Dr. Hamilos – Allergy and Immunology

Daniel Hamilos, MD:

The services that we provide in the allergy clinic, we try to cover the whole broad range of allergy and immunology diseases that we need to be treated. Many patients come in just for simple allergies like hay fever, trouble there with hay fever symptoms, or with asthma, which can be driven by allergies in many cases. But then we have many other problems too, like food allergies, drug allergies, people who are having recurring infections, especially sinus infections, lung infections. There are often the patients that come to see me to try to understand if they have an underlying immune deficiency. I think allergists have to be detail-oriented because so much of our practice involves sleuthing out what the causes of allergies are for patients. So the first thing that we’re trying to do is establish what allergy problems exist, and that’s usually done by skin testing. But skin testing is nice because we can do it right there in the clinic the day that we see them.

Foods can cause many problems for people. Anything from just making you feel upset stomach or diarrhea, to having more classic allergic symptoms like hives, a skin rash, or even anaphylactic shock. We can’t cure allergies. Medications can alleviate the symptoms. Drugs that actually block some component of the immune-allergic pathway that can actually shut down allergic responses. Allergy shots is another really good treatment that’s probably as close as we come to curing allergies is by giving allergy shots because there we’re building up your immune tolerance to the things that you’re allergic to. And what the shots do is gradually move you to the point where we reduce your allergic tendency and we build up your tolerance. And then, for example, if you’re allergic to cats or dogs, the likelihood is that after you are in the shots, you can be around cats or dogs and not be very bothered by them.

Most asthma starts in childhood as an allergic problem, most of it. But other things also contribute to it. Viral infections play a big role in children and adults. Many children outgrow asthma eventually, but then oftentimes later in life, they’ll start having problems again. A breathing machine that we have, which we call spirometry, is a very good test for looking for asthma, for example. It measures the airflow rate out of the lungs. It also gives us an indication of how well people take breaths in and how well they breathe out. Having asthma, then we can give them a bronchodilator to see whether the bronchodilator improves their symptoms and their lung functions, which would be a good way to help confirm that somebody has asthma. I just love helping people. I mean, that’s the whole joy of being a doctor, is to help people solve medical problems. And I never stopped that. Never stopped enjoying that. I really enjoy it now.