In The News: Skin Testing

Allergy and Immunology: A Misunderstood Medical Field

Ever wonder why there is a specialized medical field just for allergy? How about those old tales you’ve heard of classic allergy symptoms only to realize they were caused by something else? Believe it or not, there are plenty of misconceptions about allergy and asthma, which is why our team is dedicated to educating our patients on their condition and treatment every step of the way. Dr. Lindsey S. Steadman took the time to share about her experience becoming a board-certified allergist and how our team’s training equips us to give our clients the very best allergy and asthma care.

 

How does an allergist become an allergist?

In order to become an allergist, we go through many years of medical school and clinical training:

  • 4-year undergraduate degree – Most healthcare providers choose a major that they feel best prepares them for medical school, such as biology, chemistry, biochemistry, etc.
  • 4-year medical school degree – Medical school provides the basis of education in becoming a doctor, covering a wide variety of medical care and topics to ensure a well-rounded education.
  • 3-year residency program – All physicians must enter a residency program of some kind to complete their specialty training. As allergists and immunologists, we all have to receive training in either pediatrics or internal medicine. These are both 3-year residency programs, and they are each followed by a board exam that must be passed in order to become a certified pediatrician or internist.
  • 2 to 3-year fellowship – Residents interested in specializing further can then apply to various fellowship programs. The majority of allergy and immunology fellowship programs are two years long (occasionally three years long). Once we graduate from fellowship, we must pass a board exam in order to be certified in allergy and immunology.

After passing our boards, we are able to treat patients of all ages with any sort of allergic or immunologic disease. This includes, but is not limited to, environmental/seasonal allergies, food allergies, stinging insect allergies, anaphylaxis, hives and swelling, eczema, asthma, chronic/recurrent infections and immunodeficiencies.

 

Why is allergy and immunology such a misunderstood field?

Allergy and immunology is a poorly understood field not only in the general population, but also within the medical community. There are many different myths and “old wives’ tales” out there about allergy signs, symptoms and treatments amongst the general population. When patients are not properly educated by allergy experts, these myths and misinformation continue to circulate and become accepted as fact. Even in the medical field, allergy is a misunderstood because there is very little, if any, dedicated teaching or training on allergy and immunology in medical school or residency programs. Fellowship is where the true allergy and immunology training occurs, so a board-certified allergist is always recommended for patients suffering from any sort of allergic disease or immune deficiency.

We are trained on how to obtain a detailed history to determine whether or not testing and further work-up is needed. We are taught how to interpret the results of both skin and blood tests for various types of allergies, lung function testing for asthma, and blood work for immune disorders, all of which are oftentimes not very straightforward. We are also taught how to appropriately manage these issues with medications, allergy shots, biologics, immunoglobulin replacement, oral food/drug challenges and oral immunotherapy for select food allergies. Therefore, it is always recommended to seek the help of a board-certified allergist because we are the experts in the disease process, pathophysiology, diagnosis, management and treatment of all allergic and immunologic diseases.

 

What are some common myths about allergy and immunology?

  • Every sniffle or sneeze is an allergy and every cough or episode of shortness of breath is asthma… FALSE. Fortunately, we are trained to determine whether or not patients have allergies and/or asthma. Not only can we diagnose and treat these issues, but if patients’ allergy- or asthma-like symptoms are caused by something else, we can often help with those problems as well.
  • Every hive or episode of swelling is due to an allergic reaction… FALSE. This can be true at times, but there are also instances when hives are caused by other things as well. We are trained on how to determine whether or not there is an allergy-causing patients’ hives and swelling and how to treat them no matter the cause.
  • All allergic reactions get worse with subsequent exposures… FALSE. There is no way to predict the severity of an allergic reaction based on previous reactions or testing methods. However, we can help diagnose the cause of the allergic reaction (foods, insect stings, medications, etc.) and educate patients on what exposures would be unsafe and how to handle reactions in the future.

 

If you believe you’ve been experiencing allergy or asthma symptoms but you’re unsure of what to do next, leave it to the experts! All of our allergists are board-certified and our team is dedicated to helping you breathe better, feel better and live better. Schedule your appointment with the experts today.

 

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Child blowing nose

Childhood Allergies: What You Need to Know

With childhood allergies afflicting around 30% of children, many parents are left wondering what to do. If your child is wheezing, sniffling and coughing often, you may be curious about the cause and what you can do to help. We’ll run through many of the common questions that parents have about childhood allergies, so you can put your mind at ease.

What are the most common symptoms of allergies?

There are many common symptoms that children deal with when suffering from allergies. These symptoms can vary greatly depending on whether the allergy is environmental, a food allergy, a drug allergy or an insect sting allergy.

Environmental allergies, also known as allergic rhinitis, are the most common form of allergic reaction. Most commonly, children will be sneezing or coughing and will experience a runny nose and itchiness in the nose and roof of the mouth. It is also common to experience red, watery eyes. Symptoms are similar to but not the same as the common cold.

Symptoms for allergic rhinitis will usually be seasonal, although this isn’t always the case. If your child is experiencing allergy symptoms only during the spring and summer, allergic rhinitis is likely. However, you should see a board-certified allergist to confirm the root cause.

The most common culprits for environmental allergies in the Lowcountry are dust mites, cockroaches and mold. These often have a year-round impact on an allergic individual’s health.

Food allergies can cause a variety of symptoms, such as tingling or swelling in the mouth, hives, or even anaphylaxis in more severe cases. When food allergies are less severe, they can often be hard to diagnose, especially when the allergen is less common.

If your child ever experiences these symptoms, you should investigate as early as possible. Knowing the cause of a food allergy provides invaluable information so that you know how to best care for your child and eliminate risks of allergic reactions.

How are allergies in children treated?

There are three main ways that allergies can be treated: avoidance, medication and immunotherapy.

Avoidance

Avoidance simply means not coming in contact with the relevant irritant. This will help greatly, but can sometimes be hard to keep up. If your child wants to play outdoors during summer, but comes home with a runny nose or worse, it can be hard to find a balanced solution.

When symptoms are more severe, this can require children to miss school or be unable to see their friends. Finding a way to deal with allergy symptoms can greatly impact a child’s life well into the future, so make sure to deal with the issues head-on.

There is usually a comfortable middle ground to find if the allergies aren’t too severe. For example, dust-proofing your child’s bedroom or making sure to shower after coming indoors to remove any pollen spores can aid in the quick cessation of allergy symptoms.

One question we often get asked is, “Do I need to get rid of my pet if my child is allergic?” While pet allergies can be a nuisance to say the least, your board-certified allergist can provide recommendations on how to best avoid allergens within the home. We certainly won’t ask you to get rid of your pet! Our top recommendation for individuals with pet allergies is to receive immunotherapy, which has shown to be extremely beneficial in treating the cause of pet allergies.

Medications

Allergy symptoms can be further aided by using certain medications. Do not give your child any medications without first consulting your doctor or board-certified allergist. If you are told that a given medication doesn’t come with any risk, it may be worth a try.

Medications don’t make allergies go away permanently, but they help deal with symptoms and inflammation. Especially when symptoms get severe, medications can be the difference between a normal day at school and a day spent wheezing and unable to focus. Once you know a given medication is safe and effective, it can be good to have on hand in case your child’s symptoms flare up unexpectedly.

One thing to consider when finding the best medication treatment for allergies are common symptoms, such as drowsiness. It’s important to find the right medicine if that’s the treatment route you wish to take, and your allergist will always be able to recommend the best medication treatment plan for you or your child. If medication isn’t doing the trick, immunotherapy is the closest thing to a cure.

Immunotherapy

Lastly, most patients benefit greatly from immunotherapy. This is a long-term treatment option that involves injecting small doses of an allergen into the patient so that they build up immunity. Each patient receives an individualized treatment plan that is custom-tailored for your child’s specific allergens.

This option can have some difficulties when it comes to kids — it can be hard to drag them to the allergist each week! But, it is the best long-term solution and the only way to get truly permanent relief from allergies without using medications. Immunotherapy is available for a variety of allergies. It is also helpful to see a board-certified allergist who specializes in care and treatment for pediatric patients. Our allergists are double-boarded to treat both adults and pediatric patients. Oftentimes, they know how to make children feel right at home during their doctor’s visits and can make shot appointments far less scary or intimidating.

Key Things to Remember

As always, the best option to pursue if you suspect your child is suffering from allergies is to see a board-certified allergist. Through allergy testing and detailed health evaluations, this can provide you with an understanding of the best treatment path that is specific to your child’s situation, rather than just a guess.

 

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When are allergy tests needed?

If you have allergies, you likely know it. Sneezing, sniffling, itchy and watery eyes, the symptoms are sometimes overwhelming. Your immune system controls how your body defends itself and it overreacts to allergens you’ve inhaled, touched or ate. For example, if you’re allergic to dogs, your immune system identifies dog hair or dander as an invader. Your immune system produces antibodies called Immunoglobulin E (or IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction. These reactions can range from annoying sniffles to a life-threatening response called anaphylaxis.  

If you’re experiencing symptoms, but aren’t sure why or what’s causing them, allergy testing may be needed. Symptoms that usually prompt testing include:

  • Respiratory – itchy eyes, nose or throat; nasal congestion, runny nose, watery eyes, chest congestion, cough or wheezing
  • Skin – itchiness or eczema  
  • Abdominal – vomiting or cramping and diarrhea consistently after eating certain foods
  • Severe reactions to stinging insect stings (other than swelling at the site of the sting)
  • Anaphylaxis (pronounced an-a-fi-LAK-sis): a serious allergic reaction that affects many parts of the body at the same time

Allergy tests are the best and safest way to tell exactly what triggers your symptoms. The most common triggers include dust mites, animal dander, mold, pollen, insects, foods, latex and drugs. An allergist/immunologist can perform multiple types of allergy tests.

 

  • Skin tests: This is the most common kind of testing done in the allergist’s office. In this test, a small amount of allergenic liquid is placed on your skin and this area is pricked or scratched. Redness and swelling at a testing site tells us you are allergic to the tested allergen. It is generally not much more bothersome than a bug bite. The results of this test are ready in minutes, so you leave the office knowing what you are allergic to.
  • Intradermal tests: Intradermal tests are more sensitive than prick tests and may be used when prick test results are inconclusive. In this test, a very small amount of the sterile testing liquid will be injected just under the surface of your skin, similar to a TB test. The results are available in minutes.
  • Challenge tests: Challenge tests are sometimes used when a doctor suspects you have a food or drug allergy. In this test, a patient will eat or inhale a very small amount of the possible allergen under the close supervision of a board-certified allergist. The amount is gradually increased over several hours to ensure a full serving or dose can be tolerated. This type of test should only be done by a board-certified allergist with experience treating anaphylaxis. For your safety, do not try this test at home!
  • Blood tests: For this test, blood is drawn and then tested for allergies. This test is more expensive than skin testing and it takes longer to receive your results. Interpretation of this test should be done by a board-certified allergist as a positive result does not necessarily mean the patient is allergic. It is best understood in conjunction with an extensive allergy history and skin test. Unlike skin testing, blood allergy testing can be done when patients are still on oral antihistamines.

 

Many people with untreated symptoms aren’t aware of how much better they will feel once they are properly diagnosed and their symptoms are managed. We are here to help you breathe better, feel better and live better!

Give us a call or request an appointment online to begin your allergy treatment plan with one of our amazing board-certified doctors!

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Penicillin allergy form checkbox

Think You Might be Allergic to Penicillin?

Have you been avoiding penicillin for years because your parents told you that you reacted to it as a child? Are you worried your child may have a penicillin allergy because of a rash they developed when taking it? Do you require frequent courses of antibiotic and are worried about drug resistance because there are so few antibiotics you can take?

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