Frequently Asked Questions

General Questions Allergy Shot Questions Allergy Testing Questions Asthma Questions

General Questions

Q: What should I expect during my initial evaluation?
A: You should allow about 2 hours for your first visit. It will probably consist of a complete history with special detail regarding the allergic aspects of your symptoms as well as extensive physical examination, laboratory evaluation, and perhaps allergy skin testing and/or pulmonary function testing. The number of skin tests, laboratory procedures, and office visits needed for complete allergy evaluation varies from patient to patient. Following the initial visit, medication and avoidance measures may be prescribed, and you may be asked to help monitor your progress. After studies are complete, the allergy diagnosis is discussed, a course of treatment is outlined, and an allergy summarizing letter is sent to the referring physician.
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Q: What should I bring with me to my first visit?
A: Please print and fill in the New Patient Packet (“Patient Forms” on our website). You should also bring in any previous medical records as they may be helpful to your provider. If you have hives or skin rashes, then it is important to bring a full list of your cosmetics, toiletries, fragrances, and other products with which you come into contact or to which you have exposure. Please also bring a complete list of your current medications (this includes prescription, over the counter, vitamins, and alternative therapies).
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Q: Do I need to bring in my old records and how do I get them sent?
A: Yes. Your prior records can be helpful, especially previous x-rays, scans, and tests completed. You can contact your previous doctor’s office before your visit with us and have the records mailed to our office, or you can complete a form at your visit with us and we will fax it to the other office for release of your records (you will need to provide their fax number).
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Q: What should I expect during my follow-up and interval office visits?
A: Follow-up and interval office visits may be suggested to monitor your progress. If you need an appointment please contact the office. If you begin receiving allergy shots, we usually like to see you in follow-up at seven months, twelve months, and then annually after beginning injections. We respect your time and try to see you at your scheduled appointment time. However, as in any busy medical office, emergencies and special situations sometimes cause us to see patients later than originally scheduled. Please bear with us during these times.
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Q: Why do you need to see my insurance card at every visit?
A: We must view your insurance card at each visit to ensure that all information is the same as what we have in our system so that we correctly file your claim.
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Q: I am running low on my prescription – how do I obtain more medication?
A: If it has been less than a year since your last physical exam, then your prescription can be obtained by calling us ("Contact Us" on our website). Our office will call in the refill to your pharmacy. If it has been more than a year since your last office visit, then we will notify you that you need to make an appointment before we can proceed with your refill.
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Q: Does my pharmacy need to fax my refill to your office?
A: Yes.
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Q: Does your office treat patients with Immunodeficiency states like common Variable Hypogammaglobulinanemia (CVIG) and Common Variable Immunodeficiency (CVID)?
A: Yes, we test for low gammaglobulin (low antibody) states as well as complement deficiencies and deficiencies in cellular immunity when needed.
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Q: Does your office see children of all ages?
A: Yes.
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Q: Does your office administer allergy drops?
A: No.
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Q: Do you give vaccinations/immunizations?
A: Only the Flu shot and Pneumonia vaccine.
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Allergy Shot Questions

Q: What is an allergy?
A: An allergy (or hypersensitivity) is an abnormal or altered reaction in the body to an ordinarily harmless substance. The substances that cause allergic reactions are called allergens. These allergens may be inhaled, swallowed, injected, or contacted by the skin itself. Common allergic diseases include hay fever (allergic rhinitis), asthma, eczema (atopic dermatitis), hives (urticaria), contact dermatitis, and insect sting allergy.
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Q: What is an allergy shot?
A: Allergy shots lower how sensitive you are to certain things around you. They do not deliver medication. An allergy shot contains extracts of allergens (such as pollen, dust, mold, and insect venoms) that are mixed to match the allergic sensitivities found through your skin test and RAST scores. After the formula is mixed, it is then diluted to a very weak strength. You will start off in the weakest dilution and gradually climb to the strongest dilution. Allergy shots will increase your resistance to the allergens that bother you so that when you are exposed to these things your symptoms will be less severe to non-existent depending upon your response to the therapy.
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Q: Do I get to stop all medications once I start allergy shots?
A: No, but that is the goal.
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Q: How often and for how long do I have to take allergy shots?
A: It usually takes several months to climb through the dilutions before reaching a maintenance dose. While you are climbing, you will need to take the shots once a week. Most patients are on a once a week schedule for one year, every other week for one year, and once a month for two (2) years after which the patient can usually stop. Most patients stop their shots after 4 years, although some patients continue allergy shots for a longer period of time.
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Q: How long before I notice improvement with allergy shots?
A: Most patients do not notice immediate improvement with shots until 6 or 8 months into therapy. There are some patients who notice results earlier, but that is not usual. Since the shots do not work right away, it will be important for you to be on a daily routine of medicines to help control your symptoms until the allergy shots take effect. After the shots begin to alleviate your symptoms, we will gradually diminish your medications. After the first year, most people notice significant improvement. Over the next several years patients will continue to improve.
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Q: Why does it take so long for allergy shots to begin working?
A: Allergy shots teach your immune system to better tolerate the allergens with which you come into contact. Through repeated exposures to the antigens in your allergy extract, your body learns how to properly process the antigens. It usually takes a year or more to change your body’s response to the allergens. Once this progression is achieved, patients typically have a better quality of life without shots or medication for their allergies.
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Q: Why do I have to get allergy shots in a doctor’s office?
A: Generally speaking, allergy shots are quite safe. Sometimes they can cause reactions. This is because they contain the very things to which you are allergic. A reaction can happen right after you get your shot or it can occur later in the day. If a serious reaction is going to take place it will usually happen soon after you take your shot. This is why we require you to wait in the office for 30 minutes after each shot.
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Q: What types of reactions can happen?
A: There are two types of reactions that can occur:
  • Local Reactions: Local reactions occur at the injection site and usually involve redness, itching and sometimes swelling of the arm. You should let the nurse know you have had a reaction before you receive the next shot so that proper adjustments can be made.
  • Systemic Reactions: This type of reaction is very rare but it is possible for you to have a systemic or “life-threatening” reaction to your allergy shot. These types of reactions usually happen within the first 15 minutes of receiving a shot. This is why it is so important for you to wait in the office for 30 minutes after every shot. Signs of a systemic reaction are: itching of the throat, nose, eyes, palms and/or skin; hives, sneezing, wheezing, shortness of breath, difficulty breathing; swelling of the tongue, lips or throat; faintness or any unusual symptom. If you notice any of these symptoms after receiving a shot, report to the nurse at once!
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Allergy Testing Questions

Q: How do you test for allergies?
A: There are many ways to test for allergies. Blood tests, prick skin tests, intradermal skin tests, patch tests, and drug challenges are some methods we use.
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Q: How long do I have to be off my medications for an allergy test?
A: Please consult the following document for more information: Medications to Stop Before Your Skin Test
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Q: How long does skin testing usually take?
A: Please allow an hour minimum. The actual test takes 20 minutes once it’s applied. After it is read, your results will be discussed with you the same day.
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Q: Is skin testing painful?
A: No. It may be uncomfortable if you react to any of the allergens, as this will produce itching. We use dull scratch needles that feel like the tip of an ink pen.
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Q: Can you skin test children?
A: It depends on the child's age. This can be discussed with your doctor during your first visit.
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Q: Can I go back to work after being skin tested?
A: Yes.
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Q: Does your office skin test on the initial visit?
A: Not usually, but will if you request to do so and are off all medications.
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Q: How long does patch testing take to get results?
A: Patches must be worn for 48 hours before being read.
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Q: Does your office test for medication allergies?
A: Yes. We do drug challenges. This can be discussed during your first visit.
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Asthma Questions

Q: What is asthma?
A: The disease of asthma is a reversible bronchial blockage of the airways. It is characterized by swelling of the airway wall caused by inflammation that can be triggered by several causes, the most important being allergic inflammation.
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Q: Who is likely to develop asthma?
A: Asthma tends to run in families although this is not always the case. Allergy, which is a predominant cause of asthma, also tends to be familial. Newer data reveals that children who have wheezy bronchitis that resolves before age 6 are not likely to experience asthma in adulthood. However, children who continue to have asthmatic episodes after age 6 are more likely to experience asthma later in life.
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Q: What factors trigger asthma?
A: There are many things that can trigger an asthma attack, such as:
  • Allergen exposure (mold, dust mites, pollen, and pets)
  • Viral or bacterial infections
  • Gastroesophageal reflux (also called GERD)
  • Drugs such as Beta Blockers, Aspirin, and other Non-Steroidal Anti-Inflammatory drugs
  • Cigarette smoke, air pollution, and fragrances
  • Drafts and cold air
  • Exercise can precipitate Asthma
  • Rarely, foods
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Q: What are the most common treatments for asthma?
A: Because there are many causes that contribute to asthma, it is important to identify the cause in each person. When asthma is caused by allergy, topical steroids and either short and/or long acting bronchodilators are effective. Sometimes these medications are supplemented with Leukotriene Antagonists such as Singulair and Zyflo. In addition, systemic steroids like Prednisone and/or Theophyllines are sometimes used. For long-term treatment, allergy injections and avoidance measures of triggers are important. Another new agent for treatment of asthma is Xolair which is used to help decrease the use of steroids and exacerbations (asthma attacks).
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