Review by L Flood
I suspect allergy is a mystery to many of us. We learnt, and just as promptly forgot, the various types of hypersensitivity for higher examinations, but probably now approach the issue in a very unscientific way. Get rid of the dog and try an antihistamine regime; if that works, then yes, you are probably allergic, but I have cured you now. The choice of antihistamine is probably determined more by which pharmaceutical representative sponsors our post-graduate meetings than its pharmacokinetics. If we are fortunate enough to have a colleague prepared to investigate further, we expect a binary, yes or no, answer, but even then we doubt it will change management.
This book should make one rethink all that. It is a paperback, of (large) pocket size, and is packed with valuable information. You do have to love any book that says in the Preface that, if you expected this to be a massive reference tome, you should demand a refund! Elsewhere it says ‘This book is not for the faint of heart, nor those without a sense of humour’. By now I was captivated and knew I would enjoy reading this book. Glancing through the contents, I noted that many chapters contain subheadings entitled ‘Serious Stuff’ or ‘Shocking Information (How to Actually Do This)’, and realised this would prove a very entertaining, informal guide to what is a very complex subject.
The book is very clearly aimed at any ENT clinician considering adding allergy management to their existing practice, and it makes a very good case for doing so. For most of us, sections on the technique of skin testing, the office set-up, or coding and billing will have little relevance. In contrast, the boxed ‘clinical pearls’, the practical management advice and the evidence-based approach to the underlying science all make this a great read for the trainee or the more open-minded senior.
The publisher’s style really favours browsing, with sensible length paragraphs, catchy titles and boxed tips. Who could resist ‘Keep Calm and Give Epinephrine’ or ‘He has to Get Rid of Fluffy the Cat. Right?’ as titles of sections. A great chapter (Chapter 3) is entitled ‘Sensitization versus Allergy’, which sounded worthy if serious. Instead, it proves to be a superb account of how the modern patient can have an absolute, if totally unfounded, conviction about their allergic status, totally at variance with objective findings. The challenge for the scientific clinician is masterfully presented. Elsewhere I learnt of ‘mad honey disease’. The book is full of such treasures.
So (everyone suddenly is starting their sentences with ‘so’, but I digress), this is a highly readable, well illustrated book, giving practical advice on the interpretation of investigation findings, treatment ranging from medication to immunotherapy or avoidance, and finally a range of non-ENT but associated atopic disorders. Throughout, the informal, indeed humorous, approach made for very easy reading, and it presents a very convincing case for introducing such work into our practice.
Amazon Link: Handbook of Otolaryngic Allergy
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