Patient Procedures


Update for Immunotherapy (allergy shots) Office Protocol during COVID-19 Pandemic

updated 3-25-2020

We continue to work to balance your access to vital treatment and providing a safe environment for all of our patients.

We have now had nearly a week of scheduled allergy shots, and it continues to go well.  Thank you to every patient who has called or texted us for a time slot.  We appreciate your efforts to help us maintain social distancing and to maximize the safety of all of our patients and our staff.  We will continue this plan for now.

We would like to reiterate, that for some patients, temporarily stopping allergy shots for the next 4-8 weeks is a reasonable option. If you choose to temporarily stop allergy shots, we will simply adjust your dose at the time you restart and then allow you to build back to maintenance dosing. We recommend patients over age 65 and those with compromised immune systems strongly consider this option.

For those of you who to continue to receive allergy shots, we will continue to schedule allergy shot visits every 10 minutes during our clinic time and will have all allergy shot patients wait in private rooms for their 20 minute post-injection observation. This will allow a minimal amount of patients in the allergy shot and waiting room areas at any given time.

 

To schedule an allergy shot appointment:               CALL 303-706-9923 or TEXT 720-476-1885.

 

In your voice or text message, please include your name and date of birth and 2-3 approximate times and dates that you would prefer.

Example text or voice message:

     Jane Doe, dob 1/1/2001, Tues 3/24 between 10-4 pm.

     John Doe, dob 2/2/1992, anytime Thurs 3/26.

We will call or text you a confirmation.

Thank you for your patience and understanding as we move forward. The recommendations for safety and to decrease the spread of COVID-19 are evolving quickly. We will get through this but we need to work together!

 

Sincerely and in good health,    Lora Stewart MD and Meghan Garcia MD

Anitbiotic Sensitivity Testing

  • ANTIBIOTIC SENSITIVITY TESTING: Penicillin allergy is the most commonly reported antibiotic allergy. In fact, penicillin allergy is reported to affect approximately 10% of the U.S. population. Confirming or ruling out true penicillin allergy is very important for future antibiotic treatment options.

Negating true penicillin allergy may allow for treatment with more cost-effective drugs and help to combat drug resistance in the community. For penicillin testing in particular, we now have the FDA-approved Pre-Pen® test available which is easy, safe, and can be completed in approximately 1 hr. Following this testing, patients with negative skin test results are challenged, in our office, with oral penicillin or amoxicillin and observed for one hour to confirm their ability to tolerate the drug. In addition to penicillin testing, we also have the capability to assess other classes of antibiotics as well.

Allergen Patch Testing

  • ALLERGEN PATCH TESTING: Patch testing is a test for a skin reaction or rash which is also called a hypersensitivity reaction. Patch testing can be done for a number of different substances including metals, fragrances, preservatives and other chemicals.

This reaction is a delayed-type hypersensitivity reaction which will occur on the skin due to contact with the allergen. Patch testing is a reliable and easy test designed to assist in identifying substances found in commonly used products such as makeup, aftershave, shampoo, jewelry, medications, medical appliances, clothing, cleaning supplies, paper/ink, disinfectants, and construction materials. Our standard patch test can identify up to 33 different materials as possible allergens. Some examples of specific allergens that may be identified include Nickel, fragrance, thimersol, formaldehyde, thiuram, and paraben. The test is applied to the skin in the form of a sticker or patch (usually on a patient’s back) and is then read at 48 hrs and at 96 hours to check for reactions. Once an allergen is identified, avoidance of this agent is curative.

Ingestion Challenge

  • INGESTION CHALLENGE: Often specific foods or prescription drugs are suspected of triggering symptoms which can range from classic hives and facial swelling to vomiting or diarrhea. For the appropriate patient we are able to test or challenge the patient to a specific food or medication in a safe environment by using a graded dosing protocol.

Skin testing initially may be performed, followed by controlled ingestion of increasing amounts of the suspected substance while under careful observation. Ingestion challenges can be performed with one food item at a time– a good example would be almonds. Ingestion challenges may also be done with antibiotics if this is the item in question. These challenges may be very helpful in expanding the diet of someone with multiple food allergies, or expanding the drug options of someone with multiple drug allergies.

Exercise Challenge

  • EXERCISE CHALLENGE: This is a test to determine how physical exertion might affect the way you breath.

Exercise-induced asthma (EIA) is a common disease and exercise is a common trigger for patients who have asthma. Exercise-induced asthma occurs as a result of drying or cooling of the airways during exercise. Lung function testing is performed sequentially both before and after a prescribed exercise protocol which is completed on a treadmill. For the majority of asthmatics, exercise can induce some airway constriction and this test will identify changes in lung function that will rule out or confirm EIA. Additionally, if a patient has a firm diagnosis of EIA, this test may also be used to assess the effectiveness of one’s pretreatment medications in preventing their symptoms. Our test is about 2 hours long and is performed in our office.