Fall Allergies Are Upon Us

Allergy and Asthma Doctor, Atlanta, Georgia  

Freedom Allergy, Fall Allergies Ragweed, Atlanta, Georgia

Autumn is rapidly approaching. As backpacks fill with homework, football games kick off, and the Georgia heat simmers down, many know ragweed season also lurks around the corner. Ragweed grows most predominantly in the southern, northeastern and midwestern United States, and thrives in warm, humid environments. According to the Asthma and Allergy Foundation of America, 75% of people who are allergic to pollen-producing plants also suffer ragweed allergies. Ragweed emits a particularly large amount of pollen – up to 1 billion pollen grains per plant – and the pollen can extend up to two miles into the atmosphere. Ten to twenty percent of Americans suffer ragweed allergy flare-ups near the end of the summer, usually peaking around early September, and these flare-ups can lead to asthma exacerbations, headaches, and chronic sinusitis. With fall allergy season already upon us, do not wait to schedule an appointment with your board certified allergist, who can help keep your allergies and asthma under control.

Read more about ragweed allergies here.


Costa S. Are Your Allergies Ready for a Relocation? U.S. News & World Report.  Aug 2014. http://health.usnews.com/health-news/health-wellness/articles/2015/08/14/are-your-allergies-ready-for-a-relocation.

Pongdee T. Ragweed Plants Packed with Pollen. American Academy of Allergy Asthma and Immunology. Aug 2011. http://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/EL-ragweed-patient.pdf.

Back to School with Food Allergies

Pediatric Food Allergy Doctor, Peachtree City, Fayetteville, Georgia

Back to School

School is right around the corner, and along with the excitement of new clothes, bright supplies, and fresh possibilities, your child may also have a few butterflies in the stomach. For a parent of a child with a severe food allergy, you may have some butterflies of your own. Many parents worry their child will accidentally eat a food they’re allergic to while at school, and suffer a severe reaction. Setting your child up at school with an epinephrine auto-injector (EAI) is important, but this also requires staff and personnel who can recognize an anaphylactic reaction and can correctly use the EAI.

Children need help from adults in managing their food allergies. One survey out of Mississippi schools revealed 97% had at least one child with a food allergy, but only 30% had action plans for these students. Schools were more likely to have action plans when the school nurse had received appropriate information from a physician. If you need refreshing on how to use your EAI, or would like assistance in educating personnel at your child’s school on recognizing and treating anaphylaxis, call our office today. Anaphylaxis action plans can also be written by physicians and distributed in daycares and schools.

Reference: O’Keefe AW, De Schryver S, Mill J, et al. Diagnosis and Management of Food Allergies: New and Emerging Options: A Systematic Review. Journal of Asthma and Allergy. 2014;7:141-164.

Allergist Versus Ear, Nose, and Throat Doctor

Allergy Doctor, Peachtree City, Atlanta, Georgia

Freedom Allergy, Ruchir Agrawal, Peachtree City, Fayetteville, Georgia

Why Choose an Allergist for your Allergy and Asthma?

Allergies and asthma are both chronic conditions, and warrant visiting a specialist for the best management. However, with so many specialists out there, how do you know which one to choose?  Read the FAQ below.

My allergies bother my ears, nose and throat – doesn’t this mean I should see an ear, nose and throat doctor?

Many times, patients go directly to an ear, nose and throat (ENT) doctor for their allergy symptoms. After all, don’t allergies bother your ears, nose and throat?

Ear, Nose and Throat doctors are surgeons who specialize mainly in structural problems that can be corrected with surgery. But many of these problems, such as difficulty breathing through the nose, or having a raspy voice or having trouble hearing, are actually due to allergies.  Allergies, eczema, and asthma are all chronic conditions that fall under the same umbrella of allergy medicine, and more than 50% of sinus problems are caused by allergies.  The other 50% are often caused by a combination of both allergy and non-allergy related problems. Continue reading

Georgia Spring Allergies

Seasonal Allergies, Allergy Doctor, Atlanta, Peachtree City, Georgia

Atlanta jumped 12 spots last year on the Allergy and Asthma Foundation of America’s (AAFA) list of Top 100 Most Challenging Places to Live with Spring Allergies.  Atlanta rose from #72 in 2013 to #60 in 2014 on this AAFA Allergy Capitals list.  As trees blossom and grasses sprout this year, it helps to know which plants peak during which months (see the chart below).  Talk to your allergist today to plan your best method of defense against these allergens!

Allergy Doctor Atlanta Peachtree City Georgia

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.

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

Food Allergy

Food Allergy – Atlanta, Peachtree City, Georgia

What is a Food Allergy?

A food allergy occurs when your body’s immune system overreacts to a protein in a certain food. In severe allergies, these reactions can be life threatening. The majority (90 percent) of food allergies are caused by eight foods: cow’s milk, eggs, fish, peanuts, shellfish, soy, tree nuts, and wheat.

Video Courtesy of American Academy of Allergy Asthma & Immunology

Click Here to read more about Food Allergies from the American Academy of Allergy Asthma & Immunology.


Food Allergy Versus Food Intolerance

Reacting to a food does not necessarily mean you are allergic to that food – you may just be intolerant to it. Food intolerance can cause similar symptoms to a food allergy, but food intolerance does not cause a full immune system response in your body. Food allergies cause an immune system response, and affect multiple organs. Generally, food intolerance causes less severe reactions, and may only cause digestive problems. People develop food intolerance for many different reasons, including lacking an enzyme necessary to digest the food, or having a sensitivity to additives in a food.

Article: Food Allergy Versus Food Intolerance

Read More….


Ways to Diagnose a Food Allergy

  1. 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.

Read More…

  1. 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.

Read More…

  1. Oral Food Challenge

Double-blinded, placebo-controlled oral food challenge is considered the “gold standard” for food allergy diagnosis. This test is often used after skin prick testing and allergy blood testing fail to provide definitive results. In an oral food challenge, the patient is given very small amounts of a food that is suspicious for an allergy. Over a certain length of time, the amount of food is increased until any sign of an allergic reaction occurs. This test is always done under strict supervision of an allergist. The oral food challenge procedure can be costly and time consuming, however, so it is often not performed.

Read More…


Delayed Food Allergy

Food allergy symptoms typically occur right after ingesting the responsible food, or at least within two hours. However, in a delayed response, the symptoms may take six or more hours to appear. These delayed responses can surface in different ways – such as a skin reaction from a food allergy, or a gastrointestinal reaction after ingesting milk or soy.


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.

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


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.)





Repeat Day 1


Repeat Day 1


(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.