Patient Education

What is Pulmonary Function Test?

Pulmonary function tests are a group of procedures that measure the function of the lungs, revealing problems in the way a patient breathes. The tests can determine the cause of shortness of breath and may help confirm lung diseases, such as asthma, bronchitis or emphysema. The tests also are performed before any major lung surgery to make sure the person won’t be disabled by having a reduced lung capacity.

What is the purpose of Pulmonary Function Test?

Pulmonary function tests can help a doctor diagnose a range of respiratory diseases which might not otherwise be obvious to the doctor or the patient. The tests are important since many kinds of lung problems can be successfully treated if detected early.The tests are also used to measure how a lung disease is progressing, and how serious the lung disease has become. Pulmonary function tests also can be used to assess how a patient is responding to different treatments.

One of the most common of the pulmonary function tests is spirometry (from the Greco-Latin term meaning “to measure breathing”). This test, which can be given in a hospital or doctor’s office, measures how much and how fast the air is moving in and out of the lungs. Specific measurements taken during the test include the volume of air from start to finish, the fastest flow that is achieved, and the volume of air exhaled in the first second of the test.

Tips to Remember: Rhinitis

Do you suffer from frequent sneezing, congestion and an itchy or runny nose? If so, you may have rhinitis. Rhinitis is one of the most common chronic conditions, affecting 10% to 30% of adults and up to 40% of children in the United States. If this includes you, you don’t have to suffer.

By learning more about rhinitis, you will have a better understanding of your symptoms. An allergist/immunologist, often referred to as an allergist, can make an accurate diagnosis and develop a treatment plan that works for you.

Allergic Rhinitis

There are two types of rhinitis: allergic rhinitis and non-allergic rhinitis. Let’s talk first about allergic rhinitis.

Allergic rhinitis is caused by allergens in the air, which are usually harmless but can cause problems in certain people.

Allergy symptoms are the result of a chain reaction that starts in the immune system. Your immune system controls how your body defends itself. For instance, if you have an allergy to pollen, your immune system identifies pollen as an invader or allergen. Your immune system overreacts by producing antibodies called Immunoglobulin E (IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction with symptoms such as sneezing, stuffiness, a runny nose, itching and post-nasal drip.

People with rhinitis are prone to itchy, watery eyes (from allergic conjunctivitis), and they may be more sensitive to irritants such as smoke, perfume or cold, dry air. Rhinitis can contribute to other problems such as asthma, sinus or ear conditions or trouble sleeping

Causes

When allergic rhinitis is caused by outdoor allergens such as tree, grass and weed pollen, it is called seasonal allergic rhinitis, or “hay fever.” Rhinitis can also occur year-round because of indoor allergens from pets, mold, dust mites and cockroach droppings. This is called perennial allergic rhinitis. You can have either seasonal or perennial allergic rhinitis, or a combination of both.

Diagnosis and Treatment of Allergic Rhinitis

An allergist can help determine which allergens, if any, are causing your symptoms. He or she will take a detailed health history, perform a physical exam and then test you for allergies. Skin tests show the results within 20 minutes. These results, as well as how frequent and bad your symptoms are, will be considered when developing a treatment plan. Steps to manage your symptoms may include avoiding the allergens you are allergic to, medications and/or allergy shots (immunotherapy).

Avoiding allergens

The American Academy of Allergy, Asthma & Immunology brochures on Indoor Allergens and Outdoor Allergens give helpful advice to help you reduce exposure to the allergens to which you are sensitive.

Medications

Some medications for allergic rhinitis are best used daily to control inflammation and prevent symptoms, while others are used only as needed to relieve symptoms. Nasal corticosteroid sprays can control inflammation and reduce all symptoms of allergic rhinitis, including itching, sneezing, runny nose and stuffiness. Antihistamines in the form of pills or nasal sprays block histamine and may relieve itching, sneezing and runny nose. But they may not be as effective in reducing nasal stuffiness. Anti-leukotrienes in the form of pills can reduce all the symptoms of allergic rhinitis. Decongestant pills or nasal sprays can be used as needed if nasal stuffiness is not relieved with other medications. Decongestant sprays should not be used for long periods of time because they can cause your congestion to return. Ipratropium nasal spray can be used specifically for a runny nose.

Allergy shots, also known as immunotherapy, may be considered if your symptoms are constant, if you don’t want to take medications or feel that they are not enough, or if you want long-term control of your allergies with less need for medications. This treatment involves receiving injections periodically-as determined by your allergist-over a period of three to five years. The end result is decreased sensitivity to allergens.

Non-Allergic Rhinitis

Some people with rhinitis symptoms do not have allergies. Non-allergic rhinitis usually begins in adults and causes year-round symptoms, especially a runny nose and nasal stuffiness.

Strong odors, pollution, smoke and other irritants may cause symptoms of non-allergic rhinitis. Non-allergic rhinitis symptoms can also develop as side effects of medications, including some blood pressure medicines, oral contraceptives or medications used for erectile dysfunction. The most common form of this type of non-allergic rhinitis is caused by nasal decongestant sprays such as oxymetazoline, when used for long periods of time. This type of medication-induced rhinitis is also called rhinitis medicamentosa.

Treatment of Non-Allergic Rhinitis

If there is inflammation in the nose, the treatment of choice is nasal corticosteroid sprays. Ipratropium nasal spray can relieve a runny nose. Decongestant pills can be used as needed to relieve nasal stuffiness.

Other forms of treatment may be considered if you have problems with the structure of your nose, such as narrow drainage passages, tumors or a shifted nasal septum (the bone and cartilage that separate the right from the left nostril). In these cases, an operation may be needed.

Healthy Tips

There are two forms of rhinitis: allergic and non-allergic. In order to control symptoms, it is important to have the right diagnosis.
Allergic rhinitis can be caused by outdoor allergens such as pollen (seasonal allergic rhinitis) or indoor allergens such as dust mites or pets (perennial allergic rhinitis).
Some people with symptoms of rhinitis don’t have allergies. This is called non-allergic rhinitis and can develop as a side effect of certain medications.
Seeing an allergist can help you understand your condition, manage your symptoms and make you feel better.
An allergist will recommend a treatment that is right for you, whether it be avoiding the allergen that causes your symptoms, certain medications or allergy shots.

Feel Better. Live Better.

An allergist/immunologist, often referred to as an allergist, is a pediatrician or internist with at least two additional years of specialized training in the diagnosis and treatment of problems such as allergies, asthma, autoimmune diseases and the evaluation and treatment of patients with recurrent infections, such as immunodeficiency diseases.

The right care can make the difference between suffering with an allergic disease and feeling better. By visiting the office of an allergist, you can expect an accurate diagnosis, a treatment plan that works and educational information to help you manage your disease.

Tips to Remember: Stinging Insect Allergy

When most people are stung by an insect, the site develops redness, swelling and itching. However, some people are actually allergic to insect stings. This means that their immune systems overreact to the venom.

If you are insect-allergic, after the first sting, your body produces antibodies called Immunoglobulin E (IgE). If stung again by the same kind of insect, the venom interacts with this specific IgE antibody, triggering the release of substances that cause an allergic reaction.

Symptoms of a Severe Reaction

For a small number of people with venom allergy, stings may be life-threatening. This reaction is called anaphylaxis (pronounced an-a-fi-LAK-sis). Symptoms may include two or more of the following: itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea. In severe cases, a rapid fall in blood pressure may result in shock and loss of consciousness. Anaphylaxis is a medical emergency and may be fatal. If you have these symptoms after an insect sting, get emergency medical treatment. After this treatment, you should also ask for a referral to an allergist/immunologist, often referred to as an allergist, to learn how to stay safe in the future.

Identifying Stinging Insects

To avoid stinging insects, it is important to identify them.

Yellow jackets’ nests are made of a paper-mach√© material and are usually located underground, but can sometimes be found in the walls of frame buildings, cracks in masonry or woodpiles.

Honeybees and bumble bees are non-aggressive and will only sting when provoked. However, Africanized honeybees (AKA “killer bees”) found in the Southwestern United States are more aggressive and may sting in swarms. Domesticated honeybees live in man-made hives, while wild honeybees live in colonies or “honeycombs” in hollow trees or cavities of buildings.

Paper wasps’ nests are usually made of a paper-like material that forms a circular comb of cells which opens downward. The nests are often located under eaves, behind shutters, or in shrubs or woodpiles.

Hornets are usually larger than yellow jackets. Their nests are gray or brown, football-shaped and made of a paper material similar to that of yellow jackets’ nests. Hornets’ nests are usually found high above ground on branches of trees, in shrubbery, on gables or in tree hollows.

Fire ants build nests of dirt in the ground that may be quite tall (18 inches) in the right kinds of soil.

Preventing Stings

Stay away! These insects are most likely to sting if their homes are disturbed, so it is important to have nests around your home destroyed.

If flying stinging insects are close by, remain calm and move slowly away. Avoid brightly colored clothing and perfume when outdoors. Because the smell of food attracts insects, be careful outdoors when cooking, eating or drinking sweet drinks like soda or juice. Beware of insects inside straws or canned drinks. Keep food covered until eaten. Wear closed-toe shoes outdoors and avoid going barefoot. Also, avoid loose-fitting garments that can trap insects between material and skin.

Treating Stings

If the insect left its stinger in your skin, remove the stinger within 30 seconds to avoid receiving more venom. A quick scrape of your fingernail removes the stinger and sac. Avoid squeezing the sac-this forces more venom through the stinger and into your skin. For all stinging insects, try to remain calm, and brush these insects from the skin. Then immediately leave the area.

The following steps can help in treating local reactions to insect stings:

Raise the affected limb and apply a cold compress to reduce swelling and pain
Gently clean area with soap and water to prevent secondary infections; do not break blisters
Use topical steroid ointments or oral antihistamines to relieve itching
See your physician if swelling progresses or if the sting site seems infected

If you are severely insect-allergic, carry auto-injectable epinephrine. Learn how and when to self-administer the epinephrine, and replace the device before the labeled expiration date.

Remember that epinephrine is a rescue medication only, and you must still have someone take you to an emergency room immediately if you are stung. Those with severe allergies may want to consider wearing a bracelet or necklace that identifies the wearer as having severe allergies.

Consult Your Allergist

If you have had a serious reaction to an insect sting, make an appointment with an allergist. With proper testing, your allergist can diagnose your allergy and determine the best form of treatment. In many cases, insect venom allergy shots (or immunotherapy) are very effective.

With a proper diagnosis, treatment plan and careful avoidance, people with an insect allergy can feel more confident and enjoy being outdoors.

Healthy Tips

Symptoms of a non-allergic insect sting include redness, swelling and/or itching at the site of the sting.
Symptoms of an allergic reaction may include itching and hives, swelling in the throat or tongue, difficulty breathing, dizziness, stomach cramps, nausea or diarrhea.
An allergist is the best physician to diagnose stinging insect allergy and provide a treatment plan designed to keep you safe and healthy.
If you have a serious reaction, get emergency medical treatment and then follow-up with your allergist.

Feel Better. Live Better.

An allergist/immunologist, often referred to as an allergist, is a pediatrician or internist with at least two additional years of specialized training in the diagnosis and treatment of problems such as allergies, asthma, autoimmune diseases and the evaluation and treatment of patients with recurrent infections, such as immunodeficiency diseases.

The right care can make the difference between suffering with an allergic disease and feeling better. By visiting the office of an allergist, you can expect an accurate diagnosis, a treatment plan that works and educational information to help you manage your disease.

Tips to Remember: Food Allergy

If you have a food allergy, your immune system overreacts to a food. This is caused by an antibody called IgE (Immunoglobulin E), which is found in people with allergies. Food allergy is more likely to develop in someone who has family members with allergies. Symptoms may occur after you consume even a tiny amount of the food.

Most allergens can cause reactions even after they are cooked or have undergone digestion in the intestines. There are some exceptions. For example, some allergens (usually fruits and vegetables) cause allergic reactions only if eaten in their raw form. Symptoms are usually limited to the mouth and throat.

The most common food allergens are the proteins in cow’s milk, eggs, peanuts, wheat, soy, fish, shellfish and tree nuts.

In some food groups, especially tree nuts and seafood, an allergy to one member of a food family may result in the person being allergic to other members of the same group. This is known as cross-reactivity.

Cross-reactivity is not as common with foods from animal groups. For example, people allergic to cow’s milk can usually eat beef, and patients allergic to eggs can usually eat chicken.

With shellfish, crustaceans (shrimp, crab and lobster) are most likely to cause an allergic reaction. Molluscan shellfish (clams, oysters, scallops, mussels, abalone, etc.) can cause allergic reactions, but reactions to these shellfish are less common. Occasionally, people are allergic to both types of shellfish.

Symptoms of Allergic Reactions to Foods

Symptoms of allergic reactions are generally seen on the skin (hives, itchiness, swelling of the skin). Gastrointestinal symptoms may include vomiting and diarrhea. Respiratory symptoms may accompany skin and gastrointestinal symptoms, but don’t usually occur alone.

Severe Allergic Reactions

Anaphylaxis (pronounced an-a-fi-LAK-sis) is a serious allergic reaction that happens very quickly. Without immediate treatment-an injection of epinephrine (adrenalin) and expert care-anaphylaxis can be fatal. Follow-up care by an allergist/immunologist, often referred to as an allergist, is essential.

Symptoms of anaphylaxis may include difficulty breathing, dizziness or loss of consciousness. If you have any of these symptoms, particularly after eating, seek medical care immediately (call 911). Don’t wait to see if your symptoms go away or get better on their own.

Diagnosis

An allergist is the best qualified professional to diagnose food allergy. Your allergist will take a thorough medical history, followed by a physical examination. You may be asked about contents of the foods, the frequency, seasonality, severity and nature of your symptoms and the amount of time between eating a food and any reaction.

Allergy skin tests may determine which foods, if any, trigger your allergic symptoms. In skin testing, a small amount of extract made from the food is placed on the back or arm. If a raised bump or small hive develops within 20 minutes, it indicates a possible allergy. If it does not develop, the test is negative. It is uncommon for someone with a negative skin test to have an IgE-mediated food allergy.

In certain cases, such as in patients with severe eczema, an allergy skin test cannot be done. Your doctor may recommend a blood test. False positive results may occur with both skin and blood testing. Food challenges are often required to confirm the diagnosis. Food challenges are done by consuming the food in a medical setting to determine if that food causes a reaction.

Outgrowing Food Allergies

Most children outgrow cow’s milk, egg, soy and wheat allergy, even if they have a history of a severe reaction. About 20% of children with peanut allergy will outgrow it. About 9% of children with tree nut allergy will outgrow it. Your allergist can help you learn when your child might outgrow a food allergy.

Treatment

The best way to treat food allergy is to avoid the foods that trigger your allergy. Although it has been shown that just smelling peanut butter will not cause a reaction, sometimes food allergens can be airborne, especially in steam, and can cause reactions. Boiling or simmering seafood is a particular offender.

Always ask about ingredients when eating at restaurants or when you are eating foods prepared by family or friends.

Carefully read food labels. The United States and many other countries require that food allergens are listed in common language, for example, “milk” rather than a scientific or technical term, like “casein.”

Carry and know how to use injectable epinephrine and antihistamines to treat emergency reactions. Teach family members and other people close to you how to use epinephrine, and wear an ID bracelet that describes your allergy. If a reaction occurs, have someone take you to the emergency room, even if symptoms subside. Afterwards, get follow-up care from an allergist.

Food allergies can be confusing and isolating. For support, contact the Food Allergy & Anaphylaxis Network (FAAN) at (800) 929-4040 or visit www.foodallergy.org.

Healthy Tips

The most common food allergens are the proteins in cow’s milk, eggs, peanuts, wheat, soy, fish, shellfish and tree nuts.
An allergist is the best qualified professional to diagnose a food allergy. Testing performed by an allergist often helps determine if foods are causing your symptoms.
Some food allergies can be outgrown.
The best treatment is to avoid the foods that cause your reaction.
Read food labels carefully and ask about ingredients at restaurants or when eating food prepared by another person.

Feel Better. Live Better.

An allergist/immunologist, often referred to as an allergist, is a pediatrician or internist with at least two additional years of specialized training in the diagnosis and treatment of problems such as allergies, asthma, autoimmune diseases and the evaluation and treatment of patients with recurrent infections, such as immunodeficiency diseases.

The right care can make the difference between suffering with an allergic disease and feeling better. By visiting the office of an allergist, you can expect an accurate diagnosis, a treatment plan that works and educational information to help you manage your disease.