Two years ago I took a risk and had Lasik done. The results were spectacular...
So, when Tanya (my fiancť) and I thought about moving in together there was something that had to be contemplated: I had allergies/asthma and could spend only a few hours in any environment with dogs or cats during any given week. Tanya is a major dog person. Our options could be summarized as: Figure out how to stop Alan from reacting, or get rid of the dogs. The latter was not a happy thing to contemplate, so it was time to see if I could do anything.
I started doing research and discovered a body experiment I could partake in with a couple of potential outcomes:
1. Spend months of your life sitting in doctors offices over 2-5 years with nothing to show for it other than a damaged wallet.
2. Spend months of your life in a doctors office over 2-5 years with some allergy resistance.. and still damaged wallet.
3. Spend months of your life in a doctors office over 2-5 years and be cured of your targeted allergies.. and yes, still a damaged wallet.
After having Lasik done, allergy shots and the potential of changing how your body reacts to allergens seemed like a very worthwhile experiment. My asthma has always caused issues and allergies are something Iíve always fought using antihistamines and the like. The concept of getting rid of my allergies was awesome, and like getting rid of glasses/contacts, is a quality of life improvement worth some risk (if I must rate it - in my case more worthwhile than the Lasik - since glasses didnít limit me from doing things, but my allergies and asthma did).
If you are not familiar with allergy shots (immunotherapy) the basic concept is this (layman non-doctor explanation):
You are injected on a regular basis (twice a week, then once a week, and now every other week in my case) with the substance you are allergic to (allergen), in doses that are gradually ramped up over time. The hope is that your immune system adapts to the higher level of allergens through production of specific types of antibodies, which block the allergen from having an effect rather than the natural response of someone with allergies, which is to become hypersensitive to the allergen and cause the symptoms we all know and love. The net effect is that you are raising the bar at which your allergies are triggered, eventually to a level where no natural level of the allergen will cause you to react badly. Wikipedia
has much more detail than this entry if you want a better explanation.
As for drugs, you are probably going to stay on them for quite awhile. Even allergy shots are not perfect, and the doc made it clear up front that if anything my drug dosages and types would probably increase for the first few years as they tried to control my allergies/asthma while working toward immunity, which they did.
The process is supposed to take 2-5 years although many places recommend staying on ďboosterĒ shots. Based around my reading many people quit the shots and years later are still fine from what Iíve read. Mileage may vary. I havenít made it that far yet, so I canít testify to the result in my case.
One mistake I made in relation to this blog entry (and wasnít contemplating at the time) was I didnít start documenting the Allergy shots until now, which is well after my initial impressions have worn off, so these observation are a bit late and probably a bit skewed....
Things to know about the Allergy Shot experience:
1. Getting started is not cheap - Iíve maxed out my insurance out of pocket the last two years, and will probably continue for at least a few more years. First there are doctor exams, then there are allergy tests (both scratch and blood tests in my case), then there are follow-up appointments, drugs to control your allergies/asthma and the ongoing costs of the shots, which are about $35 every other week for me at this time. My out of pocket cost so far has been at least $4,000 between all components since I showed up for my first exam. Side Note: Thanks to my employer
for providing great insurance and being a awesome employer for many years.
2. Allergy shots require commitment. Commitment to see doctors every 3-6 months to grade your progress/adjust medications and 2-5 years of your life of allergy shots themselves - then there is the biggest commitment - time sitting around..
3. Time sitting around - You show up at your docs office, wait for your shot (5-20 minutes typical in my case), then after the shot (takes 5-10 minutes or so to get), you must stick around the doctorís office for half an hour to make sure you donít suffer any major effects or go into anaphylactic shock. This means on you are burning close to a hour of time minus travel each time you go in for shots. On a positive note, my doc office has Wifi so that you can bring along your computer and use the Internet or work while waiting.
4. Additional Notes on Time - If you miss a few shots (no two month europe trips in the first few years), they back your dose down and ramp back up, in addition if you have a major reaction, that can also delay your progress. One other schedule impacting item is when moving to new vials of allergen you must ramp-up again over a period of 3 weeks, which means every 2-3 months having to revert to a once-a-week schedule (at least on my current dosage/visit timing).
So how are the shots?
Due to my allergy set (shrubs, trees, grasses, mice, dogs and cats if I remember correctly), they give me two shots each time. One in the back of each arm. The shots are using pediatric needles, so itís a VERY small prick, most of the time no bleeding, or if so only one or two drops. During the initial ramp-up I had much arm soreness. At a certain point the soreness and swelling reduced, but now that Iím at maximum dosage every shot is followed by arm swelling and minor pain for a few days. It is nothing major, but is a bit of a distraction.
What are the results like after a year+?
A Drug Disclaimer: The antihistamines Iím on havenít changed much - Iím on the same basic stuff I have been since a few years before the shots, which is a Claritin or Zyrtec generic. In addition Iím on some other drugs/steroids to keep my allergies under control. The asthma meds Iím on have changed dramatically. Iím now on two types of inhaled medicine to control my asthma, one being a emergency inhaler, which Iíve been on for many years and the other being a daily use control inhaler. In October 2009 I started exercising every other day, which Iím happy to say is still occurring. When I started exercising my asthma stepped up so they had to adjust my dosage of my daily inhaler, but my asthma is now is a very good place. Feel free to contact me for additional gory details :^).
So Really - what is it like after a year now that there has been a mega disclaimer?
Huge Improvement. Probably best indicated by example (keep in mind, this is shots + medicine modification):
- Emergency Asthma Inhaler + Daily Antihistamine: 2 Hours around dogs and I would have 3-5 days of asthma flare-ups and congestion for at least 8-10 hours, if not a full day. Petting the dogs would result in itchy skin in only a few minutes, heaven forbid I rub my eyes without washing my hands, they will be irritated all day. Visiting anyoneís house with pets and less than perfect house maintenance (LTPHM from here out) or significant airflow would cause reactions in 15-30 minutes, which depending on the situation could cause me to have issues for several days. Inhaler sometimes needed before exercise and before bed.
- Emergency/Long Term Asthma Meds + Increased Allergy Med Regiment + Shots: I could sit in a room with the dogs for 1-2 hours a few nights in a row, but then had to spend very limited time around them for a few days to let my asthma/allergies calm down. Petting the dogs still resulted in a fairly quick reaction. Most of the time I donít need my emergency inhaler unless Iíve pushed my luck too much recently with the dogs. LTPHM environments would cause reactions in a few hours, followed by minor annoyance over the next several days such as needing a inhaler that night, and a OTC decongestant to help clean out my system. Not as bad as before. Inhaler still needed sometimes before bed, and often during exercise.
- Increased Exercise for a few months, no other adjustments: Asthma started kicking up significantly at night, during the day and during exercise. During a doc visit they doubled my daily inhaler dosage. Within a week or two my asthma issues dramatically reduced. On the allergy front I was able to sit in a room with the dogs almost every night without any major issues sharing the same airspace, although close contact, or sitting with the dogs on the same chair still caused problems.
1 Year 3 Months
- No additional adjustments: I can spend significant time around the dogs without reaction as long as there is no direct contact. If I sit with them (dog on lap) for more than 5-10 minutes at a time I can still force a allergic reaction, or if I touch on them and donít wash my hands within 5-10 minutes. I can inhabit the same airspace (same room) with them daily for several hours without any issues. Exercise doesnít normally require a emergency inhaler, and the vast majority of the time I donít need to utilize additional decongestants or inhaler before bed.
Over the last Year my allergies and asthma have improved dramatically. We are not only keeping our two small dogs, we are eyeballing a puppy to be a partner for our younger dog, which a year ago was not even a option. I can still force allergic reactions, but they are no where near as severe as they were, and now living with the dogs is mostly pleasure rather than mostly avoidance and coping. Even better, now I donít have to think before I visit a new place, such as homes with large dogs or LTPHM - which ever since I was a little kid was always a major consideration. Big quality of life boost. At this time Iím thinking the results are 50% drug adjustments and 50% shots, but Iím already feeling MUCH better about my ability to manage my allergies and asthma. Weíll see how the future develops.