Today, I’m talking with Whitney Morgan Block. Whitney is the lead nurse practitioner at Sean N. Parker Center for Allergy and Asthma Research at Stanford University. This center is directed by Dr. Kari Nadeau, one of the nation’s foremost experts in allergy and asthma.
OIT PRIVATE PRACTICE
In this interview, we’re going to be talking about Whitney’s new OIT private practice and how oral immunotherapy for food allergies can be literally life changing.
It’s a relatively new treatment and both of my kids have been through Stanford’s OIT clinical trials with Whitney at the helm. As the lead nurse practitioner, she effortlessly and safely guided our family through the OIT clinical trial process.
Four years later, both of my children have graduated from the OIT trials with tremendous success. Life is so much better now!
Lucky for us, Whitney is now making OIT available to everyone in her new OIT private practice. Her practice is centrally located on the peninsula and serves the entire San Francisco bay area.
Let’s dive into our interview.Whitney Morgan Block is making food allergy OIT available in her OIT private practice. Click To Tweet
Q. What does your clinic: Whitney Morgan Block, An Advanced Nursing Corporation offer?
A. Oral Immunotherapy (OIT) with and without Xolair; food challenges; skin prick tests; IgE testing orders
Q. Where is your office located and what are the hours?
A. 2900 Whipple Ave Suite 132, Redwood City, CA 94062 – across the street from Sequoia Hospital ER; Wednesdays 8AM-6PM (eventually also Fridays 8AM-6PM) – Whitney Morgan Block, An Advanced Nursing Corporation has no relationship with Sequoia Hospital.
Q. What is OIT and is it safe?
A. OIT stands for oral immunotherapy. OIT is the process by which a food allergic person eats gradually increasing doses of the allergenic food to reach a state of desensitization. It has been shown in numerous research studies that this process, if done appropriately, can be safe and effective.
Q. What is Xolair?
A. Xolair is an anti-IgE medication that can be used for the off-label indication of food allergies to accelerate the desensitization process.
Q. Is OIT the cure for food allergies?
A. No, as of right now, OIT is not a cure for food allergies. More research needs to be done to determine if/how it can be a cure for food allergies. Right now OIT can be an effective treatment to achieve a state of desensitization.
Q. What are your credentials and what is your background?
A. After graduating from the Johns Hopkins Accelerated Nursing program and receiving my Masters in Nursing from Vanderbilt University as a Pediatric Nurse Practitioner, I completed an 18 month nationwide tour with the CDC researching youth fitness levels. At the conclusion of that study, I joined the team at Stanford University’s allergy research center who pioneered multi-allergen food desensitization with and without omalizumab (Xolair). I also earned a post masters certificate from University of Massachusetts which allowed me to become a certified family nurse practitioner to be able treat patients of all ages (not just pediatrics). I have been the lead nurse practitioner at Stanford University’s allergy research center since 2013. In January 2016 I expanded my services to include providing OIT services at the Asthma and Allergy Medical Group of the Bay Area.
Q. What services can you provide as a Nurse Practitioner practice?
A. I can and will provide all the necessary services required to conduct OIT, food challenges, skin prick tests, laboratory orders for IgE testing, guidance and instructions related to food allergies.
Q. Do you work under the guidance or supervision of a physician?
A. I do work with a supervising physician and have agreed upon practices and procedures as required by the California Board of Nursing. In the state of California nurse practitioners are required to have a supervising physician and must practice under the standardized practices and procedures agreed upon between the nurse practitioner and the supervising physician. The supervising physician is not required to be physically in the same location while the nurse practitioner is practicing. In many states (22 states + Washington DC) nurse practitioners have full practice authority, meaning they can evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments—including prescribing medications—under the exclusive licensure authority of the state board of nursing (without a supervising physician).
Q. What foods are eligible for OIT?
A. The most common foods people ask me about are: peanut, milk, egg, wheat, soy, cashew, pistachio, walnut, pecan, almond, hazelnut, macadamia nut, brazil nut, pine nut, sesame, sunflower seed, shellfish, white fish, and pink fish. Less common foods include oat, barley, rye, chickpea, coconut, chia seed, and flax seed. If there are other foods not previously listed, that patients are curious about I’d be open to considering them and developing a plan to achieve the patient’s goals.
Q. Is everyone a good candidate for OIT?
A. No, OIT is definitely not for everyone. In particular, it is definitely not suited for anyone with uncontrolled asthma or active eosinophilic esophagitis (EoE). In addition it is necessary for the patient and family to be compliant with dosing protocols and instructions. I can typically determine if a patient is a good candidate for OIT at the first appointment.
Q. On average, how long does it take to complete OIT?
A. The length of time of the build-up phase of therapy depends on which/how many allergens are included in OIT, what the agreed upon maintenance dose is, if therapy is with or without Xolair, and how the dose is tolerated. Typically the build-up phase of OIT with Xolair takes about 3-7 months; the build-up phase of OIT without Xolair takes 7-12 months.
Q. Will doses have to be taken forever?
A. No one knows the answer to this question right now. More research needs to be done to determine what the best maintenance dose is, how often it needs to be taken and for how long. I always tell my patients that they should have it in their minds that they’ll be taking their maintenance dose for a long time and if it’s discovered that it can be shorter than expected they will probably be happy.
Q. What is the success rate for OIT?
A. It depends on the research study that you look at and how you define success. When looking at research trials, you have to keep in mind that some people drop out (for various reasons) and others might not be counted as “successes” for reasons like they didn’t reach their maintenance dose within the defined protocol timeline. For this reason, I normally don’t like to talk about specific numbers unless we’re discussing a specific research study.
Q. How would quality of life be changed post OIT?
A. Overall quality of life typically improves after the OIT build-up, however researchers are still looking into the psychological and emotional effects of OIT. An article published in May of 2017 by Rigbi et al. concluded that “Patients with impaired quality of life at baseline improve significantly despite the treatment burden [of OIT]. Some patients with better QOL at baseline might deteriorate during OIT.” (https://www.ncbi.nlm.nih.gov/pubmed/28542911)
Q. Do you take insurance or do you plan to in the future?
A. Right now I am not taking insurance and the main reason why is most insurance plans state in their policies that they do not cover therapy/treatment for food allergies. I will provide a receipt for the rendered services which will include the treatment codes on it so if a patient wishes to submit to insurance to seek reimbursement they can, however I cannot guarantee that insurance will cover all/any of the charges. In the future if/when insurance companies change their policies to cover treatment for food allergies I will consider accepting insurance.
Q. Do you offer payment plans?
A. I will consider payment plans on an individual basis.
Q. What is the best way to further explore my options with your clinic?
A. Go to www.wmboit.com to learn a little more about OIT with and without Xolair. On there you can also add yourself/your child to the waiting list and one of my schedulers will be in contact with you via phone as soon as they can to set up your first appointment.
Q. Who are your biggest influences? Who or what inspired you to do what you’re doing now?
A. I am motivated by all of my patients. I see how OIT can change not only the patients’ but the entire families’ lives. On a very personal level, my commitment to OIT has been strengthened by recent family developments. My 12 month old nephew broke out in hives after eating peanut butter. The week after, he was diagnosed with a peanut allergy as well as severe eczema. You can bet that my sister and I will do what we can to put him on a regimen designed to desensitize him to peanuts so he won’t have to grow up living with a fear of peanuts.
Q. Do you have any last bits of advice for a food allergy parent?
A. Carry epi everywhere you go even if you are on a maintenance dose of your OIT allergen(s).
Q. How should people get in contact with you?
A. If you are interested in learning more about your allergies, OIT and/or follow-up care including skin prick testing, IgE testing and/or food challenges, go to www.wmboit.com and put your name on the waiting list. After you get your name on the list, one of my schedulers will be in contact with you as soon as possible. On that website are all the prices for services as well as a brief explanation about different options for OIT and quotes from patients about their thoughts on OIT and how it has affected their lives.
If you’re interested in being pro-active with your or your child’s food allergies, contacting Whitney may be the best thing you can do!
Learn more about Whitney Morgan Block: http://www.wmboit.com
Read about Sean N Parker Center for Allergy Research: http://med.stanford.edu/allergyandasthma.html
So are you interested in OIT? Have any concerns about OIT? Share in the comments below.
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