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1
When I was growing up in Central Texas, I had persistent problems with pollen allergies. We didn't know what in particular I was allergic to, but it seemed that anytime, any day, my eyes could start itching, or I could start sneezing, or my chest could become congested - having an asthma attack, we said - or I could have to blot my runny nose every couple of minutes. Mother used to say it was worst when the many wild and domestic cedar bushes in the Hill Country all around my hometown were blooming... but I didn't know any plant bloomed year round!
My sneezing would sometimes get so bad I would injure my neck and shoulder, and for days I'd have "a crick in my neck," sometimes very painfully.
The pediatrician always prescribed Benedryl, but that made me sleepy. So I took it only when I was feeling sort of desperate... unless my parents insisted.
I read somewhere that a youngster with a tendency to "hay fever" would outgrow it in her or his early twenties, and that it would return in one's forties or fifties. And sure enough, when I went north to college at 18, I did notice a remarkable reduction of my usual symptoms. (I didn't want to think it was really the plants in my hometown that had been giving me such problems, but...) Oh, and headaches too; I didn't mention that my head congestion often gave me headaches, as a kid at home.
2
I wasn't entirely free of pollen allergy symptoms while I was in college, but the episodes did seem to come only during certain seasons. I read then that some thought allergic reactions were brought on by stress. It occurred to me that maybe my parents had known this theory too.
In those years I found some over-the-counter medicines that helped. One had some caffeine in it, which I discovered was a good idea. I had observed too that having coffee or tea, or a Coke (preferably a Dr. Pepper) would help, sometimes as much as a pill. I took Chlorotrimeton for a time - prescribed by somebody - and Coricidin D, the one with the caffeine, was my pill of choice.
3
But still, in my - let's say - "early maturity," whether I was in the Midwest, Europe, the Northeast, or the West Coast, my allergies were everywhere what I thought of as "under control." Even when I visited my family in Central Texas, always for only a few days at a time, I didn't ever feel as vulnerable as I'd had to earlier.
Then, five years after our marriage, A----- and I moved from the East Coast to one of the Great Lakes states. My new job was in a small village, where we built a house and started our family. The region was fairly swampy, but the village had grown up around one hill in the center. Two distinctive features of the area were its black squirrels and the grove of oak trees on that central hill, who loved the acorns of course.
Even the logo of my employer was a stylized oak tree. We were proud of it. Our weekly newsletter was called "The Oak Leaf."
4
I was 33 when we made that move. The allergy symptoms returned about at the level I remembered from childhood in Texas. I thought it was too early for the return onslaught, and I got to know Coricidin D real well... as well as coffee. But I was uncomfortable most of the time, some days worse than others. We had a line of big pine trees marking the lot line next to our house, and my wife and I theorized that their blooming - seeing the waves of yellow pollen blowing around - must have been the cause of my discomfort. This theory seemed to gain strength from my mother's theory about Texas cedar. Well, pines and cedars are both evergreens, aren't they?
Always alert for new developments regarding allergies, I did know that considerable advances had been made in allergy treatments. I'd heard about "scratch tests," where the doctors figured out just what it was that provoked the allergic reactions. At that time, I didn't know what use could be made of this information.
And of course, we weren't going to move away from our wonderful new house just because of a little discomfort to Daddy, even if testing should confirm our theory about the pines next door.
5
But after three or four years, we decided to look around to see if there was an allergy specialist around. One way or another, we discovered a certain Dr. Brenneman in another small village about forty-five miles away.
But I was reluctant to call him. I thought I should wait until there was at least a brief respite in my allergies. I thought it would screw up the examination and the tests if I was at or near my worst. The episodes couldn't last forever, could they? But for a long time, I didn't feel any let-up.
Then, finally I was feeling better, so I made an appointment with Dr. Brenneman. The intake was pretty standard - a lot of paperwork focusing mainly on my allergy history, a quick encounter with a nurse who weighed me, took my temperature and blood pressure, and told me I had done the right thing coming to the renowned Dr B. even if his office was kind of far from my home.
After a while the doctor himself hustled in, his hands full of the pages of history I had carefully written out. He went through my allergy history of the last year. He would quietly ask a simple question like "when was your first episode this year?" When I would say something like "late January or early February," he would seem to pounce and call out something like "January 29?!"
That seemed odd, but the specific dates he attached to my anecdotal memories all seemed credible, so, every time he hollered one out, I said a simple "Yes."
"March 27?" he'd propose in his aggressive manner. "Yes," I'd say, quietly.
"June 3?" "Yes." (And so on.)
We wereviewed almost a whole year that way. The exchange was challenging, interesting, and laborious. But I was impressed. "Boy!," I was thinking, "this man knows, he knows!" (By the way, in the course of my review, Dr. Brenneman explained away our theory that the pine trees were the source of my problems. It turns out that any pollen you can see is very unlikely to be breathed in, creating hay fever. Such pollen is just too heavy, and simply falls to the ground.)
When we got through that part of my interview, the doctor pulled out a little pen light, tilted my head back and looked carefully up each nostril. He didn't speak during this part. Then, each ear. He probably listened to my lungs too, but I don't particularly remember that.
Finally, he looked me in the eye and said, in that somewhat stentorian voice: "You know you're sick, don't you?"
"Well, no," I said. "I waited until I was feeling good for a change before coming in."
"You have forgotten what it's like," he said, "to feel good."
6
Well, that seemed credible too, I had to admit to myself. I waited for more wisdom.
"Here's what we're going to do," Dr. Brenneman announced. I later learned that he'd published a well-known book on food allergies, but at this time it surprised me when we did not move directly to the famed scratch tests. "I have tested a special diet," he said, "consisting of a healthy combination of all the nutrients we need, but with only foods to which a tiny minority of people has ever reported allergic reaction."
I was listening, as he took a printed sheet from a little box on the desk. "You eat nothing - and I mean nothing - but rice and beets for a week...and I guarantee, a guarantee you know, that you will feel like a new man" (emphasis added by him).
I was looking over the printed diet instructions and absorbing what he said. I would like feeling "like a new man" after all, especially now that I knew I was sick right at the time I thought I was feeling fine.
"Rice and beets," he repeated emphatically. "You can have some tea if you need to, but with your meals you should have only water... Do you think your wife will do this for you?"
Of course, I was sure, if that was what was needed for my health and well-being. I didn't even wonder right away whether if I did feel like a new man after a week, I'd be eating nothing but rice and beets for my whole remaining life.
But he evidently anticipated my worrying that. "Then," he said, "when we know for proof positive," he said, "that your persistent allergies are indeed food-based, we'll start adding back to your diet various other foods, starting with those known to cause allergic reactions - like yours - for lots of people. That way we can identify the foods you must avoid in order to continue healthy, symptom-free."
I now know that this approach is known as "the elimination diet," at that time the food allergy equivalent to the scratch test for air-born allergens Anyway, I left Dr. B. vowing to cut out all foods except rice and beets, with an occasional cup of tea in-between meals. In only a week, maybe I would feel like a new man.
7
Anyway, A----- faithfully fixed me a big plate of rice and beets every evening after a smaller plate of rice and beets at noon. I can't remember if I skipped breakfast altogether, but that's unlikely. Guess what I had for breakfast?
After a rather long week of this, I headed back for my follow-up conference with Dr. Brenneman. I had to break the news to him that I didn't feel any different than I had the week before. He acknowledged, then, that the source of my problems was not in my diet. He may have been disappointed; I imagined he was. But he said, "Now, here's what we will do," and he explained the scratch test routine:
I could begin immediately in the lab across the lobby, a technician giving me a series of scratches on my back with a tiny drop of serum made from a variety of possible air-born allergies. In a couple of days, I'd come back, and the technician would check the results. The allergens I'd reacted to most would be administered later in a line across the back of my shoulder. I believe he said that they used to test for 60 different alleregens, but that number had been reduced based on experience.
Yes, that turned to be true: I was tested for only 59! My back was covered with new scratches from collar to belt-line.
A day or so later, when I took off my shirt for the technician, she said, "Oh!" implying that mine were unusual results. She showed me a printed chart with the 59 scratches and their labels. I'd had at least a minor response to 48 of them. She marked them on the chart, then marked them on a chart she would give to Dr. Brenneman, noting by number how mild or how strong the reaction had been to each.
Although some molds, house dust, cat dander, and the like had provoked some reactions, almost all my allergens were various pollens... one of which was oak. Dr. Brenneman later told me that oak was the only tree that bloomed year-round, at least in that region.
8
He himself was present at my next meeting with the technician. He wanted to tell me that my reaction to ragweed, in two different species, had been severe enough so that he had decided to dilute the serum a drop of which was to be administered under the skin that day. I can't remember which subcutaneous doses I was to receive, but it was fewer than a dozen.
Then, I was to return to the main waiting room for 30 minutes or so in order to give enough time for these pricks that afternoon to reveal how much I was allergic to them. A serum customized just for me would finally be developed.
Perhaps I'd known that I would be cooling my heels for a time. I had a paperback with me, and the time went by pretty fast. After 20 minutes, or maybe longer, someone on Dr. Brenneman's staff happened to walk by, nodding to the several folks waiting there. She paused as I greeted her, and I noticed that her eyes widened a bit.
"How are you feeling?" she asked. When I said I was all right, her next question was "Can you breathe all right?" I hadn't noticed any problem except for a slight headache and maybe a little eye strain. She took my pulse. She hadn't done this with anyone else, but I didn't know if anyone there had had the same tests as me. "Now," she said firmly, "you just stay there. Dr. Brenneman will be right with you."
One of the secretaries came right over to sit across from me. She said the doctor would be coming soon.
The next thing I knew, Dr. Brenneman was looking up into my eyes. He spoke gently and slowly. "Now, here's what we're going to do. Even though we diluted your serum to half strength, you're having a severe reaction." He took something from the nurse behind him and looked back into my eyes.
He held up for me to see a huge syringe (I thought) as he said, "I'm going to put some adrenalin now directly into your heart. That will protect you. We'll see how you respond to that, and then decide what's next. Do you understand and consent?"
Directly into my heart, eh? I said, as cheerfully as I could, "Let's just wait a little while longer, okay? I'm feeling all right. Let's just give my body more time to calm down again."
And even though I was clearly causing a major disruption in the staff's normal routine, that's what we did. I don't think anyone was delegated to sit right with me that whole time, but I presume staff members were keeping an eye on me. Did I go back to my book? Probably!
9
I later learned that I was showing symptoms of "anaphylactic shock," when one's neck swells, in the worst scenario growing so swollen that one's breathing is threatened. I was still feeling pretty good, though, and managed to remain calm.
I don't know how much longer I sat there; I'm sure it was at least another half-hour, at which time the nurse reappeared with a stethoscope and a blood pressure cuff. She said I looked much better, and I said I'd never felt really bad. She came back in a few minutes and watched as I stood up. I walked around a little (probably went to the bathroom). Following instructions, I set up another appointment in a week or so with the doctor's secretary but was free to go, if I was really feeling okay.
I really was, so I went out to my car and drove the forty-five minutes or so back to the office. I made it in time for my last scheduled committee meeting that day, which didn't last long. I thought maybe I should knock off an hour early, said Goodbye to my secretary (who agreed it might be a good idea for me to leave), and went home.
10
Everyone at the doctor's office had been studiously calm. No one had said anything unusual in my little meeting at work, and my secretary hadn't either. So it was surprising when I walked in the kitchen door, and A----- flipped out.
"What happened?!" she exclaimed. When she told me I looked terrible, I looked in the bathroom mirror. My appearance was in fact considerably altered. I looked puffy and pale. My neck, A----- said, was as big as a piano leg. I went upstairs for a little lie-down. After supper and a good night's sleep, I was looking - and still feeling - normal again. But it had been a dramatic experience, to say the least.
At my next appointment, the technician gave me a shot in the thigh consisting of an individualized mix of serum made from several of my worst allergens. After a half-hour without any drama at all, I was free to go.
Dr. Brenneman said it was fine for the company nurse to administer my shots from then on. His office would send me the serum whenever I ran out, and I would take it to the nurse for my shot. This would be weekly for some period of time and then bi-weekly indefinitely.
So I ended up giving myself the shots for six or eight years. I probably saw Dr. Brenneman at least one more time, but he just said to keep up with the shots.
11
Well, in a year or so - maybe I was by then down to a monthly shot - I noticed I was feeling better for longer periods of time than I had for decades. By george, this desensitizination treatment was working!
Then, it was time to move on. The family moved back East. I had enough serum for a little while, but I began to get a little anxious about whether or not I could continue to get my usual supply from Dr. Brenneman's office. I must have gotten it all right, but the local pharmacy seemed reluctant to sell me the insulin needles I needed without a prescription.
A----- found me a local allergist. I explained my situation, but concluded by asking a question that hadni't really occurred to me before.
"How will we know whether the shots have accomplished all they can?"
He replied: "There's only one way: you would have to stop having them." He gave me the prescriptions I needed (or he got them from Dr. Brenneman; I don't remember), but I never had them filled.
How I felt - and continued to feel - was good, better than "all right." Now, I never even wonder anymore what it felt like - years ago - to be the "old man" I used to be and before I began to feel like a "new man."
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