Our mission, as we see it, is to correctly diagnose and treat allergy, asthma, eczema, food and drug allergy, chronic urticaria (hives), angioedema (swelling), and disorders of the immune system, so as to achieve as normal a quality of life as possible for patients with these conditions. In order to accomplish these goals, we use every tool at our disposal, including a thorough history and physical examination, microscopic examination of the nasal secretions, pulmonary function tests, skin testing to airborne and food allergens, patch testing for contact allergens, blood tests for immunological disorders, and a diagnostic skill that comes from thirty years of thoughtful practice.
Any physician can perform adequate skin testing or blood tests for allergy, but knowing which airborne allergens are important in south central Texas and interpreting the results of blood tests are skills that are acquired from at least two years of training and honed by years of actual practice. These skills are tested in the examinations given by the American Board of Allergy & Immunology. Certification by the American Board of Allergy & Immunology does not guarantee competence but insures that the physician has the basic fund of knowledge required to practice the specialty. Dr. Laham is certified by the American Board of Allergy & Immunology.
We may be the only allergy clinic in town that does a microscopic examination of the nasal mucus on every new patient. This procedure is done for three reasons. First, it is often impossible to know from the history or the physical examination that the patient has sinusitis in addition to, or instead of, allergic rhinitis. Second, the patient occasionally has eosinophils or allergy cells, but the skin tests or blood tests for allergies are negative, which would indicate a diagnosis of non-allergic eosinophilic rhinitis. Third, the unified airway hypothesis states that the kind of white blood cell found in the upper airways is likely to reflect what is happening in the bronchi in asthma, and that has significant implications for therapy.
When allergy shots are clearly indicated, and they are in a small minority of patients, we take every precaution to make it a painless experience for our patients and to avoid the possible complications of therapy. The goal of allergy shots, as we see it, is to achieve a remission of the allergy, if at all possible, so as to turn the skin tests negative within three to four years. This means, by definition, that we have to use high enough concentrations of the allergens to potentially cause systemic allergic reactions to the shots themselves even as we minimize the risk to our patients.
We were the first clinic in town to perform skin testing to foods because, at the time, in the 1980’s, skin testing to foods was frowned upon. Now it is done routinely. We were the first to recommend that patients on allergy shots carry an Anakit or, later, an Epipen. And we were the first to recommend antihistamines on the day of the allergy shots. Both are done routinely today. We continue to be at the cutting edge and the forefront of medical developments and technology. We take great pride in what we do and we do it well.