Allergy Immunotherapy and Injection Therapy

Answering Your Questions About Allergen Immunotherapy

WHY?
When you are unable to avoid exposure to allergens which cause your problems, or when allergy medications fail to control symptoms or cause side effects, allergy injections are recommended.

HOW DO THEY WORK?
Instead of just relieving symptoms like medications do, immunotherapy causes your body to build protective antibodies much as do tetanus or flu injections.  Eventually your body may produce enough protection to block allergic reactions to the substances that trigger your reactions.

HOW OFTEN?
Since allergy injections contain the identical material causing your symptoms, the dose starts with dilute material and builds gradually to your maintenance dose.  At that time your doctor will assess your progress to determine how often you will need injections thereafter.  If you are doing well, the frequency is decreased to every two weeks and gradually to every three weeks.  The general length of treatment is about three to four years.

HOW SOON WILL YOU SEE RELIEF?
Often patients state they have moderate relief from symptoms as early as three to four months.  In the meantime, you may take medications to help control symptoms.

HOW DO YOU ARRANGE FOR AN INJECTION?
Call the office to schedule your injections.  We will give you a list of our injection hours.  Weekly you can schedule a time for the next injection.  If you are unable to schedule in advance, please call on the day of your injection so we can have your chart and antigen ready and you will not be delayed.  When you arrive at the office, please print your name clearly on the sign-in sheet.  The nurse will call your name and administer your injection.  You must remain in the office 20 following your injection in case a reaction to the injection occurs.  The nurse will check your arm before you leave.

WHAT SHOULD YOU EXPECT FOLLOWING AN INJECTION?
Since you are being treated with substances to which you are allergic, there is always a possibility that you may react.  You might experience a local reaction in which your arm becomes swollen, warm and itchy at the site of injection.
If this occurs and becomes uncomfortable later, you may apply ice and take an antihistamine.  If you have a local reaction the size of a quarter, or lasting longer than a few hours, be sure to inform the nurse before your next injection so the dose can be adjusted accordingly.  On rare occasions generalized itching, increased allergy symptoms and/or chest tightness may occur.  If this should happen, call the office for advice or, if necessary, return to the office immediately or the nearest medical facility for treatment.

WHAT IS THE COST OF IMMUNOTHERAPY?
The fee for allergy injections is a per visit fee regardless of the number of injections administered.  This fee includes the professional and clerical services rendered in connection with the administration of allergy injections as well as the equipment used and proper handling and disposal of medical waste generated.  (The Federal & State Governments mandate records to be maintained and specific disposal procedures to be followed for all medical waste.)
The fees of vaccines include the purchasing and processing of the antigens used in your allergy injections.  Processing costs include vials and diluent to prepare the various concentrations of antigens and the refrigerated storage of these items.  Furthermore, diluted antigens are only stable for six months, requiring us to routinely prepare fresh vials to insure the most effective and accurate dosages of antigens for you.  Antigens are billed each time the patient receives an injection.
If we participate with your insurance plan, these charges will be submitted directly to your carrier.  Any patient responsibility will be balance billed.

IMMUNOTHERAPY INSTRUCTIONS

  1. Injections start with the lowest dose and end with the highest (maintenance) dose. Doses will be raised weekly for about 7 months. After 7 months your appointments will be every 4 weeks for a total of 5 years.
  2. Take an antihistamine at least a half hour prior to injection.
  3. Print your full name on the sign in sheet outside of the shot room. Notify the nurse if arm swelling, redness or increased allergic symptoms followed your last allergy injection.
  4. Patient needs to stay in the office for 20 minutes after each injection so the nurse can monitor any reactions.
  5. Always advise the nurse of any new medication you are taking. In the event of an adverse reaction to an allergy injection, a beta-blocker would interfere with effective emergency treatment by suppressing the response to epinephrine and possibly worsening any underlying asthma.
  6. Avoid strenuous exercise one hour before and one hour after injection.
  7. Avoid such activities as mowing grass or working in areas where there would be increased exposure to pollens.
  8. If you have cold symptoms of increased allergy symptoms such as hives, wheezing, cough or increased nasal congestion please call and cancel your appointment. We usually do not give injections in these situations.
  9. Try to keep your scheduled appointment time