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The doctor is in: your questions on food allergies, pertussis, migraines and more

 

Dr. Tyeese Gaines, an emergency medicine physician and health editor for theGrio.com, answers your questions about everything from shingles to concussions. Got a question you'd like her to answer in an upcoming column? Send it to askdoctorty@gmail.com.

Q: Is it normal for a child to develop a food allergy all of a sudden (in this case, shellfish)?
- Elizabeth C.
A: Yes. Allergies can develop at any time. They’re more likely to start in childhood, but anyone -- even adults -- can become allergic to foods that that person has eaten his or her entire life.

Q: I’m pregnant with our second child and due in August. Both my obstetrician and my son’s pediatrician recommend that my husband and I get a pertussis booster shot (for whooping cough).  My husband was in the ER and given a tetanus shot. Do all tetanus shots come with pertussis in them?
- Sarah D. J.
A: No. There are vaccines with tetanus alone, and others with both tetanus and pertussis. We get excited about pertussis vaccination because pertussis -- the bacteria that causes whooping cough -- is highly contagious and dangerous to infants. The current recommendation is to give pertussis when adults get tetanus vaccines because it decreases the chances of adults passing pertussis onto the children.

Q: Why is it that when I go to the emergency room for a mega migraine everyone assumes I am a pill popper or drug addict? If I wasn’t in such unbearable pain and vomiting, I wouldn’t go.
- Aron B.
A: Unfortunately, there are people looking for prescription pain medication for the wrong reasons -- not because they have pain, but because they either want to get a euphoric high or sell the pills illegally. The problem is, it can be difficult to tell the difference. If you have two patients writhing in pain, but one is being deceptive, how do you know? And, in your case, patients who come in frequently do tend to raise flags. The best thing to do is get a good primary physician who knows you well. Either he or she can prescribe you pain medication and help you avoid the emergency room altogether or that physician can call the ER and “vouch” for you and the fact that you’re not drug-seeking. 

Q: Black spots keep coming up on my face, and my neck is darker than the rest of my body, what can I do to clear it up?
- Nic-nak J.
A: The neck can be darker than the rest of the body, especially in the folds, in a condition called acanthosis nigricans. Sometimes, it is benign, other times it means there is an underlying health problem. Acanthosis nigricans affects people of African descent more often, and tends to run in families. Obesity and other hormonal problems can lead to this discoloration. And, it is often seen in obesity-related diabetes -- sometimes as a warning sign long before the patient develops diabetes.  The darker discoloration can spread to the armpits, groin and finger joints. It fades once the underlying cause is treated.

The spots that appear on the skin with age are usually signs of long-term sun damage. It also appears to be related to genetics. Visit your physician or a dermatologist to figure out whether those are aging spots or discoloration to be concerned about.

Q: I am not a drinker. I may have a drink once or twice a month. Sometimes, when I drink, I get the “blood pressure headache.” Is it safe to pop another pill prior to having a drink in order to control my blood pressure?
- Lynn E. P.
A: This concept of people developing a headache when their blood pressure is high is often debated. The problem is, pain can increase a person’s blood pressure, so simply having a headache can make one’s blood pressure go up. If the blood pressure is taken at that point, who knows which caused which?

With respect to your headache, some people do develop headaches when drinking alcohol. Some are very sensitive to the dehydration that comes with even a small amount of alcohol intake. Others are affected by the chemicals in certain types of alcohol, such as red wine -- a well-known trigger in migraine sufferers.

Talk to your doctor and don’t assume that taking an extra blood pressure pill will prevent the headache. It may not be caused by your blood pressure at all.

Q: If it’s late at night, or on a weekend, can you help parents decide if they should take their child to the ER as opposed to calling their on-call pediatrician or waiting until office hours?
- Michelle V. S.
A: If the child is having difficulty breathing, or some other life-threatening condition, call 911 immediately. Otherwise, call the pediatrician. There is always someone on call for their patients. The truth is, many pediatric ER visits can wait until the morning when the pediatrician’s office is open. Allow the doctor to help with that decision. He or she may even call in the prescriptions you need to the pharmacy without you having to come in.

Dr. Tyeese Gaines is a physician-journalist with over 10 years of print and broadcast experience, now serving as health editor for theGrio.com. Dr. Ty is also a practicing emergency medicine physician in New Jersey. Follow her on twitter at @doctorty.

Note: The information included in this post is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider with questions. Reading the information on this website does not create a physician-patient relationship.

More from Dr. Tyeese Gaines:

The doctor is in: Shingles, teen concussion and an itchy breast