1) Q: Where do patients go for OIT?
A: As of now, a few very select board certified allergists have resources to offer OIT, including Dr. Shah. The number of practices offering it is growing, however, and may become mainstream in coming years.
2) Q: How long will the entire process take?
A: The first day’s procedure will take about 6-8 hours. The time to reach the top maintenance is about 6-8 months, depending on any symptoms during the build-up dosing.
3) Q: What age does my child need to be to participate.
A: We are enrolling children 4 years of age and older.
4) Q: Should routine allergy medications be stopped before the first day procedure?
A: No, it is not necessary.
5) Q: What is the timeline for the months after the first day?
A: Exactly how it goes, depends on each individual child/adult. Patients will come in every week for build-up dosing. If they are having any symptoms we may not increase the dose, or even decrease until better tolerated.
6) Q: What are the most common symptoms during build-up.?
A: By far, gastrointestinal symptoms are most common. Upset stomach, nausea and less frequently, vomiting. Also, patients may complain of an itchy throat after their dose. Though it is very rare, severe allergic reactions or anaphylaxis can happen during OIT.
7) Q: How often can the dose be increased?
A: The interval between dose increases is a minimum of seven days.
8) Q: What should be eaten before dosing?
A: It is important to consume a largely carbohydrate meal before doses are given, either at the Center or at home. Suggestions of foods to eat include bagels, waffles, pancakes, breakfast sandwiches, and fresh fruits on the morning of a visit.
9) Q: What time of day should home doses be given?
A: Twice a day with dosing in AM and PM, with a minimum of 9 hours or a maximum of 15 hours between doses.
10) Q: What precautions should be taken dosing?
A: Avoiding exercising or hot showers just prior and, more importantly, after the dose is given is imperative. The patient should wait at least 2 hours after dosing before exercising. Also, if the patient has a febrile illness we ask that the home dose be held during the illness. Allergic reactions can more commonly occur under these circumstances.
11) Q: How many days can doses be skipped at home and resumed safely afterwards?
A: Doses can be held at home for up to 2-3 days after which dosing can be resumed. If doses need to be held any longer than 3 days, please contact the Center for advice on how to proceed. We may require you to come into the Center to receive the next dose.
12) Q: What about home dosing on the day of the office visit for dose increase?
A: The dose should not be given at home that day. NEVER increase the dose on your own at home.
13) Q: If there is a reaction at home, what should I do?
A: Treat the reaction the same way you would any food reaction; antihistamine if there are mild symptoms (slight rash, itchy mouth or throat, a stomach ache). Give epinephrine (Epi-Pen) if there are other symptoms of anaphylaxis, or above symptoms appear to be progressing. Call us after the appropriate immediate intervention. We will give instructions on future dosing.
14) Q: At what point will we buy our own food?
A: Usually when the patient has reached the 2-3 peanut (or other allergic food) dose. As each case is different, we will inform you during your process. Prior to that we will provide all necessary supplies.
15) Q: What if I need additional doses for travel?
A: Please let us know ahead of time and we will accommodate your needs to the best of our abilities.
16) Q: When should we perform a food challenge?
A: Most patients who are desensitized should eventually be able to consume as much of the allergic food as a full serving size portion. For most patients, it is done at the completion of the OIT process.
17) Q: What is the goal of this process?
A: The goal of therapy is to desensitize patients to an allergic food. This helps reduce the risk, frequency, and severity of anaphylaxis from accidental exposure.
18) Q: What is the follow up schedule when a full portion of the food is being eaten?
A: When the full dose has been reached, we schedule follow ups after 1 month, 3 months, 6 months, and then once a year.
19) Q: What is the success rate in desensitizing patients?
A: The average reported desensitization success rate is 80-95%.
20) Q: What is the cost of the procedure?
A: As OIT is considered an elective process at this point, the coverage and reimbursement varies widely among various commercial insurances. Please check with our OIT coordinator to get the estimate on the out of pocket costs.
21) Q. If a patient has multiple food allergies, will completing OIT for one food help treat other food allergies?
A: Each food OIT process is food specific. Completing one program does not treat other food allergies. Some patients have shown benefit in cross reactive food allergies. Peanut, milk, and egg OIT are done individually. Multiple tree nuts now can be combined in one protein.
22) Q. Where can I learn more?
A: Please visit us at www.Center4AsthmaAllergy.com or call us at (631) 446-1436 for more information.
PLEASE note: frequently asked question responses are NO substitute for in-office physician care and advice.