Tuesday, January 12, 2016

Happy New Year from Storms Bowdish Allergy Clinic


The providers and staff of the Storms Bowdish Allergy Clinic want to wish you and yours a happy and healthy new year. 2016 will surely bring changes all around, but we want our patients to know we are dedicated to continuing our excellent patient care in the new year.

Friday, July 24, 2015

Pollen Is In the Air- How We Count the Pollen

Pollen Is In the Air


Written by Laurie O'Brien-Clark MA       photos also by Laurie O'Brien-Clark MA

As a pollen counter at the Storms Bowdish Allergy Clinic I am privy to some insider information...microscopic information! Summers is in full swing and so are the grasses and weed pollens. The photo attached to this post was taken with my iPhone 6 through the microscope eye piece under 400 power of  Ragweed pollens.  These tiny unseen menaces are causing many of us to have increased nasal congestion, runny nose and sneezing along with itchy, watery eyes. The recent climate change, with increased rain and daily humidity averaging above 50% (most of the time), has also added mold and mildew to the Colorado air. 

As a fellow allergy sufferer, I joke that I am the President of the "Allergic to the Planet Club". Those days when I wake up congested, or use so much Kleenex that I wish I had stock in the company, I am always wondering: "WHAT is growing out there??" Many of us could predict the cause based on our symptoms and I am always happy for the affirmation of our pollen count.

 Identifying the Culprit 

"How do you know what pollens and molds are in the air?” you might be wondering. 

Our offices in Colorado Springs and Pueblo are outfitted with special aeroallergen collection units outside (see left) that take a 24 hour sample of the stuff floating around out there. 

Our system is called a Rotorod (which is a rotation impaction aeroallergen sampler) that spins around for 1 minute every 10 minutes for 24 hours collecting pollen (upper left), spores, bug legs, and debris on to silicon greased rods (see upper right). These tiny rods are collected, placed on a slide holder, stained with a pink stain and identified through a microscope.



What we see looks like this:


In this microscope field view the bright pink things you see above are the organic material known collectively as "pollen". Pollen is defined by Webster's as: “the very fine usually yellow dust that is produced by a plant and that is carried to other plants of the same kind usually by wind or insects so that the plants can produce seeds." These pollens come from trees, grasses, weeds, crops, flowers and other plants. The brown and gold things that resemble bugs are molds, molds are resistant to the stain. Our office is not certified in mold spore identification as molds never used to be as multifarious as they are today.   The other objects in the field are mostly dirt and debris and the black spots are what are contained in smoke from a local forest fire. The recent abundance of rain and humidity, as well as other natural phenomena has changed the allergic environment. 

Our counters identify all pollens by their distinguishing characteristics and count the pollens in each field of one rod. When the counting is done we enter our raw numbers in to a spreadsheet to calculate the amount of pollen per cubic meter of air. This data is put into a graph to tell everyone the levels of pollen and mold (see below).  

Our clinic is also a certified counting station through the National Allergy Bureau™ (NAB™). All data is reported thorough this bureau as well as through our website to local news media, social media such as Facebook, Twitter and Google+ as well as to subscribers.

The NAB™ also helps define the parameters for our reporting numbers so that we know exactly what low, moderate, high and extremely high levels look like.

The information below is from the American Academy of Allergy Asthma & Immunology site (http://www.aaaai.org/global/nab-pollen-counts.aspx) about the NAB™. This shows just how many we have to see for those pollens to be categorized as HIGH.

The National Allergy Bureau™ (NAB™)

The National Allergy Bureau™ (NAB™) is the section of the AAAAI’s Aeroallergen Network responsible for reporting current pollen and mold spore levels.

The Aeroallergen Network is comprised of pollen and spore counting stations staffed primarily by AAAAI member volunteers who generously donate their time and expertise.

The NAB currently provides the most accurate and reliable pollen and mold levels from approximately 84 counting stations throughout the United States, one counting station in Canada, and six counting stations in Argentina. The stations use air sampling equipment to collect airborne pollen and spores which are then examined microscopically. This information is also used for research to aid in the diagnosis, treatment and management of allergic diseases.

Pollen counts from the NAB stations are based on actual counts, which reflect the real day to day weather events. Predicted counts reported on many websites may be based on pollen data from previous years and general weather forecasts.

Reading the Charts

The NAB pollen and mold spore levels were developed using the chart below. The concentrations in the chart (pollen or spores per cubic meter) were statistics from all certified counting sites. The levels correspond to different ranges for each of the pollen categories and for fungal spores. The concentrations were translated into levels based on the following:
•    Low levels are concentrations that are less than the median or 50th percentile (i.e. half the counts were below the median.)
•    Moderate levels are concentrations that fall between the 50th and 75th percentile
•    High levels fall between the 75th and 99th percentile
•    Very high levels are above the 99th percentile (99% of the counts are below this level)
Based on these definitions, we suggest the following ranges for low, moderate, high, and very high. 
NAB SCALE
* MOLD
0 - 6499
Low
6500 - 12999
Moderate   
13000 - 49999
High
>50000
Very High
GRASS
0 - 4
Low
5 - 19
Moderate   
20 - 199
High
>200
Very High
TREE
0 - 14
Low
15 - 89
Moderate   
90 - 1499
High
>1500
Very High
WEED
0 - 9
Low
10 - 49
Moderate   
50 - 499
High
>500
Very High

Station SCALE
* MOLD
1 - 6499
Low
6500 - 12999
Moderate   
13000 - 49999
High
>50000
Very High
GRASS
0 - 4
Low
5 - 19
Moderate   
20 - 199
High
>200
Very High
TREE
0 - 14
Low
15 - 89
Moderate   
90 - 1499
High
>1500
Very High
WEED
0 - 9
Low
10 - 49
Moderate   
50 - 499
High
>500
Very High

 * These mold levels were determined based on outdoor exposure to natural occurring spores in the environment and should not be applied to indoor exposure which may represent an entirely different spectrum of spore types.

 These levels and the corresponding ranges are based entirely on ecological measurements, not on health effects. Because the data were from all certified counting stations, the ranges allow comparisons between sites across the country and may be more appropriate than a range based on local numbers. This does mean that, for some stations, some categories will never be high. Because of this, a few stations have determined the ranges for their own locations and do not use these national ranges.

Every week day our pollen counters labor to empower our patients with the best information to help them to be self-aware of their allergy symptoms and some of the possible causes. Our staff at the Storms Bowdish Allergy Clinic works tirelessly with patients to make a plan to improve their symptoms, their environment and their quality of life.

Our pollen counts can be found Monday through Friday at the following locations:

  1. www.stormspollen.com (text and e-mail subscriptions available)
  2. www.stormsallergy.com
  3. The Pollen report hotline: 719-955-1933
  4. Also look for us on: Facebook, Twitter, Yelp, and Google+

Friday, June 19, 2015

What to expect during an initial allergy evaluation

What to expect during an initial allergy evaluation  written by Jim King, MA

  When you see an allergist for an initial allergy evaluation it can be a 2-3 hour appointment.  Therefore, be sure to bring you’re favorite mobile device and dress comfortably.  Your allergist will take a very detailed history pertaining to your symptoms.  He/she will want to know when your symptoms occur, what type they are, what you feel may be the cause of your allergic symptoms, and how severe your symptoms are. If you have treated your symptoms in the past, it would be helpful to know what you used and how successfully those treatments worked.   During this visit you will likely be tested with a wide range of allergens.  You should stay off of all antihistamine containing medications for 3-5 days prior to testing.   These tests are usually applied using the Percutaneous Method.  This method is very accurate, fast to apply, gives quality results in 15-20 minutes, and is generally regarded as painless.  The process typically uses a plastic device which resembles a toothpick.

   Each of these “toothpicks” is dipped into a separate single allergen.  Using the freshly dipped “toothpick” the medical assistant will lightly scratch or prick the topmost layer of the skin. This will introduce a very tiny amount of the allergen into the skin.  After all of the test have been applied its time to get out your mobile electronic device or book and allow time for the body to respond to the test. 
  As you sit and crush candy or sling shot birds, you may start to notice some irritation and itching at the site of some of the scratches.  You may also notice a raised bump with redness surrounding the area.  This swelling and redness will be measured and used to determine if you are allergic to the allergen and if so, how severely. Depending on the results of the test, a secondary screening may be done using an intradermal method. That’s allergy skin testing in a nut shell….. No, wait I’m allergic to nuts!!

Your Allergist will use the information you provided in the history, coupled with the skin testing results and customize a treatment plan just for you. This custom plan will be one of, or a combination of the 3 main ways to treat allergies; avoidance, medication, and immunotherapy.  These 3 ways of treating allergies will be expanded on in a future blog, so stay tuned! Like they say, the more you know, the less you sneeze!    


The information provided in this blog does not constitute medical advice.  Any questions should be directed to your primary physician.