COVID 19 VACCINE UPDATE as of 3/23/2021:

Who can get the vaccine?

  1. High risk patients with underlying medical conditions including Asthma/Lung Disease.
  2. Non high-risk patients with history of environmental, food, medication, insect or latex allergies.
  3. Patients ≥18 years of age with no underlying medical condition.
  4. Patients recovered from COVID-19 infection are advised to get the COVID 19 vaccine 90 days after symptom onset.
  5. Patients who received Monoclonal antibody (Bamlanivimab) and/or convalescent plasma for COVID 19 infection must wait 90 days before receiving the COVID 19 vaccine.

Note: As a precaution, please do not get an allergy shot within 5 days of your COVID 19 vaccine. Before getting your COVID 19 vaccine, you will be asked if you received a vaccine/shot in the last 14 days, the answer is “NO”. Your allergy shot is not a vaccine. Rate of anaphylaxis from COVID 19 vaccine is rare (<1 in 100,000).

Who should check with your doctor first?

  1. Immunodeficiency patients
  2. Mast Cell Activation Syndrome patients
  3. History of Idiopathic Anaphylaxis
  4. History of Allergic reactions to previous vaccinations
  5. History of Allergic reaction to Polyethylene Glycol (includes IV Depomedrol)

Note: Our office is experiencing an extremely high volume of calls. For patients that need to check with your doctor, please call TRIAGE (option 3) and leave a message. Please allow us 7-10 days to get back to you. 

HOW TO GET COVID-19 VACCINE:

STARTING March 24 (Wednesday), ADULTS 18 years old and older can sign up to get COVID Vaccine (with or without medical conditions)

To schedule ONLINE:

  1. OPTION #1 – vaccine distribution through Az Department of Health – Register at the website: podvaccine.azdhs.gov (PATIENT PORTAL)
    1. State Farm Stadium
      1 Cardinals Dr, Glendale
      844-542-8201
    2. Grand Canyon University
      5115 N. 27th Ave., Phoenix
      HonorHealth-N Phoenix
      2500 W. Utopia, Phoenix
    3. Phoenix Municipal Stadium
      5643 E Van Buren ST., Phx Az 85008
      602-542-1000
    4. Abrazo West
      13677 W. McDowell Rd. Goodyear
      602-506-6767
    5. Dignity Health at Chandler-Gilbert Community College
      2626 E Pecos Rd. Chandler
      602-506-6767
  2. OPTION #2 – vaccine distribution through Banner Hospital System – Call 833-509-0908
    1. Banner Del Webb
      14502 W. Meeker Blvd., Sun City West
    2. Banner-Az Fairgrounds
      1826 W. McDowell Rd. Phoenix
  3. OPTION #3 Passport Health (N Scottsdale & I-101 -18545 N Allied Way, Phoenix)- use link https://oem.passporthealthglobal.com/ClinicSignUp/Registration/COVIDSafeAZ
  4. OPTION #4 –Register at the Pharmacy website – (Walgreens, Costco, Walmart, CVS, Fry’s) or Maricopa website https://www.maricopa.gov/5659/COVID-19-Vaccine-Locations

To schedule via TELEPHONE in various locations:

  1. Dial 211, option 6, OR Call 844-542-8201 OR 480-573-0332 OR 602-542-1000
  2. Banner Health System – Call 833-509-0908
  3. Honor Health System – Call 602-506-6767
  4. Tolleson City Hall or Estrella Foothills High school Goodyear Az – Call 480-376-2170
  5. Fry’s pharmacy – Call 1-866-211-5320 (Phoenix, Avondale, Buckeye, Mesa, Gilbert, Glendale, Litchfield Park, Peoria, Scottsdale, Suncity West, Surprise, Tempe)
  6. 1st Care Medical Clinic (1635 W Glendale, Phx) – Call 602-544-2273
  7. Albertson’s Pharmacy:
    1. Litchfield Park – Call 623-535-7991
    2. Surprise – Call 623-546-8038
  8. Safeway Pharmacy:
    1. Goodyear – Call 623-935-3531
    2. Chandler – Call 480-883-0260
    3. Sun City West – Call 623-584-0501
    4. Glendale – Call 623-572-8844
  9. Bethany Home Discount Pharmacy Glendale – Call 623-440-7717
  10. Clinica La Familia (Phx, Mesa, Tempe, Glendale, El Mirage) – Call 602-569-3999
  11. Mountain Park Health Center (Phx, Goodyear, Tempe) – Call 602-243-7277
  12. One Medical Scottsdale – Call 602-218-4072

FACTS:

  1. Patients with history of allergic reactions to medications, food, outdoor allergens, insects, and latex do not have an increased risk compared to the general population.
  2. Observation in a health care setting for 20 – 30 minutes after injection is ideal to monitor for any adverse effects. (IM Epinephrine is the first line of treatment).
  3. Pfizer-BioNTech COVID 19 Vaccine is NOT a live vaccine. It can be administered to immunocompromised patients.
  4. These recommendations are based on best knowledge to date but can change at any time, pending new information and further guidance from the FDA or CDC.
  5. Arizona Asthma and Allergy Institute does not have the vaccine and is not planning to administer the vaccine.

CAUTIONARY CONCERNS: Please discuss risks vs. benefits with your provider.

  1. Patients with history of allergy to L-Polyethelene Glycol (component of the vaccine)
  2. Patients with history of allergic reactions to previous vaccinations/ mast cell activation syndrome/idiopathic anaphylaxis. (Limited data)
  3. Immunocompromised patients may have a diminished immune response.

References

  1. McNeil MM, Weintraub ES, Duffy J, et al. Risk of anaphylaxis after vaccination in children and adults. J Allergy Clin Immunol. 2016;137(3):868-878.
  2. Dreskin et al. International Consensus (ICON): allergic reactions to vaccines World Allergy Organization Journal (2016) 9:32.
  3. Wylon, K., Dölle, S. & Worm, M. Polyethylene glycol as a cause of anaphylaxis. Allergy Asthma Clin Immunol 12,67 (2016).
  4. Stone CA, Liu Y, et al. Immediate Hypersensitivity to Polyethylene Glycols and Polysorbates: More Common Than We Have Recognized.  J Allergy Clin Immunol Pract. 2019; 7(5): 1533–1540

No matter if your child is attending school online, in-person, or hybrid of both – returning to school is looking different for everyone this year. In addition to navigating the changes due to Covid-19, allergy and asthma families may have additional challenges or concerns this year. Here are some tips and thoughts if your child is back in the classroom this fall:

Stay home if sick, especially if you have a fever. Most schools have their own protocols in place regarding this. It’s important to keep your child home, monitor symptoms, and follow up with your doctor if needed.

While wearing a mask can prevent COVID transmission, a mask will not prevent allergies or asthma. Please be sure that allergy and asthma medications are continued as directed by your provider and if you feel your asthma is worse because of the mask, it’s a good idea to discuss with your provider.

Get your annual flu vaccine to keep your child healthy.

Many schools are having lunch time in the classroom, instead of the cafeteria. If your child has food allergy, remind them not to trade foods with other students. Consider meeting with the teacher to discuss any unique challenges your child may face with food in the classroom. Continue to educate your child on the importance of hand-washing to prevent the spread of germs, both in and out of the classroom.

Finally, make sure your food allergy and asthma action plans are up to date. Now is a great time to get into your allergy provider to discuss your food allergy action plans and asthma action plans and get up-to-date forms for schools. If you need your new forms completed, call our office. Some patients may need an appointment in order for their doctor or physician assistant to complete their forms.

 

 

 

 

 

 

 

 

 

___________________________________________________________________________________

Vocal Cord Dysfunction (VCD), also known as Paradoxical Vocal Fold Movement (PVFM) occurs when the vocal cords do not move or open properly. Sometimes, VCD can be confused with asthma because their symptoms and triggers are very similar. Symptoms of VCD can include shortness of breath, chronic cough, throat clearing, wheezing, loud whistling sound with breathing in, difficult getting a good breath in, frequent yawning, throat tightness, or hoarse voice. VCD can be triggered during stressful or anxious events, or with exercise. Triggers also include airborne dust, pollens and irritants, or colds and viruses. VCD can affect patients of all ages and conditioning level, and is commonly seen in elite athletes or runners. Acid reflux, seen with gastroesophageal reflux disease (GERD) and post nasal drainage seen with allergies or sinus disease, can also trigger VCD.

Diagnosing VCD can be a challenge. Often times we rely on the patient’s history, symptoms, and the timing of symptom onset. Sometimes, how a patient responds to different inhaled medications can be a clue. Spirometry, a test often used for asthma diagnosis and monitoring, can sometimes show features of vocal cord irritation. The most definitive way to diagnosis VCD is with laryngoscopy with visualization of the vocal cords.

Treatment for VCD depends on the underlying cause and is different for everyone. It involves treating the underlying cause and controlling triggers, as well as speech therapy or special breathing exercises to relax the throat muscles. The providers at AAAI can help determine if you have VCD or asthma (or both) and help find the right treatment program for you.

 

phoenix food allergy testing

May 1, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #7

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! COVID-19 cases persist in Arizona. Many of our patients are at higher risk for complications from the virus. As a result, we are providing the following update:

TO SEE ALL THAT WE ARE DOING TO KEEP YOU SAFE, VISIT OUR WEBSITE @ WWW.AZSNEEZE.COM

Summary:

  • There are lots of questions surrounding coronavirus (COVID-19) testing. You may have heard news report about PCR testing, antibody testing, and lots of testing.
  • There are many opinions about the importance of these tests, who should get them, and what you and your doctor will learn from the tests.
  • If you are interested in being tested, Board Certified Allergists/Immunologists are the best trained and the most experienced physicians to help you choose the right test or tests and to interpret the results.
  • Please schedule an appointment with AAAI (in office or telemedicine) by calling 602-843-2991. We have 5 offices around Maricopa County to serve you.

More Details (for those that want them):

COVID-19 testing update:

There are two types of COVID-19 tests: PCR (Nasal swab) and Antibody (Blood)

  1. PCR testing (Nasal swab): Tests viral particles from a nasal swab.
    1. This test is meant to measure if your body IS infected with the virus or not.
    2. This test is most accurate when a patient has active symptoms (identified below).
  2. Antibody testing (Blood): Tests your antibody response to the virus from a blood sample.
    1. This test is meant to measure if your body WAS infected with the virus or not.
    2. Test 14 days after symptom onset or later. IgG antibodies may not be present in the first 2 weeks of infection.
    3. Antibody testing may not be accurate in the following types of patients:
      1. Patients with immune deficiencies and some autoimmune diseases.
      2. Patients on immune-modulating drugs including Xolair.

We highly recommend COVID-19 tests be ordered and interpreted by one of our Board Certified Allergists/Immunologists or a physician with experience in interpreting PCR and Antibody testing.

If you would like to receive COVID-19 testing:

  1. COVID-19 tests will be performed at an offsite testing location and results sent to the ordering physician.
  2. COVID-19 tests are covered by all insurances per federal guidelines.
  3. COVID-19 appointments may have co-pays depending on insurance and federal guidelines.
SYMPTOMS OR HISTORY CONCERNING FOR COVID-19

– Active Fever  100F or in the past 2 weeks
– Chills and Myalgias
– New diarrhea
– Sudden loss of sense of smell or taste
– New cough & shortness of breath with no prior history of allergies or asthma
– Significantly worsening cough and shortness of breath with a history of allergies or asthma
– Severe fatigue with or without pounding headache.
– Exposure to someone with known COVID-19 infection, active fever, or fever in past two weeks.

We, the physicians at AAAI, daily review all COVID-19/SARS-CoV2 medical literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information. We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely, 

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.


April 20, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #6

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! COVID-19 cases persist in Arizona. Due to the nature of our practice, many of our patients are at higher risk for complications from the virus. As a result, we are providing the following update:

TO SEE ALL THAT WE ARE DOING TO KEEP YOU SAFE, VISIT OUR WEBSITE @ WWW.AZSNEEZE.COM

SYMPTOMS OR HISTORY CONCERNING FOR COVID-19
  • Active Fever of 100 or greater
  • New cough and shortness of breath with no prior history of allergies or asthma
  • Significantly worsening cough and shortness of breath with a history of allergies or asthma
  • Exposure to someone with known COVID exposure, active fever, or fever in past two weeks.
  • Fever in past two weeks
  • New diarrhea
  • Severe fatigue with or without pounding headache. 
  • Sudden loss of sense of smell or taste
PATIENTS OVER THE AGE OF 65 with NO Concerning Covid-19 Symptoms or Exposures:
  1. Keep in-office new patient appointments.
  2. Keep an in-office follow up OR schedule a TELEHEALTH follow up appointment.
PATIENTS UNDER THE AGE OF 65 with NO Concerning Covid-19 Symptoms or Exposures:
  1. Keep in-office new patient appointments.
  2. Keep in-office follow up appointments.
PATIENTS WITH IMMUNE DEFICIENCIES:
  1. Contact our office prior to your appointment to discuss options. 

***WHEN YOU COME TO YOUR OFFICE VISIT, PLEASE WEAR A CLOTH FACEMASK PER CDC GUIDELINES***

***IF YOU FEEL SICK, HAVE BEEN AROUND OTHERS WHO ARE SICK, OR DO NOT FEEL COMFORTABLE COMING IN FOR AN APPOINTMENT, CALL OUR OFFICE FOR A TELEHEALTH EVALUATION FROM A LICENSED PROVIDER***

WE ARE UP TO DATE ON ALL ACTIVE COVID-19 THERAPIES CURRENTLY UNDER INVESTIGATION AND WILL PROVIDE ADDITIONAL INFORMATION AS IT BECOMES AVAILABLE. 

We, the physicians at AAAI, daily review all COVID-19/SARS-CoV2 medical literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information. We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely, 

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.


April 6, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #5

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! COVID-19 cases continue to rise in Arizona. Due to the nature of our practice, many of our patients are at higher risk for complications from the virus. As a result, we are providing the following update:

CONCERNING COVID-19 SYMPTOMS OR EXPOSURES

– Active Fever of 100 or greater
– New cough and no prior history of allergies or asthma
– Worsening cough with a history of allergies or asthma
– Exposure to someone with known COVID exposure, active fever, or fever in past two weeks.
– Fever in past two weeks
– New diarrhea
– Severe fatigue with or without pounding headache.
– Sudden loss of sense of smell or taste

PATIENTS OVER THE AGE OF 65 with NO Concerning Covid-19 Symptoms or Exposures:
  1. Keep in-office new patient appointments.
  2. Re-schedule follow up appointments as a TELEHEALTH evaluation. 
PATIENTS UNDER THE AGE OF 65 with NO Concerning Covid-19 Symptoms or Exposures:
  1. Keep in-office new patient appointments.
  2. Keep in-office follow up appointments.
PATIENTS WITH IMMUNE DEFICIENCIES:
  1. Contact our office prior to your appointment to discuss options. 

***WHEN YOU COME TO YOUR OFFICE VISIT, PLEASE WEAR A CLOTH FACEMASK PER CDC GUIDELINES***

***IF YOU FEEL SICK, HAVE BEEN AROUND OTHERS WHO ARE SICK, OR DO NOT FEEL COMFORTABLE COMING IN FOR AN APPOINTMENT, CALL OUR OFFICE FOR A TELEHEALTH EVALUATION FROM A LICENSED PROVIDER***

WE ARE UP TO DATE ON ALL ACTIVE COVID-19 THERAPIES CURRENTLY UNDER INVESTIGATION AND WILL PROVIDE ADDITIONAL INFORMATION AS IT BECOMES AVAILABLE. 

We, the physicians at AAAI, daily review all COVID-19/SARS-CoV2 medical literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information. We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely, 

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.


March 30, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #4

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! COVID-19 cases continue to rise in Arizona. Due to the nature of our practice, many of our patients are at higher risk for complications from the virus. As a result, we are providing the following update:

IF YOU DO NOT FEEL SICK AND DO NOT EXHIBIT CONCERNING SYMPTOMS (SEE LIST BELOW), PLEASE COME INTO OUR OFFICES FOR YOUR FOLLOW UP OR NEW APPOINTMENT AS SCHEDULED. 
IF YOU FEEL SICK, HAVE BEEN AROUND OTHERS WHO ARE SICK, OR DO NOT FEEL COMFORTABLE COMING IN FOR AN APPOINTMENT, CALL OUR OFFICE FOR A TELEHEALTH EVALUATION FROM A LICENSED PROVIDER.
CALL IF YOU HAVE ANY OF THE FOLLOWING CONCERNING SYMPTOMS OR EXPOSURES:
  1. Active Fever 
  2. New cough and no prior history of allergies or asthma
  3. Worsening cough with a history of allergies or asthma
  4. Exposure to someone with known COVID exposure, active fever, or fever in the past two weeks.
  5. Fever in the past two weeks
  6. New diarrhea
  7. Severe fatigue with or without a pounding headache. 
  8. Sudden loss of sense of smell or taste
WHAT WE ARE DOING
  1. Telehealth and In-Office Appointments
  2. Outside screening of all persons entering our office.
  3. In-office sanitation and infectious disease prevention protocols (N95 masks for physicians and staff; Hand washing, frequently scheduled disinfection of office surfaces; face masks; eye shields and gowns where necessary)
  4. Social distancing and infection disease prevention protocols. (Waiting room occupancy limited to ten with spaced seating arrangement, ability to wait in the car for shots and appointments)
WE ARE UP TO DATE ON ALL ACTIVE COVID-19 THERAPIES CURRENTLY UNDER INVESTIGATION AND WILL PROVIDE ADDITIONAL INFORMATION AS IT BECOMES AVAILABLE. 

We, the physicians at AAAI, daily review all COVID-19/SARS-CoV2 medical literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information. We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely,

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.


March 23, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-Cov2/COVID 19) Update #3

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! The general population remains at low risk for serious complications from exposure to Coronavirus. Nevertheless, cases continue to rise in Arizona. Due to the nature of our practice, many of our patients are at higher risk for complications from Coronavirus. Out of an abundance of caution and concern for your health, we are providing the following update:

OUTSIDE SCREENING OF ALL PERSONS ENTERING OUR OFFICE CONTINUES

 

IN-OFFICE SANITATION AND INFECTIOUS DISEASE PREVENTION PROTOCOLS CONTINUE

 

SOCIAL DISTANCING PRACTICES INCLUDING IN-VEHICLE WAITING FOR APPOINTMENTS REMAIN IN PLACE

 

IF YOU FEEL SICK WITH A COUGH AND FEVER:
  1. At this time, we define a fever as a temperature of 100 or greater.
  2. Use an accurate thermometer if you feel feverish or sick and write your temperature down.
  3. RESCHEDULE any appointment and do not come in for allergy shots or other shots within 14 days of your most recent FEVER.
  4. If you have an ACTIVE FEVER, contact our office by phone. DO NOT COME INTO OUR OFFICE FOR ANY REASON BEFORE SPEAKING WITH A PHONE TRIAGE STAFF MEMBER OR PROVIDER.
WE ARE UP TO DATE ON ALL ACTIVE THERAPY CURRENTLY UNDER INVESTIGATION AND WILL PROVIDE UPDATES AS FURTHER INFORMATION IS AVAILABLE. 

We, the physicians at AAAI, daily review all available literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information regarding Coronavirus (SARS-CoV2/COVID 19). We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely,

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.


March 16, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-CoV2/COVID 19) Update #2

Dear patients of AAAI,

Your health and the health of our staff is our highest priority! Arizonans remain at low risk for serious complications from exposure to Coronavirus. Due to the nature of our practice, many of our patients are at higher risk for complications from Coronavirus. Out of an abundance of caution and concern for your health, we are providing the following update:

OUTSIDE SCREENING OF ALL PERSONS PRIOR TO ENTERING OUR OFFICE
  1. You will be asked four simple questions regarding your symptoms.
  2. Your temperature will be checked.
  3. You may be asked to enter our office through an alternate entrance.
  4. You may be given printed instructions and asked to reschedule.
  5. You may be asked to wait outside to consult with a provider.
SOCIAL DISTANCING THROUGH LIMITATION OF UNNECESSARY PERSONS ENTERING OUR OFFICE:
  1. We request that you bring only one additional family member or friend to your appointment or when you are receiving allergy shots.
  2. Number of persons allowed in shot lab at any given time will not exceed 50 per CDC guidelines.
  3. Patients are allowed to wait in their cars for 30 minutes after receiving their shots.
IF YOU ARE ON ANTIBODY INFUSIONS FOR AN IMMUNE DEFICIENCY:
  1. Contact our office for further instructions.
IF YOU FEEL SICK WITH A COUGH AND FEVER:
  1. At this time, we define a fever as a temperature of 100 or greater.
  2. Use an accurate thermometer if you feel feverish or sick and write your temperature down.
  3. RESCHEDULE any appointment and do not come in for allergy shots or other shots if you are recovering from a FEVER WITHIN THE PAST FIVE DAYS.
  4. If you have an ACTIVE FEVER, contact our office by phone. DO NOT COME INTO OUR OFFICE FOR ANY REASON BEFORE SPEAKING WITH A PHONE TRIAGE STAFF MEMBER OR PROVIDER.

We, the physicians at AAAI, daily review all available literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information regarding Coronavirus (SARS-CoV2/COVID 19). We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely,

Ronald K. Jorgensen M.D.,
Kevin M. Boesel M.D.,
Mark E. Rose M.D.,
Ryan M. Casper M.D.,
Levente E. Erdos M.D.,
Eiza L. Ching M.D.,
R. Joseph Mittel M.D.


March 13, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-CoV2/COVID 19) Update

WITH THE UNDERTAKING OF RIGOROUS ADDITIONAL CLEANING PROCEDURES, AAAI DELIVERS CLEAN WORKSPACES AT OUR CLINICS.

IN ORDER TO CONTINUE TO PROVIDE A SAFE ENVIRONMENT FOR OUR PATIENTS AND STAFF, WE HAVE IMPLEMENTED THE FOLLOWING PLAN:

Daily
  1. Staff temperature checks with ear thermometer. If temp above 100.5, evaluated by PA and sent home until fever is subsided for 2 days
  2. Handwashing upon arrival into the building (morning, after lunch, after any errand)
  3. Drug reps with samples will stay at the front desk. Front desk staff will bring iPads to the providers for signatures.
  4. For now, drug reps can still bring in food but they must wash hands and undergo temperature check.
Several times daily
  1. Using 1:40 bleach/water blend, Front desk wipes down lobby chairs, keyboards,  front door and other door handles (inside and out), back of clipboards, etc.
  2. Back office wipes down exam room chairs, bathroom door knobs and faucets, door handles, keyboards, etc.
  3. Confirm that hand sanitizer bottles are available at front desk and allergy lab sign in. Wipe these bottles down with bleach solution.
  4. Cell phones should also be wiped down as frequently as possible, but at least in the morning and after lunch if used.
Between patients and patient interaction
  1. Wash hands between each patient
  2. Ask patient to use their own pen/pencil to fill out forms. If not available, provide a pen but wipe down afterward.

March 9, 2020

Arizona Asthma and Allergy Institute Coronavirus (SARS-CoV2/COVID 19) Update

Dear patients of AAAI

Your health and the health of our staff is our highest priority! The general population is at low risk for serious complications from exposure to Coronavirus. Due to the nature of our practice, many of our patients are at higher risk for complications from Coronavirus. Out of an abundance of caution and concern for your health, we are providing the following update:

Common Sense Self Protection:
  1. Take your prescribed medications daily. Do not miss a dose. This is a time for strict compliance.
  2. Frequently wash your hands with soap and water for 30 seconds.
  3. Cover your nose and mouth with your elbow fold when you cough or sneeze.
  4. Do not shake hands.
  5. If you are over the age of 50, avoid elective large gatherings such as sporting events, concerts, and movies.
Fever:
  1. A fever at this time is defined as a temperature of 100.5 or greater.
  2. Use an accurate thermometer if you feel feverish or sick and write your temperature down.
  3. RESCHEDULE any appointment and do not come in for allergy shots or other shots if you have had a FEVER WITHIN FIVE DAYS.
  4. If you have an ACTIVE FEVER, contact our office by phone. DO NOT COME INTO OUR OFFICE FOR ANY REASON BEFORE SPEAKING WITH A PHONE TRIAGE STAFF MEMBER OR PROVIDER.
What we are doing:
  1. Daily screening of staff.
  2. Frequent sanitation of common areas with approved disinfectants.
  3. Daily review and updates (if necessary) of the current standard of care protocols.
  4. Continued updates and communication with you.

We, the physicians at AAAI, have carefully reviewed all available literature including published articles, World Health Organization (WHO) guidelines, Centers of Disease Control (CDC) statements, and Arizona Health Department Information regarding Coronavirus (SARS-CoV2/COVID 19). We are committed to your wellbeing and to continuing to provide exceptional Allergy, Asthma, and Immunologic care.

Sincerely,

Ronald K. Jorgensen M.D.
Kevin M. Boesel M.D.
Mark E. Rose M.D.
Ryan M. Casper M.D.
Levente E. Erdos M.D.
Eiza L. Ching M.D.
Joseph Mittel M.D.

 

Vasomotor Rhinitis

 

Vasomotor rhinitis is a condition that causes chronic sneezing, congestion, or runny nose that can be triggered by pollutants like a dusty environment, odors, foods or beverages, or weather changes. These symptoms can often seem like typical allergic rhinitis (hay fever) symptoms. About 50% of patients with allergies will have some type of vasomotor rhinitis. While vasomotor rhinitis can cause similar symptoms, what is going on in the body is much different. In allergic rhinitis, your immune system is involved and has formed antibodies to the trigger, such as pollen. In vasomotor rhinitis, the triggers merely cause an irritation which causes congestion, sneezing, runny nose.  Have you ever had a runny nose from eating a spicy food? That’s a kind of vasomotor rhinitis called gustatory rhinitis.

 

Many patients will have mild symptoms but if symptoms are constant and very irritating, there are treatment options to help control symptoms. Often, allergy testing will be performed to see how to best manage symptoms.    Often times, patients will mistakenly think they may be allergic to a smell or a food, when it’s actually vasomotor rhinitis! It’s important to discuss with your allergist if you are experiencing symptoms like these and have questions, so they can come up with the best recommendations for you!

In eczema, or atopic dermatitis, the skin is dry, irritable, sensitive and prone to inflammation and infection. The natural course of eczema is to see periodic flares in symptoms – whether there is an identifiable trigger or not. Because of this, it can be very tricky to determine if a food is causing the eczema flares. Most of the time, the food does not cause the eczema, despite someone having a strong suspicion. People with eczema are at risk for food allergies, but when the food is ingested, there will typically be an immediate allergic reaction (with hives or wheezing, for example), rather than an eczema flare. Finally, it is not common for foods that were previously eaten without problems to become the allergic trigger. If you cannot get your eczema under control and have concerns about a food trigger, it’s important to discuss with your allergist. In the meantime, here are some tips:

1. Don’t assume the rash is result of a food allergy. Eczema is due to a barrier dysfunction and inflammation in the skin. A good skin care regimen or eczema care plan can help minimize flares and keep skin under control. The most important part of a skin care regimen is moisturizing (especially after bathing) and avoiding known triggers (chemicals, certain fabrics, etc).

2. If you see typical food allergy symptoms (such as hives, wheezing, vomiting) in addition to the eczema flare, it makes it much more likely that a food could be a trigger. Treat any reactions, take note of food ingredients, and talk to your allergist.

3. Do not remove foods from the diet on your own when a relationship is not clear. Removing foods can cause social and nutritional problems, and potentially cause more issues down the road.

4. Come to your allergist appointment ready to give details. Keep a good history about the foods eaten, how symptoms started and timing of symptoms. The history is the best “test” to determine if there is a food allergy, and way more informative than any blood or skin tests. Random testing for several foods can be inaccurate and misleading, but a good “history”, or details of what happened, is the most accurate test.

Managing food allergy and eczema is complicated. If you continue to have problems controlling your eczema, make an appointment with your allergist to discuss.