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March 24
Santa Fe office hours extended!

​Santa Fe clinic hours have been extended on Wednesdays and Fridays! New hours:

Monday through Thursday 8:30 AM-5:30 PM

Friday 8:30 AM-4:30 PM

March 07
CLOSED Good Friday, April 18
March 05
Why Allergy Partners?

 

More than 20 years ago in Asheville, North Carolina, Allergy Partners was founded on a simple premise: by working together, allergists can identify and implement best practices, which will result in improved patient care. By following that premise, we have grown to almost 100 allergists and 800 team members in 17 states. We are proud to provide care for more than a half-million patients. We are even more proud of the quality of care we provide.
 
All Allergy Partners physicians are certified by the American Board of Allergy, Asthma, and Immunology. That certification requires certification by the American Board of Internal Medicine or the American Board of Pediatrics followed by a minimum of two years of fellowship training. As a result, our physicians are uniquely qualified to manage conditions including:
 
• allergic rhinitis
• asthma
• allergic conjunctivitis
• chronic cough
• chronic sinusitis
• urticaria and angioedema
• atopic dermatitis
• contact dermatitis
• anaphylaxis(bee sting, drugs, food, or other causes)
• immune deficiencies
 
To make certain we remain on the cutting edge of our specialty, we created the Clinical Excellence Committee. Under the oversight of Dr. Spencer Atwater, our Chief Medical Officer, the Committee identifies opportunities for improvement, reviews pertinent medical literature and current standards, develops recommendations for optimal treatments, and engineers systems to make sure that treatment is delivered consistently. A perfect example of that is our state-of-the-art allergen immunotherapy program and extract lab. In many ways, immunotherapy is the cornerstone of the allergy specialty. To ensure that immunotherapy is as safe and effective as possible, we worked in conjunction with nationally recognized experts to develop our formulation processes and dosing recommendations. We invested in building our extract lab after seeking input from industry experts as well as the Center for Biologics Evaluation and Research. Today we produce over a quarter million vials of allergy extract annually following USP 797 guidelines for sterile allergenic extract processing. It is through this attention to detail that we can provide you assurance that the patients you entrust to us will be provided safe and effective therapy.
 
At Allergy Partners, we are committed to using the latest technology to improve patient outcomes. Each of our locations is not only using the same electronic health record, they are also configured as a single database. In this way, as opportunities to improve care become available, we can easily build and implement the forms that will encourage that care on an enterprise level. We can and do track the outcomes of that care delivery, and use that understanding to implement further change. We have published data in national allergy journals which we hope will help other practices with what we have learned.
 
We also use our information systems configuration to improve the quality of our consultations. We have an “All Doctors” listserv set up which enables our referring physicians to benefit from the expertise of not just one, but almost 100, practicing allergists. When any of our physicians confronts a particularly unusual or difficult case, he or she can immediately tap into the expertise of our entire network. With our current size, we see this oppor­tunity utilized once or twice every day. It not only provides access to much broader expertise for our patients, it also serves to educate our own physicians on a daily basis.
 
At Allergy Partners we are proud of our history and proud of the care we provide today. We are even more ex­cited about the future and the opportunities we have to deliver even better care. We have just implemented our patient portal, which increases our opportunities to interact with patients. We are in the process of developing more robust outcomes assessment capabilities. Additionally, we are exploring ways to integrate technology in ways that will help us work with our patients to make those outcomes even better. And most importantly, we are continuing to work as a group to build a patient-centered culture. As hard as we work behind the scenes to implement best practices and improve our specialty, we work just as hard to make sure our patients recognize that we care. We pledge to provide our shared patients the very best care and the best experience possible.

  
December 13
Tips for the Holidays!

Whether it's feasting on holiday meals, setting up your Christmas tree, or
visiting your pet-owning relatives, allergy triggers may be lurking.
Unfortunately, with busy schedules, travel time and the stress of the
holidays, it is easy to forget to take the proper care when dealing
with allergies and asthma.
  

Here are some tips to help keep allergies and asthma under control
this holiday season:
  
When attending holiday parties, inform the host about your food
allergy and ask about the ingredients used to prepare the meal.
  
Carry an auto-injectable dose of epinephrine when attending a holiday
party where unrecognized food allergens could be hiding. Homemade
items do not have ingredient lists and could be contaminated with
trace amounts of allergenic foods through contact with storage
containers or kitchen utensils.
  
Remind family members and friends that strict avoidance is the only
way to manage food allergies and that even one little bite can
trigger a dangerous reaction.
  
If visiting relatives' homes who own pets, take your allergy
medication before arriving in order to minimize a possible reaction.
  
Evergreens often carry microscopic mold spores. You might think you
are allergic to your Christmas tree, but it is likely that it is the
mold spores that are causing those symptoms.
  
Clean decorations and artificial trees outside before decorating.
They can gather mold and dust while in storage. Wash fabric
decorations in hot, soapy water before displaying them to remove mold
and dust.
  
When spraying artificial snow on windows or other surfaces, be sure
to follow directions. These sprays can irritate your lungs if you
inhale them.
  
Take along your own pillow with an allergen-proof cover and request
down-free pillows if staying in a hotel or at a relative's house.
Dust mites can be especially troublesome if traveling away from home.
  
Ask your relatives and friends to avoid burning wood in the
fireplace. The smoke can trigger an asthma attack.
 
The holidays can be a stressful time of year. Pay attention to your
stress level because stress can sometimes lead to asthma attacks. Deep
breathing and relaxation can help. Remember to enjoy this special season instead of trying to make everything perfect!

 

 

October 04
Halloween and Food Allergies

Halloween--how fun  for kids to dress up and eat lots of candy! However, for families with food allergic children, this holiday can be very stressful. Many treats that are handed out are off limits to these children because they either contain or have the risk of containing (through cross contact) common foods associated with allergies like milk, egg and nuts. Here are some tips to help you and your family:

 

· If a food label indicates that the product “may contain” or is “processed on shared equipment with” the ingredient to which you or your child is allergic, avoid that food! Researchers have tested products with precautionary statements and found that major food allergens such as milk, egg and peanut have been found in about 5% of these foods.
 
· Mini-size, fun-size or bite-size versions of candy may contain different ingredients than their full-size counterparts. Make no assumptions, and read all labels carefully.
 
· Buy safe treats or inexpensive trinkets/toys that you can trade with your children for unsafe candies that they have received.
 
· Take those same safe treats and give them to your neighbors to give your allergic child when he or she comes to their door.
 
· Say NO to treats that do not have full ingredient labels.
 
· If prescribed, always have your Epi-Pen available.
 
· Make a rule that no treats can be eaten while your children are trick-or-treating. They should only be consumed after inspection by you.

 
 

October 04
A primer on asthma medications

Asthma is a common lung disorder characterized by episodes of cough, wheeze and shortness of breath. Asthma is caused by inflammation of the lining of the small airways in the lungs (bronchioles) which leads to spasm or narrowing of these tubes. This spasm triggers asthma symptoms. Approximately one person in ten has asthma and 34.1 million Americans have been diagnosed with asthma. Asthma severity varies greatly from very mild to debilitating. Unfortunately, asthma can be fatal and over 4,000 Americans a year die from asthma. For the vast majority of asthmatics, however, asthma can be well controlled. Management of asthma includes avoidance of triggers, treating underlying conditions (like reflux and obesity), allergy immunotherapy (for those who have an allergic component to their asthma) and medications. This article focuses on the different types of medications that are used for asthma control.

 

 There are two basic categories of asthma medications: relievers and controllers.
 
Relievers offer temporary relief from asthma symptoms and are typically used only when needed.
· Short term beta agonists are commonly known as rescue inhalers or nebulizers. These medications temporarily relax the muscles lining our small airways thus leading to opening of these bronchioles. Common examples of these medications include albuterol (ProAir, Ventolin, Proventil) and levalbuterol (Xopenex). These medications can come in either metered dose inhalers or as a liquid that is delivered through a nebulizer machine. The metered dose inhalers consist of a pressurized canister containing medication that fits into a boot-shaped plastic mouthpiece. With most metered dose inhalers, medication is released by pushing the canister into the boot. This type of inhaled medication delivery device requires proper technique. In those patients where poor technique is a concern, a spacer may be used. A spacer holds medication after it's released, making it easier to inhale the full dose. If you do have asthma, it is very important to keep track of how often you need either a rescue inhaler or nebulizer. In general, if you need a rescue treatment (excluding pre-exercise) because of experiencing actual breathing symptoms more than twice per week, then that is too much. In that scenario you need to see your trusted health care provider.
 
· Systemic steroids are large doses of corticosteroids that are given orally or intravenously for acute and severe allergic attacks. Examples include prednisone, prednisolone (OraPred) and methylprednisolone (often prescribed as a Medrol Dose Pack). These are medications that are used in emergency situations and chronic use of them can lead to significant deleterious side effects.

Controllers are anti-inflammatory medications which prevent or heal the inflammation inside the lungs. These are generally used every day as a preventive medication in those patients with persistent asthma. The criteria for persistent disease include needing your rescue inhaled medications more than twice per week, waking up from sleep because of asthma symptoms more than twice per month or needing systemic steroids for asthma attacks more than twice in the past year. This is not a complete list; in the end, the judgment of your health care provider is most important in determining whether you need asthma controller medication. Controller medications should be taken every day to prevent asthma symptoms from emerging

 

  • Inhaled steroids are anti-inflammatory inhaled medications that are the most effective and commonly used treatments for long-term control of asthma. They reduce swelling and tightening in your airways. Examples include fluticasone (Flovent), budesonide (Pulmicort), mometasone (Asmanex), beclomethasone (Qvar) and ciclesonide (Alvesco). Some of these medications come in a metered dose inhaler, others in a dry powder inhaler that cannot be used with a spacer. The only one of the above that comes in a nebulized version is budesonide. 
· Leukotreine modifiers are pills that are taken every day that block the effects of leukotreines which are chemicals involved in the immune system that can cause asthma symptoms. Examples include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo).
 
· Combination inhalers are inhaled asthma medications that contain both an inhaled steroid and a long acting version of albuterol. These medications are typically prescribed to those patients who have uncontrolled asthma even when taking a daily inhaled steroid and/or a leukotreine modifier. Examples of these medications include fluticasone and salmeterol (Advair), budesonide and formoterol (Symbicort), and mometasone and formoterol (Dulera). Most of these are available only in a metered dose inhaler while Advair is available in both a metered dose inhaler and a dry powder inhaler.
 
· For those patients with allergy induced asthma that is not well controlled with maximum doses of the above medications, omalizumab (Xolair) is available. This is a humanized antibody used to reduce the sensitivity to inhaled or ingested allergens. It does this by blocking the effect of immunoglobulin E (IgE) which is an important mediator of allergic disease. This medication is administered via injection either every 2 or 4 weeks depending on the individual patient who meets certain criteria.

If you suffer from asthma you should know what specific medications you take and make sure you are clear on when/how to take them. You should also keep track of how often you need your rescue treatments, how often you experience night-time asthma symptoms that awaken you from sleep, and how many bursts of systemic steroids you have taken in the past 12 months for severe asthma attacks.

 

 

August 26
The A-B-C's of Asthma

Approximately 34.1 million Americans have been diagnosed with asthma, a common lung disorder characterized by episodes of coughing, wheezing, and shortness of breath. Asthma is caused by inflammation of the lining of the small airways, or bronchiole, in the lungs, which leads to spasm or narrowing of these tubes. Common asthma triggers include upper respiratory infections, allergens, smoke, and exercise. 

For reasons that are not completely clear, the incidence of asthma and other allergic diseases has been steadily rising over the past century. Why? The truth is, we don’t know. But there is some evidence that links decreased activity (more time spent watching television, playing on the computer, etc.) to increased asthma. 

 

Before school age, it is very difficult to accurately diagnose asthma because young children are not able to perform the breathing tests (pulmonary function tests, or spirometry) that are needed for a definitive diagnosis. Also, many children who have episodic cough or wheezing during their toddler years actually outgrow it prior to starting elementary school. For this reason, many physicians use the diagnosis of reactive airway disease with young patients. History has also shown that labeling a young child with asthma can also have long-term implications for obtaining health insurance and entering the military. 

 

Unfortunately, there is no way to absolutely prevent asthma from developing. However, there is evidence that exclusive breastfeeding for at least three months at birth protects against wheezing in early life (two to five years of age). Exclusive breastfeeding, however, has not been shown to protect against the development of asthma in children with a family history of allergic disease beyond the age of six.

 

For the vast majority of patients, asthma can be well controlled. People with asthma can (and should) fully participate in sports, exercise, and other physical activity. If you or a loved one has been diagnosed with asthma, there are effective treatments.
 
Avoidance of triggers: Depending on a person’s history and test results, taking specific measures to reduce exposure to triggers is a vital part of asthma management. This will help reduce the amount of medications needed to control asthma. Since viral infections are common triggers of asthma, yearly flu vaccinations are recommended.  

 

Treatment of underlying medical conditions: Chronic sinus problems, acid reflux (heartburn), obesity, and other conditions may cause or aggravate asthma. It is important that these problems be addressed.
 
Medications: There are two basic categories of asthma medications: relievers and controllers. Relievers are commonly called rescue inhalers or bronchodilators, which temporarily relieve symptoms. These are typically used only when needed. Controllers are anti-inflammatory medications, which prevent or heal the inflammation inside the lungs. These are generally used every day as a preventive medication in those patients with persistent disease.

 
Allergy immunotherapy: For many individuals, allergies are a significant trigger of asthma and aggressive control of their allergies can decrease asthma symptoms. Allergy immunotherapy (also called allergy shots) is the most effective treatment for allergies. Immunotherapy helps build up immunity to the exact items to which someone is allergic. In a recent study from Europe, allergy shots for children allergic to dust mites lead to a significant decrease in the amount of daily asthma medications needed to control the disease.
 
 
 

June 11
Exercise-Induced Asthma

Exercise-Induced Asthma

Do you have problems with coughing, wheezing, or chest tightness when you exercise? Do you feel very tired and short of breath when you exert yourself? Some people wrongly believe that they are just out of shape when, in fact, they may have exercise-induced asthma. About 18 million Americans have asthma and, of those, 80% will have increased symptoms with exercise. In non-asthmatics, up to 15% experience asthma symptoms with exercise and 40% of people with nasal allergies may experience exercise-induced asthma symptoms.
 
What is Exercise-Induced Asthma?
Exercise-induced asthma (EIA) is a reaction of the lungs caused by exercise. The bronchial tubes become irritated and constrict, also known as bronchospasm. Excess mucus is also formed contributing to the blockage of the airway and congestion. It is thought that when you exercise the airway is cooled and dried rapidly which sets off the reaction in some people. Although chronic asthma sufferers are more likely to have EIA, the presence of EIA does not lead to chronic asthma.
 
Symptoms and Triggers
Symptoms of EIA include shortness of breath during or after exercise, coughing, wheezing, chest tightness or pain, and extreme fatigue. Symptoms usually start within 5-20 minutes after starting exercise and may last for 30-60 minutes. Sometimes symptoms start only after activity has stopped however. “Locker room cough”, or a cough that occurs after exercise, is a common form of exercise induced asthma. Shortness of breath, from poor conditioning, usually resolve within a few minutes of rest. People with EIA are overly sensitive to sudden changes in temperature and humidity. Colder, drier air is usually more of a problem. Nasal breathing helps warm and humidify the air you breathe so mouth-breathing with exercise reduces the moisture and humidity of the air that reaches your lungs. Air pollution, high pollen counts, and viral upper respiratory infections can also worsen wheezing with exercise.
 
Diagnosis
You should talk to your doctor if you think you may have EIA. You will need a good history and physical which often leads to the diagnosis. You may have a resting lung function test to make sure you have no chronic asthma. You may also have a breathing test after exercise, although this test may not be positive in everyone with EIA. A trial of bronchodilator therapy prior to exercise may be used to help determine whether you have EIA. Chest pain may be a symptom of EIA, but it is important for your doctor to rule out cardiovascular disease as well.
 
Treatment and Practical Tips
There are things that you can do to reduce the chance of having symptoms. Staying out of cold, dry air is a big fac­tor so train indoors if possible. If you do exercise in the cold, try to breathe through the nose as much as possible, wear a mask or scarf, and avoid exercise in the cold if you have a respiratory infection. Warming up 45-60 minutes before training or playing may help. Taking frequent, short breaks can help. Avoid training or playing outside on days with high pollution or pollen counts. Certain sports are tolerated more than others. Swimming is usually tolerated well due to the humidity of a pool. Lower intensity sports like golf, baseball, and weight lifting are better tolerated. Sports with short bursts of energy such as baseball, football, wrestling, gymnastics, and short-term tack events are better tolerated than soccer, basketball, hockey, skiing, and long-distance running. Always have your asthma medications with you!
 
The first step of treatment is the use of an inhaled short-acting bronchodilator medicine 15-20 minutes before exercise. These include albuterol, pirbuterol, and levalbuterol and are effective in 80-90% of patients, have a rapid onset of action, and last for 4-6 hours. If symptoms are not controlled by these short-acting medications, a daily medication may have to be used to prevent inflammation and responsiveness of the airway.
 
Most importantly, you should be evaluated and continue to exercise. Exercise and training will improve fitness, reduce the amount of breathing needed with exercise, and allow you to exert yourself at a higher intensity before symptoms begin.
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April 10
Exercise-Induced Asthma

Do you have problems with coughing, wheezing, or chest tightness when you exercise? Do you feel very tired and short of breath when you exert yourself? Some people wrongly believe that they are just out of shape when, in fact, they may have exercise-induced asthma. About 18 million Americans have asthma and, of those, 80% will have increased symptoms with exercise. In non-asthmatics, up to 15% experience asthma symptoms with exercise and 40% of people with nasal allergies may experience exercise-induced asthma symptoms.  

What is Exercise-Induced Asthma?
Exercise-induced asthma (EIA) is a reaction of the lungs caused by exercise. The bronchial tubes become irritated and constrict, also known as bronchospasm. Excess mucus is also formed contributing to the blockage of the airway and congestion. It is thought that when you exercise the airway is cooled and dried rapidly which sets off the reaction in some people. Although chronic asthma sufferers are more likely to have EIA, the presence of EIA does not lead to chronic asthma.
 
Symptoms and Triggers
Symptoms of EIA include shortness of breath during or after exercise, coughing, wheezing, chest tightness or pain, and extreme fatigue. Symptoms usually start within 5-20 minutes after starting exercise and may last for 30-60 minutes. Sometimes symptoms start only after activity has stopped however. “Locker room cough”, or a cough that occurs after exercise, is a common form of exercise induced asthma. Shortness of breath, from poor conditioning, usually resolve within a few minutes of rest. People with EIA are overly sensitive to sudden changes in temperature and humidity. Colder, drier air is usually more of a problem. Nasal breathing helps warm and humidify the air you breathe so mouth-breathing with exercise reduces the moisture and humidity of the air that reaches your lungs. Air pollution, high pollen counts, and viral upper respiratory infections can also worsen wheezing with exercise.
 
Diagnosis
You should talk to your doctor if you think you may have EIA. You will need a good history and physical which often leads to the diagnosis. You may have a resting lung function test to make sure you have no chronic asthma. You may also have a breathing test after exercise, although this test may not be positive in everyone with EIA. A trial of bronchodilator therapy prior to exercise may be used to help determine whether you have EIA. Chest pain may be a symptom of EIA, but it is important for your doctor to rule out cardiovascular disease as well.
 
Treatment and Practical Tips
There are things that you can do to reduce the chance of having symptoms. Staying out of cold, dry air is a big fac­tor so train indoors if possible. If you do exercise in the cold, try to breathe through the nose as much as possible, wear a mask or scarf, and avoid exercise in the cold if you have a respiratory infection. Warming up 45-60 minutes before training or playing may help. Taking frequent, short breaks can help. Avoid training or playing outside on days with high pollution or pollen counts. Certain sports are tolerated more than others. Swimming is usually tolerated well due to the humidity of a pool, and lower intensity sports like golf, baseball, and weight lifting are also better tolerated. Sports with short bursts of energy such as baseball, football, wrestling, gymnastics, and short-term track events are better tolerated than soccer, basketball, hockey, skiing, and long-distance running. Always have your asthma medications with you!
 

The first step of treatment is the use of an inhaled short-acting bronchodilator medicine 15-20 minutes before exercise. These include albuterol, pirbuterol, and levalbuterol. They are effective in 80-90% of patients, have a rapid onset of action, and last for 4-6 hours. If symptoms are not controlled by these short-acting medications, a daily medication may have to be used to prevent inflammation and responsiveness of the airway. 

Most importantly, you should be evaluated and continue to exercise. Exercise and training will improve fitness, reduce the amount of breathing needed during exercise, and allow you to exert yourself at a higher intensity before asthma symptoms begin.

  

 

 

           

 

April 09
Stinging Insect Allergy

Stinging insect allergy affects approximately 3% of adults and 0.4-0.8% of children in the United States, with 40-100 people in the United States dying each year from a sting reaction. This type of allergy may develop at any age, is not inherited, and can occur whether or not one has other types of allergies. People with a severe allergic reaction to an insect sting have usually tolerated a prior sting; it is rare to have a life-threatening reaction the first time a person is stung. The insects responsible for the most serious allergic reactions are honey bees, wasps, hornets, yellow jackets, and fire ants. Bumblebees rarely sting.

 
Reactions to insect stings fall into two categories: anaphylaxis and large local reactions.

Anaphylaxis is defined as a sudden onset life-threatening allergic reaction. Onset of symptoms can be immediately to within 2 hours after a sting. Symptoms may include hives, swelling, difficulty breathing, wheezing, coughing, a feeling of throat closing or throat tightness, nausea, vomiting, low blood pressure, lightheadedness, shock, or loss of consciousness. In other words, any symptoms distant to the site of a sting may be life-threatening. If a person is stung and only has swelling at the site of the sting with no other symptoms, this is called a large local reaction.

 

People who have a large local reaction to a sting are not at increased risk of a life-threatening reaction to future stings; they do not necessarily need evaluation or treatment by an allergist. However, once a person has had a severe reaction to a sting (anaphylaxis), there is a 50-65% chance of having a similar or more severe reaction if stung in the future. Any adult who has experienced symptoms consistent with anaphylaxis after an insect sting (or symptoms distant to the sting site) should be referred to an allergist. The allergist will perform an evaluation and discuss with the patient a program of venom-specific immunotherapy in order to minimize the likelihood of future reactions. Children under 16 years of age who only develop hives but no other symptoms after a sting are not at increased risk of anaphylaxis with future stings and do not need an allergy evaluation or consideration for treatment with venom-specific immunotherapy.

 
The allergist will take a detailed history to confirm the nature of the sting reaction. The insect culprit will be identified if possible. Insect allergy is then diagnosed with venom allergen skin prick and intradermal testing. Occasionally, blood testing for venom allergy may be performed to complement skin testing. Because there is cross-reactivity between some venoms and it is not always possible to identify the insect responsible for the reaction, testing for all relevant venoms is usually performed. Venom skin testing accurately identifies >90% of stinging insect venom sensitivities.
 
Treatment and Practical Tips
Treatment of stinging insect venom allergy consists of venom-specific immunotherapy, the recommendation to carry injectible epinephrine, and observing general avoidance measures to reduce the risk of being stung in the future. The allergist may also provide a written anaphylaxis action plan and recommend obtaining a medical-alert bracelet which states that the wearer has stinging insect venom allergy.
 
Venom-specific immunotherapy reduces the risk of an allergic reaction to a future sting from 50-65% to under 5%. It exposes the patient’s immune system to gradually increasing doses of the venom(s) to which they are allergic. This produces tolerance to the venom(s) that protects them against anaphylaxis if stung again. Venom-specific immunotherapy is typically given for 3-5 years. It is 98% effective in preventing future systemic reactions and is the standard of care for treating venom-allergic patients. Venom immunotherapy can be a life-saving therapy.
 

Epinephrine is the cornerstone of treatment for all forms of anaphylaxis. All patients with a history of stinging insect venom anaphylaxis should carry epinephrine at all times and be properly instructed in its use. Epinephrine should be administered immediately at the onset of any life-threatening symptoms consistent with anaphylaxis and should be followed by transport to the nearest emergency room for additional care. Because epinephrine is short-acting (15-20 minutes), symptoms of anaphylaxis may recur after the epinephrine wears off. The use of this medicine is therefore considered a temporizing measure and not a substitute for seeking medical care. An antihistamine such as Benadryl should also be used, but only after epinephrine has been given.

 
General avoidance measures to reduce the future risk of a sting include the following:
 
1. Avoid wearing perfumes and scented lotions, which may attract insects.
2. Wear shoes (closed-toed) outdoors at all times.
3. If eating outdoors, keep food covered until eaten, and leave the clean-up to others.
4. Exercise caution when eating sweet foods and drinks (sodas, juices) outdoors.
5. Avoid or exercise caution around pools, picnic tables, and trash cans.

6. If possible, leave yard-work, gardening, and landscaping to others; otherwise proceed with extreme caution.
7. Have periodic inspections of your home and property by a professional pest company or non-allergic relative or friend to exterminate nests.
 
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 About this blog

 
 

Welcome to our blog site! Stay tuned to get the latest news. We will share tips and techniques for living with and managing your Allergies & Asthma. We look forward to sharing useful resources with our patients!