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Dear Abby—Help Me I Can’t Breathe

By Dr. Paul Ehrlich

Dear Abby: I have suffered from allergy-induced asthma for 10 years. It becomes a problem only on the major holidays when we visit my mother-in-law. She has two cats and poor ventilation in her house. For years, I have followed my doctor’s treatment of inhalers and allergy remedies with slight success.
This last year, the prevention methods didn’t work. My breathing was labored for several hours after leaving my mother-in-law’s house. I am now considering not attending these holiday gatherings unless they are held elsewhere. Any suggestions?
— Feeling Well (For Now) in Buffalo

Abby (the Next Generation) foregoes any mother-in-law jokes (I’m not sure I would have) and advises sensibly that the family resort to a tactic long employed in the criminal justice system—a change of venue, rotating these events into other homes within the family circle. Since the letter comes from Buffalo, which is home to two of the nation’s great allergists, Dr. Mark Ballow and Dr. Robert Reisman, both of whom have written guest editorials for this site, I can only assume that she is getting good advice from her doctor on mitigating this uncomfortable condition. Poor ventilation is certainly a factor, and possibly mother-in-law’s housekeeping is diminishing with age.
However, we deal with this problem of visiting relatives who own cats in our book, recommending inhalable cromolyn sodium:
“Cromolyn sodium is … a perfect example of a niche medicine that can be used tactically for certain situations. One of the things that make it incredibly useful as a niche medicine is that it is incredibly safe and side effect–free. The other is that it works to stave off allergic reactions when taken before and even during high exposure to allergens. For example, if your child is allergic to cats and you’re going to visit Aunt Rachel with her beloved calico cat Rambo for the weekend, your child might start puffing cromolyn sodium on Friday.”
If Feeling Well (For Now) hasn’t tried this method, she (it doesn’t specify whether the writer is a man or woman but for convenience I’ll assume) might give it a shot. And because she doesn’t feel well after she leaves, she might also consider a last-minute change of clothes before leaving the party since, as we also say in the book, cat dander is very sticky and will follow you home, which is why children with cat allergies who have no cats often suffer from symptoms in their own homes. Contact with other kids’ clothing at school is enough to transfer allergens, and it works that way for grownups, too.

PS–Unfortunately, inhalable cromolyn sodium is available only in nebulizer form. Convenient OTC aerosols ran into propellant issues, and no drug company wanted to bear the cost of re-certifying an old medicine with the new propellants. This is an old and ugly story, especially since as now has been reported, pharmaceutical companies posing as environmentalists were behind the movement to subject drugs to the same prohibition of CDCs as other aerosols, even though they represented an inconsequential percentage of the challenge to the ozone layer.

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