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Allergen Immunotherapy

Purpose

Your individualized course of allergy shots (immunotherapy) is designed to decrease your allergic sensitivities. The vast majority of allergic patients (80-90%) will experience substantial reductions in their symptoms over time (months to years). Many also reduce or eliminate the need for other medications. Together with avoidance of offending allergens and medication allergy shots represent one of the recommended treatments for allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. Allergy shots are not useful for food/drug allergies or non-allergic conditions like infections.

Treatment Duration

The length of a treatment course varies on a case by case basis but in general a course requires 3 to 5 years of maintenance treatment for completion. Initially there is a build-up phase where the injections are given more frequently but as the High Dose, or maintenance dose, is reached the frequency of injections may be adjusted. The total duration of therapy can vary considerably from patient to patient. During your treatment you will be re-evaluated frequently by your physician. These visits will occur at least annually.

Schedule of Administration

Your series of injections begins at a low dose selected by your physician based on your skin test results and history. Over time the shots build gradually until you reach your High Dose. This High Dose is called the maintenance dose and you will stay on it for the duration of your treatment course unless it is changed by your physician. Maintenance therapy can be continued if you are pregnant BUT notify your OAAC physician when you become pregnant.

The build-up phase of the allergy shots can occur in different formats. Your physician will help you decide which is right for you. Most common is the weekly building schedule. Various accelerated schedules include: 2 or 3 time a week shots, clusters of several shots given on the same day and finally RUSH therapy where many injections are given on one day and then weekly shots follow until you are at your High Dose. RUSH therapy is associated with significantly more side effects (see below) and is not for every patient. However, it does bring you to the High Dose level in a month rather than slowly over many months. This is an advantage for some patients.

Safety

All allergy shots carry some risks for severe anaphylactic reactions. Therefore the injections need to be administered in a medical facility under medical supervision on a regular basis. Weekly or twice weekly shots from our clinic carry a risk of anaphylaxis of 0.015 to 0.02% of injections compared to nationally published risks of 0.1 to 0.3% of injections. RUSH therapy carries a nationally published risk of almost 40% of shots whereas our RUSH risk is closer to 10% of injections. This marked increase in risk however makes RUSH therapy unacceptable for many patients.

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Asthma and COPD: Differences and Similarities

You can't breathe when you exert yourself, and you suffer from episodes of coughing. There are two likely causes for this: you could have asthma, or you could have Chronic Obstructive Pulmonary Disease (COPD), such as emphysema or chronic bronchitis.

Because asthma and COPD have a number of similarities, it can be difficult to distinguish between them. However, after taking into account your symptoms, medical history, a physical examination and results of medical tests, your doctor can determine if either of these chronic diseases are at the root of your poor health.

Symptoms
Both asthma and COPD may cause shortness of breath and cough. A daily morning cough that produces phlegm is particularly characteristic of chronic bronchitis, a type of COPD. Episodes of wheezing and chest tightness (especially at night) is more common with asthma.

In addition, patients with asthma are more likely to have allergies such as allergic rhinitis (hay fever) or atopic dermatitis (eczema).

History of Smoking
COPD is almost always associated with a long history of smoking, while asthma occurs in non-smokers as well as smokers. Smoking can also make asthma worse; and smokers are particularly likely to suffer from a combination of both asthma and COPD.

Differing Treatments
Although it may take some time and effort, it is important to distinguish between asthma and COPD. The treatment for the two conditions is different, and you will greatly benefit from an accurate diagnosis and appropriate treatment plan. Whether you have asthma, COPD, or both, make sure you see your doctor regularly.

Talk to your OAAC provider to discuss diagnosis and treatment. 

The post Asthma and COPD: Differences and Similarities appeared first on Oklahoma Allergy and Asthma Clinic.

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