Personalized Treatment Plans
Each allergy patient has a unique combination of allergic triggers and environmental factors that require a unique plan for treatment. Avoidance of allergens may be practical for one patient, but more difficult for another. We devote an extended period of time, as much as three hours, to each new patient. Our evaluation consists of a thorough review of your medical history and a physical exam, followed by specific diagnostic tests as needed. Personalized recommendations are provided for anaphylaxis and asthma action plans, sinus care regimens, and environmental control measures.

Allergy Shots
Allergy shots, or Immunotherapy, are a series of injections to control allergy symptoms. Allergy shots are not a medication. They are a vaccine. In an allergic person, the immune system is responding inappropriately to the environment. This results in allergic reactions like sneezing, itching, congestion, and wheezing. Receiving allergy shots desensitizes allergic patients to their specific allergens and is the only way to "turn off" the immune system's allergic reactions. During IT, the patient will gradually develop a stronger tolerance of his or her allergens. With allergy shots, your allergy symptoms can be decreased, minimized or even eliminated.

Who should consider receiving allergy shots?
You should consider allergy shots if complete avoidance of your allergens is impossible or if you:

• have moderate to severe allergies
• have frequent respiratory infections
• do not respond to allergy medications
• would prefer to avoid a lifetime of allergy medication use
• are willing to commit to a regularly scheduled treatment plan
• have chronic sinusitis or asthma because of allergies.

How do allergy shots work?
Allergy shots work like a vaccine by containing traces of your specific allergens -- the very things that trigger an allergic reaction. By gradually increasing the doses of your allergen, your body develops an immunity and/or tolerance to that allergen. In essence, allergy shots turn off an inappropriate immune response -- your allergic reaction to a plant, tree, pet or mold -- while still allowing your immune system to respond normally to infectious agents such as bacteria and viruses.

Allergy shots occur in two phases:
Build-up phase: injections contain increasing amounts of allergens. The frequency of injections generally ranges from every 3 – 10 days with an average duration of three to six months.

Maintenance phase: begins when the effective therapeutic dose is achieved. Once this maintenance dose is reached, the time between treatments will increase, ranging from every one to four weeks.
You may begin to see the benefits of allergy shots during the build-up phase, but it may take as long as 6-12 months on the maintenance dose to start seeing significant results. On average, maintenance therapy is continued for three to five years.

What is my treatment commitment?
You must be willing to commit to a regular schedule of immunotherapy treatments, with the main commitment period occurring during the first 12 months. Although some people may consider this level of dedication as an inconvenience, a three- to five-year commitment to allergy shots is minimal when compared to a lifetime of taking over-the-counter or prescription medications.

Allergy injections must be given by a healthcare provider at a facility with proper staff and equipment to handle potential anaphylaxis. Staff must be skilled in identifying and treating any potential adverse reactions. It is recommended that you remain in the office 20 to 30 minutes after receiving your allergy shots to ensure that the injected allergen does not cause any adverse reactions.

Allergy Drops (Sublingual Immunotherapy)
In many cases, sublingual immunotherapy, or allergy drops, can be an alternative to injections in immunotherapy treatment. They are administered as a drop of liquid under you tongue. The drops are prepared individually for you, based on your allergies. This form of treatments is currently available for pollen, mold, dust mite and pet allergies. While traditional allergy injections are administered weekly-to-monthly at your doctor’s office, allergy drops may be administered daily at home.

Allergy drops provide the convenience of fewer office visits and the benefit of no needles, which is especially appealing for small children. There is also a reduced risk of severe reaction with allergy drops.

Avoidance
Once your allergic triggers have been identified, avoidance strategies can be discussed. Indoor allergens can include dust mite, animal dander and mold. Recommendations may include monitoring humidity levels, placing dust mite proof encasements on the bedding, removing indoor mold, and restricting pets to certain areas of the home or keeping them strictly outdoors. The ideal home for an allergic individual would include primarily hard-surfaced flooring, leather or vinyl furniture, and blinds instead of drapery. Outdoor allergens are more difficult to avoid. Knowing your season will be helpful in anticipating triggers before they arrive. Air-conditioning, rather than attic fans or window fans, will reduce pollen levels in your home. Wearing masks and goggles during yard work, showering and changing clothing after spending time outdoors, and limiting time spent outdoors during peak pollen times are additional recommendations. As avoidance can be difficult, time-consuming, and sometimes nearly impossible, many patients which to discuss additional options such as medication or immunotherapy.

Medication
Your doctor may recommend allergy medications as part of your treatment plan. Medications may be either over-the-counter or prescription. Antihistamines help with sneezy, itchy symptoms and can be used as needed. Prescription nasal sprays contain a topical corticosteroid that works on inflammation and post-nasal drainage. These work best if used routinely. Eye drops can also be helpful, although some over-the-counter brands contain irritants that may make symptoms work. Over-the-counter nasal sprays, such as Afrin, are helpful for short-term relief, but should not be relied on routinely as dependence and rebound symptoms may occur.