Don't Feed the Fear: Allergy Anxiety & Trauma
Welcome to "Don't Feed the Fear," where licensed psychologist Dr. Amanda Whitehouse offers expert guidance on managing the social and emotional challenges of food allergies, celiac, and related conditions. Tune in for compassionate advice, practical strategies, and inspiring stories to help you navigate anxiety and trauma with confidence and resilience.
For more info on resources from Dr. Whitehouse, go to www.thefoodallergypsychologist.com
Theme song: The Doghouse by Kyle Dine, www.kyledine.com
Used with permission from the artist
Full transcripts are available to support accessibility and inclusive listening: https://www.thefoodallergypsychologist.com/dont-feed-the-fear-blog
Don't Feed the Fear: Allergy Anxiety & Trauma
Dr. Zachary Rubin on Allergies in the Age of Social Media
In this episode, I’m joined by Dr. Zachary Rubin, board-certified allergist-immunologist, educator, and one of the most trusted voices in allergy and immunology on social media.
Dr. Rubin has built a massive following by breaking down complex medical topics with calm, evidence-based guidance. In our conversation, we go beyond viral posts to explore what it actually means to navigate allergic disease in the modern information landscape.
We discuss how social media shapes patient anxiety and expectations, and Dr. Rubin shares insights from his upcoming book All About Allergies, available for pre-order now and releasing in February, which focuses on empowering patients with accurate, compassionate, and practical medical information.
This episode is an invitation to approach health information with curiosity instead of panic, and to remember that good care is about helping people feel better, not just managing symptoms.
Links:
Dr. Rubin: https://www.oakbrookallergists.com/our-team/zachary-e-rubin-md/
Book preorder (releases 2/24/26): https://bookshop.org/p/books/all-about-allergies-everything-you-need-to-know-about-asthma-food-allergies-hay-fever-and-more-zachary-rubin/a2fea4994be4ecf4?ean=9798217047970&next=t
Special thanks to Kyle Dine for permission to use his song The Doghouse for the podcast theme!
www.kyledine.com
Find Dr. Whitehouse:
-thefoodallergypsychologist.com
-Instagram: @thefoodallergypsychologist
-Facebook: Dr. Amanda Whitehouse, Food Allergy Anxiety Psychologist
-welcome@dramandawhitehouse.com
Today's guest is someone that most of you already know and trust from your social media feeds. I'm joined by Dr. Zachary Rubin, a board certified pediatric allergist and immunologist who has become one of the most recognizable and refreshing voices in allergy education online and in the medical space. Dr. Rubin has a gift for being relatable and personable as he takes topics that are often fear provoking or confusing, and makes them approachable, evidence-based and human. His work consistently centers patients and families while holding a strong line on science, which is not always easy to do in the age of viral health advice. Today, Dr. Rubin joins me to talk about His new book All About Allergies, which is currently available for pre-order and will be officially released in February. The book is an extension of what so many people appreciate about his work online, clear answers, thoughtful nuance, and a commitment to helping people feel more informed rather than more afraid.
Speaker:Welcome to the Don't Feed the Fear podcast, where we dive into the complex world of food allergy anxiety. I'm your host, Dr. Amanda Whitehouse, food allergy anxiety psychologist and food allergy mom. Whether you're dealing with allergies yourself or supporting someone who is, join us for an empathetic and informative journey toward food allergy calm and confidence..
Amanda Whitehouse, PhD:Dr. Rubin, thank you so much for being here with me on the Don't Feed The Fear Podcast. I'm so excited to meet you again and to chat.
Zachary Rubin, MD:Yeah. Thank you so much for having me. I'm really excited to talk with you
Amanda Whitehouse, PhD:I appreciate it. doing my research, I discovered that you had a podcast for a hot minute there.
Zachary Rubin, MD:I did. It was when I was first starting out on social media. posting on Twitter back in the day, I was, I was saying to myself, you know what, I'm gonna, I'm gonna try this for a little bit. And so I, I, I created just like this little educational series about different allergy topics, and I had no idea what I was doing. This was before I was even on TikTok or Instagram, really, uh, just kind of getting my feet wet. And my wife and I are gonna eventually, we're, we're creating our own podcast
Amanda Whitehouse, PhD:So many people will be excited to hear the two of you. Are you ready to share any Details or not yet?
Zachary Rubin, MD:Uh, yeah,, she's an immunologist and I'm an allergist, so it's kind of a bench to bedside type talk, looking at different ways that science intersects with clinical medicine and how it impacts patient care. Uh, so it'll be the two of us kind of bantering back and forth to give people, uh, insight into science and medicine.
Amanda Whitehouse, PhD:I'm sure that'll be a big hit. I'm excited. For those who haven't found her, why don't you throw her, social media handles in there so people can find her if they want to.
Zachary Rubin, MD:Yeah. So she's very active on, uh, Instagram as, uh, Melanie Matthew, PhD. Um, there's a few underscores in there. And then she's also known as laughter in light. Uh, on TikTok,
Amanda Whitehouse, PhD:Perfect. I'll put those in the notes too,'cause I enjoy listening to her as well. You know, you said you started the podcast as you were getting into social media. Tell us a little bit about that journey. Um, I got to hear you talk about it at the FAACCT conference recently, um, which is where I met you. And it, it sounds like it's quite an interesting piece in of itself, how you got involved in how it unfolded and became such a big thing.
Zachary Rubin, MD:Yeah. it was not what I expected. If you had asked me six, seven years ago, I would be doing this, I'd be laughing because. I, I never expected that I would get into this type of work, but really was out of necessity initially. So I had finished my allergy fellowship right when the pandemic started, and so I was moving from St. Louis to the Chicagoland area and trying to grow my clinical practice at a small private practice called Oak Brook Allergists. And the problem was everybody was on lockdown. And when you're a specialist and you're trying to. Get new patients. You meet up with the primary care team, whether it's the pediatricians or the internists, and all their doors were essentially closed. The hospital meetings were shut down. There were no social events going on, so how was I going to meet new people to get referrals? So I decided to go on social media to try to connect with people and. Quickly, I realized that there was a lot of bad information out there about the pandemic, and then also with allergic diseases and food allergies, and so I took it upon myself to start to learn how to create content and to educate people. Starting at Twitter, and then the summer of 2021, I started on TikTok after a medical student from Canada asked me to join, even though I thought it was just a silly dancing app, I had no idea. The power of social media and the power of platforms like Instagram, TikTok, and YouTube. What they do to help put information out there, whether it's good information or not. So good information. And so slowly but surely I practiced it and learned how to. Polish my ability to give good information that was accurate and relatable and easily understandable. Uh, to where now we have about 4 million followers across all the platforms that I share information on, and I'm very proud of the work that I've done with it. And it's culminated now with the book that we're gonna be talking about.
Amanda Whitehouse, PhD:Yeah. Well, and that, that makes me think too, just to back up a little, what an initiation into being a medical professional for you to be entering into your career. Right. During that time, it must have been so challenging.
Zachary Rubin, MD:Yeah, it was, it was very stressful. I'm not gonna lie. I was very worried that I wasn't gonna have a job, you know, because, because I'm trying to learn and grow my own clinical practice with very little ability to actually reach out like we normally do. And it really did afford me opportunities to connect with the public in ways I never could imagine. I was a regular medical contributor for ABC seven News in Chicago, and my face was out there, uh, several times a month, especially on the weekends, talking about what was going on with the pandemic. And then once the seasons were changing. Transition towards talking about seasonal allergies and any type of news story that had a medical spin to it. They would often call me to ask me questions. And so I became a defacto expert because of it. And, uh, every time I have a patient coming in, they've seen me on social media and see the content that I create, and they already have an idea of who I am before I see them. They, they feel like they know me before I know
Amanda Whitehouse, PhD:Yeah. What's that? Like, that, that, that like quasi social, you know, relationship thing It must be weird.
Zachary Rubin, MD:Yeah, it, it's, it's a little unsettling to be honest for me, because. I, you know, I'll be at an airport and people recognize me and I never thought something like that would happen. But I'm also really happy because I realize that even though I'm talking to the screen and creating videos and writing messages, there are real people listening and, and real people who are looking for this information. And so to get that direct feedback means so much to me that it keeps motivating me. To keep doing the work that I'm doing, in all facets, whether it's allergic diseases, infectious diseases, pediatrics, or public health, I'm there to try to help, uh, fill the void of all of the people who are online, who are presenting information in ways that could often scare people or make it seem like it's not taken seriously. You know, we're talking about food allergies today, and we've talked about this, you know, at the FAACT meeting, which is that oftentimes food allergies are the butt of jokes or they're not taken seriously. Part of the reason why that happens is because there's a lack of understanding about what it is like living with food allergies or the challenges of managing it from a healthcare worker standpoint or or a physician standpoint, trying to help guide people in an area that's rapidly evolving.
Amanda Whitehouse, PhD:I'm curious about your thoughts on what needs to be done about that in terms of normalizing and helping people have empathy for our community. When I feel like that exists for many other people with many other diagnoses and somehow for food allergy, it doesn't translate that, that transition toward. Empathy that we're seeing in other areas. Do you agree and what do you think it's all about?
Zachary Rubin, MD:I completely agree with you. This is one of the only chronic diseases where it's made fun of on, on, on national television, you know, and SNL and pop culture. Uh, you don't see that with diabetes, heart disease, cancer, yet food allergies can be potentially life-threatening. We hear about? tragedies on a regular basis, and I think part of that has to do with the fact of. How people perceive the severity of it and how it impacts their lives because it is a bit of a public health issue, right? If you go to a social event and somebody has a food allergy, it doesn't just impact the person with a food allergy. It impacts everybody at the event potentially, and it may be seen as a nuisance or an inconvenience for other people who don't live with it. But if they don't understand why it's important, then it starts to become a, a burden and they don't really see the need and they don't necessarily see what those potential outcomes are because people don't see allergic reactions every day. It it, and sometimes it doesn't manifest physically in a way that looks scary. Uh, so, so it's the same thing with asthma, where it's, it's more internal. You don't see the external effects, like somebody who has an outwardly disability where you can actually visibly see it. It's more of an internal disability most of the time. And so there's a lot of misunderstanding as to how that really affects people and the community around us. Um, and it, and it, there's, even for people who live with food allergies, they're often given information that's incorrect. And how they perceive the world is not always correct as well. And, and my goal is to try to give people realistic expectations, to have a good risk benefit analysis about everyday life in terms of, you know, is this safe to eat? Is it safe to do this? Uh, can we go on a plane safely? Like all these different decisions that you have to make. I try to guide people in a direction that helps them a balanced approach to life.
Amanda Whitehouse, PhD:which must be so difficult in a field where, there's so much individual variation, there are so many different allergens, and each one of them is so different in terms of how likely we are to be exposed or for cross contact to occur, and then the field is changing so rapidly. You know, you acknowledge that in the book, like I'm writing this now, but it changes so quickly. That seems like a really tough challenge to be up against trying to get information out there that's helpful to a wide audience.
Zachary Rubin, MD:Absolutely, especially because of how the media landscape is, is that any study that may have a click-baity headline for either something that's really promising or something that sounds really scary, it gets people's eyes to that news article or to that story. And it's not always necessarily what is the true reality of the situation. And so nuance often gets lost in these conversations. And unfortunately, depending on the health system that you're a part of, you may not get as much time with your doctor, uh, because of how the healthcare system is set up. I'm fortunate that I have a little bit more time with my patients to really try to go over the. Nuance and answer as many questions as possible, but even then, I'm limited to it as Well, which is why I also go to social media to try to give people a little bit of additional information and why I wrote this book,"All About Allergies.".
Amanda Whitehouse, PhD:What is, the thing that you want people to know who are on social media, looking for information as far as what to follow or who to listen to or when to know if you're getting good or bad information?
Zachary Rubin, MD:Right, so it's really important to make sure that you verify. The people who are presenting the information, there are a lot of folks who are not credentialed properly to give out medical advice, and even then you're not even supposed to give medical advice on social media. But if it takes you more than a few clicks from the video or the post to find out what that person's actual credentials are, they're probably. Not worth following or listening to because they're, they're hiding something. And if they're behind a bunch of affiliate links and they're trying to sell you a, a supplement or a particular test or program, you gotta think twice about it in terms of what is it actually, is it gonna actually help you? There may be some significant harms to that, and if you hear content that gets you anxious about something without giving you any kind of nuances to what the situation is, it's just a very. This is the scary situation and that's it. Gotta think about it.
Amanda Whitehouse, PhD:Right. But then people tend to get so wrapped up in that emotional reaction and that fear mongering that, that that logical analysis of the information they're taking in, I think kind of gets lost in the, in the shuffle, unfortunately.
Zachary Rubin, MD:Right, and, and I'll, I'll say, to be fair from my content, sometimes I have to raise alarm bells when it comes to things like food recalls, because people don't necessarily have good access to that information. So if I see a relevant recall related to like a microbial contamination or uh, an an allergen that was inadvertently put into a food product, I'm gonna want to announce that because oftentimes, especially in the current landscape that we're in, people aren't getting that information elsewhere.
Amanda Whitehouse, PhD:and that is really important information to have. But I think. About that. Often when I see your content, you've managed to do that in a way where you're giving good information, not just scaring everybody like a lot of other people are doing out there.
Zachary Rubin, MD:Yeah.
Amanda Whitehouse, PhD:talk to me then please about how the social media growth then turned into a book.
Zachary Rubin, MD:So a little over a year ago now, I was approached by one of my followers who was an editor at one of the imprints of Penguin Random House, uh, one that was specifically for cookbooks, and she was telling me about her story living with allergies, and one of her children was living with various allergic issues and potentially mast cell disorders and said, you know, we don't really have a comprehensive book that's available for the public to learn about all these different issues. I, I could not really find much on there. You'll see a lot of cookbooks, you'll see a lot of things that may be about one issue like food allergies, but nothing that really encompasses. All about allergies. And so she asked me to write this book and I was initially saying to myself, you know, I don't know if I have time. I'm so busy, I'm doing all these different things. And my wife told me, she said, you know, if you don't write this book, I'm gonna write it for you. I was like, okay, I'm gonna write, I'm, I'm gonna write it. She, she really convinced me that this was so important and so I was fortunate that this woman connected me with a literary agency who I really enjoyed talking to. They walked me through the whole process of how you, um, put a book proposal together, putting all your ideas together. I, I wrote a draft. They helped edit it with me and then they shopped it around and very quickly, several publishers reached out and wanted to do this book with me, and I was really excited to sign with Plume, which is an imprint of Penguin Random House, uh, because I felt really aligned with their mission, uh, with the editorial staff. We really just. Got off on the right foot together, and I really enjoy working with them. And I had this internal monologue with myself about how am I gonna motivate myself when I'm so busy to write this book in a timely manner? And I, I just think about my family, my, my grandmother's 93 years old I said to myself, I'm gonna get this book written in a way that will be really helpful, but also. I'm gonna take all my free time so I can get it done so my grandmother could read it and I completed the book and she was able to read it, one of the first people to read it from cover to cover, and she was able to understand the vast majority of it, which made me really happy and had great feedback. Um, so I was just. So excited to be able to get that process through. It's, it's all about allergies. It's, it's a three-part book. that really sets up the stage for people to understand how the field of allergy immunology evolves and how anybody could really learn more about it to empower themselves to then take that information and lead a better life to be able to talk with their doctors about these various issues. And when you have a better understanding of these complex topics, it you feel more empowered to take control of your health.
Amanda Whitehouse, PhD:Yeah, I, I loved the video. I saw your video of you giving her the copy of the book and it was so heartwarming, but I was thinking the whole time I was reading it. How did you do this? You're doing so much. You're obviously, you are working, you're an active working clinician and um, you know, doing all this social media stuff and writing a book, it sounds like in. Like a year. Is that how much time it took? The whole process. I mean, many people, it takes years, especially for such a comprehensive, um, topic.
Zachary Rubin, MD:Well, I, I, I am fortunate that this is something that I'm, I'm very passionate about, that I love doing. I love going to clinic every day. I, I just am a sponge with my patients and I learn so much from them and from my training and, uh, I, you know, I, I made a lot of content about these topics over the years so I could lean on how do I communicate that to people and. Not skimp on the details that, that it's balanced in terms of making sure that it's access is as accessible to as many people as possible, and that's, that's a hard thing to do. But I said to myself when I was gonna go through this process that I'm gonna write every single day that I would spend. A minimum of an hour a day to, to write. And some days I got a little bit more time to write than others. Uh, some days the clinic was a little bit more quiet and less busy, and I use AI software to write my notes, so that saved me an hour to two hours a day that I could use to write a book. Um, I would do that every night before bed. I would, I would make sure that I was writing and writing and writing and rewriting and, uh. I was fortunate that I had a really good outline to start of how I was going to get the book across, and that's part of the process of getting a book, uh, accepted by a publisher is that you, when you're in your proposal, you gotta have an outline. So I had all the chapters that I wanted to write, and my editor really liked the way that I had everything laid out. So that really helped. And, and she was more of a guiding force rather than saying every little sentence has to be perfect before you go on to the next chapter. I think I would've been having a difficult time if I didn't have such a great editorial staff of this book.
Amanda Whitehouse, PhD:Well, it sounds like it all worked out and unfolded just as it was meant to be, and it was so exciting for me to get to read it ahead of time. So thank you for being so generous to have them send me a copy and I will say. Exactly what you touched on was, what stood out to me is this book, we see, you know, environmental allergens on the cover. I think there's like a peanut in there, a couple nuts, right? We think about environmental allergies and food allergies, but that's not the full spectrum of allergic disease. And you and I know most of the people we're working with are not just dealing with one of those, whether it's within the individual or the family system. So I think that is gonna make this so helpful to so many people.
Zachary Rubin, MD:Absolutely. So the book is also meant to give you empowerment towards not just the allergic world, but understanding how do you navigate healthcare and, and there's a whole chapter about what do you expect going into the allergist office that's really applicable. To any doctor's office in terms of coming prepared, asking the right questions, and then it gets into all these different common and not so common diseases and disorders, whether it's allergic rhinitis, non-allergic rhinitis to vaccine reactions to medication allergies, to urticaria, angioedema, hives, and swelling of all different types that affect, uh, millions of people or just a few thousand. And so it really is trying to reach. As many people as possible, since it's one of the most common chronic diseases in the United States.
Amanda Whitehouse, PhD:You did make it very Accessible and digestible like you said, your grandma could read it and understand most of it, which it is a challenge when, like even all the words that you're saying right now are words that most of us look at and we think, well, I don't know how to pronounce that, but I really think you explained it in a way that is as much common language as possible. And when you use a term, you explain it with short phrasing.
Zachary Rubin, MD:Yeah, and, and, and a challenge that I had was trying to. Take the concepts and put analogies to it to make sure that it really makes sense. Because if you wanna learn about whatever disease that you're facing, you do need to have a basic understanding of. Anatomy or physiology, how the body actually works when it's in a normal state versus the pathophysiology, the underlying mechanism of the disease. And so basic concepts of immunology I put in there, um, you know, maybe there was a little bit of an additional amount that may not had to have been there, but I really wanted to make sure that you had foundational knowledge so that you could take that and then say, oh, now it makes sense why my doctor was talking about all these different biologic medications. They are targeting these very specific issues, and why does that actually make sense? I think that will help, you know, turn on a light bulb, so to speak, for many people who are dealing with these severe diseases like severe asthma, eczema, food allergies,
Amanda Whitehouse, PhD:What do you want them to know about allergic diseases themselves as a whole, or if there are specific things you really wanna get across with the book?
Zachary Rubin, MD:Right. So one of the big goals for me is when I think about if as many people could read this as possible, is that we need to take these diseases more seriously as a general community. And it's not to say that the people living with them aren't taking it seriously. I'm talking about people who don't know anything about this. Or who are just curious or have family members who are dealing with this, like you've got a, an uncle or a nephew or a cousin who deal with these things and you don't. If you can pick up this book and start reading about what are the challenges, because I put a lot of stories of patients that I have. Worked with over the years or some of my followers I interviewed for the book, uh, who have told their stories online. I put that in the book in different places so that people can understand that this impacts real people and here are the types of questions that people are asking and that will help improve the empathy issue that we are having with allergic diseases because knowing is half the battle. And if we're able to that knowledge to people, I think will come from much kinder, empathetic place.
Amanda Whitehouse, PhD:Absolutely. And I think what you're saying really shows throughout the chapters and the examples and just the tone that you take is number one, not condescending. It's very like relatable, like you come across on social media, but you acknowledge throughout it like,"This might be frustrating for you to learn. It's, you know, it's okay if you don't fully understand it, but try to start getting familiar." And you, you note in a lot of places that emotional toll that allergies take, which we can't separate from the medical And I think that's a really important piece of it. So thank you for speaking to that too.
Zachary Rubin, MD:Absolutely. I, I grew up living with allergies myself, so, uh, it, it, it's a part of me. It's not the only reason why I went into this field, but, uh, oftentimes I can relate to my patients. I had severe eczema as a child and I never wore jeans, and I, and I felt always like. I had a self-consciousness about it where I always had those baggy cargo pants and I was constantly scratching my skin. It was hard to pay attention in school, and so I wanted to convey how that impacts families. You know, one of my patients who I had started a biologic for, a young kid I talked about, and recently I, I showed the chapter to that family. They were, they were just so excited about it because this child came to me, they were under three and they were just really struggling, not being able to pay attention to sleep at night. The sheets were bloodied every night. The family was exhausted, and when we were able to really get that under better control, it just completely changed. The family dynamics and their lifestyle, and we were all basically crying together in the, in the room when things were working out in a much better place. But, but the advancements in our field are enormous in the last 10 to 20 years that we're able to do these things. Now, compared to when we were kids, we didn't have nearly as many tools to help with
Amanda Whitehouse, PhD:Yeah, can you talk about that? As I said before, it must be hard to write a book about a field that's just exploding with new treatments and new ideas, and you obviously acknowledged all of that. But talk about how all of these options are becoming, you know, available and the impact it's having for clients.
Zachary Rubin, MD:So I would say this explosion's happened about the past 10 to 20 years because there's been a renewed focus on It since it's impacting so many more people that we're in a midst of an allergy epidemic, so to speak. And we're still learning about why that's the case, but because of that. There's more funding and research that's focused on understanding the immunological pathways. And once you understand those pathways and how they could be abnormal, you can then create targeted therapies. So there's a whole class of medications called biologics that have exploded and, and the number of. Diseases that we can treat now with these newer medications. It keeps adding on and on and on. And it makes it exciting for me as a doctor because I'm learning new things all the time. To the point that in my Future Directions chapter at the end of the book, uh, several new changes happened after I wrote the book, like already. And I'm starting to prescribe things that I. You know, featured as a future direction that this is likely gonna happen, but we don't know yet. And now it's here already before the book even comes out, which is, uh, pretty incredible, the speed at which we're doing these things. And as much as I try to be comprehensive about it, there's still a lot more that I wasn't even able to cover as to what we're looking into and what we can accomplish. If you go to these different meetings, there's so many. More research publications and posters being presented. It's an exciting time that I really feel hopeful that we'll have a brighter future for our children and our children's
Amanda Whitehouse, PhD:It certainly looks that way. The other thing in addition to the biologics is all of the immunotherapy options that you also talk about in the book. So can you talk about that and the place of that tool for a lot of families too.
Zachary Rubin, MD:Right. So I do oral immunotherapy for food allergies in my clinic for a few foods. Not, not a, not a lot, but peanut tree nuts, um, sesame chickpea as an example. Uh, and it's really helped provide a relief for some families who really are struggling. With their kids dealing with food allergies because they've either had multiple rounds of anaphylaxis and needing epi, or they're struggling to integrate socially in, in different situations and families wanna feel, wanna be able to do, uh, something for their kids. That gives them some level of protection. So it's something that I I go over in very. Uh, detailed discussions that I don't make a decision with families immediately about it because it confers risk and there's a lifestyle change when you do it. Uh, but, but for families that go through the process, that it, it really works out where the benefits outweigh the risks. It can be a highly effective tool to provide protection, uh, for these kids.
Amanda Whitehouse, PhD:I am curious about your experience with this because, so in my practice, obviously I'm working with people therapeutically, um, on the social emotional part of this, but often the sticking point in those decisions that I'm helping families with is not a cost benefit that you're talking about in terms of the risk of danger, it really comes down to a lot of families or the kids being so terrified of the possibility of a reaction and using their epinephrine, that that's what the whole treatment decision seems to be made on. And I don't know if you're seeing that too. And if so, what do you tell families like that, that are, that are so terrified of that epinephrine that it's running their decisions or running their lives?
Zachary Rubin, MD:Right. You know that that conversation's actually changing a lot right now because of Neffy having a needle free option. Uh, so it is a bit of a shift, and I tried to address that a little bit in the book, but it was a relatively new, uh, uh, uh, indication and approval, uh, from when I was writing it. You know, I really try to reassure families, especially the first time their, their children are diagnosed with food allergies, that, you know what, I know this is a lot to take in, but you're gonna be okay. You're a good mom, you're a good dad. You're gonna take care of your kids. And we need to come to a place where we are balanced in our approach. And, and I talk about this in the book, uh, one of the lessons I learned from one of my mentors in fellowship is this concept of. about risk, and you could be a family that travels and takes a bunch of different airplanes because you're afraid that if one plane goes down, you don't wanna lose the entire family. Versus another family would be like, oh, we're just gonna jump off the plane without parachutes. I mean, we want to get somewhere in the middle where you're comfortable with traveling, you're comfortable with making decisions and being vigilant at the same time. And on top of that, understanding the epinephrine. Is a really important tool to have and not to be afraid of that it is a safe and effective tool when used properly. And even if you overuse it, if somebody was to scoff at that, I tell them, you tell'em to call me and I'm gonna yell at them for you. You don't need to worry about it. Like we're gonna train to make sure that we understand when should we use it. If you're thinking of calling me about if you should use it, you should just. Do it and try to make it as normalized as possible. Now that we have needle free options and a newer one's about to come out soon, um, there's gonna be opportunities to help decrease some of those fears.
Amanda Whitehouse, PhD:Yeah, I expected Neffy. And have been saying too about Anaphylm, which is the under the tongue one that's coming out soon hopefully. I expected there to be, um. More of a shift in my clients and their anxiety about their epinephrine than I've actually seen. Do you think that that fear goes beyond the needle and into what you're touching on? Like it? I'm afraid that using the epinephrine is dangerous or that I'm going to overuse it. There's more to it, I think, than just the needles. Mm-hmm.
Zachary Rubin, MD:Yeah, and, and you're, you are absolutely right, and some of that I believe is just. fear of going to the emergency room. And that's a whole new conversation too, because the guidelines are shifting in terms of the risk benefit discussion about do we do universal EMS activation or not? And that, that's an evolving question. Uh, one of which that I often tell my families, you know, if you've got a young child that's not very verbal, I don't, I I don't care. You're gonna send them to the emergency room regardless of what the guidelines say. Uh, but, but older kids and adults, it's a different story. You know, they're, they're important conversations to have, but I, I do think there is some concerns about financial issues related to being in the emergency room. Um, that's a real, real problem that a lot of families face, unfortunately. Um, and also. People do pass away from food allergies. It's rare, but when you see that happening, it can create a lot of anxiety. Um, and, and some of the discourse that I see on the internet can often be really heightened and really fear mongering that can also wind. Wind people up. Uh, and I saw that recently in my clinic where there was a, there was a family where I'm not, I'm not, I'm gonna be very vague about this to make sure that I'm ensuring privacy, but, but this family was so scared from the stuff they were seeing online that they felt like it was almost like a death sentence to have a child with food allergies. And it really broke my heart because. It's, it is not the worst thing by any stretch of the imagination, uh, for a family member to have a food allergy. And I, and I, I live with it myself as a young child that I outgrew. But, um, I, I, I have to say that there are definitely challenges, but it's not generally a life shortening issue for, for the vast majority of people, it is, it's a lifestyle change. One that we have to be careful with, and because of the fact that about 10% of people have a food allergy now, there's a, there's still a lot more understanding now than there was even 10 years ago. We have a lot of work to do, but we can definitely, you know, still live a, a happy, healthy life.
Amanda Whitehouse, PhD:Absolutely. I think that's a message that we need to say more over and over very often, you know, balancing what you're doing, acknowledging that it is tough. And there are challenges that affect almost every aspect of our lives, but they're not unovercomeable They're, they're all things that we can address. One of my favorite parts, which you touched on earlier, was the section where you talk about preparing for your visit with the allergist I think that's gonna be one of the most usable, sections for people. Are you comfortable sharing the overall takeaway for people as far as walking into the doctor's office and making it a productive appointment?
Zachary Rubin, MD:There's a lot of time that could be better spent if people came in with the data, with the records, with a, a, a good story and outline of what's going on because oftentimes I have to recreate that and, and ask a lot of additional questions that. If we were able to get that focus right in the beginning, it would be a much more productive conversation. Don't be afraid to bring people into, into the room with you if you're, if you're afraid or you may forget things. It's, it's good to have family members with you to help be an advocate. Uh, I, I really find that is a more successful visit when I have more than one person in the room rather than one parent or. Or you know, just one adult patient. I think it's really important to have as many people in the room that will be able to tell the story and to give as much information as possible and for everybody to be open to questions. And also if we're suggesting something that, you know, we really wanna make sure what we follow up and look at this and think of it from the lens of the scientific method. You get all this data together, you have to synthesize it and, and whittle down that, what we call differential diagnosis of the possibilities. And then you have to test that theory out of what you think is going on by either doing additional tests or treatments. Then you gotta follow up and see, was that hypothesis correct? Do we have to reformulate it or are we good to go? And so that follow up is really important.
Amanda Whitehouse, PhD:It was really helpful the way you explained that. Genuinely, a lot of people in our community and any medical community do have negative experiences where they go to their doctor and they feel dismissed or they don't feel heard. And I think you explained really well that differential diagnosis. And just because I'm not telling you, you could have these 12 diseases and here's how I'm figuring out each one. Your doctor isn't always dismissing you. Sometimes they're trying to narrow down that possibility and use that, process of elimination that, that requires us to, like you said, follow through and give you the information that you're looking for. I, I hope people will reframe that as that's not a dismissal. That's you engaging in the problem solving with us.
Zachary Rubin, MD:Exactly. Exactly. And, and so patience is so important. Um, and, and the problem is, is that we don't have enough time with patients sometimes. And so to be able to communicate all those nuances, I try my best to, to at least entertain a couple of those to say, Hey, here's the top three things that I'm thinking of and why I think this is the most likely compared to these. But I need more time to see how do you do with this before we move on? Or if it's like a, an allergic reaction to something, we're not exactly sure what's going on. I may say, look, I don't know what's going on, but let's watch this and come back and, and have a diary and write down everything that's going on, and then let's review it later on, and hopefully, knock on wood, nothing happens, but if it does, we'll be better equipped to synthesize all of that information together.
Amanda Whitehouse, PhD:I can remember as a food allergy mom, going into an appointment trying to do some of my research online. But not understanding skin tests and blood tests and the likeli hood of a reaction and how high the number is. And for you to have explained all that in the book and for someone to not be swimming in those details. Enough that they're able to hear your feedback about what you're finding, I think could be a huge shift. It's hard to explain blood testing and skin testing that's not a post, that's a book.
Zachary Rubin, MD:Exactly. It is a book. And so I've talked about many of these things online for years. You know, on and off, on and off. But you know, the audience is only getting little snippets of that. And now with this book, which I'm really excited that people are gonna be able to read soon, you get all of that in one. Book, you get that as much detail as possible to help you really take charge and understand some of these concepts that will then, like you said, you have a better ability to, to engage in the conversations, to then ask additional questions and have a much more positive experience with the doctors that you work with.
Amanda Whitehouse, PhD:Definitely, I can see how helpful that's going to be. And I know so many people have responded so well to you online you're really resonating with people and I think that's powerful. What do you think it is? Why do you think people are relating to you so much?
Zachary Rubin, MD:You know, I think back to. Kind of how I was raised and my parents in terms of my dad's a general pediatrician. He, he is a kindhearted person, but a little bit reserved. He can be goofy at times, but very methodical, intelligent guy. My mom has the, the biggest heart you'll ever meet, and, and she came from a theater background, did all the, all the shows so she can be, uh, very ex emotional externally and, and, and was a great actor at one point. And so I, I, I feel like I'm a product of those two worlds put together with. A teaching lens because my dad and I, when I was in high school, we created a program called Dr. Ruben's Mini Medical School. Uh, and so it was meant to teach high school students about medical school curriculum. And so my dad would test the curriculum on me. I learned all about it. I was his first teaching assistant, helped run the program, gave lectures, and I took those skills to college and then worked. For a charitable foundation called the Joan C. Edwards Foundation. Six months before I started medical school at Case Western Reserve University, I was, uh, a programs manager and I taught neurology classes at a local public medic high school. And so I had a lot of training teaching. Before I even went into medical school. And, and so I felt like that was always a backbone to me. And during that process of teaching, there was a dress code where they said you had to wear some type of a tie every day. And most of the boys at the school, they just wore bow ties. And so I wore, I taught myself on YouTube how to tie a bow tie. I wore it for a while. And then one day I wore a neck tie. And I'll remember this one student said to me, you know, Mr. Rubin, you're not cool. You're not wearing your bow tie. And so I just basically became a bow tie guy after that and just. Had that with all my videos. I hula hoop for fun. I'm goofy, but I'm serious. So I have these different sides to my personality. The hula hooping is kind of symbolic to just breaking down barriers to just be your authentic self to try something new, to be physically active, but but also just creative and goofy, because we don't see that enough. In healthcare, uh, we see an ivory tower as patients sometimes, and again, you're only in there in a stark white room that is not, you know, it's not a naturally lit room. It's often very artificial. It's, it's a very scary moment for a lot of people where you're showcasing aspects of your life you would never share with anybody else. So you're in a vulnerable position, you wanna have a good experience. With your doctors. So I feel like I, I have been able to establish that rapport because I'm showing my authentic, goofy, but serious self for people and, and giving that nuance that's desperately needed in this space.
Amanda Whitehouse, PhD:I agree so much, and I hope that that's helping to remind people that their providers are people too. You know, just people with all of those sides. Earlier, you said, you know, you never saw yourself here, but it does sound like you always saw yourself heading into the medical direction. Is that accurate? Did you always know that's where you were going?
Zachary Rubin, MD:Yeah, I mean, very briefly I wanted to be an architect as a kid, but I pretty much always knew I wanted to go into medicine. My, my dad took me into his office quite a bit, and I saw what it was like. Seeing my dad working with patients and families. And I'll never forget, there was a, like a career day where you go with your parent to work in middle school and there was this one dad who, who like almost broke my hand. He shook my hand so hard and he said, you know, your dad has, uh, helped my family for like 10 years. And, uh, I love the work that he does. You should be really proud. And that, that has always stuck with me, that I always think of medicine as a calling and as a profession that helps people in ways that. Most fields aren't able to because you get to take care of people in their most vulnerable moments. And then you're also critically evaluating and constantly reformulating what you think is going on and what's going to work best. Uh, which is why I've always felt medicine was, was my calling and, and. The word doctor means to teach, right? You, whether you're a PhD or an MD or a do, uh, the, that backbone is always about teaching, and I've loved imparting knowledge onto other people because, you know, there's that old adage that you could give someone a fish to eat for a day, but if you can teach them to fish, they will then be able to eat for a lifetime. And so knowledge is so important for people to be empowered to do good in this world, which is what is the backbone of what motivates me to keep doing what I'm doing.
Amanda Whitehouse, PhD:Definitely. Well, I'm glad that all of that led to you ending up where the world needed you to be and in this space for all of us. As a psychologist, I was wondering as we wrap up, if you could let people know, is there a mindset shift that you think that this book will help them to accomplish or to experience?
Zachary Rubin, MD:I'm hoping that people will become more empowered and confident when making their medical decisions. And also decisions about lifestyle, right? Uh, how you navigate a social situation when you're dealing with food allergies, as an example, or how you prepare yourself as an athlete living with asthma and thinking about the potential triggers and, and, and so that kind of framework I think will really help people feel more confident and less anxious. About whatever they're dealing with in life. You know, whether it's allergic diseases or not. That mindset, I think will be shifted if you read this book.
Amanda Whitehouse, PhD:I think it will too. Everyone who's listening to my podcast, uh, probably already follows you, knows who you are, but tell everybody again where they can find you, and then the details on when they'll be able to get the book.
Zachary Rubin, MD:Yeah, so I'm pretty much on every major social media platform, whether it's TikTok, Instagram, YouTube, Facebook, substack, and, and Threads. Uh, it's generally gonna be Reuben Allergy. Um, or it's gonna be a Doctor Zachary Rubin, uh, easily searchable online. The book all about allergies right now is available for pre-order. It will be out February 24th. Any major retailer that you buy your books from, whether it's Amazon, Target, your local bookstore, you're gonna be able to find it pretty much anywhere. You can easily Google it. It's not hard to find me.
Amanda Whitehouse, PhD:Wonderful. Thank you so much for being here to talk about it and, and sharing it with all of us.
Zachary Rubin, MD:Thank you so much for having me.
As usual, in wrapping up today, I want to leave you with three simple action steps that you can take inspired by today's conversation. First of course, if you are curious about Dr. Rubin's new book All About Allergies, it is available for a pre-order now and it will be coming out in February. It's a great resource for patients, parents, and anyone who wants evidence-based allergy information without panic or fluff. And to make it extra easy, I'll leave a link in the show notes for you. Second, take a moment to reflect on how you consume health content. Is it all online? Where are you seeking it out or are you not searching for it? It's just being fed to you by your algorithm. Ask yourself, which accounts leave you feeling informed. And which leave you activated or overwhelmed, curious or fearful? Mindful social media use is especially important when you live with a chronic condition. And third, the next story or video that you pause to watch, consider the source. What are the qualifications and the motivations of the person sharing that information with you? As always, thank you for being here and engaging in these conversations with openness and curiosity. If the episode resonated with you, consider sharing it with somebody else who might benefit, and don't forget to subscribe, so you don't miss what's coming next. the content of this podcast is for informational and educational purposes only, and is not a substitute for professional medical or mental health advice, diagnosis, or treatment. If you have any questions about your own medical experience or mental health needs, please consult a professional. I'm Dr. Amanda Whitehouse. Thanks for joining me. And until we chat again, remember don't feed the fear.
