Allergy Shots in the Leg? Abdomen?

It is not uncommon that we have patients that ask if allergy shots can be administered in the leg (or other part of the body) rather than the usual behind the upper arm.

Before we answer that question, let's ask why we given it in the upper arm in the first place!

1) Easy to access
2) Easy to monitor for any adverse reaction
3) All the good studies done are based on injections administered to the upper arm
4) No good studies performed determining whether injections done at other body sites has equal efficacy to the arm.
5) If anaphylaxis occurs, a tourniquet can be easily applied to the arm proximal to the injection site which theoretically would decrease allergen traveling systemically

Given these answers, is it possible to give allergy shots in other body locations other than the arm?

Yes... BUT...

1) No good studies performed determining whether injections done at other body sites has equal efficacy to the arm.

2) If anaphylaxis occurs, may not be possible to apply a tourniquet easily (if given in the abdomen for example)

3) May not be as easy to monitor for a reaction (if given in the buttocks for example)

SO...

It is recommended that allergy shots be given in the upper arm and not other locations.

Reference:

Ask the expert. AAAAI 2/6/12

Earthquake Helps Man Regain Hearing... Perhaps Not!

Fox News reported on Aug 25, 2011 about Robert Valderzak who suffered conductive hearing loss for a few months... until the earthquake shook him and the rest of the East Coast after which he was able to hear.

Though this may sound miraculous, conductive hearing loss is one of those reversible type of hearing loss. It is not permanent. Example of conductive hearing loss include:

• Earwax
• Fluid in the ears
• Ear infection
• Eustachian tube dysfunction
• Problems with the middle ear bones

All these problems can be "fixed" and the hearing loss reversed. Permanent hearing loss is due to nerve damage and a reversal of a nerve type of hearing loss could be considered "miraculous."

Now how could an earthquake conceivably reverse a conductive hearing loss? Without benefit of having examined Mr. Valderzak, perhaps he had a lot of earwax and the quake "shook" the earwax out or free (kind of like when a person goes swimming and gets some water in the ear that requires head-shaking to get it out).

It could also be coincidence. There are thousands of people who suffer conductive hearing loss every day for one reason or other. Often, this type of conductive hearing loss will spontaneously resolve one day after days or weeks or even months go by even if not aggressively treated medically. That's why in kids who have fluid in the ears (which causes conductive hearing loss), we sometimes wait 3 months before we put ear tubes in. Quite a number resolve on their own spontaneously.

Now if there are thousands of people with conductive hearing loss and we expect a few to spontaneously recover their hearing each day... and the earthquake was felt by millions throughout the East Coast... I'm surprised that this particular patient is the only one who regained his hearing after the earthquake. I suspect there's at least a dozen that probably regained their hearing that day that the media has not heard/reported about... as well as the day before and the day after. I also suspect that there's probably a few hundred that "lost" their hearing during the earthquake due to earwax, fluid buildup in the ears, ear infection, etc.

Read the Fox New article here.