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Old 06-17-2013, 06:03 PM   #1
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Allergy shots not working?

I've been receiving allergy shots for 8 months. I am getting extremely frustrated by my allergy symptoms because they will not budge one bit. I've reached my supposed maintanence dose and am now only going every 3 wks for shots. I get 7 shots total. My allergic symptoms, else I've ranted about before, are mainly swelling in my upper respitory tracts. I am allergic to many things indoor/outdoor according to my intradermal testing. My allergist doesn't seem to think this is a problem, which kind of scares me. At my last visit, he told me I should start taking 2 zyrtecs daily, in addition to my daily Flonase. I try to not use the Zyrtec very much honestly because I very rarely get the symptoms it treats- itchiness and runniness. Instead, as I mentioned, I get swelling and inflammation. I've lined up a consult with a different allergist for mid July. I'm bringing my skin testing results with me, and am going to request another intradermal test. My last test was march 2012. I'm concerned about a couple things:
1.) that my maintanence dose is too low to be effective. They decided to keep me at the last dose I didn't react to, so I never reached the last serum bottles for a few things.
2.) that I've developed new allergies in addition to the ones I already have.
3.) that my dr's frequent use of steroid bursts on me when my symptoms were extreme and debilitating (probably once a month that last few months) has somehow affected my shots effectiveness. My allergist says this isn't so.

I'm frustrated and miserable. My main symptoms are chronically swollen turbinates and a sensation to varying degrees of ear fullness or swelling. I never get a runny nose, itchy eyes, etc. I feel like I should be seeing at least SOME symptom relief since I'm past the 6 month mark. I know everyone is different, but honestly when I started the shots last year, I immediately began noticing a difference. Now I've plateaued and nothing seems to be getting better. I'm looking for opinions from those who receive allergy shots or have received them. Alternative therapies can be mentioned, if it was helpful, but I don't want to make it a primary focus here.
Thanks!
Jen

 
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Old 06-17-2013, 06:19 PM   #2
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Re: Allergy shots not working?

I'm a little concerned about your doctor also. I would be interested in why you get 7 shots each time. And why every 3 weeks. And why he didn;t take you to the final vials. The generally accepted regimen is that it usually takes about 10 months to get to maintenance and then you go to once every 4 weeks. In the build up stage you can go twice a week if you want in order to build up sooner. And I have always shown allergies to everything they test for (environmental, that is) and the most I've ever had is 2 shots at a time. And it lasts for 5 years. I've done it 3 times in my life (I'm 67) so I'm sort of used to the whole regimen. You might be better off with another allergist. Do you have a teaching hospital where you are? That might be an option.

 
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Old 06-17-2013, 07:09 PM   #3
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Re: Allergy shots not working?

Thanks Titchou,
My allergist is actually at a teaching hospital, and he's the only allergist on staff. He told me the buildup phase takes 11wks, during which time I went once a week. Then because of my reactions, they decided not to take me to the final vials. Ugh, I'm really annoyed right now to hear that this regimen might not be the right one, or at the very least, not the most effective one. Thanks for the heads up.
As far as the new allergist, he's at another teaching hospital in Chicago. I am just going nuts waiting for that appt.

I receive 7 shots because my current allergist believes in separating each allergen into a separate serum. According to him, this is more effective. The only ones that are mixed are the molds, grasses, and trees. I didn't make it to the final vials of molds or dust mites. I kept having severe local reactions (giant lumps that weren't just itchy, but painful). So they chose to leave me at the next to last vials for those. I hope this new allergist will order another intradermal test and Ill be able to find out if he had a different perspective.

Jen

 
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Old 06-17-2013, 07:24 PM   #4
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Re: Allergy shots not working?

Well, I don't know that you need endure the intradermal test. The skin scratch test shouldbe adequate. And that seems screwy about the mixing. I always had to have 2 injections because the molecules were different sizes for some of the allergens and so they wouldn't mix. This just all sounds odd. My allergist headed up the allergy department at UAB and it's one of the top medical centers in the country. He's conservative but good. And did you take an antihistamine the day of your shots? if not, that might have helped with the reactions.

 
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Old 06-17-2013, 09:39 PM   #5
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Re: Allergy shots not working?

I find it interesting how our allergy shot treatments are so different.

I'm on my second go-round with allergy shots. I had them for 5 years in my 20's and started my current round of them in my late 30's. Both times, I was about a year out before I really noticed the difference.

This round, I was on weekly shots for my first 3/4 years. I then went to every other week. It was during this time that I started monthly Xolair shots so I ended up going in for that shot on one of my in-between weeks. It was only about 2 months ago when I got the go-ahead to get them every three weeks. I'll do that for 6 months, then 6 months of once a month before determining if I can 'finish'. By that point, I'll have been on them for about 6 1/2 years.

I do know I'm making progress though because when I started on the shots I was on 4 allergy meds (allegra, singulair, flonase, astelin) daily and I'm off of all of them now.

My ENT/Allergist has been extra cautious with me because of my severe asthma flares. My asthma is a mix of environmental and allergic in addition to reflux triggered so we have a lot to deal with there.

How many of your allergens are being treated? This time, I'm being treated for my 28 worst allergens. They have them split into 2 vials so I get 2 shots each visit. I've never heard of someone getting 7 shots in one visit. Usually 1-3 is typical. I do know that my "B" vial shots always give me more of a reaction than the "A" ones.

I've had both the interdermal and skin ***** testing done. Both gave good results. If I have it done again, I'd probably choose the interdermal one though. It seemed to be the most in-depth at really determining the severity of each allergy. Be prepared though. I had well over 300 shots when I had that one done. I had rows and rows up and down both arms and up to my shoulders. I was quite itchy for a few days after.

For the itchy eyes, I find Zaditor helps. It is available in OTC generics too. Do you have dry eye? I find that makes my eye allergy symptoms much worse.

Are you on any daily asthma meds at this time?

If you are looking for alternative therapies, you might research NAET. I have some friends who found success with it. I was a couple years into immunotherapy treatment when I found out about it so I never went that route myself.
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Old 06-17-2013, 10:57 PM   #6
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Re: Allergy shots not working?

MR,
I've read about NAET but honestly I'm a tad skeptical. I don't have asthma, my sister does along with her allergies, but I don't. I have done well in the past on Zyrtec and Flonase even before allergy shots. I have tried singulair, but unfortunately I got horrible, massive headaches from it. I haven't yet tried it again, but oddly, my girls (6 and almost 4) have been on singulair and children's Zyrtec daily for almost a year. They tolerate the singulair well, no noticeable or reported (by them) side effects. They hardly ever get ear infection too since we started treating their obvious allergies- yay!
Anyway, back to my interest in a new intradermal test. I've already had one, so I dread doing it again, but you're right in that it really is valuable in determining the level of allergic response to a particular allergen, vs just a general response. I will not do simple testing because my case had become too complex in my opinion at this point. I need to see if my reaction to my current allergens has been reduced, so I must have the intradermal test. I didn't find it too traumatizing, but that might be because I've had a giant needle stuck into my spine (spinal block anesthesia) prior to my 2007 c-section. I still hate needles, but I'm kind of getting better about them.
As I stated previously, the reason that my allergist does the multiple injections is because he believes (and he may be wrong) that they are more effective when introduced separately. He does have the molds all put together in one shot, the same goes for grasses and trees. But for example I get a dust mite shot separate from my molds shot, separate from my ragweed shot, and so in. My allergy nurse labels each site with what it is and charts where each injection went as well. It definitely helps them and me to know what allergens I'm might be reacting more to, just by knowing where each shot of allergen was placed. That's how I found out just how much I am allergic to dust mites- my goodness the lumps! And I do take a Zyrtec 24hr the day of my shots, so that's just crazy. I'd love not to get 7 shots, but its nice to have the knowledge of what went where.
I was also told by my current allergist and the allergy nurses that some people cannot make it up to their final vial for certain things. I couldn't for mold, dust mites, and ragweed. I was told it was not necessary to reach the final vial for the shots to be effective, but I guess that's why I'm seeking a second opinion. I need to know if I'm on the right track. My current allergist has offered me another intradermal test, but wants to wait until my one year mark to do it, and I don't really want to wait until the end of October. It's important for me to know if any new allergies have surfaced, and if the shots have yet reduced my reactivity to my current allergens.
As far as eye symptoms of allergies, I have signs of allergies in my conjunctiva but no actual symptoms. I would almost rather have those because my allergies as I've mentioned and complained about countless times seem to like to bother my ears. I get swelling in my Eustachian tubes, actually my whole allergic reaction anywhere in my body is mainly swelling/inflammation. This seems like a hard type of reaction to control. I have been put on steroids many times to attempt to curb this response. In fact, the last eye allergy attack I had was giant papillary conjunctivitis, which is a swelling/inflammation of the mucus membranes on the inside of the upper/lower eyelid. Rx? Prednisolone eye drops and no contact lenses for almost 2 months!!
I believe my immune system is very very overreactive. I've never mentioned this before on this board, but I have a chronic inflammatory(and possibly autoimmune, research is pending) disease called interstitial cystitis. It began with a harmless catheter insertion needed for an emergency ultrasound when I was pregnant with my older daughter(in early pregnancy they need you to have a full bladder to see the embryo properly). After the catheter, I noticed bladder infection symptoms. But it wasn't an infection. My body began producing chronic inflammation in my bladder for no reason. This began my painful 4 year saga, which included daily low dose morphine and amitryptaline to control pain. I was even on morphine during both of my pregnancies because while addictive, its technically safe. Anyhow, when my IC symptoms began fading a couple yrs ago, that's when my allergies went crazy. I got that eye infection, etc. My IC is now in remission, but I still have to be diligent about what I put into my body so as not to cause a flare. Recently I took some ibuprofen out of desperation to avoid taking more steroids for some major allergic inflammation and ended up having an IC flare. Ibuprofen can actually cause cystitis (bladder inflammation) in some who are sensitive to such things. I was miserable and in severe pain for 2 days. So loooooong story short, I think I have a hyperactive immune system that likes to go all willy nilly with inflammation. I'm currently looking into an anti histamine/inflammatory diet. I became interested when I found a correlation between my summer daily Starbucks iced green tea and a reduction in my allergy symptoms. Turns out some components in green tea are anti inflammatory and anti histamine. The effects are very nearly as immediate as if I'd taken a Zyrtec. I'm still stunned that it could help my body that quickly. Now I just need to stop spending so much money at Starbucks and just get the green tea from the grocery store...

Jen

 
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Old 06-18-2013, 07:03 AM   #7
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Re: Allergy shots not working?

You are a better woman than I if the intradermal doesn't bother you that much! I had to have it in March for a penicillin allergy test and I hope I never have to do that again.
I hate needles but usually have a high pain tolerance. Didn't help much on this. They wanted me to come back for a retest in 30 days but I declined. bad enough the first time around. Of course, it didn't help that I was highly allergic!

 
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Old 06-18-2013, 08:06 PM   #8
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Re: Allergy shots not working?

I've been reading up on anti-inflammatory diets a lot lately too. I found one that has a food elimination component to help identify food sensitivities as well. I know I should just jump in and try it, but something keeps holding me back.

When you have troubles with your ears, do they scope your eustachian tubes to make sure it is the allergies?

I have many of your same severe allergies. Molds are horrible for me. As are grasses, ragweed, dustmites, pets, etc... My trees have responded better with the immunotherapy. If fact, when I was tested before starting this round of immunotherapy, they were only mid-range. Before my first go-round on immunotherapy, I was extreme with all of them.

I was on daily antihistamines for many years. On the allergy shot days, I used to add Benedryl as well. Now, 5 years in, I don't usually need anything. Sometimes a bit of Ice on the injection site if I have problems does the trick.
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Old 06-18-2013, 09:25 PM   #9
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Re: Allergy shots not working?

MR,
Yes they usually do the nasal endoscopy of my e tubes at some point (4x now this year!) and aske to do all the crazy stuff- say the letter k, swallow, etc. then they say my e tubes are not blocked and opening when they should. Sometimes they say they see some post nasal drip back there, other times its not mentioned. They also order tympanograms. The tympanograms have been coming back normal since my e tube dilation surgery last year. I do have slightly negative pressure sometimes, but its not significant according to the audiologist. I think the normal range is anywhere from -100dapa to +50 daPa. The most negative pressure ive had so far was -25 daPa. So using that scale of normalcy, its not something an ent is going to jump to treat. And there are no good treatments anyway for e tube problems. I doubt I'd get much more than a new nasal spray or something if my pressures were abnormal. I guess I assume its allergies because its all I know as far as ear problems. For me, bad allergies=ear problems. I have no really way of knowing for sure honestly. One thing of note is that using (gentle) valsalva on my ears pops both of them, but doesn't change the 'fullness'. I've started sometimes going mad with ear popping thinking just ONE more time will get rid of the stuffy sensation. It never does. It makes no sense to me at all. My e tubes also make crunchy noises, as if there was fluid or inflammation in them, but there's no fluid (tympanogram would've shown that) and so Im guessing its inflammation from allergies. I cannot know for sure.
I have been looking more into the anti histamine diet today. Holy cow, there are alot of foods that are either histamine rich, or cause histamine to be released by the body. Many of them are common food allergens as well, but some surprised me. I'm going to start trying to at least not eat the foods on this lists that I've found, and try adding in some of the natural anti histamine foods, and see how it goes.
I'm also going to give up the money for a tmjd consultation, it seems like robbery to take $300 from someone just to consult, but I guess drs do it too, its just that insurance pays most if it. I'm not sure yet, given my extensive allergic history, but am totally willing to consider all options. It's just that this option is quite expensive, and very difficult to wrap my head around with 2 little girls with needs that come before mine and my husband's. I keep having to remind myself a healthy mommy is a happy mommy and that my girls would prefer me to be healthy and not begrudge me the money spent on medical care.
Trying the Zyrtec daily, 3rd day taking it consistently. I've taken it daily in the past, but for some reason got very concerned that it was going to make me worse by drying me up. But I actually spoke to a pharmacist today who told me that 'drying things out' isnt the primary action of the drug anyway, its to block histamine from binding to receptor sites. Not sure why I didn't know this myself, as I'm a scientific type person, I guess sometimes we get worried and don't think clearly. So the pharmacist said just to stay very hydrated to counteract any drying effects. I'm going to try this for a few days to see if anything improves.

Jen

 
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