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Reasons to visit an allergist?
February 21, 2007 7:38 AM   Subscribe

Reasons to visit an allergist?

After meeting with a pulmonologist this week, he diagnosed me with chronic asthma and told me to visit an allergist. My first meeting with an allergist will cost approx $1000, an amount that won't be covered by my insurance. Second-hand, I was told that my doctor could perform a much cheaper blood test to determine my allergies (though it might not get as many of them).

What would the advantages of visiting an allergist and getting the full range of tests be?
posted by drezdn to Health & Fitness (12 answers total)
 
One reason is that you might find out about allergies you never imagined you had. I knew I was allergic to x and y, but the allergist examined me and told me that I have a kind of low grade allergic reaction going on at all times, and when I was tested I was shocked at some of the allergens I'm apparently reacting to all the time without my knowledge. If you are allergic to allergens you weren't aware of, and you can be treated for them, your quality of life might significantly improve.
posted by Amizu at 7:47 AM on February 21, 2007


Well, I suppose it depends on how severe your allergies are. If there's something bad enough that it's causing anaphylaxis, it'd be best to get checked out. Another advantage might be knowing more specifically exactly what you're allergic to... such as answering the question "are you allergic to a product or just one ingredient of the product?"
posted by IndigoRain at 7:48 AM on February 21, 2007


Amizu is right - you might be VERY surprised at what the allergist finds out - depending on how badly you're suffering, that $1000 might be worth it.

(Allergy sufferer all my life, here)
posted by agregoli at 8:14 AM on February 21, 2007


Question: why isn't your insurance covering your allergy appointment? It's not like it's experimental.
posted by Taken Outtacontext at 9:00 AM on February 21, 2007


I had bad asthma and bad hay fever all my life. When I went to an allergist a few years ago, he just confirmed through the scratch tests that I was indeed allergic to dust, pet dander, molds, pollens, etc. He said the only thing I could do was go in for weekly allergy shots. As it would've cost a fortune, and would've taken up a lot of time, I decided it wasn't worth it, especially since allergy shots don't always work, and the doctor informed me that it could take up to a year to actually help.

A few months later, my regular doctor did a blood test to determine food allergies. I was blown away by all the food allergies (or sensitivities) I had. From the test results, it seemed my body really didn't like vegetables, fruits, or nuts. At first, I cut out everything I was allergic to, but I lost so much weight, I couldn't keep that up for too long. But just cutting back on the foods that I was extremely allergic to, eased my allergies so much, there were days I didn't even have to blow my nose - which was a small miracle for me. And I haven't had a problem with my asthma (knock on wood) since my modified diet.

My doctor explained that the food sensitivities probably compounded my hay fever, and my hay fever was frequently a trigger for my asthma.

So anyway, the point of all that is just to say that I definitely recommend the blood test for allergies. The blood test also tests for pollen and dust and stuff - not just food. I would say if money was an issue, the blood test is a pretty good indicator.
posted by eggplantia5 at 9:07 AM on February 21, 2007


Early on, it seemed my dust allergy was manageable, but that pollens were my real problem. Visiting an allergist helped me by clarifying some things I didn't really understand. For example, when I'm affected by one allergen, I become much more sensitive to other allergens; that means that if I really work to avoid dust, I'm going to take much less of a hit from pollens. Also, it's easier and more effective to prevent allergy symptoms than to get rid of them. Third, some antihistamines can be used together if one isn't doing the job. Once I got these ideas into my head and behaved accordingly, I needed to use the inhaler much less often.

You do need to know what you're allergic to. You also need to get information that'll make a real difference in how you take care of your health. A good allergist can help you get that bigger-picture view of your asthma that'll motivate you to coordinate what you do.
posted by wryly at 9:46 AM on February 21, 2007


He's going to do a blood test? Then chances are he's giving you a RAST test, which I would consider more comprehensive than a skin test, anyway (of course, IANAD). I've gone to allergists all my life, and though I am grateful to them for helping me become aware of things I am allergic to, I think that a regular doctor will be able to do this, as well. Once you know what you're allergic to, you avoid those things. There's not really much else a doctor can do.
posted by billysumday at 10:49 AM on February 21, 2007


Oops - my previous comment was more specific to food allergies, so, now that I see you're talking principally about asthma, let me say that I would HIGHLY recommend allergy shots if you have seasonal and environmental allergies. They helped me greatly and cleared up my asthma. Recent studies have shown that allergy shots really do work (though sometimes they take a really long time before benefits are seen - I took them for almost 10 years). If this necessitates a visit to the allergist, then I would go. However, I have no idea why your health insurance wouldn't on cover it. If your regular doctor can give you a RAST test to detect environmental allergies and put you on shots, then I would recommend that. If he or she can't do that, then by all means, go to an allergist, if for no other reason than to get prescribed for and to begin a regimen of shots.
posted by billysumday at 10:54 AM on February 21, 2007


However, I have no idea why your health insurance wouldn't on cover it.

My insurance is an HSA, where I have to spend $2000 a year before they cover anything.
posted by drezdn at 11:06 AM on February 21, 2007


One thing that hasn't been mentioned yet is that a skin test can be tailored to the place that you're living - i.e. it will test you for local trees, grasses and flowers. So if you didn't have trouble in the place you were living before, this could help you pinpoint things in your area to avoid. I don't know if the blood test does the same.

Again, in the case of skin tests, they're not great for animals since those allergens can be pretty animal-specific but most people are well aware of whether they're allergic to pets. I can only guess that the blood test is equally un-enlightening on that point.

As to what your allergist will tell you vs. what your doctor will tell you - the allergist will probably have more access to the sera you'd need for allergy shots. That's a long-term solution that may take years to work and may require maintenance depending on the severity of your allergies. That being said, you can always have the allergist send the sera to your doctor for the actual injections, but I don't imagine that will change the cost at all. (In my case, that meant an estimated 3 years of weekly shots before improvement and a guaranteed lifetime of monthly shots to ensure that the allergies stayed away-ish.)

Both the allergist and the doctor should be happy to prescribe any number of antihistimines, steroid treatments and inhaler options for your upper respiratory and pulmonary allergies. Any allergist who tells you your ~only~ option is to get shots seems a bit questionable to me.

I was very happy to find an allergist that did a comprehensive skin test (read: used the entirety of my back and did follow up sub-cuteaneous injections of the questionable allergens) to know exactly what I should avoid. I then proceeded to quit the shots and just stick with allergy and asthma medication re-prescribed by my primary care physician as I've run out., which is a livable solution in my mind. In Phildelphia, the full skin test cost roughly 600usd.
posted by oreonax at 1:11 PM on February 21, 2007


If the question is, "What can the allergist tell me that the blood test won't?" I'm less qualified to answer. Presumably the allergist is more knowledgeable in his specialty.

If it is more along the lines of "Why visit a allergist?" I can say that your quality of life can definitely improve. I've been unable to effectively breathe through my nose my whole life, and I am constantly having to cough or deal with draining sinuses. I had no idea these were both allergy related until I finally went to an allergist and started meds. It's really nice not to have to make rude noises all the time 'cause you feel like you're choking.

Asthma can be a pain, too (life-threatening, potentially--but I'm guessing you would have been diagnosed sooner if that's the case). Asthma can show up as a chronic cough (that's what I'd had).

Have you considered if your normal doctor can do this? Certainly he/she'll be able to diagnose asthma and prescribe for it, if the asthma is your concern.
posted by RikiTikiTavi at 1:30 PM on February 21, 2007


If you have allergic asthma--asthma where environmental allergens trigger your asthma--then an allergist is the way to go.
Likely your pulmonologist suspects allergic asthma, that's why he/she referred you.
But... unless you really want to find out what you are allergic to, you're probably OK with sticking with the pulmonologist to treat your asthma.
The pulmonologist will read the same guidelines that the allergist does to treat asthma. If the pulmonologist suspects an allergic component to your asthma, he/she will put you on an allergy medication (OTC stuff like Benadryl and Claritin first, then Rx stuff like Singulair, Zyrtec, etc) in addition to a long-acting corticosteroid (like Advair). It's all in the guidelines. The meds sometimes take a few weeks to figure out, and not everyone reacts the same way to things. For example, Allegra and Claritin make me super hyper, but Singulair is side-effect free for me.
Kudos to you for going to a pulmonologist to get a diagnosis, by the way. It's great to have a specialist treat you. A lot of PCPs know about asthma but are ignorant about the lifestyle changes that have to occur to effectively treat it.
I've seen an allergist to treat my moderate allergic asthma for about two years. I am glad I went. She did skin tests and I discovered I'm allergic to basically everything except cats and dogs. I was concerned about the animals since I love pets, and I was going to have to learn how to live with it if I were allergic to dogs. But my allergist has also helped me figure out effective ways to exercise outside in the Atlanta pollen, clean up my home to limit dust and get my acid reflux (a common co-morbid to asthma) under control. I think it's just important to have an expert in asthma at your disposal, no matter if it's a pulmonologist or allergist.
posted by FergieBelle at 4:25 PM on February 21, 2007


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