Meet John M. James, MD
Colorado Allergy & Asthma Centers
Food Allergy Action Hero
Dr. James, who lives in Fort Collins, Colorado, is board certified by the American Board of Allergy and Immunology, as well as the American Board of Pediatrics has been with the Colorado Allergy and Asthma Centers since 1997. Dr. James is on the medical advisory board for The Food Allergy and Anaphylaxis Network (FAAN) and is also the medical director of the Parents of Asthmatic and Allergic Children, a support group for asthmatic and allergic children in Northern Colorado.
Recently, Allergy Free Table had the opportunity to spend some time with Dr. James talking about his experience.
ALLERGY FREE TABLE: Why did you choose to become an allergist/immunologist?
JOHN M. JAMES, MD: I come from a very atopic and allergic family including several individuals with eczema, asthma, hay fever and food allergies (my mother and two of my sisters have peanut allergy). These family experiences sparked an early interest in the field of allergy. During my pediatric residency in Salt Lake City, UT in the late 1980’s, I encountered many challenging and interesting patient cases that further stimulated my interest in this area of medicine. I did a clinical rotation during this training program with an Allergy and Immunology specialist to gain a better understanding of this field. In addition, I completed a research project with an immunologist to learn more about the science behind immune responses. I then completed an elective at Johns Hopkins Hospital to gain a better understand what a career in this field would entail. I was fortunate to work with several national allergy experts during that rotation including Dr. Robert Wood, Dr. Hugh Sampson and Dr. Peyton Eggleston. This rotation really confirmed that Allergy and Immunology was the area of medicine that I wanted to pursue further. Ultimately, I ended up doing my fellowship training in Allergy and Immunology at Johns Hopkins Hospital with a specific emphasis on food allergy and this launched my official career as a specialist in this area.
ALLERGY FREE TABLE: How long have you practiced?
JOHN M. JAMES, MD: I have been in clinical practice in this field for 18 years. The first four years, I was in an academic department of Allergy and Immunology at the University of Arkansas in Little Rock. I worked very closely with Dr. Wesley Burks on clinical research studies related to food allergy and asthma.
ALLERGY FREE TABLE: As your career progressed did you see in increase in patients with food allergies?
Yes, the prevalence of food allergy has seemed to have increased over time during my clinical practice. Specifically, the prevalence of allergies to peanuts and tree nuts has increased. We don’t know exactly why this happening, but a great deal of research has been focused on this issue.
ALLERGY FREE TABLE: Please explain this progression based on what you have experienced over the years.
JOHN M. JAMES, MD: No one is really certain why the prevalence of food allergy has increased over the past couple of decades. Like asthma and atopic dermatitis, food allergy has increased in prevalence. This is certainly a very active area of research at the present time and will continue to be in the future.
ALLERGY FREE TABLE: When we met my first impression was that you have an abundance of positive energy, enthusiasm, and a penchant for helping others by giving back to the community. Would you tell our web viewers what organizations you are working with and what you do for them?
JOHN M. JAMES, MD: I have always been a “glass half full person” as opposed to a “glass half empty” person and I try to maintain a very positive and enthusiastic approach to everything I do in my clinical practice and my approach to my patients and their families. In addition, I have always tried my best to become very involved in organizations that relate to the field of Allergy and Immunology, as well as community organizations that complement and support my specialty. I will highlight some of my current activities here:
- I am a member of the Medical Advisory Board of the Food Allergy and Anaphylaxis Network (FAAN), which is a national support group for patients with food allergy and asthma. I currently serve as the medical director of the FAAN Teen Newsletter.
- I am the medical director of the Parents of Asthmatic and Allergic Children support group in Fort Collins, CO. I am also very involved in a Fort Collins food allergy support group called “Inspiring Children with Food Allergies Network” or ICAN.
- I am a member of the Food Allergy Task Force that works with the Poudre School District to help oversee and shape policies for children with food allergies in the school setting.
- I am on the Board of Directors of the American Board of Allergy and Immunology, which is the board that oversees certification for physicians specializing in the field of Allergy and Immunology.
- I am on the American Academy of Pediatrics National Planning Group for the National Conference and Exhibition that is held annually. I am responsible for planning and coordinating programs for Allergy, Immunology and Pulmonary.
ALLERGY FREE TABLE: Now let’s discuss what information you give to families who manage food allergies.
ALLERGY FREE TABLE: When a parent brings in a child who has had a severe allergic reaction what advice do you give them for food allergy management?
JOHN M. JAMES, MD: First and foremost, I try my best to listen to my patients and their specific medical concerns about possible food allergy reactions. After taking an appropriate patient history, performing a physical examination and conducting appropriate diagnostic testing (i.e. skin testing for food allergy), a diagnosis can be established. In terms of medical management, I stress the importance of necessary food elimination diets to prevent further allergic reactions. This can be very challenging because it is critical to eliminate the key food allergen(s) without restricting other foods and nutrients that are needed for good nutrition and growth. Next, I work closely with my patients and their families to develop the safest and most reasonable food allergy management plan. This plan outlines the specific food to avoid, clinical signs and symptoms to be aware of that indicate a potential allergic reaction to a food, medications to use for allergic reactions (e.g. antihistamines and injectable epinephrine) and when to call for medical advice and help (including emergency medical services-#911) and appropriate follow-up measures with healthcare providers, urgent care and emergency room services. Finally, I always try to identify ancillary and related food allergy resources and support groups for my patients with food allergy and their families.
ALLERGY FREE TABLE: How often should food allergy testing occur and why?
JOHN M. JAMES, MD: There is no one correct way to answer this question because what is right for one given patient with food allergy might not be the best approach for the next patient with food allergy. Generally, it is useful to test for food allergy on an annual or every other year basis to see if the allergic sensitivity to a given food allergen is decreasing, increasing or staying the same. This information can be very helpful in determining if the patient might be “outgrowing” a specific food allergy or in other word, developing tolerance to a food allergen. In addition, this type of information can be useful in deciding when a graded, oral dose food challenge in the allergist’s office should be considered and is appropriate.
ALLERGY FREE TABLE: Food allergies are often coupled with other chronic disease. Please explain what chronic diseases and what parents should do to manage them.
JOHN M. JAMES, MD: Two common chronic diseases that have a link to food allergies include atopic dermatitis (i.e. eczema) and asthma. Approximately 30-40% of children with chronic atopic dermatitis that is difficult to control can have a food allergy that might be contributing to this inflammatory and pruritic skin condition. Likewise, some patients with chronic asthma (probably less than 5%) can have a food allergy that is playing a role in the ongoing inflammation of the airways in asthma. For both of these clinical situations, appropriately identifying food allergens as trigger factors and eliminating them from the diet can help in the overall management of these atopic conditions. Granted there are many medications that are readily available to properly manage these diseases. Formulating an appropriate management plan for these conditions with a qualified healthcare provider is very helpful in successfully managing on-going clinical symptoms and achieving the best possible outcomes.
ALLERGY FREE TABLE: You must be very excited about the ‘Guidelines for the Diagnosis and Management of Food Allergy in the United States’ recently released by NAIAD (National Institute of Allergy and Infectious Diseases) and the recently sign federal legislation FAAMA or the Food Safety Modernization Act, which is also known as the Food Safety Bill. Both of these are a result of much advocacy and support.
ALLERGY FREE TABLE: How do you feel the guidelines and legislation will help Americans and especially children with food allergies?
JOHN M. JAMES, MD: First, these types of state, regional and national guidelines help to raise the general public’s awareness of the importance of food allergies. Second, these guidelines and legislation provide much needed education for patients with food allergy, their families, their healthcare providers, schools and the general public regarding the prevalence of food allergy, the appropriate diagnosis and management of food allergy, available treatments including emergency treatment measures and the natural history of specific food allergies. Finally, these measures help to standardize the approach to the recognition, diagnosis and treatment of food allergies, which has been lacking in the past.
ALLERGY FREE TABLE: Thank you Dr. James; we appreciate you taking time for this interview and all you have done to help those with food allergies.