General Allergy Information
What are allergies?
Allergies are the result of your body’s immune system having a heightened sensitivity resulting in reactions to foreign substances that are otherwise harmless. These substances include pollens (trees, grasses and weeds), animal dander and saliva (cats and dogs), mold spores, dust mites, cockroaches, foods, and medications.
Under normal conditions, your immune system would only react if being threatened by harm from pathogens such as bacteria, viruses, fungi, parasites or cancers. However, those who suffer from allergies often experience specific symptoms triggered as your immune system reacts to those harmless substances. Depending on the severity of the allergic reaction, the symptoms can be relatively tolerable or excruciatingly unbearable.
How do you identify allergens?
We can identify allergens by performing blood tests or skin tests
How can you treat allergies once you’ve identified them?
We can discuss hygiene and avoidance measures that will decrease the burden posed by the allergen on your body. When these measures aren’t enough, we discuss treatment options with medications, allergy shots and allergy drops. For Patients doing allergy shots, we offer traditional, rush and cluster protocols to build up to the maintenance dose. Most patients, when presented with the options of the various dosing schedules, choose cluster protocol immunotherapy because it offers fewer visits and faster results compared to traditional schedules and a better safety profile than rush schedules.
What is Cluster Immunotherapy (CIT)?
Cluster immunotherapy is a method for rapidly desensitizing patients to inhalant allergens. Our cluster protocol involves giving a person multiple allergy injections over several hours over several days, achieving a near-maintenance dose in a very short amount of time. In this way you can do a year’s worth of allergy shots in 6-8 weeks! The procedure involves 2-3 rounds of allergy injections, with incremental increases in dose, which are given in a span of 1.5 to 3 hours. After CIT, a person comes into the allergist’s office once a week for the next several weeks. Then we will start spacing out the frequency of your injections according to our immunotherapy (IT) protocol.
What are the advantages of Cluster Immunotherapy?
- More rapid clinical improvement with fewer visits for injections
- Allows the patient to achieve maintenance dose more rapidly
- Allows the patient to reach monthly maintenance injections quicker
Are there any drawbacks or risks to Cluster Immunotherapy?
- Risk of anaphylaxis (severe allergic reaction) to slightly more than traditional schedules but less than rush protocols. We reduce this risk with a specially designed medication regimen that you take before the procedure
- Premedication with anti-leukotriene’s (montelukast) and antihistamines has been shown to decrease the incidence of systemic reactions with CIT significantly May not be covered by all insurance companies, thus cost may be higher
- Still requires you to continue medication during the build-up phase
What are some possible reactions to Cluster Immunotherapy?
- Local reactions (swelling, itching, or tenderness at the injection sites)
- Systemic reaction, which may include:
- Hives, itchy eyes, nose or throat, runny nose, nasal congestion, sneezing
- Tightness in chest and or throat, coughing and or wheezing
- Nausea and vomiting, abdominal cramps
- Lightheadedness or faintness and possibly shock
What do you need to do before your cluster immunotherapy visits?
Premedication: 1 day prior and the morning of the procedure.
Histamine (H1) Blocker: Options include Claritin 10 mg, or Zyrtec 10 mg, or Allegra 180 mg once a day, Montelukast (Singulair) 10 mg once a day. Take both pills at the same time each day if possible.
- Day 1 – Day before CIT Premedication Time
- Day 2 – Day OF CIT Premedication Time, 8AM
If you are getting skin tested, AVOID Antihistamines.
How long will Cluster Immunotherapy take?
The Cluster Immunotherapy protocol takes 1 ½ – 2 hours in the clinic. There is a 30 min wait in between injections and a 1 hour wait after the last injection. You can do CIT up to 2 times a week, with 48 hours in between each CIT
What do you bring on the day of the visit?
- Books, activities, laptop, etc.
- Wear a half sleeve or sleeveless shirt
- Have a light breakfast the morning of the procedure
- Have a light snack before the procedure
What will Greater Austin Allergy do on the day of your visit?
- Make sure your asthma, if present, is under good control.
- Obtain baseline spirometry – FEV1 above 70%
- No B-blockers, ACEI, or evidence of cardiovascular disease
- Ensure we have Informed consent in chart
What happens after Cluster Immunotherapy?
For most patients, the final dose received during CIT will be repeated for the first post-CIT injection the week after.
For patients who experienced a systemic reaction during CIT, the first post-CIT dose will be lowered.
Following CIT, the regular IT schedule will be followed going forward.
Generally if you tolerate the whole protocol you will continue on weekly injections for another 3-4 weeks, then we can proceed to every other week shots, followed by every 3 week shots, then monthly.
Why see an allergist when there are so many doctors who treat allergies?
The short answer is that we do it better and actually fix the problem, not just treat endlessly and/or inadequately.
Why do we do a better job?
The immune system is responsible for allergies, and it’s a complicated beast! We spent 2-3 years after our residency programs doing nothing but learning about how the immune system works. Plain and simple, if you don’t know the inner workings of something, you can’t change it. Because we understand it, we can be more aggressive and actually cure the underlying source of the problem.
What do we do differently than other allergists?
In addition to really caring about you, we’re also nerds! We stay on top of the latest, greatest medications and treatment methods and will insure that if it works and is safe, we’ll do it.