Services / Procedures

Allergen Immunotherapy

Also known as desensitization, is a medical treatment for some types of allergies. It is useful for environmental allergies, allergies to insect bites, and asthma. Its benefit for food allergies is unclear and thus not recommended. Immunotherapy involves exposing people to larger and larger amounts of allergen in an attempt to change the immune system’s response and essentially make the person less allergic to those specific allergens.

Allergic Conjunctivitis

Allergic conjunctivitis occurs when the conjunctiva becomes swollen or inflamed due to a reaction to pollen, dander, mold, or other allergy-causing substances. The conjunctiva is a clear layer of tissue lining the eyelids and covering the white of the eye.

Allergic rhinitis (Hay fever) takes two different forms:
Allergic Rhinitis: is also known as “hay fever” develops when the body’s immune system becomes sensitized and overreacts to something in the environment
Allergies: An immune response by the body to a substance, especially pollen, fur, a particular food, or dust, to which it has become hypersensitive.

Allergy Drops

Immunotherapy treats the cause of allergies by giving small doses of what a person is allergic to, which increases “immunity” or tolerance to the allergen and reduces the allergic symptoms. Unlike injection immunotherapy, which is given as shots, sublingual immunotherapy is given as drops under the tongue. This can be done daily and the patient can do it at home. However, allergy drops have been found to be less effective than allergy shots.
Allergy shots are administered one to three times a week during the building phase which can take three to six months. Once the maintenance level has been reached, allergy shots are administered once every four weeks.

Allergy Shots

Allergy shots is the same as immunotherapy which involves exposing people to larger and larger amounts of allergen in an attempt to change the immune system’s response and essentially make the person less allergic to those specific allergens.

Allergy Testing

Allergy testing can be done by skin prick testing, intradermal testing or with blood tests. Skin prick testing is done by placing a small amount of substances that may be causing your symptoms on the skin, most often on the forearm, upper arm, or back. The skin is then pricked so the allergen goes under the skin’s surface. The health care provider closely watches the skin for swelling and redness or other signs of a reaction. Results are usually seen within 15 to 20 minutes.
Also known as chronic rhinosinusitis, this condition interferes with drainage and causes mucus to build up.

Anaphylaxis

Anaphylaxis is a severe, potentially life-threatening allergic reaction. It can occur within seconds or minutes of exposure to something you’re allergic to, such as certain foods or the venom from a bee sting.

Angioedema

An acute or chronic disorder that affects the mucous membranes and deepest layers of the skin along with underlying tissue and that is marked by rapid swelling, large welts, and pain. Swelling results from a buildup of fluid leaking out of blood vessels with walls that have become abnormally permeable. The lips, mouth, throat, eyes, hands, and feet are most commonly affected. Swelling of the throat may interfere with breathing and can be life-threatening. Angioedema may be caused by an allergic reaction (as to food or drugs), is sometimes due to a hereditary condition (hereditary angioedema), but is often of unknown cause.

Asthma

A respiratory condition marked by spasms in the bronchi of the lungs, causing difficulty in breathing. It usually results from an allergic reaction or other forms of hypersensitivity.

Atopic Dermatitis

Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It’s common in children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare periodically and then subside. It may be accompanied by asthma or hay fever.

Bee sting

Bee stings can produce different reactions, ranging from temporary pain and discomfort to a severe allergic reaction.
Blood tests will look for reactions to specific allergens.

Breathing capacity test

Breathing capacity test is a test that evaluates how well the patient is breathing and how well their lungs are working.
Chronic cough is defined as lasting eight weeks or longer in adults, four weeks in children.

Chronis Sinusitis

Chronic sinusitis is a common condition in which the cavities around nasal passages (sinuses) become inflamed and swollen — for at least eight weeks, despite treatment attempts.

Cluster

In Cluster Immunotherapy, multiple allergy injections are administered over a single day in order to build-up your tolerance to the things that you are allergic to more quickly.

Eosinophilic Esophagitis

In eosinophilic esophagitis, a type of white blood cell (eosinophil) builds up in the lining of the tube that connects your mouth to your stomach (esophagus). This buildup, which is a reaction to foods, allergens or acid reflux, can inflame or injure the esophageal tissue. Damaged esophageal tissue can lead to difficulty swallowing or cause food to get caught when you swallow.

Eosinophilic esophagitis is a chronic immune system disease.
Exercised-induced asthma is a narrowing of the airways in the lungs that is triggered by strenuous exercise. It causes shortness of breath, wheezing, coughing and other symptoms during or after exercise. The preferred term for this condition is exercise-induced bronchoconstriction.
Expiratory reserve volume (ERV). This measures the difference between the amount of air in your lungs after a normal exhale (FRC) and the amount after you exhale with force (RV).
Expiratory reserve volume (ERV). This measures the difference between the amount of air in your lungs after a normal exhale (FRC) and the amount after you exhale with force (RV).

Extract

An allergen extract is composed of the specific allergens a patient is allergic to diluted down to small amounts.

Food Allergies

A food allergy is an abnormal immune response to food. The signs and symptoms may range from mild to severe. They may include itchiness, swelling of the tongue, vomiting, diarrhea, hives, trouble breathing, or low blood pressure. This typically occurs within minutes to several hours of exposure. When the symptoms are severe it is known as anaphylaxis.

Food Challenges

A food challenge test is the best way to both confirm a food allergy and see if a patient has a reaction to a food or medication when there has been a question if the patient is truly allergic and reacting to the food. You or your child will be given small but increasing amounts of the food and monitored very closely for any reaction. Only one food can be tested at a time. The in-office food challenge can take a couple of hours to complete. If there is an allergic reaction at any point in the challenge, the test will be stopped and the patient can be treated for the allergic reaction.
Forced expiratory flow 25% to 75%. This measures the air flow halfway through an exhale.
Forced expiratory flow 25% to 75%. This measures the air flow halfway through an exhale.
Forced expiratory volume (FEV). This measures the amount of air you can exhale with force in one breath. The amount of air you exhale may be measured at 1 second (FEV1), 2 seconds (FEV2), or 3 seconds (FEV3). FEV1 divided by FVC can also be determined.
Forced expiratory volume (FEV). This measures the amount of air you can exhale with force in one breath. The amount of air you exhale may be measured at 1 second (FEV1), 2 seconds (FEV2), or 3 seconds (FEV3). FEV1 divided by FVC can also be determined.
Forced vital capacity (FVC). This measures the amount of air you can exhale with force after you inhale as deeply as possible.
Forced vital capacity (FVC). This measures the amount of air you can exhale with force after you inhale as deeply as possible.
Functional residual capacity (FRC). This measures the amount of air in your lungs at the end of a normal exhaled breath.
Functional residual capacity (FRC). This measures the amount of air in your lungs at the end of a normal exhaled breath.
Hay fever

Headache

Headache, also known as cephalalgia, is the symptom of pain anywhere in the region of the head or neck. There are five types of headaches: Migraine, rebound headaches, Sinus headache, Cluster headaches, and tension headaches.

Hives

Hives, also known as urticaria, affects about 20 percent of people at some time during their lives. It can be triggered by many substances or situations and usually starts as an itchy patch of skin that turns into swollen red welts. Hives are very common, and most often their cause is elusive.

If the diagnosis of a penicillin allergy is uncertain or your doctor judges an allergy unlikely based on the symptoms and test results, he or she may recommend a graded drug challenge.

Influenza

Influenza, one of the most common infectious diseases, is a highly contagious airborne disease that occurs in seasonal epidemics and manifests as an acute febrile illness with variable degrees of systemic symptoms, ranging from mild fatigue to respiratory failure and death.

Intradermal skin testing involves injecting a small amount of allergen into the skin. The health care provider then watches for a reaction at the site after about 15 minutes, similar to prick testing.

Intradermal

Injection that is given between the dermis or layers of skin.
Maximum voluntary ventilation (MVV). This measures the greatest amount of air you can breathe in and out during 1 minute.
Maximum voluntary ventilation (MVV). This measures the greatest amount of air you can breathe in and out during 1 minute. Slow vital capacity (SVC). This measures the amount of air you can slowly exhale after you inhale as deeply as possible.

Metal allergy testing

The most commonly used test to diagnose a metal allergy is skin patch testing. (see information below about patch testing)

Methacholine Challenge

The purpose of the inhaled bronchial challenge test using methacholine is to determine how responsive (or irritable) the patient’s airways are and to determine the severity of any asthma.

Nasal Congestion

Nasal congestion or “stuffy nose” occurs when nasal and adjacent tissues and blood vessels become swollen with excess fluid, causing a “stuffy” feeling. Nasal congestion may or may not be accompanied by a nasal discharge or “runny nose.”

Nickel Allergy testing

The most commonly used test to diagnose a metal allergy is skin patch testing. (see information below about patch testing)

Patch Testing

A patch test is a method used to determine whether a specific substance causes allergic inflammation of a patient’s skin. Any individual suspected of having allergic contact dermatitis or atopic dermatitis can receive patch testing. Patch testing is done over three days. On day one, the patient will come into the office and have the patches placed on the back. The patient should leave the patches alone and should not shower while the patches are in place. Two days later the patches will be removed and an initial reading will be done over the sites. On day five the patient will return and have a final reading and will be given the results of the test.
Peak expiratory flow (PEF). This measures how much air you can exhale when you try your hardest. It is usually measured at the same time as your forced vital capacity (FVC).
Peak expiratory flow (PEF). This measures how much air you can exhale when you try your hardest. It is usually measured at the same time as your forced vital capacity (FVC).

Penicillin Testing

With a skin test, the nurse administers a small amount of the suspect penicillin to your skin either with a tiny needle that scratches the skin or an injection. A positive reaction to a test will cause a red, itchy, raised bump.
Perennial: People with perennial allergic rhinitis experience symptoms year-round. It is generally caused by dust mites, pet hair or dander, cockroaches or mold. Underlying or hidden food allergies rarely cause perennial nasal symptoms.

Post Nasal Drip

Post Nasal Drip occurs when excessive mucus is produced by the nasal mucosa. The excess mucus accumulates in the throat or back of the nose. It is caused by rhinitis, sinusitis, gastroesophageal reflux disease (GERD), or by a disorder of swallowing (such as an esophageal motility disorder). It is frequently caused by an allergy, which may be seasonal or persistent throughout the year.
Residual volume (RV). This measures the amount of air in your lungs after you have exhaled completely. It can be done by breathing in helium or nitrogen gas and seeing how much is exhaled.
Residual volume (RV). This measures the amount of air in your lungs after you have exhaled completely. It can be done by breathing in helium or nitrogen gas and seeing how much is exhaled.
Seasonal: Symptoms of seasonal allergic rhinitis can occur in spring, summer and early fall. They are usually caused by allergic sensitivity to airborne mold spores or to pollens from grass, trees and weeds.
Similarly, if you are allergic to one type of penicillin, your doctor may recommend a graded challenge with a type of penicillin or cephalosporin that’s less likely — because of known chemical properties — to cause an allergic reaction. This would enable your doctor to identify an antibiotic that can be used safely for a current bacterial infection and guide choices in future treatments

Skin Testing

See skin prick/Allergy testing above Slow vital capacity (SVC). This measures the amount of air you can slowly exhale after you inhale as deeply as possible.
Some people may experience both types of rhinitis, with perennial symptoms getting worse during specific pollen seasons.

Spirometry

(this is a repeat from Breathing Capacity Test already done)
Spirometry is the first and most commonly done lung function test.
The flood of chemicals released by your immune system during anaphylaxis can cause you to go into shock; your blood pressure drops suddenly and your airways narrow, blocking normal breathing. Signs and symptoms of anaphylaxis include a rapid, weak pulse, a skin rash, and nausea and vomiting. Common triggers of anaphylaxis include certain foods, some medications, insect venom and latex.
The more common lung function values measured with spirometry are:
– The patient will be asked to inhale a mist that contains different concentrations of methacholine. The mist is produced by a device called a nebulizer and they inhale the mist through a mouthpiece. Before the test begins and after each period of inhalation, you will be asked to blow forcefully into a spirometer. Depending on the patients response to the challenge will determine the level of asthma severity.
– Total lung capacity (TLC). This measures the amount of air in your lungs after you inhale as deeply as possible.
– Total lung capacity (TLC). This measures the amount of air in your lungs after you inhale as deeply as possible.

Urticaria

Urticaria, commonly referred to as hives, is a kind of skin rash notable for pale red, raised, itchy bumps. Hives may cause a burning or stinging sensation.They are frequently caused by allergic reactions; however, there are many nonallergic causes. Most cases of hives lasting less than six weeks (acute urticaria) are the result of an allergic trigger. Chronic urticaria (hives lasting longer than six weeks) is rarely due to an allergy.

Venom Testing

Skin test method – During skin testing, a small amount of allergen extract (in this case, bee venom) is injected into the skin of your arm or upper back. This test is safe and won’t cause any serious reactions. If you’re allergic to bee stings, you’ll develop a raised bump on your skin at the test site. Allergy blood test method – A blood test can measure your immune system’s response to bee venom by measuring the amount of allergy-causing antibodies in your bloodstream. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to possible allergens.

Vocal Chord dysfunction evaluation

Vocal cord dysfunction is the abnormal closing of the vocal cords when you breathe in or out. It’s also called laryngeal dysfunction or paradoxical vocal cord motion. Like asthma, vocal cord dysfunction can be triggered by breathing in lung irritants, having an upper respiratory infection or exercising. However, unlike asthma, vocal cord dysfunction isn’t an immune system reaction and doesn’t involve the lower airways. Treatment for the two conditions also is different.
With this procedure, you receive four to five doses of the suspect penicillin, starting with a small dose and increasing to the desired dose. If you reach the therapeutic dose with no reaction, then your doctor will conclude you aren’t allergic to that type of penicillin. You will be able to take the drug as prescribed.
Xolair is used to treat moderate to severe asthma that is caused by allergies in adults and children who are at least 12 years old.

Xolair

Xolair (omalizumab) is an antibody that helps decrease allergic responses in the body.
Your healthcare provider can find out if you have VCD by testing your breathing and looking at your vocal cords. The breathing test is called spirometry and must include a flow-volume loop. This test shows how well air moves in and out of your lungs. If you are having VCD symptoms during the test, the test will usually, but not always, show blockage mainly of the air flowing into the lungs. Breathing test results can be normal if your VCD is not active at the time of testing. This is one reason why it can be hard to determine if you have VCD.

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