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Congratulations to Dr. Wexler for being selected to Mpls. / St. Paul Magazine's annual Top Doctor list for 25th time!
Six Twin Cities Top Doctors who are on the forefront of innovation in medicine weigh in on the medical breakthroughs—from healthier kids to better sleep—we can expect in the next 20 years.
by Rhoda Fukushima | July 2, 2015 | Mpls St. Paul Magazine Article |
25 years of Top doctors recognition
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MANAGING ALLERGIC RESPONSE
Michael R. Wexler is the son of a doctor and the father of a doctor. He is a board-certified allergist/immunologist and pediatrician specializing in allergies, asthma, and immunology. A graduate of the University of Minnesota Medical School, Wexler practices at Advancements in Allergy and Asthma Care Ltd. He is also on staff at several local hospitals and is an associate clinical professor at his alma mater. In September 2014, his practice began offering the FARM (Food Allergy Risk Management) program.
What troubles you about how food allergies are traditionally managed?
The normal course is to identify what someone is allergic to, then avoid it. If the kids happen to eat [what they’re allergic to], you treat it with emergency medicines. It’s very unsatisfactory for parents and physicians to be told, “Just do your best to avoid the food.” There’s no in-between.
How can we prevent this?
There’s been a lot of discussion over the years about trying to desensitize children. They were seeing results a couple of decades ago when they were doing allergy shots with food. Then there was a mistake, tragically, and the child died. That was the last big approach before switching gears and introducing the food orally. Dr. Richard Wasserman has been a real pioneer.
How does FARM work?
Rather than just give medicine to treat the symptoms, we’re trying to train the body to tolerate it. The very first dose is 2.05 micrograms of peanut. One peanut weighs 250 milligrams. We have only been doing peanuts.
While we do the buildup phase, the kids eat the food twice a day within a window of time and they can’t exercise for a certain time before and after eating. If they’re sick, we have to back down a bit. If things go smoothly, the kids will get their maintenance dose in four to six months. Some parents are happy if the kids can eat foods with trace amounts [of peanuts] safely. Some parents want their kids to be bite-safe. The current recommendation is that they eat the food daily, indefinitely.
Have there been any side effects?
It’s rare, but sometimes the kids have allergic reactions and they need epinephrine. Typically it occurs when they’re exercising or sick. The most common concern is developing eosinophilic esophagitis, an allergic condition of acid reflux. We watch for it.
Has the FARM approach been tested independently?
Dr. Wasserman and I are clinicians. We know the kids and can see what is happening. I understand the way of medicine is very controlled studies, but the approach has been so slow and cumbersome. Dr. Wasserman has desensitized about 300 kids and adults. He hasn’t had anyone who developed eosinophilic esophagitis. As long as we’re careful and know when to back off, it seems to be safe for the vast majority of people.
Michael R. Wexler is the son of a doctor and the father of a doctor. He is a board-certified allergist/immunologist and pediatrician specializing in allergies, asthma, and immunology. A graduate of the University of Minnesota Medical School, Wexler practices at Advancements in Allergy and Asthma Care Ltd. He is also on staff at several local hospitals and is an associate clinical professor at his alma mater. In September 2014, his practice began offering the FARM (Food Allergy Risk Management) program.
What troubles you about how food allergies are traditionally managed?
The normal course is to identify what someone is allergic to, then avoid it. If the kids happen to eat [what they’re allergic to], you treat it with emergency medicines. It’s very unsatisfactory for parents and physicians to be told, “Just do your best to avoid the food.” There’s no in-between.
How can we prevent this?
There’s been a lot of discussion over the years about trying to desensitize children. They were seeing results a couple of decades ago when they were doing allergy shots with food. Then there was a mistake, tragically, and the child died. That was the last big approach before switching gears and introducing the food orally. Dr. Richard Wasserman has been a real pioneer.
How does FARM work?
Rather than just give medicine to treat the symptoms, we’re trying to train the body to tolerate it. The very first dose is 2.05 micrograms of peanut. One peanut weighs 250 milligrams. We have only been doing peanuts.
While we do the buildup phase, the kids eat the food twice a day within a window of time and they can’t exercise for a certain time before and after eating. If they’re sick, we have to back down a bit. If things go smoothly, the kids will get their maintenance dose in four to six months. Some parents are happy if the kids can eat foods with trace amounts [of peanuts] safely. Some parents want their kids to be bite-safe. The current recommendation is that they eat the food daily, indefinitely.
Have there been any side effects?
It’s rare, but sometimes the kids have allergic reactions and they need epinephrine. Typically it occurs when they’re exercising or sick. The most common concern is developing eosinophilic esophagitis, an allergic condition of acid reflux. We watch for it.
Has the FARM approach been tested independently?
Dr. Wasserman and I are clinicians. We know the kids and can see what is happening. I understand the way of medicine is very controlled studies, but the approach has been so slow and cumbersome. Dr. Wasserman has desensitized about 300 kids and adults. He hasn’t had anyone who developed eosinophilic esophagitis. As long as we’re careful and know when to back off, it seems to be safe for the vast majority of people.