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Allergies
Carlo Martin Alcala
October 2007

When we were much younger, I envied my other siblings because my mother
was extra-doting to them. I had a sweet-tooth, and it perplexed me why my elder
brother Larry could take the honey-flavored Brondil Elixir while I couldnt; or
why my sister would see the pretty lady in white and ride the dentist chair,
oftener than I did.

In retrospect, I think I should feel lucky that during our tender years, I didnt
have Larrys asthma; or wasnt averse to infant milk like Chatty. Without
hesitation, Nanay would dress crab/shrimp/fish viand for me to eat with
gusto, which was much more than what she could do for my young brother,
averse as he was to these crustaceans as well as to shellfish/ molluscs. On second
thought, maybe I must realize that I was not totally out of the woods as Id
love to think, as I shall discuss below.

I was to learn later this thing doctors would call allergy. This scourge
reportedly comes about as a result of the persons exaggerated reaction to a
foreign substance introduced in the body. Whenever food, drug, insect venom, or
toxin enters the body, the immune system identifies it as either friend or foe. In
the latter case, macrophages and lymphocytes, the mainstay white blood cells
produced by the system, surrounds the foreign substance, and eventually engulfs
and absorbs or expels it along with waste byproducts like urine and feces.
Sometimes both processes are involved.

The system, unfortunately, doesn't always work as simply or as fool-proof as it
sounds. Not infrequently, relatively benign or even nutritious compounds that
have been previously tolerated by the antibodies (or soldier cells as they are
called by my physician) may be recognized, quite erroneously as harmful
allergens at a later time. This may happen if the ally resembles or has somewhat
a similar chemical structure as the potentially devastating alien. Thereafter, a
group of mast cells produce histamines to ward off these pseudo-invaders.
Histamines are compounds that command (1) the blood vessels to dilate, thus
lowering the blood pressure (Ephinephrine/Adrenaline is thus the antidote for
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Illustration 1: allergies I contracted in October
October 2010
the resulting lethargy); (2) the invaded organ, tissue or body part to secrete more
fluids, such as mucus in the respiratory organs, against, for example, an
asthmatic attack/ rhinitis; or (3) stimulate the nerves that cause muscles to
spasm, as in the case of diarrhea in reaction to ingested allergens.

Although I have observed how my sister and brothers have outgrown their
childhood allergies, I have read somewhere that allergies may surface later in
life, and that it is usually genetically transmitted.

Due to the stresses of work in 2003, I
easily contracted pulmonary
tuberculosis, for which the doctors
prescribed Rifampicin and
Cotrimoxazole. My sporadic adherence
to these antibiotics proved fatal, as the
PTB recurred with vengeance, and
made me allergic to the drugs. The
immunologist explained to me that
inconsistent taking of the medicines,
instead of desensitizing me, roused
whatever is left of my body's fighter cells to wage an all-out war against what
they identified as allergens. Injections upon injections of anti-histamines knocked
me off to sleep for what seemed like days. To altogether annihilate the PTB,
streptomycin intramuscular shots were administered to me three times a week
for one year in 2005, combined with a cocktail of ingested daily (or oftener)
drugs. While I was not even recovering from the debilitating emaciation caused
by the ancient TB malady, something in my liver acted up and developed in me a
multi-drug resistance. I became even darker as a result of hyper-pigmentation
and what the doctor termed as mild Steven Johnson's Syndrome. A team of
doctors that included my dermatologist friend, a hepatologist, hematologist,
allergist-immunologist and pulmonology/infectious-disease expert tried to
figure out what food, drug or toxin caused my whole integument to grow
blistering rashes.

The red, pimple-like swellings first appeared in the torso, the back, then onto the
extremities, but leaving my dusky face, and most of what is covered by my
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underwear more or less scot-free. The allergist forbade me from eating/drinking:
chicken, eggs, tomatoes, pepper, garlic, onion, sesame seeds, peanuts,
canned/preserved foods including instant noodles and my favorite snack,
Chippy, soda, and anything with just a
tiny fraction of any these in it. The
pulmonologist banned the taking of
Azithromycin and Crixivan. The team
prescribed antihistamines in increasing
order of potency: Iterax, Telfast, Benadryl,
etc. Initially, I would feel groggy upon
ingestion, but eventually, after I became
impervious to the soporific effects of the meds and had bouts of insomnia, my
neurologist cousin would prescribed even more pills: Unisom, Stilnox.

Apart from the topical ointments and creams I applied twice daily after each
bath, my dermatologist friend punched out a sample section of my skin and had
it examined by a Manila laboratory. The diagnosis was Ulticaria multiformes or
hypersensitivity drug-reaction. In other words, my body rejected drug therapy
and wanted to be left alone.

The overall attending physician would have none of this finding, however. As
she painstakingly researched for second and third opinions, I patiently (and I
was notorious for being the impatient patient!) continued with all the drugs, and
slowly, secretly inched my way back to eating little amounts of the prohibited
foods.

The bulbous rashes (on their own, I suppose) gradually flattened and coalesced
with each other as they healed and became dark scars. Immune reconstitution
followed. Your lungs are clear, my doctor mumbled to herself, as she
quizzically pressed the lymph nodes behind the cheeks and at the depression of
the clavicle bone. I didn't exactly understand what she meant, although I could
care much less for as long as I was up and about.

Before I left Bacolod for Cebu in 2005, the doctors' words reverberate through my
head: You're not out of the woods yet.

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Recently, I chanced upon an article that spelled out the worst scenario in
allergology/immunity, which is autoimmunity-- when the formidable and
overzealous combatants of the immune system attack other substances or
enzymes that naturally occur in the body. Racing through my thoughts are the
times when my father was diagnosed to have diabetes (a case when the bodys
immunity responds by attacking the insulin-producing cells), and when my
sister said she has mild lupus. Hopefully, I will not have to endure these forms of
self-loathing and/or identity-crisis in my lifetime. Against the odds, how I
wish my immune-abnormalities would remain confined to those merely
acquired, rather than inherited.