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Allergy & Asthma Advocate: Spring 2006
How to choose an allergist for your child
By Clifford W. Bassett, MD, FAAAAI
If your child is one of the millions in the United States that suffer from asthma, sinus infections, seasonal or year round allergies, eczema, hives, or have allergic type reactions to food or medications, he/she may benefit from seeing an allergist. An allergist is specially trained to diagnose and treat children with allergy-related health problems from birth through their teenage years. An allergist is required to do a 2 year fellowship in allergy, asthma and immunology after first completing either a pediatric residency or a medical residency over 3 years time.
Genetics and Allergy
Family history is a very important part of allergic diseases and how it affects parents and children alike. With one parent with some form of allergy and/or asthma about 25% of the time a child will inherit and develop allergies, and with both parents being “allergic” there is a chance of at least 50% or greater of having an allergic child.
Allergy vs. colds and infections
Allergy symptoms may easily be confused with colds, sinus infections and respiratory infections, especially in children when the presenting complaint may be very different from adults. In general, with an allergic problem there is typically “itchiness” of some kind with a pattern of exposure associated with symptoms such as sneezing, runny nose, congested nasal and sinus passages as well as cough. With a cold, one would typically see a change and color of the nasal mucus, loss of appetite, constitutional complaints including fever, chills, fatigue as well as cough and other lower respiratory symptoms. In children cough certainly can be associated with a lower respiratory infection. A recurrent or persistent cough can be the only finding in a child with asthma.Diagnosing and treating your allergies
An allergist can perform a variety of tests to determine if your child does have allergies. Examples of allergic “triggers” include pollens, molds, dust mites, pet dander to mention a few that can be properly diagnosed via allergy skin tests. This test is almost painless and can be performed with results within 20 minutes in most cases. Alternatively, laboratory or blood tests may be performed to detect whether allergic sensitivity is present in your child. Both diagnostic allergy tests are valid and invaluable to the allergist as well as the family. Appropriate avoidance measures and environmental modification can be implemented in addition to medication as well as other strategies. Oral antihistamines, nasal steroid sprays, eye drops are a few of the most commonly prescribed medications for an allergic child. An allergist will also evaluate your child to determine if he/she is right for a program of allergy immunotherapy (allergy injections). This form of treatment has excellent short and long term effectiveness in reducing allergy and associated symptoms.
What to expect at the time of your visit
If your child is suffering from the typical allergy type symptoms including non-stop runny nose, nasal and sinus congestion, itchy eyes, nose and throat and/or persistent coughing that is not improving you may want to ask your pediatrician to refer you to an allergist for a proper evaluation of these complaints. A child with a persistent cough will need to have an assessment of lung capacity and function referred to as a “spirometry”, and this will help to properly evaluate whether asthma is present and what type of treatment will be necessary. In most cases there are allergic “triggers” in a child with pediatric asthma. An allergist will take a detailed environmental and allergy history and examine your child in a relaxed atmosphere to make them comfortable. Make sure you are comfortable with the doctor, his staff and procedures.Locating the “right” allergist for your family
You may find the practice website to a good source of information regarding an individual practice, too. Perhaps the specialist has an interest in various areas such food allergy or exercise associated asthma that would be helpful to you when selecting the most appropriate physician. The American Academy of Allergy, Asthma and Immunology can assist in finding a board certified specialist via their “allergist finder” section of the website at www.aaaai.org. Speaking to a medical professional such as a nurse can also be helpful in identifying a family allergist that will meet your needs.
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