Did you know that as many as 30 percent of adults in the United States suffer from allergies? In most cases, the symptoms are merely a minor annoyance and are easily solved with over-the-counter medications. Unfortunately, some allergies are more difficult to deal with than others. In these tougher situations, it can be worthwhile to seek professional help to pinpoint the allergy and deal with the symptoms.
Allery Testing Consultation
During your consultation with Dr. Rubinstein, you’ll review your symptoms and your medical history. He’ll conduct an examination to be sure your allergy hasn’t developed into a problem like sinusitis or turbinate hypertrophy. After the examination, you’ll get ready for testing to determine the source of your allergies. If necessary, Dr. Rubinstein will also prescribe stronger medications to help you deal with the discomfort until the allergen is determined.
Determining allergens can be done with either a blood or a skin test. Skin tests are quicker and more common and involve injecting tiny amounts of potential allergens under the skin to check for a reaction. Blood tests take a little longer because the blood sample must be sent to an external lab, where small amounts of blood will be exposed to the specific proteins found in various allergens to see if they provoke the development of antibodies. Regardless of the type of test used, finding your specific allergen will allow treatment to begin.
The correct course of treatment will depend on your specific allergy. Allergies to foods or medications are best treated simply by avoiding the allergen. If you have one of these allergies, Dr. Rubinstein may prescribe an epinephrine injector for use in emergencies or a rotation diet to minimize the symptoms.
For other allergies such as pollen or household dust, avoidance is not really an option. In some cases, these can be controlled with over-the-counter medications like antihistamines or decongestants, or stronger medications may be prescribed. In serious cases where quality of life is affected, a treatment called immunotherapy may be beneficial.
Immunotherapy is a long-term way to control allergy symptoms caused by things like pollen, mold, dust, and pet dander. By regularly injecting the patient with tiny amounts of the allergen, immunotherapy allows the body to build up an immunity to the proteins that trigger the allergic reaction.
Most patients begin with weekly shots for the first year. The treatment involves delivering a slightly higher dose each week until you reach the maximum dose of the allergen, which will allow you to switch to maintaining your new level of immunity. Since it depends on raising the dose each week, consistency is vital for making immunotherapy effective.
Once you’ve reached your maintenance level of the dose and stayed at that level for four weeks, Dr. Rubinstein will begin to reduce the frequency of the treatment. In most cases, this means receiving your injections every other week during the second year of treatment. During this period, you’ll be carefully monitored to be sure that your symptoms do not recur. As long as your symptoms do not reappear, you’ll be able to switch to having shots every third week in the third year and monthly in the fourth year.
In some cases, particularly during peak allergy season, symptoms can begin to return after the injections are decreased to every three or four weeks. If this happens, Dr. Rubinstein will simply return you to a more frequent treatment schedule in order to eliminate your allergy symptoms. In most cases, though, treatment frequency can be decreased every year for 3-5 years. After that point, treatment can be discontinued entirely for more than 80% of patients without the return of symptom. For the other 20% or so of patients, they will be able to remain symptom-free but must continue with treatments every 2-4 weeks indefinitely.
Once you have received treatment for at least three years and been symptom-free for a full calendar year, Dr. Rubinstein will begin to taper off the injections. Once you have completely stopped treatment, you’ll have follow-up appointments every six months to be sure that your allergies have not returned. While the injections can always be restarted as needed, most patients will be able to live allergy-free after their course of immunotherapy.