Patient Evaluation
During the initial visit, Dr. Song will do a complete history / physical exam and diagnostic procedures which may include spirometry, X-rays, and rhinoscopy. During the subsequent visits, the skin tests will be done if indicated. Depending on the age and the complexity of the symptoms, skin testing may take more than one session. At the completion of the diagnostic procedures, a session will be devoted to summarize and explain the findings and to formulate the treatment plan.
Procedures
Skin Test
This is the most important procedure from which an allergist can obtain useful information on the patient’s condition. Test allergens include grass pollens, tree pollens, weed pollens, mold spores, dust mites, animal hair/dander, and foods. The most common and relevant allergens are selected and administered in groups on the patient’s back or arms/forearm in one to three separate sessions. Initially, prick tests are done using plastic devices. If the test results are negative, more sensitive intradermal tests may be applied. By inspecting the skin swelling from the test sites, Dr. Song will determine to which allergens a patient is sensitive and will apply the information to the therapeutic plan. Please read the Skin Test Instruction, the Clinical Information section, and Skin Test Panels (appendix) of the guidebook for further information.
Patch Test
This test is done to find out if the patient’s skin rash is caused by contactants such as cosmetics, leather, nickel, etc. This test is especially useful for the patients with hand dermatitis. We use T.R.U.E. Test by Glaxo-Wellcome Inc. Two plastic sheets ( 3” x 5”), each containing 12 aluminum disks of test materials, are taped on the back of the patient and are read in 72 hours
Spirometry
This test is done to assess the lung function of the patients. Many allergic patients have subtle asthma which may not be detected by physical exam alone. This test will help detect the early signs of respiratory compromise and follow the progress of the disease. This test is routinely used in our office to follow the patient with respiratory disease.
Exhaled Nitric Oxide(eNO) Test
This test measures the level of nitric oxide from the breath. The increased level suggests the inflammation in the airways as seen in asthmatics and may be present in the absence of spirometric changes. Please ask for the patient education material.
Peak Flow Meter
This is a simple test used for assessing the lung function and may not be as complete as spirometry but is less time-consuming. Patients will often be asked to measure the peak flow at home with a portable one.
Rhinoscopy
This procedure is performed to assess the anatomy of the nasal cavity. After the lining of the nose is numbed with a local anesthetic, a small caliber tube is inserted into the nasal space for inspection. The degree of swelling and inflammation of the nasal tissue and the presence of polyps will be determined.
Audiogram/Tympanogram
To assess hearing and to detect abnormal tympanic membrane activities. This test will detect the presence of fluid in the middle ear.
