Dr Hibberd firstly takes a detailed HISTORY of the presenting disorder, then a general past medical history, then a family medical history, and a social history of the patient: occupation, smoking, drugs etc.
NEXT he does a relevant physical EXAMINATION – nose, lungs, skin, abdomen etc.
NEXT he performs SKIN PRICK TESTS for a range of allergy-precipitating agents known as ‘allergens’. These tests are for immediate sensitivities (reactions within 5 to 20 mins), and embrace airborne allergens such as plant pollens, dust mite, mould spores, and animal danders (cat, dog, and horse). They also test for foods (such as peanut, egg white, cow’s milk, soy etc.), and candida yeast These are ‘classical allergies’.
It is now known, scientifically and clinically, that there are DELAYED ALLERGIES, and that these operate within a different pathway in the immune system. They are most common among foods, but can also be manifested in reactions to certain airborne chemicals. There are no tests for these, since research lacks somewhat in this area. Diagnosis is made by diet work, and avoidance, if possible, of suspect chemicals.
IF skin tests come up positive Jack orders RAST blood tests, which more accurately indicate the degree of allergy.
IF the RASTs to airborne allergens and to insect venoms (bee and two wasps) are at moderate or high levels, then courses of DESENSITIZATION injections can be carried out to block the the appropriate allergy or allergies. This entails injecting the patient with the allergens (in gradually strengthening doses) to which she or he is allergic. Uninformed medical opinion has it that these are not safe. They are VERY SAFE, since the allergen now is slowly released over 24 HOURS.
DESENSITIZATION is some 90% successful with hay fever, 80% with eczema, and 70% with asthma. Good odds. There are other allergic causes of these disorders than can be addressed beside desensitization.
IF immediate sensitivities are not prominent, then attention is focused on DELAYED, mainly to FOODS and YEASTs. Preliminary (mild) and more restricted diets usually help, along with serial reintroductions of foods – like tests (‘challenges’) – which can nail a culprit food, or foods, by provoking typical symptoms.