First Visit Information
Your initial appointment may last 2-3 hours depending on the amount of testing that is performed. Fasting and avoidance of most medication is not required. However, it is generally necessary to remain off of antihistamines as many as 7 days prior to the visit, depending on which medication you are taking. Antihistamines will interfere with allergy skin testing. Examples of antihistamines include diphenhydramine (Benadryl®), loratadine (Claritin®, Alavert®), cetirizine (Zyrtec®) and fexofenadine (Allegra®), among others. Medications such as montelukast (Singulair®), nasal and inhaled steroids, and albuterol may be continued. If you are not sure whether your medications contain antihistamines, or if your allergy symptoms are too severe to stop your medications even for a short while please call to discuss options.
In order to save yourself time, you can complete most of our required paperwork ahead of time after printing it out using the links below.
- Patient Information Form (two pages) (pdf)
- HIPAA Form (pdf)
History gathering
The most important part of your visit is the medical history. It determines if and what kind of testing should be performed. It is helpful if you can tell us the duration of your symptoms, any identifiable triggers which make them worse, and the medications you have tried (successful or not). We may ask you about related allergy symptoms, and if other members of your family suffer from allergies. Please bring a list of all of the medications you are currently taking, as it may affect what we prescribe. If you have had any allergy testing previously, please bring those records with you or make arrangements to have them sent to our office. If your concern is about an allergic rash that comes and goes, consider taking a picture in case it is not present on the day of your appointment.
Skin testing
Skin testing is used to identify the specific causes of your symptoms, and different types are used for different types of problems, whether they be environmental, food or drug allergies. The first type of skin testing, called skin prick testing, involves the placing of allergy extract drops on the upper back and gently poking the skin with a small pick. A multi-test device may be used on younger children in certain instances. Any presence of reaction (redness or hives) is noted at each location after fifteen minutes. A second type of testing, known as intradermal testing, involves injecting a minute amount of extract or drug just underneath the surface of the skin on the upper arm, similar to the placement of a PPD (tuberculin) test, which you may have had for a school or work physical. In some circumstances, patch testing may be used to evaluate different types of food or contact allergies. During patch testing, special adhesive strips containing these substances are placed on the upper back for 48 hours.
Pulmonary function testing
If your symptoms involve wheezing, cough or shortness of breath, we may perform a test of your lung capacity and strength by having you exhale into a special plastic tube (connected to a computer) as hard as you can. Sometimes the test is repeated after administration of a dose of albuterol or other bronchodilator, for comparison.
Treatment and follow-up
After testing is complete, a customized treatment plan will be prepared for you that may include a combination of specific avoidance instructions, medications or allergy shots if indicated. You will be asked to return a few weeks later to evaluate the effectiveness of the treatment, and periodically thereafter as necessary.
