What to expect

Welcome to the Allergy & Asthma Care Center!

Thank  you for choosing us.

We provide high-quality, cost-effective allergy and asthma care which can make a big difference in a person’s life. We want your visit here to be helpful and positive. Whenever you have questions or concerns, please feel free to talk to Dr. Dalan, or with any of our staff, Wendy, PharmD, PA-C, AE-C, Pam-RN,  Lori-CMA, Shona-CCRC, Mary, Dyan, or Joan. You were either referred here by yourself, by your primary physician, a specialist such as Ear, Nose and Throat, dermatologist, pediatrician, or other health professionals, or friends. For your convenience, we recommend appointments be made prior to each visit. Skin test materials may need to be prepared and may incur a cost. You will receive confirmation by return mail and or by a phone call. If you are unable to keep your scheduled clinic appointment, please call in advance and we’ll help you reschedule a new one. A clinic representative will call and provide you with information and directions to the clinic. When you arrive at the clinic, patient services will help you complete the paperwork for your medical record and billing. Although appointments are carefully planned, sometimes delays do occur. If you feel you have been waiting too long, please let the receptionist or nurse know. We may decide that you need further tests. Any time you have questions or concerns, do not hesitate to ask.

What to expect in our clinic: assessment

An assessment of your symptoms including the following:

1.  A nurse, resident physician, or medical student will do an initial intake evaluation where a history is obtained and a questionnaire answered and filled out. Vital signs such as blood pressure, temperature, pulse, and/or pulmonary function tests will be performed. This is important information which will be reviewed or repeated by the attending physician and allergist.

2.  An allergy specialist will then visit with you, review important points in your history and questionnaire or ask new questions. This is considered the History.

3.  You will be asked to wear a gown for a Physical Examination of relevant affected body organs, such as ear, eyes, nose, throat, chest, heart, abdomen, and skin.

Depending on the symptoms and problems posed, several tests may be proposed and explained to you before proceeding. There may not be any tests done.  This is considered Informed Consent. These may include:

What to expect in our clinic: skin tests

We conduct a skin test, where sterile drops of solution of common allergens will be placed on the back, and a small prick lancet used to break the skin through this solution.

the prick lancet

skin test materials

The number of tests done vary depending on the history from 20-40. The most discomfort is if the test is positive, otherwise, the sensation felt is like that of a mosquito bite. Positive tests after a 15 minute wait include redness, swelling, and itching.

positive test

A negative test does not rule out an allergy. If the doctor is still suspicious, a second part called intradermal testing (using a small syringe such as an insulin syringe) is used to introduce up to 10 items under the skin of the forearm. This may be more discomfort for some, but it’s tolerated by most people tested. Testing takes 30 to 60 minutes. The materials used are shown above.

What to expect in our clinic: asthma tests

Pulmonary function tests include blowing into a tube connected to a computer to determine cause of cough, shortness of breath, and wheezing. This will include three trials of blowing. Other tests may be done such as a repeat of the test after inhaling nebulized medicines looking for improvement. An asthma test called a methacholine challenge involves a series of blowing test after inhaling nebulized solutions which may provoke asthma symptoms. These tests may last 5 minutes for simple lung tests or up to 30 minutes for an asthma test.

our pulmonary function computer

What to expect in our clinic: other tests.

c) Rhinomanometry involves procedures looking inside the nose using masks sealing the nose and breathing into the computer. Endoscopy involves looking deeper into the nose and throat with a lighted scope. Nasal smear involves inspection of the nose with a lighted hand held scope or nasal speculum and sampling the skin inside with a Q tip or a curette. Most experience pressure, itching, sneezing, but rarely pain or discomfort. These tests take seconds or up to 15 minutes only.

d) X-rays or blood tests may be conducted the same day; CT Scans must be scheduled another time.

e) Other specialized tests are rarely done, however if deemed important they will be further discussed with you by your allergist. These may include oral food and drug tests or an antibiotic challenge.

5. A review of the problem, an explanation of different possible diagnoses, tests, and recommendations for further tests, treatment, follow-up will then conclude the visit. A summary of your visit including diagnosis and treatment will be mailed to you and/or your referring physician.

What to expect in our clinic: insurance information.

8. We will file all health care insurance forms for you if the necessary information is provided. Please bring all your insurance cards with you when you come to the clinic. You will be responsible for full payment of services rendered, regardless of the amount paid by any third parties, such as insurance companies or Medicare. Our clinic will accept personal checks, cash or credit cards. Arrangement for other payment schedules can be arranged with our business manager. If you have any questions or concerns about your clinic bill at any time, our business manager or your physician is available to discuss it with you. Cost of this visit will vary depending on time and number of tests. The final bill is a reflection of the time spent by people in the office involved with your care from the office staff, secretary, nurses, physician, clinic managers, plus the cost of the tests done in our office. Lab, x-ray, or cost of other doctors involved may be billed from their office. Most insurance companies pay for some, most, or all the bill depending on your policy.