Allergy Services

- Allergy Specialist Dr. Michael Bublik - Los Angeles, Beverly Hills, Glendale

Allergy Specialist Los Angeles, Beverly Hills

Dr. Michael Bublik and his staff are committed to the highest quality patient care provided with compassion and personal attention, and the availability of the most advanced, innovative diagnostic and therapeutic technology and techniques. Patients come to our practice looking for relief of allergy symptoms that often interfere with the patients’ ability to enjoy life. In fact, one out of five Americans suffer from allergies. Computing to roughly 45-50 Million Americans.

With years of experience and expertise in the field of allergy and immunotherapy Dr. Michael Bublik can help relieve your symptoms and get you back to enjoying your life again. If you are someone who suffers from chronic allergies please contact us today! (818) 649-1433.

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What is Allergy?

One out of five Americans suffer from allergies, computing to roughly 45-50 million Americans suffering from allergy. For some, allergies are simply a short lived nuisance; however for millions it's a life altering disease. The only treatment that reprograms the overreacting immune system is immunotherapy which involves gradual delivery of the substances that trigger allergies to acclimate the body to the world around it. An allergy is a reaction of your immune system to something in the environment or food that you may consume. People who have allergies often are sensitive to more than one thing.

Substances that often cause reactions are

  • Pollen
  • Dust mites
  • Mold spores
  • Pet dander
  • Food
  • Insect stings
  • Medicines
  • Food

Allergic rhinitis was once known as hay fever because workers would sneeze and develop nasal and sinus congestion when they worked around hay in the fields. Hay fever, asthma, and eczema are the most common symptoms of an allergic reaction.

Allergy symptoms appear when the body's immune system begins to respond to a substance as though it were a dangerous invader (called an antigen or allergen). It does this by sending specific defenders called antibodies to the entry site. This results in a release of chemical mediators, such as histamine which is release from mast cells, directly into the bloodstream which cause changes in the body producing the symptoms that we feel. Those symptoms are itching eyes, sneezing, nasal stuffiness, nasal congestion and drainage, and sometimes headache. Some people experience hearing changes, scratchy sore throats, hoarseness, and cough. Other less common symptoms include balance disturbances, swelling in face or throat tissues, skin irritations, and even respiratory problems and asthma.

Some allergy sufferers experience symptoms all year. Others find certain seasons bring on attacks. Allergy symptom control is most successful when multiple management approaches are used simultaneously. Minimizing exposure to allergens, managing symptoms with medications, and desensitization with allergy shots are all methods that can be useful in controlling allergic symptoms.

Medications properly used can be very helpful. Over the counter drugs can be beneficial, but some cause drowsiness. Sometimes prescription medications offer the best chance for good control.

Immunotherapy, or allergy shots, provide the only treatment method that can offer lasting relief or cure from allergies. Before beginning a series of such shots, allergy testing must be performed.


What are Allergens?

Some substances, because of their chemical make-up, are more prone to generate an allergic response in humans. Pollens, food, mold, dust, feathers, animal dander, chemicals, drugs such as penicillin, and environmental pollutants commonly cause many to suffer allergic reactions.

  • Hay fever is caused by pollens. The most significant cause of hay fever in the United States is ragweed. It begins pollinating in late August and continues until the first frost. Late springtime pollens come from the grasses, i.e., timothy, orchard, red top, sweet vernal, Bermuda, Johnson, and some bluegrasses. Early springtime hay fever is most often caused by pollens of trees such as elm, maple, birch, poplar, beech, ash, oak, walnut, sycamore, cypress, hickory, pecan, cottonwood, and alder.
  • Certain allergens are always present. These include house dust, household pet danders, foods, wool, various chemicals used around the house, and more. Symptoms from these are frequently worse in the winter when the house is closed up.
  • Mold spores cause at least as many allergy problems as pollens. Molds are present all year long, and grow outdoors and indoors. Dead leaves and farm areas are common sources for outdoor molds. Indoor plants, old books, bathrooms, and damp areas are common sources of indoor mold growth.
  • Colorful or fragrant flowering plants rarely cause allergy because their pollens are too heavy to be airborne, but can be a problem for people that work with these plants every day, such as florists.

What is a Nasal Allergy?

The medical term rhinitis refers to a disorder often characterized by symptoms including an itchy and runny nose, sneezing, and nasal congestion from a variety of causes. One of the most common types of rhinitis is allergic rhinitis or "nasal allergy."


Allergic Conjunctivitis (Eye irritation)

A clear, thin membrane called the conjunctiva covers your eyeball and the inside of your eyelids. If something irritates this covering, your eyes may become red and swollen and this is called conjunctivitis.

When an allergen is the cause of the irritation, the condition is called allergic conjunctivitis. Some common allergens include pollen from trees, grass and ragweed; animal skin and secretions such as saliva; perfumes and cosmetics; skin medicines; air pollution and smoke. Other causes of conjunctivitis are viral and bacterial infections.


Cat Allergy

What Is A Cat Allergy

Approximately two percent of the United States population is allergic to cats. This is caused by a glycoprotein, Fel d-I, secreted by the subaceous glands in cats and is the major cat allergen. This allergen is found in the fur, pelt, saliva, serum, urine, mucous, salivary glands, and hair roots of the cat. The main sources of the allergen, however, are the skin and saliva.

Cat allergen is so small it can remain airborne for months. It is about 10 times smaller than pollen or dust particles. According to research, it can be found in the dust of almost one third of homes that do not own a cat. It can be carried in on clothing or already be present from a previous cat owner.

Cat allergy can play havoc with the eyes, nose, ears, throat, lungs, and skin. The eyes may become red, itchy, watery, or swollen. The nose may itch, run, sneeze, or become congested. The ears may become plugged or itchy. The throat may have post-nasal drip, frequent throat clearing, itching and hoarseness. The lung symptoms may include coughing, wheezing, chest tightness, shortness of breath, and frequent bronchitis. The skin may develop itchy rashes or hives.

Male cats produce substantially more of the Fel d-I protein than female cats. Also neutered males produce less than non-neutered males. These factors, however, do not guarantee a female or a neutered cat will be safe for an allergic individual.

Preventative Measures

Two major factors that affect airborne cat allergen in the home are the quantity of soft furnishings and whether a cat is kept indoors or outdoors.

The "ideal" way to reduce cat allergen in the home is to remove the cat from the home. Once the pet is removed, then all floors should be vacuumed or mopped thoroughly, walls wiped down with a damp cloth, and rooms aired out regularly to reduce the level of cat allergen. A special filter should be used on the vacuum cleaner to prevent re-depositing the allergen into the air. Remember to replace the heating/air system filters during this process. Keep in mind it may take up to 6 months to reduce the allergen in your home.

If removing the cat is not an option, there are ways to reduce the allergen. First, vinyl or hardwood floors are recommended instead of carpet. The use of soft upholstered furniture and draperies should be minimal. Limit the cat to certain parts of the house. The bedroom and living room should be off limits. Research shows a significant reduction in allergen levels if a cat is washed weekly.

Treatment for Cat Allergy

As with any allergy, avoidance is the main course of treatment. A cat allergic individual should avoid being around cats at all times. However, since many cat allergic people ignore the advice of their physician, there are ways to help reduce the reactions. Over the counter medications, prescription medications, air purification, and allergy shots are all ways to treat cat allergy.


Allergy to Dogs

Allergies to dogs can strike anyone at any age. Most people that suffer from dog allergies often have other mild or moderate allergies to pollens or molds. There is a strong genetic correlation in developing allergies, so if your parents have allergies then you are likely to have them also.

Is Any Dog Safe?

No dog is considered non-allergenic because all dogs produce dander, saliva, and urine which are the offending allergens. There are dogs that produce less dander, however. For instance, dogs that shed their skin about every 21 days include poodles, airedales, and schnauzers.

Symptoms

Dog allergens can produce nasal congestion, runny nose, itchy nose, sneezing, itchy and watery eyes, coughing, a scratchy sore throat, itchy skin rashes or hives, headaches, fatigue, difficulties in breathing, and asthma.

Helpful Tips

Be sure to always wash your hands after each time you touch or play with a dog. You may even want to shower and change your clothing.

Dog allergens are small and sticky and can stay airborne for a long time. They can adhere to walls, clothing, carpet, furniture, and heating and cooling ducts. For this reason, it is best to keep dogs away from the bedroom or any other rooms you spend a lot of time.

Avoid using heavy carpets, large draperies, and upholstered pieces that become collecting grounds for pet allergen. If you have carpet, steam clean it several times a year. Wash walls and baseboards also.

The use of HEPA room air cleaners and replacing central heating/cooling system air filters frequently can help reduce the allergen in the air.

Research has shown that if a dog is washed and brushed frequently (not more than twice weekly), the airborne allergens are cut drastically. This task should be done outside of the home. Be sure the shampoo you use does not dry out the dog's skin which may worsen the problem. Remember to also wash the dog's bedding and toys. Feed your dog a well-balanced diet which includes some natural fat that helps reduce skin dryness and flaking.


Pollen Allergy

Each spring, summer, and fall tiny particles are released from trees, weeds, and grasses. These particles, known as pollen, hitch rides on currents of air. Although their mission is to fertilize parts of other plants, many never reach their targets. Instead, they enter human noses and throats, triggering a type of seasonal allergic rhinitis called pollen allergy, which many people know as hay fever. Of all the things that can cause an allergy, pollen is one of the most widespread. Short of staying indoors when the pollen count is high--and even that may not help--there is no easy way to evade windborne pollen.

People with pollen allergies often develop sensitivities to other troublemakers that are present all year, such as dust mites.

Year-round airborne allergens cause perennial allergic rhinitis, as distinguished from seasonal allergic rhinitis.

What is pollen?

Plants produce microscopic round or oval pollen grains to reproduce. In some species, the plant uses the pollen from its own flowers to fertilize itself. Because airborne pollen is carried for long distances, it does little good to rid an area of an offending plant--the pollen can drift in from many miles away.

Among North American plants, weeds are the most prolific producers of allergenic pollen. Ragweed is the major culprit, but others of importance are sagebrush, redroot pigweed, lamb's quarters, Russian thistle (tumbleweed), and English plantain. Samples of ragweed pollen have been collected 400 miles out at sea and 2 miles high in the air.

Grasses and trees, too, are important sources of allergenic pollens. Although more than 1,000 species of grass grow in North America, only a few produce highly allergenic pollen. These include timothy grass, Kentucky bluegrass, Johnson grass, Bermuda grass, redtop grass, orchard grass, and sweet vernal grass. Trees that produce allergenic pollen include oak, ash, elm, hickory, pecan, box elder, and mountain cedar.

One of the most striking features of pollen allergy is its seasonal nature--people experience it symptoms only when the pollen grains to which they are allergic are in the air. Each plant has a pollinating period that is more or less the same from year to year. Exactly when a plant starts to pollinate seems to depend on the relative length of night and day, geographical location, and variations in weather patterns.


What is a Pollen count?

 

A pollen count, which is familiar to many people from local weather reports, is a measure of how much pollen is in the air. This count represents the concentration of all the pollen (or of one particular type, like ragweed) in the air in a certain area at a specific time. It is expressed in grains of pollen per square meter of air collected over 24 hours. Pollen counts tend to be highest early in the morning on warm, dry, breezy days and lowest during chilly, wet periods. Although a pollen count is an approximate and fluctuating measure, it is useful as a general guide for when it is advisable to stay indoors and avoid contact with the pollen.


Mold Allergy

Mold spores cause at least as many allergy problems as pollens. Molds are present all year long, and grow outdoors and indoors. Dead leaves and farm areas are common sources for outdoor molds. Indoor plants, old books, bathrooms, and damp areas are common sources of indoor mold growth.

Three ways to reduce your exposure to mold

  1. Control mold growth indoors
  2. Avoid places where mold is likely to grow
  3. Avoid or reduce activities that can release mold spores into the air.

Avoid such breeding grounds for molds as

  • basements breed mold
  • garages breed mold
  • crawl spaces breed mold
  • barns breed mold
  • compost heaps breed mold
  • woodpiles breed mold
  • fallen leaves breed mold

Ways to discourage mold growth

  • Maintaining the humidity in your house below 50%. Use air conditioners and dehumidifiers if humidity is high, particularly in basements and other damp and enclosed areas.
  • Removing humidity from the bathroom and kitchen by using exhaust fans placed in the ceiling or wall and over the stove to avoid mold.
  • Letting damp clothes and shoes air dry before you put them away.
  • Removing laundry promptly from your washer.
  • Cleaning your refrigerator and empty its water pan at frequent intervals and promptly throw out food that's "gone bad".
  • Making a regular schedule and clean shower curtains and bathroom tiles, grouting, and fixtures with mold-unfriendly solutions.
  • Buying only machine-washable bathroom floor mats and wash them frequently.
  • Stretching out the shower curtain when you leave the shower.
  • Considering reducing or eliminating the number of indoor plants you keep because soil encourages mold growth.
  • Always use a mask when transplanting houseplants or digging in soil.
  • Being aware that holiday wreaths and dried flowers may contain molds.
  • Storing firewood outdoors.
  • Selecting hypoallergenic pillows, mattresses, and furniture rather than those filled with foam rubber because your body's moisture and perspiration can encourage mold to grow in foam rubber.
  • Humidifiers with mold can spray mold spores into the air you breathe. Be sure to clean humidifiers regularly, according to manufacturer's directions.
  • A HEPA air filter may help to remove mold spores from the air inside your home.

Dust Mite Allergy

This is the house dust mite (also known by it's latin name Dermatophagoides). It is a few fractions of a millimeter long and cannot be seen with the naked eye. It lives off dead skin and is present throughout the house. As much as 10-20% of the weight of old pillows may be dead skin. Dust mites, having eaten the dead skin, then leave droppings / excrement everywhere which contains some of their stomach enzymes. It is these stomach enzymes that we are allergic to; these allergies can lead to asthma, excema, but most importantly for us, rhinitis - a blocked, itchy, runny or sneezy nose. This in turn can cause sinusitis and ear problems.

Dust mites like warmth, humidity and dead skin. The ideal room for them to grow in is a bedroom, over centrally heated, under ventilated, with lots of fabric like thick curtains, thick long pile carpet, bedding, cuddly toys, infrequent laundry with only warm water.

Dust mites don’t like cold and dryness. Good ventilation, being exposed to the atmosphere to dry up, direct light. Temperatures over 60 degrees centigrade and under freezing will kill them. Some chemicals will also kill them. The dust mites worst possible room is:

  • somewhere with a dry climate - like the Alps or Arizona
  • no carpet (stone, wood or linoleum)
  • no soft furnishings at all
  • window wide open
  • no heating

How to get rid of Dust Mites

  • Get allergy testing and make sure that you are actually allergic to house dust mite.
  • Generally speaking, although killing mites is initially very desirable, if the dust is left in place, the mites will soon come back, so take action against the dust and the mites.
  • Focus on the bedroom, since this is their major breeding ground.

Step by Step Around the House

Floors: Carpets are an ideal place for dust to settle. The best thing is to get rid of them and either have bare floorboards or vinyl. People in flats may not be able to do this for reasons of noise. In this instance a short pile carpet is a good idea and a very good vacuum cleaner used regularly.

Curtains: Wooden blinds or plastic curtains are ideal. Damp dust them regularly (weekly) to stop the dust building up.

Bedding: Wash all bedding regularly (weekly) in temperatures above 60 degrees centigrade. This gets rid of dust and kill mites.

Mattresses: Mattresses harbour lots of dust. Turn the mattress over regularly and vacuum it with a good vacuum cleaner.

Mattress and Pillow covers: Probably the single most important item to get. They stop the dust getting at the mattress and pillows and stop the mites under them getting out. Get mattress and pillow covers. The mattress and pillow covers will also need to be washed at 60 degrees regularly.

Replace your pillows regularly.

Making the Bed: Instead of making the bed normally, turn the duvet down to expose the mattress and underneath of the duvet every morning and leave it like that until bedtime. This will expose the mites to light, cold and ventilation and dry them out.

Furniture: Upholstered furniture traps dust. Ban all upholstered chairs and sofas from the bedroom. Plastic, leather or wood is fine. In the rest of the house this helps, but is less important.

Furry toys: The best thing is to get rid of them completely and if your child wants something to cuddle, a blanket (especially a cotton one) is ideal, as long as you can regularly wash it at 60 degrees. If parting with teddy is a worse prospect than the underlying problem, then regularly wash it in the machine. Tumble dry on hot to be extra sure or place in freezer for 24 hours which will kill the mites, but not get rid of the dust.
Vacuum Cleaners: Make sure you change the filter regularly.


Over the counter Medications

Drugs for runny nose, sinus trouble, congestion, and the common cold constitute the largest segment of the over-the-counter market for America's pharmaceutical industry. When used wisely, they provide welcome relief for at least some of the discomforts that affect almost everyone occasionally and that affect many people chronically. Drugs in these categories are useful for relief of symptoms from allergies, upper respiratory infections (i.e., sinusitus, colds, flu), and vasomotor rhinitis (a chronic stuffy nose caused by such unrelated conditions as emotional stress, thyroid disease, alcohol, pregnancy, and others). These drugs do not cure the allergies, infections, etc.; they only relieve the symptoms, thereby making the patient more comfortable.

Antihistamines

Histamine is an important body chemical that is responsible for the congestion, sneezing, and runny nose that a patient suffers with an allergic attack. Antihistamine drugs block the action of histamine, therefore reducing the allergy symptoms. For the best result, antihistamines should be taken before allergic symptoms get well established.

The most bothersome side effect that antihistamines produce is drowsiness. Though desirable at bedtime, it is a nuisance to many people who need to use antihistamines in the daytime. Another possible side effect of antihistamines is weight gain.

Typical antihistamines include Benadryl, Claritin, Allegra, Zyrtec, etc.

Decongestants

Congestion in the nose, sinuses, and chest is due to swollen, expanded, or dilated blood vessels in the membranes of the nose and air passages. These membranes have an abundant supply of blood vessels with a great capacity for expansion (swelling and congestion). Histamine can stimulate these blood vessels to expand.

Decongestants, on the other hand, cause constriction or tightening of the blood vessels in those membranes, which then forces much of the blood out of the membranes so that they shrink, and the air passages open up again.

Decongestants are chemically related to adrenalin, the natural decongestant, which is also a type of stimulant. Therefore, the side effect of decongestants is a jittery or nervous feeling. They can cause difficulty in going to sleep, and they can elevate blood pressure and pulse rate. Decongestants should not be used by a patient who has an irregular heart rhythm (pulse), high blood pressure, heart disease, or glaucoma.

Typical decongestants are phenylephrine (Neo-Synephrine), and pseudoephedrine (Sudafed)

Combination remedies

Theoretically, if the side effects could be properly balanced, the sleepiness sometimes caused by antihistamines could be cancelled by the stimulation of decongestants. Numerous combinations of antihistamines with decongestants are available: Allegra-D, Clarinex-D, Zyrtec-D, Claritin-D, et cetera.

Nose sprays

The types of nose sprays that can be purchased without a prescription usually contain decongestants for direct application to nasal membranes. They can give prompt relief from congestion by constricting blood vessels, but can result in a “rebound” congestion effect, which is very unpleasant and undesirable. If the patient uses the spray again, it starts the cycle again. Spray-decongestion-rebound-and more congestion. This can lead to serious “addiction” problems to nasal sprays such as Afrin and therefore we caution their use and limit it to a few days.

Prescription Nasal Steroids and Nasal Antihistamines

Nasal steroids include Flonase, Nasonex, et cetera. They are used for chronic nasal inflammation and congestion from allergies and other causes. They are the mainstay of symptomatic control of nasal symptoms related to allergies. Other nasal sprays include nasal antihistamines (Astelin, et cetera) which can be used in conjunction with nasal steroids or by themselves for nasal vasomotor rhinitis (runny nose).


Allergy Tests & Treatments

Allergy Testing & Evaluation

As an Otolaryngologist and Allergy Trained specialist, Dr. Michael Bublik is specialized in treating disorders related to nasal and sinus allergies. This is important because allergies are not isolated illnesses, but very often have associated sinus and nasal infections, and may accompany other obstructions such as polyps or deviated nasal septum.

As Medical Director of the Allergy Testing and Treatment Center, Dr. Bublik uses methods in the diagnosis and treatment of your allergies that are time-proven not only to identify the specific allergens that are causing your allergic reaction, but also to achieve quick, effective control. He also uses the most cutting-edge, painless, techniques for maximal patient comfort and satisfaction.

There are many methods of allergy testing. Among the more common are

  • Skin tests
  • Elimination-type tests
  • Blood tests

Below are the type of testing that is offered at our office.

Skin Testing

We use a new relatively painless technique to test for allergies. Instead of using individual needles, we combine, it in one “patch” call a Comfort Ten tray which exposes the patient to less needles and is painless and well tolerated. This will pinpoint what you are allergic to. We always want to confirm that you are indeed allergic to what is found and therefore we follow this test by applying a small amount of an allergen (trees, weeds, grasses, molds, mites, dander, et cetera) just beneath the skin causing a small wheal or bleb. This is NOT painful. We allow the allergen to settle under the skin and measure the swelling in about 10 - 15 minutes. Depending on the wheal size, the next allergen will be either weaker or stronger. The amount of injections that you will receive depends on how you respond to the particular antigen that you are being tested for. Most of the patients, even small children, do rather well.

Allergens Tested

You will be tested for what is prevalent in the Los Angeles area. This includes seasonal allergens (Trees, Weeds, and Grasses). You will also be tested for perennial allergens (Molds, Mites, House Dust, Cat and Dog dander/hair) and common food allergens.

Allergy Treatment

Once we have the results of what allergies you have then we consider treatment options. One treatment option starts with avoidance strategies. This can be a very simple task if only one allergen is predominant, such as giving away the family cat or dog, getting rid of mold, et cetera. Avoidance or minimizing your risk for several indoor allergens can be accomplished. If your results show heavy indoor and outdoor allergy, then you may consider Allergy Immunotherapy, which has been used for over 100 years, but has now evolved into a relatively painless and pleasant procedure. Allergy shots or Immunotherapy build up your resistance to the things that cause your symptoms, so the next time you are exposed to them, they will cause you little or no trouble. Overtime the dose of allergens will increase which helps get the body used to the allergens (desensitization). Your immune system builds up a tolerance to the allergens and your allergy symptoms diminish over time.

People that suffer from other nasal symptoms that can be related to allergy, like chronic sinusitis and nasal polyps do very well as well. Patient have a significant improvement in quality of your life and often find they need less or no medicine than before to control your allergies.

Most patients really enjoy their appointments and think of it as a very pleasant experience. It is truly an interactive experience where patients are very involved in their care making it rewarding for everyone.

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