All About Allergies: Everything You Need to Know About Asthma, Food Allergies, Hay Fever, and More

INTRODUCTION

YOU ARE NOT ALONE

Growing up, I had a cow's milk allergy, eczema, and seasonal allergies. My cow's milk allergy disappeared early on, but I dealt with eczema throughout my childhood. I could never wear jeans as a kid because the fabric irritated my skin so much, so I had to wear khaki pants every day. That, combined with thick glasses and a bowl cut, gave me the stereotypical "nerd" look.

Don't get me wrong, being a nerd rules, but in pop culture, a nerd has been synonymous with being weak, a loser, and clutching an inhaler. Think of Milhouse from The Simpsons, Mikey from The Goonies, and Stevie from Malcolm in the Middle. In Hitch, Albert either clutches his inhaler or uses it whenever he sees his crush, Allegra. However, when he throws his inhaler away, he finally has the courage to kiss her. It appears that his asthma is "in his head" and he can get what he wants only when he overcomes his anxiety. Like most allergic diseases, asthma is complicated and highly misunderstood, yet these diseases affect millions of people. People who do not live with these diseases may not realize how severe or life-threatening they can be for someone.

Today, despite being a nerd who spent high school more focused on learning to play the trumpet and hula hooping than impressing my classmates, I am a double board-certified pediatrician specializing in allergy treatment and immunology, who reaches millions on social media, where I raise awareness about allergic diseases and how they can be treated. My food allergies and eczema have resolved, but I still have some lingering symptoms of seasonal allergies that are under much better control, especially around dogs and cats. I never thought that I could have three dogs, but I have used what I have learned over the years to manage my allergies well.

I fell in love with medicine early on because I grew up being immersed in the field. I was fortunate because my dad is a pediatrician, so I spent a lot of time in his clinic and observing the impact that he had on his patients and their families. He was solving complex problems, helping families, and getting to know them along the way.

I wanted to be like my dad.

He told me many stories about when he was a medical student. His first lesson in medical school was about chest X-rays. His professor talked about a patient who died because he choked on a fishbone that, because it was made of cartilage, was difficult to identify on a chest X-ray. He talked a lot about the pace and expectations of medical school, and we realized that because technology had changed so much, medical education had likely changed a lot from when he was a student.

There were no premedical courses or clubs at my high school, so we decided to put in a lot of research to develop our own course, called Dr. Rubin's Mini Medical School. My dad tested the curriculum on me to see if I could understand it as a high school student, and I became his first teaching assistant. The program was an eighteen-hour course separated into six sessions that had lectures and hands-on activities. I learned various physical examination and basic procedural skills that I helped teach to my classmates. I not only felt that medicine was my calling, but I also needed to find some capacity to teach.

Fast-forward to my third year in medical school; I tried keeping an open mind about what specialty I would pursue in residency. I thought about gastroenterology, dermatology, and radiology. Ultimately, I picked general pediatrics. While my experiences with my dad influenced me, pediatrics appeared to be a good fit with my personality and how I wanted to help people, especially children.

In my fourth year of medical school, plans quickly changed. I did an elective rotation in allergy/immunology, and I immediately fell in love with the specialty. Outside of a series of lectures on basic immunology, medical school did not dive into the breadth and depth of allergy. The diseases were complex, and the treatment options were expanding rapidly. I really liked the idea of practicing more preventive medicine and helping keep people out of the hospital as much as possible. It was also a bonus that I would be able to take care of people of all ages, so I could still see my pediatric patients when they were grown up.

After three years of general pediatrics residency, I completed two years of a fellowship in allergy/immunology. However, the beginning of the COVID-19 pandemic occurred right as I was transitioning from my fellowship training to my first job at a private practice. I had moved to a new state and there were limited connections for me. Social events were canceled, and primary care clinics were in survival mode. I decided to start posting on social media to connect with people locally.

At first, I was posting on Twitter (now X) and then I switched to TikTok, Instagram, and YouTube. This helped me connect with people locally. However, I quickly realized that there was a lot of incorrect health information (also known as misinformation) on social media, and I was seeing the effects of this misinformation in my clinic. One time, I met a parent who was putting povidone iodine in their child's nose when their child was sick because they had seen it recommended on social media. Currently, we do not know the risks of putting iodine in a child's nose, and there is no substantial evidence that it can help children.