A. An allergist is a doctor who specializes in the treatment of allergic disorders such as hay fever, asthma and sinusitis. Following four years of medical school, an allergist must complete a three-year residency in either pediatrics or internal medicine and pass the board certification process for his or her respective primary field. Then an allergist must complete a minimum of two years of further training, a “fellowship,” in allergy and immunology. Only then is a physician eligible to take the rigorous board examination in allergy and immunology. Only those who pass can call themselves “board certified allergists.”
Q. Do I need to do anything before my first visit?
A.Any previous allergy tests, allergy shot records, x-rays, CT scans, or other relevant medical records will provide valuable information and should be brought to the initial visit. Our office can assist you in obtaining these.
Many medications can interfere with skin testing. For a partial list of these medications, click here. If you have questions about any medications you are taking, be sure to contact our office staff prior to your first visit.
Q. What can I expect the first time I see an allergist?
A. During your fist visit, your doctor will conduct a thorough history and physical exam. Following this, most patients will need to be tested to determine what their allergic sensitivities are. This can be done by either skin tests or blood tests. If asthma is a possibility, your provider may perform a set of breathing tests to measure your lung function. If there is a history of frequent sinus infections, an X-ray or CT scan of the sinuses may be ordered as well.
At the end of the visit, your allergist will gather all the information and recommend a treatment plan that is specific for you. Recommendations for specific allergy avoidance measures will be made based on your specific allergies. Medication recommendations may be made based on your individual circumstances. Your allergist may also recommend immunotherapy, commonly called allergy shots or allergy drops, to desensitize you to your allergic triggers.
Q. Who needs an allergist?
A. Anyone suffering from allergy problems can benefit from an allergy evaluation. Allergy problems may include:
Classic sneezing, runny nose and itchy watery eyes
Nasal congestion and drainage
Wheezing, chest tightness and shortness of breath
Coughing
Sinus infections
Headaches
Ear infections
Ear popping and fullness
Hives
Food reactions
Bees sting reactions
Q. “I’ve heard the testing is really painful and it takes forever. Is that true?”
A.In allergy skin testing, a device coated with an individual allergen or mixture of allergens is used to prick the superficial layer of skin. If a person is allergic, the prick will result in redness and itching of the area lasting 15-20 minutes. The number of tests performed varies based on age and the type of problems you’re having. If prick testing is negative, additional tests may be performed by injecting a tiny amount of allergen under the skin using a very small needle. Special considerations are taken for young children and persons who are “needle-phobic”.
Testing generally takes 30-40 minutes. Most patients describe the process as mildly uncomfortable, but much less painful than they had anticipated.
Q. “Isn’t everyone allergic?”
A. No. Fully one third of patients who undergo testing in our office are
not allergic.
Q. “I really need to be allergy tested, but I can’t come off my antihistamines without getting sick. What can I do?”
A.This is a common issue and can easily be worked around. We can recommend different medications that will allow you to come off antihistamines without getting sick. Alternatively, blood tests can be performed to look for allergies. Antihistamines do not interfere with the blood tests.
Q. “Doesn’t everyone who goes to an allergist just go on shots?”
A. No. More than half our patients do not require allergy shots.
Q. “I have a friend who went on allergy shots and said they didn’t work, so why should I bother?”
A.No “perfect answer” exists in medicine, but studies have shown that 85% of properly selected patients will benefit from allergy shots.
Q. “I’m too busy to get allergy shots. What can I do?”
A. If avoidance and medications aren’t working and allergy shots aren’t an option, then sublingual immunotherapy, allergy drops, may be a good option. They are safe enough to be given at home.
Q. “I’d like to fix my allergies, but I don’t want to be on shots forever.”
A. Typically, a course of allergy shots runs 4-5 years and for the majority of that time, patients receive injections every other week or once a month. The benefits of allergy shots last long after the shots are stopped.
Q. “Are allergy drops homeopathic?”
A.No. Allergy drops, what allergists call sublingual immunotherapy or SLIT, operate under the same principle as traditional allergy shots: administering gradually increasing doses of an allergen will desensitize the body to that allergen. Homeopathic remedies operate under an opposite assumption, that by making a solution less and less concentrated, it becomes more and more powerful. SLIT has data from randomized, placebo controlled medical trials to support its use. Trials examining homeopathy have failed to show effectiveness.
Q. “How old does my child need to be to see an allergist?”
A.Allergy problems can occur in children and adults of all ages. Very young children may develop food allergies or sensitivities to year round allergens such as dust mites. Sensitivity to seasonal allergens such as ragweed or grass and tree pollen typically does not occur until children reach age 4 or 5.
Q. Why allergy shots?
A.Allergy shots have repeatedly been shown to:
Improve allergy symptoms
Reduce medication usage
Reduce the complications of allergies like sinus infections and ear infections
Improve asthma
Help stop the development of more allergies
Help prevent the development of asthma
Help prevent reactions to bee stings
Provide long lasting benefits even after the shots have been stopped
Where can I find out more about asthma?
An excellent resource for people with asthma is the Asthma and Allergy Foundation of America. Visit their website at www.aafa.org.
What about children and asthma?
Asthma is the most common chronic illness among children. If a child's asthma is left untreated, it can result in loss of sleep, exercise limitations, absenteeism, emergency room visits and, in a few cases, death.
The good news? Just like adult asthma, a child's asthma can be effectively treated with medications and “trigger” avoidance. Again, receiving medical help for asthma is essential.
Where do I look for allergens?
Click here to find potential allergens around your bedroom and how to avoid them.
For an appointment or for more information call
(615) 595-NOSE (that's 615-595-6673).
