Venita Currie (Host): Welcome to Conversations with MIT Health. I'm Venita Curry. People living with allergies have to think ahead for almost everything they do. What if they're traveling, trying out a new restaurant or visiting friends who forgot? You have allergies. And what about the medications you need in case you have an allergy attack in or out of your home?

We've got a wonderful panel of medical experts to help us think ahead and to keep you healthy. Joining us today is Dr. Cody Nelson, an allergist specializing in allergy and immunology, registered nurse Nicole Boulay, and nurse practice manager of medical specialties and occupational health Kate Dirk.

All of them can be found working hard at MIT Health. I'd like to get started with you, Dr. Nelson. I had a roommate who had an allergic reaction to meat. She didn't connect the dots for so long. It took her many years to figure out she had that kind of allergic reaction to meat. What are some of the signs we should be looking for that tells us that maybe we should get checked out, that maybe we have an, allergic reaction?

Cody Nelson, MD: Sure, so when someone's having a severe allergic reaction, oftentimes we refer to it as anaphylaxis, and some of the concerning signs for anaphylaxis include, hives, sort of like a full body red rash. as well as shortness of breath, where you have chest tightness, similar to someone, with asthma might have, you can feel light headed, oftentimes people who are having anaphylaxis describe the sensation of throat swelling, where they feel like, uh, that they can't swallow or, breathe properly.

 So in combination, these signs and symptoms can indicate a severe allergic reaction. And there's something that, we're concerned about as allergists.

Host: So if a patient kind of feels like there's something happening in their body and they come to you, what are the steps that you take to help them confirm if they truly do have an allergy and what kind of treatment they can get?

Cody Nelson, MD: Yeah. So the history is really important. the timing of onset of the symptoms in relationship to food, I'm assuming you're talking about food allergies. so the history is critical and oftentimes we can't rely on physical exam since this is happening after the fact, but, if that's happening during the event, the exam is really important.

And beyond that, we have a tool set of, laboratory tests as well as skin tests that we can check to see if patients have evidence of an allergy. And if they do, oftentimes we advise avoidance of the thing that triggered their attack. if they don't have evidence of a true allergy, sometimes we can challenge them to that food, to tell them if it's a real allergy or not.

In terms of medications that we can offer, if someone's having a severe food allergy, anaphylaxis to, a food, The safest thing is for them to self administer epinephrine or an EpiPen. And so oftentimes these patients with food allergies will have to carry an EpiPen with them at all times.

Host: I'm married to someone who's allergic to cats, so it's hard to visit friends who have cats. So there's a whole long list of triggers that can happen for folks who are allergic to many different things is, could you kind of explain what the range is for folks?

Cody Nelson, MD: So basically allergies are an inappropriate response of our body to the outside environment. So really you can be allergic to, oftentimes we think about foods like we were talking about earlier. You can be allergic to things in the environment, pollens, molds, dust. So those are probably the two most common things we see. Some people think that they're having reaction to strong odors or scents. that's a little bit less clear whether that's a true allergy. It's probably just triggering a reaction. but honestly, anything that our body interacts with and responds inappropriately to is, is an allergy.

Host: I'm wondering, you know, who can utilize the services that you have at your facility?

Kate Derr, RN: Yeah, that's a great question. Anyone with MIT insurance and students can use the allergy services offered at MIT Health.

Host: If there are patients who are receiving care elsewhere, how do they transition over to you?

Kate Derr, RN: Well, you would have your allergist, your current allergist send us your immunotherapy extract contents with proper labeling and expiration dates. your administration record with administration dates and doses, any related protocols for SHOT administration, as well as a recent provider visit note, and lastly, best to include your asthma and or allergy diagnoses, as well as any skin test results that you have.

Host: I imagine you see every age and every one in the community. That's a variety of different people who could have allergies. So Nicole, what do you love most about working in the MIT community?

Nicole Bouley, RN: What I love most about working in the MIT community is really getting to know my patients. it's a lot of fun because I mostly administer allergy shots and it's really cool because when they're first getting their allergy shots you're seeing them every single week. so I learn what they do here, where they work.

I'm hearing of jobs I've never heard of, and I get to really know my patients. You know, they get to know me too, um, whether I guess they want to or not. but it's a lot of fun just seeing what MIT is doing. part of our MIT health mission is, bettering our community so they can create a better world.

And it's really nice, like, seeing that I'm a part of that, and that like our allergy department is allowing like our community to be a part of that world. a lot of my patients are in research or they're teaching and it's just wonderful being able to like be a part of that and, being able to help them so that they're not sneezing and, outside like crying all the time because the allergens are bothering them.

Like it's really cool. I really enjoy working here and, getting to know my community.

Host: Sounds like you become a part of their family.

Nicole Bouley, RN: Yeah, yeah, definitely. Like you really get to know each other when you're working that intimately. And when you see each other more often sometimes than I see my parents.

Host: Yeah. Yeah. And I imagine sometimes patients can get real jittery when it comes to having to get a shot, especially if they're a first time kind of patient for you calming their nerves and their fears and helping them. Get adjusted to this new world they're in.

Nicole Bouley, RN: Yeah, absolutely. And you know, it can be scary too because allergy shots definitely come with, risks, right? Like everything has a side effect, unfortunately in life. And, you know, I have to go over those after Dr. Nelson goes through them, with them as well. and I'm the one there monitoring them and making sure that after I give the allergy shots, they're okay, and sometimes they're not.

So it can definitely be scary in those instances, but knowing that they're in a safe environment and that they're going to be taken care of and, it's really important to them that, they know that I'm there for them and that they're going to be taken care of if, an anaphylactic reaction is to occur.

Host: It really sounds like you give really customized care to make sure people are comfortable and make sure they understand what their condition is

Nicole Bouley, RN: Absolutely.

Host: Kate, I'd love to hear from you on how people can schedule an appointment.

Kate Derr, RN: Sure. allergy appointments can be made by calling, MIT Health, 617 253 6175. 4481, press option 7 for the allergy department, to schedule an initial appointment. with our allergist.

Host: Wonderful. Well, thank you all. I learned a lot today and I hope our listeners did too. Thank you for a great conversation. And that concludes this episode of Conversations with MIT Health. Head over to our website at health. mit. edu for more information and to get connected with one of our providers.

Please remember to subscribe, rate, and review this podcast and all of the other MIT Health podcasts. For more health tips and updates, please follow us on your social media channels. I'm Vanita Curry. Thanks for listening. Have a great day.