Board
Certified Physicians specializing in the treatment of Adult and
Pediatric Allergy, Asthma, and Immunology, providing our allergy
and asthma patients with 18 years of dedication and experience.
We provide you with complete care based on science and
experience, which we deliver professionally and
conveniently.
Specific
Specialties:
- Food
Allergies
- Food
Allergists
- Food
Allergens
- Child
Asthma
- Allergy
Shots
- Food
Allergy
Allergy
Immunotherapy
Allergen Immunotherapy is
often called "allergy shots." It is a form of therapy for allergies
that has been utilized since 1911. It continues to be used because
it is very effective. The process involves the injection of the
same things to which the allergic person was just shown to be
allergic.
The
most common allergy shots contain pollens, dust mites, molds,
animal proteins, or bee venom. In a sense, it is also a form of
immunization. However, unlike routine immunizations for infectious
diseases, it takes many injections. Since the person is allergic to
each of its components, it is necessary to begin by administering
an extremely low dose of the mixture.
The
dose is so low that one would not ordinarily experience significant
allergic symptoms, but the immune system will detect the presence
of the allergen and begin the process of regulation of the allergic
response. Once tolerance has been shown, the dose is carefully
increased with each successive injection.
Shots
are given once or twice a week, each at a slightly higher dose. As
a result, sensitivity is lowered with each injection. The only
reason this is possible is because of the marvelous capacity of the
immune system to adjust or adapt by producing protective
antibodies.
Many
other immune adjustments also take place, including the lowering of
a troublesome antibody called IgE. One could consider IgE to be a
"rogue" antibody, one which serves no purpose, but which is present
in too large an amount in the allergic person. One can reach a
"maintenance level" in about five months if they are able to get
and tolerate the injections twice each week.
Afterwards, shots are given every two weeks for a
time and then adjusted subsequently with longer intervals by your
allergist when the desired effect has taken place. You should see
the allergist yearly to decide to continue, when to modify the
serum, and when to stop.
Are
allergy shots safe?
One
could worry about having an allergic reaction to the shot. After
all, we are injecting a mixture of materials to which an allergy
was just proven by skin testing. Some reactions take place but they
are ordinarily minor. It is rare for a patient to experience
anything more severe that local swelling and itching.
When those
reactions do take place, your physician will be there to treat the
reaction until it has resolved. Most reactions are the result of
mistakes in injection of too large an amount. However, our nurses
are very experienced and we have the greatest confidence in them.
We appreciate the patient having "another set of eyes" to assure
that they receive the proper dose.
Allergy
Shots Management
Allergy shots therapy national recommendation is for 5
years. The dosages management are as follows:
1. Building phase:
Patients will be receiving shots twice a week
for a period of 4 months.
2. Maintenance Phase:
Once patients achieve their Maintenance
dose, (normally Vial # 5 Concentrate) Patients will be receiving
shots twice a month for a period of 6 months then shots
intervals will be every month for 5years.
Patients receiving
allergy shot therapy will need to see theirs allergist for a follow
up appointment every year. This visit usually is made when the
patients vial # 5 expires or run out of solutions.
What
is best for your?
Many
will have responded to medications. However, most patients who come
to our office have already failed to get relief from an excellent
medical regimen.
Allergen immunotherapy
(allergy shots) is the only treatment currently available that
makes a patient less allergic. Its major drawback is that it is not
convenient. However, if one can arrange their schedule to receive
the injections on a regular basis, you will almost certainly enjoy
a marked reduction in your allergies that usually lasts for many
years.
Speak
with Dr. Andrade, Dr. Brown, Dr. Song or our Head Nurse, Elisa
Sukenick, R. N. for further information about immunotherapy. It is
a long journey, but well worth the trip!
Allergy
Tips:
House
Dust
Many
people suffer from allergies to house dust. This allergy can cause
miserable nasal symptoms, but it can also cause asthma and eczema
to be more severe.
The
severe nasal stuffiness can also precipitate sinus infections. In
1964, two Dutch scientists discovered that a microscopic pest is
the main component that causes allergies in house
dust.
The
scientific names of the two most common varieties and
dermatophagoides farinae and dermatophagoides pteronyssinus. The
dust mite is not an insect, but is more closely related to
spiders.
Unfortunately, these
creatures tend to concentrate in the very places in which we spend
most of our time, because their source of food is the tiny flakes
of skin that we each produce every day. They are found in our own
beds, blankets, pillows, carpeting and wherever house dust is
found.
Fortunately, there are
many things that you can do to reduce the impact of this invisible
menace. The most important measures apply to places that you spend
the most time.
Below are some steps you can take to
reduce exposure:
Mite-proof casings around the pillow and mattress. A waterbed is a
great substitute for the mattress casings.
- Regular
laundering of the blankets, preferably in hot water.
- Remove
carpet or use a HEPA vacuum.
- HEPA or
electrostatic filters often make a difference.
- Room
HEPA filters often makes a difference.
- Minimize objects in the
bedroom that can accumulate dust, such as stuffed toys,
bookshelves, wall hangings, Venetian blinds, etc.
- Dust
mites thrive in moist, warm environments. In fact, their only
source of water is the humidity in the air. A dehumidifier can help
by keeping the relative humidity in your home at 40% -
50%.
Allergy & Asthma Specialty
Services PS
Animal
Allergen
We are
a nation of pet lovers. Our dogs and cats have successfully become
an important part of society and many families.
Unfortunately, the
development of an allergy to our fur-bearing friends is a common
event. They are, at times, major offenders in causing severe
asthma.
It appears the most allergic pet owners would rather suffer
from their allergies and asthma than find new homes for their pets.
Most are very fond of the family pet and others feel an obligation
to the animal or to those who gave them the
animal.
Below are a
number of ways to reduce the impact of such
allergies:
- Keeping
them outside.
- Frequent bathing. Yes,
most cats can be bathed, although some are more willing that
others. For cats that won't tolerate bathing, stroking them with a
moistened cloth can make a difference.
- Keeping
pets outside the bedroom.
- Filtering the air in
the home, just as you would do for dust mite allergies. Placing one
strategically in the bedroom can compensate for pet proteins, which
may drift into the room.
Mold
Allergies
Molds can be a problem both indoors and outdoors. Outdoor
molds are actually more plentiful on warmer, dry days. Rain is
necessary for their growth, but will also keep them from
dissemination.
Mold sensitive persons often have more difficulty while
doing yard work. Turning the soil, raking leaves, and even mowing
the lawn will typically increase exposure to outdoor
molds.
Use of a good filtration mask while doing such yard work
often helps. An effort should be made to avoid large accumulations
of lawn clippings and other vegetation such as leaves.
Indoor molds can also be an enormous problem. They often
become a problem when faulty roofing or other building materials
allow moisture to enter our homes. Leaky plumbing can also be a
source of problems.
Crawl spaces and basements are particularly vulnerable to
mold growth. A survey of the home should focus on areas of
excessive moisture.
Besides repairing any leaks, one should assure proper
ventilation of bathrooms, use dehumidifiers in chronically moist
rooms, spray mold retardant materials onto surfaces that exhibit
chronic mold growth, and use mold retardant paints such as Kilz.
Household bleach or X-14 (available commercially) are especially
able to kill mold and mold spores.
Pollen
Allergies
When outside, stay away from tall grass, weeds, and trees.
While the pollen can travel many miles away, it will still be more
concentrated in close proximity to the source.
Some have gone to the trouble of removing weeds and trees to
which they are allergic from their property. This may reduce the
overall exposure, but it is generally not enough in the most
sensitive person.
Keeping windows and doors closed will reduce the interior
pollen count. One practical compromise is to get a small portable
air conditioner that can be rolled from room to room for cooling on
the hottest days.
Sublingual
Immunotherapy
Traditional method of allergy shots (immunotherapy) is given
by a shot into the arm. This is a highly effective treatment for
patients with airborne allergies. Allergy shots have been approved
by the US FDA, Food and Drug Administration, and are widely
used.
There is exciting research out of Europe for treatment of
allergies called sublingual immunotherapy (SLIT). This is a way of
offering “allergy shots” by taking drops or tablets by
mouth instead of the conventional allergy shot. SLIT, has shown to
decrease time to get relief, maintain relief of allergies and
reduce risk of side effects.
A lot of research is being conducted in the US to gather
more data. Some research has shown benefit over the conventional
allergy shot while some studies showed no benefit. There are many
questions that need to be addressed before SLIT gets approved by
FDA in the United States.
The doctors at Allergy & Asthma Specialty Service are
excited about SLIT and its potential use for patients. Once there
is better research on safety, efficacy and approved by the FDA, we
will offer this treatment to our patients.
Allergy
Class
- The allergy class will
last about two hours.
- Pts. may bring their
family members, and friends to the class.
- The fee for the class
is only $39.00. The fee will first be billed to pts. insurance. If
insurance does not cover the fee, the pt will be responsible to pay
the fee.
- To accommodate pts.
from the Puyallup and Gig Harbor offices, all classes are held in
the Lakewood WA Office.
Products & Services
- Asthma
- Coughs, Wheezing and/or
Exercise Induced Asthma
- Allergies to stinging
insects (Examples: Yellow Jackets, Yellow Hornets, White Faced
Hornets, Wasps, and Honey Bees)
- Food Allergies
(Examples: Milk, Peanuts, Eggs, Fish, Shrimp, Wheat,
etc.)
- Food
Challenges
- Latex
Allergies
- Mold
Allergies
- Animal Allergies
(Examples: Gerbil, Guinea Pig, Cat, Dog, Rabbit, Hamsters, Rat,
Horses, Cow, etc.)
- Feathers (Examples:
Chicken, Duck, Canary, Parakeet, etc.)
- Metal
Allergies
- Local Anesthetic
Allergies (Xylocaine, Pontocaine, Nesacaine, Carbocaine, Marcaine,
Novocaine, etc.)
- Skin problems
(eczema)
- Hives and
Angiodema
- Anaphylaxis
- Methacholine
(provocholine) Challenges
- Drug Allergies
(Examples: Penicillin, Ampicillin, Cefazolin, Sulfa, Erythromycin,
etc.)
- Drug
Desensitizing
- Skin
Test
-Environmental
Allergies (Grasses, Trees, Weeds, Molds, Dust Mites,
Animals,
Cockroaches)
-Food and
spices
-Latex
-Local
anesthetic
-Antibiotics
- Allergy shots to
environmental allergies and insect allergies
- For Xolair
shots
- Immunoglobulin IV
Therapy
- Immunodeficiency