2015年6月29日 星期一

吃了就吐…食物過敏兒自救戰

美國約有590萬兒童患有食物過敏症,學校每13個孩子就有一個食物過敏。在中國,1億多0到6歲的嬰幼兒中,約有1000萬兒童患有不同程度的食物過敏,且不再像以往那樣,隨著年齡增長就會自然消退。
四歲的小女孩動動出生至今,只能吃五種食物:青菜泥、牛肉泥、玉米泥、氨基酸米糊和一種帶著「臭雞蛋和魚腥味」的氨基酸奶粉。除此之外,任何一種食物都會讓她嚴重過敏,頻繁的嘔吐、腹瀉、便秘和哭鬧會讓她生長發育幾乎停滯。
作為母親,旻蘇的職責是保證女兒的安全。她堅持全家人的食譜都和動動保持一致。除了醫院,動動沒有在任何地方留宿過。當旻蘇上班時,姥姥會全天陪在動動身邊。
動動屬於中國過敏兒群體中最嚴重的1%。畢業於北京大學的旻蘇在國內知名的高知社群「水木清華」上發了一個帖子。很快,她就見到了「甜媽」,發現在北京還有第二個像動動這樣「不食人間煙火的孩子」。隨後「過敏兒家長聯盟」QQ群建立。不到兩年時間,群裡已經聚集了全國各地上千個嚴重過敏兒的家長,他們聯合在一起,尋找科學解決之道,因為中國醫學研究還不能負擔起應對兒童過敏的重任。
寶寶出生後…拒喝母奶
2011年5月,動動出生了。當旻蘇還沉浸在初為人母的喜悅中,動動就出現強烈的拒奶和大哭,出生第三天就出現噴射狀嘔吐。「這世界上怎麼還有不能吃母乳的孩子?」旻蘇難以相信。
到六個月,大部分寶寶開始嘗試輔食,但即使是大米、胡蘿蔔等低敏食物,動動都會出現嚴重過敏反應。七個月時,旻蘇第一次從北京協和醫院的董梅醫生那裡聽說「食物蛋白過敏」,這是一種複雜的由IgG(免疫球蛋白G)介導的Ⅲ型變態反應性疾病,也被稱為遲發型過敏反應。而通常人們所說的過敏,屬於IgE介導的速發過敏反應。
這種因過敏引起的食物不耐受,可以表現在消化系統的各個部位,從口腔、胃食道,到結腸、直腸,因此會嘔吐、腹瀉,有些嬰兒還可出現口腔潰瘍、消化道出血和咳嗽等呼吸道症狀。
快兩歲時,其他孩子和成年人的飲食幾乎沒什麼區別了,動動依然食欲極差,不斷地嘔吐或乾嘔,頭臉部散見皮疹,下巴和脖頸大片紅疹,經常把自己撓得遍體鱗傷。有時會毫無來由地號哭幾個小時。到了晚上又精力旺盛,爬上爬下。
旻蘇帶孩子把全國各大公立和私立醫院的醫生及特需兒科專家幾乎都看了個遍。但多次檢測過敏源、食物不耐受,包括免疫和代謝相關基因,均未發現特異性問題。
查不出毛病…家長有病?
「很多專家認為『孩子沒病我有病』。」旻蘇說。
那是她最初的噩夢:消化科沒見過,就推給變態反應科,變態反應科只處理IgE介導的速發過敏,轉給兒童保健科,兒保科查不出毛病就推給中醫科,中醫開了中成藥,吃了就吐。「我當時認為動動是在中國都獨一無二的孩子。」旻蘇感到絕望。
她想知道到底是什麼食物讓女兒受到這樣的折磨?遵循北京兒童醫院特級專家陳賢楠的建議,她用七個黑皮筆記本記錄下了全部的信息:天氣、環境、所有的日常活動、接觸的物體、攝入食物種類分量,到每一次過敏出現時的症狀,都被事無巨細地記錄下來,時間精細到了分鐘。
這樣的記錄繁瑣且低效,但旻蘇極為滿足,畢竟在記完五大本之後,她終於發現了孩子所有不能吃的食物。嚴格控制後,她快速成長發育,嘔吐等反應也大大減輕。
旻蘇得出結論:一份按時記錄、簡明扼要、重點突出的孩子病史,對就醫和應對過敏問題是最有效的手段。
4歲了,動動的過敏仍沒有任何緩解跡象,可以吃的食物數量依然只有五種。旻蘇會用玫紅色、熒光綠的器皿盛著女兒的三餐,以掩蓋日復一日的單調食譜。
旻蘇有時忍不住再給孩子試一點食物。比如用網購的棉花糖機做出一個又大又鬆軟的棉花糖,動動歡天喜地的吃了一個。然而,當天夜裡就開始嘔吐,紅色的疹子布滿她的臉。「白糖」自此也被畫入禁區。此後,就再不敢讓動動嘗試任何新的食物了,她認識草莓、檸檬,都是透過塑料玩具和繪本。

動動最愛粉色,家裡儼然一個公主樂園。但客廳的沙發是用隔尿墊全覆蓋的,因為沙發上的絨毛會引起過敏。床上、枕頭上也鋪著除蟎墊。家裡擺著雛菊、綠色植物,仔細一看,全是假的。陽台上囤著一罐罐進口氨基酸奶粉,堆得快要倒下來。
每一罐奶粉都很有意思,因為動動只能吃某一特定批次的氨基酸奶粉,換批次就會產生過敏反應,旻蘇發動認識的所有人都幫她海淘這個批次的奶粉,結果全國各地寄來了80多罐。「現在米糊也遇到了這個問題,我又囤了30多罐。」旻蘇說。
貌似有些謹慎過度。但對於患有嚴重過敏反應的孩子們來說,微不可見的痕量污染物也足以致命。
走過鬼門關…選擇避食
動動有兩次跟死亡擦肩而過。第一次凶手是混合輔食。1歲1個月時,她吃了混合果泥和肉泥,之後就出現嚴重的皮疹,並突發病毒性腦炎,動動很快就失去意識並驚厥抽搐了足足15分鐘。第二次是住院期間,動動突發高燒寒顫,全身發灰發紫。姥姥站在一旁嚇得腿直哆嗦。之後,醫生用物理降溫、使勁摩擦動動已經變色的皮膚和一大堆藥物才把她搶救回來。
和所有過敏的孩子一樣,動動免疫紊亂,容易感染上多種病毒。不幸的是,在腦炎住院期間,動動又在三人間的病房感染上了肺炎。腦炎剛出院就開始治療肺炎,其間又因為過量抗生素讓過敏反應更加劇烈,病程長達一個半月。
這些年下來,旻蘇對腸炎、腦炎、肺炎、鼻炎、皮疹、濕疹如數家珍,每一次住院都是死裡逃生。沒有人能體會那種常年憂心如焚、睡眠不足、幾近崩潰的生活。旻蘇的客廳電視機上面的牆壁上貼著兩張白紙,上面寫著四個大字「冷靜、克制」,那是在又一次爭吵之後,孩子爸爸貼的。
目前,全世界對於過敏的首選方法都是「避食」,即不再吃引起過敏的食物。對於數以千萬計的食物過敏的孩子而言,還沒有什麼療效確切的方法。家長們不願就此等待。不到兩年時間,QQ群裡已經匯聚了上千個過敏兒的家長,這些受過良好教育的家長在找尋科學方法時不遺餘力。
在建立「過敏兒家長聯盟」的兩年間,家長們分享和總結各地醫生的治療方法和建議,積累日常護理的經驗教訓。他們跟蹤過敏相關的最新研究,分工合作翻譯最新的醫學指南和過敏食譜。
旻蘇是其中最堅定的一個,單位裡堆滿了孩子過敏的相關書籍。下班回家,照顧完動動,她便會翻閱國內外醫學文獻,認真搜索所有海外報導的病例,並把有意義的文章翻譯成中文,分享給群內的媽媽們。她指導群裡的媽媽撰寫最有效的病史紀錄,光搜集到的案例就有一、兩百封。
想過敏 口服免疫最流行
畢生研究兒童過敏的韋斯利‧伯克斯是美國過敏、哮喘以及免疫學學會主席。他說,20年前大部分的孩子僅對一兩種食物過敏,現在對多種食物過敏的嬰幼兒數量飛速增長。
過敏增多的原因是多種多樣的。伯克斯指出,目前醫學界有幾種理論,包括衛生假說理論(該理論認為生活在太過於乾淨和衛生的環境中,會使人們沒有機會接觸自然界的微生物,從而影響免疫系統發育)、環境污染(比如柴油廢氣顆粒物污染物、殺蟲劑),不同國家不同的飲食方式等。
而史丹福大學旗下的露西爾‧帕卡德兒童醫院過敏和免疫學副教授卡麗‧納多(Kari Nadeau)則相信,食物過敏可能是「基因和環境之間的某些因素——空氣污染物、煙草煙霧、添加劑和化學物質的共同作用」。
她的團隊正在臨床試驗的口服免疫療法是當下最前沿的療法之一——已經讓對花生嚴重過敏的兒童成功「脫敏」。下一步,可能就會輪到多食物過敏的兒童了,伯克斯教授認為,在這之後第二代和第三代的治療法將會為多種過敏原脫敏。
旻蘇彷彿看到了希望,她試圖聯聯繫多,希望他們為中國的過敏兒建立一個口服耐受療法的試驗分中心。另一方面,她用有組織的志願者聯盟形式,透過微信平台為更多的家長科普,讓家長了解遭遇相關症狀時,首先考慮「食物過敏」,而不是盲目就醫和慌張失措。她還設想組織醫生與家長們座談,討論今後可能的治療方案。
最近,她準備重新讓動動去幼兒園了,半年前第一次入園因為嚴重的過敏和感染肺炎中止。儘管動動沒有打過任何疫苗(對疫苗嚴重過敏),也可能再次處在風險之中。但她知道,與同齡人交流是如今動動最渴望的事。

資料來源: 

2015年6月27日 星期六

You Could Be Allergic to Your Beauty Products - 可曾想過, 愛美的妳都可能對化妝品敏感?

As someone who is allergic to most awesome things (dairy, soy, avocados, being outside), I've become adept at navigating food labels and blooming gardens. The only area where I'm lax: My products. I mean, if I'm not shoving it into my mouth or rolling around in it, it can't hurt me, right? I ran my sound logic by cosmetic allergist Julie Kuriakose, and surprise! I was wrong. Products containing the same ingredients that make you sneeze, wheeze, and feel sick to your stomach can also cause issues on your skin, says Kuriakose.
Even a few drops of, say, avocado oil or blueberry extract may still contain the fruit’s protein, which is what causes a person’s allergic reaction, Kuriakose explains. And if you have seasonal allergies, don’t think you’re home free just because products never contain ragweed or pollen. Get ready for this truth: Chamomile and honey are both part of the ragweed family; tea tree oil contains tree pollen, and daisy extract comes from weeds.
Of course, you probably won’t go into anaphylactic shock from a few dabs of daisy-extract lotion—unless your allergies are really severe—but the aftermath isn’t really worth the risk. “Intense itching and redness that last for days are common symptoms of an allergic reaction to a product,” says dermatologist Joshua Zeichner. Or if your scalp suddenly and persistently itches, even if you didn’t use anything in your hair, you could be having a reaction, adds Kuriakose.

2015年6月25日 星期四

Milk- and Egg-Free Cake - 無蛋和奶的蛋糕食譜

DAIRY-FREE & EGG-FREE CHOCOLATE CAKE

Heat oven to 350.

Grease pan(s) with an allergy safe food if you are making this for someone with food allergies. We have luck with most Pam sprays and or dairy-free margarine also works.  

1.5 c flour
1 c sugar
1/4 cup cocoa powder
1 tsp baking soda
1/2 tsp salt
1 tsp vinegar
1 tsp vanilla
1/3 cup oil
1 c cold water

Combine ingredients by hand or with a mixer. Pour batter into greased pan or muffin cups afterwards. 

Bake in oven until done, when cake springs back to the touch or a toothpick comes out clean. Time varies on the pan you use, 15 to 30 minutes possibly.

Source: http://www.milkallergymom.com/2008/05/dairyegg-free-cake.html

2015年6月22日 星期一

孕媽咪吃花生 寶寶出生就過敏

台灣每3個孩子就有1個過敏,只要遇上好發季節或是吃到致敏食物,皮膚癢、咳不停等症狀就會反覆發作,讓爸媽相當頭痛。於是,有些準媽咪從孕期就開始防範,避免食用花生、牛奶、豆類等高過敏原食物,希望不要生出過敏兒。但是,不吃這些食物,寶寶就真的不會過敏嗎?
只要孕媽咪懷孕前不會對花生、牛奶等食物過敏,孕期就可以放心食用。
所謂過敏,就是「過度敏感」的簡稱,是人體的免疫系統對於外來物質反應過度所造成。如果準爸媽本身就有過敏體質,生出過敏寶寶的機率就比較高;即使調整孕期飲食,也未必就不會生出過敏兒。
因此,如果孕媽咪原本就對花生、牛奶、雞蛋、黃豆等食物不會過敏,懷孕期間就可以安心食用,千萬不要一聽到是過敏原食物就拒吃,以免營養不均衡,影響寶寶發育。
如果準媽咪不確定自己對哪些食物過敏,王子南營養師建議,可以前往醫院的風濕免疫科,進行「過敏疾病檢查」,透過免疫螢光法測定各種過敏物質,包含食物、藥物,以及吸入性過敏原。事實上,不只是食物有可能導致準媽咪過敏,生活壓力也是潛在因素。
深紅色和深黃色蔬果富含類胡蘿蔔素,有助於提升準媽咪和寶寶的免疫力。
避免急性壓力 遠離過敏
王子南營養師指出,比起食物,感冒以及熬夜和過度操勞所造成的急性壓力,反而才是比較可能導致孕媽咪過敏的原因。由於急性壓力會造成免疫系統紊亂,原本不會過敏的準媽咪,也有可能轉變為過敏體質。
因此,與其不吃致敏食物,不如從作息正常和飲食均衡加強免疫力。抵抗力好,孕媽咪不生病,才能間接讓肚子裡的寶寶更健康。那麼,究竟要怎麼吃,才能降低過敏機率,又能提升免疫力呢?
多吃紅色、黃色蔬果 調節免疫力
王子南營養師表示,蔬菜水果不但極少造成過敏,更是讓準媽咪和寶寶的免疫系統更強健的好食物。其中,蔬菜對於腸胃消化和代謝特別有幫助,孕媽咪有好的腸胃,才能吸收更多營養,並且傳送給寶寶。而深紅色和深黃色蔬果,因富含β-胡蘿蔔素、葉黃素、玉米黃素,具有調節免疫力、預防感冒的功效。
紅色蔬果包含:紅鳳菜、紅蘿蔔、紅紫蘇、番茄、紅地瓜、紫山藥、紅蘋果、草莓、櫻桃、葡萄、紅豆等等;而黃色蔬果則有黃玉米、黃地瓜、南瓜、金針花、柑橘、枇杷、木瓜等等,孕媽咪可以適量食用,幫寶寶打造好體質。
為了自己還有肚中寶寶的健康,準媽咪一定要遵守作息正常、飲食均衡且適量的原則,並且多多利用紅色和黃色蔬菜的營養,提升母子免疫力。這樣做,才是讓孕媽咪和小寶貝一起遠離過敏的治本之道!

2015年6月20日 星期六

調查指本港嬰幼兒過敏症普遍

香港過敏協會委託香港大學民意研究計畫於上月進行了一個關於嬰幼兒過敏的調查,發現511位受訪母親中,75%表示其子女現時或曾經出現敏感症狀,主要是濕疹/皮膚敏感(58%)、鼻敏感/花粉熱(32%)及哮喘/氣管敏感(25%)。該會主席兼香港過敏科醫學會會董何學工指,家族遺傳、二手煙、空氣污染和剖腹生產都是導致嬰幼兒過敏的高危因素,而牛奶和雞蛋則是嬰幼兒最常見的致敏原,但該調查發現只有21%的受訪者能指出牛奶和雞蛋可能會導致過敏。調查又指,僅35%的受訪者認為餵哺母乳是預防兒童敏感的最佳方法。該會榮譽顧問譚一翔建議,嬰幼兒出生首6個月應以全母乳餵哺,能強健免疫系統及減低敏感風險。

資訊來源: http://news.sina.com.hk/news/20150428/-32-3737230/1.html?cf=hp-tab1Realtime

2015年6月18日 星期四

You Asked: Do I Have a Gluten Allergy? 我是否有麩質敏感?

What you eat could be the cause of your headaches, joint pain, sluggishness or dozens of other ailments. Or maybe not.

People tend to conflate the terms allergy, intolerance, and sensitivity when they talk about food-related reactions, and especially gluten. The first two refer to well-understood digestive disorders with predictable symptoms, says Dr. Robert A. Wood, division chief of allergy and immunology at Johns Hopkins.
If you have a true allergy, your immune system produces antibodies designed to protect you from something it sees as a threat—be it nuts or shellfish. Even a little nibble can cause cramping or stomach pain, a runny nose, skin rashes, or swelling and breathing issues, Wood says.
An intolerance is an inability to properly digest or absorb specific foods or nutrients, often due to a lack of one or more digestive enzymes. (For example, people who are lactose intolerant don’t have the enzymes required to break down lactose.) This inability can lead to gastrointestinal problems like stomach pain, vomiting or diarrhea. Wood says food intolerances, unlike allergies, tend to be “dose dependent”—meaning the more of the food you eat, the worse you feel.
Take gluten, a type of protein found in grains like wheat, rye and barley. When it comes to gluten-related health concerns, says Dr. Alessio Fasano, director of the Center for Celiac Research at Massachusetts General Hospital, roughly 1% of the population has celiac disease—a condition that causes a sufferer’s immune system to attack the small intestine whenever gluten is present. A smaller percentage of people, maybe 0.5%, have a related wheat allergy. “We can verify each of these through blood tests and screening,” Fasano adds. Blood tests are the first step in identifying the underlying condition; to get a definitive diagnosis, a gut biopsy is usually required. For people with these conditions, cutting gluten or wheat is an absolute necessity.
But unlike allergies and intolerances, food sensitivities occupy a gray zone. Like an allergy, they may be related to immune reactions. But they’re poorly understood and symptoms are hard to pin down, says Fasano. “If you believe reports, a food sensitivity could cause a stomachache one time, then a headache, then joint pain or even cognitive problems,” Fasano says.
Because the mechanisms underlying sensitivities aren’t known, Fasano says there’s no way to test and validate them. That ambiguity has led to a lot of confusion and disagreement among researchers, while creating ideal conditions for spurious health “experts” to push food elimination diets that may do more harm than good, he says.
Eliminating gluten is the most common (and some would say trendy) example of this, Fasano says. Some estimates suggest a third of Americans are trying to avoid or altogether ditch gluten. “There’s this misconception that gluten-free foods are healthier or somehow linked to weight loss,” Fasano says. “But for most people, going gluten-free probably will not be beneficial.”
There may be another category of people who suffer from a sensitivity to wheat or gluten. Some popular books have suggested, in the words of Grain Brain author David Perlmutter, that gluten “represents one of the greatest and most under-recognized health threats to humanity.” But there’s not much data to support such claims. Fasano says what data there is point to stomach or abdominal pain as the most common symptom of gluten sensitivity, followed by skin conditions like eczema. While foggy thinking and fatigue are tied to gluten, there’s no agreed-on explanation for these symptoms, Fasano says.
Aside from celiac disease, Johns Hopkins’s Wood says that the medical science community is so convinced gluten isn’t a major health issue that there’s very little funding or interest in studying the subject further. “I think the bulk of people avoiding gluten are avoiding it unnecessarily,” he says. “Most doctors or people who’ve looked into it think it’s more of a lifestyle choice than a valid health issue.”
And when people claim to feel healthier after ditching wheat or gluten? “Lots of junk foods and snack foods contain gluten,” Fasano says. Some estimates show one-third of all grocery store items contain gluten—many of them the additive-stuffed, overly processed packaged foods nutritionists would love for you to eighty-six from your diet. “If you cut out those things, of course you’ll feel better,” Fasano says. “But it’s not because your body has a problem with gluten.”
While he doesn’t believe gluten is the health villain many have made it out to be, Fasano says food-related reactions are common, from gastrointestinal issues like stomachaches or cramps to non-GI issues like headache and joint pain. Fruit, beans, alcohol and many other common foods have been linked to symptoms of allergy or intolerance.
If you feel certain foods, including gluten or wheat, may be triggering pain or another type of physical reaction, Fasano recommends visiting a gastroenterologist or an expert dietitian—someone who can help you identify the source of your problem without putting you at risk for a nutritional deficiency.
“You wouldn’t take antibiotics or insulin without seeing a doctor first,” he says, “and you should take the same precautions when it comes to making changes to your diet.”

2015年6月15日 星期一

Parents, schools work together to manage food allergy concerns – 控制小朋友的過敏問題需要家長和校方一同合作

One in 13 children, about two in every classroom have a food allergy.  In all, Food Allergy Research & Education (FARE) reports that about 6 million children in the U.S. have a food allergy.

Trevor Mulheisen, a second grade student at Oak Ridge Elementary school in Royal Oak, is one of them.

"Trevor has tree nut allergies: pistachios, cashew, and walnut," said Elizabeth Mulheisen, Trevor's mother. "If he has a suspected ingestion of his allergen, for my comfort level, he is to be given the EpiPen immediately."

Oak Ridge Elementary is a peanut-restricted school.   All classrooms are peanut and tree nut free.  

The Mulheisen's have a written plan outlining what to do if he is exposed to his allergies at school.   As part of his plan, Trevor has an EpiPen in his lunch box, his classroom and the school office.

"There's a document called a 504 plan, which children with life-threatening food allergies qualifies under the Americans with Disabilities Act and so that can really help in navigating with the schools to set up a 504 plan that talks about everything to do with your child's needs in the school environment and then that way everybody has a copy of it" said Mulheisen.  "They can reference to really understand the individual child with the food allergy or any other medical condition they might have."

In 2013 the Centers for Disease Control released voluntary guidelines for managing food allergies in schools. Among the recommendations, schools should have a food allergy management and prevention plan. 
Every child at risk for anaphylaxis should also have a written plan like a 504.  That plan would outline how a child will be safely included in activities and how an allergic reaction will be handled.

Mulheisen is on the allergy awareness committee for the PTA at her children's school.  They look for ways to raise awareness about allergies and educate the students.    She is very happy how her school is managing her son's food allergy.

"We've had wonderful open communication, and his teachers have been really proactive," said Mulheisen about working with Dr. Jason Parrott, the school's principal and his staff. "They've just been wonderful to work with, and always asking questions, and making sure that Trevor is not only safe but also included in things that happen at the school."

"It's a lot of education not just to the child but to everyone in his life," said Kim Speck, Palmer and Lanie's mother.

In the Speck family, Palmer, 12, is allergic to peanuts, beef, eggs, dairy, sesame, and mustard and his sister Lanie, 7, has a peanut allergy.  They go to public school in Oxford.

"Sending him to school was obviously very nerve-wracking but we've had great experiences with the public school system and them being very accommodating," Kim Speck said. "Especially now that he's gone to middle school and it's not just into one classroom.  They wipe down his chairs daily, each teacher in between classes wipes his chairs down so his chair is free of any danger.  The same thing happens at lunch.  Everyone is very aware."

Randy Speck said raising children with food allergies helps him with his job as the superintendent of Madison District Public Schools.

"For a lot of kids food is a major staple that they need and schools provide much of that, so we need to make sure that they're safe and families feel like they're safe," said Randy Speck.

Children with severe food allergies are at risk for a potentially fatal reaction called anaphylaxis.  If they have an allergic reaction, they need the drug epinephrine quickly.  In Michigan, all public schools are required to have EpiPens and staff trained how to use them.

"If our students are coming to school and are worried about being safe, or worried about having something in the building that could hurt them or harm them, then they're not really thinking about what they have to do in the classroom," said Dr. Jason Parrott, principal at Oak Ridge Elementary school.

The Michigan Department of Education is trying to do more and is developing state guidelines for handling food allergies.  The state has convened a group of people that represents many sectors, including education, public health, school nurses, pediatricians, allergists, and parents to help develop the guidelines.  They hope to finalize them this summer so schools can use them in the next school year.

Speck believes it's time for there to be a uniform approach to how schools deal with food allergies.  He said parents shouldn't have to worry.

"Schools have an opportunity to be leaders in this real cause for kids. We would do it for most any other disability, we do it for special education needs

"If there was a uniform policy it would make life, it would allow me to breath easier that's for sure and I think it just sends a message across the board that this is a significant issue," Kim Speck said.  "It's on the rise and it's life and death. It's not that they might get sick, it's that they could lose their life."
because we know there is a need to serve all students when it comes to academics. Well there is a need to serve all students when it comes to their dietary needs as well, we just got figure out a way to do it," Randy Speck said.

2015年6月11日 星期四

壓力難解 當心全身過敏

又到了節氣轉換而容易過敏的季節,晨芸的皮膚開始紅一塊腫一塊,這次要去大陸和客戶開會,早早就囑咐好備餐不能有蝦;但其實她也沒真正搞懂過,究竟是這幾天忙著出國準備簡報太過勞累才引起過敏?還是前陣子吃蝦過敏?這已經不是第一次了,只要長期工作加班或熬夜,有時還引發急性氣喘就醫……。
壓力會加重過敏症狀 根據美國俄亥俄州州立大學心理學和精神病學教授格拉色(Janice Kiecolt-Glaser)的最新研究,壓力確實會加重過敏症狀。換句話說,過敏與過敏原有關,但壓力恐怕會加重症狀表現,尤其過敏反應一旦產生後,若壓力還持續存在,症狀就變得更嚴重。

香港生物保健科所做的「最新食物過敏研究」調查亦發現,即使吃的食物一樣,以前雖沒出現過敏,現在也會因為壓力,使身體免疫力降低,而出現過敏癥狀。

國泰綜合醫院風濕科醫師全以祖特別指出,當壓力來臨時,過敏體質的人更要避免過去較少接觸的食物,或對較易產生的過敏原,如魚蝦、牛奶、酒精等,以及吸入式的花粉、塵蟎,和接觸式的精油、肥皂等。

過敏性體質是指容易發生過敏反應及過敏性疾病,卻又找不到發病原因的人。這類患者更容易因壓力而導致抵抗力降低,尤其皮膚是人體最大的器官,分布無數萬個痛覺點、觸覺點和熱覺點,因此,當內部的基因和外部的環境相互作用時,就可能引發皮膚對冷、熱、痛、壓的過敏性反應。
輕劑量和減藥量的用藥原則 精神健康基金會董事長、國立臺灣大學醫學院名譽教授胡海國指出,壓力會同時造成生理和心理的反應。經由腦的邊緣系統,在心理上會感受到緊張、焦慮、沮喪等種種情緒,又經由腦神經系統的生理機轉,會引起腦下垂體和腦下視丘的連串生理反應,進而引發自律神經系統、賀爾蒙系統、免疫系統的三種反應,其中過敏的癥狀即屬於免疫系統。

免疫系統遍佈於全身,是防禦敵人的重要防線,一方面要對外抵抗病毒和細菌的來襲,二方面則辨識與清除體內的異常細胞或被病毒感染的損壞細胞。也因為免疫系統的上游是腦神經系統,因此當壓力造成這一連串下來的連鎖反應之後,就會引發免疫系統的高度活化,使得人體接觸某些本來是正常的外界物質時,卻因產生過度的反應或誤判,而釋放出強烈刺激性的化學物質,也就是「組織胺」,導致鼻塞、打噴嚏、皮膚出疹和皮膚發癢等不適症狀。

全以祖醫師表示,身體會產生過敏,多因累進性的壓力,一直累積到最後一根稻草才發作,因此要治療過敏,就要懂得釋放壓力,或搭配輕劑量的藥物治療,例如以抗組織胺為主的藥劑,來減輕身體的過敏反應。

然而,抗組織胺只是減少紅癢所引起的身心不安,並無法治癒,因此雖然剛開始較容易壓下過敏的症狀,但若不懂得調整作息、改善壓力來源,或增強腦的耐受力,過敏起起伏伏的時間一久,就會變成慢性過敏或急性發作,包括蕁麻疹、異位性皮膚炎、濕疹等症狀,這時就更需要長期用藥,以口服類固醇來強力壓制免疫系統的發炎反應。此外,一旦變成慢性過敏,類似的因子還會不斷的重複再犯。

「治療過敏一定要透過免疫科或皮膚科的醫師開立藥方,而基本上要從輕劑量或減藥量為原則,以免用藥過強而造成反彈,刺激免疫系統更不平衡,引發副作用。」他強調,慢性過敏一定要定期回診,藉由每次的過敏反應來調整用藥。
培養腦力 以增強壓力的耐受度
然而,解決因壓力造成的過敏症狀,最基本的還是要了解壓力的來源。根據臺北市政府衛生局委託1111人力銀行分別針對勞工與企業主兩方進行「職場健康指數大調查」的結果發現:「長期外食、營養不均」、「工作壓力過重」、「缺乏運動」是勞資雙方公認的前三大職場健康殺手。而在類似的調查中也發現:「薪水太低」、「中年轉業」以及「競爭激烈」是職場壓力三大源頭。

胡海國指出,現代人由於工作的複雜度、時間性,以及個人對成就感的要求、人際關係的往來,普遍地造成腦力負擔過重,再加上社會的變動和經濟的低迷等因素,更普遍引發了安身立命的不安感,因此壓力已經成為現代人不可避免的生活常態。

他表示,正因為壓力無所不在,所以更要培養腦力。而腦力的培養分為應對急性壓力的「定靜」能力和平常的腦力充沛操練,前者是在平常生活裡就要練就「足定氣靜」的功夫,「足定」顧名思義就是腳要站穩,「氣靜」則心不亂,他說「遇事的當下,一亂就會失去穩定度,所以愈是緊急就愈要施展定靜的放鬆工夫,以中和腦內一連串的壓力反應;後者是要在每天生活中從事生理面的規律生活與心理層面的豐富感,來充沛腦力。

簡單地說,由每天生活型態來充沛腦力,需要養成生活的規律性,包括日常作息、運動和休閒活動等多方面。在作息方面,上床和起床都要定時,因一天滿是壓力的忙碌工作後,腦內會產生多量代謝物,而固定且足夠的睡眠才能有效排除腦的代謝廢物,讓第二天一早頭腦清新、腦力充沛;此外,要培養運動的習慣,可選擇太極拳、瑜珈、跑步等藉以減壓,增強信心;每個月或每周也要安排不同的休閒活動,或參加朋友聚會,以拓展視野,舒放身心。

胡海國認為,透過良好的生活型態管理,包括飲食、睡眠、作息、運動、休閒和放鬆等的規律性安排,經過長時間累積,情緒會變得較穩定,自然而然壓力的耐受度也會增強,而有充足的體力、腦力、心力來應付壓力的挑戰。

除規律性之外,還要有充實感。胡海國指出,生理的反應來自於心境的影響,因此若能找到有意義、有價值、有目標、正向的事物進行,會讓心靈產生充沛感、豐富感,使腦內神經傳達物質的分泌量穩定,增強腦力的庫存量與韌性。如此,在壓力生活中仍然保持心情愉快,而更有勇氣和力道去突破困難,建立新的立足平衡點,超越困境,構築樂活精神。 做好壓力管理 取得身心靈內外平衡 儘管減輕壓力也未必會使過敏症痊癒,但卻能減少過敏發作的頻率,讓症狀減緩。當現代人面臨的是一個壓力無所不在的環境時,二十一世紀的成功秘訣正在於如何做好壓力管理,以取得身心靈的內外自在平衡。

資料來源: http://mag.chinatimes.com/mag-cnt.aspx?artid=31038

2015年6月8日 星期一

Shelley thought she had hay fever. In fact CHEESE was causing her sneezing fits – 47歲美藉女子的嚴重花粉症原來是由芝士引起?

Shelley thought she had hay fever. In fact CHEESE was causing her sneezing fits 

  • Shelley Coleman, 47, from Plymouth, had severe hay fever symptoms
  • Her eyes would stream, nose would run and she'd get a tight throat
  • Six months ago she had a mildly irritable bowel so went to an allergy clinic
  • Practitioner suggested that she may be intolerant to dairy
  • She cut cheese, milk and butter from her diet - and results were immediate


With her eyes streaming, nose running and throat tight, Shelley Coleman reached for her usual antihistamine remedy.
'I'd had severe hay fever symptoms since my teens,' says Shelley, 47, who lives with her husband Martin, 57, a retired banker, in Plymouth. 'It was something I just accepted as a burden I could do nothing about.
'In my 20s, I would take as many as three or four tablets a day to try to keep the symptoms at bay. Back then, the pills made you really drowsy, so I would often walk around like a zombie.

'But without them, my eyes would water, I couldn't stop my nose running and I'd get a dreadful itch at the back of my throat, which I'd try to scratch with my tongue - which in turn made me sneeze. It was unbearable.'
Hay fever, an allergic reaction to pollen, tends to worsen in the summer, but Shelley, who runs a curtain and blind-making business, suffered all year round.
'I assumed I was allergic to pollen from a range of plants and grasses,' she says. 'The fact that the sunshine tended to make it worse only confirmed that in my mind.'

Source: http://www.dailymail.co.uk/health/article-3037515/Shelley-thought-hay-fever-fact-CHEESE-causing-sneezing-fits.html

2015年6月6日 星期六

米可白嘴饞吞餅 鬧過敏癢不停

29歲的幸福台灣人妻米可白昨在臉書上抱怨自己因體質問題,只要一吃餅乾就會過敏起疹子,讓她癢到受不了,忍不住向粉絲訴苦,說她真的很愛吃巧克力棒,但吃完下場就變成這樣,覺得相當無奈。
 
粉絲相當擔憂她過敏太嚴重,要她先看醫生,仔細檢查自己到底對什麼食物過敏,才能對症下藥,提醒她嚴重過敏會出人命,要她千萬別耽誤了。



資訊來源:
http://www.appledaily.com.tw/realtimenews/article/entertainment/20150502/603117/%E7%B1%B3%E5%8F%AF%E7%99%BD%E5%98%B4%E9%A5%9E%E5%90%9E%E9%A4%85%E3%80%80%E9%AC%A7%E9%81%8E%E6%95%8F%E7%99%A2%E4%B8%8D%E5%81%9C

2015年6月4日 星期四

換季皮膚易過敏 加強保濕防曬

人們都說春天萬物復甦,氣候轉暖,是保養肌膚的好時機。但是,你知道嗎?春季百花開,季節交替,不僅容易引起呼吸道過敏,不可忽視的還有肌膚問題。許多人都有相同困擾,一旦時節進入春天,不論擦什麼保養品、吃什麼藥,皮膚就是乾癢!

台灣淡水馬偕醫院皮膚科王仁佑醫師表示,在季節交替之際,可能會有肌膚敏感的問題,輕則乾燥、脫皮,嚴重者容易因氣溫冷熱或摩擦導致發炎,可能引起濕疹、蕁麻疹等。皮膚在冬季時已習慣當時空氣中的濕度與溫度等其他外在因素,而當進入春天時,因氣候改變,與皮膚原本習慣的狀態不同,有敏感肌問題者就容易更敏感。

王仁佑醫師說,以老年人為例,因其皮脂腺已經萎縮,皮脂分泌已不如年輕時旺盛,所以冬天容易敏感、發癢,所以我們常聽到老年人會有冬季癢的問題;而到了春天,因為開花植物會有傳播花粉的現象,空氣中瀰漫著花粉細粒,改變了空氣中的濕度;其次,又因為冬天的紫外線較弱,皮膚刺激不大,但進入春天時,紫外線漸強,若是皮膚有不適應的問題就容易引起過敏反應。

春天的肌膚保養,著重於保濕與防曬。王仁佑醫師說,隨著氣候改變,民眾可依個人需求更換保養品,主要的原因是因外在因素改變,如冬天皮膚所需的水分比春季還高,就應選用保濕度較高之保養品。建議敏感性肌膚者避免使用含有香料或植物萃取,盡量選用成分簡單的保養品,而一般民眾也可依照自身的肌膚狀況選用適合自己的保養品,才可在春季擁有漂亮又水嫩的肌膚。


資料來源: http://www.ettoday.net/news/20150501/499162.htm

2015年6月1日 星期一

Hong Kong has a serious lack of allergy specialists: journal – 研究數據顯示,香港嚴重的缺乏過敏專家

When Julian Ngai was five years old, he sipped a teaspoon of milk and suddenly stopped breathing. His mother Sandra Lai Pui-ling was terrified as an unconscious Ngai had to be sent to the intensive care unit, where he was administered extra oxygen.
It had been part of a traumatic – but life-saving – allergy test he was given at the Queen Mary Hospital in Hong Kong, with doctors later concluding he had severe reactions to dairy, particularly eggs, as well as peanuts.
Since then, Ngai, now 10, only eats food his family has packed for him – even when they are going out to a restaurant. There are rare exceptions with restaurants where they know the food doesn’t contain anything he’ll react to, like the fries at McDonald’s. He has also undergone six months of treatment which helped him recover from his egg allergy.
He has even gotten to the point where he can eat one egg a day. “Once he’s tasted an egg, he always wants to eat them in front of other people to prove that he’s over the allergies,” says his mother, who is an accountant.
Ngai’s parents got him tested for allergies shortly after he was born in Canada. By then, they knew he had food allergies, but got him tested again at Queen Mary Hospital when he was older because some children will just get over their allergies at that age.
“Now he’s very happy because he can finally taste eggs. He says even raw eggs taste good,” says his father, Andrew Ngai, adding that Julian has not had an allergic episode in three years.
Hong Kong Allergy association chairman Marco Ho, a child immunology and infectious diseases specialist at Queen Mary, suggests Ngai is one of the lucky ones. The lack of allergy specialists in the city means that desensitisation treatments like Julian’s are not easy to come by.
An article published in the Hong Kong Medical Journal this month found that allergy services are a “seriously unmet need” in Hong Kong.
A desensitization treatment involves gradually injecting larger and larger doses of allergens (eggs, in Julian Ngai’s case) until the person no longer has a reaction. But it starts with another test like the one that sent Ngai to the ICU.
The Journal explains that only four public hospitals (including Queen Mary) have clinics for food and drug allergies, but they cater to child patients only. There are two full-time and four part-time staff members at Queen Mary’s allergy clinic.
The overall ratio is about one allergy specialist, or allergist, for every 1.46 million people in Hong Kong, according to the journal authors. Comparing that to numbers from the World Allergy Organisation, that puts Hong Kong well behind other developed countries like Japan and Australia.
Ho says that though there is a “definite demand” for proper allergy assessments and treatment, patients often have to wait for nine months to a year.
Sandra Lai says that after their family moved back to Hong Kong from Canada more than a year after their son was born, they spent three months looking for an allergy doctor.
She also says they had to go to the private Hong Kong Sanatorium & Hospital for the treatment, racking up HK$200,000 in bills. So far, the treatment worked. Ngai eats an egg every day. If he keeps it up for three years, then he’ll definitely be over his egg allergy.
“In Hong Kong, we barely have paediatric clinics and there are no facilities at all for adults. Quite often, [young patients who become] adults will come back to us for care and we have to tell them that we’re paediatricians and can’t treat adults,” said Marco Ho, the specialist.
He adds that in countries like Britain, there are different specialised allergy services for children and adults. He explains that some people only show symptoms of allergies as adults, so under Hong Kong’s current shortage of adult specialists, adult patients have trouble even getting diagnosed. He adds that allergies are chronic conditions, which means they don’t go away without treatment.
Adults must seek out specialists on their own, outside of dedicated clinics.
This is bad news for people like Ida Lam Shuk-yee, 48, who has been living with allergies all her life. One can see it in her hands – the lines and creases of her skin turning a shade of red, looking like open wounds that had recently healed.
There are also faint red spots on her skin – a condition called eczema, a skin allergy.
Adding to her health woes, Lam, who has asthma (asthma and allergiesoften occur together), is allergic to painkillers, seafood and chemicals like perfume, paint and cleaning products.
Lam says she has had difficulty finding a job because of her obvious condition.
“A lot of people might not hire you for fear that your physical appearance can affect their business. For example, restaurants and hospitals will want someone presentable,” Lam says. “But even on our best days, you can still tell we have skin allergies because we’ll never have smooth skin.
“Once, an employer said to me, ‘I can hire you, but you have to get a doctor to certify that you’re not infectious. And you have to wear white gloves if your skin gets red’,” she recalls.
 “I wondered, ‘Do you want me to wear gloves to protect me or because you don’t want other people to see something that they’ll find gross?’” she says.
The incident struck a nerve with her and to this day she can’t see white gloves without recoiling.
Lam worked for seven years as a clerk in an industrial building, but in 2011, her allergies got so severe that she could not even walk up the stairs.
She quit her job and for the past two years has been living off her savings. She also has to take care of her elderly parents, who are 88 and 80.
Lam still needs regular check-ups for eczema at a public hospital. “Worst-case scenario is I use up all my savings and I [get] public assistance,” Lam says. “Getting treatment is very expensive, beyond the reach of a lot of patients.”
Marco Ho, the specialist, says the eczema clinic at Queen Mary Hospital is treating around 700 cases, while the food allergy clinic has a similar caseload.