Chuck Klucka - Allergy and Asthma - Frequently Asked Questions

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Frequently Asked Questions!!

My child gets infections frequently, and goes to the pediatrician often for antibiotics. He/she misses a lot of school because of it—is this unusual? Are these infections caused by something else? Answer
What are the signs and symptoms of allergies? Of asthma? Answer
I heard that skin testing in an allergist’s office hurts a lot! Will my insurance cover it? Answer
I was stung by a flying insect, presumably a bee, and had to go to the emergency room because I had itching all over, and started to cough and have chest tightness. Should I be further evaluated by an allergist? Answer
Several months ago, I began having a terrible itching condition. I break out in “whelts” and they itch terribly. I rarely have a day without the itch! I have been to my family doctor and to a dermatologist, and have tried many creams, but nothing seems to help much. What can I be allergic to?? Should I see an allergist? Answer
My child has an eczema condition diagnosed by his pediatrician, and uses creams frequently for it. He gets frequent attacks, and itches at it a lot. This makes it worse! I read somewhere that eczema can be related to a food allergy. Is that true? Answer

1. My child gets infections frequently, and goes to the pediatrician often for antibiotics. He/she misses a lot of school because of it—is this unusual? Are these infections caused by something else?

Answer: Although colds and upper respiratory infection in general are more common in school age children than in adults, particularly during the school year, recurrent infections, such as ear infections, frequent bouts of colds, or even bronchitis, requiring more than one or two visits a year to the primary care doctor, is very often a sign of significant underlying allergy and/or asthma. “Colds” that linger off/on for weeks, or are not always associated with a fever, for example, may be your child’s ongoing chronic reaction to allergens such as pet proteins, dust mites, and seasonal or perennial pollen or mold allergens. Allergists can definitively diagnose whether a patient has allergies, including the exact allergens in question, and determine the severity and extent of such allergies by a thorough examination and allergy skin testing. Treating the underlying allergies will result in much greater symptom improvement and much less susceptibility to infection.

2.What are the signs and symptoms of allergies? Of asthma?

Answer: Typical seasonal or perennial allergies affecting the nose and eyes is very common---about 15-30% of the population, depending on the age group---and symptoms include itching, sneezing, nasal stuffiness (obstruction), and drip, either out the front, or down the back of the nose (post-nasal). Eye symptoms also include itch, redness, watering and puffy eyelids especially after itching them. 85% of allergy patients have some eye symptoms, but a lot of patients with allergy have little or no eye symptoms, despite having significant allergy!!

Asthma symptoms can be as mild as a intermittent or chronic dry cough, or may also include chest tightness, wheeze, shortness of breath or even some sputum production, (usually clear or white), depending upon the severity of the asthma. Many asthma patients only get an attack when they get a viral infection, such as a head cold that “goes into the chest”, or with exercise, as when a person start coughing or gets chest tightness during an aerobic activity such as jogging or playing tennis. All these patients should be evaluated for possible asthma and/or allergy.

3. I heard that skin testing in an allergist’s office hurts a lot! Will my insurance cover it?

Answer: Skin testing is by far the best way to test for most allergies. 95% of allergists use skin testing instead of drawing blood and sending that to a lab. It is very straight-forward and is associated with minimal discomfort for the patient. We do it the same way in all patients 8 years and up. (For the younger patients, “multi-tests” are used, so the actual placement of the test takes only a few seconds!) In almost all instances, it can be done in a matter of two(2)-- half-hour visits to our office. Two types of tests are done, and in each instance, the tests are applied in a matter of just 3-4 minutes. Reactions take place in about 15 minutes, and a visit with the doctor follows. At that time, results are discussed, the patient receives a copy of their test, and treatment recommendations are made. Almost all insurances cover the types of allergy testing done in our office, including Medicare, subject to the patient’s benefits (if you have a copay, deductible, or coinsurance that applies, our front office staff can inform you of your share of cost, if any.)

4. I was stung by a flying insect, presumably a bee, and had to go to the emergency room because I had itching all over, and started to cough and have chest tightness. Should I be further evaluated by an allergist?

Answer: Yes, without question!! Stinging insect allergy, (including severe fire ant allergy), causes over 40 deaths per year in the US, and thousands of near death experiences requiring ER and ICU treatment. Your chance of having a reaction as severe or more severe, the next time, is 50-60%! In addition to having self-administered adrenaline (epinephrine) available, persons having any reaction more than a large local rection (ie itch and swelling at the sting site), should be tested and given the option of allergy injections, if positive. These injections are overwhelming effective in the event of a future sting, may save your life, and certainly give you much greater peace of mind when outdoors!!

5. Several months ago, I began having a terrible itching condition. I break out in “whelts” and they itch terribly. I rarely have a day without the itch! I have been to my family doctor and to a dermatologist, and have tried many creams, but nothing seems to help much. What can I be allergic to?? Should I see an allergist?

Answer: What you are describing is actually quite a common complaint, and allergists see similar cases as yours every day in their office. Chronic (lasting more than 6 weeks) hives (or even sometimes, chronic itch without hives) is a condition that may or may not have an obvious cause. Allergists tend to see and treat these cases much more often than other specialists. A visit to your allergist will help to sort out the possible causes, and, much more importantly, can give you the best chance for successful treatment and/or remission for this frustrating condition.

6. My child has an eczema condition diagnosed by his pediatrician, and uses creams frequently for it. He gets frequent attacks, and itches at it a lot. This makes it worse! I read somewhere that eczema can be related to a food allergy. Is that true?

Answer: YES! Childhood eczema (unlike adult eczema) is very often associated with a delayed type allergy to one or several different foods. Therefore, it is the feeling of most allergists that all children with eczema must be evaluated for food allergy! Please make an appointment with us to evaluate your child for food allergies, and get him better control of his chronic skin condition! Several well controlled studies have shown that simply avoiding the offending food(s) results in complete or near complete remission of symptoms in over 70% of children with eczema, without the need for significant medication! Allergists are well-trained to treat both childhood and adult eczema very effectively, with a minimum of medication side effects.