There are many ways that allergies can be evaluated, and some people are not familiar with the different types of tests available. The way that allergy testing is performed has changed slightly over the years, allowing the procedure to be relatively painless for most people. Let’s review the different types of testing done in the allergy clinic!

Skin prick testing: Skin testing, also referred to as “scratch” testing is the most common way that we evaluate allergies. Skin testing involves a small amount of allergens being “pricked” onto the surface of your skin, often with a small plastic device that looks like a toothpick. If you are sensitized to an allergen, this will trigger a reaction on your skin and cause a wheal or hive, similar to an insect bite. Skin testing usually takes about 15 minutes. Skin prick testing is performed for evaluation of possible environmental triggers such as pollens, molds, and animal dander. Skin prick testing is also performed for food allergy if there is a history of allergic reactions to a food (called IgE-mediated food allergy). Skin testing to foods can cause false positives and testing alone does not mean you are allergic to a food. Drug allergies such as penicillin are also evaluated via skin testing.

Intradermal testing: Intradermal testing can also be performed for evaluation of environmental triggers, insect allergy, or drug allergy. This involves a small amount of allergen placed just below the surface of the skin with a very small needle.

Blood tests: Blood tests can be performed for environmental allergens, insect venoms, and food allergies. Blood testing measures allergic antibodies in your blood. Like skin testing, blood testing to foods without a history of reaction to food can sometimes give false positives, and a positive test alone does not diagnose food allergy.

Challenge tests: Challenge tests are done in-office and involve the allergen being taken by mouth (such as foods of drug allergies). Challenge tests are among the most accurate tests to diagnose food allergy, and can help differentiate false positives or if someone has outgrown their food allergy.

Patch testing: Chemical patch testing is a way to evaluate for chemicals or metals that could be causing allergic reactions on the skin. Patch testing involves application of a chemical patch onto the back, with delayed readings in office in 2-3 days or longer, depending on the situation.

Caution!!! There are several tests available over the counter or online labeled as “food sensitivity tests”. These tests are not recommended and do not provide accurate results. Other tests such as food IgG testing, mail-in fingerstick allergy testing, kinesiology muscle testing, hair analysis, ALCAT testing, or neutralization testing are not recommended due to lack of scientific evidence that they correlate with any food allergies.

Your allergy provider will work with you to determine what type of testing is necessary to determine the cause of your symptoms and help guide further treatment.

10/1/2015 – 6/15/2020

Arizona Asthma and Allergy Institute Provides Notification of Data Security Incident

Peoria, AZ – Arizona Asthma and Allergy Institute (“Institute”) announced today a data security incident that may have impacted limited protected health information belonging to Institute patients. The Institute takes the privacy and security of all information very seriously.

The Institute learned that certain data made publicly available under the name of a different organization for a brief period in September 2020, and may have included Institute data. Upon discovery, the Institute immediately began investigating, with the assistance of a third-party forensic security firm, to determine the scope of this incident. Based on this investigation, the Institute confirmed on March 8, 2021, that the available data included limited information related to Institute patients that received services between October 1, 2015 and June 15, 2020. 

The personal information available included individuals’ first and last name in combination with their patient identification number, provider name, health insurance information, and treatment cost information. It is important to note that the Institute has no evidence to suggest that any personal information has been misused. Nonetheless, out of an abundance of caution, the Institute is providing notice to those affected individuals. The notices include information about this incident and about steps that potentially impacted individuals can take to monitor and help protect their information. The Institute takes the security of all information very seriously and has taken steps to enhance security measures to help prevent a similar occurrence in the future.

The Institute recommends that individuals remain vigilant in regularly reviewing and monitoring their explanation of benefits statements to guard against any unauthorized transactions or activity. The Institute has established a dedicated assistance line to address any questions individuals may have which can be reached at 855-654-0915, Monday through Friday, 7 a.m. to 7 p.m. Mountain Time. The Institute may also be contacted by mail at 13965 N 75th Ave, Peoria, AZ 85381. 

 

 

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

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!

The beginning of the school year is an exciting time for many, but it can also be a time of anxiety for children who have asthma or allergies.  Help your child walk confidently into school this year, knowing that they are prepared as possible.

1. Keep on top of medication before the school year starts.

Make sure that your child is on top of their necessary medication before the first week of school arrives. Making a routine of knowing what medication to take when can relieve anxiety surrounding taking medication at school.

2. Get a tour.

Contact the school to get a tour of your child’s classroom and the nurse’s office.  Going into school before the school year starts will calm your child’s nerves, by allowing them to know what to expect when they need to go to the nurse’s office for help or medication.

 3. Have a Signal.

It would also be a great idea to talk to your child’s teacher about a discrete signal that the two of them can use when your child needs to go get medication from the nurse. This way your child can get the help they need, when they need it, without drawing attention to themselves.

4. Know Their Limitations.

It’s important for all children, even those with exercise-induced asthma, to get regular exercise. Talk to your chid’s doctor about what types of physical activity are less likely to trigger asthma and allergy symptoms, and consider encouraging your child to participate in those activities. Make sure that your child uses their inhaler before they exercise and that they have plenty of water to keep hydrated!

 

 

If you or your child is in need of an appointment with one of our allergy or asthma specialists, contact us today for an allergy or asthma appointment!

 

 

 

 

 

The monsoon season is an eerily beautiful time of year that brings with it storms and sweet relief from the scorching summer heat. Unfortunately, with the monsoons also come monsoon season allergies, infection and issues with digestion for many.

Whipping winds with pollen, dirt and dust particles are the perfect recipe to aggravate your allergies. Not only this, but the rain and wet clothes can lead to the spread of infection during the monsoon season. An unanticipated effect of the monsoons are digestion issues.

Here are some tips to keep yourself as healthy as possible and keep control of your monsoon season allergies.

  1. Watch What You Eat.

    If you’re eating food from the garden or if you’re buying food from a food cart on the side of the road, dust and other particles are more likely to be in those foods. Be aware of this and counter it by making sure you’re rinsing food off food as much as possible before consuming it.

  2. Limit your exposure.

    Roll up the windows while you’re in the car, keep windows closed and make sure to shower every night before going to bed, to keep away and rinse off any allergens that may be aggravating your symptoms.

  3. Wash your hands.

    While dust storms do kick up a great deal of dust and allergens, washing hands before every meal can do a great deal for those with allergies from the dust storms.  Washing your hands will keep away many infections and rinse off allergens that may be on your hands and arms from being out in the dust storms.

Are you suffering from monsoon season allergies or asthma? Contact Arizona Asthma and Allergy Institute to schedule your allergy or asthma appointment today!

Asthma During Pregnancy

Asthma is one of the most common medical problems that occurs during pregnancy. It can be potentially serious. Some studies have suggested that asthma complicates up to 7% of all pregnancies. About 30% of all women with asthma report their asthma  worsened while pregnant. But with the right treatment and care, you and your baby can have a good outcome.

Does Asthma Cause Complications During Pregnancy?

Potential Complications

Pregnant women with asthma may have a bit greater risk of delivering early. Or the infant may have a low birth weight. High blood pressure and a related condition known as pre-eclampsia are also more common in pregnant women with more severe asthma.

Complications of asthma during pregnancy

It is not known if uncontrolled asthma causes these problems directly or if other reasons are to blame.

However, optimal control of asthma during pregnancy is the best way to cut the risk of these complications.

Changes in Asthma Severity

About one-third of pregnant women with asthma will see their asthma symptoms get worse. Another third will stay the same. The last third will see their asthma symptoms improve.

Most women with asthma whose symptoms changed in any way during pregnancy will return to their pre-pregnancy condition within three months after giving birth.

Changes in severity chart

There is a tendency for women whose asthma symptoms increased or decreased during one pregnancy to experience the same thing in later pregnancies. It is difficult to predict how asthma will change during pregnancy.

Because of this uncertainty, asthma should be followed closely. This way, any change can be promptly matched with an appropriate change in treatment. This calls for good teamwork between the  obstetrician, primary care physician and asthma specialist.

How Does Uncontrolled Asthma Affect the Fetus?

Uncontrolled asthma cuts the oxygen content of the mother’s blood. Since the fetus gets its oxygen from the mother’s blood, this can lead to decreased oxygen in the fetal blood. The result may impair fetal growth and survival. The fetus requires a constant supply of oxygen for normal growth and development. There is evidence that adequate control of asthma during pregnancy reduces the chances of fetal or newborn death and improves fetal growth inside the uterus. There are no indications that a mother’s asthma contributes to either spontaneous abortion or congenital malformation of the fetus.

What Should I Do to Avoid Asthma Attacks During Pregnancy?

Avoid Your Asthma Triggers

Avoiding asthma triggers is always important, but is particularly important during pregnancy. Pregnant women with asthma should increase avoidance measures to gain greatest comfort with the least medication.

  • Stay away from people who are sick with respiratory infections.
  • Avoid allergens like dust mites, animal dander, pollen, mold and cockroach.

Stop Smoking Cigarettes/Tobacco

Giving up cigarette smoking is important for any pregnant woman. Smoking may worsen asthma and harms the health of the growing fetus as well.

Exercise

Regular exercise is important to health. Talk to your obstetrician for the best advice about exercising during pregnancy. Swimming is a particularly good exercise for people with asthma. Using quick-relief medicine 10 minutes before exercise may help you tolerate recommended exercise.

Are Asthma Medicines Safe to Use During Pregnancy?

Is It Safe to Use Asthma Inhalers or Corticosteroids While Pregnant

Ensuring asthma is well-controlled is key. It is recommended that mothers seek regular check-ups to ensure their asthma remains controlled. Working with an asthma provider is essential. The asthma regimen that is best suited for the mother is the best approach.

Some asthma medicines are considered “safer” during pregnancy because their risks appear to be less than the risks of uncontrolled asthma. These include:

  • short-acting  inhaled bronchodilators
  • anti-leukotriene agents like montelukast (Singulair)
  • some inhaled corticosteroids, like budesonide

Based on the severity of the mother’s asthma, a doctor may consider switching her treatment to an inhaled corticosteroid alone.

Long-acting beta agonists (like Serevent, Symbicort and Advair) and theophylline are not considered first-line treatments for pregnant asthma patients. But doctors may consider them if the mother’s asthma is not adequately controlled by the above medicines.

If asthma is very severe, oral steroids such as prednisone, may be necessary for the health of the mother and baby.

Remember: It is better for mother and baby if the mother maintains asthma control (using any approved asthma drugs).

Are Allergy Shots Safe During Pregnancy?

Pregnant woman with asthma already receiving allergy shot therapy can usually continue if they are not having reactions.

As an extra precaution, though, the allergist may cut the dosage of the allergy extract to reduce the chance that a severe allergic reaction occurs or at a minimum keep the dose the same but the dose should not be increased during pregnancy since that increases the chance of a reaction.

Are Flu Shots Safe to Receive During Pregnancy?

People with asthma should get flu shots. Pregnancy does not change that recommendation. In fact, influenza may be particularly severe in pregnant women.

Asthma Attacks During Labor

When asthma is under control, asthma attacks almost never occur during labor and delivery. Also, most women with well-controlled asthma are able to perform breathing techniques during their labor without difficulty.

Is It Safe to Breastfeed?

Doctors do not believe asthma medicines are harmful to a nursing baby when used in usual amounts. The transfer of asthma medicines into breast milk has not been fully studied.

When breastfeeding, drinking extra liquids to avoid dehydration is also important (as it is for all people with asthma). Discuss with your baby’s pediatrician.

Will I Pass On Asthma to My Baby?

Genetics plays a role in whether a baby will develop asthma. In other words, asthma tends to be more likely in a baby if their relatives have it. The environment also plays an important role.

Can I Do Anything to Prevent Asthma in My Baby?

One major prenatal risk factor for the development of asthma is maternal smoking. Giving up cigarette smoking is very important. Other prenatal factors that may influence the development of asthma are:

  • maternal stress
  • diet
  • vitamin D levels
  • antibiotic use
  • method of delivery

Talk to your doctors about identifying your risk factors and making safe changes in preparation for your new baby.

 

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Original article can be found here
Medical Review November 2016.

References

Subbarao, P., Mandhane, P.J., Sears, M. R. (2009). “Asthma: epidemiology, etiology and risk factors.” CMAJhttp://www.cmaj.ca/content/181/9/E181.full.pdf+html

Willemsen, G., van Beijsterveldt, T.C.; van Baal, C.G.; et al. (2008). “Heritability of self-reported asthma and allergy: a study in adult Dutch twins, siblings and parents.” Twin Research and Human Genetics. https://www.ncbi.nlm.nih.gov/pubmed/18361713

Holberg, C.J., Elston, R.C., Halonen, M., et al. (1996). “Segregation analysis of physician-diagnosed asthma in Hispanic and non-Hispanic white families. A recessive component?” American Journal of Respiratory and Critical Care Medicine. 1996;154:144–50. [PubMed]

Lawrence, S., Beasley, R., Doull, I., et al. (1994). “Genetic analysis of atopy and asthma as quantitative traits and ordered polychotomies.”  Annals of Human Genetics. 1994;58:359–68. [PubMed]

Fraga, M.F., Ballestar, E., Paz, M.F., et al. (2005). “Epigenetic differences arise during the lifetime of monozygotic twins.”  Proceedings of the National Academy of Sciences of the United States of America. [PMC free article]

Qiu, Jane. (2006). “Epigenetics: unfinished symphony.” Nature.

Camargo Jr, C.A., Rifas-Shiman, S.L., Litonjua, A.A., et al. (2007).  “Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age.” The American Journal of Clinical Nutrition. https://www.ncbi.nlm.nih.gov/pubmed/17344501