Allergies And Allergists

I have previously written about how allergies affect so much of what I deal with as an Ear, Nose and Throat physician.  Today I would like to reinforce some of what I have said in the past and talk a little bit about my personal background and experience in managing allergic diseases. Allergies can be defined as an abnormal response of our immune system to microscopic things in our environment such as plant pollen, mold and animal hair by products.  It is estimated that each year more than 100 million Americans suffer from allergic diseases, with allergies constituting the sixth leading cause of chronic disease in the United States. We have a healthcare expenditure of approximately $40 billion annually to treat and try to control allergic diseases. Physicians who specialize in the treatment of allergic diseases are generally referred to as Allergists.  There are three training pathways in which a doctor can become an Allergist.  The first two start as either a fully trained internal medicine specialist or pediatrician.  Following that training a general allergist will do 1 or 2 years in fellowship at a medical school or large academic training hospital.  They then usually become accredited by the American Academy of Allergy Asthma and Immunology. My specialty is officially called Otolaryngology.  During my 4 years of training in this field I treated numerous patients with nasal and sinus diseases that were the result of allergies.  There is a fellowship status for ENT doctors in allergy.  It is through a national organization called the American Academy of Otolaryngeal Allergy.  To attain fellowship status through them requires 120 hours of classroom lectures to be held at least 2 locations then there is a 2 day written and oral examination process that I completed in 1989. Historically it is interesting that one of the pioneers in allergy testing was an ENT specialist Dr Hansel who published skin testing techniques in 1937. So for 29 years I have been an accredited trained specialist in the field of allergy.  During that time I have seen multiple changes in both testing and treatment techniques.  However many of them such as skin testing remain in my opinion the absolute best way of diagnosing allergies especially to inhaled irritants in the air. Blood testing for allergies has been available since 1985.  And while the technology has improved there are still many patients who have allergies with a negative blood test.  Treatment of allergies based on the blood test can be difficult. Management of diseases caused by allergies whether it is in the nose or asthma in the lungs can be a challenging task.  By combining the techniques of allergy testing and immunotherapy for desensitization, as well as use of a wide variety of medications including prescriptions and new natural plant based antihistamine type medications, we can provide relief to patients from age one to 91.