Got allergies? Don't suffer anymore - get help today!
If you're experiencing allergy (including FOOD allergies), asthma, sinus disease or related respiratory problems, CARE is here to alleviate your symptoms. Your CARE team will work closely with you to ensure that you are in charge and have control over your allergy and asthma symptoms!
Get personalized, state-of-the-art attention! We offer comprehensive, experienced, friendly and prompt care for cough, recurrent sinus/ear infections, asthma, nasal allergies, hay fever, recurrent bronchitis, atopic dermatitis, food allergies, bee sting and other insect allergies, latex sensitivity or allergy, medication allergies, urticaria (hives), angioedema (tissue swelling), anaphylaxis and immunodeficiency. We believe in providing specialized allergy care in a personalized manner and are always available to you for help and advice!
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- Call 434-298-ASAP (2727) for your FREE phone consultation. (Yes, you can speak to the doctor directly!)
Charlottesville Allergy & Respiratory Enterprises FAQ
Q: I think I suffer from Asthma…how do I know for sure?
Screening for Asthma is simple and involves breathing tests using Spirometry.
Spirometry involves the use of a spirometer for making pulmonary function measurements to evaluate airway obstruction and its reversibility with use of a bronchodilator. Simply stated, this involves measurement of the volume and/or speed of flow of air that can be inhaled and exhaled.
Q: What can be done to treat asthma?
Individuals suffering from asthma may be able to minimize their symptoms and improve their quality of life by identifying and then avoiding their asthma triggers. Some of the common triggers for asthma include:
Treatment and Management:
- House dust mites, animal dander, molds, pollen, cockroach droppings or foods
- Tobacco smoke, which is an irritant that often aggravates asthma
- Bacterial and viral infections such as common cold and sinusitis
- Strenuous exercise
- Exposure to cold, dry air
- Acid refluxMedications such as Aspirin, Ibuprofen, Beta Blockers and others can cause or worsen asthma
- Certain foods can trigger wheezing in some people
- Emotional anxiety may also increase your asthma symptoms and trigger an attack
Asthma is not a homogenous disease; instead, it is a syndrome that involves a variety of causative factors. Therefore, individualized assessment & treatment of asthma is recommended. A personalized plan for care often involves control of environmental control measures to avoid your asthma triggers, careful selection of medications, an asthma action plan, and of course, a partnership between you, your family, your allergist and other healthcare providers. Once asthma is well-managed, most individuals can participate in their routine activities. Furthermore, since asthma is a chronic ailment, it requires ongoing management including optimal use of medications to prevent and control asthma symptoms and to reduce airway inflammation. There are two general classes of asthma medications, quick-relief and long-term controller medications, both of which are often prescribed by your allergist.(Information only; not intended to replace medical advice; adapted from AAAAI)
Q: I seem to have asthma symptoms, but only after running or a workout. Otherwise I am fine. Is this asthma or something else?
Individuals who develop chest tightness, shortness of breath, wheezing or cough following exercise may have exercise-induced bronchoconstriction. This implies that there is a transient narrowing of breathing tubes during exercise which results in the above-mentioned symptoms. It is also important to note that certain individuals with allergies may have similar symptoms during exercise. It is believed that individuals with exercise-induced asthma or bronchoconstriction are particularly sensitive to certain environmental stimuli such as dry air, low temperature, high pollen levels and air pollutants. Similarly, respiratory infections, nasal allergy and vocal cord problems may predispose an individual to have similar symptoms.
Individuals suffering from tightness of chest and/or wheezing should undergo an examination by your allergist, who may then recommend a breathing test called spirometry and also, possibly an exercise challenge test. Thereafter, your allergist will help develop a treatment plan for you. It has been found that exercise-induced bronchoconstriction that is associated with more generalized asthma can be prevented with controller medications taken regularly or by using medicines before you exercise. Furthermore, when such bronchoconstriction symptoms occur, they can be treated with short-acting beta-agonists.
It is important to note that the goal of an asthma treatment plan is to keep your symptoms under control so that you can enjoy exercising or sports activities. With careful assessment, proper diagnosis and optimal treatment, majority of such individuals can participate and excel in sports or other outdoor activities.
(Information only; not intended to replace medical advice; adapted from AAAAI)
Q: What exactly is ‘hay fever’?
Individuals who suffer from frequent sneezing, itchy or runny nose and congestion may be suffering from rhinitis. Rhinitis is believed to affect up to 40% of children and 10-30% of adults in the US. Rhinitis can be classified as Allergic and Non-allergic.
Allergic rhinitis is caused by aero-allergens. These symptoms result from the body's immune response to the allergen, which results in antibodies that release chemicals that further result in symptoms such as post-nasal drip, runny nose, itching, stuffiness and sneezing. Individuals with allergic rhinitis may also have watery eyes that are more sensitive to cold, dry air, smoke and perfume. The symptoms of rhinitis commonly co-occur with sinus and ear problems, asthma, and even trouble sleeping. When allergic rhinitis is related to outdoor allergens such as tree, grass and weed pollen, it is called seasonal allergic rhinitis, or "hay fever." However, individuals can have rhinitis all year-round as a result of indoor allergens such as pets, mold and dust mites. This is called perennial allergic rhinitis.
Your allergist can help identify which allergens, if any, are causing your symptoms and then discuss treatment options with you. These options may include plans for avoiding allergens, taking medications, and sometimes allergy shots or immunotherapy.
Non-Allergic Rhinitis refers to the presence of rhinitis symptoms in individuals who may not have allergies. Non-allergic rhinitis usually begins in adults and often causes year-round symptoms, especially including runny nose and nasal stuffiness. It has been reported that pollution, smoke and similar irritants and strong odors may cause these symptoms of non-allergic rhinitis. Furthermore, such symptoms may also be related to adverse effects of certain medications, including some blood pressure medicines, oral contraceptives or medications used for erectile dysfunction. Interestingly, prolonged use of nasal decongestant sprays may also result in a form of non-allergic rhinitis termed as rhinitis medicamentosa. Treatment options for non-allergic rhinitis are best discussed with your allergist.
Q: What exactly are allergies and how can I be tested?
If you have an allergy, your body is reacting to something you may have inhaled, touched or eaten. Such agents that trigger an allergic reaction are called allergens. Reactions to these allergens may range from being annoying to life-threatening. Individuals with untreated allergy symptoms are often not aware of how significantly better they can feel after their symptoms are properly diagnosed and managed by an allergist.Benefits of Allergy Testing:
Allergy tests, when combined with the specialization and precision of your allergist to interpret them, can give accurate information about what you are allergic to. After a thorough history taking, exam and allergy testing, you and your allergist will team up to develop a treatment plan to manage the allergy symptoms. Allergy testing is a fairly safe and accurate procedure for both adults and children. Some of the common agents that may be responsible for the allergy symptoms include dust mites, molds in home or air, tree, grass and weed pollen, and proteins found in dander, saliva and urine of furry animals. On the other hand, more serious allergies can be caused by venom from stings of bees, wasps, fire ants, yellow jackets and other similar insects.Common symptoms for suspected allergies:
The following symptoms may prompt your Allergist to recommend skin testing:
Types of Allergy Tests:
- Respiratory system: These symptoms may include itchy nose or throat, often accompanied by itchy eyes; nasal congestion, watery eyes, runny nose, congestion in the chest, cough or wheezing or problems with breathing
- Dermatological: The presence of itchiness of skin, generalized bumps or hives, atopic dermatitis
- Abdominal: Diarrhea, constipation and cramping after eating certain foods
- Severe reactions to insect stings
- Anaphylaxis: a serious allergic reaction that affects many parts of the body at the same time
The allergen extracts that are used for performing allergy tests meet the requirements of the U.S. Food and Drug Administration (FDA). Allergy tests are categorized into the following:
(Information only; not intended to replace medical advice; adapted from AAAAI)
- Skin Testing:Skin testing is the most common way of performing an allergy test. It involves a small prick on the skin surface to deliver a very small amount of allergen and is relatively painless. In individuals with allergy to that particular introduced agent, a little swelling will occur. In such patients, these reactions typically occur within 15 minutes. It is likely that such individuals will not have any other symptoms other than the swelling discussed above. This symptom often disappears within 30 minutes. However, if these skin tests are negative, but your physician suspects allergies, he or she may recommend the more sensitive intradermal test which involves injection of a small amount of allergen within the skin. These skin tests are done in your Allergist's office to allow for observation and management in case of any rare adverse effects.
- Challenge Tests: Challenge tests may involve ingestion or inhalation of a very small quantity of the suspected allergen. These tests are often done with food or medication allergies and are monitored by your Allergist.
- Blood Tests:As the name suggests, these tests involve drawing blood and as a result, the results may not be as quickly available as the skin tests.
Q: What about FOOD allergies?
Individuals with food allergy have an overreactive immune system towards a particular food. Such a response happens due to an antibody called IgE (Immunoglobulin E). Individuals suffering from food allergy often have a family history of allergies. The most common food allergens are the proteins in cow's milk, eggs, peanuts, wheat, soy, fish, shellfish and tree nuts.
The symptoms on food allergy may not depend on the amount of allergenic food consumed and may even happen with consumption of tiny amounts. It is also important to note that many allergens may cause symptoms even after they have been cooked, and even after undergoing the digestive process. On the other hand, some other allergens, typically certain fruits and vegetables, may only cause allergies when consumed raw.
In some food groups, such as seafoods and tree nuts, a phenomenon called cross-reactivity may be seen. This implies that if an individual has an allergy to one member of a food family, they may also be allergic to other members of the same food group. Interestingly, cross-reactivity may not be as commonly seen in foods from animal groups. For example, it has been found that individuals who may have allergies to cow's milk may still be able to eat beef. Similarly, individuals with egg allergies may still be able to eat chicken. It has also been found that among shellfish, crustaceans (shrimp, crab and lobster) are most likely to cause an allergic reaction. Other mollusks such as clams, oysters and scallops are somewhat less commonly associated with allergies.
Symptoms of Food Allergies:
Symptoms of allergic reactions are commonly dermatological in nature and may cause skin itching, hives and swelling. Vomiting and diarrhea are common gastrointestinal symptoms. Symptoms of the respiratory system usually occur only in conjunction with skin and gastrointestinal symptoms.
Severe Allergic Reactions:
Anaphylaxis is a serious allergic reaction that happens very quickly and needs immediate and urgent attention! The symptoms often include difficulty in breathing, loss of consciousness and dizziness. If you notice any of these symptoms, especially after eating, call 911 right away. It is imperative to seek medical care immediately (call 911). Don't wait to see if your symptoms go away or get better on their own. Without immediate treatment and effective and expert medical care, anaphylaxis can be lethal. It is essential to follow up with your allergist in such cases.
An allergist is the best qualified professional to diagnose food allergy. Your allergist will take a thorough medical history, followed by a physical examination. You may be asked about contents of the foods, the frequency, seasonality, severity and nature of your symptoms and the amount of time between eating a food and any reaction.
Allergy skin tests may determine which foods, if any, trigger your allergic symptoms. In skin testing, a small amount of extract made from the food is placed on the back or arm. If a raised bump or small hive develops within 20 minutes, it indicates a possible allergy. If it does not develop, the test is negative. It is uncommon for someone with a negative skin test to have an IgE-mediated food allergy.
In certain cases, such as in patients with severe eczema, an allergy skin test cannot be done. Your doctor may recommend a blood test. False positive results may occur with both skin and blood testing. Food challenges are often required to confirm the diagnosis. Food challenges are done by consuming the food in a medical setting to determine if that food causes a reaction.
Another question that is commonly asked is whether children outgrow their food allergies. It has been reported that most children may outgrow certain allergies such as those to soy, egg, cow's milk and wheat allergy, even if they have a history of a severe reaction. About 20% of children with peanut allergy will outgrow it. About 9% of children with tree nut allergy will outgrow it. Your allergist can help you learn when your child might outgrow a food allergy.
The best way to treat food allergy is to avoid the foods that trigger your allergy. Always check the ingredients when eating, especially when out of home. Carefully read labels that indicate food information.
Carefully read food labels. Always carry and know how to use injectable epinephrine and antihistamines to treat emergency reactions. Teach family members and other people close to you how to use epinephrine! It is also important to wear an ID bracelet that describes your allergy.
Food allergies can be confusing and isolating. For support, you may contact the Food Allergy & Anaphylaxis Network (FAAN) at (800) 929-4040.
(Information only; not intended to replace medical advice; adapted from AAAAI)
Q: What should I know about bees and wasps?
After being stung by an insect, a majority of individuals develop redness, swelling and itching only at the local site. On the other hand, certain individuals may have over reactive immune responses to such venoms, and thus are allergic to these. The phenomenon of being allergic to stinging insects involves the production of antibodies called Immunoglobulin E (IgE). In case of a repeat incident of stinging by the same kind of insect, the venom then interacts with this already existing IgE antibody, thereby causing the release of substances that constitute an allergic response. For some individuals, such allergic responses may even be life-threatening and are referred to as anaphylaxis. Anaphylaxis may result in symptoms such as swelling in the throat or tongue, difficulty breathing, itching and hives, dizziness, abdominal cramps, nausea or diarrhea. In very severe cases, individuals may even have a rapid fall in blood pressure, which can then cause shock and loss of consciousness. Anaphylaxis is a medical emergency and may be fatal. If you have these symptoms after an insect sting, get emergency medical treatment. Your allergist can help with prevention of any further similar incidents.
The following information helps you to understand more about the common insects that can cause:
- Yellow jackets have nests that are made of a paper-maché material and are often located underground. Sometimes, they can be found in the cracks in masonry, walls of frame buildings or even in woodpiles.
- Honeybees and bumble bees only sting when provoked. However, Africanized honeybees or "killer bees" found in the Southwestern US are more aggressive and may even sting in swarms. Wild honeybees live in "honeycombs" colonies in hollow trees or cavities of buildings.
- Paper wasps have nests that appear to be made of a paper-like material which forms a circular comb of cells. The nests are often located behind shutters, in shrubs or woodpiles.
- Hornets are typically larger than yellow jackets. They have gray or brown nests that appear football-shaped. These nests are often found on branches of trees, in shrubbery or in tree hollows.
- Fire ants have nests of dirt in the ground that may be quite tall.
The most important advice for preventing stings would be to stay away and stay clear! These insects are most likely to sting if they are provoked or if their homes are disturbed. It is, therefore, important to have nests around your home destroyed.
If you find any flying stinging insects close by, move slowly away. Also, brightly colored clothing and perfume may attract insects when outdoors. Keep your food covered until eaten. Wear closed-toe shoes outdoors and avoid going barefoot. However, if the insect stings and left its stinger in your skin, remove the stinger within 30 seconds to avoid receiving more venom. A quick scrape of your fingernail will removes the stinger and sac. Avoid squeezing the sac-this forces more venom through the stinger and into your skin. You may raise the affected limb and apply a cold compress to reduce swelling and pain. You may also gently clean area with soap and water to prevent secondary infections. Please see your physician if the swelling progresses or if the sting site seems infected.
If you are severely insect-allergic, carry auto-injectable epinephrine. However, epinephrine is a rescue medication only, and you must still have someone take you to an emergency room immediately if you are stung. You may also want to consider wearing a bracelet or necklace that identifies the wearer as having severe allergies. If you have had a serious reaction to an insect sting, make an appointment with an allergist. With a proper diagnosis, treatment plan and careful avoidance, people with an insect allergy can feel more confident and outdoors.(Information only; not intended to replace medical advice; adapted from AAAAI)
Q: What is Anaphylaxis?
Anaphylaxis is a serious allergic reaction that is quite rapid in onset and may even be lethal. This medical emergency requires immediate treatment and then follow-up care by an allergist. Many individuals may not realize they have an allergy until they experience anaphylaxis. An allergist can examine, make a proper diagnosis and discuss the appropriate treatment plan.
Anaphylaxis is triggered when the immune system overreacts to an allergen (such as peanut or penicillin) causing mild to severe symptoms that affect various parts of the body. Symptoms usually appear within minutes to a few hours after eating a food, swallowing medication or being stung by an insect. Sometimes, however, these symptoms initially go away, and then return a few hours later; it is therefore important to call 911 and reach a hospital as soon as an anaphylactic reaction begins and to remain under medical observation for as long as the reaction and symptoms continue.
Symptoms of anaphylaxis may include:
- Breathing: wheezing, shortness of breath, throat tightness, cough, hoarse voice, chest pain/tightness, trouble swallowing, itchy mouth/throat, nasal stuffiness/congestion
- Circulation: pale/blue color, low pulse, dizziness, lightheadedness/passing out, low blood pressure, shock, loss of consciousness
- Skin: hives, swelling, itch, warmth, redness, rash
- Stomach: nausea, pain/cramps, vomiting, diarrhea
- Other: anxiety, feeling of "impending doom," itchy/red/watery eyes, headache, cramping of the uterus
The most dangerous symptoms are low blood pressure, breathing difficulty and loss of consciousness, all of which can be life threatening. If you have any of these symptoms, particularly after eating, taking medication or being stung by an insect, call 911 and seek medical care immediately. Don't wait to see if symptoms go away or get better on their own.
Anaphylaxis is commonly associated with the following allergens:
- Foods: Any food can cause an allergic reaction, but foods that cause the majority of anaphylaxis are peanuts, tree nuts (e.g., walnut, cashew, Brazil nut), shellfish, fish, milk, eggs and preservatives.
- Stinging insects: Insect sting venom from yellow jackets, honeybees, paper wasps, hornets and fire ants can cause severe and even deadly reactions in some people.
- Medications: Almost any medication can cause an allergic reaction. Common medications that cause anaphylaxis are antibiotics and anti-seizure medicines.
- Latex: Some products made from natural latex contain allergens that can cause reactions in sensitive individuals. The greatest danger of severe reactions occurs when latex comes into contact with moist areas of the body or internal surfaces during surgery.
- Exercise: Although rare, exercise can cause anaphylaxis. Oddly enough, it does not occur after every exercise session and in some cases, only occurs after eating certain foods before exercise.
Treatment and Prevention:
If you (or anyone you are with) begin to have an allergic reaction, call for medical help to get to the closest emergency room. The sooner the reaction is treated, the less severe it is likely to become. Your physician may give an epinephrine (adrenalin) shot to relieve breathing problems and improve circulation, and other medications such as antihistamines (that reduce swelling and itch) or steroids (that further reduce the allergic response).
Once you've had an anaphylactic reaction, visit an allergist to get a proper diagnosis. The allergist will take your medical history and conduct other tests, if needed, to determine the exact cause of your reaction. Your allergist can provide information about avoiding the allergen as well as a treatment plan. Avoiding the allergen(s) is the main way to remain safe, but requires a great deal of education. In some cases, your allergist may suggest specific treatments, such as allergy shots (or immunotherapy) to virtually eliminate the risk of anaphylaxis from insect stings, or procedures that make it possible to be treated with certain medications to which you are allergic. Your allergist may also discuss the use of auto-injectable epinephrine. You may also be asked to wear a special ID that identifies you as having a severe allergy. If you have had an anaphylactic reaction, inform family, healthcare workers, employers and school staff about your allergy so they can watch for symptoms and help avoid your allergen.
(Information only; not intended to replace medical advice; adapted from AAAAI)
Q: My spouse snores…I am concerned about sleep apnea. Is that something you can help with?
YES! Charlottesville Allergy & Respiratory is able to test and treat sleep apnea.