Q: What should a person with undiagnosed asthma expect on a first visit to an allergist?
William Berger, MD: A person with undiagnosed asthma should have certain expectations when they see an allergist for the very first time.
When you arrive at the allergist, you will likely be given a health history form to fill out. The allergist will then ask a series of questions to help with the diagnosis. For example:
- What are the symptoms? For asthma, it’s coughing, wheezing or shortness of breath.
- How long have you had symptoms?
- How frequently have you had symptoms?
- What are the potential triggers?
- Are there any other related respiratory or allergic conditions?
- What medications (if any) are you taking for any other medical problems.
Of course, you and the allergist will also discuss your family health history. Many patients have a mom, dad, brother, sister, uncle or aunt who may have asthma or allergies.
Allergists will certainly ask about triggers in the home. Is there smoking? Is there pet dander? Is there a lot of dust?
The allergist may also ask how symptoms are impacting your quality of life. Are you decreasing your exercise? Are you decreasing your ability to do the things you like to do?
Q: What are some tests used to diagnose asthma?
William Berger, MD: Pulmonary function tests help make the diagnosis of asthma. You blow into an air tube to measure air flow. Allergists may give you a bronchodilator inhaler to help open up your airways and see if there’s an improvement in breathing.
Allergists may give you a fractional exhaled nitrous oxide (FeNO) test to measure nitrous oxide gas in your lungs or airways. Nitrous oxide is elevated in people with asthma.
Q: Should you undergo allergy testing as part of an asthma diagnosis?
William Berger, MD: Very often an allergist will recommend allergy testing on a first visit. Skin prick testing is the most common form of allergy testing. In some cases, allergists may recommend a blood test instead.
In allergy testing, allergists look for all types of allergens – pollen, mold, pet dander, dust mites, and more – as well as any unidentified triggers.
Q: If asthma is the diagnosis, what is the next step?
William Berger, MD: Your allergist will put together an Asthma Action Plan. This will tell you what medicines to take, when to take them, how often to take them, and what to do if you start having significant symptoms.
The bottom line is, working with an allergist, an asthma patient should be able to live a fill and active life with no restrictions at all.
William E. Berger, MD, FACAAI, is a board-certified allergist with Allergy & Asthma Associates of Southern California in Mission Viejo, California. He is a Distinguished Fellow and Past President (2002-03) of the American College of Allergy, Asthma & Immunology (ACAAI).
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