Purpose
Your doctor has recommended immunotherapy as part of your allergy care. The purpose of injection therapy is to help your body produce blocking antibodies to reduce your symptoms. It will not "cure" the allergy. The process of building up these antibodies is slow and you may not begin to see the positive effects for six months or more. immunotherapy is a commitment of at least three years with many patients electing to remain on injection therapy for the long term management of their allergies.
Procedure
Your serum consists of four bottles of extract that contain the same main ingredients. The difference is in the concentration. We start with the weakest solution and work up to the most concentrated, or undiluted solution. In the initial building up phase injections are given weekly, for about seventeen to twenty weeks. At this point you will make an appointment for a serum evaluation. This is an office visit where we review the past few months, make any further adjustments in medications or serum, and check to see that your physical findings correlate to how you are feeling. If you have reached your maintenance, you will now come every two weeks until the completion of your first year. An office visit will again be scheduled for another comprehensive review and the series continues every three weeks for one year and then every four weeks for the third year.
This type of schedule is a guide, not necessarily a promise, and adjustments will be made based on your individual needs. Not every patient will reach the fourth, or undiluted bottle of extract. That means that your maintenance, the dose that will help produce blocking antibodies occurs at a lower level. The goal is to reach the highest level that you can tolerate without producing an unwanted reaction.
Reactions
Since you are receiving injections of the allergens to which you are allergic, it is possible to have a reaction from the extract. Serious reactions are rare; however, it is for your safety that you wait thirty minutes following each injection. If you take antihistamines as part of your regular routine, you may continue to do so on the day of your injection. You should not take any medication for the purpose of trying to prevent itching or swelling as this could possibly mask symptoms that warn the dose is getting too high.
Reactions may be local with redness, heat and itching at the site of the injection. Any discomfort can be relieved by applying ice and taking an oral antihistamine. Any swelling, known as the wheal, should be measured, comparing the size of the swelling to a dime, nickel, quarter or half dollar. If you have any reaction, one of the professional staff must be notified at your next appointment and they will determine if any adjustment is needed in your dosage. Often for swelling of about a quarter the same dose will be administered until you no longer have such a reaction. For swelling larger than a half dollar, your dosage may be reduced by one half the previous injection. Any symptom that occurs regularly after receiving an injection should be reported. Delayed reactions can occur eight to twenty-four hours later, although the longer the time lapse usually the less severe the reaction.
A more serious reaction can be hives, generalized itching, shortness of breath, dizziness, wheezing or tightness of the throat. As a rule of thumb any symptom which develops immediately after receiving your injection should be reported before you leave the office. If a severe reaction should occur within one to two hours after your injection you should return to the office or go to the nearest emergency room.
Summary
Injection therapy is a commitment. You will not experience immediate results, and may continue to need supplementary medications. The professional staff is available to help and offer ongoing evaluations. The office is generally open Monday thru Friday from 9 a.m. to 5 p.m. We will be happy to answer any questions or refill prescriptions during this time. There is always a medical staff member on call nights and weekends. This is for emergencies, since you do not have your medical records at home. Any medication that you may need can be reviewed before Friday afternoon. Time has been set aside on Monday morning for a follow-up office visit on every patient that requires emergency help over the weekend, your well-being is our primary concern.