When Should I See An Allergist?

Nationwide, millions of people suffer daily with allergies, but here in the South, where the growing season is long and the climate temperate, allergic symptoms are especially prevalent.  When flowers and trees start pollinating, allergists are bombarded with phone calls about running noses, watery eyes, and scratchy throats.  But these minor discomforts are not the only symptoms of allergies, and pollen is not the only cause.

Definition of an Allergy
An allergy (or hypersensitivity) is an abnormal or altered reaction in the body to an ordinarily harmless substance called an allergen.  Allergens may be inhaled, swallowed, injected, or contacted by the skin and can occur in both natural and manmade environments.  An allergic reaction may occur anywhere in the body but usually appears in the nose, eyes, lungs or skin. Allergic reactions can also affect the sinuses, throat and lining of the stomach.  A person can be allergic to almost anything: pollen, dust, mold, smoke, animals, insect stings, foods, medicines, or even an old sweater or a popular perfume.  When exposed to an allergen, an individual may experience symptoms similar to the common cold, or in severe cases, itching, hives, breathing difficulty, and shock.  People with allergies can even develop asthma, and asthmatic patients frequently cite allergic "triggers" such as smoke and strong perfume as signals of an oncoming attack.  Currently, there is no cure for asthma, but there are many helpful treatments for allergic diseases and their symptoms that may help allergy sufferers keep the condition under control. 

When to See an Allergist
If you have (or suspect that you may have) asthma or another allergic disease, an allergist will help you learn more about your condition and provide treatment that controls or eliminates your symptoms. Often, the symptoms of allergic diseases develop gradually over a period of time.  Allergy patients may become so accustomed to chronic symptoms such as sneezing, nasal congestion or wheezing that they do not consider their symptoms to be unusual. Yet, with the help of an allergist, with his or her specialized training and expertise in evaluation and management, these symptoms can usually be prevented or controlled through a treatment plan for your individual condition.  The goal will be to enable you to lead a life that is normal and symptom-free as possible.

Allergists and Immunologists: Credentials and Experience
Pediatricians, general practitioners, internists, allergists, and pulmonologists can all treat asthma and allergies.  Allergists or immunologists are internists and pediatricians, who have additional training in the immune system and special skills in evaluating and treating asthma and allergies.  They become board certified when they pass an examination in the specialty area of allergy and immunology. 
Because allergists tend to see more allergic and asthmatic people than other kinds of doctors, they are more experienced in them.  This is especially important because about 90 percent of children and 50 percent of adults with asthma have allergies that trigger asthma symptoms.  Identifying and learning to control these allergies can be the key to better asthma control.  Your primary care physician may refer you to an allergist to test you for allergies and to get your asthma under better control.

Tips on Choosing an Allergist
Your allergist will be your partner in care, so it is important to choose carefully from those available to you. In some managed care plans, you will generally be limited to choosing from only certain doctors; in other plans, some doctors may be "preferred," which means they are part of a network and you will pay less if you use them. Ask your plan for a list or directory of providers. The plan may also offer other help in choosing.

You can ask doctors you know, medical societies, friends, family, and coworkers to recommend an allergist. You may also contact hospitals and referral services about doctors in your area.
Once you have narrowed your search to a few doctors, you may want to set up "get acquainted" appointments with them. Ask what charge there might be for these visits, if any. Such appointments give you a chance to interview the doctors-for example, to find out if they have much experience with any health conditions you may have.

You can also look in the Yellow Pages of your phone book under Physicians. The physicians will be listed under their specialty area, such as "Allergy & Immunology." Choose an allergist that is "Board Certified."  You can also call or visit the web sites of the following organizations: American Academy of Allergy, Asthma and Immunology (800-822-2762; Web site: www.aaaai.org) or American College of Allergy, Asthma & Immunology (847-427-1200; Web site: www.acaai.org)

The Consultation and Diagnosis
When treating a patient, an allergist/immunologist examines the patient's background and symptoms and performs tests to identify the cause of the allergic or immunologic problem.  The most common of these tests is "skin prick/puncture testing." This test involves placing separate drops of solutions of allergen vaccines/extracts onto the skin of your forearm or back and then using a very fine needle to prick through the drop into the skin. A positive test results in a small raised wheal with a red surrounding flare.  Other common ways of isolating particular allergic sensitivities are through blood testing and elimination diets.

You Should See an Allergist if:
· Your nasal allergies are causing secondary symptoms such as chronic sinus infections, nasal congestion or difficulty breathing.
· You experience hay fever or other allergy symptoms several months out of the year.
· Antihistamines and other over-the-counter medications do not control your allergy symptoms or create unacceptable side effects, such as drowsiness.
· Your allergic disease is interfering with your ability to carry on day-to-day activities.
· Your allergy symptoms decrease the quality of your life
· You are experiencing warning signs of asthma such as:
- You sometimes have to struggle to catch your breath.
- You often wheeze or cough, especially at night or after exercise.
- You are frequently short of breath or feel a tightness in your chest.
- You have previously been diagnosed with asthma, but despite treatment, you have frequent acute asthma attacks.

Typical Treatment
In addition to environmental controls and avoidance measures designed to reduce exposure, allergists typically prescribe a mixture of antihistamines, decongestants, and nasal sprays to relieve the symptoms of allergies.  Patients who also have asthma may be given inhalers or daily breathing treatments containing medication.  Some allergic patients may begin injection therapy or desensitization.  All of the above methods of treatment are designed to increase the patient's tolerance to certain substances and reduce allergic symptoms.

For more information on specific allergies and treatments,