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DR. ANDREW MURPHY
West Chester | Coatesville | Jennersville
Dr. Andrew Murphy
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DR. ANDREW MURPHY:
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Andrew W. Murphy, MD, was born and raised in Delaware County, PA. He graduated in 1986 from Saint Joseph's University with a BS in Biology. After spending two years doing basic science research, he enrolled at Penn State University College of Medicine and graduated in 1992. He then completed his residency at the Milton S. Hershey Medical Center at Penn State University College of Medicine in 1995. Subsequently, he became a Fellow in Pediatric and Adult Allergy at the Asthma and Allergic Diseases Center of the University of Virginia. Prior to joining Asthma, Allergy and Sinus Center, Dr. Murphy was in practice in Baltimore, Maryland. He is a former faculty member in the Allergy Fellowship program of the Thomas Jefferson University / A.I. DuPont Hospital for Children where he played an active role in educating medical students, residents and allergy fellows. He has numerous publications in scientific journals. Dr. Murphy is board certified in allergy (1997-2007), re-certified (2007-2017).
Dr. Murphy is a recognized national leader in allergy and immunology. He is the founding Chief of the Allergy Section of PENN MEDICINE Chester County Hospital. He is a fellow and a member of the Board of Directors of the American Academy of Allergy Asthma and Immunology and as such has played an integral role in various national projects regarding Allergy/Immunology medical education, practice and patient care. Regionally Dr. Murphy has been intimately involved with advocacy related to injectable epinephrine available in schools, newborn screening for immune system disorders (SCID) and accurate physician representation of their training and credentials. He has been on the Alumni Board of the Penn State University College of Medicine and served as its President-elect, President and Past President. He is a past member of the Board of Regents of the Pennsylvania Allergy Association, past President of the Philadelphia Allergy Society, past representative for Allergy to the House of Delegates, and the Specialty Leadership Cabinet of the Pennsylvania Medical Society (2010 – present).
Dr. Murphy resides in Chester County with his wife Karen and three sons. He is a fan of Penn State football and NCAA Lacrosse.
ASTHMA
SINUSITIS
ALLERGIES
FOOD ALLERGY
VENOM ALLERGY
SKIN DISORDERS
DRUG ALLERGY
IMMUNE DEFICIENCY
— ASTHMA —
There are an estimated 17 million people living in the United States with self-reported asthma. Asthma is a chronic disease marked by wheezing, chest tightness, and/or shortness of breath.
If you or someone you know:
• Coughs a lot while exercising or following exercise;
• Has shortness of breath;
• Wheezes while breathing;
• Has a tight feeling in the chest
Then consult a physician because any one of these symptoms can be a sign of asthma.
Asthma symptoms are caused by the constriction (tightening of the muscles) and the inflammation (swelling and irritation) of the airways. Constriction and inflammation of the airways and increased mucosa make it difficult and sometimes impossible to breathe.
about asthma
Allergens, irritants, respiratory infections and/or exercise can trigger asthma symptoms. Asthma is often placed in different categories according to symptom “triggers.”
For example:
• Allergic asthma is triggered by allergic reactions to allergens such as pet dander, dust or dust mite, mold or pollen.
• Seasonal asthma is triggered by seasonal allergic reactions to allergens such as trees, grasses or weeds.
• Non-allergic asthma is triggered by irritants in the air that you breathe such as tobacco smoke, wood smoke, room deodorizers,
fresh paint, perfume, etc.
• Exercise-induced asthma is triggered by exercise or physical activity.
• Nocturnal asthma can occur in a patient with any type of asthma, though the asthma symptoms will increase or worsen at night.
For treatment, it is important to recognize asthma “triggers.” Airway inflammation may always be there, even when you are seemingly symptom-free.
causes of asthma
Though there is not a cure for asthma, the symptoms can easily be controlled through physician recommended medications and trigger avoidance. New medications make it possible to lead a normal life; there are long-term controller medications that help treat and control asthma. Avoiding the irritants and allergens that trigger asthma will help prevent asthma symptoms as well. A high percentage of asthma patients suffer from allergies. Controlling those allergies is the first step to controlling their asthma.
asthma treatment
It is extremely important to seek medical attention for asthma. Airway inflammation is more likely to occur and become severe the longer asthma goes untreated. Asthma is not a medical condition that goes away. Not treating airway inflammation and constriction may cause you to lose lung function; thus, seeking medical care is essential.
For those individuals with allergic asthma, identifying and treating your allergies is instrumental in treating your asthma. An allergist can help you determine your allergies and prescribe an effective treatment plan.
untreated asthma
Asthma is the most common chronic illness among children. If a child’s asthma is left untreated, it can result in loss of sleep, exercise limitations, absenteeism, emergency room visits and, in a few cases, death.
The good news? Just like adult asthma, a child’s asthma can be effectively treated with medications and “trigger” avoidance. Again, receiving medical help for asthma is essential.
children and asthma
— SINUSITIS —
There are two types of sinusitis: Acute and Chronic. Acute sinusitis is typically a bacterial infection that occurs several days after a cold. Chronic sinusitis is more likely to represent chronic inflammation in your sinuses. While bacteria may be involved the main issue is related to inflammation.
about sinusitis
There can be several causes of sinusitis. Acute sinusitis is typically a complication of a cold. Allergies can lead to acute sinusitis as well, as the swelling from an allergic reaction can impair the proper draining of your sinuses. One can also see structural problems causing sinusitis: a deviated septum, tumors, polyps or other anatomic obstruction can interfere with the normal function and drainage of your nose causing either acute infection or chronic inflammation.
causes of sinusitis
Acute Sinusitis:
Typically a course of antibiotics will be prescribed. If your symptoms resolve quickly and do not return there may be no further treatment. If your symptoms return your physician may discuss the following evaluation and treatment options: skin testing for allergies, allergy immunotherapy, CT scan of your sinuses to evaluate for structural problems, blood work to make sure your immune system is intact.
Chronic sinusitis:
People who have more persistent symptoms may be diagnosed with chronic sinusitis. In general you could expect the following to be suggested, depending on your symptoms: allergy skin testing and/or immunotherapy, blood work to evaluate your immune system and CT scan of your sinuses.
The medical treatment for sinusitis can involve the use of following medications:
• Nasal saline: salt water nasal washes are a non-pharmaceutical that may have decongestant properties and help “wash away” some of the inflammatory mediators that are involved in sinusitis.
• Nasal steroids: for those with allergy this may be particularly helpful.
• Nasal antihistamine: these may have an anti-inflammatory property, like nasal steroids, that may be helpful.
• Prednisone by mouth: If the inflammation in your sinuses is particularly bad you may be placed on a several week course
of prednisone by mouth.
• Antibiotics: For acute sinusitis a short 7-14 day course of antibiotics may be prescribed. For chronic sinusitis, there is active debate in the literature about the utility of antibiotics. You may be prescribed a 21-28 day course of oral antibiotics.
• Allergy Immunotherapy: For those with significant relevant allergens a course of allergy immunotherapy may be recommended. Allergy immunotherapy will, over the course of time, attempt to decrease your reaction to particular allergens. For example, if your are dust mite allergic and getting recurrent sinus infections because of the allergic inflammation for your dust mite allergy, allergy immunotherapy will over time decrease your bodies reaction to dust mites so that you won’t get allergic inflammation and sinus infection/inflammation.
sinusitis treatment
— ALLERGIES —
There are some symptoms that are commonly associated with allergies such as:
• Runny nose • Post nasal drip • Sneezing • Congestion
• Coughing • Watery eyes
Less common allergy symptoms include:
• Headaches • Loss of taste and smell • Fatigue
• Low productivity/Poor concentration
• Sleep disturbances • Snoring
Allergy symptoms can be more than bothersome or irritating. They can interfere with your day-to-day activities and sleep. Allergies can result in loss of productivity, missed work or school and an overall poor quality of life.
Seeking the help of an allergist is the key to treating your allergies.
symptoms
Check out our tips for successful allergy avoidance. From cat allergies to mold allergies... you can find help and suggestions to help fight allergies on our Allergy Avoidance page!
How do you know when to see an ENT and when to see an allergist? After all, an ENT deals with your ears, nose and throat, right? And all of those things are what start to bother you most when allergy symptoms are likely to peak; so should you see an allergist only when it’s allergy season and an ENT when it’s not? What’s best for your health and peace of mind?
allergist or ENT?
Ear, Nose and Throat doctors are surgeons who focus mainly on structural problems and ENT complexities that can be corrected with surgery. Their ENT training typically causes them to look for bone and cartilage defects first. A patient will see an ENT specialist when she is having difficulty with nasal breathing, is experiencing a sore throat or raspy voice, and/or has trouble hearing clearly.
But did you know that most of those problems are due to allergies? In fact more than 50% of sinus difficulties are caused by allergies, with the majority of the remaining percentage caused by a combination of allergy and non-allergy related symptoms.
Because of the prevalence of allergies, many ENTs offer allergy testing; but this is where the main difference between an allergist and an ENT exists.
Board certified allergists are physicians who have completed extensive training in pediatric and adult allergy. These physicians have completed three years of training in either pediatrics or internal medicine, and then an additional two to three years of training, called a fellowship, in pediatric and adult allergy and clinical immunology. In their fellowship, these physicians receive thousands of hours of structured education and supervision of their patient care by senior level physician mentors. After they have completed this training they are able to take the board certification exam offered by the American Board of Allergy and Immunology (ABAI). Once they pass this test they are then board certified in allergy. In addition, board certified allergists participate in “maintenance of certification,” which is an ongoing educational process required by the ABAI in order to maintain their board certification. When you see a board certified allergist you are seeing a physician who has received thousands of hours of education and supervised training, and you will receive care that is careful, thorough and knowledgeable as it relates to your allergies. An allergist’s main focus and expertise is on your allergies.
It’s very likely that your ENT has received less than two weeks of allergy training, which would need to cover all possible allergens, type of allergic reactions, how to test for allergies, how to interpret those results, and how to best treat the patient. All of that in two weeks! Incredibly, some ENTs even take weekend courses in allergy and then offer allergy care. Even more concerning is that some physicians who offer allergy care deliberately attempt to mislead the public by saying they are board certified but fail to clarify in which field. Most assuredly, they’re not board certified in allergies and immunology.
From a trained board certified allergist you can expect:
• A complete allergy history and physical exam
(including a skin test)
• Properly conducted and interpreted skin test results
• A sophisticated treatment plan, which can consist
of avoidance, medication and/or immunotherapy
Since the underlying cause of sinus disease and related symptoms is frequently allergy, an allergist should always be seen first. If your allergist suspects structural problems in combination with allergic symptoms, he will gladly guide you to an ENT for proper care.
At Asthma Allergy and Clinical Immunology of Chester County, our allergists are board certified in allergy and immunology. They have received the best training available in determining the underlying causes of allergic and sinus-related diseases and their treatment. Trust us in providing quality allergic and sinus care. And just as important, trust us first.
The allergist will conduct a patient history including an assessment of your symptoms, a relevant physical exam and a thorough environmental evaluation. The allergist will also conduct a skin test/allergy test—a skin test determines exactly what you are allergic to. Substances such as dust mites, pollens, mold and pet dander are considered common allergens.
what to expect
A skin test determines your individual allergens. This skin test is effective to evaluate both indoor and outdoor allergens.
A skin test is a simple procedure that is best described as tiny scratches that are given on the surface of the skin on your back or arm. The scratches are conducted with a small instrument similar to a plastic toothpick.
The instrument contains small amounts of common allergens. The skin is lightly scratched on the surface with a tiny amount of the allergen. If you are allergic to a substance, a small mosquito bite-like bump will appear. For those patients who do not react to this type of skin test, an intradermal process may be performed (similar to a TB test).
The allergist can determine your specific allergy profile. Because everyone is unique in what their specific allergic triggers are, knowing what you are allergic to is important for the effective treatment of allergies.
skin testing
Once the allergist knows the allergens that are causing your symptoms, an effective treatment plan can be recommended. These treatment plans include:
• Avoidance of allergens
• Medications
• Vaccination/Allergy shots
treatments
avoidance
Obviously, you aren’t expected to live your life in a bubble, but there are things that can be done to minimize your exposure to specific allergens. For example, if you are allergic to dust, you can dust-proof your bedroom by using allergy-proof mattress and pillow covers. If you are allergic to pollen and/or grass, it is beneficial to keep your windows closed and to shower immediately following outdoor activities. There are many ways to cut down on the allergens in your environment. Talk to your allergist or physician about any information that they can provide on allergy avoidance.
Dust Mite Avoidance
They feed off our skin scales and other
debris found in “dust” around our homes, in our bedding (pillows and mattress) and carpet, and on upholstered furniture. Dust mites thrive in environments around 70 degrees Fahrenheit with 70% relative humidity. In other words, they do quite well in most households. If you are allergic to dust mites, you’re most likely allergic to their waste. How can you best avoid dust mites?Avoidance Steps:
• Use hypoallergenic covers (“dust mite covers”) for bedding (pillows, mattress, box spring).
• Keep humidity levels at 45% or lower.
• Before cleaning dusty areas, wet the dust to prevent mites from spreading or traveling to other areas.
• Keep your home clean by vacuuming at least every other day and dusting daily. If you can, use a vacuum with a built
in HEPA filter to filter the air that is being disturbed by the vacuum.
• Wash all bedding in 140-degree hot water at least twice a month.
• Ideally, remove all carpeting and install hard wood floors.
• Opt for leather furniture.
Mold Avoidance Indoor / Outdoor
Indoor Mold AvoidanceIndoor mold can be on surfaces such as bathroom faucets, tubs, toilets, showers, walls and floors. It grows easily and rapidly in any porous material that has been exposed to moisture. Mold can also be very dangerous, especially for children and the elderly, which is why it’s important to follow these tips for avoiding indoor mold.
Avoidance Steps:• Look for and fix any leaky water sources (pipes, roof, windows).
• Clean all visible mold off any mildewed areas. Disinfect the area using a solution of one part bleach to one part water
or an appropriate cleaning agent.
• Use a dehumidifier.
• Minimize the number of plants in your home.
Outdoor Mold Avoidance
Outside sources of mold are everywhere. From landscaping mulch to vinyl siding on homes, it’s hard to avoid outdoor mold. Here are some pointers to limit your exposure.
Avoidance Steps:
• Keep window and doors closed.
• Use your A/C.
• Don’t hang your clothes outside to dry.
• Use a mask and gloves when gardening.
• Shower after doing yard work and before going to bed.
• Store all gardening tools and garden accessories outside.
Cat Allergen Avoidance
Did you know that, in general, male cats make more allergen than female cats and neutered cats make less allergen than non neutered cats? Allergic symptoms are actually triggered by the cat’s saliva and Sebaceous glands, which are mostly found in the skin of the chin, base of the tail, eyelids, lips, and around their reproductive organs. These glands are connected to the hair follicles. Since all cats make saliva and have these glands, all cats create a potential allergen. If you have a cat, controlling the allergens is very difficult. Even if you’re willing to remove the cat, it can take up to six months before the allergen levels are reduced. However, if Fluffy is family, here are some steps to control cat allergens.Avoidance Steps:
• Short of removing the cat from your home, it is very difficult to control cat allergen.
• Dust mite covers may be helpful.
• Keep the cat out of your bedroom.
• Wash all bedding in 140-degree hot water at least twice a month.
• Wash your hands immediately after petting your cat (do not rub your eyes).
• You can try to clean your cat at least once a month to control exposure to dried saliva. Allerpet® is a liquid you can apply to
your cat’s coat to reduce the amount of allergen released in the air. Another option is to dampen a microfiber cloth and rub
down the cat’s coat to get rid of any visible dander. Most of the data suggests use of these techniques will give only a very
temporary reduction in cat allergen.
Pollen Avoidance
Pollen consists of tiny, egg-shaped male cells that usually multiply according to a seasonal pattern. Since pollen can travel several miles, it’s important to follow avoidance steps even if the sources of the pollen (trees, weeds, etc.) aren’t visible in your neighborhood or yard.Avoidance Steps:
• Keep window and doors closed.
• Use your A/C.
• Don’t hang your clothes outside to dry.
• Minimize early morning activity (pollen levels tend to be highest in the early morning).
• Take a shower after outdoor activities and before going to bed.
• Use a mask when performing yard work.
Cockroach Avoidance
Cockroach allergens are serious triggers of asthma. The allergen itself is from the cockroaches’ feces, saliva and bodies.Avoidance Steps:
• Call an expert pest controller if you see any cockroaches in your home.
• Do not leave food or garbage uncovered.
• Look for and remove any water sources (they need to drink water).
• Repair any holes in walls (a way for them to come and go).
— FOOD ALLERGY —
For most people, celebrations are fun events. But for parents of food allergic children, or even for food allergic adults, activities involving food can be filled with worry. This is because coming in contact with a food allergen has the potential to cause a very serious allergic reaction.
Allergies are the result of a reaction that starts in the immune system. For instance, if you have an allergy to eggs, your immune system identifies a protein found in eggs as an allergen. Your immune system reacts by producing antibodies called Immunoglobulin E (IgE). These antibodies attach to cells in your skin, lungs and gastrointestinal (GI) tract. If you come in contact with the allergen again, the cells release chemicals including histamine, which cause food allergy symptoms such as itching, hives, swelling, diarrhea, wheezing and a potentially life-threatening reaction called anaphylaxis (an-a-fi-LAK-sis). Without immediate treatment—an injection of epinephrine and expert care in a hospital—anaphylaxis can be fatal.
There is a difference between food allergy and food intolerance. A food allergy involves the immune system while food intolerance, such as lactose intolerance, does not. Food intolerance typically involves the GI tract, causing uncomfortable symptoms like abdominal pain, nausea, vomiting and diarrhea, but there is no risk of anaphylaxis.
food allergies
common food allergens
The most common food allergens are cow’s milk, eggs, peanuts, wheat, soy, fish, shellfish and tree nuts. These foods probably represent 90% of the food allergens that are clinically important. However, any food can potentially be a problem and there are emerging food allergens that need to be considered - for example sesame and some meats. 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.
Interestingly, research is showing that more than half of children with milk and egg allergies can tolerate extensively heated milk and egg in baked foods. But a careful evaluation of these patients must be done before this recommendation can be made. For patients with pollen allergy, some will have “Oral Allergy Syndrome.” This typically occurs with fresh fruits and vegetables and is usually limited to symptoms in the mouth and throat. Patients with OAS usually can tolerate cooked
forms of the offending fruit and/or vegetable, as the protein that is the allergen is heat sensitive, so cooking the food
destroys the protein.
diagnosing food allergies
It is very important to understand that food allergy is a diagnosis that is generally made based upon the history of have a reaction to a specific food. A history of eating a food and having symptoms consistent with an allergic reaction is absolutely key to understanding if a food allergy reaction has occurred. Random screening skin tests or a blood test to “see what one is allergic to” is not productive. In the absence of an appropriate history, food allergy skin testing and blood testing runs very high (up to 60-70%) false positive results (this means although the test is “positive,” clinically the patient is not having symptoms). An allergist/immunologist, often referred to as an allergist, has specialized training and expertise to determine if your symptoms are caused by a food allergy or due to other food-related disorders such as food protein-induced enterocolitis syndrome (FPIES) or eosinophilic esophagitis (EoE).
Your allergist will take a thorough medical history, followed by a physical examination. You will be asked about the foods you eat, the frequency, 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, this 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 an IgE blood test. Today the food allergy blood tests are becoming more sophisticated for certain foods and may be used to complement the history and skin testing that has been done. Food challenges can confirm the diagnosis and are done by consuming the food in a medical setting to determine if it causes a reaction. Food challenges should not take place at home.
Unproven Food Testing
There are a variety of tests that are advertised as being able to diagnose food allergy. Food allergy testing, meaning testing done to confirm an IgE (allergy antibody) to a particular food, can be done only by skin test or blood test that looks for an IgE antibody reaction for the specific food in question. Other tests that are on the market to identify food allergy have very little if any data to support their clinical use.
There is currently no cure for food allergy, but there are many promising treatments under investigation—including oral immunotherapy. While some of these studies look promising, avoidance, education and preparedness are still the keys to managing food allergy.
People with food allergy should always carry auto-injectable epinephrine and have an allergy treatment plan to be used in the event of an anaphylactic reaction.
treatments
Most children outgrow their allergies to cow’s milk, egg, soy and wheat, even if they have a history of a severe reaction. However, shellfish and tree nut allergy tends to persist through adulthood. Some individuals can outgrow peanut allergy but need a close follow up. Repeat allergy testing with your allergist can help you learn when you or your child’s food allergies are resolving with time.
outgrowing food allergies
important tips
• Always ask about ingredients when eating at restaurants or when you are eating foods
prepared by family or friends. Never assume that you know what is being used for a
particular dish.
• Carefully read food labels.
• Always carry and know how to use auto-injectable epinephrine and antihistamines
to treat emergency reactions. Know what your allergy treatment plan says to do.
— VENOM ALLERGY —
symptoms
For most patients, the reaction is short-lived, with redness and swelling followed by pain and itching that lasts only a few hours, although some may last longer. For others, however, allergic reactions to these insect stings can be more generalized and potentially life threatening. This more severe reaction is called anaphylaxis, or anaphylactic shock, and can include: itching and hives over most of the body, swelling of the throat and tongue, difficulty in breathing, dizziness, headache, stomach cramps, nausea, vomiting, loss of consciousness and death.
Immediate medical attention is required.
prevention
Avoidance! Avoidance! Avoidance! Most of these insects will not sting unless disturbed. So pay attention and be aware of potential nesting and food sources of these insects. Some suggestions for avoidance include:
» When outdoors, make sure you and your child watch for insect nests in trees, shrubs and flower beds.
Other areas in which to use caution include swimming pools, woodpiles, under eaves of houses, and
trash containers.
» If flying stinging insects are close by, remain calm and move slowly away.
» 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.
treatments
Acute Management
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.
These 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 and follow your allergy treatment plan. If epinephrine is used, call 911 and get to the nearest emergency room.
Long term management
Patients with sting reactions should be seen by an allergist. After taking a history and performing a physical exam, venom skin testing and/or venom blood testing may be in order to understand the sting reaction and if it was an allergic reaction to a sting. Rarely sting reactions can unmask another serious disease, called mastocytosis, which requires further investigation.
Along with the common sense approach outlined above, for patients with severe sting reaction histories venom immunotherapy (VIT) is the treatment of choice. Patients with severe sting history are at very marked increased risk of having a severe and potentially life ending sting reaction in the future. Research data suggest that this risk of future life threatening reaction may be as high as 60-70% . VIT has been shown to significantly reduce this risk to probably less than 10%. VIT is a highly effective means to attempt to effect long term risk reduction from a future sting reaction.
Complementing VIT for long term management of sting reaction is the implementation of an Allergy Action Plan and the use of
self injectable epinephrine.
— SKIN DISORDERS —
what are hives?
Urticaria is the medical term for hives. Hives are red, itchy, raised areas of the skin of various sizes that can occur anywhere on your body. Most cases of hives are known as acute and go away within a few days or weeks. Chronic hives are hives that last more than six weeks and come and go for several months or years.
what is angioedema?
While related to hives, angioedema is swelling that affects the deeper layers of the skin. It is usually not red or itchy and often involves the eyelids, lips, tongue, hands and feet. Angioedema commonly occurs with hives, but can occur on its own.
what causes hives and / or
angioedema?
Hives can have a variety of causes including: food, drug or insect sting reactions, viral or bacterial infections and physical factors such as cold, heat, exercise, pressure and exposure to sunlight. Most times with chronic hives the cause is never identified and routine testing, such as blood counts or allergy screens, are not recommended as they are unlikely to determine a cause and do not make a difference in treatment strategies. As with hives, there can be several causes of angioedema, including some unusual metabolic or inflammatory disorders. It is also not uncommon that a cause is not found.
what is dermatitis?
Dermatitis, or eczema, is an inflammation of the skin that produces a red, scaly, itchy rash that can occur anywhere on the body. The two most common types are atopic dermatitis and contact dermatitis although many other forms of dermatitis do exist.
what is atopic dermatitis (AD)
AD is a chronic skin condition that can begin early in life and can be associated with food allergy, allergic rhinitis and asthma.
Triggers for eczema are varied. In young children, food allergy can be a trigger. Skin staph colonization or infections can cause flare-ups of eczema in children and adults. Animal dander, dust mites, sweating, or contact with irritants can be triggers for eczema as well.
Avoidance of known triggers, moisturization, prevention of itch and anti inflammatories are the mainstay of medical treatment for eczema. Daily bathing in cool water, minimizing the use of soaps and moisturing immediately after bathing while still wet can help maintain the proper moisture barrier of the skin. While difficult, don’t scratch or rub the rash. If the itching is particularly bad, cold compresses can provide some relief. Use of antihistamines can he helpful as well.
Corticosteroid and other anti-inflammatory creams that are applied to the skin are most effective in treating the rash. Rarely, antibiotics may be prescribed to address the excess staph bugs that may be on the damaged skin of patient with severe eczema.
what is contact dermatitis
Contact dermatitis is when your skin becomes irritated when it comes into contact with certain plants, chemicals or other substances. Contact dermatitis is either irritant or allergic.
what is irritant contact
dermatitis (ICD)?
ICD occurs when your skin becomes damaged from contacting certain substances. These are typically chemicals. The damage to the skin will become more severe with repeated or prolonged exposure. There is no test to ICD and the treatment involves recognition of the irritant and subsequence avoidance.
what is allergic contact
dermatitis (ACD)?
ACD occurs after contact with a chemical and a rash typically develops 24-48 hours after contact and can last up to 2-3 weeks. Poison ivy is a classic example of ACD that most are familiar with. Metals, including nickel, perfumes, dyes, rubber (latex) products, cosmetics topical medicines also frequently cause allergic contact dermatitis.
how is ACD treated?
ACD treatment includes avoidance, local symptomatic treatment, topical steroids and if a severe reaction then use of oral prednisone may be needed. After the resolution of the rash, your physician may suggest patch testing to try and identify the cause of the rash.
— DRUG ALLERGY —
what is a drug allergy?
Everyone reacts to medications differently and, importantly, most of the time a prescribed medication can be taken and there are no problems. However, sometimes one can take a medication that was prescribed correctly, and side effects can occur. These side effects can range from relatively minor problems (a bad taste or upset stomach) to potentially more serious ones. Allergic drug reactions account for 5 to 10% of all adverse drug reactions and any drug has the potential, at any time, to cause an allergic reaction.
what are the symptoms of an allergic reaction?
The symptoms of an allergic drug reaction can include: rash, itchiness, hives, lips/tongues swelling, cough, wheezing, shortness of breath and, if severe enough, one can stop breathing and have blood pressure problems. Rarely allergy drug reactions can be so severe that one can die.
are there other types of allergic drug reactions?
Allergic drug reactions can be allergy antibody mediated (IgE, as described) or may involve other cells of the immune system.
Examples include:
where the surfaces of your eye, lips, mouth and genital region may be eroded.
, where the upper surface of your skin detaches like in a patient who has suffered burns.
Certain medications for epilepsy (seizures) and gout are often associated with these severe skin reactions.
are there risk factors for allergic drug reactions?
There are potential risk factors for the development of a drug allergy reaction, including: body size, genetics, body chemistry or the presence of an underlying disease. Having an allergy to one drug may predispose you to having more drug allergies. A family history of a reaction to a specific drug does not increase your chance of reacting to the same drug.
what are some types of
non-allergic drug reactions?
The type of symptoms that one could have from non-allergic drug reactions vary depending upon the type of drug that is being used. Some examples of these type of reactions include:
• Chemotherapy drugs often may cause patients to have vomiting and hair loss.
• Intravenous dyes used in X-rays or CT scans may cause people to experience flushing, itching or a drop in blood pressure.
( It should be noted that contrast reactions are not related to shellfish allergy—this is a myth that has no basis in the scientific literature.)
• Antibiotics can cause upset stomach and diarrhea.
• ACE inhibitors ( a specific type of medicine for high blood pressure) rarely may precipitate the development of a cough or facial and tongue swelling.
what are the most common medications that cause allergic reactions?
Non-steroidal anti-inflammatory drugs, antibiotics, chemotherapy drugs, monoclonal antibodies, anti-seizure drugs and ACE inhibitors cause most allergic drug reactions.
Non-steroidal anti-inflammatory drugs, antibiotics, chemotherapy drugs, monoclonal antibodies, anti-seizure drugs and ACE inhibitors cause most allergic drug reactions.
when to see an allergist/immunologist
If you have a history of reactions to different medications, or if you have a serious reaction to a drug, an allergist/ immunologist, often referred to as an allergist, has specialized training to diagnose the problem and help you develop a plan to protect you in the future.
what are PIDDs?
Our immune system is composed of white blood cells, which play a very important role in protecting and defending us from infections from germs, bacteria and fungi. In patients with PIDD, some or all of these cells or the antibodies they produce are missing. These missing components allow infections to occur that may be recurrent, in unusual places, or very difficult to treat. These infections can occur in the skin, respiratory system, the ears, the brain or spinal cord, or in the urinary or gastrointestinal tracts. In some patients other organs may be affected as well. For example, in some patients heart defects are present; other patients have altered facial features. Some primary immune deficiencies stunt normal growth, and still others are connected to autoimmune disorders such as rheumatoid arthritis.
what are the symptoms
of PIDD?
PIDDs can present very early in life or may not be apparent for several decades.
Important signs that may indicate a PIDD include:
» Recurrent, unusual or difficult to treat infections
» Poor growth or loss of weight
» Recurrent pneumonia, ear infections or sinusitis
» Multiple courses of antibiotics or IV antibiotics necessary to clear infections
» Recurrent deep abscesses of the organs or skin
» A family history of PIDD
» Swollen lymph glands or an enlarged spleen
» Autoimmune disease
how is PIDD treated?
In general the goal of treating patients with PIDD is to prevent infections, treat infections and restore their immune systems back to as close as normal as possible. Depending upon the age of the patients and the type of PIDD diagnosed treatment may be as simple as monitoring the patient and treating infections with antibiotics to as complex as bone marrow or stem cell transplants.
— PRIMARY IMMUNE DEFICIENCY DISORDERS (PIDD)—
Obviously, you aren’t expected to live your life in a bubble, but there are things that can be done to minimize your exposure to specific allergens. For example, if you are allergic to dust, you can dust-proof your bedroom by using allergy-proof mattress and pillow covers. If you are allergic to pollen and/or grass, it is beneficial to keep your windows closed and to shower immediately following outdoor activities. There are many ways to cut down on the allergens in your environment. Talk to your allergist or physician about any information that they can provide on allergy avoidance.
Dust Mite Avoidance
They feed off our skin scales and other
debris found in “dust” around our homes, in our bedding (pillows and mattress) and carpet, and on upholstered furniture. Dust mites thrive in environments around 70 degrees Fahrenheit with 70% relative humidity. In other words, they do quite well in most households. If you are allergic to dust mites, you’re most likely allergic to their waste. How can you best avoid dust mites?Avoidance Steps:
• Use hypoallergenic covers (“dust mite covers”) for bedding (pillows, mattress, box spring).
• Keep humidity levels at 45% or lower.
• Before cleaning dusty areas, wet the dust to prevent mites from spreading or traveling to other areas.
• Keep your home clean by vacuuming at least every other day and dusting daily. If you can, use a vacuum with a built
in HEPA filter to filter the air that is being disturbed by the vacuum.
• Wash all bedding in 140-degree hot water at least twice a month.
• Ideally, remove all carpeting and install hard wood floors.
• Opt for leather furniture.
Mold Avoidance Indoor / Outdoor
Indoor Mold AvoidanceIndoor mold can be on surfaces such as bathroom faucets, tubs, toilets, showers, walls and floors. It grows easily and rapidly in any porous material that has been exposed to moisture. Mold can also be very dangerous, especially for children and the elderly, which is why it’s important to follow these tips for avoiding indoor mold.
Avoidance Steps:• Look for and fix any leaky water sources (pipes, roof, windows).
• Clean all visible mold off any mildewed areas. Disinfect the area using a solution of one part bleach to one part water
or an appropriate cleaning agent.
• Use a dehumidifier.
• Minimize the number of plants in your home.
Outdoor Mold Avoidance
Outside sources of mold are everywhere. From landscaping mulch to vinyl siding on homes, it’s hard to avoid outdoor mold. Here are some pointers to limit your exposure.
Avoidance Steps:
• Keep window and doors closed.
• Use your A/C.
• Don’t hang your clothes outside to dry.
• Use a mask and gloves when gardening.
• Shower after doing yard work and before going to bed.
• Store all gardening tools and garden accessories outside.
Cat Allergen Avoidance
Did you know that, in general, male cats make more allergen than female cats and neutered cats make less allergen than non neutered cats? Allergic symptoms are actually triggered by the cat’s saliva and Sebaceous glands, which are mostly found in the skin of the chin, base of the tail, eyelids, lips, and around their reproductive organs. These glands are connected to the hair follicles. Since all cats make saliva and have these glands, all cats create a potential allergen. If you have a cat, controlling the allergens is very difficult. Even if you’re willing to remove the cat, it can take up to six months before the allergen levels are reduced. However, if Fluffy is family, here are some steps to control cat allergens.Avoidance Steps:
• Short of removing the cat from your home, it is very difficult to control cat allergen.
• Dust mite covers may be helpful.
• Keep the cat out of your bedroom.
• Wash all bedding in 140-degree hot water at least twice a month.
• Wash your hands immediately after petting your cat (do not rub your eyes).
• You can try to clean your cat at least once a month to control exposure to dried saliva. Allerpet® is a
liquid you can apply to your cat’s coat to reduce the amount of allergen released in the air. Another
option is to dampen a microfiber cloth and rub down the cat’s coat to get rid of any visible dander.
Most of the data suggests use of these techniques will give only a very temporary reduction in
cat allergen.
Pollen Avoidance
Pollen consists of tiny, egg-shaped male cells that usually multiply according to a seasonal pattern. Since pollen can travel several miles, it’s important to follow avoidance steps even if the sources of the pollen (trees, weeds, etc.) aren’t visible in your neighborhood or yard.Avoidance Steps:
• Keep window and doors closed.
• Use your A/C.
• Don’t hang your clothes outside to dry.
• Minimize early morning activity (pollen levels tend to be highest in the early morning).
• Take a shower after outdoor activities and before going to bed.
• Use a mask when performing yard work.
Cockroach Avoidance
Cockroach allergens are serious triggers of asthma. The allergen itself is from the cockroaches’ feces, saliva and bodies.Avoidance Steps:
• Call an expert pest controller if you see any cockroaches in your home.
• Do not leave food or garbage uncovered.
• Look for and remove any water sources (they need to drink water).
• Repair any holes in walls (a way for them to come and go).
JENNERSVILLE
COATESVILLE
WEST CHESTER
Jennersville
PENN Medicine Southern Chester County Medical Building
450 Woodview Road • Suite 230 • West Grove, PA 19390
484.889.2429
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PENN Medicine Southern Chester County Medical Building
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COATESVILLE
KENNETT SQUARE
WEST CHESTER
about asthma
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There are an estimated 17 million people living in the United States with self-reported asthma. Asthma is a chronic disease marked by wheezing, chest tightness, and/or shortness of breath.
If you or someone you know:
• Coughs a lot while exercising or following exercise;
• Has shortness of breath;
• Wheezes while breathing;
• Has a tight feeling in the chest
Then consult a physician because any one of these
symptoms can be a sign of asthma.
Asthma symptoms are caused by the constriction (tightening of the muscles) and the inflammation (swelling and irritation) of the airways. Constriction and inflammation of the airways and increased mucosa make it difficult and sometimes impossible to breathe.
Allergens, irritants, respiratory infections and/or exercise can trigger asthma symptoms. Asthma is often placed in different categories according to symptom “triggers.”
For example:
Allergic asthma is triggered by allergic reactions to allergens such as pet dander, dust or dust mite, mold or pollen.
Seasonal asthma is triggered by seasonal allergic reactions to allergens such as trees, grasses or weeds.
Non-allergic asthma is triggered by irritants in the air that you breathe such as tobacco smoke, wood smoke, room deodorizers, fresh paint, perfume, etc.
Exercise-induced asthma is triggered by exercise or physical activity.
Nocturnal asthma can occur in a patient with any type of asthma, though the asthma symptoms will increase or worsen at night.
For treatment, it is important to recognize asthma “triggers.” Airway inflammation may always be there, even when you are seemingly symptom-free.
causes of asthma
Though there is not a cure for asthma, the symptoms can easily be controlled through physician recommended medications and trigger avoidance. New medications make it possible to lead a normal life; there are long-term controller medications that help treat and control asthma. Avoiding the irritants and allergens that trigger asthma will help prevent asthma symptoms as well. A high percentage of asthma patients suffer from allergies. Controlling those allergies is the first step to controlling their asthma.
asthma treatment
It is extremely important to seek medical attention for asthma. Airway inflammation is more likely to occur and become severe the longer asthma goes untreated. Asthma is not a medical condition that goes away. Not treating airway inflammation and constriction may cause you to lose lung function; thus, seeking medical care is essential.
For those individuals with allergic asthma, identifying and treating your allergies is instrumental in treating your asthma. An allergist can help you determine your allergies and prescribe an effective treatment plan.
untreated asthma
Asthma is the most common chronic illness among children. If a child’s asthma is left untreated, it can result in loss of sleep, exercise limitations, absenteeism, emergency room visits and, in a few cases, death.
The good news? Just like adult asthma, a child’s asthma can be effectively treated with medications and “trigger” avoidance. Again, receiving medical help for asthma is essential.
children and asthma
West Chester
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1065 Andrew Drive • West Chester, PA 19380
610.436.5491
Highlands Corporate Center • 495 Highlands Boulevard, Suite 103 • Coatesville, PA 19320
610.380.8045
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Acute Sinusitis:
Typically a course of antibiotics will be prescribed. If your symptoms resolve quickly and do not return there may be no further treatment. If your symptoms return your physician may discuss the following evaluation and treatment options: skin testing for allergies, allergy immunotherapy, CT scan of your sinuses to evaluate for structural problems, blood work to make sure your immune system is intact.
Chronic sinusitis:
For those who have more persistent symptoms they may be diagnosed with chronic sinusitis. In general you could expect the following to be suggested, depending your symptoms: allergy skin testing and/or immunotherapy, blood work to evaluate your immune system and CT scan of your sinuses.
The medical treatment for sinusitis can involve the use of following medications:
• Nasal saline: salt water nasal washes are a non pharmaceutical that may have decongestant properties and help “wash away” some of the inflammatory mediators that are involved in sinusitis.
• Nasal steroids: for those with allergy this may be
particularly helpful.
• Nasal antihistamine: these may have an anti inflammatory property, like nasal steroids, that may be helpful.
• Prednisone by mouth: If the inflammation in your sinuses is particularly bad you may be placed on a several week course of prednisone by mouth.
• Antibiotics: For acute sinusitis a short 7-14 day course of antibiotics may be prescribed. For chronic sinusitis, there is active debate in the literature about the utility of antibiotics. You may be prescribed 21-28days course of oral antibiotics.
• Allergy Immunotherapy: For those with significant relevant allergens a course of allergy immunotherapy may be recommended. Allergy immunotherapy will, over the course of time, attempt to decrease your reaction to particular allergens. For example, if your are dust mite allergic and getting recurrent sinus infections because of the allergic inflammation for your dust mite allergy, allergy immunotherapy will over time decrease your bodies reaction to dust mites so that you won’t get allergic inflammation and sinus infection/inflammation.
sinusitis treatment
There are some symptoms that are commonly associated with allergies such as:
• Runny nose • Post nasal drip • Sneezing •Congestion
• Coughing • Watery eyes
Less common allergy symptoms include:
• Headaches • Loss of taste and smell • Low productivity/Poorconcentration
• Fatigue • Sleep disturbances • Snoring
Allergy symptoms can be more than bothersome or irritating. They can interfere with your day-to-day activities and sleep. Allergies can result in loss of productivity, missed work or school and an overall poor quality of life.
Seeking the help of an allergist is the key to treating your allergies.
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Check out our tips for sucessful allergy avoidance. From cat allergies to mold allergies... you can find help and suggestions to help fight allergies on our Allergy Avoidance page!
How do you know when to see an ENT and when to see an allergist? After all, an ENT deals with your ears, nose and throat, right? And all of those things are what start to bother you most when allergy symptoms are likely to peak; so should you see an allergist only when it’s allergy season and an ENT when it’s not? What’s best for your health and peace of mind?
Ear, Nose and Throat doctors are surgeons who focus mainly on structural problems and ENT complexities that can be corrected with surgery. Their ENT training typically causes them to look for bone and cartilage defects first. A patient will see an ENT specialist when she is having difficulty with nasal breathing, is experiencing a sore throat or raspy voice, and/or has trouble hearing clearly.
But did you know that most of those problems are due to allergies? In fact more than 50% of sinus difficulties are caused by allergies, with the majority of the remaining percentage caused by a combination of allergy and non-allergy related symptoms.
Because of the prevalence of allergies, many ENTs offer allergy testing; but this is where the main difference between an allergist and an ENT exists.
Board certified allergists are physicians who have completed extensive training in pediatric and adult allergy. These physicians have completed 3 years of training in either pediatrics or internal medicine, and then an additional 2 to 3 years of training, called a fellowship, in pediatric and adult allergy and clinical immunology. In their fellowship, these physicians receive thousands of hours of structured education and supervision of their patient care by senior level physician mentors. After they have completed this training they are able to take the board certification exam offered by the American Board of Allergy and Immunology (ABAI). Once they pass this test they are then board certified in allergy. In addition, board certified allergists participate in “maintenance of certification,” which is an ongoing educational process required by the ABAI in order to maintain their board certification. When you see a board certified allergist you are seeing a physician who has received thousands of hours of education and supervised training, and you will receive care that is careful, thorough and knowledgeable as it relates to your allergies. An allergist’s main focus and expertise is on your allergies.
It’s very likely that your ENT has received less than two weeks of allergy training, which would need to cover all possible allergens, type of allergic reactions, how to test for allergies, how to interpret those results, and how to best treat the patient. All of that in two weeks! Incredibly, some ENTs even take weekend courses in Allergy and then offer allergy care. Even more concerning is that some physicians who offer allergy care deliberately attempt to mislead the public by saying they are board certified but fail to clarifying in which field. Most assuredly, they’re not board certified in allergies and immunology.
From a trained board certified allergist you can expect:
• A complete allergy history and physical exam (including a skin test)
• Properly conducted and interpreted skin test results
• A sophisticated treatment plan, which can consist of avoidance, medication and/or immunotherapy
Since the underlying cause of sinus disease and related symptoms is frequently allergy, an allergist should always be seen first. If your allergist suspects structural problems in combination with allergic symptoms, he will gladly guide you to an ENT for proper care.
At Asthma Allergy and Clinical Immunology of Chester County, our allergists are board certified in allergy and immunology. They have received the best training available in determining the underlying causes of allergic and sinus-related diseases and their treatment. Trust us in providing quality allergic and sinus care. And just as important, trust us first.
allergist or ENT?
The allergist will conduct a patient history including an assessment of your symptoms, a relevant physical exam and a thorough environmental evaluation. The allergist will also conduct a skin test/allergy test—a skin test determines exactly what you are allergic to. Substances such as dust mites, pollens, mold and pet dander are considered common allergens.
what to expect
A skin test determines your individual allergens. This skin test is effective to evaluate both indoor and outdoor allergens.
A skin test is a simple procedure that is best described as tiny scratches that are given on the surface of the skin on your back or arm. The scratches are conducted with a small instrument, similar to a plastic toothpick.
The instrument contains small amounts of common allergens. The skin is lightly scratched on the surface with a tiny amount of the allergen. If you are allergic to a substance, a small mosquito bite-like bump will appear. For those patients who do not react to this type of skin test, an intradermal process may be performed (similar to a TB test).
The allergist can determine your specific allergy profile. Because everyone is unique in what their specific allergic triggers are, knowing what you are allergic to is important for the effective treatment of allergies.
skin testing
Once the allergist knows the allergens that are causing your symptoms, an effective treatment plan can be recommended. These treatment plans include:
• Avoidance of allergens
• Medications
• Vaccination/Allergy shots
treatments
Obviously, you aren’t expected to live your life in a bubble, but there are things that can be done to minimize your exposure to specific allergens. For example, if you are allergic to dust, you can dust-proof your bedroom by using allergy-proof mattress and pillow covers. If you are allergic to pollen and/or grass, it is beneficial to keep your windows closed and to shower immediately following outdoor activities. There are many ways to cut down on the allergens in your environment. Talk to your allergist or physician about any information that they can provide on allergy avoidance.
avoidance
Dust Mite Avoidance
Dust mites are in the same family as ticks and spiders. They feed off our skin scales and other
debris found in “dust” around our homes, in our bedding (pillows and mattress) and carpet, and on upholstered furniture. Dust mites thrive in environments around 70 degrees Fahrenheit with 70% relative humidity. In other words, they do quite well in most households. If you are allergic to dust mites, you’re most likely allergic to their waste. How can you best avoid dust mites?Avoidance Steps:
• Use hypoallergenic covers (“dust mite covers”) for bedding (pillows, mattress, box spring)
• Keep humidity levels at 45% or lower
• Before cleaning dusty areas, wet the dust to prevent mites from spreading or traveling to other areas
• Keep your home clean by vacuuming at least every other day and dusting daily. If you can, use a vacuum with a built in HEPA
filter to filter the air that is being disturbed by the vacuum.
• Wash all bedding in 140-degree hot water at least twice a month
• Ideally, remove all carpeting and install hard wood floors
• Opt for leather furniture
Pollen Avoidance
Pollen consists of tiny, egg-shaped male cells that usually multiply according to a seasonal pattern. Since pollen can travel several miles, it’s important to follow avoidance steps even if the sources of the pollen (trees, weeds, etc.) aren’t visible in your neighborhood or yard.Avoidance Steps:
• Keep window and doors closed
• Use your A/C
• Don’t hang your clothes outside to dry
• Minimize early morning activity (pollen levels tend to be highest in the early morning)
• Take a shower after outdoor activities and before going to bed
• Use a mask when performing yard work
Mold Avoidance Indoor / Outdoor
IndoorIndoor mold can be on surfaces such as bathroom faucets, tubs, toilets, showers, walls and floors. It grows easily and rapidly in any porous material that has been exposed to moisture. Mold can also be very dangerous, especially for children and the elderly, which is why it’s important to follow these tips for avoiding indoor mold.
Avoidance Steps:
• Look for and fix any leaky water sources (pipes, roof, windows)
• Clean all visible mold off any mildewed areas. Disinfect the area using a solution of 1 part bleach to 1 part water or an
appropriate cleaning agent.
• Use a dehumidifier
• Minimize the number of plants in your home
Outdoor
Outside sources of mold are everywhere. From landscaping mulch to vinyl siding on homes, it’s hard to avoid outdoor mold. Here are some pointers to limit your exposure.
Avoidance Steps:
• Keep window and doors closed
• Use your A/C
• Don’t hang your clothes outside to dry
• Use a mask and gloves when gardening
• Shower after doing yard work and before going to bed
• Store all gardening tools and garden accessories outside
Cat Allergen Avoidance
Did you know that, in general, male cats make more allergen than female cats and neutered cats make less allergen than non neutered cats? Allergic symptoms are actually triggered by the cat’s saliva and Sebaceous glands, which are mostly found in the skin of the chin, base of the tail, eyelids, lips, and around their reproductive organs. These glands are connected to the hair follicles. Since all cats make saliva and have these glands, all cats create a potential allergen. If you have a cat, controlling the allergens is very difficult. Even if you’re willing to remove the cat, it can take up to 6 months before the allergen levels are reduced. However, if Fluffy is family, here are some steps to control cat allergens.Avoidance Steps:
• Short of removing the cat from your home, it is very difficult to control cat allergen.
• Dust mite covers may be helpful
• Keep the cat out of your bedroom
• Wash all bedding in 140-degree hot water at least twice a month
• Wash your hands immediately after petting your cat (do not rub your eyes)
• You can try to clean your cat at least once a month to control exposure to dried saliva. Allerpet® is a liquid you can apply
to your cat’s coat to reduce the amount of allergen released in the air. Another option is to dampen a microfiber cloth and
rub down the cat’s coat to get rid of any visible dander. Most of the data suggests use of these techniques will give only a
very temporary reduction in cat allergen.
Cockroach Avoidance
Cockroach allergens are serious triggers of asthma. The allergen itself is from the cockroaches’ feces, saliva and bodies.Avoidance Steps:
• Call an expert pest controller if you see any cockroaches in your home
• Do not leave food or garbage uncovered
• Look for and remove any water sources (they need to drink water)
• Repair any holes in walls (a way for them to come and go)
1065 Andrew Drive • West Chester, PA 19380
610.436.5491
West Chester
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Highlands Corporate Center • 495 Highlands Boulevard, Suite 103 • Coatesville, PA 19320
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Jennersville
PENN Medicine Southern Chester County Medical Building
450 Woodview Road • Suite 230 • West Grove, PA 19390
484.889.2429
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"I would like to thank you for conducting my drug
challenge and passing me with negative results.
As such, I have been cleared for duty and sworn into the United States Marine Corps. I hope you have much success in your practice further down the road. Thank You!"
"Keep up the good work"
"Everything was perfect"
"Erica was great"
"Services are great"
"Everyone is great"
"I have been a satisfied patient for
15 years."
"Great Doc & friendly staff. They value your time as much as theirs, they don't keep you waiting. Dr. Murphy & his team keep up on the cutting edge in their field. Continuing education & keeping up with the latest research in the field is extremely important to him. Most importantly they treat you as a person not a condition or a disease. If you speak up they will take the time to listen."
~ RW (via Facebook)
" This is one of the kindest staff I have interacted with"
"The entire staff was very helpful"
"Very accommodating office"
"Nicest staff we ever had in a Doctors office"
"Crystal has been very patient with all the insurance filing / troubles."
"Ketona was extremely helpful. Everything was great".
Pharmaceutical Coupons:
The costs of prescription medications are astronomical. We are very cognizant that our recommendations for medications cost money. To that end, we have compiled links for coupons/information for the various asthma/allergy medications that are available.
If your medication is not listed we may have not found a link or coupons that are available from the pharmaceutical company. The links provided are all pharmaceutical company links, and we in no way, shape or form have reviewed or endorse any of the information on these links. We simply provide this list of links in one location so that, if needed, you can take advantage of these coupons. If there are links to other allergy medications that you are aware of please let us know and we will add them to our list.
Pharmaceutical Company Assistance Programs
These programs, offered by various pharmaceutical companies, offer various degrees of assistance in obtaining your medications (whether they are allergy medications or not).
If you don’t have insurance, have limited coverage or are having a difficult time affording
your medications, take the time to review the appropriate companies websites and see
if they can help.
• Partnership for Prescription Assistance
This is a great resource for multiple organizations that provide assistance and discount programs. Lots of information on their website
• Pennsylvania Prescription Price Finder
This is the Pennsylvania Prescription Drug Cost comparison website. By using your zip code you may be able to comparison shop for various allergy / asthma medications as well as other medications.
Rx Assist is a web-based resource center for various assistance programs for medications.
NeedyMeds is a 501(c)(3) non-profit with the mission of helping people who can't afford to pay for their medications.
Antihistamines
Allergy Eye Drops
www.pataday.com (patanol as well)
Nose Sprays
Asthma Rescue Medications
Asthma Controller Medications
Anaphylaxis Medications
Wellness/Education Program
Asthma, Allergy and Clinical Immunology of Chester County is pleased to offer communication education programs on a variety of allergy topics ranging from food to asthma to anaphylaxis. If your group or organization would be interested in an allergy-specific program, please contact us. These programs occur in a relaxed and friendly atmosphere and allow participants to gain a general overview of the topic being discussed. An interactive question-answer session can be held as well. Please note, however, that these programs offer a broad overview of a particular topic and are not a replacement for advice from your physician.
Our Wellness/Education Program is designed to benefit your community organization, school, university, PTA group, or corporate wellness program. So please contact us for more information on how we can help establish a solid understanding of allergies and asthma.
Asthma Screening Programs
Asthma is a chronic inflammatory condition of the lungs, and it’s being diagnosed more and more frequently. Common misconceptions about the diagnosis and treatment of asthma are resulting in significant loss of productivity and time from work and school. This all in addition to the individual burden of the patient with asthma.
For the past several years, Asthma, Allergy and Clinical Immunology of Chester County has participated in the National Asthma Screening Day sponsored by the American College of Asthma, Allergy and Immunology. Because of the growing number of people affected by asthma, AACICC has expanded this program to offer asthma screenings to interested organizations and corporations. By offering asthma screenings on a year-round basis, we will be better able to identify undiagnosed asthma patients and patients who may need more aggressive asthma care. The result: patients who gain better control of their asthma and consequently have less time lost and higher productivity at school and work.
For more information on either of these programs, please call 610-436-5491 and ask to speak with Dr. Andrew Murphy or Felicia.