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First Office Visit

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Four major components are utilized by the physician to define the diagnosis of the patient: specific measurements of lung function, a detailed patient history, a physical examination, and allergy testing.

Spirometry and a peak flow meter are two devices to measure lung function. A spirometry is a computerized measurement of lung function performed in the office. Spirometry is often measured before and after receiving medication. The percentage of change in lung function is a factor in making the diagnosis of asthma. Peak flows are measured both in the office and in the home setting by the patient.

A detailed patient history is reviewed by the physician and an examination performed. Appropriate testing will be ordered and results reviewed with the patient and family. Nursing staff will review a detailed written treatment plan that outlines proper use of medication and devices, avoidance techniques, and follow-up care. The treatment plan will also be forwarded to your primary care doctor.

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Testing & Treatment

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Allergy Skin Testing

Prick skin testing, also known as scratch testing, is one type of allergy testing. A small disposable prick device applies the allergy extract to the skin and then scratches or pricks the skin. Common allergy extracts are grasses, weeds, trees, house dust, animals, and molds. A hive or raised bump will occur at the site of the prick. Each test site will be measured and specific allergies of the patient identified. Prick testing may be applied to the forearms or the back depending upon the age of the patient, the number of tests ordered, and the condition of the skin. Click here for photograph.

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Food Testing

Food testing may be initially performed by scratch skin testing. If indicated, a graduated oral food challenge over several hours will be performed in the medically safe environment of the office. Another type of testing known as a RAST involves examining specific IgE in the blood.

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Patch Testing

Patch testing to specific metals and other substances determines if the patient has a delayed hypersensitivity reaction. A strip of substances or customized patches are applied to the skin of the back. Potential reactions are evaluated in the office at 48 hours and 72 hours after application of the test substance.

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Venom Testing

Venom testing checks for allergy to a group of insects known as hymenoptera. Testing to honey bee, wasp, yellow jacket, yellow hornet, and white hornet is available. Testing involves both scratch testing and intradermal testing. Venom immunotherapy is available to patients with positive test results.

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Antibiotic Testing

Testing for drug allergies, such as antibiotics, is available. Commonly tested antibiotics are penicillin and the cephalosporins. Testing begins with a scratch test of a weakened dilution of the drug. Intradermals are the next level of testing. The final part of the testing within the office is a graduated oral challenge to the medication. Patients with negative results to the test drug will then be instructed on how to complete the rest of the challenge.

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Vocal Cord Dysfunction (VCD)

Vocal cord dysfunction is characterized by a closing or tightening of the vocal cords during inspiration. This condition may produce mild shortness of breath to severe spasms of choking and an inability to breathe. This condition may mimic an asthma episode to the casual observer. However, VCD is characteristically different than asthma and requires different treatment.