Skin and Blood Testing

Allergy Doctor, Atlanta, Peachtree City, Georgia
Skin Prick Testing, Freedom Allergy, Atlanta, Georgia

Skin Prick Testing

Ways to Diagnose an Allergy

Skin Testing

During allergy skin testing, your skin is exposed to several allergens (food and/or environmental) and assessed for an allergic response. Your allergist will use a small plastic device to prick the skin and apply the allergens. If your skin becomes red, raised and itchy after 15-20 minutes, this may indicate an allergy.

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Allergy Blood Testing

Allergy blood tests are used if a patient can’t stop a medication that interferes with skin testing, if the patient has a skin condition like dermatitis, psoriasis or eczema, or if it would better suit the patient to have just one “poke” versus several (ie, a baby or young child). Blood testing is also used if the patient has poorly controlled asthma, or if the allergy is so severe that the testing could cause a systemic or anaphylactic reaction. Allergy blood tests are also used to check how well a patient’s allergy treatment is working.

Types of allergy blood tests include Enzyme-Linked Immunosorbent Assay (ELISA) and Radioallergosorbent Test (RAST). ELISA is used more commonly than RAST, and measures the amount of antibodies in your blood specific to certain allergens.

Complement testing can be used to measure the amount of a specific antibody or a specific antigen in the blood. The test helps determine which foods may be causing inflammation in the body and triggering an immune response.

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Patch Testing

Patch Testing is a way to test for the allergens responsible for delayed allergic reactions. Instead of poking the skin with a plastic device to administer an allergen (as in allergy skin testing), patch testing occurs by placing a patch on a patient’s back that contains a small amount of the allergen. The patch stays on for two days, since a delayed allergic response will not occur quickly enough for skin prick testing. The patch site will be observed for redness, blisters, and swelling.

Sensitivity Testing

Sensitivity Testing is a blood test used to check for food sensitivities (different from food allergies). Food sensitivity is different from food allergy and food intolerance, and essentially describes an inconsistent and unpredictable reaction to certain foods. A person with food sensitivity may eat the food one time with no reaction, but experience symptoms (stomach cramps, nausea, acid reflux) at other times.

Allergy Shots

Allergy Treatment, Allergy Shots, Immunotherapy, Peachtree City, Georgia

 

Children and adults with allergic rhinitis, allergic asthma, and conjunctivitis can benefit from allergy treatment known as “immunotherapy,” or allergy shots.  Allergy shots work similarly to immunizations, where the body is given an injection of an allergen, and develops immunity or “tolerance” to that allergen.  These shots can relieve allergy symptoms and lessen a person’s sensitivity to the allergen.  With allergy shots, you will receive an injection of a small concentration of the responsible allergen.  Over weeks to months, the concentration of the allergen will be increased until the body develops enough of a tolerance that it will not react to the allergen the way it used to.

Read more from the American Academy of Allergy Asthma & Immunology.

Video courtesy of American Academy of Allergy Asthma & Immunology

Rush Immunotherapy

Allergy Treatment, Rush Immunotherapy, Peachtree City, Georgia
Rush Immunotherapy, Allergy Doctor, Atlanta, Georgia

Rush Immunotherapy

Immunotherapy is a method of treating allergic reactions through a series of injections containing the responsible allergen. This method of allergy desensitization provides faster relief and fewer reactions than traditional allergy shots. “Rush” immunotherapy allows patients to complete their treatment in an even shorter time period than with conventional immunotherapy. This means fewer office visits, fewer copays, and faster relief!

With this treatment, patients are pre-medicated with a steroid, and over a 4-6 hour time period (versus 6-8 months with conventional immunotherapy), they receive injections of increasing allergen concentration. Once patients are close to the strongest dose, they will return weekly for 4-6 weeks until they can tolerate their maximum dose of allergen. Once that maximum dose is achieved, patients return once every 4-6 weeks for the following 3-5 years until they are desensitized to that allergen.

Rush immunotherapy does pose an increased risk of local or systemic reaction.  However, most reactions (if any) are not severe, the most common of which is usually flushing, generalized itching, or swelling of the shot site.  Patients will remain under a physician’s supervision for a longer time period after rush immunotherapy (usually 1.5-2 hours), in order to ensure patient safety.

Sources:
American Academy of Allergy Asthma & Immunology. Practice Parameters and Other Guidelines. 2014.http://www.aaaai.org/practice-resources/statements-and-practice-parameters/practice-parameters-and-other-guidelines-page.aspx
Cox L, Nelson H, Lockey R. Allergen Immunotherapy: A Practice Parameter Third Update. Journal of Allergy and Clinical Immunology. 2011.http://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/Allergen-immunotherapy-Jan-2011.pdf

Conditions & Procedures

Allergy & Asthma Doctor, Peachtree City, Marietta , Georgia

Conditions We Treat

  • Adverse Drug Reactions
  • Angioedema
  • Asthma
  • Allergic Rhinitis
  • Allergies (Seasonal, Food, Environmental)
  • Anaphylaxis
  • Aspirin Allergy and Desensitization
  • Chronic Cough
  • Cough from Allergies
  • Dry Eyes from Allergic Rhinitis
  • Dry Throat and Runny Nose
  • Eczema
  • Eosinophilic Esophagitis
  • Eosinophilic Disorders
  • Food Allergy
  • Food Intolerance (Comprehensive Diagnosis and Management)
  • Environmental Allergies
  • Functional Medicine
  • Headaches, Fatigue and Cold Symptoms
  • Hives/Urticaria
  • Immunodeficiency
  • Integrative Medicine
  • Recurrent Infections
  • Sinus and Nasal Infections
  • Sinusitis (Acute)
  • Sinusitis (Chronic)
  • Skin Rashes
  • Sneezing (Frequent and Prolonged)
  • Stuffy Nose
  • Vocal Cord Dysfunction
  • Wheezing

Procedures We Offer

Oral Immunotherapy

Oral Immunotherapy – Atlanta, Peachtree City, Georgia

What is Oral Immunotherapy?

Oral immunotherapy (OIT) is a method of desensitizing your body to an allergen. A person suffering from a food allergy can develop a tolerance to the food by ingesting small doses over set time intervals. The concentration of food gradually increases throughout the therapy until you can eat the food without having an allergic reaction. This treatment should only be performed by an experienced board certified allergist, in the safety of a medical setting. Dr. Agrawal at Freedom Allergy is only one of a few board certified physicians in the Southern Region to perform this innovative allergy treatment.

Which Foods can Freedom Allergy Treat with Oral Immunotherapy?

  • Peanut
  • Tree Nuts (almond, pecan, walnut, hazelnut, cashew, pistachio, brazil nut, macadamia nut)
  • Milk
  • Egg
  • Contact us to inquire about other foods

What Ages Can Undergo Oral Immunotherapy?

We treat patients as young as 2 years old through adult.

Who Should Not Undergo Oral Immunotherapy?

Contraindications to OIT include unstable asthma and eosinophilic esophagitis.

Rush Immunotherapy Instructions

Allergy Treatment, Rush Immunotherapy, Atlanta, Peachtree City, Georgia

 

What To Do Prior to your Appointment 

Our office will send prescriptions for Prednisone, Singulair (Montelukast) and an epinephrine auto-injector.  The patient will need to purchase Zyrtec and Zantac, over-the-counter medications.  The medication listed in the chart should be taken starting two days prior to your RUSH immunotherapy appointment, and also on the morning of your appointment.

Day Adult Instructions Child Instructions
DAY 1

 

To be taken in the Morning:

Zantac – 300 mg

Zyrtec – 10 mg

Prednisone – 60 mg with a meal

(3 tablets of 20mg together)

Montelukast/Singular – 10 mg

To be taken in the Morning:

Zantac – 6 mg/kg (children under 12 y.o.)

Zyrtec – 5 mg

Prednisone – 1 mg/kg with a meal

Montelukast/Singular – 5 mg (children under 15 y.o.)

 

DAY 2

 

 

Repeat Day 1

 

Repeat Day 1

DAY 3

(RUSH Day at Office)

 

Repeat Day 1

(take medication before coming to your RUSH appointment)

Repeat Day 1

(take medication before coming to your RUSH appointment)

**Bring your epinephrine auto-injector to your RUSH appointment.**

 

What to Expect on RUSH Day

Be sure to eat a complete breakfast before arriving to the office, and take your morning medicationsBring your epinephrine auto-injector to the appointment.

A total of 6-8 allergy shots will be given at 15-20 minute intervals, in increasing concentration, over a course of 3-4 hours.  Patient will be monitored continuously to ensure shots are being tolerated.  There will be a one-hour wait period after the last shot to monitor the patient.

You will remain in the office during the entire visit, so bring snacks and drinks, and items to occupy your time.  You may bring your laptop/tablets, and wi-fi is available in the office.  Depending on your appointment time, you may also bring a lunch.

 

What Happens Afterwards

It is advised to avoid lifting and strenuous exercise for the remainder of the day after RUSH.

Some patients may experience a delayed onset of hives or other allergic symptoms during the evening following the procedure.  Call our office if you develop such problems.  If it is after-hours and you receive the office voicemail, please leave a message, and it will be returned promptly.

You will be instructed to return to the clinic for your next allergy shot(s) in 3-7 days, then weekly, and once a stable maintenance dose has been established every 3-4 weeks.

 

Allergy Testing Instructions

Allergy Testing, Atlanta, Peachtree City, Georgia

FREEDOM ALLERGY SKIN TESTING INSTRUCTIONS

Allergy skin testing is a fast, safe and reliable way of identifying allergic sensitivities to inhalant allergens (e.g.,pollens, molds, dust mites and animal danders). Allergy testing can also diagnose allergic sensitivities to insect stings, antibiotics and foods. Allergy test results help tell which allergens you should avoid, which is the first and most important step in treating your allergic disorder. Allergy test results may also be used to formulate allergy shot extracts. In order to make your allergy testing appointment as productive as possible, we ask that you review the following instructions before coming to your appointment:

  • Although the testing itself may be completed in one hour or less, additional time may be needed to discuss results, allergy avoidance measures and treatment options.
  • Wear a shirt or blouse that can be easily removed. Prick skin testing is performed using the Multitest device applied to the back.
  • The medications listed below will interfere with allergy skin testing and should be discontinued in the time specified below. If you have a medical condition or severe allergic symptoms that could worsen without medications, please consult us prior to stopping these medications. If you have forgotten to stop these medications by the specified time, please call our office to determine whether or not you need to reschedule your allergy testing appointment.

ANY MEDICATIONS NOT LISTED BELOW WILL NOT INTERFERE WITH
SKIN TESTING AND SHOULD BE CONTINUED AS PRESCRIBED.

DISCONTINUE 10 DAYS PRIOR TO SKIN TESTING:
Cetirizine (Zyrtec) Cyproheptadine (Periactin) Imipramine (Tofranil) *
Levocetirizine (Xyzal) Doxepin (Sinequan, Adapin) Chlorpromazine (Thorazine) *
Desloratadine (Clarinex) Amitriptyline (Elavil) * Thioridazine (Mellaril) *
Loratadine (Claritin, Alavert) Nortriptyline (Pamelor, Aventyl) * Thiothixene (Navane) *
Fexofenadine (Allegra) Clomipramine (Anafranil) * Trifluoperazine (Stelazine) *
Hydroxyzine (Atarax, Vistaril) Desipramine (Norpramin) *

* IF YOU ARE TAKING A STARRED MEDICATION, PLEASE CONSULT WITH THE
PRESCRIBING PHYSICIAN TO DETERMINE IF IT IS SAFE TO DISCONTINUE

DISCONTINUE 5 DAYS PRIOR TO SKIN TESTING:
Chlorpheniramine (many prescription & OTC brands, including Ahchew, Chlor-Trimeton,
DAllergy, Deconamine, Durahist, Extendryl, Histavent, Omnihist, Rescon, Rynatan,
Triaminic Cold & Allergy, Triaminic Multi-Symptom)
Diphenhydramine (many OTC brands, including Benadryl, Tylenol PM, Tylenol Cold & Sinus,
Triaminic Night Time Cold & Cough, Advil Cold & Sinus, Sominex, Nytol)
Brompheniramine (Dimetapp, Bromfed)
Tripelennamine (Actifed, PBZ)
Certain Medications for Motion Sickness / Nausea: Dramamine, Compazine, Meclizine (Antivert), Phenergan (promethazine)
Anihistamine Nasal Sprays: Astelin, Astepro, Patanase, Dymista.
NOTE: all other nasal sprays are OK!
Antihistamine Eye Drops: Alomide, Livostin, Optivar, Pataday, Patano
DO NOT DISCONTINUE THE FOLLOWING MEDICATIONS:
Medications for Asthma: Including Advair, Flovent, Pulmicort, Qvar, Asmanex, Singulair Zyflo
Topical cortisone nasal sprays: Including Flonase, Nasonex, Nasacort, Rhinocort, Veramyst
Medications for acid reflux, high blood pressure and other chronic medical conditions.
Please call our office at (678) 400-6650 with any questions.

(Instructions courtesy of Dallas Allergy & Immunology)

What to Expect at Your First Visit

Allergy, Asthma Doctor, Atlanta, Peachtree City, Georgia

What to Expect at Your First Asthma Visit:

Even with asthma, you can live a normal and active life, and sleep through the night without interruption from your breathing. Here are some possibilities you may expect during your first asthma visit.

  • Detailed history, including medication review.
  • Review of previous health conditions, including hospitalizations or emergency visits for asthma.
  • Pulmonary function testing.
  • Skin testing, if needed, to evaluate for allergic components of your asthma.
  • Creation of a plan for optimal asthma control.

What to Expect at Your First Food Allergy Visit:

Freedom Allergy offers comprehensive evaluation and management of food allergies.  We offer any of the following at your initial allergy visit.

  • Detailed history, including medication review.
  • Review of previous skin test or blood test results.
  • Review of previous health conditions, including hospitalizations or emergency visits for allergies.
  • Order allergen-specific IgE levels, if needed.
  • Skin testing, if needed.
  • Identify food allergens and severity.
  • Anaphylaxis plan (avoidance and management), including use of epinephrine auto injector.