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We provide a wide range of care with an emphasis on Allergies, Asthma and Immunological disorders. Below is a brief description of some of our specialties. It is not all-encompassing. If you would like to know more about any of these or anything not listed please call us.
Environmental allergies are very common with upwards of 30% of the population experiencing symptoms. We have specialized testing looking for IgE antibodies to these allergens. Accurate diagnosis often consists of skin testing and the results can be read in about 15 minutes. Based on the history, exam and testing we will develop a plan that may consist of avoidance, medications or immunotherapy. Immunotherapy is a process of desensitizing an individual to allergens
Asthma is on the rise, but fortunately the treatments are getting better and better. Asthma diagnosis often consists of a detailed history including symptoms of shortness of breath, cough, and wheezing. We may need to access lung airflow with spirometry, a non-invasive procedure involved forced blowing into a specialized tube. Other types of tests may also be necessary. Asthma consists of three main problems in the lungs: muscle tightening around the airways, inflammation in the airways, and increased mucous production. We will discuss different medication options for each of these problems if needed. There are many Olympic and professional athletes with asthma and our goal is to allow all of our patients to continue life without limitations from asthma.
Food allergy symptoms consist of any of the following: hives, skin rashes, difficulty breathing, vomiting, diarrhea, feeling faint, bloody stools, swelling of the face or exposed area, or itching of the mouth. The rate of food allergies has increased lately, most likely due to the delayed introduction of highly allergenic foods. Diagnosis of food allergies consists of a history of detailing what was ingested, the amount, and time to the reaction and what medicines were needed to alleviate the symptoms. Testing entails either blood tests, or skin tests (placing the food extract on the skin and scratching the skin with a specialized instrument and observing the reaction compared to 2 controls after 15 minutes). We will often do food challenges in clinic or if necessary in a hospital. Food allergy is a hot topic in Allergy research with many new advances on the horizon.
ECZEMA (ATOPIC DERMATITIS):
Atopic dermatitis is a dysregulation of the skin barrier. Often this leads to moisture leaving the skin and resulting dry skin. Environmental or food allergies can often trigger flares and therefore testing may be needed. The main goal of treatment is to keep the skin hydrated and this is often achieved with creams that may need to be medicated.
HIVES (URTICARIA)/SWELLING (ANGIOEDEMA):
Hives can be caused by many etiologies but in most cases they are autoimmune in origin, meaning that it is not something in your environment. Diagnosis consists of history, exam and at times blood or skin tests. Treatments often consist of antihistamines to start and if they are not beneficial other treatments can be used.
Rashes of unknown etiology are often contact dermatitis. The rash often shows up 48-72 hours after exposure. Common etiologies are Poison Ivy or Nickel. Special testing in clinic is often needed in which various standardized agents are placed on the back and the patient returns in roughly 48 hours and then in 72 hours and a diagnosis can be made.
We have specialized testing for various drug allergies. The two most common ones are Penicillin and Aspirin. Penicillin allergy is often labeled on patients and they never had the allergy or have outgrown it. Testing consisting of skin tests and an oral challenge can rule this out in most cases. Aspirin is another agent that can cause various problems from anaphylaxis to asthma exacerbations and desensitization can be done. We have privileges at various hospitals so if needed the procedures can be done in a hospital setting.
Honey bee, wasp, hornets, yellow jackets (flying vespids) can cause anaphylactic reactions after a single sting. We have the agents that cause the anaphylaxis in diluted forms and perform skin testing if necessary. Once we have accurately identified the agent causing the anaphylaxis options include keeping epinephrine on hand or else undergoing desensitization in the clinic. This is a very effective treatment for many individuals.
The immune system helps protect us from infections. Sometimes an impaired immune system is the reason for recurrent infections. Based on history, blood tests may be needed to access for the proper functioning of the immune system.
The sinuses are hallow cavities in the skull that often fill with mucus leading to sinus infections. Symptoms often consist of facial pressure, headaches, difficulty smelling, decreased taste, runny nose, post nasal drip, ear pain, ear infections, and general fatigue. Allergies are often an etiology. Other etiologies are nasal polyps (benign growths in the nose) or anatomical abnormalities. These can often be diagnosed on exam or imaging may need to be performed.