Drop by Drop (2017) Movie Script

So there's this story
in medical history,
back in the 1840's, about
a man who gets hired
at a hospital in Vienna
and he starts to notice
that there are two
maternity wards,
and in one of the maternity
wards, the death rate
among moms and their
children who were being born
is a lot higher than in
the other maternity ward.
And he's like,
okay, let's look at
what's different
between the two of them.
What could be causing such
tremendous death
rate in one of them?
And the only difference
that he found was that
one of these maternity
wards was run by midwives.
The other one was run
by medical students
who were delivering the kids.
And he's like okay, what's the
difference between those two?
And the difference
between those two was that
the medical students were
going and doing autopsies
and working with
corpses afterwards.
So he thought they must be
carrying something on their hands
from the corpses over to
the moms and their children.
And he took this idea to
the doctors and was like,
you know, you guys should
maybe like wash off your hands
while you're walking
between these two areas
or before you help
deliver a baby.
And the doctors responded with
no, you're absolutely insane.
We could not be responsible
for killing our patients.
It can't be our fault.
At this point, nobody
knew what a germ was.
This guy's name was
Ignaz Semmelweis.
He essentially invented the
idea of washing your hands,
but when he was alive, it
was almost impossible for him
to get anybody to listen to him.
He actually ended up
dying in an insane asylum
because he just went crazy
because nobody listened
to such a simple,
mundane solution
that ended up saving hundreds
of thousands of lives.
It just seems so boring
and simple today,
and when I heard this story,
it just made me wonder,
well, okay, what
else is out there?
Has this changed?
Are there still
Ignaz Semmelweises
who have these simple solutions?
Or is change in the medical
world just like the water
that's going through their hands
and it just moves
slowly drop by drop?
- Ready?
Good job, I got my drop.
I often say we need a pink
flamingo on the front yard
and calling us the last resort
because many, many
patients have been
to so many other places
and so many other doctors
that they're at their wit's end.
Even when I went
to medical school,
allergies and even severe
allergic conditions
like asthma were so
poorly understood
that we were often being
taught about allergy and asthma
in the chapter of
psychosomatic disorders.
There was a tendency
back in those days
to blame allergies and allergic
manifestations of diseases
on psychiatric disorders.
This just shows
you how much things
have changed over
the last 30 years.
You can have vaginal irritation,
vaginitis from allergies.
You can have chronic
bowel problems
as my nurse was mentioning
a few minutes ago
related to ingestants.
And probably one of the
biggest things with allergies
is when people have all
of this stuff going on,
they often have fatigue,
they often have a
quality of life issue,
they don't feel well
and they're tired.
I went back to my doctor
and said, you know what,
I think I have food allergies.
She said, there's no such thing.
I think the general
perception is allergies
are just some minor thing that,
oh, if you complain about them,
you're just kind
of whiny and nerdy.
We see so many
people who are hopeless
and when they come here, and
they come from miles around,
Montana, Florida, we have people
that come from China
every two years.
So they're not coming because
they have a little cough
or a little post-nasal drainage.
They're coming because
they're very complex
and nobody's figured it out.
- It's 2008.
I have had issues with allergies
when they had the flood
over here in Cedar Rapids.
It was the first
time I was tested,
and I was very much
allergic to mold and dust,
and I would lose my voice.
I mean, it was ridiculous.
To where, you know,
when you're having
like a bronchial attack
where you can't talk,
you can't breath, you
can't do anything.
I thought I was just sick,
and then they had
my allergies tested.
At the first place,
they had two allergies,
and I'm like, okay, well, I
tried doing four Benadryl a day.
Try working and driving; it
didn't really work very well.
I have a 10 year old that has
the same type of allergies
and we thought she had a cold
most of the time because...
Forever telling her
to get a Kleenex.
And after going through
the test and we found out,
wow, we live in Iowa,
surrounded by corn fields,
soy beans, wheat, trees,
grass, the whole nine yards,
and we're allergic to it.
Allergies can really
define you because it defines
how you see the world
and what's around you.
But a lot of it, I don't
remember because I was so little
and I think I blocked
out a lot of it,
and I rely mostly on my mom
to tell me what
actually happened.
The first time I knew
Alex had allergies was when
I had him in the
high chair one day
and I gave him a
half a piece of toast
with just a thin layer of
creamy peanut butter on it,
and I washed him
break out in hives
and I knew that it
was the peanut butter
because he had not
had that before,
and so luckily, it was
treated quickly with Benadryl.
I was able to treat it
quickly with Benadryl,
follow up with the pediatrician,
had a discussion about this,
and of course, we
avoided peanuts,
but from then on, I
was on alert as to
what other foods maybe
he's sensitive to.
I've always
had the allergies.
Nobody else in my
family is allergic
to really anything at
the level that I am.
- Alex is our fourth child,
and so I was an
experienced parent
but I had never had
a reaction like this
with any of my kids.
I had a few allergic
reactions with peanuts
when I would eat peanuts, and
I would just like break out
and it would be, my
throat would swell up
and I'd just down
a bunch of Benadryl
and that's pretty much
all I've ever done
is taken so much medication.
When I started taking
Alex to the allergist,
he did a lot of the skin
testing that was normal
for environmental and yes,
some of that did show up
and we started allergy
shots at the age of five.
However, he really
did not listen to me
when I said, what about foods?
Couldn't there be other foods
if he's allergic to peanuts,
then how do we test for that?
And he really dismissed
me and said, well, mom,
we just can't test
for everything.
And you know, you can't
take him off of all foods.
So the treatment
really didn't help.
The shots didn't help; Alex
just got progressively worse,
and then he started having
this muscle pain and cramping
and that was causing
problems at school,
sitting in his desk and just
being very uncomfortable,
waking up with leg cramps,
and that was terrifying.
They sent me to elementary
school in second grade
and I have a little pad on
the back of my metal chair
and this pad was like this.
I mean, it did
absolutely nothing.
It was the stupidest
thing I've ever seen,
but I had to sit with a
pad and that identified me
to all the other kids
that there's like,
Alex apparently has to have
a pillow while he's at school
and that makes you
just look ridiculous.
I think that it's
easy to underestimate
how much allergies
can impact your life.
They impacted
Alex's social life.
I think they impacted
every aspect of his life
because when he was
little, he didn't feel well
so much of the time,
and that really impacted
what he was able to
do, what he felt like.
You know, he tried flag football
but he would be
sliding in the grass
and would come out with rashes
all over so we stopped that.
And that impacts all
aspects of a child's life.
When I would go outside
and I'd see people
sitting in the grass and to me,
I'm like why would
you wanna do that?
Because for me, sitting in
the grass makes me itch.
So allergies change
your entire perspective
of what the world is around you.
I look at grass as an enemy.
People look at grass as something
that's like fun to sit in
and roll around and
go outside and play,
and I just think of it
as, I'm gonna sit...
Who sits down
barefoot in the grass?
He was going to the
emergency room probably monthly
and having horrible rashes
and was on steroids,
prednisone frequently;
also had a nebulizer
that we were doing
treatments with daily.
So a lot of meds and
he was losing weight,
he was just really
starting to look sick.
I remember I had a girl
that thought I was sick
and would tell me that all
the time, and it's just like,
geez, nobody had any
understanding or sympathy
and they just think that
you're being really whiny,
and that it's your fault
that your allergic to stuff
and that it's your
fault that you can't do
what other people can do
and that wasn't my choice,
and so now I think more people
are beginning to
understand that.
One year, we spent
$11,000 out of pocket
just going around getting
different opinions,
and we had excellent insurance.
I worked at a hospital
where we had our insurance,
but you know, it
really adds up quickly
and he saw rheumatologists;
he also saw an immunologist.
At age seven, he was
diagnosed with fibromyalgia
and I just really thought
that was ridiculous.
I never thought it
was fibromyalgia.
I just did not believe
that, a seven year old.
And then we took
him to Mayo Clinic,
and Mayo Clinic doctor
looked at all of the testing
that had already been
done by the allergist
who came to Fort Dodge;
did not reside there
but came to Fort
Dodge, and just said,
well, this looks pretty good
and didn't retest any of it
and he actually
said to me, well,
we'll just have to
hope that it goes away
and I was so angry
and he knew it.
Of course, that was from fear.
I was terrified
because I thought
if Mayo Clinic doesn't
know how to help my son,
then where am I gonna go next?
What are we gonna do?
- What was strange is to me,
it was just like
this is my life.
This is what it will be, this
is what it will always be.
I will always have to not
eat what everybody else eats.
I will always have to
kind of live in a bubble.
I'm pretty stubborn and so I
decided to just keep looking.
We were gonna look until we
found something that worked
and this was before the days
of Google, so you really
couldn't look for resources
as easily as you can now,
but I'd heard about a
clinic Dallas, Texas
and we were getting
ready to take Alex there
when another friend told me
about Allergy
Associates in La Crosse
and said that they had
had a lot of success there
and this woman had even gone
through gallbladder surgery
that had been a
misdiagnosis when in fact,
it was a lot of different
symptoms from allergies.
When I found out
that I had allergies,
my original thought was great,
I'm gonna be taking pills
and having a nasal spray
the rest of my life
and I got lucky,
I ran into the Allergy
Associates of La Crosse
as a reference from my sister
and a person I worked with,
and taking the time
to drive four hours
to the office to get
checked out up there
was the best
decision I ever made.
I always tell people that
my mom gave me life twice.
She gave me life when she
actually had me as a child,
and then she gave me life
when she took me to
Dr. Mary's office
and solved what kept me
from enjoying the world
that she brought me into.
- When I took Alex to La Crosse,
I was surprised
that it was small
because I just imagined
this great big clinic.
It clearly was not
like originally a clinic.
We were in the
professional arts building
which is part of St. Francis
and it was the old
nursing dormitory
that had been sort of put
to clinical use by my dad,
and as each doctor came,
we got a little corner,
a little more space.
I actually started working
in the clinic when I was 13.
I worked Saturday
mornings and summers
from the time I was 13
until I finished college
and went off to medical school,
so I had had a long
experience with the clinic.
I saw the patients myself.
I mean, not by myself
but I was here.
I heard them talking about
the success they'd had
and it was exciting
to me to be able
to actually make those
types of changes.
- I was a former engineer.
I have a very
pragmatic approach.
You know, what are you
doing and is it working?
And when I came to Dr. Morris
a few years out
from my training,
I was not happy
with how I was doing
with shock therapy at all,
and Dr. Morris offered
this approach and I
thought, let me try it
and I'll see if it's helpful.
And as I said earlier,
the rest is history.
Allergies quite simply
are a pathologic response
to a normal thing
in the environment.
So for example,
someone can be outside
in the middle of August and say
this is the most beautiful
thing I've ever seen,
and the person standing next
to them is sneezing, itching,
their immune system
has become activated,
they're inflamed
everywhere, miserable,
and the two people are in
the exact same environment.
Those are things that
our body should tolerate
and for some reason, our
immune systems have decided
that they're foreign and they
are a danger to our bodies
so our immune systems gonna
activate it and start fighting.
So let's take a
look at what's happening
inside your body visually
when you have an allergy.
Allergies are an overreaction
from the immune system.
The immune system
is what fights off
a disease or foreign substance.
People who have allergies
have an immune system
that reacts to
something in the world
that's usually harmless,
like pet hair or pollen.
Any substance that causes
an allergic reaction
is called an allergen,
and people can be allergic
to a lot of stuff.
A person can be
exposed to an allergen
by inhaling it, swallowing it
or getting it on their skin.
After a person is exposed,
a series of events create
what we think of as
an allergic reaction.
Number one, the body
starts to produce
a specific type of antibodies.
Number two, the antibodies
then attach to specific types
of white blood cells
and tissue cells.
This causes these cells to
release a variety of chemicals.
Histamine, the main
chemical released,
causes most of the
symptoms of what
you think of as an
allergic reaction.
This is why a lot of
over-the-counter medication
is called an antihistamine.
It prevents the body's
natural reaction
to foreign substances by
preventing or blocking histamines.
It's somewhere between
50 and 70 million Americans
that have allergies
of some sort,
and then you pile on top of that
the people that have asthma,
most of that's
caused by allergy.
Sinusitis, it's
usually some kind of
a mold sensitivity
in the sinuses.
And you layer on those numbers,
it's a huge, huge number of
people that would benefit
from addressing the
cause of their allergies.
I was like one
of one or two kids
who was allergic to peanuts
and had all these allergies,
and now it's totally different.
Think of it as
a growing issue.
It may be a littleoverstated
on how much it's grown.
I mean, I think it's
grown significantly
in the last probably 50 years.
I'm not sure it's
been just 10 years.
I think a lot of this has to
do with survey and awareness
and the way we're looking at it.
Eight, seven, six,
five, four, three, two, one.
Alright, let's start
walking, good job, guys.
Thousands of people every
year are newly diagnosed
and we're just trying
to raise some funds
to give support to our
community and letting people
really understand what
a food allergy means.
It's not just that you
have to avoid the food.
If you don't avoid the
food, you could die.
I can tell you that the
incidence of food allergies
in young children has
grown exponentially
since I've been in practice.
When I think back to
just the rare child
that I had with
life-threatening food allergies
to now, every single
day, I'm seeing children
with not just one food
allergy, but several.
What usually surprises
people is that allergies are
a disease that mainly affects
the developed countries,
the economically powerful
western countries
that are cleaner,
we have a different
food system than
other countries.
It's those, it's the powerhouses
that end up suffering
from allergies the most.
My own feeling
is over the last
three and a half decades
or so that I've seen
more people with food
sensitivities than I used to,
and none of us as allergists
are absolutely sure why that is.
I don't remember anyone
when I was growing up
having food allergies,
and now, for example,
in my son's class, there's
him and another girl.
We probably have 20 other
people at the same school
that have a food allergy, so
it's just much more common
than I remember it ever
being when I was growing up.
There are several research
studies that they are funding
that both deal with
trying to find a cure
and also until a cure is found,
dealing with treating symptoms
and things that we have now
that we know we're
living with now,
so yeah, they're
working on both fronts.
- There are a number of factors.
A big one is cigarette smoking.
Then you go into other
areas like climate change.
Well, when it comes
to the CO2 levels,
we know that weeds
love and thrive
on higher CO2 environments.
Our immune system is
losing its direction.
This is just to put
it in a nutshell.
Longer pollen seasons,
sedentary lifestyle, obesity.
Diesel particulates
have been shown
to increase the
incidence of asthma.
And in certain areas, we're
getting a lot more moisture.
So in general, those kind
of things have a factor.
There is some discussion
about what's going on
with changes that we've
made in our food supply.
We certainly see patients
here that are sensitive
to food additives,
dyes, things like that.
We know that processing
of food has altered it
to some degree, and for
sensitive individuals,
they're having
problems with that.
Probably the most common
thing you'll hear about
is one called a hygiene theory,
where our western lifestyle
predisposes individuals
to develop allergy or asthma,
and that's kind of a
good and a bad situation
'cause if you're aware that
around the turn of the century,
last century, we had a
50% infant mortality rate
from a lot of the bad
things like poor hygiene,
poor food handling, you
know, things like that.
And the fact that we've improved
those public health measures,
that's what really the westernized
lifestyle is all about.
So you've taken
out off the table
kids dying from measles and
strep and things like that
and so now they don't have
that immune response going on.
They may be more predisposed
to develop the allergy
immune response.
One of our concerns,
of course, is the issue
of the altered microbial
environment in the intestine
and with the advent of
antibiotics and the frequent use,
I think that that can
potentially amplify
the development of
food sensitivities.
There's this one study from
the University of Chicago
that shows a link between
using antibacterial soap
and medicine when you're little
to children who get allergies.
What their theory is that
because you're getting rid of
all of the germs
when you're little,
you're also getting rid
of the good bacteria,
so it means that you can
also get allergic to things
that are not actually bad because
you're cleaning it all off
and your body's not
gonna be used to it
when it comes into contact
with it in normal life.
So we may be using too much
medication when we're little
or washing our hands too often.
Sometimes, children
or young adults
will have an allergy condition
that manifests principally
with recurring infections,
and this may be chronic
throat infections,
chronic ear infections,
and by necessity,
the children are given
antibiotics to use.
Now, like anything
else, if it's once
in a infrequent interval,
it's probably not a big thing,
but it's not uncommon for
us to see children in here
who have been on five, eight,
10 courses of
antibiotics in a year.
Now it would make sense
that their intestinal flora
has been altered under
those conditions,
and we know that
proper intestinal flora
helps to maintain
immunologic balance.
So one of our concerns
as a profession is
we may be needing to
intervene at an early stage.
Typical treatment would be
avoidance, trying to stay away
from those things that
you're allergic to
and/or pharmacotherapy,
taking medications.
And again, if you
do the latter two,
you're just addressing
the symptoms
and you're really doing
nothing about the cause.
So not having something to change
the course of the disease,
I think people just said, you
know what, we'll live with it.
We'll put up with it; it's
really the prevailing approach.
But it's not really what
is going to ultimately
make a difference
in somebody's lives.
We take small amounts of
what a person's allergic to
and introduce them
gradually into the body
subcutaneous immunotherapy,
allergy shots have
been the mainstay,
and they still are
the most effective
overall for most patients.
I don't like shots,
I don't like needles.
I don't even take a
flu shot with a needle.
I have to do the inhalable.
The exciting thing
about what we do,
which is different
than allergy shots,
is we actually put the
extracts under the tongue.
I've had allergy shots, and
I think my mom said I did it
for one or two years and it
didn't make a difference,
and I'm not really sure why
the drops work sometimes
for people when it's under
their tongue and not in the arm,
because it's the exact
same allergy extract.
It's the same stuff.
It's just a different way
of going into your body.
How it works is you take
a drop under your tongue
three separate times a day.
You get a bottle for your
environmental allergies
and then you get a bottle
for your food allergies,
and inside each one
drop is all the antigens
that you're allergic
to, so with one drop,
you're fighting a bunch
of different allergies,
and the idea is that it
just builds up resistance
against those allergies
'cause it exposes it
little by little to your body
and then your body says,
alright, this isn't so bad.
I think I could
get used to this.
So everything
we're talking about,
like with sublingual
immunotherapy, the drops,
that's an off-label usage,
so the extract is available.
So the physician feels based
on the current medical evidence
and the literature
comfortable in doing that,
they're able to use it that way.
Because it's not FDA approved
doesn't mean we can't use it.
It just means that none of
the insurance companies,
Medicare, Medicaid, will
cover the sublingual drops,
so that's a challenge
for patients
and they have to
pay out of pocket.
In the 60's, when my
dad started doing this,
no one understood how
that could possibly work,
but we now realize that
that is a very privileged
immunologic site in the body.
Dr. David
Morris's health didn't
allow him to be
interviewed by us,
but he got started by treating
Wisconsin farmers for
their mold allergies.
He tried shots but
they just didn't work.
So he didn't come up
with the idea of drops
and he's not the only
doctor to use it.
The first known use of
these drops was used
to fight a dust
allergy back in 1900.
By 1936, Dr. French Hansel
became the first guy
to publish anything that showed
these things can help get
rid of dust allergies.
Like we said, Dr. David
Morris didn't even find out
about allergy drops
until the mid 1960's,
when he goes to an allergy
doctor's conference in Hawaii.
Then he gets to writing himself,
and publishes his own
paper on how he thinks
drops can even help
stop food allergies.
In 1970, he opens his clinic
in La Crosse, Wisconsin.
It takes a long time for the
process to be taken seriously,
but by 1998, the World
Health Organization
says sublingual
immunotherapy, or drops,
works just as well as shots.
He was presenting
at, I believe,
at our State Allergy
Society meeting
and one of the doctors
stood up and said,
okay, well, he
started talking right
in the middle of his
giving the lecture
and goes, well, how could
that work to his colleagues.
That's ridiculous, they don't.
It was very, very difficult.
I would say I felt shunned that
it was at least perceived by me,
that if I would sit down,
people would get up and leave,
or if I'd try to
talk to someone,
they would turn from
me and walk away.
Allergy Associates of
La Crosse was treated
like they didn't even exist.
When I had joined
Dr. Morris years ago,
it was pretty much
an ignored area.
So at medical
meetings, for example,
we were put the farthest
table away from everyone else.
We would talk about what we do
and people would
just roll their eyes.
You know, the
support, the enthusiasm
behind sublingual
hasn't really developed
with the college or the academy.
Our partners,
they all knew we
were goodhearted,
very solid basic physicians,
but they seemed to think
we had a little quirk.
I don't really
know specifically
what they do and
what they don't do
as far as the type of
treatment they use.
I think it's unfortunate
they felt that way
that they were being shunned.
I've never intentionally
shunned anyone
if they're, you know, at
a meeting or something.
Well, the response
is getting better.
I would call it the
movement glacial.
It's moving, and it's
gonna continue to move.
There was also a
period of time where
there were many meetings
that we went to,
the college and academy meetings
where there was just
outright discussion about
the impact of sublingual on
the income of the allergists.
When you're
delivering the shots,
you have this steady,
recurring, you know,
weekly, biweekly, monthly,
you know, for years on end
of patients coming in
and getting their shots,
which provided an
ongoing revenue stream,
so yeah, there's a lot of
discussion around revenue.
heck, it's great.
We'll just put it
in under the needle
and then we get paid every time
you come in for an office visit.
We get paid every
time you get a shot.
You know, over and over again,
and the bottom
line comes down to
it's a lot cheaper to do under
my tongue every day, myself,
than it is for me to
take off time from work
to go down, pay the doctor,
pay the office visit,
pay the shot, to
get the same result.
So your question is,
I'm gonna repeat it,
would an allergist
make a decision
solely on financial
reasons as far as choosing
subcutaneous or allergy
shots over other treatments.
The answer is I would hope not.
I think that, I can't speak
for every individual allergist.
There are around 5,000 board
certified allergists in the US,
and when we look at
treating the patient,
we look at multiple factors,
and certainly, it would
be very unfortunate
if an allergist chose a therapy
just because they thought there
was a financial incentive.
I think that'd be no
different from an oncologist
treating a cancer patient
because they administer
the chemotherapy in their
office, which a lot of them do.
And I think there is always
in any business or any field,
you can, including the
media, there may be people
that do things because
there's a financial incentive.
You can't ever eliminate
that human behavior,
but I would say that the vast
majority, 99% of physicians,
try to offer their
patients the best treatment
based on their current
medical scientific knowledge.
Allergists who's
in the community
takes a considerable
risk to stop
his or her practice with
injection immunotherapy
and begin sublingual
if it isn't covered
by insurance.
So you have each side not
wanting to take the first step,
because of their own issues,
both being in a sense,
somewhat financial.
Sublingual immunotherapy
has never really been
gone through some of
the rigorous studies.
There are more
studies being done.
The US
government looked into
which works better,
drops or shots.
And, like pretty much everything
that the government does,
they say, okay, we need
to continue to study this.
What's important is they found
almost the same level of
effectiveness for both of them.
They couldn't decide.
What's really important here
is that they couldn't say
that drops doesn't work
and that shots work.
They say, well, they
both seem to work.
Over the years, the
sublingual immunotherapy,
some of the problems have been
in the scientific studies,
you couldn't see the
biological markers
as we knew more about
what immunotherapy did,
but I think as we
move into another era,
you're gonna see that some
of that will be validated.
an insurance company's
not gonna cover
the allergy drops,
and one of the big
reasons for that,
probably the biggest
reason for that,
is because a lot of
insurance companies
base what they reimburse
on Medicare rules,
and back in the
1990's, Medicare ruled
that drops are not safe
and they're not effective.
- We have shared our protocol.
You know, we have an
extensive 130 page protocol
that explains
where it came from,
how the mechanism
works, everything,
with the FDA, with the leaders,
with the presidents
of the college
and academy and
whatnot, and yeah,
all of that information
that we've provided
has really gone without
really being looked at,
at least to our knowledge,
and we're not quite sure why
but there's been research
studies that have been started
and whatnot and the
invitations that we've had
to be involved in those have
been few and far between,
but we've initiated a lot of
our own research to do that.
Now, there's so much
scientific evidence
that shows this works.
The older doctors
seem to be hesitant
to make any changes
in how they do things,
but I'm seeing a real change
in the younger doctors.
They're still at a
stage in their lives
where they can
look for themselves
and say, oh, well, indeed
this is safe and effective.
Why aren't we doing this?
So I think part of it
is we have to just hope
the older people are not
in positions of power.
So we did a Freedom
Of Information request
to find out what is the basis
that the FDA has
allowed allergy shots.
We wanna know how do
they know that they work,
why are they FDA approved
and drops aren't,
and what we ended up finding is
it's called the Summary
Basis of Approval,
or why they approved
it in the first place.
I did this for all five major
pharmaceutical companies
that have allergy extracts,
and all the Summary Basis of
Approvals said the same thing.
Because there are no adequate,
well-controlled trials
with this product
to prove efficacy,
efficacy means does it
work, the optimal treatment
must be based on the clinical
response of each patient.
So, what they're saying is it's
based on patient to patient.
None of them have had to
do the types of studies
that the FDA now
demands of drops.
We then turned to
the FDA and asked,
okay, why did you
approve something
that there was no well-controlled
study to approve?
And their response
made total sense.
Allergy shots were proved
back in the 1920's,
and you didn't
actually have to prove
how well any of
your products worked
to the federal
government until 1962,
and after that got
passed, the FDA has since
been trying to make the shots
meet their current standards
and they've done study
after study in the 80's,
some shots are not
available anymore,
but you can actually still watch
the advisory committee hearings
where all these allergists
get together and talk
about whether or not
the FDA should approve
stuff, and they're seeing
that the shots don't meet
the current standards
but they know the shots work.
Once these are
taken off the market,
the road back is very difficult.
It's not gonna be
the same standards,
and I think once our extract
is removed from the market,
it will be years, likely,
before we have that
available again
and I think there's
a real possibility
of taking a step
backward in terms of
our clinical care
that we can offer
to patients and to the public.
And it's just like,
you know, drops work
but they aren't even in
the discussion really
for FDA approval, and you
can hear them talk about
how they don't wanna
get rid of these shots
because they know
these extracts work,
but they also know
that they don't meet
the current FDA standards, so
there's a lot of nuances here.
You can actually even
hear one guy ask,
so, since sublingual drops
are the same thing as shots,
can companies also just
get grandfathered in
and we can start using that?
Quite a few clinical
studies now evaluating rules
for certain various aspects of
sublingual and oral therapy.
As one of these studies actually
verifies an extract
as showing efficacy.
I hate to simplify
it, but essentially,
what they say is they have
to start from the ground up
and do these well-controlled
studies and meet the standards
since it's a different way
of taking the treatment.
I don't know what the FDA
approves or doesn't approve.
I do know that this
is the same stuff
that they approved for
giving it to me in the arm,
so I don't see
why they can't say
sublingual is just
another alternative way
of delivering the same product.
For our
investigation, we asked
three of the pharmaceutical
companies that make extracts,
if they ever wanted
to get approval
for their stuff to
be used as drops.
You know, did they ever
try and it just failed?
We wanted to know, and
Allergies Laboratory, Inc. said
they have never pursued it.
Greer said they are
planning to do it,
and ALK totally
ignored the question
and responded by telling us
about their brand new pill
that you can put
under your tongue
if you're allergic
to grass or ragweed.
- This was recently approved
through the FDA in this country.
It's been approved in
Europe for about 10 years.
These sublingual
tablets, they're actually
a form of immunotherapy,
right now approved
for only grass and
ragweed in this country,
and they've been show to
be effective for those two
if you have patients who are
only sensitized to those two
so that's kind of our
treatment options we have.
The most important
development has been
the release of the grass
and ragweed tablets
that treat a single allergen,
allergy, if you will,
and that has really
kind of awakened
the notion and
interest in sublingual,
even more than was there before.
For my patients as a whole,
it really doesn't matter
because we do what the
grass tablet is doing.
We give virtually the same dose
and we do it on a regular
basis as part of our treatment.
- It still doesn't address
the multi-antigen approach,
the multiple allergies
that people have and addressing
all of those simultaneously
which is what we do in the
La Crosse method protocol.
Sublingual therapy
is versatile.
You can give a dose to suit
the patient's own
allergy condition.
Each immunotherapy set
that the person receives
is customized for
them, so unlike some of
the newer single antigen
tablets, for example,
that are, quote, one
size fits all, end quote,
with this form of immunotherapy
and the way we do it here,
various things are escalated
at varying rates depending
on the clinical response.
So for example, I personally
see that dust mite,
pollens, cat, dog, tend
to improve more quickly
than something
like mold allergy.
- What we're pleased about is
so here's some FDA
approved products
saying that sublingual works.
It's safe, it's effective
and so it's a step
in the right direction
and we're glad of that.
What's important here
for my life is that
shots and pills only deal
with environmental allergies.
What Allergy
Associates does also
helps you fight food allergies.
When we left there that
day, we had a lot of answers.
I knew that he was allergic
to corn and all corn products,
corn starch, corn
syrup, yeast, grapes,
which I had just sent in
his lunchbox the day before,
and I'd not known
that, but then I knew
why I couldn't figure out
what foods he's allergic to
because corn starch
and corn syrup
and yeast are just
in everything.
So by getting him
off of those foods,
we started immediately
to see an improvement.
Then the magnesium level
was low, and that is
what she concluded was
causing the muscle cramping,
and she said, you know,
it's hard to know for sure
but we think that the
allergies are acting
as a major illness in his body
and depleting his
body of magnesium.
So she put him on a supplement.
My thought, that if the
heart's a muscle, you know,
what effect could this
have taken over years?
Maybe even his life,
if this had not been
diagnosed properly.
I remember I was
allergic to yeast
and I had to eat
this fake bread,
and it's like, what even
is bread if it's not yeast?
I don't even know
what I was eating.
And now I can eat a sandwich.
I can eat anything I want,
almost, except peanut butter.
My peanut allergy is so bad
that they haven't been able
to get that totally
under control,
but they have been able to do
it for a lot of other people.
In addition to getting
him off the foods
that he was allergic to and
the magnesium supplements,
they started him on
the allergy drops,
and that was
wonderful relief to me
because I could
give them at home.
It wasn't another
doctor's appointment
and time off work for me,
time from school for him
usually, and pain, of course.
- It's changed my entire world.
I'm able to have confidence.
People don't know I have
allergies unless I tell them.
That's a huge difference.
Everybody could tell immediately
when I walked into a room
that I had allergies or
I had flu all the time,
one of the two things.
And that's all gone,
so I can actually...
I'm now part of society.
ER visits were
really eliminated.
He wasn't on prednisone anymore,
so the cost of medications
also went down.
Dr. Mary, though, she's my angel
because I really feel
like she saved Alex's life
and the drops have been a
wonderful form of treatment.
He is a whole different person.
In fact, last year, he
ran the Chicago Marathon
and both my husband and
I were just in tears
because we never, ever
would have thought
that this little boy who had
this horrible breathing issue
and asthma and eczema,
we didn't think
that he would ever be able
to do something like that.
I can sit in the
grass with my shoes off
and it's gonna cause
a massive reaction.
I can pet a cat,
I can pet a dog.
I can eat corn, I can
eat my popcorn now.
I went right back
to the allergist
we had dealt with for two and
a half, well, more than that,
two and a half years earlier,
and pretty much went
head to head with him.
I just wanted him to know
exactly what we'd done.
He looked at the documentation,
called it rubbish,
and I said, well, you
know what we've been doing
for several years now
has not been helping.
Alex is visibly getting worse,
and so we're gonna try this
because this makes sense to me,
and he was very angry, but
at that point, I didn't care.
I was gonna try it and I felt
like we were on the right path
and then this last year,
which has been 18 years later,
one of my friends told
me that a man told her
that he was taking
his son to La Crosse
because that same allergist
referred him there,
and I asked her to
repeat the story
because I thought I must
have heard it wrong,
and she said, no, he
actually referred someone
to La Crosse, to
Allergy and Associates,
and I said, well, then
Hell just froze over.
I can't believe it.
The difference now
is my eyes don't water.
I can breathe and I
can be outside 24/7.
I can go camping again.
I can do anything, and this
doesn't stop me at all now,
where before, it was miserable.
Before, it was like,
oh, get Benadryl.
I'm sorry, Benadryl
makes me go to sleep.
They had me on four Benadryl
a day, trying to cover it up,
where now, it's like,
stop, take a squirt.
Twenty seconds,
I'm out the door.
I mean, it's a no-brainer, it's
a game changer in my world.
There's certainly
many allergists
that have practice using
sublingual immunotherapy
and why that hasn't
become more mainstream,
you know, that's a question
I think only the leadership
of the college, the ACAAI
and the Quad AI can answer.
immunotherapy will be accepted.
It's not a question of
if it's gonna become
the dominant treatment.
It's just a question of when.
Patients will drive
it, they'll demand it,
and I think that's
the other reason
you're seeing some of
the work and acceptance
in the American
allergy community
is that they have had
two things happen.
They've had their European
colleagues emphasize
the effectiveness of the treatment,
colleague to colleague,
and you've had patients
come up and demand it
because they have
seen its benefits
in relatives and other people.
There has been a huge
change, I would say,
in the last five
years, especially now
that the science is
solidly behind it,
so suddenly, I'm having
people come up to me
at meetings and going,
wow, you guys were right.
So all of that's been kinda fun.
You should be allowed
the option of using drops.
It's not about
getting rid of shots
and taking this away from
allergists as a great tool.
It's just, let people do it
at home, let people try it.
If you say we can't
let people do it
because they're not
gonna be responsible
enough to do it,
well, that's stupid.
You need to let
people be adults.
And if there's better
ways to do things,
or at least comparable
ways to do things
but more people will do
it because compliance
and adherence and
that'll be better,
we need to pursue those things.
If we're gonna make
any kind of a dent
in the health care
costs in this country
and improve health overall
and all those sorts of things,
that's what we have to do.
We have to be
pursuing those things.
So I think the rationale,
what is driving health care
and health care change today
is different than it was.
We cannot put up
with the status quo.
It just isn't getting
the job done anymore,
and there's so much
innovation out there
that we do need to
find, harness it,
focus it in the right direction.
It's gonna have a huge impact
on costs, health care costs
and also the overall
health of the country.
We're dealing with
the immune system.
As we all know,
it's highly complex.
So as we learn more, the more
we learn, the less we know,
and I think we'll have a
lot of treatment options
in the near future and down the
road, the next 20, 30 years.
Certainly, a young physician
starting out in this field now,
when they reach the stage
after 35 years like me,
there's gonna be a lot of
breakthroughs, I think.
- Was there anybody in history
that my dad really
identified with?
There's a Dr. Semmelweis that
my dad always would bring up.
He spent his entire career
trying to get doctors
to wash their hands, not
only after autopsies,
but in between patients
and he was so ostracized
by the medical community
because of that,
he ended up dying
in an insane asylum.
It was something that now
we look back 150 years ago
and say, how could
that possibly be?
That the doctors
were so insulted
and felt that they were being
accused of killing these women
that they couldn't take
a step back and say,
okay, what could
we do differently?
Which is wash your hands.
So that's the story my
dad always brings up, is,
you know, 150 years from
now, we'll probably look back
and go, well, that was
such a common sense thing.
How could that have caused
a controversy in the
medical community?