2950 East Wattles Road
Suite 300
Troy, MI 48085
P: (248) 524-2121
F: (248) 524-2035
E: info@aaast.com


 

THE DOCTOR SAYS...

Understanding the different over the counter nasal sprays

Posted one year ago

Now that 2 more nasal sprays previously available only by prescription have gone over the counter there are more choices and more confusion. How do you decide which one is right for you or your child? There are 3 types of sprays available.
1. SALINE NASAL RINSES. These are safe to use for everyone. They come in different sizes and force of spray, multiple brands including the store brands are ok to use. Pick whichever is most comfortable for you, a nasal spray where there is more volume of liquid per spray versus a mist in a squeeze bottle or canister. If you choose to use a Neti Pot or a bottle such as a Neil Med where you mix the saline packets or uniodized salt in water the FDA recommends only using distilled, boiled, or properly filtered water to prevent infections from contaminated water. If using boiled water make sure to let it cool to warm or room temperature prior to using. The hypertonic solutions contain more salt to draw out more mucus but can be more irritating.
2. NASAL STEROIDS. There are now 3 different nasal steroids available over the counter. Nasal steroids are recommended as one of the first lines of medical treatment for allergic rhinitis. They help shrink the swelling in the nose that causes nasal congestion , sinus and ear pressure as well dry up the mucus to prevent the runny nose and post nasal drip which make you miserable during the allergy season. They typically take about three days to start working and peak efficacy can be 1 or 2 weeks. This is why you want to start them early in the season and use them on a regular basis through the season. The most common side effect is irritation of the nose and nosebleeds. Discontinue them if bleeding occurs. FLONASE or fluticasone is still available as a generic prescription and the same medication is now in the CLARISPRAY. Some people do not tolerate this spray because of the flowery smell of the preservative. NASACORT and RHINOCORT are both scent free and have less volume per spray so are sometimes tolerated better by children. RHINOCORT or budesonide is the spray that is category B for pregnancy and the other two are category C. (category B drugs are preferred during pregnancy)
3. NASAL DECONGESTANT SPRAYS. This category of nasal spray includes medications like AFRIN, DRISTAN, SINEX and VICKS (the nasal spray not the vapor rub) which contain OXYMETAZOLINE and NEOSINEPHRINE which has PHENYLEPHRINE. All of the major stores may have their own brand as well. They work great. Within minutes of using them the nose will be less stuffy. However, these sprays cannot be used for more than three days because they are addicting and can cause rebound swelling in the nose that can be worse than what you originally had. Also decongestants even in the nasal spray can aggravate high blood pressure, heart disease, thyroid disease and enlarged prostate.
4. ESSENTIAL OILS. Many find these to be very helpful particularly eucalyptus, peppermint, lavender, lemon, rosemary and tea tree oil. However many individuals with vasomotor rhinitis, which is a very sensitive nose to certain smells and weather change will actually experience a worsening of their symptoms or headaches and need to be cautious. In those who are very sensitive to the pollens some of the botanicals can aggravate their symptoms. Pay attention to proper dilutions, doses and purity. Do use a reputable company. Do not eat or drink them and be very careful with use around small children. Misuse has caused children to stop breathing.

Spring is in the air!!

Posted one year ago

Due to the unseasonably warm weather the spring pollen season has come early and is predicted to be a “bad one”. Plants are already blooming and tree pollen is in the air. It is time to resume your antihistamines and nasal steroids. Flonase, Nasacort and Rhinocort are available over the counter. The generic of Flonase, fluticasone is still available as a prescription. Allergy medicine works best if started early and taken preventatively. If nasal steroids and antihistamines haven’t controlled your allergy symptoms in the past adding montelukast (Singulair) may be an option. Sublingual immunotherapy to grasses and ragweed is available. You are able to desensitize yourself by placing the tablets under your tongue daily at home. Contact the office if you are interested. These do need to be started weeks before the season starts to be effective.

Remember that the pollen count is highest between 5 am and 10 am so you may want to avoid doing outside activities during that time. Do monitor the pollen count at www.pollen.com. Shower and change your clothes when you come home in the evenings. Do take off your shoes at the door and don’t forget that your pets will bring pollen in the home as well. Keep windows closed when the count is high. The counts decrease when it rains and will increase after it rains. They are highest when it is dry and windy. Insect allergic patients make sure you remember to check the expiration dates on your Epi-Pen devices. Please call the office if you need any refills and if you still have an Auvi-Q please be aware that those devices have been recalled and you will need to get it replaced with an Epi-Pen.

Don’t let allergy symptoms keep you from enjoying your spring.

Dr. Ross

Happy New Year!!

Posted one year ago

HAPPY NEW YEARS!

I hope all of you have enjoyed your holidays and welcome to 2016. Let’s be proactive in making this a year of good health.

Do be vigilant in avoiding your food and environmental allergens. Read labels and always carry your Epipens. Auvi Qs have been recalled and you should have exchanged them for Epipens. Now is a good time to make sure your homes are as allergy free as possible. Is it time for new pillows? They should be changed every year or two. They are a significant source of dust mites, mold and bacteria. Do cover them with allergen covers. Make sure your furnace filters have been changed and that your humidifiers are working. Keeping well moisturized is key in keeping your eczema under control especially during the winter months.

Take your medications as prescribed. If you have changed insurances or the formulary has changed and your current medications are no longer covered please let us know so we can provide an appropriate substitute. Especially at this time of high deductibles we are aware of how expensive medications are. Please do not let financial hardship cause you or a family member to be ill. Contact us and we will do our best to help you.

Staying fit and eating well can improve your lung function, sinuses and skin, decreasing the need for medications and cost of health care.

Do allow us to assist you in your commitment to wellness this year!

Dr. Ross

Enjoy the Holidays!

Posted more than a year ago


Don’t let allergies and asthma keep you and your family from having a joyful holiday season. By planning ahead potential allergy triggers can be avoided.

1. Make sure holiday decorations and artificial Christmas trees are free of dust from storage. You may need to wear a mask when bringing things out of storage. Wash your hands after handling ornaments and decorations. Store them in plastic containers in dry areas.
2. Before visiting friends or relatives explain what your allergy triggers are and ask that they put pets away, not burn scented candles or fires in the fireplace.
3. If you have children with food allergies make sure that foods which may contain what they are allergic to such as nuts are put up high and are labeled. Make sure there is one serving spoon per dish so that there is no cross contamination. Always bring a dish or snack that you know is safe to eat and have your EpiPen readily available. Teach your child not to share food and to ask you if something is safe before eating it since other adults may not be as vigilant about reading labels. Young children should wear food allergy ID bracelets.
4. Rinsing the trunk of a live Christmas tree and letting it fully dry before bringing it in the house can reduce some of the mold spores and sap, however the piney scent can still be an irritant.
5. Unfortunately we are also in cold and flu season as well so try to avoid those who are sick, get your flu shot and wash your hands regularly.
6. Keep your holiday plans simple and as stress free as possible. Do not over extend yourself. Feel free to decline invitations and say no to school or church projects.
7. Make sure you have all of your medications prior to going on vacation. Please call us for prescriptions.

We wish all of you a happy and safe holiday season.

Dr Ross and staff

MAKING YOUR HOME ALLERGY FREE THIS SEASON

Posted more than a year ago

The house is closed and the furnace is now on. Did you get your house in shape before the holidays are upon us? These are a few things you can do to cut down on your family’s allergy exposures in your home.

1. Make sure you have the right air filter on your furnace. It does help remove irritants and allergens from the air. Make sure it is HEPA (high efficiency particulate air) rated and large enough to filter the space it is needed for. Do clean or replace your filters on a regular basis.
2. Minimize your knick knacks, books, magazines, wall hangings and photo displays to decrease dust collection.
3. Wipe down your plants. Clear away any dead leaves and to avoid mold spore growth, water only when the soil is getting dry and use just enough to keep the soil moist. Once winter hits many indoor plants go dormant and may need less water.
4. Monitor the humidity in your home. As the weather gets colder, humidity levels drop and can aggravate asthma and eczema. Get a hygrometer at any hardware, discount store or online to measure the humidity in the air. The humidity should be kept between 35 % and 50%. Invest in a humidifier if your home becomes to dry.
5. Your pillows and mattress should be covered with allergy covers. Both are major sources of dust, mold and bacteria. Pillows should be replaced every 1 to 2 years. Wash your bedding in hot water.
6. Keep pets out of the bedroom and have them groomed regularly to decrease dander exposure.
7. Leave your shoes at the door to prevent tracking allergens into the home.
8. Have adequate ventilation in the home. Use exhaust fans to decrease moisture when cooking and showering. Remember to clean them often as well as any ceiling fans you may have.

HALLOWEEN SAFETY!

Posted more than a year ago


Halloween can be a frightening time for children with allergies and asthma. Keeping your child safe requires planning ahead. These simple measures can keep the fun in Halloween and reduce the scare.

1. Purchase treats your child can safely enjoy and swap them for treats with allergens that your child may have gotten trick or treating. Emphasize to them the importance of not eating anything until you have inspected the treats. Read labels carefully. If you are not sure of what is in the food don’t let your child eat it. Be sure that you do have an epinephrine device on hand just in case.
2. If your child has asthma consider having them use their quick relief inhaler before going out trick or treating. Running from house to house especially in the cold air can trigger an asthma attack. Do make sure that they are carrying their inhaler with them in case they do develop symptoms.
3. Beware of potential allergens in Halloween costumes. Costumes retrieved from storage can be dusty. If your child has problems with latex be sure that the costumes and masks are latex free. Avoid masks that interfere with your child’s vision. Read the contents of Halloween make up to be sure that it does not contain preservatives or ingredients that may cause a contact dermatitis.
4. If your child is mold allergic discourage them from jumping in the leaves which can cause the mold to stir into the air and trigger an allergic reaction.

WISHING EVERYONE A SAFE AND HAPPY HALLOWEEN!!!

BACK TO SCHOOL!

Posted more than a year ago

Summer is winding down and it is now time to prepare to go back to school. For children with asthma and food allergies we need to make sure that everything is done to involve the school in helping to manage their care. That means there will be several school forms that need to be filled out. If the parent portion of the school forms are filled out when I get them it makes it alot easier for me to fill them out and get them back to you in a timely manner.

Please put the name of the inhaler you will be sending and whether your child will need to take it prior to gym or recess as well. Most school forms have the physician check whether the child should be allowed to carry his or her inhaler on their person. I believe that you know how responsible your child is better than I do, so please indicate whether you would like them to carry their inhalers on them and self administer them.

In addition to the forms giving permission for the medications to be at school for those with asthma there should be an asthma action plan and for those with food allergies a food allergy emergency plan. Know if your childs classroom will be allergy free and the lunch room policies for manging food allergies. Is their an allergy free table and does your child need to sit there? What do they do to make sure your child doesn't feel ostracized and alone at lunch? Where are the Epipens or Auvi Qs and who in the school knows how to use them? If you do have the Auvi Q make sure your school staff is familiar with it.

Wishing everyone a safe and successful school year.

Dr. Ross

Those Pesky Bugs!

Posted more than a year ago

This is the time of year that insect bites and stings occur. The reaction most people have is local swelling,itching, warmth and pain.

Treatment for a normal reaction: Clean the area. If there is a stinger remove it by scraping it off with a flat surface such as a credit card. Do not use tweezers or your fingertips, this may cause more venom to be squeezed out into the sting area. Apply ice or cool compress to reduce swelling. Apply anti-itch medication such as hydrocortisone and take an antihistamine. DO NOT SCRATCH! It will increase the swelling and put you at risk for a secondary infection.

Symptoms of a systemic allergic reaction: Hives, itching or swelling in areas other than the bite or sting site.
Throat or tongue swelling
Difficulty breathing
Stomach cramps, nausea, vomiting or diarrhea
Dizziness, lightheadedness or severe headache

If any of these symptoms occur use your epinephrine device if you have one and call 911. Seek immediate medical attention. Anyone who has had a severe reaction to an insect sting should have venom allergy testing and is a candidate for allergy shots to venom. We do like to wait at least 6 weeks after the sting to do any testing. You must start carrying an epinephrine device at all times

What about ticks? Ticks are found in the grass and on shrubs. They can attach to people as they walk by. One type of tick does spread Lyme disease, but to do that it must remain attached for a while in order to give you the infection. If bit by a tick gently remove the tick from you skin using tweezers grabbing it as close to the skin as possible and pulling it straight out.

Ways to reduce your chances of being bit or stung:
Wear shoes, long sleeved shirts and pants when outside , especially at dusk when the mosquitos are worse.
Tuck your pants into your socks if you are concerned about ticks.
Avoid wearing brightly colored clothing.
Do not wear perfumes and cologne.
Keep food and drinks covered when you are outside.
If you see a stinging insect, stay calm and slowly back away. Do not swat at it.
To prevent mosquito bites wear insect repellant with DEET. Spray your clothing if you wish to avoid having it on your skin. DEET does not prevent stings.
Drain areas of standing water near your home. Mosquitos breed in standing water.
If you find an insect nest in or near your house, call a pest control service to get rid of the nest safely.

Spring is in the air!

Posted more than a year ago

Spring is officially here and it is time to implement measures to prevent pollen and mold allergy symptoms.

  • Do monitor the pollen count. Keep windows in your home and car closed when the pollen count is high.
  • Wear longsleeves, gloves, and a mask when doing yard work.
  • Avoid placing plants that you are allergic to close to window and doors.
  • Shower before going to bed.
  • Wipe off pets after they have been outside and bathe them more frequently.
  • Do saline nasal rinses at the end of the day to help wash out pollen grains and relieve symptoms.
  • Start your nasal steroids.
  • Take your antihistamines proactively. Do not wait until you are miserable.
  • Those of you with sting allergies be sure to update your Epi Pen or Auvi-Q prescriptions.
  • Please be on time for your allergy shots and be sure to let us know if you have been having allergy symptoms. The risk for a reaction is higher during the pollen season.

Brrrr It's cold outside!

Posted more than a year ago

The cold air can cause your nose to run and your asthma to flare. The dryness in the cold air is thought to be the primary asthma trigger. When an individual with asthma rapidly breathes in the cold air, it can sap the humidity from the mucus membranes in the lining of the airways causing inflammation and constriction. Therefore if you have asthma do cover your mouth when out in the cold. Try to breath through your nose so the air is warmed before it hits your lower airways. If you are going to be engaging in any physical activity in the cold air use your bronchodilator before going out and dress appropriately.

BACK TO SCHOOL

Posted more than a year ago

Summer is winding down and it is now time to prepare to go back to school. For children with asthma and food allergies we need to make sure that everything is done to involve the school in helping to manage their care. That means there will be several school forms that need to be filled out. If the parent portion of the school forms are filled out when I get them it makes it alot easier for me to fill them out and get them back to you in a timely manner.

Please put the name of the inhaler you will be sending and whether your child will need to take it prior to gym or recess as well. Most school forms have the physician check whether the child should be allowed to carry his or her inhaler on their person. I believe that you know how responsible your child is better than I do, so please indicate whether you would like them to carry their inhalers on them and self administer them.

In addition to the forms giving permission for the medications to be at school for those with asthma there should be an asthma action plan and for those with food allergies a food allergy emergency plan. Know if your childs classroom will be allergy free and the lunch room policies for manging food allergies. Is their an allergy free table and does your child need to sit there? What do they do to make sure your child doesn't feel ostracized and alone at lunch? Where are the Epipens or Auvi Qs and who in the school knows how to use them? If you do have the Auvi Q make sure your school staff is familiar with it.

Wishing everyone a safe and successful school year.

Dr. Ross

Spring is finally in the air!

Posted more than a year ago

After a very looong cold winter it is slowly beginning to feel like spring. The temperature is warming up, the trees are starting to bloom and those of you with pollen allergies may be starting to sniffle and sneeze. Yes, it is time to resume your nasal steroids and take your antihistamines. Please call the office if you are in need of refills. If you haven't been seen in the past year you are due for an office visit. Those of you with asthma should be seen every six months.
Do start monitoring the pollen count at www.pollen.com.

HAPPY NEW YEAR!!!

Posted more than a year ago

2014 has brought frigid temperatures that can literally take your breath away. For those of you with asthma do try to minimize your time outside when the temperature is extremely low. If you have to go out, do cover your mouth with a scarf and try to breath through your nose to warm the air before it hits your lungs. You may need to increase the dose of your controller medication and/or take your quick relief medication prior to spending any significant time outside. Please be very careful with snow shovelling. If you do have to shovel take your quick relief inhaler first and take frequent breaks as needed. Try to push the snow as opposed to lifting it to prevent injuries.

Do be careful and dress appropriately for the weather. Please check your expiration dates on your inhalers. Contact the office if you require refills. Some of you may have to change your medications due to a change in your prescription formularies. Check your policies and let us know.

Dr. Ross

Recommendations for an allergy symptom free holiday!

Posted more than a year ago

Premedicate with your allergy and asthma medication prior to bringing out the holiday decorations from wherever they have been stored. Consider wearing a mask if the storage area is particularly dusty.

Wash the Christmas tree, particularly the trunk prior to bringing it in the house. This helps remove the mold spores,pollen and terpene, an allergenic substance found in the sap of the tree. Wait until the tree is fully dry before bringing it in. Live trees can be a significant trigger for many with allergies and asthma so you may want to stick to an artificial tree.

Be cautious about visiting homes that contain known irritants and allergens such as, wood burning stoves, scented candles, potpourri, plug ins, cigarette smoke or pets. Ask your hosts to refrain from using fragrances and smoking while you are there. Made sure you have taken your asthma and allergy medication prior to going and that you have your quick relief inhaler with you.

Cover your mouth when out in the cold air if you have asthma.

Don't share or offer food to children other than your own. Use one serving spoon per dish to avoid food allergen cross contamination.

As always if you have food allergies don't eat it if you don't know what is in it and always carry your epinephrine device.


Have a happy and safe Holiday Season!

Dr. Ross


OH NO COLD SEASON IS HERE!!!

Posted more than a year ago

The average adult experiences 2 to 3 colds per year, while children average 8 to 12 per year. People with colds tyically carry the cold virus on their hands, where it can infect another person for at least 2 hours. Some cold viruses can live on surfaces such as door handles, keyboards, phones for several hours.

Handwashing is an essential and highly effective way to prevent the spread of infection. Hands should be wet with water and plain soap. Rub them together for at least 15 to 30 seconds. Pay special attention to fingernails, between the fingers and the wrists. Rinse thoroughly and dry with a single use towel. If a sink is not available use an alcohol based hand rub.

Viral infections are the number one trigger for asthma. If you or your child has asthma start or increase your controller medication first sign of a cold. Colds typically last 5 to 10 days. Treatment with an antibiotic is not helpful and puts you at risk for developing resistant organisms. If you have difficulty controlling your asthma or your cold symptoms persists do contact us.

Maintaining sinus health during the cold and flu season is challenging. Now that the house is closed up and the heat is on, do make sure that you changed your furnace filter and that your humidifier works. Keep well hydrated and do saline nasal rinses to keep the nasal discharge thin.

Dr. Ross

Halloween Safety

Posted more than a year ago

If your child has asthma running from house to house, especially in cold air can trigger an attack. Make sure their asthma is well controlled. Consider giving them 2 puffs of their quick relief inhaler prior to Trick or Treating and have them carry it with them.

Halloween is especially dangerous for the child with food allergies. For school parties parents should volunteer to be there if possible. Do provide treats that your child can safely eat and discourage them from eating anything that is not on a pre-approved list. Enlist the help of the teacher and other parent volunteers. Do not let your child eat while Trick or Treating. Read all product labels carefully before allowing your child to indulge in any treats. If you don't know what's in it don't let them eat it. Be sure to have benadrly and an epinephrine device readily available. Do check the expiration dates on your epinephrine devices now.

Enjoy your Halloween and be safe!!!!!

Flu Shot Reminder.

Posted more than a year ago

If you have asthma, it is especially important to protect yourself from the flu. Even if your asthma is well controlled influenza infection can trigger asthma attacks and lead to pneumonia. People with asthma should get the flu shot made with inactivated flu virus and not the nasal spray. To protect your loved one at home with asthma all family members over 6 months of age should be vaccinated against the flu.
If you do get the flu, it can be treated with antiviral medication, but it must be started within 48 hours of the onset of symptoms. Avoid the antiviral drug Relenza (zanamivir) if you have asthma because it may causing wheezing in asthmatic individuals.
Keep you and your family safe from the flu this cold and flu season.

Back to School Again

Posted more than a year ago

Summer is quickly coming to an end. The kids are going back to school. Make sure they have updated inhalers and if needed Epipens. There is a new epinephrine device called AuviQ which is smaller and actually talks to you. We have trainers here you can try as well as coupons for both at the office. If your child hasn't been seen for a year do set up an appointment. We are be bombarded with school forms to fill out. Please fill out your portion. Let us know the name of the medications you want in the school, indicate if you wish them to carry and self admimister them and if you would like them to use their inhaler before gym or recess. Also include whether the benadryl will be the generic, liquid, chewables or 25mg pills so there is no confusion in dosing. Thank you. If we have all the necessary information we will have your school forms ready for you within 1 to 2 business days.

SPRING IS HERE!!!

Posted more than a year ago

It's time for those of you with pollen allergies to start your steroid nasal sprays and daily antihistamines. Do monitor the pollen and mold count. Wear a mask when doing yard work. Change your clothes, take a shower and wash your hair after being outdoors.

The Winter Itch

Posted more than a year ago

Winter often brings dry skin leading to chronic itching, red, chapped and cracked skin and eczema flare ups. Prevention is key. Keep well moisturized. Soak your skin in warm water, towel dry gently and immediately apply your moisturizer. Creams and ointments tend to be more effective. Drinks lots of water, Make sure you are running a humidfier, keeping the humidity between 40 to 45 %. Higher humidities can promote dust mites and mold to thrive. Wear clothes that breath such as cotton. Avoid irritating fabrics like wool and clothing that is too tight. Also avoid harsh soaps and strong cleaning products. Try to minimize stress which can be an aggravating factor. Take antihistamines to control ithching if needed, however in the winter they can be very drying.

Brrrr it's freezing outside!

Posted more than a year ago

Winter is bringing the cold air. For those of you with asthma this can be a significant asthma trigger. If you do have to be outdoors cover your mouth and nose to keep the cold air out of the airways. Breathing through your nose will warm the air before it reaches your lungs. Taking your quick relief inhaler (albuteral) 15 to 20 minutes prior to going outside can prevent asthma symptoms especially if you are going to be participating in winter sports or have to shovel snow. Do dress warmly and wear appropriate footwear, head gear, gloves or mittens. Warm up prior to cold weather activities. Go back indoors if you start having any asthma symptoms or signs of impending frostbite.

Prepare to enjoy the holidays

Posted more than a year ago

Enjoying the holidays when you have allergies and asthma is easier if you plan ahead. The holidays are filled with foods to be avoided by people with food allergies. Inform family members and friends of dietary restrictions so that there are safe foods available. Offer to bring allergen-free dishes that complement the meal. If you have children with food allergies make sure that there are no snacks or appetizers in easy reach that may contain the foods they need to avoid. ALWAYS carry Benadryl and 2 Epipens.

When going to someone else's home, inquire if they have any pets. Do be cautious about potential smoke exposure including those burning wood in a fireplace or wood burning stove. Do premedicate with your antihistamine and take your asthma medications as prescribed. Be sure to have your quick relief inhaler with you.

Wishing you a safe and joyful holiday season!

Dr. Ross

Back to School

Posted more than a year ago

Summer is winding down. It's time to make sure your child is prepared for the school year. Contact us for refills on your epi-pens and inhalers. If it has been over a year since your child has been seen an office visit may be needed. Call for an appointment. All children with food allergies and asthma need an emergency plan for school. Make sure you get the appropriate forms from your school. Please fill out the parent portion and the names of the medications you are sending to school. Let me know if your child will need to use his or her inhaler prior to gym or recess and if they have any cold air restrictions. You know your child best to determine if he or she is responsible enough to carry their inhaler and/or epi-pen on their person. Do find out who in your school knows how to use the epi-pen and inhalers if your child needs them. I will try to get school forms done within 24 hours of your getting them to me. The more information you provide me the more efficient I can be.

Thank you for your cooperation and for allowing me to participate in your childs care.

Dr. Ross

4TH OF JULY HOURS!

Posted more than a year ago

We will be closed on Thursday July 5th, Friday July 6th and the morning of Monday July 9th we will reopen Monday July 9th @ 1:00.

ARE YOU READY FOR SUMMER?

Posted more than a year ago

Summer is here but to truly have fun in the sun you must be prepared. Hives and eczema can be triggered by heat or sweat so make sure you and your kids are drinking plenty of fluids, avoid becoming too hot and wear sunscreen. (Don't forget to reapply) Watch out for poison oak, sumac or ivy which can lead to severe rashes. Learn to recognize them, remember "leaves of three let them be". Monitor the pollen count (www.pollen.com). Try to avoid doing outdoor activities and keeping your windows open when the pollen count is high. Take your antihistamine before pollen exposure. Avoid insect stings and if you have a history of sting allergy make sure your epi-pen is updated.

This is Dr. Ross wishing all of you an enjoyable summer. Please contact the office during our open hours for refills and follow up appointments. Atheletes don't wait until the end of summer to start conditioning for your fall sports.