What You Can Expect

We listen to our patient’s concerns and discuss various options for care. This conversation is then reinforced by providing each patient with an individualized written plan of care to help manage allergy and/or asthma in their daily routines.

We practice preventive and proactive medicine which means the staff is in regular contact with our patients with active allergy-related problems through telephone and mail. Our nurses triage incoming calls daily and we see patients who need urgent care on the same day that they call, in most situations. A week after the initial patient’s visit we communicate with our patients to follow their clinical progress, answer questions, and provide additional help if needed. We also follow up with a telephone call for patients who require urgent care, acute care, had food oral challenge, drug testing and challenge, problems with medications and other needs. We provide coverage for our patients 24 hrs a day 7 days a week. Due to this approach, our patients seldom visit the emergency room for allergy-related conditions.

We provide frequent updates and important information to patients’ primary care physicians in a timely manner to assure continuity of medical care. We also often contact school nurses to provide education as well as specific plans of action regarding their students and our patients with asthma and food allergies.

Conditions We Treat

As specialists, we provide evaluation, testing, diagnosis and management of the full range of Allergy, Asthma and Immunology conditions, including but not limited to:

Food Allergies

If you or your family member is diagnosed as having a food allergy, you are not alone. Twelve million Americans have food allergies. Approximately 90% of all food allergies are linked to just eight foods: milk, egg, peanut, soy, tree nuts, wheat, fish, shellfish, and more recently, sesame seeds.

The symptoms of an allergic reaction to food can range from a mild rash or gastrointestinal symptoms to anaphylaxis, a life-threatening condition characterized by generalized hives, swelling, closing of the throat, and difficulty breathing that can progress to collapse. Also, many people with hay fever are developing allergies to fresh fruits and vegetables. And a newly described condition called eosinophilic esophagitis can cause difficulty swallowing, acid reflux and eventually severe esophageal obstruction in children and adults.

Our doctors at The Allergy & Asthma Group will take a detailed history and use skin and blood tests to arrive at a diagnosis of your specific food allergy. In general skin testing is more reliable than blood tests, but sometimes neither is conclusive. The most recent 2010 guidelines for food allergy management recommend the use of oral food challenges for more accurate diagnosis.

Oral food challenges, in which patients are exposed to tiny amounts of the suspect food under close medical supervision, can be performed in some children to determine whether the diagnosis of serious food allergy is correct. In many children, food allergy can also be outgrown. This is the usual case for milk and egg allergies, and occasionally for peanuts and tree nuts. Carefully supervised challenges in the office are the only safe way to determine whether a food can be introduced back into a child’s diet.

Based on this evaluation, our doctors will give specific dietary recommendations and provide the education and skills necessary to manage an allergic reaction should one occur. They will also periodically re-evaluate their patients and provide the necessary medical support at all times.

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Seasonal and Perennial Allergies

At different times of year, pollen from trees, grasses and weeds cause seasonal allergies. It’s difficult to avoid these common triggers but these allergies can be treated and brought under control. Common symptoms include nasal congestion, sneezing, runny nose, postnasal drainage, sinus headache, clogged ears, dry cough and itchy, watery eyes. People with perennial allergies may experience similar symptoms all year long because they are caused by indoor allergens such as molds, pets and dust mites. Our doctors and medical staff will educate you on how to avoid exposure to allergens by implementing measures of environmental control. This definitely helps to diminish allergy symptoms, though many people still require treatment to control their symptoms better – one such treatment option is immunotherapy with airborne allergens, which provides long term improvement in most cases.
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Sinus and Ear Problems

Sinus problems are common. They can present as sporadic, recurrent, or chronic sinusitis. Symptoms may include nasal congestion, post-nasal drip, discolored nasal discharge, constant sinus pressure or headaches, and even toothaches. Allergy plays an important role in causing a predisposition to sinus problems by causing swelling in the nasal passages and production of excess mucus. Other risk factors are viral upper respiratory infection, smoking, and immunodeficiency. Nasal polyps may develop, impair sense of taste and smell and often contribute to chronic sinus condition. Continuous nasal congestion may affect the Eustachian tubes, which are essential to drainage of the middle ears, leading to fluid accumulation, ear infections and hearing problems. An Allergist-immunologist is also specialized in the management of sinusitis and ear problems.
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Asthma and Vocal Cord Dysfunction

Asthma is a chronic inflammation of airways in the lungs that causes cough, wheezing, chest tightness, shortness of breath and difficulty breathing. It affects millions of people across the globe. Asthma has increased significantly in the last 30-40 years, particularly among children, and the scientific community is committed to understanding why. Studies have shown that genetics, indoor and outdoor allergens and environmental factors such as pollution are all factors. When treated properly, prognosis is usually good. The airway obstruction that patients experience is usually reversible but if left untreated, permanent impairment of the lungs can occur. Pulmonary function testing is essential to proper diagnosis and management. Our doctors use in-office spirometry to determine the severity of asthma and whether prescribed medications are working optimally. Spirometry may also suggest when medications are no longer necessary. Often, asthma symptoms improve simply by avoidance of allergic triggers identified through allergy testing. For some individuals, more permanent improvement can be achieved with allergen injections designed to reduce sensitivity to environmental allergens.

Other respiratory conditions, such as vocal cord dysfunction can mimic asthma. This condition may manifest with wheezing and shortness of breath, but does not respond to asthma medication. Well-trained and experienced specialists can properly diagnose this condition.
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Drug Allergies

Unlike side effects, Drug Allergies are actually immune system responses to what the body mistakenly perceives as a threat. Reactions range from relatively minor symptoms like skin rash, to very severe symptoms including generalized hives, face, tongue and throat swelling, difficulty breathing and swallowing, vomiting and diarrhea, confusion and fainting. By far, the drugs most people are allergic to are penicillin, sulfa drugs and related antibiotics. Many other drugs also can trigger allergies. Exact diagnosis is determined by taking a detailed history and sometimes by doing special skin testing. Treatments focus on relief of symptoms and strict avoidance of the allergy-causing medication in the future. Occasionally this requires drug challenge and desensitization which is always done by an allergy specialist.
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Skin Allergies

Skin allergies can manifest in many different ways. The most common conditions are hives, contact dermatitis, and atopic dermatitis (eczema).

Hives, also called urticaria, are raised, itchy welts which can be transient or stay for months and years. For difficult cases, it is appropriate to consult with an allergist-immunologist, who is trained to determine the cause and help manage the symptoms.

Contact dermatitis involves a range of symptoms – redness, swelling, blisters, oozing and crusting and could be triggered by nonspecific irritants, chemical allergens and sun exposure. This could affect hands, face or other parts of our body. An allergist often uses an allergy patch test to make a proper diagnosis. Avoidance of identified allergens helps to address a problem.

Eczema, also known as atopic dermatitis, is experienced by people of all ages but more often affects children. A severe form of eczema causes skin changes which are similar to contact dermatitis skin changes. A milder form of eczema manifests mostly as scattered dry patches. Allergy to food plays a significant role in development of atopic dermatitis. Finding the food allergen assures better control of these types of rashes. An allergy specialist could help finding the food allergen, provide a plan of the identified food allergen elimination and efficiently treat these types of rashes.
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Insect Allergies

The stinging insects include bees, wasps, hornets, yellow jackets and fire ants. Most people experience insect stings with minor itching and swelling. However, some people develop allergic reactions to the insect’s venom. Symptoms occasionally could be mild and manifest as local or generalized hives. Quite often allergic people quickly develop a life-threatening anaphylactic reaction which must be treated as soon as possible with epinephrine and then be transported to an emergency room. Based on scientific observations allergy to the stinging insect venom is considered one of the most serious forms of allergic reaction which cannot always be stopped by epinephrine. After the first episode of allergic reaction to the stinging insect venom an individual should be evaluated and tested by an allergy specialist. If the test confirms the allergic sensitivity to the insect’s venom, immunotherapy with the venom preparation should be started promptly. The immunotherapy in this case is considered to be a life-saving procedure, as it is very difficult to avoid subsequent insect stings.
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There are many types of Immunodeficiency and they occur more often than is commonly thought. Most common clinical manifestations of immunodeficiency are continuous or recurrent health problems such as sinus, ear, throat and lung infections, persistent skin rashes, gastro- intestinal symptoms, etc. An allergy and immunology specialist can help by making a proper diagnosis and crafting an appropriate management program to decrease the impact of immunodeficiency to the individual health.
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