Lawyer Belinda Koh, 42, has had allergy miseries for as long as she can remember. As a child, she had eczema, asthma and allergic rhinitis. That meant she was either scratching at dry, scaly and itchy skin, wheezing from tortured airways, or blowing a runny nose and wiping teary eyes.
She grew out of the skin condition. The asthma and allergic rhinitis continued, however, leaving her with a constant sniffle, cough and watery eyes.
The last thing she expected was a cure for life. But two years ago, that is what she got, through a relatively new treatment which adjusts the body's immune response to allergens.
But growing up, she tried both Western and traditional Chinese medicine (TCM). Nothing helped.
'I put up with it,' she says.
Allergies affected her two sisters as well, though not her two brothers.
But her symptoms eased a little when she moved to live in England from 1980 to 1995, first studying and then working. Spring and summer the first two years left her with fierce sniffles, as plant pollen gave her hay fever. In her third year, she had injections in the winter to prepare her for the high pollen months ahead.
An allergy is an over-reaction by the body to a foreign substance such as dust mites, pollen, animal hair or foods.
Though she did not know it for sure, Ms Koh felt her trigger was the dust mite, which is a microscopic bug that lives off dead skin cells shed from humans and pets. Feeding grounds for the bugs are mattresses and carpeting, which could have tens of thousands of dust mites feeding, defecating and dying in them.
In 1995, the single lawyer returned to Singapore.
Her body protested.
'When I returned to Singapore, my sinusitis got worse. I would always carry a nasal spray and asthma inhaler with me,' she says. Her doctor told her that the tropical climate is conducive to breeding dust mites, which love humidity.
Finally, she decided to do something about her stuffed up condition and made an appointment with DrPang Yoke Teen at the Centre for Ear, Nose, Throat, Allergy and Snoring in Paragon Medical Suites.
Dr Pang gave her a prick test to find out if she was allergic to the dust mite, as she always suspected. Indeed, the microscopic bug was the culprit.
Then, to her surprise, he offered her what sounded like a cure.
Sublingual immunotherapy (Slit) works by changing the way the body responds to the triggering allergens, in effect desensitising it.
Every morning, for a year, she put liquid drops of allergen solution under her tongue. Every three months, she would collect her three-vial pack from DrPang. It cost her around $2,000 for a year's worth of Slit.
After nine months, she was cutting down on the used of antihistamines and nasal sprays. After a year, she could visit friends with pets without suffering. When the haze hit Singapore last year, the difference in her reaction also showed her that the therapy was changing how her body reacted: 'Two years ago, I had a lot of problems with the haze.'
Haze is atmospheric pollution where dust and smoke accumulate in dry air, resulting in a greyish mist.
'Last year, while I was on the immunotherapy, everyone in the office was getting sick except for me.'
She has both antihistamines and inhalers at home for emergency situations, but has not needed either so far this year.
She says: 'I feel that I now have the freedom to do what I like without being anxious about the physical environment.'
Allergen-specific immunotherapy works by desensitising and decreasing the individual's responses to his or her allergy.
Immunotherapy can be delivered via injection or by drops under the tongue. The latter technique is more convenient and can be administered in the comfort of the home.
The allergen drops are absorbed into the blood stream through the blood vessels under the tongue.
Once the allergen enters the blood stream, it is taken to lymph nodes in the surrounding area, where tolerance to the allergen is built up. Tolerance increases over time as more of the allergen is delivered at regular intervals in small but increasing amounts.
The individual will then mount a minimal response to further allergen exposure, hence achieving relief from the allergy symptoms.
Generally, this can be achieved in 12 to 18 months of treatment. The protection achieved by immunotherapy can last up to 10 years.
Immunotherapy is allergen specific meaning that immunotherapy against dust mites will only work for dust mites and not other allergies.
Multiple allergies can be treated at the same time.
