DEAR DR. ROACH: After giving myself allergy shots at home for years, my allergy doctor’s group has decided that it’s too dangerous for patients to do this anymore. The allergy practice will no longer send a vial unless you can prove the shot will be given in a medical facility. Even if you are a nurse or doctor yourself, you still must prove that the shot will be given in a medical facility! Of course, there is a charge per shot if you drive across town to have the allergy practice’s nurse give it. Not long after getting this notice, I read an article about a local child who has improved an insulin injection device. After the alteration, several more doses could be extracted. The article also mentioned children being able to give themselves insulin shots at school! This is such an obvious money grab. How can it be safe for children to give themselves insulin at school but too dangerous for adults to give themselves shots at home? Do you know any reason for this change of policy for giving shots other than docs who can’t get more patients, so they bleed the ones they have dry? — P.S.
ANSWER: Insulin therapy is very different from allergy shots. Insulin is routinely given at home, work and school, and is very safe. The difference with an allergy shot is that you are getting a substance you are known to be allergic to.
Comparatively, there is a significant risk of an allergic reaction. Only 3% to 5% of people getting allergy immunotherapy will have a systemic reaction, and only 1 out of 5,000 shots or so will require epinephrine. That might not sound like a high risk, but for a busy allergy clinic, that means about one person per month. The epinephrine is used to both treat and prevent life-threatening reactions. The guidelines from allergy experts clearly state that injections must be given under qualified medical supervision. Your doctor’s group was not following the standard of care before.
DEAR DR. ROACH: In a recent column, you mentioned that your smartwatch warns you every hour to stand up. Is this a good idea? What else is it good for? — D.K.
ANSWER: The evidence that standing periodically has health benefits is fair. One study showed that when people did light-intensity activity (such as walking) for two minutes a day instead of sitting, premature death rates were reduced. Prolonged sitting is associated with heart disease, diabetes and overall cancer rates. The evidence isn’t definitive, but it’s suggestive enough that I do get up and walk around (when I can) when my watch reminds me that I’ve been sitting for a long time.
It’s not 100% clear that exercise trackers like pedometers and more advanced devices, such as a smartwatch, increase activity for everyone. It clearly does motivate me. I think it’s a personal decision that needs to be made based on whether you need more exercise (nearly everyone would benefit) and whether it would be motivating. I will say that, or many people, the social aspects of it do get some people to exercise more than they would have otherwise. Some devices let you see your friends’ activity and engage in friendly competition and support.