What to expect at your appointment

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New patient appointments by referral only - We are currently accepting NEW referrals at this time

Attention new patients: Please email back the filled in new patient appointment information form PRIOR to your appointment, along with the name and fax number of the pharmacy you prefer. Our email address is tsaiallergy@gmail.com (this is an unsecure email). All new consultations are back to being in person. 

Please contact your family physician

New patient appointment Information

Skin Testing:

Skin testing is a quick procedure used to diagnose environmental, food and medication allergies.

1)  A small duo-tip (similar to a toothpick) is dipped in a well with various purified allergens:

  

2) The duo-tip is quickly pressed against your lower inner arm (may be done on your back)


3) You will then wait in the office for 10-15 minutes

4) The doctor will then check your arm.  If you are allergic to any of the allergens, you will develop a welt (raised itchy bump).



5) The doctor will then measure the size of the welt


I am coming in for testing to food, and I was asked to bring a small piece of the food I am allergic to, will I have to eat it?  No, for food skin testing, fresh food provides the most accurate results.
*** Note: You do NOT need to bring in items such as tree-nuts, peanuts, milk, eggs, soy or wheat.

At what age can skin testing be done?
- Under the age of 1 can be tested, however it can be less accurate
- For children under 3, they have not seen enough seasons to develop seasonal allergies.  Therefore, their skin test would only involve perennial allergies, such as dust mites, pets (cats, dogs etc), and mold.

Occasionally, we do need to use a further type of skin testing that involves injecting pharmaceutical allergen extracts.  It is a quick test where a small amount of the allergen is injected between the top layers of skin (inter-dermal).  A small raised area will form (a bleb). This test only takes 15 minutes to get results.
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Asthma Testing:

Please bring all asthma medications and aerochambers to your appointment

For patients aged 6+, a simple breathing test (spirometry) will be performed at the office. 

  • You will be asked to blow into a tube, and the machine will measure a number of different things about your lungs. 
  • Occasionally, you may be given Ventolin (Salbutamol), and then asked to perform the test again. 
  • This test will help you and the doctor decide what is best for your asthma management. 
  • You will also have the opportunity to learn proper inhaler technique. 
  • Please feel free to ask questions.


Spiro machine:

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Patch Testing:

Patch testing is used to determine if you have a contact allergy.  Patches (like stickers), are applied to your back, and then you return to clinic after 72 hours to see if you are allergic to any of the allergens applied to your back.  See links below for complete information.


Information sheet:  What is patch testing?
and  Patch testing instructions

***Please remember that when doing patch testing, you must refrain from showering, and participating in strenuous activities that may cause you to sweat excessively, until you return to clinic to see the doctor.  Please plan accordingly. 

***If required, please reduce hair on upper back by shaving as necessary 1 day prior to the test.

Links:

Contact allergen database

Allergeaze allergen database

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Food & Medication Challenges:

After all testing has been completed, you may be booked for a food or medication challenge.  This appointment will be booked for first thing in the morning. 

  • Expect to be at the clinic for the full morning. 
  • You should come prepared with things to do, such as reading material, DVDs (we have a TV and DVD player available), homework, etc. 
  • For food challenges:  You will also need to bring the food, already prepared (ie peeled and sliced, nuts out of shell, foods cooked). 
  • For younger patients, you may need to bring items that will appeal to their eating habits (like ketchup, sauces they have eaten before, chocolate covered nuts, etc).
  • For drug challenges: Please bring the medication as prescribed by the doctor.
  • You are allowed to bring small snacks and drinks, however they must be consumed in the challenge room. 
  • If you have any questions, we encourage you to ask.
What happens at this appointment:
  • When you first arrive, the doctor/nurse will talk to you, check your vital signs (blood pressure, pulse etc), check your skin to obtain a baseline.
  • PLEASE NOTIFY THE DOCTOR/NURSE, BEFORE WE START, IF YOU ARE TAKING HEART MEDICATIONS (BETA-BLOCKERS OR ACE-INHIBITORS)
  • Once you are cleared to start:
                      - Food challenges:  The nurse will give you a very tiny amount of the food.  Then in 20 minutes, as long as you are 
                        ok, you will get another slightly bigger amount of the food.  This will continue, as long as you are ok, every 20
                        minutes until the prescribed amount of food has been ingested.
                      - Medication challenges:  The nurse will give you a small dose of the medication as prescribed by the doctor. 
                        Then in 30-45 minutes, as long as you are ok, then next prescribed dose is given.
  • After you have had your last dose, you will be required to wait in the office for 1 hour, after this time, the doctor will check to ensure you are clear to go.
What if I have a reaction?
  • If you have a reaction, the doctor and nurse will treat you in the clinic.  Our office is equipped to treat any anaphylatic emergency, so there is no need for you to use your own EpiPen/medication.

Information sheets for:

Eggs in baked goods challenge

Milk in baked goods challenge

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Special Clinics:

Each month we run separate clinics for Penicillin allergy testing and Venom (stinging insect) allergy testing.

These clinics involve a lot of preparation , by all of our staff, and are costly.  It is important to attend your appointment as scheduled.  If you are unable to attend your appointment, you must give at least 48 hours notice.  Otherwise you will be charged a $80 no show fee, and will not be booked into future clinics until this fee is paid.

It is important that you call our office to confirm attendance to your appointment.  If there are not enough confirmed patients, the clinic will be canceled and re-booked.

Please see the information sheet regarding these clinics:

Venom Testing Clinic

Penicillin Clinic Note: there is a $50.00 fee for this clinic, not covered by OHIP, payable at your appointment.




***For these appointments, it is important to note that testing will be done using a series of needles.  It can be quite uncomfortable for our younger patients.  Please consider using EMLA patches.  These should be applied to the patients upper, outer arm (just below their shoulder), about 2 hours prior to their appointment.  The nurse will remove the patches prior to testing.

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