AASC offers various services to fulfill your allergy, asthma and sinus needs. We provide a full range of allergy services for both children and adults. Click each service below to expand and learn more.
The most important step in addressing your allergies is knowing what allergens cause your symptoms. Allergy skin testing can give us precise information about your allergens. Skin testing is the most common allergen test and is relatively painless. A very small amount of suspect allergens is put into the surface of your skin with a plastic testing device.
If you have allergies, you will experience a bit of swelling that looks and feels like a mosquito bite. This will only occur at the site of the allergen to which you are actually allergic. It is exceedingly rare for skin testing to cause any allergy symptoms anywhere other than at the site of the test.
Reactions usually occur within 10–15 minutes. Any reactions that occur usually go away within 30–90 minutes. The areas that showed reactions will usually go away within 30 minutes. If the prick skin tests are negative but we still suspect you may have allergies, a more sensitive test may be used in which a small amount of allergen is injected within the skin.
We have several lung function testing options available at our office:
Spirometry: A device called a spirometer is one of the ways that we can assess your lung function. We will measure how much air you can move in and out of your lungs as well as how fast you can exhale. We use this test to diagnose and understand the severity of asthma, COPD and other lung disorders and to check how well your treatment plan is helping your lung function.
Exhaled Nitric Oxide: Nitric oxide is produced when there is allergic inflammation in the lungs. Since inflammation is an indication of asthma, the results of this test can determine whether steroids will be an appropriate treatment. This is most commonly used to help make the diagnosis of asthma as opposed to other lung problems that don’t result in an increase in nitric oxide production, such as COPD and non–asthmatic chronic cough. It also helps us decide whether you might benefit from increased medication dosage, if your lung function still isn’t normal after completing your initial treatment plan.
Impulse Oscillometry: Impulse oscillometry is used by less than 1% of allergists worldwide but is a new and exciting way of detecting abnormal function well before any other symptoms develop in children. At AASC we are proud to be able to offer this exciting diagnostic opportunity to our patients.
Patients can make an appointment with our asthma educator, Elizabeth Koll, FNP. The one–hour discussion will include information about what asthma is, how to find and avoid triggers, how to use medications properly, how to prevent attacks, and more. This is especially important for children, who may need to understand their asthma while at school or camp, and for those who are newly diagnosed. You will leave this visit knowing how to further manage your asthma with your individual Asthma Action Plan.
Fiberoptic rhinoscopy is a quick, inexpensive means to evaluate the upper airway. This is used to detect any obstruction, persistent infections, sinus drainage, evidence of reflux or problems with the vocal cords. In many cases, our in–office rhinoscopy will avoid the need for an CT scan, and can determine whether a referral to a Ear, Nose and Throat (ENT) surgeon is appropriate. A common problem is when a patient is referred to an ENT office, only for the surgeon to examine the patient and determine that it is not a surgical problem. Although our allergists are not surgeons, they can evaluate further with Fiberoptic rhinoscopy whether a difficult problem requires a surgical solution and can refer you to an ENT. Rhinoscopy in the allergy office prevents patients from wasting both their time and that of the ENT surgeon on a consultation that could have been avoided.
Various conditions can cause people to have difficulty breathing during and after exercise. Standard lung function testing can show whether asthma is the cause and in some cases, an asthma inhaler can be used to relieve their symptoms. But when the lung tests are normal and the response to asthma inhalers is poor, most allergy offices are ill-equipped to investigate further. At AASC, we have a treadmill facility for patients to exercise in a controlled environment in order to bring out their symptoms, at which time we re-test lung function to determine exactly what is going on and what to do about it.
Asthma is no longer considered an absolute contraindication to scuba diving.
While serious problems can arise in asthmatics who dive, they are exceedingly rare except in people with severe or uncontrolled asthma. Most experts – both medical societies and diving groups – now agree that asthmatics can safely dive if their asthma is not severe and is well controlled.
Dr. Steven's protocol for diving clearance takes into consideration the recommendations of several professional groups. Lung function testing is performed, and an individualized treatment plan is formulated to maximize lung function and minimize lung inflammation. There is also an exercise challenge to ensure that lung function does not decrease with physical activity. The last, and most important, part of the process is an extensive educational program so that the diver understands the risks of diving with asthma.
If you have asthma and would like to dive, we'll do everything we can to enable you to participate in the fun of scuba diving!
Our physicians both bring their unique expertise when caring for your child. Dr. Steven has his own unique perspective since he was diagnosed with asthma and allergies at the age of three. Dr. Bukstein is board–certified in Allergy/Immunology, Pediatric Pulmonology and General Pediatrics and brings more than 30 years of experience.
Caring for children requires patience and a gentle approach. Our experienced nurses have just what it takes to make your child feel as comfortable as possible. From the children's area of our waiting room to our specially–designed pediatric exam room, we do our best to serve our youngest patients.
At AASC we can test to the major metals that are used in a variety of implants in different specialties. This is done for two reasons: 1) to identify an existing metal allergy prior to implant or 2) development of a metal allergy to an already existing implant. If the patient shows any existing metal allergies, we want that metal to be avoided in any implants that are going to be used. If the patient has developed a metal allergy, it is important to ensure that the problem will go away if one goes to the trouble of having an implant removed.
The Chronic Cough Clinic will work with cough patients to systematically evaluate all of the possible causes of cough, starting with the most common and continuing on to the rarest, until we ultimately silence the cough. Not all coughs are allergic in origin, and although we are not part of a multi–specialty clinic, we have board–certified allergy and pulmonary expertise in house. We have also put together a referral network of ENT physicians, neurologists, psychologists and gastroenterologists among whom we refer to bring together all of the expertise necessary to get you the relief you need. We have developed procedures to streamline the communications between these specialists and your primary care physician. Importantly, since it can take months to identify the cause of a chronic cough, and you have undoubtedly already had several tests done, we designed a tracking system to log all of the types of tests and results, so we don’t wind up needlessly repeating tests that have already been done.