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What would be good questions for first visit to allergist for allergic asthma?

Hi, In a week I have my first appointment with an allergist.   I would appreciate suggestions from those of you who deal with allergies or allergic asthma ( or anyone else who has a good idea!    ) on what things I should ask.  

I have been seeing a pulmonary specialist since I was diagnosed with asthma over five years ago  Just diagnosed with allergic asthma about two months ago.  I am on several maintenance asthma meds.  I started on Xolair just over one month ago. 

My blood work showed I am allergic to two kinds of dust mites. I know you can never be completely rid of dust mites no matter how well you clean and vacuum.  We have put the special zippered covers on the mattress and pillows.  We had the carpet removed and hardwood flooring put in the bedroom.   I plan to ask if the two kinds of mites that I am allergic to are mainly in houses or are they also in the horse barn.  

What would be some good questions to ask the allergist?  

Thank you!!

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  • Melissa G

    Lisa, personally I would ask how you can manage the allergies better. I know with my crew once we get the allergies under control, the asthma is better controlled. All of us take different combo of allergy meds to help. My youngest needs allegra and atarax, where my dh needs xyzal and a decongestant. 

  • LK

    Melissa, Thank you for the suggestions!  I am making a list of questions so I don't forget them.  

  • Shea

    I would let them know areas and weather that seems to trigger you, what your symptoms are, and what they recommend to help you in those places/ situations. Also if you want any more allergy tests fir specific things to rule in or out. And then what your treatment preferences are and action plan for flares is always good– or letting them know about your asthma plan if u have one, and how they are related.

  • Marie E Natzke

    LK, 

    My first visit to the allergist they took my information and what my current problem was at that time. I'm assuming you had skin tests done? If so bring all those results with you. They may want to test you further unless that has been done already. They should give you info on do's and don'ts but you've done some of that already. If you have window air conditioner you are better off than forced air/heating. If you have forced air/heating they may suggest to block off the vent in your bedroom and use an electric heater and window unit if possible. If you have pets keep them out of your bedroom. 

    They will tell u up front if they feel you will benefit from allergy shots. They are time consuming and a pain in the butt to do but they do help. Give them a chance to work. You will know they are helping when you notice that when your due to get them you feel worse. Within about 20 minutes of getting my shots I start feeling better. By tomorrow I'm going to start feeling lousy as I'm due to get my shots on Wednesday of this week.

    Bring a complete list of meds you are allergic to and what you take including any supplements/ over the counter drugs. As some drugs can interfere with allergy shots. 

    Any other health problems you have let them know about. One thing my Dr told me was to watch my stress levels as it can help set off some of your allergies. Once you can get your main triggers to calm down it will help with the rest of your allergies.

    I hope this helps you out.

  • LK

    Thank you, Marie, for all the helpful information!  Never would have thought of a lot of those things. 

    I have not had skin tests done just the Rast panel that my pulmo ordered.  I will take those results with me.  The allergist's office did say to stop taking Claritin at least 4 days prior to my appointment since they will be doing testing on me.  Not sure it it is skin tests or what.

    Thank you all for taking the time to post this information.  Having some idea of what to expect really makes me more at ease to deal with this new 'adventure'!  

  • Christopher Casteel

    Hi Lisa,

    I think it is great that you have taken control of your house. Environmental control is often overlooked with asthma. I also love horses and have spent a fair amount of time in horse barns. They tend to be very dusty and particulate filled places. You may already, but I was going to suggest thinking about starting to wear one of those disposable paper masks while you are in the barn.  It is something that you should think about if you haven't already. I make my niece wear one while she is in the barn, especially when they are cleaning or putting out hay and it has helped her symptoms significantly.  After all, the best allergen is one you never breathe in at all. 

    All the best,

  • K8sMom2002

    Christopher, sounds like you are a good uncle to take care with your niece! 

    Lisa, sending good on your upcoming allergist appointment!  You've gotten some great advice!

    One question that I've learned to ask docs when they suggest a change in my treatment plan is:

    "When should I see a change? When will I know that this change is working or not working for me?"

    Another question, and this is just me because I've been wondering for a long time. I know that food allergy tests can have a high rate of false positives, but what about environmental allergies? What sort of false positive rates do they have?

    It sounds like you will have skin tests … you might ask your doc if you can go ahead and take an antihistamine after the test is read so that you can counteract any of the itchies that come with it. 

  • LK
    Christopher Casteel posted:

    Hi Lisa,

    I think it is great that you have taken control of your house. Environmental control is often overlooked with asthma. I also love horses and have spent a fair amount of time in horse barns. They tend to be very dusty and particulate filled places. You may already, but I was going to suggest thinking about starting to wear one of those disposable paper masks while you are in the barn.  It is something that you should think about if you haven't already. I make my niece wear one while she is in the barn, especially when they are cleaning or putting out hay and it has helped her symptoms significantly.  After all, the best allergen is one you never breathe in at all. 

    Christopher,  Thank you for the very good suggestion about wearing a mask in the barn.  You are quite correct in that horse barns are especially dusty and particulate filled areas!  Thankfully, my DH has taken over mucking stalls and picking up manure in the dry lots.  I have asked him to wear a mask even though he does not have lung problems but he is hard to convince!

    I was wearing the paper masks for several years until last fall and then I started wearing longer-term masks that I can hand wash and/or replace the filters.  These new masks have N99 filters which really helps.

    Good point that the best allergen is one you never breathe in at all!  

    That is good of you to have your niece wear a mask.  Thank you, again!

  • Shea

    I love everyones advice on here! My son and I will be meeting with our new allergists soon (since weve moved now) and these are good reminders fir our apoontments too, so thank you LK for posting this topic!

  • LK

    Thanks, Cynthia, for the well-considered advice on what to ask!  Great ideas!

    I am feeling at least a little bit prepared for my appointment!  I have a running list of questions and concerns to talk with the Dr about.

  • LK

    Anytime, Shea!  

    Good luck at your and your DS's appointment!

  • Pljohns

    I keep a yearly planner just for my pulmo appointments-if I'm having issues, I can mark numbers on the calendar, if I add extra meds, i can mark that on the calendar and I have room to write questions and answers also.  It gives me something to go back and look at and I don't have to try and remember when it was from.  I use to keep a notebook type one that I could just get refills for every year but the refills have gotten more $$ than a total new one so this year, I changed.  I also note any new meds we added, the dose and how I reacted to it and when/if we discontinued it.

  • LK

    Such helpful suggestions, Lynn!  Thank you!  I have been trying to keep a small log of my FEV1/FEV6 readings and have been making some notes in there.  I need to find a larger notebook/planner so I can make better notes and questions.  

  • Pljohns

    I have an app for my phone that I keep all of the numbers in until I can transfer them to Excel but all of my notes, I keep in the notebook and it has made it so much easier for me to be able to go back especially tell a doc-nope-already tried that med and here's what happened and here's when we tried it.

  • LK

    Wish I had thought of keeping notes on all the meds I have been on.  Good idea!

  • Pljohns

    With my affinity for allergic reactions to meds, I don’t dare take some of the ones that i’ve tried in the past.  don’t want a repeat of some of those reactions!

  • Melissa G

    I agree Lynn, that would not be good!  I have only ever reacted to penicillin and a muscle relaxer I was on. I ended up in the ER, and the dr did not believe it could be the medicine so dummy me went home and took my next dose and back to the ER I went. Face swollen, blisters on my eyes and hives every where.  Definitely not doing that again. 

  • Shea

    Oh man Melissa, I dont blame you– when the doctor assures you its not the medicine, and then it ends up being the medicine — that is all on the doctor! (But your the one who suffered).. So that is why I agree with second guessing doctors and listening to yourself.

    In my perfect world, the doctor would encourage you to have an opinion and make gueses on your health situation, they would honor reality when an effect from a medication is different for you than others, and they would be cautious with treatments– oaying close attention to medications that might counteract with eachother. 

    So many just want to cut and paste treatments– I want a doctor that listens to my story and uses logic and tells me how a medicine works AND all of the potential side effects and risks. I have so much need for medicine and doctors but so little faith… And gaining that faith back has been slow-going for me.. But it has also taught me a lot about Serenity, and doing what I CAN do: I CAN communicate my discomfort and find a doctor who meets with me to discuss, not just to prescribe– who makes a plan with me that I understand and can follow, who addresses my concerns without acting like they are above me, or that my concerns are not legit. When I find that doctor…. Well… I'll invite you all to the wedding, lol, (a girl can dream!).

  • Pljohns

    Melissa-what an ordeal!  Unfortunatley with me, the reaction to meds was more immediate.  Usually within 5 min it hits me and there is no way I will take them again.  I've learned-I WILL NOT take new meds that say "take at bedtime" or not when DH is home.  I've just had too many experiences.

    Shea-if you find that doctor-see if he believes in cloning because we could all use one of him!  A lot of the doctors now just want to order every test under the sun and let the tests tell them what is wrong-they don't want to listen or use any sort of logic or reasoning-it's just blindly throw every test at it known to man and see what happens. 

    It was funny reading back through my doctors notes from my old PCP-you could tell he LISTENED and he made notes just like he talked but it was there-no "format" or anything like that-just more like a conversation.  I wish I still lived where I could see him.

  • Pljohns

    I'm starting my list for my next pulmo appointment (even though it's a few months away).  I want to broach the subject of changing my meds to an ASTHMA med and getting off a COPD med.  I'm tired of insurances giving me grief.  I'm willing to go back and retry some of the meds that caused me problems before-not the bad ones-and see if I react differently to them now.  Levabuterol gave me problems the very first time I used it too but I'm fine with it now so maybe some of the others will be OK too.  I'll have to try them in his office but I want to try something.  Guess it's time to pull out the list of meds we've tried and see what I'm willing to retry again-of course, he may not be willing to retry any of them.

  • K8sMom2002

    Lynn, that's a good idea! A person's reactions to medications can be caused by all sorts of things, I'm guessing, and some of those could be the other medications you were on at the time.

    One thing that one good and conservative doc suggested to me is that we periodically look at meds and see what's working, what's not, and if there needed to be a change. As people's situations change, sometimes a person may not need to be on that med anymore, or a person may need to swap to a different one.

    Lisa, so glad you are feeling more prepared!

    Shea, good luck finding a new allergist that will work well with you and be convenient as well!

  • Pljohns

    Shea-I hope you can find good new doctors for you and Tommy.  I HATE hunting a doctor, wasting the time to go see them and the copay only to have them not work out for whatever reason.  

  • LK

    Oh my goodness, Melissa!  That would shake anyone up!  Glad you are okay!

  • Shea

    Thanks PLJohns– it will be a process I am sure… Step one is just getting nearby doctors and my normal prescriptions filled, and getting referrals. 

    I feel like if a COPD med is working for you after all youve tried you should be able to take it, off-label and the insurance should not hassle you…. I have CSS and so most meds for asthma work for tge asthma part of it. COPD is so similar to asthma. There are a few things about inhaled medications that give me problems so I get the weird reactions thing– and it is probably more common than doctors know its just that not as many people pay attention to their body and report it.  My old doctor got a lot of complaints sbout powdered inhaled meds and I swear even now I should just do breathing treatnents over inhalers because I am constantly clearing my throat since trying to switch to inhalers from nebulizers and I considered my doctor's thought that the moisture frim the neb might be the difference by getting the mypurmist but Im still having the issue. Im just hoing to go back for a while to nebbing to see if it helps.  But jeez if you find a med that works dont let your insurance tell you otherwise– you just tell them and your doctor your thankful to have found one (and if it aint broke dont fix it!!) That is my opinion at least (for the 2 cents its worth lol).

  • Marie E Natzke

    sorry LK forgot to warn you about stopping allergy meds.  It's to help you to react to what you are allergic to instead of making it. The longer you are off the allergy meds the better results you will get.  So they ask for a least 3 days if you can go longer try to do so.   It helps them with determing what you are allergic to and if shots will help you… what to have in your shots. Be prepared for welts and itching take your allergy meds with you so when they are done testing you can take them there.  They may offer to give you something after the tests are done. I reacted so bad they cut the test short they did 2 types interdermals which is a  shot just under a few layers of skin and the skin prick type.  My arms were sore for a few days after.  Whenever I would shower the welts would come back up a little. They also should test you to see if you are allergic to what they use to test you with…so one you will react to 1 you shouldn't react to.. good luck to you!!!

  • LK

    That's okay!  Thank you, Marie!   They did say to stop the allergy meds 4 days out so I am doing 5 days out.  Figure it can't hurt!  Thank you for the extra information.  I feel somewhat prepared for my appointment early Monday.  

    One more question for everyone -  Do you go by yourself for the testing or does it bother you enough that you should plan on having someone else drive?  

    DH hasn't offered to take off work and I don't plan on asking him.  My mother has offered to come with me.  She is great moral support but since she's in her mid 80s I hate to have her to have to sit there for several hours.  

  • Pljohns

    Lisa-DH went by himself and was fine-they rub something on the spots to take the itching away as soon as you react-at least they did for him and me both.  Unfortunately I always have to go to dr appointments alone

  • LK

    Thanks, Lynn!  Good to know!  Except for these these Xolair shots, I always go on my own, too.  Before I started on them, I never thought about having someone go with me to appointments.

  • Melissa G

    I typically go by myself. If dh sits somewhere too long, like 5 min, he is asleep and snoring. It is so embarrassing. 

  • Marie E Natzke

    LK.. I was by myself both times I've been tested. They gave me oral allergy meds when they were done and rubbed an antihistamine on my arms

  • LK

    Went to the allergist appointment this morning only to find out that I can't do the allergy testing since I am on Xolair.  You would think that would have been one of the questions they asked me when I set up the appointment.    

    In a small way I am relieved that I couldn't take the tests.  The last time I had a provocative medical test, the Methocholine Challenge, I ended up with severe asthma.  Before the test I had had a cough and was sometimes a little short of breath but nothing like it has been since then.

    Anyway, really like the allergist.  He listens and asks good questions.  He says it's possible that I have Vocal Cord Dysfunction.  I know I have seen it mentioned somewhere on these forums.  I have a test scheduled for it in June.  

    Found this information about it on the Mayo Clinic website.  So far that is all I know about it.  

     

    Looks like it's possible to have one or the other or both.  

  • Pljohns

    Oh bummer Lisa!   You would think with all of the new biologics out they would add that to the "do not take" list o before they make you come in for allergy testing.  I'm so sorry!

  • Pljohns

    I guess the first question from now on for an allergist visit should be (before the visit) does taking XXX meds disqualify me from allergy testing?

  • K8sMom2002

    Lisa, that is a bummer!  I hate that you wasted your time AND went without your meds for that long!

    I know that @GigiGibson did some speech therapy for possible VCD.  And I think @Nemo88 has also had speech therapy.