Our physicians are here to provide the treatment you need for your allergy conditions, combining an in-depth interview, environmental exposure history, and a physical examination together with specific laboratory tests to help arrive at a diagnosis for your specific allergy conditions. Common tests performed in an allergist’s office includes allergen skin testing and spirometry which is a test to measure lung function. One of our allergists will provide individualized allergy treatment plans focusing on environmental avoidance measures and prevention in addition to medical treatment. Allergists are especially recognized for being the expert provider of allergen immunotherapy (allergy shots and sublingual drops). Allergen immunotherapy is the only active intervention that can alleviate allergy or asthma symptoms without the use of medications.
What are allergies?
Allergy conditions are the result of your body’s immune system having a heightened sensitivity resulting in reactions to foreign substances that are otherwise harmless. These substances include pollens (trees, grasses and weeds), animal dander and saliva (cats and dogs), mold spores, dust mites, cockroaches, foods, and medications. Under normal conditions, your immune system would only react if being threatened by harm from pathogens such as bacteria, viruses, fungii, parasites or cancers. However, those who seek allergy treatment often experience specific symptoms triggered as your immune system reacts to those harmless substances. Depending on the severity of the allergic reaction, the symptoms can be relatively tolerable or excruciatingly unbearable.
Common Allergy Conditions:
How do you identify allergens?
We can identify allergens by performing blood tests or skin tests.
How can you treat allergies once you’ve identified them?
We can discuss hygiene and avoidance measures that will decrease the burden posed by the allergen on your body. When these measures aren’t enough, we discuss treatment options with medications, allergy shots and allergy drops.
For Patients doing allergy shots, we offer traditional, rush and cluster protocols to build up to the maintenance dose. Most patients, when presented with the options of the various dosing schedules, choose cluster protocol immunotherapy because it offers fewer visits and faster results compared to traditional schedules and a better safety profile than rush schedules.
Advantages of Cluster Immunotherapy?
More rapid clinical improvement with fewer visits for injections
Reactions to Cluster Immunotherapy
Local reactions (swelling, itching, or tenderness at the injection sites)
Systemic reaction, which may include:
What to do before your visit:
Premedication 1 day prior and the morning of the procedure.
Histamine (H1) Blocker: Options include Claritin 10 mg, or Zyrtec 10 mg, or Allegra 180 mg once a day, Montelukast (Singulair) 10 mg once a day.
Take both pills at the same time each day if possible
Day 1 – Day before CIT Premedication Time
What is Cluster Immunotherapy (CIT)?
Cluster immunotherapy is a method for rapidly desensitizing patients to inhalant allergens. Our cluster protocol involves giving a person multiple allergy injections over several hours over several days, achieving a near-maintenance dose in a very short amount of time. In this way you can do a year’s worth of allergy shots in 3-6 weeks! The procedure involves 2-3 rounds of allergy injections, with incremental increases in dose, which are given in a span of 1.5 to 3 hours. After CIT, a person comes into the allergist’s office once a week for the next several weeks. Then we will start spacing out the frequency of your injections according to our immunotherapy (IT) protocol.
Any drawbacks or risks of Cluster Immunotherapy?
Risk of anaphylaxis (severe allergic reaction) to slightly more than traditional schedules but less than rush protocols. We reduce this risk with a specially designed medication regimen that you take before the procedure
Premedication with anti-leukotriene’s (montelukast) and antihistamines has been shown to decrease the incidence of systemic reactions with CIT significantly May not be covered by all insurance companies, thus cost may be higher Still requires you to continue medication during the build-up phase
How long will it take:
The CIT protocol takes 1 ½ – 2 hours in the clinic.
What to bring on the day of the visit:
Books, activities, laptop, etc.
What we will do the day of the visit:
Make sure your asthma, if present, is under good control.
What happens after CIT:
For most patients, the final dose received during CIT will be repeated for the first post-CIT injection the week after.
For patients who experienced a systemic reaction during CIT, the first post-CIT dose will be lowered.
Following CIT, the regular IT schedule will be followed going forward
Generally if you tolerate the whole protocol you will continue on weekly injections for another 3-4 weeks, then we can proceed to every other week shots, followed by every 3 week shots, then monthly