OF YEARS
BEFORE.
AND MOST OF THEM HAD REACTED.
A FEW OF THEM WE PICKED UP AS
INFANTS AND WE WERE KIN TESTING
AND HAD A POSITIVE SKIN TEST
BUT NEVER HAD A CLINICAL
REACTION.
BUT 8 OUT OF 10 HAD
ACTUALLY HAD A CLINICAL
REACTION THAT-- THAT I HAD
DOCUMENTED SHORTLY AFTER--
SHORTLY AFTER BECAUSE THEY CAME
TO VISIT ME TO CONFIRM, AND WE
CONFIRMED IT.
SO THE ANSWER IS YES, THAT
THERE ARE THOSE.
NOW, POSITIVE SKIN TEST DOESN'T
NECESSARY INDICATE THERE WILL
BE A CLINICAL REACTION.
THE LARGER THE POSITIVE,
PROBABLY THE MORE LIKELY.
MORE THINGS YOU'RE POSITIVE TO
THE MORE LIKELY YOU HAVE
ASTHMA.
THOSE THINGS ARE THE KIND OF
THINGS THAT PROBABLY IDENTIFY
THE INDIVIDUAL WHO'S LESS
LIKELY TO LOSE EVEN THE
CLINICAL SENSITIVITY.
SO HOPEFULLY, SICK KIDS,
THEY'LL DO A STUDY IN WHICH
THEY'LL TRY AND PROVE THAT.
IN FACT, I'VE BEEN TALKING TO
THEM ABOUT A STUDY IN WHICH WE
TAKE A LOOK AT ASTHMA
PARAMETERS, BECAUSE I WORK OUT
OF THE GAUGE INSTITUTE ON
COLLEGE STREET WHERE WE DO SOME
THINGS WITH ASTHMA WHERE WE CAN
CHARACTERIZE SOME OF THE KIDS
IN TERM OF WHAT THEIR ASTHMA IS
REALLY LIKE BEFORE THEY UNDERGO
THE CHALLENGE AND SEE WHETHER
IF THEY HAVE SOME SIGNS THAT
THEIR ASTHMA'S NOT UNDER
PERFECT CONTROL, THEY'RE MORE
LIKELY TO HAVE A REACTION TO
MEAN OUT NOW, HOW OFTEN-- HAVE
A REACTION TO PEANUT.

Maureen says NOW, HOW OFTEN DO YOU HAVE A
CHILD WITH A MEAN EVEN THOUGH
ALLERGY AND THEN ASTHMA?

Dr. Zimmerman says VERY COMMON.
FOR EXAMPLE, 86 CHILDREN THAT
RETAINED THE POSITIVE, PROBABLY
OVER 60 OF THEM CONTINUED AND
HAD ASTHMA.
OKAY?
SO THE VAST MAJORITY OF THEM
ACTUALLY HAVE A NUMBER OF
DIFFERENT ALLERGIC THINGS.
YOU FIND ALLERGIC REACTIONS--
HAYFEVER AND THAT KIND OF THING
AS WELL.
BUT THE KIDS VERY COMMONLY HAVE
ASTHMA.
WE'VE KNOWN FOR SOMETIME AND
NOT IN PERFECT DATA THAT KIDS
WITH ASTHMA ARE MORE AT RISK
WHEN THEY DO GET AN ACCIDENTAL
INGESTION OF PEANUT OF
TARGETING TO THE LUNG.
I'VE HAD A COUPLE OF EXAMPLES
RECENTLY.

Maureen says YEAH, TELL US ABOUT THOSE.

Dr. Zimmerman says THESE ARE KIDS THAT NEARLY
LOST THEIR LIVES FROM IT.
WHICH WAS REALLY AS CLOSE AS
I'VE SEEN IT.
ONE OF THEM WAS A 12-YEAR-OLD
BOY.
AND, UM, MOM AND THE BOY ARE
AWARE THAT-- THAT I CAN TALK
ABOUT IT, BUT OBVIOUSLY I WON'T
IDENTIFY THEM.
I HAD SEEN HIM MANY YEARS
BEFORE AND CONFIRMED THAT HE
WAS SENSITIVE TO-- HE HAD A
REACTION TO CASHEW AND HAD A
POSITIVE TO PEANUT AND HE
AVOIDED PEANUT.
I SAW HIM A FEW YEARS AGO AFTER
THAT AND HE HAD A STRANGE
REACTION IN THE DENTIST OFFICE.
TURNED OUT HE WAS ALLERGIC TO
LATEX.
HE WAS GRADUALLY BECOMING MORE
ALLERGIC.
AT THE TIME.
HE HAD VERY MILD ASTHMA.
BUT IN THE LAST FEW YEARS, THE
ASTHMA HAS BECOME MORE
DIFFICULT.
HE WAS USING CALLED A
BRONCHOLDILATER, THE BLUE PER,
AND HE WAS USING IT ON A
REGULAR BASIS.
WHICH ISN'T A MANAGEMENT TO
ASTHMA.
GIVES YOU CENTRAL RELIEF. BECAUSE IF WE LOOK AT WHAT'S
GOING ON IN THE LUNGS IN
ASTHMA--

Maureen says WHY DON'T YOU PULL THAT OVER
THERE AND SHOW PEOPLE.
THIS IS WHAT THE LUNGS LOOK
LIKE.

Dr. Zimmerman pulls out a drawing of the lungs and the inside of air tubes.

He says THIS IS A NORMAL LUNG.
BUT WHAT HAPPENS WHEN YOU HAVE
ASTHMA IS IT FILLS UP WITH MUCK
US AND THE MUCK US IS IN-- IS
THAT IT FILLS UP WITH MUCOUS
AND THE MUCOUS IS ANGRY AND
FILLS WITH CELLS AND IT HAS
RESTRICTION, AND THAT'S WHERE
THE AIRWAYS CONTRACT.
AND ALSO THE INFLAMMATION LEADS
TO THICKENING OF THE AIRWAVES
AND PERMANENT CHANGES.
SO THE KIDS THAT HAS ASTHMA CAN
HAVE BOTH THE MUCOUS AND
INFLAMMATION AND THE AIRWAYS GO
INTO SPASM.
WHEN THAT-- THE AIRWAYS GO INTO
SPASM, THE BLUE PER WILL OPEN
UP THE TUBES BUT DOES NOTHING
ABOUT THE LUNGS.
THIS IS A BOY TAKING IT
VIRTUALLY 3 TIMES A DAY,
THE BLUE PER, AS A WAY OF
MANAGING HIS ASTHMA.
AND HE HAD NEVER HAD A-- HAD
THE REACTION TO THE FOOD FOR A
LONG TIME.
BECAUSE AT SCHOOL, THE-- AT
EASTER THEY GAVE A CHOCOLATE
EASTER EGG.
IT WAS SUPPOSED TO NOT CONTAIN
PEANUT OR NUT.
IT DID.
HE BEGAN TO HAVE A REACTION.
HIS MOTHER WORKS AT THE SCHOOL.
SHE HAD AN-- THEY HAD A NEEDLE
AT THE SCHOOL.
HE DIDN'T WANT TO USE IT
BECAUSE HE HAS A NEEDLE PHOBIA.

Maureen says MOST PEOPLE DO.
MY DAUGHTER DOES.

Dr. Zimmerman says IN THIS GROUP OF KIDS THAT I
FOLLOWED UP, OUT OF THE 86 THAT
RETAINED THE POSITIVE SKIN
TESTS, 7 OF THEM HAD HAD A
REACTION TO PEANUT FROM THE--
FROM THE TIME I FIRST SAW THEM
AND THE RETURN.
6 OF THEM HAD BREATHING
PROBLEMS WHEN-- WITH WHAT I
WOULD CONSIDER, AND ONLY ONE OF
THEM WAS--

Maureen says SO THERE'S A RESISTANCE TO
USING--

Dr. Zimmerman says WE CAN TEACH IT BUT DOESN'T
MEAN IT WILL BE USED.
THIS IS A PROBLEM WE HAVE.
THIS IS TO DISDICE THE FACT
THAT IT'S A NEEDLE.
YOU SAW HOW IT WAS USED IN THE
MOVIE, IN THE FILM.
BUT BASICALLY IT'S STILL-- THE
KIDS ARE NERVOUS ABOUT IT.

Maureen says SO HE DOESN'T WANT MOM TO
USE--

Dr. Zimmerman says NO, SHE GAVE HIM BENADRYL
AND HE HAD SYMPTOMS TO THE
POINT-- AND HE STILL DIDN'T
WANT IT, WHERE HE WAS CLUTCHING
THE THROAT IN A PANIC AND HIS
THROAT CHANGED.
911 WAS CALLED.
THEY CAME.
THEY ADMINISTERED ADRENALINE.
AND HE WAS TAKEN TO THE
EMERGENCY AT SICK KIDS.
AND THEY GAVE ADRENALINE AGAIN.
AND THE SYMPTOMS-- HE WAS
COVERED WITH HIVES.
HE WAS PUFFY.
THE VOICE HAD CHANGED.
EVERYTHING SEEMED TO BE
RECEDING.
SO MOM WAS SENT TO FILL IN
PAPERS AND THEN THERE WAS A
CALL TO COME BACK QUICKLY
BECAUSE EVEN AFTER THE
ADMINISTRATION OF THE SECOND
ADRENALINE, THE SYMPTOMS HAD
ALCOHOL BACK, HE COLLAPSED.
THEY HAD TO PUT HIM ON
VENTILATION AND RE REESE CUE
HIM FROM THAT.
SO HE NEARLY DIED.
NOW, THE REAL MESSAGE AGAIN
BECOMES THAT HE HAD ASTHMA THAT
TURNED OUT WAS NOT FULLY
CONTROLLED.
AT SICK KIDS, THEY PUT HIM ON
INHALED STEROID PER WHICH A LOT
OF PEOPLE ARE AFRAID TO USE
BECAUSE THEY'RE AFRAID OF SIDE
EFFECTS.
WHEN HE CAME TO THE OFFICE A
WEEK LATER, WE DID BREATHING
TESTS.
HIS BREATHING TEST WAS 50 PERCENT OF
PREDICTED WHEN IT SHOULD BE
GREATER THAN 80 PERCENT OF PREDICTED.
IT WAS WHICH DOWN.
I USED AN ORAL STEROID PLUS A
HIGH DOSE OF THE INHALED
STEROID.
IT WILL TAKE A LONG TIME TO
CLEAR THE GUNK OUT OF HIS
LUNGS.
SO HE WAS AT RISK.
THE OTHER LITTLE GIRL WHO
NEARLY LOST HER LIFE, SHE USED
TO HAVE REACTIONS TO PEANUT
WHERE WOULD GIVE HER AN ITCHY
LIP AND PUFFINESS.
SHE NEVER HAD AN-- SHE HAD BAD
ASTHMA.
HER PHYSICIANS MANAGED HER WITH
TRYING TO REDUCE THE AMOUNT OF
INHALED STEROID BY
SUBSTITUTEING SOME OF THE
NON-STEROIDS AND STUFF.
BUT SHE WAS UNRECOGNIZED.
SHE WAS GOING OUT OF THE
CONTROL.
WAKING UP IN THE MIDDLE OF THE
NIGHT AND NEEDING THE BLUE PER
AND QUICK RELIEF.
ALL SIGNS THAT THE ASTHMA IS
OUT OF CONTROL.
SHE ACCIDENTALLY GOT INTO
PEANUT.
THIS TIME, INSTEAD OF JUST A
LITTLE ITCHING AND SWELLING IN
THE LIP IT, WENT TO THE CHEST.
WENT TO THE CHEST.
SHE WAS REALLY TIGHT.

Maureen says SO YOU'RE SAYING THAT IN
SOME CASES, THE-- THE ASTHMA
THAT'S NOT CONTROLLED CAN
EXACERBATE THE PEANUT OR VICE
VERSA.

Dr. Zimmerman says PEANUT BECOMES LIKE ANY ALLERGY.
IF YOU HAVE AN ASTHMATIC NOT
UNDER GOOD CONTROL AND ARE
ALLERGIC TO CAT AND RUN INTO A
CAT, AND IF THEY HAVE LUNGS
THAT ARE FILLED WITH
INFLAMMATION AND THEN WITH
PEANUT, TARGETS TO THE CHEST.
AND WITH THE KIDS, IT'S THE
CHEST SYMPTOMS THAT DO THEM IN.
ADULTS ARE CAN CARDIO VASCULAR
ACCIDENTS THAT DROP THEIR BLOOD
PRESSURE, ESPECIALLY IN THE
OLDER ADULTS, CAN'T STAND THE
DROP IN THE BLOOP.
AND THE HEART-- THAT'S RIGHT.
AND THE KIDS CAN USUALLY HANDLE
THAT PART.
THEY HAVE HAVE THE BREATHING
PROBLEMS.
SO IN FACT, IT'S VERY IMPORTANT
WHEN YOU HAVE ASTHMATICS THAT
THEIR ASTHMA BE UNDER GOOD
CONTROL IF THEY'RE ALLERGIC TO
PEANUTS IN CASE THEY COME IN
CONTACT.

Maureen saysTHANK YOU.
VERY INTERESTING.
WE'RE TALKING TO DR. ZIMMERMAN
THIS AFTERNOON ABOUT ALLERGIES
AND ASTHMA.
WE'LL GET TO THE CALLS NOW AT:
AND JILL IS IN TORONTO.
HI, JILL.

Jill says HI, HOW ARE YOU?
THANKS FOR TAKING MY CALL.

Maureen says YOU'RE WELCOME.

Jill says I HAVE A 3-YEAR-OLD SON, DR.
ZIMMERMAN, AND HIS PEANUT ALL
ALLERGY WAFMT WAS IDENTIFIED ON
AN AIR-- ALLERGY WAS IDENTIFIED
ON THE AIRPLANE, UNFORTUNATELY.
WE DIDN'T KNOW HE HAD THE
ALLERGY AND LUNGCALLY HE WAS--
HE CLEARED IT OUT.
BUT HE WAS TESTED SHORTLY AFTER
THAT AND DOES HAVE A PEANUT
ALLERGY.
SINCE THAT TIME, HE'S DEVELOPED
TERRIBLE SKIN AXEMIA THAT SEEMS
TO GET WORSE AND WORSE.
AND THE LAST COUPLE OF TIMES
HE'S HAD AN ILLNESS, HE'S HAD A
BIT OF ASTHMA IN HIS CHEST.
AND HE SEEMS TO BE DEALING WITH
EACH ONE OF THESE THINGS AS--
THE CORTISONE AND A LITTLE BIT
OF PER AND A LITTLEITY OF
BENADRYL AND NOW THE HATE FEVER
SEASON AND ALL OF A SUDDEN THIS
YEAR HE'S ALL STUFFED UP AND
ALL CONGESTED.
AND IT SEEMS TO ME THAT HIS ALL
ALLERGIE ARE GETTING WORSE AND
WORSE AND MANIFESTING IN
DIFFERENT PART OF-- PARTS OF
HIS BODY AND I'M TAKING CARE OF
BITS OF THEM AS THEY COP UP.

- CROP UP.
AND I'M CONCERNED ABOUT THE
MEDICATION THAT IS I'M GIVING
HIM.
AS I GIVE THEM PROPERLY, IS
THERE SOMETHING MORE
ENCOMPASSING?
BUT THEY SAID IT MANIFESTS AS A
TRIAD AND WE COPE WITH IT.
AND ALSO THE ALLERGIES SEEM TO
GET WORSE AND-- WORST AND I'M
ENCOURAGED THAT YOU SHOW THAT
KIDS OUT GROW IT AND SHOW
ALEAVEATION OF THE SYMPTOMS AS
THEY MATURE.
AND IS THERE A BETTER WAY TO
DEAL WITH EACH OF HEESE?

Maureen says WHAT DO YOU THINK?

Dr. Zimmerman says WELL IN THE OLD DAYS WE USED
TO USE SHOTS.
WE DON'T USE SHOTS AS MUCH
ANYMORE.
AND IN FACT, WHAT WAS DONE IN
THE OLD DAYS WAS ATROCIOUS
BECAUSE THEY WERE INJECTING
GARBAGE.
THERE'S A LOT MORE
SOPHISTICATED RESEARCH GOING ON
NOW TO-- TO ALLOW US TO TRY AND
MODIFY THE IMMUNE SYSTEM.
SO WHAT THE ALLERGIC IMMUNE
SYSTEM IS, ABOUT 20 PERCENT OF THE
POPULATION HAVE AN EXTRA
RESPONSE IN THE IMMUNE PARTS
WHERE THEY-- THEY HAVE
INFLAMMATION TO CERTAIN COMMON
ALLERGIES.
FIRST COUPLE OF YEARS OF LIFE,
THEY'RE ALLERGIC TO FOODS AND
MOVE OVER AT ABOUT 2 AND-A-HALF
OR 3 TO AIR BORNS AND THAT'S
CALLED THE ALLERGIC MARCH.
YOU'RE PROBABLY SEEING THAT IN
THE CHILD.
WHAT WE CAN'T CONTROL IS THE
DEGREE OF WHICH THE ATOPIC
IMMUNE RESPONSE IS COMMITTED TO
BEING ALLERGIC.
BUT AFTER THE FACT, YOU SHOULD
DO ALLERGY CONTROL EARLY.
DUST MITE CONTROL IN THE HOME.
NO PETS IN THE HOME.
DO YOU HAVE ANY PETS?

Jill says NO.

Dr. Zimmerman says GOOD.
GOOD.
GOOD.
ANY CONTACT WITH ANIMALS?

Jill says MINIMAL.
BECAUSE WE-- WE KNOW THAT--
THAT IT'S ALL REALITYED AND THE
FEWER CHALLENGES YOU CAN
PRESENT TO HIM THE MORE COMMON
THE SYSTEM-- THE REACTIONS WON'T
PROGRESS AS QUICKLY.

Dr. Zimmerman says THAT'S RIGHT.
WHAT YOU'RE ATTEMPTING TO DO IS
DECREASE THE AMOUNT OF
CHALLENGE.
YOU CAN HAVE AGS MA WITHOUT
BEING ALLERGIC.
IT'S BABY ASTHMA AND KIDS GO TO
DAYCARE AND GET FREQUENT COLDS.
IF THEY STAY WITHOUT ALLERGY,
THEY HAVE A VERY GOOD PROGNOSIS
FOR OUT GROWING IT.
KIDS HAVE A SECOND MECHANISM.
AND IN THE COLD AND IN THE
INFLAMMATION.
WE NOW FROM THE STUDIES DONE,
THE ALLERGINS MOST IMPORTANT TO
ASTHMA ARE THE INDOOR OR
CHRONIC, THE DUST MITE AND
ANIMAL AND MOLDS.
BOTH THE SEASONAL MOLDS, WHICH
ARE ARE OUT NOW AND THE INDOOR
MOLDS.
THE POLLENS ARE MORE HAYFEVER
ORIENTED.
LESS OF A PUSH TO ASTHMA.
SO IN TERM OF THE MANAGEMENT,
YOU WANT TO DO EVERYTHING YOU
CAN IN-- TO AVOID AND TO DO THE
ALLERGY PREVENTION.
THE-- IT WILL LIKELY IMPROVE,
BECAUSE THAT'S THE NATURAL
COURSE.
USUALLY DOESN'T PERSIST AS THE
KIDS GET OLDER.
LESS AND LESS.
IT REMAIN A LITTLE BIT ON THE
HANDS.
THE ASTHMA TENDS TO PERSIST T
TENDS TO COME IN.
THE-- THE HAYFEVER, YOU KNOW,
IT'S THERE.
YOU USE SYMPTOM RELIEF AS MUCH
AS POSSIBLE.
BUT IF YOU PLUG UP YOUR NOSE,
YOU WON'T END UP IN THE EMPTY--
EMERGENCY DEPARTMENT.
IF YOU PLUG UP THE LUNGS,
YOU'LL END UP IN THE EMERGENCY
DEPARTMENT.
IT'S IMPORTANT THAT ASTHMA
PEOPLE ARE TREATED EARLY.
THE ALLERGIC ASTHMATICS.
THE OTHER ONES THAT ARE PUTTING
THIS JUNK IN THEIR LUNGS.
AS THEY PUT IT IN, IF YOU DON'T
USE THE MEDICINE RACE, THEY'LL
REMODEL THE AIRWAYS.
AIRWAYS WILL CHANGE AND THEY
HAVE MORE TROUBLE OUT GROWING
IT.
WE'RE GETTING LONG-TERM DATA
THAT SUGGESTS WHEN YOU TREAT
AND REDUCE THAT INFLAMMATION,
YOU ACTUALLY IMPROVE THE OUT
COME.
2 WAYS OF IMPROVING THE
INFLAMMATION.
FIRST, AVOIDANCE.
KNOWING WHAT THE CHILD IS
ALLERGIC TO AND MAKING SURE IN
THE HOME.
AND THEN USING THE DREADED
INHALED STEROIDS.
NOTHING WORKS ON ASTHMA LIKE
INHALED STEROIDS.
WE HOPE AND WE'RE GETTING DATA
THAT THE SOONER THE TREATMENT
BEGINS AND THE BETTER THE OUT
COME AND HOPE THE-- HELP THE
KIDS TO OUT GROW IT.

Maureen says SHE FEARED ALL THE DRUGS SHE
WAS GIVING HIM.
FEAR ALL YOU WANT BUT GIVE HIM
THE INHALED STEROIDS.

Dr. Zimmerman says RECOGNIZE THEM.
SOME ARE FOR SIMPLE RELIEF LIKE
HAYFEVER.
WHAT YOU WANT TO DO IS MAKE THE
CHILD COMFORTABLE.
RECOGNIZE WHAT YOU'RE DOING,
IT'S THE ASTHMA THAT'S VERY
IMPORTANT AND WITH THE PEANUT
SENSITIVITY, THE SCENARIO THAT
I SAID, WHEN THEY HAVE ASTHMA,
LITTLE OR MORE AT RISK FOR
TARGETING TO THE CHEST.
WHEN YOU MANAGE THE ASTHMA
FULLY, YOU'RE PROTECTING
AGAINST A SIGNIFICANT REACTION
TO PEANUT.

Maureen says OKAY.
GOOD LUCK, JILL.
THANK YOU FOR THE CALL.
LINDA IS IN PETERBOROUGH.

Linda says I HAVE 2 QUESTIONS.
MY FIRST IS I'M-- AS A BREAST
FEEDING MOM, SHOULD I AVOID
EATING PEANUTS OR PEANUT BUTTER
MYSELF SO AS TO PASS IT ON
THROUGH THE BREAST MILK.
AT WHAT AGE SHOULD I INTRODUCE
PEANUT BUTTER IN MY WILD'S--
CHILD'S DIET?

Dr. Zimmerman says WE KNOW THAT CHILDREN HAVE A
REACTION TO PEANUT, OFTEN HAVE
A REACTION THE VERY FIRST TIME
THEY'VE KNOWINGLY BEEN GIVEN
IT-- TO IT.
WITH THE ALLERGIC RESPONSE, YOU
HAVE TO HAVE IT ONCE AND THEN
SENSITIZED AND THEN HAVE IT
AGAIN.
USUALLY THE REACTIONS OCCUR THE
VERY FIRST TIME THEY'RE GIVEN
THE PEANUT.
WHERE WERE THEY SENSITIZED?
ORIGINALLY WE THOUGHT BREAST
FEEDING.
SOME OF IT CROSSES INTO THE
BREAST.
THEN BACK AT DURING PREGNANCY?
BECAUSE IT'S A BIT OF AN
UNKNOWN.
SO THE ANSWER IS THAT-- IS THAT
THE DATA'S NOT PERFECT.
BUT WE DO SUGGEST IS THAT WHAT
YOU'RE BREAST FEEDING,
ESPECIALLY IF IT'S A RISK
FAMILY WITH ALLERGY, ELIMINATE
MEAN OUT AND NUTS FROM YOUR
DIET.
THERE ARE A FEW OTHER THINGS TO
TRY AND REDUCE.
BUT ELIMINATE PEANUT AND NUTS.
NOW, WHEN KIDS ARE ALLERGIC THE
FIRST COUPLE OF YEARS TO LIFE,
IT'S USUALLY TO THE FOODS.
THEN THE ALLERGIC MARCH.
THEY CHANGE TO AIRBORNE
ALLERGINS AROUND AGE ABOUT
RUFFLE.
AND TRY AND AVOID PEANUT UNTIL
AFTER AGE 3.
AND IF THERE'S ANY DOUBT, A
PEANUT SKIN TEST.
BECAUSE AS DR. GOLD SAID IN
THAT LEAD UP, WHEN THEY'RE
NEGATIVE, THE-- THE VIRTUALLY--
IN FACT, I THINK DONE PROPERLY,
IT RULES OUT, IF YOU DO NOT
HAVE A POSITIVE SKIN TEST, IF
IT'S BEEN DONE PROPERLY WITH
APPROPRIATE MATERIAL, THERE'S
NO WAY THAT YOU CAN HAVE A
MECHANISM FOR REACTION.

Maureen says BUT YOU'RE NOT SAYING TO--
TO GIVE EVERY CHILD A PEANUT
SKIN TEST, ARE YOU?

Dr. Zimmerman says NO, WHAT I'M SAYING IS THAT
WITH KIDS WHO ARE IN FAMILIES
THAT ARE HIGHER RISK--
WHERE THERE'S REAL
WORRY.
BUT IN FACT IF YOU ASK ABOUT
AVOIDANCE, THE LATER THAT YOU
GIVE PEANUT-- I MEAN, THAT'S A
PROBLEM.
BECAUSE WE SAY THAT 20 PERCENT, 30 PERCENT OF
THE POPULATION ARE ALLERGIC, IT
MEANS THAT WE'RE SUBJECTING
EVERYONE TO THE RESTRICTION.
WHEN YOU THINK ABOUT WHAT WE'RE
DOING IN SCHOOLS NOW, THAT'S
WHAT WE'RE DOING.
WE'RE DOING AS MUCH AS POSSIBLE
TO ELIMINATE PEANUT AND THE
DANGER OF REACTION IN THE
SCHOOL.
SO A LOT OF SCHOOLS HAVE GONE
TO THE POINT OF BANING PEANUT.
WHICH IS REALLY HARD.
WHICH MEANS THAT ESSENTIALLY
WE'RE TAKING THE 80 PERCENT WHO ARE
NOT ALLERGIC, SUBJECTING THEM.
WE USED TO THINK THE SAME WAY
PREVIOUSLY WITH THE EPIPEN.
USED TO TRY AND PICK WHICH
CHILDREN IN AN-- HAD AN
ALLERGIC REACTION TO PEANUT AND
TEACH THEM THE EPIPEN.
THOUGHT WE WERE OVER CALLING IT
BY TEACHING EVERYONE AND
SUBJECTING THOSE THAT HAD NO
REACTION TO THE FEAR AND
EVERYTHING.
BUT IN THE LAST FEW YEARS, WE
DECIDED WE WOULD TRY AND
PROTECT THE ONES TRULY AT RISK.

Maureen says YOU TALKED EARLIER IN THE
DUST MITES IN THE HOME.
I READ TOO THAT THE SCIENTISTS
THINK THE INCREASE OF ASTHMA IN
THE DEVELOPED WORLD COULD BE
THE FIXSATION ON CLEAN LIVING.
IN COUNTRIES WHERE THEY DON'T
HAVE-- HAVE VERY GOOD
SANITATION, THERE'S A LOT FEWER
ALLERGIES.

Dr. Zimmerman says THERE'S BEEN A REAL PUZZLE
AS TO WHY WE HAVE SO MUCH
ALLERGY.
IT'S IN THE WEST.
IT DOUBLED IN MY PRACTICE
LIFETIME.
IN THE LAST 235 YEARS.
GOOD EVIDENCE FROM THE-- FROM A
COUPLE OF GOOD PLACES LIKE
GREAT BRITAIN AND THE UNITED
STATES AND CANADA THAT THERE'S
BEEN VIRTUALLY A DOUBLING IN
THE ALLERGY WHICH LEADS TO MORE
SENSE-- MORE PEANUT SENSE TIFLT
AS WELL.
WHY?
BECAUSE IT'S NOT FOUND IN THE
NON-INDUSTRIALIZED COUNTRIES.
THEN FIRST WE THOUGHT
POLLUTION.
THEN THERE'S EVIDENCE COMPARING
THE SEES IN EASTERN EUROPE AND
WESTERN EUROPE, EASTERN EUROPE
WHEN THEY CAME OUT OF THE
COMMUNISM HAD HAD A LOT OF
POLLUTION.
THEY DON'T HAVE.
THEY HAVE HALF THE RATE OF
ALLERGY.
AS THEY'RE GETTING MORE
INDUSTRIALIZED, THEY'RE GETTING
MORE ALLERGY.
AND THE QUESTION IS WHY.
THE FIRST INDOOR AIR QUALITY.
BECAUSE SOME OF THE THIS
DOUBLING SEEMED TO OCCUR WHEN
WE TIGHTENED UP OUR HOUSES WITH
THE OIL CRISIS.

Maureen says RIGHT.

Dr. Zimmerman says OKAY.

Maureen says ENERGY EFFICIENCY AND ALL OF
THAT.

Dr. Zimmerman says THAT'S RIGHT.
AND THEN THE OTHER THEORY IS
BECAUSE WE KNOW THAT-- THAT THE
IMMUNE SYSTEM, PECULIAR IMMUNE
RESPONSE, THE CLASSICAL IMMUNE
RESPONSE THAT PROTECTS US
AGAINST VIRUSES AND WHEN WE
VACCINATE, ACTUALLY TURNS OFF
THE ALLERGIC IMMUNE RESPONSE,
AND VICE VERSA.
THERE SEEMS TO BE A YING-YANG
RELATIONSHIP BETWEEN THE
T-CLELS THAT-- CELLS THAT LOOK
AFTER THESE 2 RESPONSES.
AND THERE'S DENY -- I'VE BEEN
REVIEWING SOME DATA.
IT'S FOR THE PUBLICATION IN
WHICH EVEN IN CANADA, UM, DID--
THERE WAS A RECENT PUBLICATION
T LOOKS AS IF CHILDREN WHO ARE
BROUGHT UP ON A FARM HAVE LESS
ALLERGY THAN THEIR CITY
COUSINS.
THAT'S BEEN FOUND IN SWEDEN.
THERE ARE A NUMBER OF STUDIES.
THE THINKING IS THAT MAYBE ON
AT THAT REMEMBER FARM YOU'RE
EXPOSED TO ALL THAT DUNG IN THE
BARNS AND EVERYTHING.
YOU'RE HEALTHIER AS FAR AS YOUR
IMMUNE IS.

Maureen says AND ENDURE-- DO YOU THINK
PARENTS SHOULD STOP BE-- I KNOW
PARENTS THAT WON'T LET THEIR
CHILD PICK UP SOMEONE ELSE'
STUFFED ANIMAL BECAUSE IT MIGHT
HAVE DIRT IN IT OR SOMETHING.

Dr. Zimmerman says RIGHT.
AT THIS POINT, IT'S HARD TO
SAY.
BECAUSE OBVIOUSLY ONE OF THE
THINGS THAT'S OCCURRING IN
WESTERN SOCIETY IS THAT THE
KIDS GO INTO DAYCARE VERY
EARLY.
THEY GET A LOT OF VIRAL
ILLNESSES.
BUT THE VIRAL ILLNESSES DON'T
SEEM TO PROTECT THEM.
SO THE RESEARCH IS NOW LOOKING
AT OTHER THINGS THAT-- THAT
MIGHT BE FOUND IN DIRT.
UM, AND-- AND I WOULDN'T
NECESSARILY, AH, GO OUT AND
HAVE THE KIDS EAT DIRT.
BUT, YOU KNOW, RECOGNIZING--
RECOGNIZE THAT AT TIMES, THE
OFTEN IS NOT-- THE OBVIOUSLY IS
NOT SO OBVIOUS AND THAT MAYBE
IN FACT IT WILL TURN OUT THAT
WE CAN RELAX A LITTLE BIT
AROUND DIRT.

Maureen says OKAY.
TO BARB IN HUNTSVILLE.
HI, BARB?

Barb says GOOD AFTERNOON.
I JUST WONDERED, I HAVE A
16-YEAR-OLD.
AND SINCE HE WAS 7-- EVERY TIME
HE GOES INTO THE WATER, LIKE
GOING TO THE LAKE AND THAT, AND
GO HAVE A SWIM, HE WOULD BREAK
OUT AFTER HE COMES OUT.
LIKE, ALMOST LOOKS LIKE
SCABBIES.
WOULD THAT-- WOULD THAT
CONTINUE WITH HIS ALLERGY?
I DON'T KNOW IF IT'S AN
ALLERGY.

Maureen says IT SOUNDS LIKE SWIMMER'S
ITCH?

Barb says THAT'S RIGHT.
IT'S A REAL QUESTION OF WHETHER
IT'S ALLERGY OR POLLUTION AND
ALGAE IN THE LAKE.
IN FACT, THAT'S A DIFFERENT
PHENOMENON THAN-- AND THAT
PROBABLY I THINK WILL CONTINUE.
BUT IT'S NOT A TRUE ALLERGIC
RESPONSE.
TO BE A CONTACT PHENOMENON.
BUT IT TENDS TO BE BECAUSE OF
THE POLLUTION.
NOW, POLLUTION REALLY WITH
ALGAE.
THE ALGAE GROW IN THE LAKES
BECAUSE OF OTHER POLLUTIONS, DE
DETERGE .
T AND NITROGEN WASTE THAT'S
APPEARING IN THE LAKES.
SO---- DETERGENT AND NITROGEN
WASTE THAT'S APPEARING IN THE
LAKES.
THAT DOESN'T SOUND LIKE AN
ALLERGY BUT WHAT IS CALLED
SWIMMER'S ITCH.

Maureen says A DOCTOR CAN TELL IT.

Dr. Zimmerman says A FAMILY DR. SEES A LOT OF
THAT.
ALONG WITH POISON IVY.

Maureen says I THINK THE MINISTER OF THE
ENVIRONMENT CAN LET YOU KNOW
WHETHER THE PARTICULAR LAKE
WHERE WHERE YOU'RE SWIMMING IS
KNOWN TO HAVE SWIMMER'S ITCH.
BECAUSE I LOOKED INTO THAT
ONCE.
THANK YOU, BARB.
WE HAVE A REQUEST FOR
YOU TO YOU SHOW US HOW TO USE
AN EPIPEN.

Maureen hands Dr. Zimmerman an epipen. Its a long thin tube with a pointed end.

He says WELL, THIS IS THE DEVICE.
IT WAS SHOWN, UM, IN-- IN THE
FILM THAT STARTED THINGS.
AND BASICALLY, THE CAP COMES
OFF.
AND WHEN THE CAP COMES
OFF... IT'S NOW READY.
SO THE THEORY IS THAT THERE'S
ANOTHER DEVICE CALLED AN
ANIKIT THAT LOOKS LIKE A
SYRINGE.
WE FELT PEOPLE WOULD BE MORE
WORRIED ABOUT USING A SYRINGE
THAN THIS.
WHAT HAPPENS WITH THIS IS THAT
YOU ACTUALLY PRESS IT HARD, AND
FLESHY PART OF THE THIGH, AND--
AND THROUGH THE CLOTHING, AND
IT WILL GO RIGHT THROUGH THE
CLOTHING.
AND YOU ESSENTIALLY HEAR IT
CLICK.
LET ME SEE IF I CAN DEMONSTRATE
IT ON MY HAND.

He jams the pointed end of the epipen into the palm of his hand and continues
CLICK.
YOU HOLD 10 SECONDS.
COUNT THE SLOW TEN.
AND THEN YOU PULL OUT.
AND WHEN YOU PULL OUT, YOU WILL
SEE THE NEEDLE.
THERE'S A GOOD SIZED NEEDLE IN
THERE.
BUT IT WILL AUTOMATICALLY
INJECT IN.
AND SO IN FACT, THE-- THE
RATIONALE IS IT'S SIMPLER TO
USE THE EPIPEN THAN THE WHOLE
NEEDLE BUSINESS AND MOST PEOPLE
ARE NOT TRAINED.
BUT WHEN A REACTION OCCURS,
IT'S NOT THE TIME TO READ THE
PACKAGE INSERT.
IT HAS TO BE-- YOU HAVE TO BE
READY FOR IT.
IT HAS TO BE A NO BRAINER.
AND YOU CAN'T TALK YOURSELF OUT
OF IT.
IT'S SAFER TO USE ADRENALINE,
ESPECIALLY IN CHILDREN, THAN
NOT USE IT.
IT WILL LAST 15 TO 20 MINUTES.
IT TAKES THINGS DOWN, AND IT
WILL TAKE EVERYTHING DOWN, ANTI
HISTAMINES LIKES BENADRYL ARE
NOT FIRST LINE.
THEY'LL HELP YOU WITH THE MILD
STUFF AND ITCHING AND RUN ANY
NOSE.
WHEN YOU GET TO ANYTHING
SIGNIFICANT LIKE BREATHING
PROBLEMS, THE ADRENALINE FAILS
YOU.
SIGNIFICANT SWELLING AROUND THE
VOCAL CHORDS, FAILS.
ADRENALINE TAKES CARE OF IFERG.
IT INCREASES THE HEART RATE AND
INCREASES THE BLOOD PRESSURE IN
CASE THERE'S BEEN A DROP.
IT GIVES YOU THE 20 MINUTES
THAT YOU NEED.
AND IF YOU NEED TO, YOU CAN USE
A SECOND ONE ON THE WAY TO THE
EMERGENCY.

Maureen says BUT GET TO THE EMERGENCY
ROOM.

Dr. Zimmerman says GET TO THE EMERGENCY.
IT'S A MUST SITUATION.
AND, AH, I'VE HAD KIDS THAT
TURN AROUND AND SAY THIS
HAPPENED BEFORE.
I'LL TAKE A BATH I'LL WAIT IT
OUT.
BUT YOU CAN NEVER TELL WHETHER
THAT EPISODE WILL BE DIFFERENT.
IT'S NOT OVER WITH FOR 3 OR
4 HOURS.
OKAY?
AND SO YOU CAN-- YOU CAN MORE
SLOWLY DEVELOP SWELLING.
SURE, THE FIRST TIME THE
SWELLING OF THE LIP THIS, TIME
IT'S SWELLING AROUND YOUR VOCAL
CHORDS.
BY THE TIME YOU RESPOND, A
LITTLE BIT LATE.

Maureen says THE LITTLE BOY YOU SCRIBITDE
AT THE BEGINNING WHO-- WHO
DIDN'T WANT TO USE IT BECAUSE
IT'S A NEEDLE, WHAT-- WHAT DOES
HE SAY NOW?

Dr. Zimmerman says NOW, IN FACT, I ASKED HIM
EXACTLY THAT.
HE WILL USE IT.
IN THIS STUDY THAT I DID, UM,
WHERE-- WHERE 86 PATIENTS CAME
BACK, AND THERE WERE-- THEY
RETAINED THE POSITIVE, 20 OF
THEM HAVE HAD 40 REACTIONS TO
DIFFERENT FOODS OKAY?
NOT JUST PEANUT.
AND 5 OF THEM USED THE EPI
EPIPEN.
ONE MOTHER IN USING THE EPIPEN
WAS SO NERVOUS THAT SHE
INJECTED IT UP SIDE DOWN AND IT
ACTUALLY PUT IT INTO HER THUMB.
THAT'S RIGHT.
WHICH IS THE REASON THAT YOU
HAVE TO-- THIS HAS TO BE A NO
BRAINER.
AS MANY TIMES AS YOU CAN GET TO
PLAY WITH THE TRAINER IN THE
DOCTOR'S OFFICE AND SOME
TRAINING YOU DO IT.
OF THAT GROUP, 7 OF THEM, AS I
MENTIONED, UM, HAVE REACTIONSS
TO PEANUTS.
6 OF THEM HAD WHAT I WOULD
REGARD AS RESPIRATORY SYMPTOMS.
ONLY ONE USED THE EPIPEN.
THERE WAS OCCASION WHEN THEY
DIDN'T HAVE THE EPIPEN, BECAUSE
OFTEN IT'S AWAY FROM THE HOME.
AND OTHERS, IT WAS A NEEDLE
ONE--

Maureen says YEP, IT'S THAT NEEDLE THING.
IS IT A FINE NEEDLE?
NOT LIKE THIS GREAT BIG HONKING
KNITTING NEEDLE, IS IT?

Dr. Zimmerman says IT'S MORE TURDY THAN THE
FINE-- BECAUSE IT HAS TO GO
THROUGH CLOTHING AND STUFF,
OKAY?
SO IT'S-- IT'S-- YES, BUT--
BUT, IN FACT, I HAD ONE BOY
WHO-- WHO, UM, WHO BASICALLY WE
AGREED THAT HE-- VERY ALLERGIC.
HE WAS HAVING REACTIONS.
HE CAME IN AND I ASKED HIM IF
HE USED THE EPIPEN.
I ASKED HIM IF HE USED IT AND
HE SAID I WOULD HAVE TO USE IT
EVERY WEEK OR SO.
AND HE WAS TRADING FOODS AND
STUFF.
HE WAS HAVING REACTS.
I WAS SAYING THAT YOU CAN NO
NOT DO THAT.
AND YOU HAVE TO AGREE THAT
YOU'LL USE IT.
SO SOME MONTHS LATER I GOT A
CALL FROM THE SCHOOL.
IT WAS THE PRINCIPAL.
HE WAS HAVING HIVES.
HE-- THEY WEREN'T SURE WHAT TO
DO.
THEY WANTED TO USE THE EPIPEN.
HE SAID NO.
SO I SAID PUT HIM ON THE LINE.
HE CAME ON.
I SAID THAT WE AGREED THAT YOU
WOULD USE YOUR EPIPEN.
OKAY.
HE SAID IT'S GOING TO HURT.
I SAID NOT AS MUCH AS IF YOU
DON'T COME OUT OF THIS AND THEN
YOU'LL GO TO THE EMERGENCY
DEPARTMENT.
OKAY?
SO BASICALLY HE GOT OFF.
AND-- AND THEN, UM, THE EPIPEN
WAS USED.
HE AGREED.
AND THE NEXT THING I GOT A
CALL, THIS BUSINESS OF GOING
INTO THE EMERGENCY.
HE WANTED TO GO BY TTC.
HE DIDN'T THINK THAT-- HE
THOUGHT IT WAS TOO FUSSY TO GET
AN AMBULANCE.
I SAID “WELL, WAIT A MINUTE.
WE'RE NOT SURE WHY YOU GOT
HIVES.”
YOU HAVE TO GO AND YOU HAVE TO
GO BY AMBULANCE.
BECAUSE YOU'RE NOT GOING TO THE
EMERGENCY ARE R WITH AN OLD
HANG NAIL.
THIS IS AN EMERGENCY SITUATION.
IT'S CORRECT USE OF THE
EMERGENCY DEPARTMENT.
SO MONTHS LATER, I ASKED HIM, I
SAID “OKAY, YOU WERE DREEGD IT
AND EVERYTHING.
WOULD YOU NOW AFTER YOU DID IT
IT,” BECAUSE HE-- HE SAID YOU
WOULD SAY-- YOU SAID IT WAS
LIKE A MOSQUITO BITE.
AND HE SAID IT WAS MOTHER THAN
A MOSQUITO BITE.
BUT I ASKED HIM IF HE WOULD USE
IT NOW.
HE SAID YES.
ALL OF THE PARENTS TALKED TO
AFTER THE FACT, THEY SAID THEY
WOULD USE IT AFTER WE
ENCOURAGED THEM THAT IT'S
NECESSARY.

Maureen says LET'S GO TO TERESA IN
OTTAWA.
HI.

Teresa says HI.
MY QUESTION IS THAT 5 YEARS
AGO I HAD A SERIOUS CAR
ACCIDENT AND I DEVELOPED A-- A
SEVERE CASE OF ASTHMA.
WHICH IS A SPONTANEOUS AS MAT
TICKET CONDITION.
AND I HAVE TO TAKE-- I'M
STEROID DEPENDENT NOW.
AND AS WELL AS VENTALIN AND
OTHERS.
I'M WONDERING IF THERE'S
ANYTHING ELSE THAT I SHOULD BE
LOOKING AT?
I DID THE RESEARCH AND SO ON.
BUT I GO INTO SPURTS-- LIKE, I
HAVE TO TAKE 20 MILLIGRAMS A
DAY OF-- AND GO UP TO 50 AND
DOWN AGAIN.
IT'S CONSTANT.
IT'S REALLY NEVER IN CONTROL.
AND I'VE BEEN HOSPITALIZED AND
I'VE HAD A CARDIAC ARREST
BECAUSE OF THE ASTHMA.
AND I'M JUST WONDERING IF
THERE'S ANYTHING ELSE THAT I
SHOULD BE LOOKING AT.

Dr. Zimmerman says WELL, BASICALLY, THIS IS
EXTREMELY HIGH LEVEL AND
THREATENING ASTHMA.
IN YOUR FAMILY, ANYONE WITH
NASAL POLYPS OR ASPIRIN
SENSITIVITY?

Teresa says NO, MY MOM HAS DEMERAL AND
THOSE TYPE OF ALLERGIES.

Dr. Zimmerman says THERE'S A NON-ALLERGIC TRIAD
ASTHMA WHERE IT'S SEVERE.
YOU DON'T HAVE TO BE ALLERGIC.
ASSOCIATED WITH NASAL POLYPS
AND ASPIRIN SENSITIVITY AND CAN
BE-- YOU REQUIRE THE ORAL
STEROIDS.
THE FACT THAT YOU REQUIRE THE
ORAL STEER RIDES THAT-- AND THE
PROGNOSIS AFTER AN INVASION FOR
ASTHMA IS VERY GUARDED OVER THE
NEXT 5 YEARS.
UM, WHAT THEY DO HAVE THAT
MIGHT LIGHTEN THE BURDEN FOR
YOU A LITTLE BIT IS-- BECAUSE
WE NOW BELIEVE THAT A CERTAIN
LEVEL OF STEROID, WE'VE DONE
WHAT WE CAN DO WITH STEROID.
BUT YOU MENTIONED THAT YOU
STILL REQUIRED A DAILY
VENTALIN.
I DON'T KNOW WHETHER YOU LOOKED
INTO THE LONG ACTING
BRONCHILATORS.
THERE'S DATA NOW THAT IF YOU
COMBINE THE BRONCHILATOR WITH
THE STEROID-- BUT THERE'S ONE
THAT'S A COMBINED DRY POWDER
SYSTEM THAT COMBINES THE
INHALED STEROID ALONG WITH THE
LONG ACTING BRONCHILIATOR.
BASICALLY BY USING THAT, IT
REDUCES THE NEED FOR VENTALIN.
IF YOU NEED QUICK RELIEF, IT'S
VENTALIN THAT YOU USE BUT IT
CONTROLS THE TIME.
BUT-- SO WHAT I WOULD SUGGEST
TO YOU IS YOU NEED TO BE
PATIENT WITH YOUR ASTHMA.
BECAUSE IT SOUNDS LIKE YOU
REQUIRE THE TYPE OF MEDICATION
THAT'S REALLY HEAVY DUTY TO
MAINTAIN CONTROL AND TO PRONT
WHAT WOULD BE REALLY A
THREATENING SITUATION.
AND REALLY-- AND TO CONTROL
WHAT WOULD BE A REALLY
THREATENING SITUATION.
REALLY WHAT I WANT YOU TO DO IS
RATINOALI-- RATIONALIZE.
THAT LITTLE GIRL I WAS TALKING
ABOUT EARLIER.
THEY TRIED TO REDUCE THE
STEROID ASTHMA.
AND THEN SHE-- I WOULD SUGGEST
THAT YOUR ASTHMA IS-- AS YOU
TRY AND PLAY WITH STEROID
DOSAGE, UM, CAN BECOME VERY LAY
MILD SO THERE'S A CERTAIN
AMOUNT OF STEROID THAT YOU
NEED.
THEN AFTER THAT, YOU COULD LOOK
TO SEE WHETHER A LONG ACTING
BRONCHOLIATOR WOULD SMOOTH OUT
THE DAY-TO-DAY.

Maureen says HOW MANY TIMES A WEEK SHOULD
THE PATIENT USE THE INHALEER?

Dr. Zimmerman says IT'S VERY INTERESTING.
BECAUSE THE-- THE-- THE
INTERNATIONAL GUIDELINES SAY
THAT IF YOU USE IT MORE THAN
3 TIMES A WEEK, YOU NEED
TO-- TO-- WE'RE TALKING NOW
ABOUT THE BLUE PER, THE
VENTALIN, THE QUICK RELIEF, THE
ONE THAT OPENS THE WHEN
THEY'RE?
SPASM BUT DOESN'T DO ANYTHING
ABOUT THE JUNK THAT'S IN THERE.
THAT'S THE WARNING TO THE
PATIENT AND THE DOCTOR.
BUT, UM, REALLY I FIND THAT--
THAT, UM, IT'S NOT ALL THE THE
CASE.
I THINK YOU-- YOU KNOW, YOU
NEED SOME EXPERIENCE.
BECAUSE I THINK AS WE DISCUSSED
BEFORE, I-- I'VE BEEN STUDYING
CHILDREN WHO ARE ALLERGIC TO A
PET IN THEIR HOME USING A
TECHNIQUE IN WHICH WE GET
THAT-- THE TECHNIQUE DEVELOPED
IN HAMILTON WHERE WE GET THAT
JUNK UP.
AND THE TECHNICIAN CAN PULL OUT
THE STUFF FROM THE LOWER LUNGS,
COMPARED TO WHAT'S FROM THE
SALIVA, PREPARE IT IN A CERTAIN
WAY, AND PUT IT ON A MICROSCOPE
SLIDE AND WE CAN SEE THE
INFLAMMATION.
SO THE KIDS COUGH UP THIS
STUFF.
IT WAS DEVELOPED BY-- IT'S--
IT'S FROM MCMASTER.
VERY NICE TO BE ABLE TO SEE
WHAT'S GOING ON IN THE LUNGS.
AND SOME OF THE KIDS THAT ARE
ALLERGIC TO A PET, THEIR
SYMPTOMS SEEM MINIMAL.
THEY'RE BREAKTHROUGH SYMPTOMS.
THEY ONLY OCCASIONALLY NEED
D. NEED VENTALIN.
BUT IT SHOULDN'T BE-- IT
SHOULDN'T BE THAT THEY WAKE UP
IF THEY HAVE MILD ASTHMA AND
ALL OF A SUDDEN NEED VENTALIN.
OR RUNNING AT SCHOOL AND THE
SCHOOL-- IN A GYM DAY, FORCING
THEM TO RUN MORE THAN USUAL AND
THEY GET VERY TIGHT.
MILD ASTHMA DOESN'T DO THAT.
SCHOOL SHOULDN'T BE CALLING
HOME IN A PANIC.
ASKING FOR THE VENTALIN.
BUS THAT-- BECAUSE THAT WOULD
INDICATE, ESPECIALLY IN KIDS
HAVING PROBLEMS WITH EXERCISE,
THEY HAVEN'T REMODELED THEIR
LUNGS.
YOU HAVE TO SUSPECT THAT
THEY'VE GOT THE INFLAMMATION.
THEN YOU HAVE TO START AN ANTI
INFLAMMATORY.
SO REALLY ANTI INFLAMMATORY,
REALLY INHALED STEROID, IS THE
PRIMARY MANAGEMENT OF ASTHMA.

Maureen says ALL RIGHT.
THANK YOU FOR THE CALL.
I WISH YOU LUCK.
GRANT IS IN ST. CATHARINES.
HELLO.

Grant says HELLO.
HELLO, DOCTOR.
HOW ARE YOU?

Dr. Zimmerman says I'M GOOD THANKS.

Grant says MY QUESTION IS WHAT I WAS
PROBABLY 11 OR 1 IT,-- 11 OR 2,
I WAS DIAGNOSED WITH AN
EXERCISE TYPE OF ASTHMA.
AND-- WHEN I WAS 11 OR 12, I
WAS DIAGNOSED WITH AN EXERCISE
TYPE OF ASTHMA AND I HAD-- I
WAS ALLERGIC TO POLLEN.
AND WHEN I GREW, THE ASTHMA
SEEMED TO GO AWAY.
AND I'M 25 NOW AND THE
ALLERGIES SUBSIDED SOMEWHAT BUT
IT SEEMS NOW THAT THE ASTHMA IS
COMING BACK.
IT SEEMS TO BE TAKING LESS AND
LESS ACTIVITY TO-- TO CAUSE THE
SPASMS.
AND IT'S BECOMING-- IT'S
BECOMING MORE INCREASINGLY
DIFFICULT TO BREATHE.
LIKE, I WOULD HAVE A BIT OF A
WHEEZINESS AND TAKE THE BLUE
INHALEER.
BUT NOW IT SEEMS LIKE WHEN I'M
TAKING THE BLUE INHALEER, I'M
MORE STRUGGLING TO BREATHE THAN
I WAS BEFORE.
AND I'M JUST WONDERING, UM,
IS-- IF THIS WILL CONTINUE TO
PROGRESS OR BREAK OUT IN TO
JUST SPORADIC ATTACKS.

Dr. Zimmerman says WELL, I WOULD SUGGEST FIRST,
IF YOU HAVEN'T BEEN PROPERLY
EVALUATED, YOU NEED TO BE
PROPERLY EVALUATED.
BECAUSE IT'S-- IT SOUNDS LIKE
THAT OVER A PERIOD OF TIME,
WHEN YOU THOUGHT YOUR ASTHMA
WAS ACTUALLY GOOD, YOU HAD
OUTGROWN IT, YOU PROBABLY
REMODELED YOUR LUNGS.
THAT YOU HAVE-- YOU NOW HAVE
TWITCHING.
BUT THE REAL QUESTION EVEN IN AN
ADULT IS DO YOU ALSO HAVE THE
INFLAMMATION?
BACK WHEN YOU WERE A YOUNGSTER,
IT WAS CALLED EXERCISE-INDUCED
ASTHMA.
I WOULD LIKE TO SUGGEST THAT--
THAT KIDS USUALLY DO NOT HAVE
EXERCISE-INDUCED ASTHMA.
THEY HAVE ASTHMA.
A VERY-- OF VARYING DEGREES.
BECAUSE WHAT HAPPENS IS WHEN
YOUR LUNGS ARE FULL OF THIS
STUFF, THEN EXERCISE ACTS TO
IRRITATE THE LUNGS.
THEY-- THEY GO INTO SPASM.
THEN YOU HAVE SOME PROBLEM.
BUT YOU HAVE-- YOU HAVEN'T AS A
CHILD-- YOU HAVEN'T REMODELED
THE LUNGS, SO THEREFORE,
REALLY, WE'RE LOOKING AT A
PROCESS OF-- THAT'S UNDERWAY.
YOU CAN BE FOOLED.
POLLENS ARE NOT A BIG PUSH FOR
ASTHMA.
HAD YOU BEEN EVALUATEED AND
FOUND YOU WERE ALLERGIC MORE
THAN THAT, YOU PROBABLY WOULD
HAVE NEEDED AN INHALED STEROID
EVEN THOUGH IT SEEMED
CLINICALLY THAT ALL YOU NEEDED
WAS A LITTLE BIT OF VEFT--
VENTALIN EVERY SO OFTEN IF--
AND IF THE AIRWAY IS REMODELED
YOU IN THEORY OUT GROW.
BUT THE REASON FOR ASTHMA
COMING BACK IS THE ALLERGIES
COMING BACK.
YOU SAY THE ASTHMA SEEMS LESS
BUT YOU CAN SOMETIMES BE FOOLED
BY THAT.
IF THE TESTS DONE IN HAMILTON
WERE ROUTINELY AVAILABLE, IF
THE GOVERNMENT WERE WILLING TO
PAY FOR A VERY EXPENSIVE TEST,
THEY WOULD DO THIS SPETEM TEST
ON THIS AND THERE'S A VERY GOOD
LICKLY HOOD THAT WE WOULD FIND
ABNORMAL LEVELS OF
INFLAMMATION.
ARE YOU ON AN INHALED STEROID?

Grant says NO, I'M NOT.

Dr. Zimmerman says I THINK YOU NEED TO BE
EVALUATED.
AND I THINK THERE'S A FAIR
CHANCE THAT WHAT BROUGHT IT
BACK IS REALLY INFLAMMATION.
BECAUSE THE QUESTION IS HOW DO
YOU ARRIVE WITH THE
EXERCISE-INDUCED?
EITHER REMODELED YOUR LUNGS SO
THAT THEY'RE PERMANENTLY
CHANGED.
EVEN THOUGH YOU NO LONGER HAVE
INFLAMMATION AND YOU HAVE A
PERMANENT CHANGE, I DON'T THINK
SO.
I THINK WHAT BROUGHT IT BACK IS
THE INFLAMMATION, INDEPENDENT
OF HOW IT'S ARRIVED AT.
YOUR ASTHMA IS WORSENING.
AND THE EXERCISE AND THE TIP OF
THE ICEBERG.
IT'S A WARNING.
ARE YOU WAKING UP IN THE MIDDLE
OF THE NIGHT OR IN THE MORNING
FEELING TIGHT?

Grant says AH, NO.
NOT-- NOT-- NOT REALLY.
NO.
IT JUST SEEMS TO BE-- WHAT'S
HAPPENING NOW IS JUST TAKING
LESS AND LESS PHYSICAL ACTIVITY
TO-- TO--

Dr. Zimmerman says WELL, AS FAR AS I'M
CONCERNED, THAT'S INCREASING
ASTHMA.
THE REAL QUESTION BECOMES: HOW
MUCH IS ACTIVE INFLAMMATION?
AND BASICALLY, UM, IT NEEDS TO
BE EEVALUATED.
THERE-- THERE ARE TESTS THAT
CAN BE DONE TO MAKE SURE IT'S
ASTHMA.
BECAUSE DIAGNOSING ACROSS A
TELEVISION SET ISN'T THE
PERFECT WAY OF DOING IT.
ONCE WE'RE CERTAIN YOU HAVE
ASTHMA, I WOULD REGARD THAT
YOUR SYMPTOMS ARE A HIGH LEVEL
OF ASTHMA.
THAT WE COULD BE BEING FOOLED.
THAT IT JUST SEEMS TO KNOW
OCCURRING WITH EXERCISE.
AND I WOULD BE FAIRLY
AGGRESSIVE.
I WOULD BE AGGRESSIVE ABOUT
SORTING IT OUT.
YOU NEED TO SEE YOUR DOCTOR AND
PROBABLY NEED A REFERRAL TO A
SPECIALIST TO SORT OUT EXACTLY
WHERE YOUR ASTHMA STANDS.

Maureen says ONCE HE'S CONTROLLING IT,
CAN PEOPLE GO BACK TO BEING
ACTIVE AND DOING EXERCISE?

Dr. Zimmerman says ABSOLUTELY.
ABSOLUTELY.
PROVIDED YOU HAVEN'T LET THIS
CARRY ON TO THE POINT WHERE YOU
HAVE PERMANENT CHANGES.
OKAY?
SO YOU WANT TO GET RID OF THE
INFLAMMATION, THE INHALED
STEROID.
AND GRADUALLY IT WILL REDUCE
THE LEVEL OF ASTHMA.
IT WILL TAKE YOUR ASTHMA SAFER,
OKAY?
AND YOU CAN IN FACT DO
EVERYTHING YOU WANT TO DO.
YOU'LL LEAD A NORMAL LIFE.
BUT YOU MAY REQUIRE SOME
MAINTENANCE INHALED STEROID.
YOU HAVE TO BE METHODICAL ABOUT
IT.
SO, INITIALLY TO BRING A PERSON
UNDER CONTROL, YOU HIT WITH A
GOOD WHACK, INCLUDING ORAL
STEROID IF NECESSARY.
AND THEN YOU REDUCE.
ONCE YOU HAVE THEM UNDER
CONTROL.
THE STUFF-- TO GET RID OF THAT
STUFF TAKES 3 OR 4 WEEKS
OF A PROPER DOZE OF AN-- OF A
PROPER STEROID AND THEN YOU CAN
BEGIN THE PROCESS OF GRADUALLY
ROOTSING.
THE FIRST THINGS THAT GOES IS
OTHER SYMPTOMS AND THE LAST
THING YOU IMPROVE UPON IS THE
EXERCISE TOLERANCE.
BUT YOU WANT TO DO IT BEFORE
THE PERMANENT CHANGES OCCUR IN
THE LUNGS.

Maureen says ALL RIGHT.
THANK YOU, GRANT.
I THINK IT'S GOOD THAT YOU
CALLED IN TODAY.
JOYCE IS CALLING.
HI.

Joyce says MY QUESTION IS ABOUT POISON
IVY.
I HAVE A DAUGHTER WHO'S 8
NOW.
AND SHE WAS EXPOSED TO-- 2 OR
3 YEARS AGO TO POISON IVY.
AND, UM, EVERY YEAR, SHE'S--
EVERY SUMMER, SHE SEEM TO GET
IT EVEN THOUGH-- WE DON'T THINK
SHE'S BEEN EXPOSED TO IT.
UM, AND-- AND I WAS TOLD, YOU
KNOW, THAT THIS HAPPENS.
IS THAT TRUE?
OR?

Dr. Zimmerman says WELL, IT IS TRUE.
NOW, DO YOU HAVE A PET?

Joyce says WE HAVE A CAT AND A DOG.

Dr. Zimmerman says IF IT'S AN OUTSIDE DOG, THE
DOG COULD CARRY BACK POISON IVY
BACK.
IT'S A DIFFERENT TYPE OF AN
IMMUNE RESPONSE.
PART OF THE YOUNH AND YANG.
POISON IVY IS THE IMMUNE
RESPONSE YOU GET THAT PROTECTS
FROM VIRUSES.
IT'S THE OPPOSITE OF THE ALLERGI
ALLERGIC IMMUNE RESPONSE.
IT CREATES THE LAID HYPER
SENSITIVITY.
SO IT'S A CONTACT PHENOMENON.
THE QUESTION IS, WHERE IS THE
CONTACT SUFFERING?
CAN IT COME BACK WITHOUT
CONTACT?
I DON'T THINK SO.
I THINK THERE'S CONTACT.
OFTEN YOU'RE LOOKING AT, UM,
IT-- ONCE YOU BECOME
SENSITIZED, IT DOESN'T TAKE
THAT MUCH CONTACT.
EVEN THE DOG ROOTING THROUGH--
HE MAY NOT END UP WITH POISON
IVY BUT CAN BRING IT HOME.
THERE USED TO BE SOME-- SOME
IMMUNOTHERAPY, SHOTS FOR POISON
IVY.
I DID A LITERATURE SEARCH TO
SEE HOW GOOD IT IS.
IT'S NOT GOOD ENOUGH TO
WARRANT.
THE REAL QUESTION IS, CAN WE
TURN THE RESPONSE OFF?
AFTER A FEW YEARS LIKE THAT
OFTEN THE RESPONSE RECEDES.
I DIDN'T DO THE LITERATURE
RESEARCH, SO I'M NOT SURE OF
THE EXACT UNDERSTANDING.
WHETHER IT RECEDES WHEN YOU
HAVE NO LOPPINGER HAVE CONTACT
OR BLAME THE PET FOR THE
CONTACT.
BUT AFTER A FEW YEARS IT, SEEMS
TO LESSEN.

Maureen says HMM.
OKAY.
ALL YOU CAN DO IS TRY TO AVOID
IT AND HAVE THE PET AVOID IT.

Dr. Zimmerman says THAT'S RIGHT.
YOU'RE USING THE OLD TOPICALS
AND SUCH TO TRY AND GIVE YOU
RELIEF.

Maureen says AS A DOCTOR, HOW CONCERNED
ARE YOU ABOUT AIR POLLUTION IN
ONTARIO?
THE STORIES IN TORONTO LAST
THE-- THE LAST COUPLE OF DAYS,
ABOUT AS MANY AS A THOUSAND
DEATHS A YEAR BEING ATTRIBUTE
TODAY SMOG.

Dr. Zimmerman says OKAY.
VERY CONCERNED.
WELL, ONE OF THE THINGS THAT--
THAT-- I'VE JUST RECEIVED, UM,
A LITTLE BUNDLE OF MONEY FROM
THE GOVERNMENT TO DO A STUDY AT
THE GAUGE OCCUPATIONAL,
ENVIRONMENTAL HEALTH UNIT.
TO LOOK AT KIDS AND WHAT I'LL
DO IS LOOKING AT SUSSEPTEMBER
ABLE KIDS.
THESE ARE KIDS WITH AS--
LOOKING AT SUSCEPTIBLE KILLED.
THESE ARE KIDS WITH ASTHMA.
I'LL USE OZONE, BECAUSE THE ONE
BEST CHARACTERIZEED AND I CAN
DO IT IN KIDS.
AND THE KIDS I'LL LOOK AT ARE
KIDS THAT HAVE ASTHMA THAT SEEM
TO HAVE SYMPTOM-FREE ASTHMA.
BUT YET WHEN WE DO THIS STUDY
OF LOOKING AT WHAT'S GOING ON
INSPECT THEIR AIRWAYS, WE FIND
THEY HAVE INFLAMMATION.
THEY'RE ALLERGIC TO THE PET AT
HOME AND THINK THE ASTHMA IS
MINIMAL AND WE HAVE A LOT GOING
ON.
WHEN WE CHALLENGE THEM WITH
OZONE, WE'LL SEE A RISE IN THAT
INFLAMMATION I THINK.
AND WHEN THEY'RE TREATED WITH A
TREATED STEER ROID, WE'LL SEE
NOT THE-- WITH A TREATED
STEROID, WE'LL SEE NOT THE SAME
RISE BUT LITTLE DIFFERENCE.
THERE'S EPIDEMIOLOGY... IF YOU
WONDER WHY COFFEE CAN BE GOOD
FOR YOU AND NOT GOOD FOR YOU
AND THE CELL PHONE IS GOOD AND
NOT GOOD FOR YOU, BECAUSE
EPIDEMEOLOGY, YOU HAVE TO GET
5-- GET 5 STUDIES THAT
SAY THE SAME THING BEFORE YOU
GET THE RESULT.
WE HAVE DATA FROM ONTARIO
THAT-- THAT WAS DONE A FEW
YEARS AGO, AND THE CHALLENGE
STUDIES THAT ARE COMING OUT
NOW, THAT YOU PUT AN INDIVIDUAL
INTO A BOX AND CHALLENGE THEM,
IN THIS CASE, I WOULD BE DOING
IT WITH OZONE IS THAT THE -- IS
THAT THE AIR POLLUTANTS ARE
VARIOUS TYPES.
THEY'RE PART TICKLES AND
SULPHUR DIOXIDE AND OZONE.
WHAT THEY DO IS ENHANCE AN
INFLAMMATORY RESPONSE.
THEY ACT AS AN AGITANT.
IF YOU HAVE A LITTLE BIT OF
INFLAMMATION GOING ON, THEY
REALLY BRING IT UP.
SO THEY MAY NOT BE THE DIRECT
CAUSE OF ALLERGY, FOR EXAMPLE,
THIS WAS IN A COMPARISON OF
CITIES IN WESTERN EUROPE
COMPARED TO EASTERN EUROPE.
BUT THEY ENHANCE THE
INFLAMMATION IN THE AIRWAYS.
SO SUSCEPTIBLE PEOPLE ARE
REALLY AT RISK.
THAT RISK INCLUDES ASTHMATICS
AND AIRWAY DISEASE.
PEOPLE WITH CHRONIC BRONCHITIS.
CIGARETTE SMOKERS THAT SHOULD
NOT BE SMOKING AND SHOULD NEVER
SMOKE IN THE HOME BECAUSE OF
THE DAMAGE THEY DO TO THEIR
KIDS.
BUT ALSO PEOPLE WITH HEART
DISEASE AND CARDIO VASCULAR
PROBLEMS.

Maureen says ARE YOU LOOKING FOR KIDS FOR
THIS STUDY OR DO YOU HAVE THEM?

Dr. Zimmerman says IN FACT, I'LL ASK KIDS--
KIDS FROM MY PRACTICE.
AND WHAT IT ALLOWS US TO DO, IT
IS REGRET, IT-- GREAT, IT
ALLOWS TO US CHARACTERIZE THE
KIDS' ASTHMA BY LOOKING AT THE
TECHNIQUE OF REDUCED SPETUM
DONE IN HAMILTON.

Maureen says COME BACK AND TELL US ABOUT
IT.

Dr. Zimmerman says I WILL.

Maureen says GOOD TO HAVE YOU AGAIN THANK
YOU.
DR. BARRY ZIMMERMAN IS A
PEDIATRIC ALLERGIST IN TORONTO
AND ONE OF THE AUTHORS OF “THE
ALLERGY AND ASTHMA HANDBOOK.”
FOR MORE INFORMATION ON ASTHMA
AND ALLERGIES.” IT'S PUBLISHED BY RANDOM HOUSE CANADA.
FOR MORE INFORMATION ON ALLERGIES AND ASTHMA, CHECK OUT SYMPATICO'S HEALTH CENTRAL AT SYMPATICO.HEALTHCENTRAL.CA. AND THE ANAPHYLAXIS FOUNDATION OF CANADA WANTS TO PUT TOGETHER A REGISTRY OF PEOPLE KNOWN TO BE ALLERGIC OR ANAPHYLACTIC TO FOOD, INSECTS, STINGS, LATEX OR MEDICATION. FOR MORE INFORMATION CALL 416-438-1917 OR VISIT THEIR WEBSITE AT WWW.ANAPHYLAXIS.ORG.
FOR THOSE OF YOU WHO WILL
BE GARDENING AT THE COTTAGE,
HERE'S PERENNIAL PLANT EXPERT
VAL WARD WITH SOME GREAT TIPS
FOR A WEEKEND GARDEN.

Val's in her fifties with brown hair tied back. She wears a blue-jean shirt. “The caption changes to “Val Ward. Buds garden centre...”

She says CHOOSING PERENNIALS GOOD FOR
THE COTTAGE REPRESENTS A
SPECIAL CHALLENGE FOR GUARD EN
ENERS.
THE BIGGEST MISTAKE PEOPLE MAKE
IS PICKING PLANTS THAT NEED
WATERING FAR TOO MUCH.
THE AMOUNT OF TIME THAT THEY
CAN SPEND AT THE COTTAGE.
YOU NEED TO FIND PLANTS THAT
ARE GOOD AND HEARTY FOR THAT
AREA AND THAT DON'T REQUIRE TOO
MUCH WATERING.
SO WE'LL LOOK AT SOME SPECIAL
TIPS TODAY FOR CHOOSING RIGHT
PLANTS TO TAKE UP TO THE
COTTAGE WITH YOU.
AND THIS IS THE ARTEMESIA
SILVER BROCADE.

Val picks up a leafy green plant and continues
THIS IS A PERFECT EVENLY TYPE
OF PLANT.
IT'S VERY, VERY HEARTY.
ZONE 2.
UM, AND IT'S QUITE RESILIENT AND
DROUGHT TOLERANT.
ONE OF THE BEST THINGS ABOUT
THIS PLANT IS WHAT IT WILL DO
TO THE OTHER PLANTS THAT YOU
SEE IN THE GARDEN.
IT'S VERY GARDEN FRIENDLY.
AMPLIFIES AUFTS COLOURS NEXT TO
IT.
IT REALLY, REALLY GLOWS.
AND THIS IS ONE THAT'S GOOD FOR
THE COTTAGE.
AND ANOTHER ONE THAT'S VERY,
VERY GOOD FOR THE COTTAGE IS
THIS ONE.

Val picks up a red flower and says
MOST OF US ARE FAMILIAR WITH
THE GREEN TYPE.
THIS IS RED SEMPERVIVUM.
THERE'S A LOT OF VARIETIES OUT
THERE THAT DON'T GET USED AS
FREQUENTLY.
THIS IS A RED TYPE.
IT'S NOT-- THERE ARE DIFFERENT
TYPES THAT ARE BLACK AND 2
TONED.
AND VERY TOUGH, VERY RESILIENT.
DROUGHT TOLERANT.
GOOD AT THE COTTAGE.
EVEN EVERGREEN.
HAVE THAT EFFECT IN THE WINTER
IF YOU COULD SEE IT UNDERNEATH
THE SNOW.
THIS IS AN EXCELLENT PLANT FOR
THE COTTAGE.

Val picks up a green grassy plant and says
DIANTHUS MOUNTAIN MIST IS A GREAT PLANT FOR THE COTTAGE.
THIS HAS A GREAT SUMMER FOLIAGE
TO IT.
THEY'RE DEEP PINK, THE FLOWERS,
SCENTED AND DROUGHT TOLERANT.
USUALLY BLOOM MORE THAN ONCE IN
A SEASON IF YOU CUT OFF THE
SEED HEADS AFTERWARDS.

Val picks up tall green plant with rounded leaves and says
THIS IS SEDUM.
MOST OF US HAVE SEEM THEM AND
MOST OF US HAVE THEM IN OUR
GARDENS.
VERY RESILIENT.
WILL TAKE DROUGHT.
IT'S THE KIND OF PLANT THAT YOU
CAN PUT IN THE GARDEN AND
PRETTY MUCH FORGET ABOUT.
THEY'RE HAPPIEST WHEN THEY'RE
LEFT ALONE.

Val picks up a tall red flower with tall green grass.
IRISES ARE ALSO EXCELLENT.
AND IN COT ANXIOUS.

- AND IN COTTAGES.
THEY ACTUALLY ENJOY DRY
CONDITIONS.
MOST OF THE TIMES WE'VE HAD
PROBLEMS WITH OURS IS BECAUSE
WE TRY TO CARE FOR THEM TOO
MUCH.
IF YOU OVER FERTILIZE THEM,
THEY PRODUCE FOR PLANTS THAN
FLOWERS AND THE INTERESTING
THINGS ABOUT IRISS IS THEY HAVE
2 ROOT SYSTEMS.
DOWN IN HERE, YOU SEE THIS
CALLED RISON.
THEN INSIDE, UNDERNEATH, A
MUCH DEEPER ROOT SYSTEM.
AND IT'S THIS DEEP ROOT SYSTEM,
SYSTEM,WHEN PLANTED CORRECTLY,
THAT-- THAT IS GOING TO HELP
THIS PLANT TO SURVIVE IN THE
COTTAGE ENVIRONMENT.
THERE ARE ALSO WAYS TO PLANT
YOUR PERENNIALS SO THE SOIL
WILL RETAIN MORE MOISTURE.
LET'S LOOK AT HOW WE MIGHT BE
ABLE TO DO THAT.

Val kneels down in front of a large pot filled with dirt. The tall red flower is planted in the middle.

She says NOW, OKAY, SO NOW HE HAVE THE
RYE RIS PLANTED IN HERE.
WE'LL LOOK AT ONE OF THE WAYS
THAT WE CAN USE TO KEEP THE
PLANTS HEALTHIER LONGER AND
HAPPIER.
OKAY.
WHAT WE HAVE HERE IS SOME
MULCH.
I'M GOING TO TAKE THIS MULCH OR
WITH WE COULD TAKE COMPOST, AND
FORM A RING AROUND THE PLANT,
LIKE A DOUGHNUT A FEW INCHES
DEEP AND A FEW INCHES AWAY FROM
THE BASE OF THE PLANT.

She pours dirt around the circumference of the plant.

She continues PUT IT UP LIKE THAT.
THIS WILL HELP KEEP MOISTURE
TRAPPED WITHIN THE DISH SHAPE
OF THIS LITTLE CONSTRUCTION.
AND IT ALSO ACTUALLY ACTS LIKE
A SPONGE.
AND RELEASES MOISTURE SLOWLY.
AND ANOTHER TRICK... TAKE SOME
STONES.
AND MOVE THEM CLOSELY TO THE
PLANT.

Val pours rocks on top of the dirt.

She continues BRING THEM ALL THE WAY AROUND.
THIS ALSO HELPS TO KEEP SOME OF
THE MOISTURE TRAPPED IN CLOSE
TO THE PLANT.
AND IT'S-- IT'S CLEAN DIRT SO
THAT NO MILDEW WILL FORM.
DOING THIS WILL HELP TO KEEP
THE PLANTS HAPPY AND ALIVE AND
HEALTHY SO THAT THEY ARE IN BLOOM FOR YOU TO ENJOY WHEN YOU GET TO THE COTTAGE.

Maureen says THANKS VAL, AND THANK YOU FOR WATCHING THIS EDITION OF “MORE TO LIFE.” I'M MAUREEN TAYLOR, HOPING YOU WILL JOIN ME MONDAY THROUGH FRIDAY ON TVO AT 1 O'CLOCK.

A closing slate reads “The advice given in the preceding program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances.”

Watch: Allergies