The first physician most people see for allergies is their primary care provider. But when your itchy, drippy nose or eyes continue to get you down despite over-the-counter and prescription medications, it’s time to see a specialist. If you are experiencing symptoms of coughing, wheezing, shortness of breath and serious sinus infections, or if you suspect food allergies, see an allergist as soon as possible.
A board-certified allergist is trained to look at the whole picture: your family history, your overall health, your history of symptoms — and put it together with specialized diagnostic tests to reach a diagnosis and set up an individualized treatment plan.
Don’t let allergies rule your life! See an allergist. Here’s what to expect:
The allergist will first ask about personal and family medical history and allergy symptoms:
— When did you first notice symptoms, how long did they last, what made them better or worse?
— Do you have a history of runny, sneezy, itchy or congested nose or eyes?
— What time of year?
— What were you doing when they arose?
— What did you do to treat them?
— Was the treatment successful?
— Have you had episodes of wheezing or difficulty breathing?
— What did you do to treat it, and did it help?
— Do you have skin rashes or itchy skin?
— Have you noticed symptoms such as skin rash, runny nose, itchy mouth, stomach discomfort or difficulty breathing after eating particular foods?
— Does anyone in your close family have allergy, asthma, eczema or colds that linger for months instead of days?
[See: 16 Ways Your Body Adjusts to a New Climate.]
Allergy Testing
If signs point to allergy, the doctor will likely perform an allergy test — perhaps on a follow-up visit. Based on your history and your home and work environment, the doctor will choose which allergens to test for.
Allergists do not usually test for a full spectrum of allergens, as the results can be misleading. False positives are common — meaning that the test result may be positive, but you do not experience symptoms when actually exposed to the allergen. When testing for food allergy, too many false positives can prompt you to limit your diet unnecessarily, possibly affecting your nutrition. An accurate allergy diagnosis combines your personal history of symptoms along with test results.
The most common allergy test is the skin prick test. When a small amount of liquid allergen is pricked onto your arm or back, a small raised bump will appear if you are sensitized to it. The test is quick (the whole thing takes about 30 minutes), accurate and can be done in one visit.
Sometimes the doctor will recommend a blood test. This is usually done if there are specific reasons you’re unable to undergo the skin tests — sensitive skin, perhaps, or a medication regimen that would affect the skin reaction. Blood tests must be sent away and processed in a laboratory, and results can vary from one lab to another.
[See: 7 Lifestyle Tips to Manage Your Asthma.]
Allergy Treatment Plans
After the diagnosis, the allergist will work with you to set up a treatment plan, which is likely to combine the following:
— Allergen avoidance. What can be done to reduce exposure to your allergens? This may involve taking steps to reduce dust or other allergens inside the home, changing family habits to reduce exposure to pets, or discussing ways to reduce exposure to outdoor pollens and mold.
— Non-medical therapies. Are there ways to ease symptoms without medication, such as nasal washes or eye drops? What about using HEPA vacuum filters when cleaning or face masks when working outdoors?
— Medications. A wide variety of preventive and as-needed allergy medications are available to fit your lifestyle.
— Immunotherapy. The decision to add allergy shots to treatment is not usually part of the first appointment, unless you have a life-threatening allergy such as insect venom. It will be considered later, based on the frequency and severity of symptoms, your response to medications and allergen avoidance, and the degree of unavoidable allergen exposure you face.
[See: How to Survive Ragweed Allergy Season.]
Your first appointment with an allergist is the beginning of an important relationship. Allergies and your body’s response to allergens change as you age and as your lifestyle evolves. You’ll want to see the allergist on a regular basis to adapt and update your treatment plan.
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Purvi Parikh, MD, is an allergist and immunologist with Allergy & Asthma Network, the leading nonprofit patient education organization for people with allergies, asthma and related conditions. She practices in New York City at Allergy and Asthma Associates of Murray Hill and New York University School of Medicine. She sits on the Board of Directors for the advocacy council of the American College of Allergy, Asthma & Immunology.
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What to Expect From Your First Allergist Appointment originally appeared on usnews.com
