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Allergy in East Tennessee

Oh, the sneezing and sniffling and runny noses and itchy eyes that are all around us this time of year.  And it’s not just your imagination – Knoxville ranks as the fifth worst city in the country for allergy sufferers.  That comes as no surprise to the legions of residents who this spring are dealing with all that sneezing and sniffling.  Add on the headaches, fatigue, cough, and popping in the ears, and you have a real damper on your enjoyment of spring and summer.  Further complications to allergy can include asthma flare-ups, sinus infections, ear infections, and sleep disturbance to name just a few.

Estimates vary, but up to about 20% of the population suffer from allergy, and about 20% of allergy sufferers also have asthma.  That doesn’t even include a category called non-allergic rhinitis (rhinitis is the medical term for an inflamed runny nose).  These folks have all the symptoms of allergy, but upon testing, come up negative.  There are seven different types of non-allergic rhinitis and each is treated a bit differently from true allergy. We won’t delve further into all that, but it is one reason why treatment of allergy symptoms isn’t a one size fits all proposition.

Diagnosis of allergy often involves simply recognizing the symptoms and doing a trial of an over-the-counter antihistamine such as Claritin, Allegra, Zyrtec or one of their generic equivalents.  If that does the job, it’s sometimes not a bad way to go.  If not, it’s probably time to check in with your physician.  Treatment options will include:

  • Environmental control measures and allergen avoidance: These include keeping exposure to allergens such as pollen, dust mites, and mold to a minimum
  • Medication management: Patients are often successfully treated with oral antihistamines, decongestants (if high blood pressure is not a problem), Singulair, or nasal steroids, antihistamines, or anticholinergics to name only some of the available options.
  • Immunotherapy (allergy shots): This treatment may be considered more strongly with moderate or severe disease or poor response to other treatment options.

Specific allergens can be identified by skin testing or blood testing, with skin testing generally being deemed the most precise.  So, who should have allergy testing?  Allergy testing can have several benefits.  First of all, it can identify those who have non-allergic rhinitis.  These folks will generally not respond to traditional antihistamines and need other approaches.  Secondly, allergy testing may identify certain allergens to which the person can reduce their exposure.  For example dust mites, mold, animal dander or cockroach are indoor allergens which can be reduced by a variety of methods.

Finally, for those who are not getting good relief despite meds, immunotherapy may be a good option.  Its success rate is generally over 80%, although it usually takes a few months to see improvement.  The entire process may take a couple years to establish and maintain the benefits.  But for those who habitually sneeze and sniffle their way through the day in misery, often grabbing meds on a daily basis, it can be well worth while.

So if the sights and smells of this beautiful East Tennessee spring and summer are being blurred by watery eyes and masked by a runny nose, check in with your doctor and see what can be done!

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville.  Contact him at 982-0835.

Same day in office allergy testing is available at Trinity’s main office in Fort Sanders West.  Consider our unique model of allergy injections which offers at home shots saving you the hassle of coming to the doctor’s office three times a week or taking time off from work.  Call 539-0270 to schedule an appointment to discuss these options.


Save money by seeing your own doctor

In the world of high healthcare prices there are several online services cropping up that hope to improve price transparency for patients 

In this example, you can see the range of costs for a routine screening colonoscopy. It seems like you’d be saving a bundle by shopping around at various specialists. But did you know that Trinity physicians, Dr Allsop and Dr Pardue, are expertly trained to perform colonoscopies?  Our price is less than one-half the LOWEST price listed here and under $1000.  We work with most insurances and our price for uninsured patients is the same as those with insurance. We don’t have double standards. We offer the same low price to everyone. 

So by seeing your own doctor you can save the most on services you need. Call our office today to discuss scheduling your colonoscopy. 


Direct Primary Care open house tomorrow in Maryville

Trinity Direct of Maryville will host their monthly open house tomorrow, May 17th, from noon to 1pm.  Dr. Hone and her staff will be on hand to discuss the DPC program, its benefits, and options.  Please come to hear how a Direct Primary Care membership offers improved access to less expensive primary care.

Don’t wait for Washington or Nashville to decide how you should obtain your healthcare.  You can be part of a healthcare revolution and take back ownership.

Bring your questions and your friends.  This will be an informative and educational time.

For more information call the Trinity Direct of Maryville office at 980-8551.

The office is located at 1515 E. Lamar Alexander Blvd. Maryville, TN 37804.


Hepatitis C

Jan, a fifty-something mom, registered some surprise when I listed hepatitis C as one of the things I would test in her bloodwork.  “But I’ve never had jaundice or anything that would say I have liver disease. Maybe I’m tired a lot, but who isn’t?”

I explained that the recommendation is that all “baby boomers” born between 1945 and 1965 get one blood test for hepatitis C even if they have no symptoms.  In fact, the majority of folks with hepatitis C virus (HCV) are without symptoms.  If they do get them they tend to be vague with many other possible causes – things like fatigue, muscle and joint aches, tingling in the extremities and itching.  Due to its minimal symptoms, HCV is known as the “silent epidemic” and many infections go unrecognized and untreated for many years.  But the baby boomer generation comprises about three fourths of the chronic HCV infections so screening them could help diagnose and treat a majority of the as-yet-undetected HCV infections.

HCV is caused by a virus that was finally identified in 1989.  The virus particularly attacks the liver, and 75% of those who get it go on to a chronic infection that continues to damage the liver indefinitely unless treated.  In some 20% this chronic HCV leads to cirrhosis, liver failure and/or liver cancer.  The identification of the HCV led to the development of a blood test for it in 1990 and thus the ability to test the blood supply.  This nearly knocked out the previously common problem of contracting HCV from transfusions.

HCV is so common that about 3% of the world’s population has been infected and there are more than 170 million chronic carriers.  Here in the U.S. less than 2% of the population has HCV, but it nevertheless has surpassed HIV as a cause of death.   Likewise, HCV just edges out alcohol as the #1 cause of chronic liver disease in the U.S.  One of the reasons our bodies has such a hard time killing HCV when we are infected is that HCV can produce a staggering 10 trillion new viral particles each day.

So, how does one catch HCV?  As noted, prior to 1990, blood transfusions were a common way for people to contract HCV.  Nowadays the majority of new hepatitis C infections are from the use of illegal drugs with nonsterile needles or in those who snort cocaine with shared straws. HCV can also be transmitted by tattooing with improperly re-used needles, sharing razors, and acupuncture. The use of disposable needles for acupuncture eliminates this transmission route. Although sexual transmission is less likely it still ranks as the second most common mode of transmission.  Infected pregnant women can also occasionally pass HCV on to their unborn child

If you do have any suspicion that you may be infected, if you were born between 1945 and 1965, or if you have engaged in any of the above-mentioned more high risk behaviors, a simple blood test can rule HCV in or out.  Hopefully, if you get a HCV test it will be negative.   But if the test shows that you have been infected with HCV and that it is still active in your system, there are now some highly effective treatments.  A number of treatments, typically taking about 12 weeks, now result in cure rates greater than 90%.  They are admittedly expensive, but there are a number of programs through which many patients receive help in getting their medications at least partially paid for.  Of course avoiding alcohol and other liver toxins becomes even more crucial for those with HCV.

So the best bet for exposing and eradicating the silent epidemic of HCV infection is a rather simple and inexpensive blood test.  If you’ve never had it tested and have any of the risk factors mentioned, ask your doctor to test you.  It’s far better to break the silence than to let this little virus continue to advance its stealth attack on you and your liver.

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville.  Contact him at 982-0835