The Allergy Saga continues...
(As always, if you are not up to speed on the events of The Allergy Saga, read these posts:
- In Which I Learn The Hard Way
- In Which I Am At A Loss
- In Which I Am In Exile
- In Which The Saga Continues
- In Which I Throw In The Towel
- In Which I Hide
These posts chronicle everything that has happened in the past month and a half, all of which is relevant to this post. I'm not going to recap anything here, so refer to those posts if you get confused.)
I mentioned in Friday's post that I had an appointment with the Dr House of allergies early next month. To be specific, it was scheduled for October 6th. However, they called me on Tuesday and told me they had a cancellation, and thus an opening, for an appointment on Wednesday. I leaped at the chance, glad to be able to see him sooner, and made the trip down yesterday to his office.
After giving him the whole spiel about how it all started and how I got to where I am, he asked me the same routine of questions I had answered dozens of times before. No, there are no new foods, soaps, or detergents. Yes, I've checked my apartment for mold. My pillow is brand new, there is an allergen cover on my mattress, and I've got a HEPA air filter running non-stop in my apartment.
I told him that I had done the prick test not too long ago, and that I tested negative for anything. To be thorough, though, he re-did the prick test. To no surprise to me or to him, I tested negative again. That put me in the same position I was in after the previous allergist I saw:
Okay, so now what?
Testing negative again to the prick test didn't deter the doctor at all. He left the exam room and came back with a swab, and swabbed my nose. He wiped the swab on a slide and examined it under a microscope. He motioned me over to have a look at the slide, and as I peered through the scope he told me that I had these cells called Eosinophils in my sinuses. Simply put, eosinophils are a type of white blood cell that (among other things) help fight off allergic reactions.
The doctor went on to say that these cells accumulate if there isn't any treatment to get rid of the cells themselves, or if one is exposed continuously to the source that is triggering the production of the cells. Once they build up to a certain point, they will cause the body to react by producing hives and respiratory problems. After giving me a moment to absorb that information, the Dr House of allergies jumped right into his speculation as to the cause for the presence of these cells.
After asking me some other questions, about what I use for pain relievers, and some of the types of foods I eat, he told me that he thinks I have an aspirin sensitivity.
Technically speaking, it's not an allergy. Sensitivity to aspirin means that I can tolerate it in small amounts, but my body will produce these eosinophil cells in response to higher amounts of aspirin once it's introduced into my system.
Now, avoiding aspirin isn't as easy as one would think. Aspirin is, obviously, in a lot of pain relievers, like Bayer, Ibuprofen (Advil), Motrin, and naproxen (Aleve). The category of NSAID pain relievers as a whole should be avoided, as they also contain aspirin. Therefore, pretty much the only thing I can use to treat pain or fever is acetaminophen (Tylenol).
There's more, though.
Those who have aspirin sensitivity also have to avoid other things aside from NSAID pain relievers. Aspirin also occurs naturally in a lot of foods, in the form of salicylates, or salicylic acid. Due to it's chemical make-up, salicylic acid reacts much in the same way as aspirin to those who are sensitive to it. You've probably seen saliclyic acid in the ingredient lists for a lot of foods, as it is most commonly used as a preservative, but it also occurs in various foods as just a natural ingredient or chemical found in it. A list of foods and the level of salicylates found in them can be seen here. It's also often the main active ingredient in acne treatments.
People with aspirin sensitivity also are sensitive to Tartrazine, better known as yellow dye #5. Like salicylates, tartrazine is similar enough in it's chemical composition to aspirin where products that contain it should be avoided as well. To quote the Wikipedia page referenced above, here is a partial list of foods that contain tartrazines, or yellow dye #5:
- Cotton candy,
- Soft drinks or energy drinks,
- Instant puddings,
- Flavored chips (Doritos, Nachos, etc),
- Cereals (corn flakes, muesli, etc.),
- Cake mixes and pastries,
- Custard powder,
- Soups (particularly instant or "cube" soups),
- Some rices (like paella, risotto, etc.),
- Powdered drink mixes or sports drinks,
- Ice cream and ice pops,
- Candy and chewing gum,
- Jam, jelly, gelatins, and marmalade,
- Pickles and other pickled products,
- Many convenience foods,
- Lemon and honey products.
Here's where a lot of the puzzle pieces started falling into place.
Remember the joint pain I've been having? Some blood work I had done recently revealed that I have Parvovirus. It's more commonly known as Fifth's Disease and mostly occurs in pediatric patients, but adults can get it, too. It can cause arthritis. And of course, how did I treat the joint pain?
With ibuprofen and naproxen.
Way back when I first had that isolated incident, before we adopted the dog, where I had breathing trouble out of the blue? The night before, I had eaten macaroni and cheese for dinner, and I had finished the leftovers for lunch just an hour or two before I had the anaphylaxis. What is one of the ingredients in macaroni and cheese?
Yellow dye #5.
All summer long, I have been indulging a hardcore fixation of Mountain Dew. What is one of the ingredients in Mountain Dew, the ingredient that gives it it's unique color?
Yellow dye #5.
Without even knowing it, I've been essentially poisoning myself.
To put it mildly, with having to avoid salicylates and tartrazines, I'll have my work cut out for me. I'll be examining product ingredient lists like it's no body's business. It will be a huge adjustment, not only in diet but in lifestyle, but if it gets me feeling better, then I'll do what it takes.
The heartbreaking thing is that I really am not allergic to dogs. That means that the adorable and loving dog that The Boss and I adopted didn't have to go back to the shelter. The symptoms I had after exposure to her were just coincidental, and probably triggered by a seasonal allergy to ragweed or pollen. (Ragweed season begins in mid-August; my symptoms started in mid-August.) It breaks my heart to think of all the confusion she must have felt when we brought her back, but these things happen for a reason.
As far as treatment goes, the allergist put me on Singulair to treat the eosinophils in my sinuses. That, in combination with avoiding aspirin, salicylates, and tartrazine, should make my symptoms disappear. When I see him again in two weeks, he'll swab my nose again and check to see if the cells are gone.
If they are gone, well, then we've found our problem. I'll continue the Singulair for a while just to be safe, and keep avoiding aspirins, salicylates, and tartrazines. If the cells are still there, then the diagnosis of aspirin sensitivity gets thrown out, and we'll keep investigating. I do have to mention, though, that the allergist is pretty confident that I have aspirin sensitivity.
After all of this time, waiting and wondering about what is making me so sick, I'm glad to finally have an idea about what may be the source of all this. It's something to work towards, but at the same time, knowing all that I have to avoid to keep myself healthy is a bit daunting right now.
I don't think it's fully hit me yet, but I'm sure it will in time.