“Oh dear,” the doctor said, studying the grid of hot itchy bumps on the back of my arm. He singled one out and poked it. “This little fellow, this is tree pollen. But this big guy here is the real culprit. Ragweed.”

I’d already told him I was allergic to ragweed, a fact I’d established definitively through two decades of end-of-summer misery. But he was the doctor, and pricking new patients with a potpourri of allergens was his method.

“You’re what we call ‘highly allergic,'” he said.

“Yes, I know,” I said.

“Actually, ‘severely allergic.'”

Which is exactly what I’d told him before the test.

He explained that allergies were a kind of mistake, the immune system encountering an unfamiliar bit of fluff and mistaking it for a dangerous pathogen.

I nodded patiently, but really, this was Allergy 101.

Then he opened the doors of one of the bland wall cabinets and started pulling samples from the shelves.

“Let’s see…” he said. “Allegra-D, sure. Nasonex. Singulair. Hm. What else?”

“All of those?” I asked.

“Oh, yes. Also daily nasal washes. And we’ll get you started with the immunotherapy next week.”

The immunotherapy, he explained, was a course of weekly injections of a special cocktail of allergens, designed to deaden my immune response over time.

“We’re really going to load you up,” he said gleefully. “By the end, the dose of ragweed will be hundreds of times what you’d get from seasonal exposure.”

“So I won’t be allergic any more?”

“Not really. But the drugs will control any residual symptoms.”

Immunotherapy sounded pretty good — except for the ‘residual symptoms’ part — especially in light of the fact that my health insurance was going to cover everything but the co-pays.

The prescription drugs were another story, but the doctor told me that his cabinets were overflowing with free samples. He drew a pie chart to explain what each of the them was supposed to do.

“Actually,” he said, conspiratorially, “a nasal wash with buffered saline solution is the single most effective treatment there is. It’ll take care of 50% of the symptoms.”

The other 50% was divided into three wedges: an antihistamine; a nasal steroid, and a bronchial anti-imflammatory.

“But the immunotherapy is the big gun,” he said.

So every Tuesday for the next two years, I appeared at his office, greeted the nurse, bared my arm, and got my shot. It was pretty bad at first: swelling and itching at the site of the injection, followed by a day or two of nausea and feeling wiped out. But eventually my body got used to the weekly envenomation.

I collected free drug samples by the bagful, although at a certain point, the supply of Allegra-D dried up, and I was forced to start paying for it. Which, in retrospect, was pretty standard drug-dealer behavior.

Ragweed season came and went. The treatment was working! I could breathe pretty well — I’d give the breathing a strong C+ or a weak B-, which was a vast improvement over decades of Ds and Fs. But that C+ or B- was now a year-round grade, not just a seasonal one, thanks to the weekly injections. Basically, my allergy-season misery had been amortized, spread across the entire calendar, rather than being confined to spring and late summer.

Not to mention the fact that all of the prescription drugs in my system were having some significant side effects, like mental fog and insomnia.

But I soldiered on. This was modern medicine! I wasn’t going to let the sex dust of a common field weed claim victory over my body. More injections! More drugs!

At the end of the second year, I came in for another allergy test, identical to the one they gave me on the first visit. If I was cured, this time I wouldn’t react to any of the allergens. The nurse loaded up her miniature bed of nails and pressed it into my arm. We waited fifteen minutes. Then the doctor came in.

He studied the back of my arm. “Hm,” he said. “Looks like you’re quite allergic to ragweed.”

“Still?” I said. “After all that?”

“Sorry, buddy,” he said. “Seems you’re in that small group of people who don’t respond so well to immunotherapy.”

I left the office that day and never went back.

The immunotherapy had cost my insurance company thousands of dollars, and had cost me significantly in lost productivity. The prescription drugs had done their job, but with plenty of tedious side effects.

The nasal wash, on the other hand, while unpleasant, was surprisingly effective. And cheap. A year’s supply of the little salt packets costs about $25.

Lately, I’ve been taking a generic version of the drug Claritin called “loratadine.” The price for loratadine plummeted when the manufacturer’s patent for Claritin expired. You can get a year’s supply from Costco for $15.

These days, I’d give my breathing a B or B+.

Disclaimer: I’m no doctor, and you shouldn’t decide on a course of medical treatment based on a newspaper article. This is just one man’s experience with the limitations of expensive, corporate, profit-driven 21st century doctoring.

The insurance company paid for most of my treatment, but I’d estimate that my own outlay was on the order of $500 a year, between co-pays and prescriptions.

I’ll take the $40 a year treatment that works better, thank you very much.

Those savings are…nothing to sneeze at.

This column was published in the Perry Co Times on 12 April 2012

For more information, please contact Mr. Olshan at writing@matthewolshan.com