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Allergies (I got that sinus again doc!) are a way of life where I practice. Most of the town is afflicted. I never had allergies before moving here. I manage most on my own but do refer a few on to either an allergist or ENT (who also does shots/drops in town), especially if it is contributing to a chronic flare of asthma. I've had patients come off of their daily asthma medications after getting their allergies under control. The shorter the med list the better. 1 weekly shot is better than Qvar + Singulair + Flonase + Zyrtec.
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Same. I manage allergies on a daily basis (have them pretty bad myself). I refer to allergy for shots if they get to the point where one pill and one nose spray aren't enough.
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At least one or two a week. Live in one of the worst cities in the world for them. Anyone getting a sinus infection at the same time every year who wants to do shots I will send. If someone isn't interested in shots I probably won't send them. Also I give them regular allergy medications first.
D
deleted87716
If a patient isn't interested in allergy shots, there's nothing (literally, nothing) that an allergist will offer them that I can't (and probably haven't already). Allergy testing...? If you don't want shots, what's the point? "OK, you're allergic to such-and-such, so you should avoid such-and-such." Duh.
Oh, and "sinus infections...?" Here ya' go...
https://www.idsociety.org/uploadedF...ial Rhinosinusitis in Children and Adults.pdf
Oh, and "sinus infections...?" Here ya' go...
https://www.idsociety.org/uploadedF...ial Rhinosinusitis in Children and Adults.pdf
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No one likes when I cite those reccs haha. But we are fracked through Epic and it is a metric for us next year, silly patients.
D
deleted87716
I imagine you meant "tracked," but (if you ever watched Battlestar Galactica) what you said is probably also accurate. 😉
[nerdalert]
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IMHO patients who insist on a referral to allergy testing are also who come up with weird compliants and sometimes c/o fibromylagia
on a handful of occasions I have referred but that was when it was significantly impacting their work
on a handful of occasions I have referred but that was when it was significantly impacting their work
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Are you in an allergy ridden area? I am and started the shots myself. I can now breathe during pollen season. I refer earlier than some other people who don't suffer from ridiculous allergies and don't seem as sympathetic to the plight of those patients. I tell people the shot schedule first and tell them if they don't want to do that then there really isn't much point in going since I can give them the same meds they'd get there. I do refer anyone with a history of anaphylaxis. I can't count how many patients I've had who have no idea why they stopped breathing that one time and never had allergy testing but have a prescription for an epipen that they don't carry with them. I want to know what they are allergic to.
I hate taking a daily medication for something like this and I'm slowly being able to not take allergy meds every day.
