Skin Testing
Skin testing is the most convenient,
efficient, and reliable procedure used to aid us in the diagnosis of suspected
allergies in you or your child. In this procedure, solutions made from extracts
of pollen from trees, weeds, grasses, mold spores, house dust, foods, cats,
dogs, etc. are placed in the superficial layer of the skin. This is the most
common method of skin testing and is often referred to as the "prick"
method. These tests are performed on your back and/or on your arm depending on
the number of skin tests to be performed.
A very small sharp
plastic like device, often referred to as a "prick", with a
droplet of the solution (extract) is used to barely prick the outer layer of
skin placing the extract just under the skin’s surface. We utilize both
individual prick applicators and multi-pronged applicators for the
administration of our skin tests. The multi-pronged applicators are most often
used for our pediatric patients.
Reactions to the extract, red bumps, will
develop generally within 20 minutes of application. These reactions indicate
positive or negative results. They are measured, interpreted and documented in
your chart. Your doctor may also want you to have additional allergy
testing done depending on the results of your skin test. The results
of your allergy tests will be used by your doctor to
develop your individualized treatment plan.
Patch Testing
Patch testing is a simple procedure to help diagnose
allergic contact dermatitis and identify the causative agent(s). It is
designed to help me find out whether you are allergic to the substances
included on the test panels. The test patch panels contain different
substances known to cause allergic contact dermatitis. The patches will be applied to your upper
back. In addition to the standard patch test, you are also able to bring in
your own products to be applied as a patch test.
This
is a skin reaction that occurs when you touch or contact substances that you
are allergic to. Your skin can be itchy, cracked, red, sore, and even
bleed.
Immunotherapy/Allergy Shots
Allergy shots contain small amounts
of the things that you are allergic to. These things are called
allergens (or antigens). The dose of
allergen starts very low and is slowly increased over many weeks. The goal is to increase your immunity
(resistance) to the allergens, and to reduce your allergy symptoms. When this happens, you can take less allergy
medicine.
What are the benefits of allergy
shots?
- You might be cured of your
allergies.
- You may need less allergy medicine.
- You may be sick less often and miss
less work or school because of illness.
- You may feel better in general.
- The shots may stop children from
getting other allergies.
- The shots may stop children with
allergies from getting asthma.
Oral Food or Drug Challenge
An oral challenge is a carefully
supervised procedure that can play a key role in the evaluation and management
of food and drug allergies. The procedure begins with a tiny amount/dose
of the food or medication. There is constant monitoring and
supervision throughout the challenge. The amount/dose is increased
approximately every 15 minutes. Specific monitoring protocols are
followed prior to each dosage increase.
Spirometry
Lung function tests, also referred
to as PFT’s for pulmonary function tests, are tests used to determine how well
your lungs work. Spirometry is the most common of the PFT’s. It
measures how much air (the volume) your lungs can hold and the speed (flow rate)
you can move air in and out of your lungs. Spirometry is a very important
tool used for assessing conditions such as asthma and COPD.
One
of our medical assistants will guide you through the process. You will be
instructed to breathe in deeply and then exhale. Then, you will be asked to
breathe in and seal your lips around the spirometer's mouthpiece. With the
mouth sealed around the mouthpiece, you will be asked to blow out air as hard
and as fast as possible until there is absolutely no air left in the lungs. You
may be asked to perform this exercise multiple times to achieve an average
measurement.
There are several lung function
values measured with spirometry. Your printed test results will be
interpreted by your doctor to assist him in your diagnosis and making
recommendations for optimum management of your condition.
Feno
Doctors
define asthma as a chronic inflammatory disease of the airways. In
our search for the latest and most useful technology, we have found the NIOX
MINO Airway Inflammatory Monitoring System very valuable. In addition to
other tools we use to diagnose respiratory symptoms and evaluate the success of
therapy, the NIOX MINO gives a specific “biomarker”, a gas measuring the
presence or absence of airway inflammation. The amount of NO (Nitric
Oxide) exhaled out shows how much inflammation is present in your lungs.
The American Thoracic Society has published clinical guidelines for this Fractional Exhaled Nitric Oxide (FENO) and strongly recommends the use of it. This is an easy method of a simple 10 second exhalation that you or your child will find completely painless and even a little fun.
A few of the many benefits of the technology are:
- The possibility of lowering the medication dosage when appropriate
- The ability to adjust medication based on individual patient needs
- Insight into your treatment’s efficacy
- Better prediction of asthma relapse and exacerbation
- Early identification and close monitoring of airway inflammation
We
value your trust in us and are committed to offering the most up-to-date and
accurate ways to control your asthma and its symptoms.
Xolair
Xolair (pronounced
"ZOH-lair") is a prescription medicine for patients 12 years and
older with moderate to severe allergic asthma caused by year-round allergens in
the air, such as dust and pet dander. Exposure to allergens is
known to be the most common trigger for asthma symptoms and attacks. Your
doctor will perform a skin or blood test to determine if you have allergic
asthma. Depending on the severity of your asthma and effectiveness of your
prescribed inhaled steroids, your doctor may recommend adding Xolair to your
existing asthma treatment plan. This therapy may provide you with excellent
control and end, or reduce, the dosage of oral steroids you need.
Xolair is a subcutaneous injectable
(an injection just under the skin) prescription given every 2 weeks or once a
month. The injection must be given in a doctor’s office. Patients
receiving Xolair shots are required to stay in the office for 2 hours after
receiving each of their first three injections, and ½ hour after all remaining
injections. This waiting period after each injection is to allow continued
patient observation, as a severe allergic reaction called anaphylaxis has
occurred in some patients after they have received their shot. Xolair
patients also need to come in for follow-up appointments at our office every 3
to 6 months.
Before you can start treatment your
doctor will need to submit a statement of medical necessity to a Specialty
Pharmacy for Xolair. There will be forms for you to sign as well. The Specialty
Pharmacy is a specific type of pharmacy that handles drugs like
Xolair. The Specialty Pharmacy will let you and our office know if
your insurance company will cover Xolair. Most companies do, but you may need
prior authorization depending on your health history and the type of plan you
are on. Xolair is an expensive drug, but Xolair often provides coverage
reimbursement support and patient assistance.