Allergy Program

Allergies are due to an overreaction of the body’s immune system to normally harmless substances. These substances vary from pollen, dust, animal dander, and molds to foods and chemicals. When the immune system recognizes allergens that the body is sensitive to, it overreacts by releasing chemicals. These chemicals include histamine, prostaglandins, and many more. These chemicals leak into the tissues in our bodies and cause allergy symptoms some of which are listed below

Common symptoms of allergies:

* runny nose
* nasal congestion
* sneezing
* cough
* itchy/watery eyes
* itchy ears
* itchy throat
* sore throat
* wheezing
* eczema/hives
* headaches
* fatigue
* muscle aches/pains

Allergies can also attribute to asthma, breathing problems, and decreased mental clarity.

Allergy Testing:

The first step in further evaluating and treating allergies is to have an allergy test to determine the cause of the symptoms. There are a few different types of testing available for allergies. The two main types of allergy testing include either a skin test or a blood test.

A blood test identifies the antibodies that the body has developed to certain allergens. Antibodies are made in the body when the immune system reacts to a substance. This can also be done for foods or environmental allergens although the child has to have been exposed to the allergen in question to have antibodies. Most children age 6 months and older have been exposed to all the environmental allergens tested, although not the food allergens.

A skin test can test for either environmental or food allergies and involves multiple ‘pricks’ on the back. The prick is placed with a drop of the allergen which is being tested and gently pokes only the first few layers of the skin. The drops then sit on the back for 15 minutes while the child lies on his/her tummy. During this time the skin may or may not react to the allergen with a red hive or welt. After 15 minutes the test is then ‘read’ and the results are measured based on how the skin reacts to a certain allergen. Skin tests can be performed on children down to age 1 although are usually not recommended for children less than 3 years of age due to the process and time it takes to complete the test.

There is a test available for chemical allergens called a patch test. This involves 3 patches that stay on the back for 48 hours. Unfortunately, this is only available for teenagers or older at this time.

* Blood test (RAST test) – identifies which antibodies your body has to certain substances (allergens), which means substances your body has previously reacted to.

* Skin test – includes 60 environmental allergens (pollen, grass, animal dander, etc) that are placed on the skin with a few pricks. The skin test takes approximately 30 minutes total and is measured based on how your skin reacts to a certain allergen. A skin test can also be performed for certain foods.

* Allergy patch testing – chemical and contact allergies, involves placing a patch with a set of predetermined chemicals on the skin for 48 hours.

* Your provider and you may determine which type of allergy testing is best for you based on your allergy and asthma history, medications you are currently taking, and history of skin disorders. You may need to be retested for allergies on an annual basis based on your symptoms and response to treatment.

Allergy Treatment:

* Avoidance – Avoid the things you are allergic to, which may include removing a pet, not eating certain foods, and staying inside. This can also include using allergy proof covers on mattresses and pillows. This method is very often difficult and can become costly.  Measures that can help environmental allergies include removing a pet from the household, changing air filters frequently and keeping the doors and windows shut.

* Medications – These medications include antihistamines, such as Benadryl, Claritin, Zyrtec, etc. These medications block the chemical histamine that your body releases as a response to allergies. Antihistamines work by blocking the chemical histamine that the body releases in response to allergens. These can be taken as needed or as an attempt to prevent symptoms. The downfall of this method of treatment is that you are only covering up a problem, rather than ‘fixing’ it. Many people also state that after taking these medications for an extended period of time, they feel as if the medication no longer relieves their symptoms. Other medications include prescription nasal sprays which are beneficial in decreasing nasal congestion.

* Immunotherapy – Includes taking allergy shots (subcutaneous immunotherapy) or allergy drops (sublingual immunotherapy). Both of these methods give the body small amounts of the allergens you are allergic to over a period of time in order to ‘desensitize’ your body to what you’re allergic to. In other words, the goal of immunotherapy treatment is that your body will no longer react to the normally harmless substances, and you will no longer have allergy symptoms.

Allergy Drops:

Allergy drops can help children with a wide range of allergies without the use of shots, in the safe and nonthreatening environment of their own home. We have had tremendous success with our allergy program and have been able to help our children in dealing with allergies and their symptoms and at the same time decrease their need for medications. Allergy drops are drops which are composed of a mixture of allergens including pollens, molds, dust and animal dander that are given under the tongue on a daily basis for an average of 3 years.  This is the amount of time it takes for the immune system to become ‘desensitized’ to the allergens. Drops are dispensed in 3 month supplies and the child is seen in the office every 3 months for a follow up. There are no medications that interact with the drops and therefore the typical allergy regimen is continued during the initial start-up of the drops. Once symptoms are improved, medications (including inhalers) may be reduced or even not needed. Most children will notice an improvement in their symptoms within the first 6 months of taking drops, if not sooner. The effectiveness of the drops has been shown to last at least 10 years. The greatest benefit is that there are no shots involved! Allergy shots are available through an allergist’s office for children age 5 and older. Allergy shots are given in weekly doses at the allergist’s office for an average of 3 years.

The highlights of the program are:

* Serum composed of over 100 allergens (pollens, molds, dust, animal dander, etc), that is placed under the tongue over a period of time
* Taken every day for 3 months, then twice a week for approximately 3 years
* Safe for patients of all ages
* Most patients notice a benefit within 3-6 months with a reduction in allergy and asthma medications
* Safe to be taken with other medications
* No reports of adverse reactions
* Requires office visits every 3 months (as opposed to weekly shots with subcutaneous immunotherapy)
* Trains your body to not react to allergens, rather than only covering the problem with medications
* Benefits last >10 years following completion of treatment
* Requires allergy testing prior to treatment
* Side effects include mild nausea, occasional itching or tingling in the mouth
* No shots!

Insurance related issues:

Most insurance companies will cover allergy testing. If you prefer to check with your insurance for coverage prior to having allergy testing, the billing (CPT) code is:

Allergy Skin Testing – CPT code 95004

Insurance companies do not pay for allergy drops but we are able to provide those at a discounted price to our families. Also the families are able to save on specialist copays as we will typically need to see you only once in 3 months, rather than every week, as required for allergy shots.

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