There are days when it seems no matter what you do allergy symptoms take over your life. This is especially frustrating when you have already gone through the series of skin testing, locked the dog out of the bedroom and spent some hard earned dollars on allergy medication.
Allergists are trained to comprehensively evaluate patients before deciding on the appropriate course of treatment. The treatment plan is four tiered:
1) Counsel patients or parents on environmental triggers that may be avoided (for example dust mite controls, pet removal)
2) Prescribe medication tailored to the patient’s needs. This is based on the combined input of a patient’s previous response to medication, and the nature of current or anticipated symptoms.
3) Inform patients and their families about the allergic response, exposure patterns (seasonal vs. perennial or outdoor vs. indoor triggers), how certain medications should be used (nasal spray/ inhaler technique), how they work, and the natural course of their disorder. Often other resources of information are provided such as pamphlets, other handouts and web site referrals.
4) Consider allergy shots if the above three tiers of treatment are not effective or if medications are not well tolerated (or not desirable despite being effective and well tolerated).
The above therapeutic model is highly successful for many allergy sufferers, but some people continue to struggle with bothersome nasal and/or asthma symptoms despite this approach. **_What do you do if your response to allergy treatment falls short of your expectations?ere are 5 tips things to ask your allergist:***Ask your specialist to review ** environmental controls** with you. Often an avalanche of information is given at the first visit but many people have a tough time remembering all the recommendations and tips. If you have misplaced some pertinent handouts or written instructions ask to get more of them.
Inform your allergy specialist about the specific symptoms that have persisted or emerged and how they impact your day or night. Ask if you are correctly following your treatment plan (is your nasal spray technique up to par?). Ask if the current treatment plan can be modified to address your concerns.
Ask about alternative therapies that may enhance your therapeutic response by adding them to your current treatment plan. Many people benefit from nasal saline irrigation (Neti pot or other rinse kits) or special exercises (aerobics, swimming, yoga).
Inquire about allergy shots if you are not already getting them. They have a high success rate. Many allergists don’t recommend allergy shots initially because medications and environmental controls may be adequately effective. Your specialist depends on your feedback for follow-up decision making.
Ask your allergist about new medications or new treatments that may be available in the near future. Doctors are often detailed about new medications and procedures long before they are approved by the FDA. You may benefit by having earlier intervention with new therapies if you know when to look for them.
Allergists are interested in addressing the unmet needs of their patients at follow-up visits. Don’t give up on your specialist too soon. He or she usually has other ideas as a back-up plan when initial strategies fail. It may take a third or fourth visit to get it right but do your part to assist your allergy care provider by making the follow-up appointment and detailing your persisting problems and concerns. Sometimes simple adjustments of your treatment plan may be all you need.
Do you have additional tips that have helped you assist your specialist in fine tuning your allergy treatment?
Board Certified Allergist and Asthma Specialist