Tell me about your experiences going to/working with an allergist

In My Humble Opinion
1

I’ve had long-running allergies to (I think) grass and pollen, but now that I’m retired, I’m starting to think that going into an office/traveling every week was protecting me more than I realized, maybe from pet dander or something else.

I feel like - no doubt highly exaggeratedly - my nose has been running almost non-stop the last 8.5 months. So…I’m thinking I’ll make an appointment with an allergist, I just wondered what everyone’s experiences have been - What was the process? What ended up being helpful?

Many thanks. (achoo!)

2

Over 40 years ago now I went to my first allergist.

First thing was an extensive medical history of symptoms, times of occurrences, what we thought might be the problem, etc.

Extensive testing followed - a RAST test, the old skin-prick test, and cross-referencing and some “challenge” tests to eliminate false positives (which are more likely with RAST than skin tests).

For awhile I kept a food diary (I’ve got multiple food allergies). There was some dietary counseling in conjunction with that, but I’m not sure if that was out of the allergist’s office or a referral.

There weren’t nearly as many alternatives for medication are there are today - subsequent visits over the decades with doctors has led me to use some that simply didn’t exist back in my first go-around with allergy medicine. You might be asked to be off all medication for awhile, or have your medications changed.

I wasn’t introduced to neti pots back then - I learned about those decades later - but proper use can definitely help with allergies. I hope any allergist you go to will mention them.

What helped ME the most - and keep in mind that experiences vary immensely on this topic - were two things: First, identifying my food allergies and learning to avoid those triggers. My health improved quickly and immensely and has remained much better ever since. Second, five years of desensitization shots, four shots a week for five years. Worth it. Totally worth it. The only reason I stopped was because maximum benefit had been obtained and continuing was unlikely to provide any additional benefit. If it would improve my allergies more than their present state I’d totally do it all again, another five years worth.

A third thing is that I became much better at managing my allergies - anticipating problem situations, pre-medicating at time, better medications, better coping strategies, etc. which has definitely improved my quality of life.

3

Thank you for that detail! (and the link) That must have been stressful, but glad it’s working for you. We’ll see how all this goes, I’ll be calling tomorrow to set up an appointment…

4

Keep in mind I have an inordinate number of allergies, some of them even life-threatening. Most people don’t have quite as intense a need or experience as I did.

There may be some discomfort and “homework” (like a food diary) involved, but it can also help you a great deal. It’s not always about shots and drugs - I’ve learned a number of other techniques (like neti pots and using a mask to protect my lungs/sinuses/nasal passages when cleaning) that not only make me more comfortable, but enabled me to significantly reduce my need for medication.

I hope you find it as useful as I did.

5

I think a more usual allergist experience is this (which I’ve done more than once):

  1. They do a scratch test on your back. They draw a grid of however many squares and prick you with a bunch of different you-may-be-allergic-to-this substances. Wait a bit then the ones you react to will be a bump that’s probably itchy as hell. They write down all the reactions and grade them from strongest to slight to no-reaction. You go home with a way-itchy back.

  2. From that they form a tailored solution of “stuff you’re allergic to.”

  3. Once a week you go in and they inject you just under the skin with this stuff. Very fine, very short needle. You wait 15 minutes so they can see how you reacted (measure the bump, observe the redness) and probably to see if some severe reaction happens that they didn’t anticipate. You go home with an itchy mosquito bite on your forearm(s).

Repeat step 3 for 1-2 years. After that time your reaction to those allergic substances is lessened or eliminated.

  1. Wait 15-20 years and congrats! You’ve developed new substances you’re allergic to! Go back to step 1.

This was my experience with being allergic to grasses and pollens.

6

I’ve had seasonal and environmental allergies my whole life. It was moderate to severe (as the pharmaceutical ads put it) as I moved all all over the country growing up, but during my first fall after moving to New England, I thought I was going to die. I found myself completely congested, eyes watering and itchy, interspersed by sneezing fits in which I’d sneeze 20 or 30 times in a row. The only allergy medicine I had that worked for me at the time was Actifed, which had awful side effects. In desperation one day, I stupidly took a second dose, and almost ended up in the ER.

So the next day, I made an appointment to see an allergist. I saw two different doctors over the course of the next 7 years. Both doctors did skin testing, and determined I was allergic to several dozen allergens, including pollen (trees, grasses, and weeds), mold, dust mites, pet dander (especially cats), etc.

I then got allergy shots for the next 5 years or so. I don’t think the shots did much. I was always getting bad reactions when they tried to increase the dose, and they’d have to back off. After a few years, they had basically plateaued.

What did help was daily Zyrtec and Flonase, which the doctor also prescribed. I had previously tried the newer allergy medications (including Zyrtec, Claritin, and Allegra), but none seemed to help much. Then my son was born, and he had bad allergies, which Zyrtec seemed to help. So I tried Zyrtec again, and found out you have to take it for several days to see any improvement.

It’s now been over 25 years since I went to see that first allergist, and nearly 20 years since I had any allergy shots—but I still take Zyrtec and Flonase (generic equivalents) every day year round.

I now have virtually no allergy symptoms whatsoever, even here in New England in the fall.

7

In my case the shots helped a great deal, though over a period of a couple years it’s hard to notice the change until you realize spring and summer aren’t the same miserable ordeal. I do have period where I’ll take claritin for a couple or so weeks even now, so I agree the meds are still useful in addition whatever treatment you’ve had. My experience was the need for them was greatly lessened.

8

I originally sought out an allergist because my GI doctor suggested it.
I found one, did my scratch tests and then did rapid (?) shots. Something like 200ish shots over the course of two days.
On my second to last shot of that series, I noticed a little, itty bitty red dot on my arm and showed it to the nurse. She went into full panic mode, grabbed the doctor from wherever he was and they gave me some epinephrine. Dear god, is that stuff awful. I just about jittered right off the edge of my chair and my back hurt like hell for a few hours.

In any case, after all these years, the shots are really no big deal. I stop in once a month, I get three shots (and my flu shot while I’m there, like I did last week) and go on with my day.

Depending on the amount of glycerin your doctor uses, the allergy shots can sting quite a bit. Now, shots really never bother me, at all, but those ones are a bit more on the painful side. I don’t know how common this is, but my doc will happily add in a little lidocaine (and even bendryl). It take the edge off. Then all you have to think about is the big welt you’ll have for the next 24 hours or so.

Anyway, the allergies I tested positive for on the scratch test, I’ve had a few bites of here and there without noticing any problems. Many of the would make my throat start itching within seconds of having it in my mouth. But I haven’t really tested it beyond a bite or two.

I did also recently mention to one of the nurses that I used to get really nasty sinus infections (like, I’d end up in urgent care if it happened on a weekend) once or twice a year, but I’ve only had one since I started this. She said that’s pretty common. Less allergies mean less gunk in your sinuses and less chance of an infection…or something like that.

The real test will be to see if my esophagus gets inflamed to the point where I can’t get food down anymore. A diagnosis of eosinophilic esophagitis is what got me the allergy recommendation in the first place. Now, it took 20 years to go from ‘odd, a pill is stuck in my throat’ to the point where I was getting food caught in my throat at least once a day and decided I needed to deal with this. But in the 5ish years I’ve been getting allergy shots, it hasn’t returned.

9

Something else to keep in mind, depending on your insurance, this can be a bit expensive. You might want to talk to the doctor or your insurance company if money is going to be an issue.

The way it works at my doctor is that each time I stop in for injections, I get billed for an office visit. After the insurance discount, I end up paying $10-$20 (just depending on what plan I’m on and the negotiated rates) per visit. I need to get new vials about once a year. Those seem to range from $300-$400 up to maybe $600.
I usually tell people to assume it’s going to cost about a thousand dollars a year. Your mileage may, and very likely will, vary.

10

Shots don’t work well for about 1 in 5 people who try them.

I don’t react well to Zyrtec so that’s one I personally don’t take.

The thing to remember about allergies is that they differ from person to person and what works for me may or may not work for you, or robby, or someone else, and vice versa.

Oh yeah, epinephrine is evil. On the other hand, twice it has probably saved my life (along with a crap-ton of diphenhydramine and metholpredisone). Given a choice between anaphylaxis and epinephrine I’ll take the epinephrine… but that’s about the only time.

Yep. I had had multiple sinus infections in one year, a couple ear infections (I had never had them as a baby, but suddenly I was getting them), and had had multiple rounds with pneumonia when they shuffled me off to an ENT, who took one look at me and said “You have allergies, right? Let me send you to this guy and see if that helps”.

Haven’t had an ear infection or pneumonia since. A couple sinus infections, by which I mean maybe three in the past 40 years.

As I said, it made huge difference in my overall health.

11

And I forgot to mention, about 6 hours later I noticed that I had some hives showing up. Within a half hour or so, I was covered in them. I felt totally fine, I just had all these red dots/splotches all over myself. It was about midnight, I called the office, assuming I’d get an answering service, but it was recording with his cell phone. I called him at home, told him what was going on, that I already took 4 benedryls and what should I do. He said as long as I felt fine and wasn’t having any breathing issues, the benedryls were exactly the right thing to do and I’d be fine by morning, which I was.

I learned that a biphasic reaction, getting hives and then getting them again a few hours later is actually pretty normal and why epipens (which my doc requires his patients to have when they start getting shots) come in packs of two.

12

Do not take any allergy medication before you go.

I went to one several years ago, and I had been taking an allergy medication (over the counter). I stopped two weeks before the appointment. The tests the allergist gave me showed no allergies. WTF?

I had to wait another month, went back, and this time I found out I was allergic to everything. At least this time I got an accurate reading. I got a prescription which not only worked way better than the over the counter stuff, but was actually cheaper.

13

I think at my place, they request you don’t take anything for a few days before the tests. Maybe it’s longer, I don’t remember what they told me, but I often hear them calling new patients to get them ready for their tests.

Also, just to be clear, you only need to lay off allergy meds before they to the allergy test. When you go in for shots, allergy meds are encouraged.

14

Did not know that. Ignorance fought, thanks.

15

They told me two weeks and that was not sufficient time. For me, lesson learned.

16

When you consider that allergy shots are to re-program an immune system honed by a billion or two years of evolution it’s sort of a wonder they work as often as they do.

17

I have a lot to think about here, thanks to everyone for your answers.

18

I was taken to an allergist when I was about 3; one of my earliest memories was crying at his office (because of course back then, testing was one tiny injection right after another). I saw him again when I was about 10 and his bedside manner sucked mightily (like, walking up to me, shoving a cotton swab up my nose, leaving it there and walking away, without a word to me). All in all, this lead to years of nonstop allergy shots - which may or may not have done much to help me.

As an adult, I voluntarily went through similar testing because I was hoping that they could do a round of shots to reduce some of my environmental allergies. I think that ultimately did help, though it’s a very slow process.

To my mind, the best use of the testing is to help identify allergies you aren’t sure you have. I mean, if you start sneezin’ and wheezin’ when you’re around a cat for 10 minutes, you don’t need to be tested. But if you’re having major symptoms around the house, is it the flowers in bloom outside? mold in the air conditioner? the dog? Then you have the option of eliminating the source, if possible, or seeking treatment to reduce sensitivity.

As I understand it, food allergy testing is still hit or miss. My son had a very definite reaction to eating peanuts as a a toddler - definite enough (per my report) that the doctor wouldn’t even conduct skin testing for peanuts. She did test for other foods and identified a number of possible culprits (soy, chicken etc.) that he’d never had an issue with. We did an elimination diet followed by slowly reintroducing those, and he was fine.

Blood testing was either very new, or nonexistent (this was 23 or so years ago). Next go-round, when he was about 12, they did blood testing which suggested some of things from the previous round were not problems.

I haven’t been to an allergist in 23 or so years - last time I saw mine was when I was pregnant with my daughter. I haven’t felt like investing in a course of shots, and I haven’t had any inexplicable symptoms, so I haven’t felt the need. If they had a better track record for dealing with cat allergies, I’d be all for it!!

Oh, and I do think the series I had as an adult (in my mid-20s and again in my mid 30s) did help with the “hay fever”-type of allergies; those are substantially better than they were before I started them. I don’t have enough faith in the cat component to risk getting one, though.

19

My first allergist was willing to give me shots against pet allergies, but I didn’t have a pet at the time, so I didn’t bother.

I asked my second allergist about it, and he was adamantly against allergy shots for animals and pets. His reasoning was that while it’s all but impossible to avoid pollen and dust mites, you can avoid problematic pets and animals.

Also, he said that the shots for animal-related allergens were much more dangerous. He said that the few times he had to use a crash cart on a patient it was after injecting them with an animal-based allergen.

So I have simply avoided cats and horses ever since. The last time I tried to ride a horse was 24 years ago, and I had such a bad allergic reaction that my uncle (a physician who was on the trip in question) told me I was taking my life in my hands if I ever tried it again.

20

P.S. These particularly bad allergic reactions (to cats and horses, as well as exposure to something like poison ivy), have always gotten much worse for me on each subsequent exposure.