Your Everyday Guide to Living Well With Asthma

Latex Allergy: 'A Balloon Could Kill Me'

Liz Knight can no longer read a newspaper or touch the buttons on her remote controls, because they both contain latex

Balloons are a common sight at children's birthdays, weddings, restaurants and shops. But Liz Knight has spent most of her life avoiding them because coming into contact with one could kill her.

As a child, Liz was allergic to dust, animal hair and feathers. By the age of 12, doctors found she was also allergic to human hair. Her long blonde ponytail was duly cut off into a short, cropped style that wouldn't cause any irritation.

It didn't stop there - the extent of her allergies only grew and some of her earliest memories involve being isolated because of them.

"We went to visit a relative when I was four; I think it was an aunt or a great-aunt of mine. She had a budgie - everyone seemed to have them in the 60s and 70s - and I was really bad with any type of feathers.

"I can remember we parked up in the drive, my parents went in with my two sisters, and I couldn't go in. The budgie meant I had to stay in the car on my own. It made me feel very left out - I couldn't do what normal people do."

Liz had to have her long blonde hair chopped off

Liz, from Paignton in Devon, has suffered with irritated skin her whole life. In her 20s, her eczema got infected and led to septicaemia, which left her hospitalised for weeks. But it wasn't until the 1990s, when she was at a fair with her family, that she suspected a latex allergy.

"One of my daughters handed me a handful of these great, big, thick helium balloons and asked me if I could hold them while she ran off to do something. I must have touched my face after holding them because that's when this dramatic swelling started."

Liz, now 56, believes she developed the allergy by repeated exposure to latex from going to the doctors so much, which exposed her already fragile skin to the material.

Her everyday life has been impacted in a multitude of ways. She can no longer read a newspaper, because the ink contains latex. It is the same with the buttons on remote controls, the handle of her carving knife, her blender, mixer and hairdryer, all of which are covered with cling film so she can still use them.

Whenever there are road-works nearby, Liz has to keep her doors and windows closed because the road surface also contains latex. She says she often feels like a prisoner in her own home.

"I often feel trapped. Sometimes I stay at home for up to a week, just because it's safe."

She has to cover her remote controls with cling film because the buttons contain latex

Then four years ago, Liz got confirmation of what she was dreading: her latex allergy had gone airborne. She had walked into a shop with her husband during the winter and her lips instantly swelled and she broke out in hives.

"I went straight back outside and said, 'I don't know what's in there, but something's making me feel really bad'."

They looked back and saw six balloons tied around a stand at the back of the shop. In that case, the latex proteins had been circulating through the heating system. But Liz's allergy is so severe that even if a room has had a balloon in it in the past 48 hours - especially if it has popped - she might have a severe reaction because the latex proteins could still be in the air.

Most reactions cause her to start sweating, her lips swell and she has a feeling of "impending doom". She can normally handle the symptoms by leaving the area, going outside and letting herself recover - although it can take hours to get back to normal.

What is a latex allergy?

Latex is a milky sap from plants like the tropical rubber tree and is collected by drilling into the trunk

It is used to make rubber items such as household and medical gloves, shoes, tyres, balloons and condoms

Allergies are caused by your immune system overreacting to something it perceives as a threat, with symptoms ranging from a mild rash to anaphylaxis

Up to 5% of people could have an allergy to latex, according to the NHS, although not all will show symptoms

A tendency to develop allergies can be hereditary, although conditions like asthma and eczema also make people more susceptible

The only way for sufferers to avoid reactions is to avoid latex as much as possible

Regular contact with latex, such as the gloves sometimes used in healthcare professions, will lead to higher chances of a latex allergy, with repeated exposure often making reactions worse

There are experimental treatments to desensitise people from latex, but they are not yet widely available

Source: NHS, British Association of Dermatologists, Globalaai

One recent reaction at her home, however, was more extreme, and left her in serious trouble.

"A few months ago I made a sweet and sour dish using a sachet that had 2% pineapple juice. Within about 15 minutes of eating it I could feel my tongue swelling, and then my throat started going a bit funny. My tongue was getting worse and worse."

Tropical fruits have proteins that are almost identical to the latex protein, and often produce a very similar reaction. She used her Epipen, a self-administered injection of adrenaline which slows the effects of allergic reactions.

Liz was monitored in hospital for several hours to make sure she didn't have a biphasic reaction - a delayed reaction comparable to the aftershocks following an earthquake - and ultimately the symptoms died down.

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Liz's allergies have had an effect on many aspects of her mental health. Her social circle has "drastically shrunk" and she had to quit an exercise group she attended for years because of the latex in mats, trainers and aerosol sprays.

She has also had to give up her work at a pharmacy due to repeated reactions which were endangering her health, and now feels guilty that she can't contribute financially at home.

Despite all of this, Liz says she's determined not to let her latex allergy completely take over her life. "I can walk, I can do and see things, and I've got to be grateful for the things I do have."

Liz regularly breaks out in hives when she has a reaction

Globalaai was formed in 2016 after its founder, Dr Pooja Newman, had an anaphylactic shock at a concert in Melbourne. A surprise balloon drop left her in intensive care for nearly a week and inspired her to raise awareness of latex allergies around the world.

While recovering, she made a Facebook page to tell her story and the non-profit organisation was founded.

"Part of the reason for this charity is to recognise the trauma people suffer as a result of an anaphylactic event and the issues around feeling discriminated or not included in everyday life," said Dr Newman.

The organisation has developed Epipen stations in public places and has supported the ban of latex gloves in food preparation in several US states, as well as a proposed restriction of balloons in public spaces in Australia.

Liz's work with the group has seen progress in Paignton, with many shops changing their practices on her advice. While recognising the many ways in which her allergies limit her life, Liz's outlook remains positive.

"When it feels really unfair I get a bit depressed about it I suppose, but there's always that feeling that it could be worse. I try to talk to as many people as possible about latex allergies. The more people that know about it, the more things can change.

"I'm determined not to let allergies take away everything in my life, and I'll work to improve things, not just for me, but for other people as well."

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Health Benefits Of Jujube (Chinese Red Date)

Jujube, also known as the Chinese red date, is a round fruit commonly grown in Southeast Asia. The bright red jujube fruit is about the size of a plum. Inside the fruit is a white pulp covering the jujube seed. Jujube fruit is rich in fiber, vitamin C, and anti-inflammatory plant compounds.

In traditional Chinese medicine, jujubes are consumed to improve sleep and remove toxins. Jujubes have been grown in China for over 4,000 years. You can enjoy jujubes as fresh fruit and in some dessert recipes.

Jujube contains antioxidant compounds like phenolic acids and flavonols. It's also rich in vitamin C, an antioxidant vitamin. Antioxidants help protect the body from harmful free radicals, which can come from things like pollution, smoke, and ultraviolet rays. These free radicals can damage healthy cells, making them weaker and more likely to cause health conditions like heart disease and cancer. Metabolic syndrome (MetS) is a group of conditions that increase your risk for health conditions like heart disease, stroke, and type 2 diabetes. An imbalance of cholesterol, blood sugar, and triglycerides primarily causes metabolic syndrome. In a small study, participants who ingested jujube powder saw improvements in their HDL cholesterol levels and triglycerides in participants. However, they did not see any changes in fasting blood sugar, LDL cholesterol, or blood pressure. Another study found that participants diagnosed with type 2 diabetes saw reductions in blood sugar, total cholesterol, and blood sugar. However, each of these studies showed varying results on the effectiveness of jujube in treating metabolic disorders. More research is needed to know if jujube has any major effect on these health conditions. Many people use herbal supplements to try to improve sleep quality. A study tested a supplement called LZComplex3, which includes jujube, magnesium, vitamin B6, and other ingredients. The study focused on participants with insomnia. There was no significant difference in sleep quality between the placebo group and the participants who took the supplement. Some participants from both groups also reported experiencing side effects. In another study, participants who consumed jujube capsules saw more improvements than the placebo group. However, more research and larger studies are still needed to confirm the effects jujube has on sleep quality. Chronic spontaneous urticaria (CSU) is the medical term for chronic hives, which can last for more than six weeks. Second-generation H1 antihistamine medications are the first line of treatment, but about 50% of people don't respond to them. Interest in using herbal medicine for CSU has grown among people who do not see any improvements from antihistamine medications. A small study found that jujube may help improve sleep. Participants were randomly divided into two groups. One group received Ziziphus jujube syrup, while the other received a simple jujube syrup. Both groups also took an antihistamine. The Ziziphus jujube group reported better sleep than the simple jujube syrup group. This suggests that Ziziphus jujube syrup could improve sleep. However, there is limited research on the effects of Ziziphus jujube. Jujube provides small amounts of nutrients like potassium and copper, but it's especially rich in vitamin C, an antioxidant that supports the immune system and aids in wound healing. Vitamin C also helps your body absorb iron from plant foods. A 100-gram (3.5 ounces) serving of raw jujube provides the following calories and nutrients: Calories: 79 Protein: 1.2 grams (g) Fat: 0.2g Carbohydrates: 20.2g Fiber: 10g, or 36% of the Daily Value (DV) Vitamin C: 69 milligrams, or 77% of the DV Jujube is also high in fiber, which is important for gut health. Fiber can help you feel full and keep your blood sugar and cholesterol levels steady, which can reduce the risk of heart disease and type 2 diabetes. Jujube comes in different supplement forms, including capsules, gummies, liquid extracts, and powders. However, there is no standard recommended dosage for Jujube. Since supplements are not verified by the U.S. Food and Drug Administration (FDA), consider purchasing supplements that have been third-party tested. Researchers generally recommend getting antioxidants from whole foods rather than supplements. Still, if you're considering taking a Jujube supplement or any other supplement, speak with your healthcare provider first. Jujube is generally safe to consume. However, in rare cases, Indian jujube (Ziziphus Mauritiana Lam) has been linked to reports of latex fruit allergy. Indian jujube is smaller and not as sweet as the common jujube. People with a latex allergy might also react to some fruits containing similar proteins to those in the tree sap used to make latex. Avocado, banana, and bell pepper are examples of foods that some individuals with a latex allergy may be allergic to. Symptoms can range from itchy or swollen skin and mouth to severe reactions like anaphylaxis. If you have a latex allergy, consult your primary healthcare provider before consuming jujube. You can enjoy jujubes on their own as fresh fruit or as a sweet topping. Ways to add jujube to your diet include: Blend jujube into smoothies Stir chopped jujube into cereal, oatmeal, or yogurt. Mix dried jujube into baked goods like muffins and bread. Add chopped jujube to salads for a sweet contrast to savory ingredients. Steep dried jujube in hot water to make tea Jujube is a sweet red fruit traditionally used in Chinese medicine for its antioxidant properties. It is rich in vitamins and minerals like vitamin C and fiber. Although more research is needed, jujube has been used to improve sleep quality, reduce your risk of metabolic health conditions, and prevent the symptoms of chronic hives. Consult your healthcare provider before consuming jujube supplements.

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Allergies To Dental Materials

Suspected allergies in dentistry should be confirmed by an allergy test conducted by a dermatologist or allergist, due to the potential for a life threatening allergic reaction or the development of a long-term occupational disability. When an allergy test to a certain dental material is found to be positive, the dental team should take appropriate precautions to eliminate the use of the offending allergen by using alternative materials, for example, latex-free gloves or nickel-free alloys.

Research demonstrates that there are numerous potential allergens in everyday dental practice. However, currently there is not enough evidence to indicate that use of popular dental materials should be discontinued. Nevertheless, the dental team should remain vigilant and acutely aware of the potential of the many available dental materials and products to cause allergic hypersensitivity within the mild to severe range, both intra-orally and at unrelated parts of the body. Materials that warrant particular awareness include latex, nickel, methacrylate, eugenol and polyether impression materials.

References available from the author on wiltshir@cc.Umanitoba.Ca.

Box 1: Test yourself

1. What proportion of orthodontic patients with pierced ears is allergic to nickel?

A. 60% B. 20% C. 30%

2. When did latex allergy become more common?

A. 21st century B. 1980s C. 1940s

3. A Type IV reaction is:

A. Delayed B. Immediate C. Fatal

ANSWERS: 1C, 2B, 3A.

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