DEAR DR. ROACH: Can you tell me if there is any hope of a cure for tree-nut allergy, particularly for a child? — X.M.
ANSWER: Tree-nut allergies, like all allergies, vary in severity from mild to lifethreatening. Allergies to tree nuts (these include walnuts, cashews, almonds and others) are common, are more likely to be severe, and tend to persist throughout lifetime. People with one treenut allergy may have others, and about 30 percent to 40 percent also may be allergic to peanuts (despite their being legumes, they share enough characteristics for co-allergic reactions). Peanut and tree-nut allergies appear to be increasing in prevalence over time.
The mainstay of treatment is avoiding the allergen, which requires constant vigilance, careful reading of nutritional labels and a plan for treatment in case of ingestion, such as an epinephrine auto-injector.
Only about 15 to 20 percent of younger children will develop tolerance to (“outgrow”) their allergy; an allergy that develops later in life usually is life-long. Your allergist can do skin testing to see if the allergy is resolving.
DEAR DR. ROACH: I’m retired ob-gyn and am married to a practicing MD. I’m writing you today about autism and its use as a diagnosis. My view is that each individual is unique, mentally and physically. While autism may be one way to describe a personality, each person must deal with the world on its terms, not because of a diagnosis.
I personally believe I am a variant of Asperger’s, but who knows? I don’t qualify as an Asperger’s if given a test prepared by psychologists/psychiatrists. Yet, I have had many life experiences that are best explained by an Asperger’s diagnosis. What are your thoughts on Asperger’s syndrome? — A.G.
ANSWER: Since I recently published a letter by an adult who believed he was autistic despite never having received a diagnosis, I have had several letters like this.
Autism, including its variant Asperger syndrome, is a spectrum of illnesses that share deficits in social interaction, communication and stereotyped, repetitive behaviors. In Asperger syndrome, there is no clinically significant delay in language and intellectual development.
I certainly agree with you that each person is unique and that the label of a psychiatric condition, such as autism, bipolar or a personality disorder, has only limited usefulness. In the best case, it can give a person a way to start learning how to overcome challenges that similar people have faced. At worst, a label predisposes others to look at the person through a certain lens and to expect certain behaviors.
I have had many patients with psychiatric diagnoses ask me not to put that into their medical record, after having built up enough trust to share the diagnosis with me. People have had such negative experiences based on their diagnosis, their label, that I don’t blame them for wanting to avoid being stereotyped. There is so much variation in all of these conditions — even in those of us considered neurologically typical — that we need to recognize the good and the bad side of making such a diagnosis.
©2016 North America Synd.