She completed her Allergy and Immunology Fellowship at Thomas Jefferson University / A.I. DuPont Hospital for Children in Philadelphia, PA, where she was honored with the position of Chief Fellow. Dr. Streets has participated in numerous scholarly activities and her research focus has been in food allergy.

Difficult years: “Sam was diagnosed with allergies very early. He had severe eczema when he was an infant. We would bounce between the allergy office, the dermatology office and the pediatric office. He’d be on prednisone, antibiotics, antihistamines and nasal sprays, and nothing would help. He was diagnosed with asthma around age two and needed maintenance asthma medications. With any allergen exposure he would develop wheezing and need albuterol. We started him on sublingual immunotherapy drops in 2008, and within six months his skin was clear, his symptoms were under control, and we were starting to take him off medications.”

Sublingual immunotherapy drops: “They are allergy drops which are formulated specifically for each individual patient. It’s a way to slowly desensitize people to the allergens. The more typical immunotherapy is to get allergy shots. We often will veer more toward allergy drops with children who are more phobic of needles.”

What they help: “We have some patients that do the allergy drops for recurring sinus infections, some for food allergies, and some for typical seasonal allergies as well as eczema and skin reactions.”

Clinician and mom: “When I practice, yes, I’m a clinician first, but the mom side definitely comes into play. When I treat my patients, particularly the children, I’ll only treat them with medications I’d be comfortable treating my own children. I think particularly having a food allergic son I’m more empathetic with the parents of food allergic children who might have anxiety about reintroducing foods into a diet or situations where accidental exposures are a possibility, like a birthday party where you’re worried about, ‘Will there be peanuts there, does that mom know how to use the EpiPen?’ I understand the hassles of having to train all of your caregivers with anaphylactic treatment and asthma treatment.”

Making connections: “I develop personal relationships with a lot of my patients in all of the offices, particularly with allergy shot patients who come in every week or every other week, so we know what’s going on in their lives, they know what’s going on in our lives. I had emergency surgery in November and I had patients calling me, ‘Do you need meals, do you need help with your children?’ I was blown away by the support. It was amazing.”

Seasonal allergens: “Tree pollens usually start in March, but they’re definitely peaking right now. Summertime is when grasses peak around here, and autumn is more of the weeds, and ragweed, and we worry more about the dust mites, animal dander when you close up the house in the winter.”

Read the rest of the original article by By Cindy VanSchalkwyk here.

You may be eligible for a research study of an investigational drug for Human Rhinovirus infection (the cause of most colds) to see if it is safe, tolerable, and effective in reducing the severity and/or length of a cold in asthmatics.

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Nasal flu vaccine should not be given to asthmatics.

How do allergy drops work?

Allergy drop treatment works similar to shots by delivering a slowly increasing dose of physician-prescribed antigen that over time builds the body’s tolerance. The difference is that the drops are placed under the tongue and affect the immune system through very specialized cells found under the tongue. Research shows these cells are a friendlier and effective route for long-term desensitization, making it an ideal option for patients who aren’t candidates for shots. Most patients take allergy drops each day for three to five years.

What are the advantages of allergy drops?

Aside from the benefits of being able to treat more patients, including children, asthmatics and others who aren’t able to tolerate shots, there are other advantages to allergy drops.

• Lower cost, fewer clinic visits. Compared to shots, allergy drops cost less and require fewer clinic visits. Most patients receiving allergy drops need only a few clinic visits the first year, and once every 6-12 months thereafter until visits are no longer needed.
• More convenient, fewer medications. You can take allergy drops at home or wherever you need to be, making it much easier to stick with treatment. And many patients find they need less medication to control symptoms after beginning allergy drops.
• More healthy days. The end benefit is simply feeling better. Our patients typically report fewer clinic visits and hospitalizations, as well as less time lost from work and school, after taking their drops consistently.

Are allergy drops safe and effective?

Allergy drops have been used around the world for more than 60 years, and many studies show that allergy drops are safe and effective. Dosing levels and the route of administration are safe enough to effectively treat infants, children, and people suffering from chronic conditions that previously made them unable to receive immunotherapy via shots. In fact, the World Health Organization has endorsed sublingual immunotherapy as a viable alternative to injection therapy. The well-respected Cochrane Collaboration, the world’s most-trusted international organization dedicated to reviewing healthcare treatments, recently concluded allergy drop immunotherapy significantly reduced allergy symptoms and use of allergy medications. The safety profile for sublingual immunotherapy is superior to injection based on research studies and patient treatment experience. Systemic reactions occur 3x less with sublingual, and there has never been an anaphylactic reaction (life threatening) recorded over the 30+ years of sublingual treatment. Compliance has not been studied extensively. However, one large managed-care organization did find 50% of patients receiving allergy shots dropped out of therapy during the first year. In looking at sublingual compliance among patients in many of the studies identified previously, approximately 90% of patients complete their treatment.

Steps to Allergy Drops treatment

Sublingual immunotherapy treatment is similar to injection therapy, with a few unique additions:

• Testing & Evaluation
  Our first step is to confirm which allergies are present and how severe they are. Patient history plays a large role here. Skin testing is used to confirm suspected allergies. We often use intradermal skin tests to help the physician assess how severe the allergy may be. In vitro (blood) testing may be used to identify food and inhalant allergies.
• Environmental Control
  Once allergies are confirmed, we help patients find ways to avoid allergens by suggesting changes in diet and lifestyle when possible.
• Pharmacology
  To help reduce symptoms, you might be prescribed medications, such as non-sedating antihistamines and nose sprays. As treatment continues, most patients find their need for medication decreases.
• Immunotherapy
  Allergy drops, customized for the patient’s specific allergies, helps alter the disease state so that eventually, allergic reactions are no longer a problem. With allergy drops, patients are able to be treated at home. Your physician will monitor your progress throughout your care. Several antigens may be in one vial. Possible treatment regimens include: 

  Preseasonal treatment
  This is a quick build up of antigen weeks prior to an “allergy season.” Treatment continues during the season using a maintenance dose. Common treatments are for spring grasses, trees and ragweed.

  Threshold dosing
  Allergies to dust, molds and foods require an ongoing build up of antigen, followed by a maintenance or threshold dose schedule.

  Anaphylaxis Treatment
  This is, of course a very careful and slow treatment guided by in vitro specific IgE levels (blood testing) or intradermal skin testing. Doses are increased only when we see sensitivity to the allergen decrease. To ensure your safety, the first dose is given in our office.