What To Expect On Your First Visit
As with any visit to a specialist, there are some unique aspects to your allergy/immunology appointment at Hedberg Allergy & Asthma Center. Therefore, we have put together a brief guide to what you can expect with your initial visit to HAAC, as well as what to expect after the first visit.
The Initial Visit:
As a general rule, the first visit to our clinic will be the longest and most involved. We generally estimate about 2 hours for a new patient visit. Make sure to bring all of your medications or an updated list of all of your medications to each clinic visit – this includes both allergy medications and non-allergy medications. After checking in at the front desk, you will be taken to an exam room by a member of our nursing staff. Our nurses will review the reason for your visit and your medical history. You will then meet one of our four board-certified allergists. He or she will discuss your issues, perform a physical exam, and recommend any tests or procedures (i.e. Skin prick testing for allergies, lung function testing, etc). After the procedures, if indicated, are completed, the physician will wrap up the visit by making any necessary recommendations (lab studies, medications, referrals, imaging, etc.). After this, a follow up appointment may be discussed depending on your individual situation. If labs were ordered at your initial visit, we will contact you in 2-4 weeks when the lab results have been received and interpreted by the physician.
Follow Up Visits:
Most of our patients will be scheduled for one or more follow up visits. These visits are typically shorter than the initial visit. The time between visits is different for different patients and will be determined by the physician. It is important to note that if we diagnose a chronic allergy/immunology problem (severe seasonal allergies, asthma, hives, immune system problems, etc.), we want to be involved in your care! We want to work with your primary care physician to treat your condition in the best possible way.
Because of the nature of our practice, it is not often possible for us to work in emergent visits. We will do our best to see you for a timely follow up visit if you are having problems related to allergies, but your best bet is often to visit your primary care physician or an urgent care clinic for same-day issues. We do encourage you to call our clinic if you have questions about your condition and our staff will point you in the right direction.
As part of their initial evaluation, many of our patients will undergo some type of allergy testing. There are two different ways to determine whether or not you are allergic to a particular substance (food, pollen, animal dander, etc.): skin prick testing and blood (serum) IgE testing. The most commonly used method in our office is skin prick testing. This method uses a small plastic “pricking” device (not a needle!) that has been dipped in an allergen extract. The device then makes a small prick on the surface of the skin. After about 15 minutes, positive tests will appear as large “wheals”, much like a mosquito bite. The advantage to prick testing is that it gives a very accurate result that allows you to know exactly what you are allergic to when you leave the clinic. In some instances, if prick testing results are unclear, your allergist may recommend a series of intradermal tests. These involve injecting a tiny amount of allergy extract under the skin. Like with prick testing, a positive test is indicated by the development of a wheal. Occasionally, we will order serum IgE testing, a blood test that was formerly known as RAST testing. We rarely use this type of testing as a first line test to look for allergies, but may use it to track positive food allergy tests. For instance, if your child has a positive prick test for peanut, we may obtain a serum IgE level for peanut so that we can track the progress of your child’s allergy over time. Overall, allergy testing is very safe and well tolerated by even small children.
I Take Allergy & Asthma Medications, Should I Stop Them Before My Visit?
This is a question that we are frequently asked. The answer is, “Yes and No”. Some medications should be stopped before your visit as they can interfere with allergy testing. These are medications called antihistamines and are listed below. We do not want you to stop any inhalers, steroid nasal sprays (fluticasone, etc.), or most of your other non-allergy/asthma medications (there are some exceptions as you will see below). If you have any questions, don’t hesitate to contact our clinic!
STOP THESE MEDICATIONS 10 DAYS PRIOR TO VISIT
Imipramine (Check with prescriber before stopping this medication)
STOP THESE MEDICATIONS 5 DAYS PRIOR TO VISIT
Loratadine (Claritin or Alavert)
STOP THESE MEDICATIONS 3 DAYS PRIOR TO VISIT
Diphenhydramine (Benadryl, also found in some over the counter sleep aids like Unisom)
Azelastine Nasal Spray/Eyedrops
Olopatadine Nasal Spray/Eyedrops (Pataday/Patanase)
Dymista Nasal Spray
Amitryptyline (Check with prescriber before stopping this medication)
DO NOT STOP ASTHMA INHALERS, STEROID NASAL SPRAYS (FLONASE, NASACORT, NASONEX, RHINOCORT, ETC), MONTELUKAST (SINGULAIR), OR ANY NON-ALLERGY/ ASTHMA MEDICATIONS NOT LISTED ABOVE.