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The Benefit of Allergy Shots
Relief from both seasonal and perennial allergies can be achieved temporarily with medications available both over-the-counter and by doctor's prescription. However, they offer no long-term benefit (in fact, their effect stops when usage is discontinued). Part of the problem with medications is that each is designed to partially block only one specific mediator of allergy- for example, histamine. But any given seasonal or perennial allergy can involve a multitude of other mediators, nearly all of which are unaffected by treatment with medications currently available. Thus, even if you are prescribed several different medications, you'll at best see only partial improvement of your allergy condition. An option well worth your consideration is immunotherapy, which has proven very effective at helping people achieve real and lasting freedom from seasonal and perennial allergies.
One apt analogy for allergy shots is the difference between renting and owning. Five years down the line of taking allergy medications is akin to renting. You leave the way you started. After you have finished a course of allergy vaccination however you are more like an owner. Allergy immunotherapy is just that -- it seeks to make a change in your immune response to the allergy. No other medication does that.
Immunotherapy is most safely and effectively delivered by a board-certified and fellowship-trained allergist, like those at family Allergy & Asthma Care. Our expertise enables us to readily and reliably identify the nature of allergies and make sure you receive the right interventions, taking into full account the vagaries posed by internal medicine problems that allergies can mask or hide behind.
If you would like to discuss seasonal and perennial allergy treatment in further detail or are considering allergy shots (allergy immunotherapy) please make an appointment at one of our locations. We are here to help.
Pediatric Asthma
The Center for Disease Control and Prevention estimates that approximately 6.7 million children in the US have asthma. Not only do they suffer from the disease, many don’t get to experience an important part of childhood development and fun: physical activity. These children miss school too- accounting for over 14 million absences per year. And to care for these young patients, parents miss work. The hours in lose productivity among parents of asthmatic children costs approximately $1 billion each year, according to Asthma Statistics in America. And after reading that these kids make several million physician visits annually and several hundred thousand require hospitalization, it may come as no surprise that the annual cost of treating children with asthma is estimated at $2 billion.
However, when healthcare providers can recognize the symptoms, diagnose the disease and teach young patients to manage it, many of the problems associated with asthma disappear. The desired result of asthma treatment, to prevent chronic and troublesome symptoms with minimal adverse reactions is most often achieved when symptoms are realized early. With symptoms accurately exposed, early, aggressive treatment, when needed, can begin. Family Allergy & Asthma Care welcomes pediatric cases. We offer expert diagnosis and treatment of asthma, allergies, and other related conditions for children of all ages. We work closely with each child’s parents or guardian to ensure the peace of mind of both child and adult.
Early indication of persistent asthma often can be discovered by following the “rule of two,” meaning the two night awakenings or two “rescue medications” per week. A thorough review of medical history may not always be possible with young children, so symptomatic and recent medical events are often most relevant. However, a close look at family history is also critical, which may reveal a history of asthma, allergies or other lung disease. After a full physical examination and listening to the heart and lungs, there are a number of tests that can be performed, including in-office pulmonary function testing. Exhaled Nitrous Oxide (eNO) measurement and allergy tests all can help determine if asthma is present and if there are other conditions affecting it.
With early and accurate asthma identification and aggressive (when necessary) treatment, you can control asthmatic symptoms and flare-ups and live healthy, active lives.
If you would like to discuss pediatric asthma in further detail or have a friend you with to refer, please don’t hesitate to call the Family Allergy & Asthma Care location nearest you.
Seasonal Allergies
It’s springtime in Maryland and the smell of fresh flowers fills the air but you can’t enjoy it because your head is stuffed up, your nose is runny and your throat itches. It’s summer and you have developed itching and hives after mowing the lawn or lying in the grass. Or it’s autumn and plants and weeds are spreading their wind-blown pollen everywhere, causing you congestion and teary-eyes. As you can see, this is part of Maryland presents us with a whole host of seasonal and perennial allergies.
Ragweed, which lives by the side of roads, in vacant lots, just about everywhere- releases pollen from August through November. But the lung- clutching sneezes and wheezes, nasal drippiness, watery eyes, itchy skin and head-pounding stuffiness don’t end there- because soon after comes the pollen from trees (maple, oak, and elm). That problem runs roughly from February through April, then makes way for the pollen generated by grass (Bermuda and Timothy), which doesn’t abate until after June.
All of those are seasonal allergies. There also are allergies of a perennial nature. Perennial allergies have a different set of causes and are present year-round, but the misery is just as intense as the served up by their seasonal counterparts. Sources of perennial allergies include household dust, mold, pet dander, foods, dust mites and their droppings, and decomposing cockroaches and industrial pollution.
What to Know about Skin Testing
Tomorrow's Testing Methods ... Today!
Dr. Eghrari-Sabet and Dr. Dapul- Hidalgo use today's most efficient, accurate and patient-friendly testing methods to diagnose allergies. These include the scratch test for adults and children, which involve the placement of potential allergens on the skin. A tiny piece of disposable plastic is then gently rubbed on the skin to evaluate the skin's reaction.
The results of the scratch test are available in just 15 minutes. You'll be happy to know that Dr. Eghrari-Sabet and Dr. Dapul- Hidalgo invested in a painless method of scratch testing for kids that takes just 5 seconds to complete. If indicated, an intradermal test will be conducted during a second office visit, and with a special numbing cream for optimum comfort. Additionally, a patch test is performed to help diagnose contact dermatitis.
Once your evaluation and in-office skin test is complete, Dr Eghrari-Sabet or Dr. Dapul- Hidalgo will present you with your customized treatment plan.
Direction for EMLA
EMLA is a topical anesthetic which will numb the patient’s arm and therefore make the patient more comfortable when undergoing certain types of allergy testing. We can use EMLA for intradermal testing, stinging insect testing, penicillin testing or influenza testing. EMLA should be applied one hour before your scheduled appointment.
- For intradermal testing for environmental allergies or influenza testing, place a thick coat of EMLA on the outside of both upper arms, from the shoulder to the elbow. You should be able to see the cream. DO NOT RUB IN THE EMLA.
- For penicillin testing or stinging insect testing, place a thick coat of EMLA on the inner surface of both forearms, from the wrist to the elbow. You should be able to see the cream. DO NOT RUB IN THE EMLA.
Wrap both arms in plastic wrap so the EMLA stays in place.
Our medical staff will remove the plastic wrap when the patient is ready for the testing.
Patients need to be off all antihistamine for 3 days prior to testing. This includes: Benadryl, Claritin, Zyrtec, Allegra, Xyzal, Patanase, Astepro, Astelin, and over the counter cough and cold medications.
What to Know about Food Challenges
The area of food allergy is exploding with new information. There are new testing devices to help us pin point who really has a food allergy and new ways of managing food allergy. Within the next few years we may be able to "cure" food allergy. For now we are here to help you navigate all the ins and outs and ups and downs of parenting a child with food allergy.
Check out Dr. Eghrari's recent interview about new blood tests that are available through our office.
Please schedule an appointment for us to discuss if we can help your child build tolerance to certain foods, or needs further testing to determine if they are ready for a food challenge.
An in office food challenge involves feeding increasing amounts of a certain food to see if a patient has outgrown a particular food allergy. Food challenges will last for approx 2 hours, so please come prepared to be in our office for 2 hours, with books, toys and work. Please do not bring other children since this is such a long appointment. Food challenges are done with the first morning or first afternoon appointment. When scheduling a food challenge please inform our receptionist so you are placed in the proper appointment time. You are responsible to bring the food to the appointment.
- Egg challenge: Please make one piece of French toast using one whole egg. You may bring syrup to make the french toast more palatable.
- Peanut challenge: Reese’s pieces and/or a jar of peanut butter with some crackers or bread
- Milk: Please bring a variety of dairy products, which may include chocolate milk, vanilla yogurt, vanilla ice cream and cheese.
- Shellfish: We will let you know which shellfish to bring to the challenge. Try to bring the shellfish with very minimal seasoning.
- Wheat: Water crackers or a simple cracker that does not contain soy, egg, seeds or nuts
Patients need to be off all antihistamine for 3 days prior to testing. This includes: Benadryl, Claritin, Zyrtec, Allegra, Astelin, and over the counter cough and cold medications.
