I had a skin test when I was about 11. That test showed a reaction to maple and mold. A repeat test about age 40 showed no reaction. The most recent test was not a skin test, but one in which they drew blood and tested it for allergies. That is the one that the pulmonologist said indicated a reaction, but no specific trigger was identified by the test. Could an exposure to a virus- sinus infection cause this reaction for the blood test. I still have tons of post nasal drip and a cough/sore throat. I am moving air well, have minimal wheezing and slightly decrease breath sounds in the lower portion of the right side. So far, my asthma seems to be reasonably well controlled despite being in the middle of an infection. I saw my primary doctor today who felt that I am on too many different types of decongestants and my nasal cavity was very dry which could contribute to my persistent sore throat. I am finishing the medrol pack, antibiotics, continuing with advair and singular and taking one decongestant. My primary doctor feels that both advair and asthmamex combined is not necessary considering that my lungs do sound pretty good considering the amount of post nasal drip that is still occurring.
It was interesting, buy we do know the pharmacist who fills our prescriptions. He told my husband that he feels the doctor from the walk in office tends to over prescribe medications. That is the one that added the extra decongestants which have dried me out so. Pharmacists definitely are aware of prescribing habits of local doctors.
What do you do when you have differing opinions?
You ask, “Is it possible for a flare up to cause the test to be positive for an allergic reaction?” It is more likely that the test is positive because that allergen is involved in the airway inflammatory response, which resulted in bronchospasm.
The important thing, in the circumstance of multiple positive skin tests, is to seek a correlation between one of the positive reactions and your real-life, environmental exposure to that allergen.
Your doctor’s medicine recommendations are sound. The principle involved is to gain control of the airway inflammation with the Medrol® (methylprednisolone) and then maintain it with one or more inhaled steroids. Asmanex® Twisthaler® 220 mcg (mometasone furoate inhalation powder) is an effective inhaled steroid. Using it with the Advair® HFA (fluticasone propionate and salmeterol) Inhalation Aerosol is the equivalent of at least doubling your inhaled steroid, so as to better maintain the state of reduced inflammation, accomplished with the Medrol® (methylprednisolone).
A question to be asked is whether immunotherapy such as allergy shots or sublingual immunotherapy (SLIT) might help with your asthma control. You may want to request a board certified allergist’s opinion on this, as well as the pulmonologist’s opinion.
Finally, if with all this medicine and immunotherapy, your asthma remains sub-optimally controlled, you might be a candidate for the administration of a monoclonal antibody called Xolair® (omalizumab). You should also discuss this with both specialists.
Good luck.