Maybe you or your child tried a new food and wound up in the bathroom vomiting and breaking out into itchy hives. Or perhaps you suspect environmental triggers like dust mites or pollen are making your child cough and suffer congestion. This has prompted your family doctor to refer you to an allergist for the first time.
According to the National Institute of Allergies and Infectious Diseases, allergists are encouraged to use a combination of medical history and a physical exam to help diagnose allergies and figure out possible triggers.
To help you get the most out of that first visit, Allergic Living asked leading allergists for their recommendations – and what they wish patients knew before stepping into their offices.
What to check in advance
Leading up to that first visit, speak to your doctor or allergist to ensure that you are not taking any medications that could cause problems at your appointment.
“Some types of medications interfere with skin-prick testing, especially antihistamines,” says Dr. David Stukus, a pediatric allergist at Nationwide Children’s Hospital in Ohio. You may be asked to stop using these medications for around five days before seeing the allergist to prepare for testing.
Stukus stresses, however, that it’s important to ask your health-care provider before discontinuing any medications, since many, such as asthma inhalers, should not be stopped.
What to bring
In short: as much information as possible.
“The visit is not to just get “tested,” explains Dr. Scott Sicherer, chief of the allergy and immunology division at the Icahn School of Medicine at Mount Sinai in New York City. When investigating a potential food allergy, “the most important part of a first visit is telling the story of symptoms, and why there may be a suspicion of an allergy,” he says.
In order to give the allergist the most complete story possible, Sicherer suggests keeping a diary that details all meals and beverages consumed – with and without symptoms.
Make the entries as precise as possible, he advises, including things such as:
• how long it took before symptoms appeared,
• whether food came into contact with the skin,
• how the reaction was treated,
• and other factors such as whether the patient had been exercising, drinking alcohol or took medication prior to the reaction.
All of this information can give the allergist a better idea of what could be triggering reaction.
“This is important because allergy tests are more useful in confirming a suspicion of a food trigger rather than identifying triggers from a large list – and random testing can result in many positive tests that have no real meaning,” Sicherer recently wrote in his Ask the Food Allergy Experts column in Allergic Living magazine.
Doctors also advise putting smartphone technology to good use to better document allergic reactions. “Photos of any skin involvement may be helpful, as many allergic rashes or swelling will resolve by the time of the visit,” says Chicago allergist Dr. Aaron Donnell.
Besides jotting down a personal record, allergists also advise patients to bring a full list of any medications used or still in use as well as relevant medical documents (especially if an allergic reaction landed you in the hospital), test results and any previous allergy evaluations.
Labels from foods that caused problems can also give allergists added insight into possible culprits.
What to wear
There is no strict dress code for visiting the allergist. However, since testing could be involved, New York allergist Dr. Clifford Bassett says, “Patients should consider wearing comfortable clothing that would more easily allow virtually painless allergy skin tests on your arm and/or back.”
What questions to ask
Along with a food and symptom diary, write down questions that come up prior to your appointment. These can include:
- Do I need to get tested for this type of allergy?
- What foods am I being tested for and why?
- What do the allergy test results mean?
- How can I identify and avoid allergy triggers?
- How serious could my symptoms be?
- What food allergy management tools are available?
- How can we determine the best way to manage this food allergy?
- What should I monitor after the visit?
- When should I follow up with the office?
- Could my allergy improve or worsen with time?
If you are diagnosed, Sicherer advises asking how to manage the allergy on a daily basis, including discussing possible reactions, how and when to treat symptoms, and any concerns about medication side effects.
What to take away
The first meeting with the allergist can contain a lot of new information, so Bassett suggests getting reliable materials that you can take home and read at your leisure.
“Don’t forget to ask for additional resources such as educational websites and patient handouts on a variety of allergy conditions,” he says.
Dr. Sicherer is the author of Food Allergies: A Complete Guide for Eating When Your Life Depends on It.
Dr. Bassett is the author of The New Allergy Solution.