dr. peter c. s. lee

If your first visit is going to be over the phone, Dr. Lee will be collecting information such as medication lists, your past medical history, and notable family history, etc. Complete the history form to have the information on hand and ready for the call, or send it in for us to upload to your chart.

If you have moved or changed phone numbers during the time you had to wait for your appointment, please update our office so that you do not miss your telehealth appointment.

If your first visit is a telehealth consultation, please download and complete the history form and have the information ready for your telephone consultation (e.g., family history, medication lists, etc.) You may also send it to us ahead of your appointment via the secure upload link below. This will help us prepare and ensure a more efficient consultation.  

You may upload your history form or other information through our secure encrypted file transfer link before your telehpone or in-office appointment. If sending photos or documents, make sure that your name is in the filename to identify and file to your chart.

To make the most of your visit and avoid having to rebook your skin scratch testing, please do not take any antihistamines such as Reactine, Allegra, Blexten, etc. for 5 days prior to the appointment. If an antihistamine is required, you can use Benadryl only (diphenhydramine) up to 24 hours prior to your appointment.

Medications with antihistaminic properties, such as tricyclic antidepressants like amitriptyline and nortriptyline, should be discontinued prior to the test. (Please always check with your prescribing physician before discontinuing any medications.)

Also, note that some over the counter sleep aids and nighttime cold medications may contain antihistamines. For pretatal patients, diclectin is also an antihistamine.

Other medications, including pseudoephedrine, prednisone, asthma treatments, nasal sprays, topical creams, eye drops, or regular allergy injections may be continued.

We can test most common foods (nuts, dairy, wheat, seafood, etc.) and aeroallergens (grass, tree and weed pollens, mold) with extracts that we have in the office.

Feel free to bring other food items you may suspect could be causing you an allergic reaction, such as fruit, vegetables, spices, alcohol, and processed foods.

We do scratch testing with plastic DuoTips.  

A drop of extract or a sample of a fresh food item will be collected between the bifurcations on the tip and then scratched on the surface of the skin.  This will be done on the forearms in most patients.  Young children may be get the scratches on the back to avoid the child rubbing or scratching the area and compromising the accuracy of the test. 

One control is done to confirm that there are no antihistamines in the system, so at least one spot should develop an itchy welt like a mosquito bite.  Depending what you might test positive to, several welts of varying sizes may develop.  The itching is temporary and antihistamines can be used after the test.  Cold applied to the area may also help alleviate itching until the welts resolve. 

Past testing is done to test for contact allergens. The testing includes 80 different causes of contact allergies, such as things found in household, workplace, and health and beauty products such as: 

• Adhesives
• Fragrances
• Ingredients used in soaps, shampoos, hair dyes and cosmetics 
• Materials used in making clothes or shoes
• Metals
• Preservatives
• Plastics, resins, acrylates, rubber additives
• Topical medications

The link below lists all the compounds that will be included in your patch test in our office. 

North American 80 Comprehensive Series 

Patients must attend all three appointments. In some circumstances, you may be able to photos send in for the third appointment. Please discuss this with the office. All testing is booked on Fridays, Mondays, and Tuesdays only, as we have other testing procedures scheduled throughout the week. 

You will get eight patches placed on your upper back. Patches need to be placed on clean, dry skin, so shower before you attend your appointment and avoid applying any lotions to the area. 

For men who have excessive hair, this can cause the patches not to adhere properly, so shaved skin is recommended for the best results. As irritation may occur from shaving that may make the results difficult to read, we recommend shaving a week prior to the scheduled appointments. 

Some of the compounds may stain clothing, so wear something that you won't mind possibly getting discolored. 

The patches need to stay in contact with your skin at all times until the doctor has taken them off at your follow-up visit.

After the patches have been off the skin for 24 hours, they will be observed again.  This will allow any possible irritation from removal of the patches to resolve and results to be more visible. Any late reactions may also be observed at this time. 

If you have arranged to send in photos on Tuesday, please see instructions here. 

Results of the testing will be given once the final observations are done on Tuesday.

We often recommend patients to check out the SkinSafe website or app, where they can look into ingredients found in health and beauty products to help them avoid contact with them. It is free to use for basic features so you are not required to pay unless you want to use more premium features.  

For steps on how to access the free SkinSafe version CLICK HERE. 

Penicillin testing is a two-part test and may take anywhere from 45 minutes to approximately 2 hours. Once testing has commenced, the patient will not be able to leave the office until discharged.

Penicillin testing is done on Wednesdays and some select Thursdays. Please do not ask to rebook to another day of the week as our weekly schedule is based on different testing procedures. Be aware that rebooking may also delay your test considerably as spots are limited and in high demand.

There is a $30 charge for the Pre-Pen supply that will be used for the test.

No debit or credit card payments are available.
We accept cash, cheque, or e-transfer. Be aware that cheques may not be deposited right away. A receipt for medication (Pre-Pen) will be provided.

There will be an initial scratch test consisting of 2 intradermal scratches. If the result is positive, the test is over with a positive result for penicillin allergy.

If the scratch test is negative, it is safe to proceed to the challenge portion of the test. During this part of the test, incremental doses of penicillin in the form of amoxicillin will be given orally until a cumulative dose is reached.

As this is an allergy test, no antihistamines should be taken for 5 days prior to the appointment (see SKIN SCRATCH TEST INSTRUCTIONS).

FOR PRENATAL PATIENTS

Penicillin testing is scheduled according to the availability of penicillin and due dates of patients. We try to schedule patients at least a month or longer before their due date for the skin testing. In many cases, the challenge portion of the test is booked around the 37-week mark to coincide with the completion of group B strep swab testing.

Penicillin testing in safe during pregnancy. For more information see this patient information sheet by BC Women's Hospital here.  

Patients may be asked to come in for an oral challenge appointment. This may be for food or a drug. The duration of these tests is from 1 to 2 hours. Once the testing has commenced, patients will have to remain in the office.

FOOD CHALLENGE

For food allergies, patients will be asked to bring in a particular food item. The patient will be asked to consume small incremental amounts of food throughout the morning until a reasonable amount has been eaten. The patient will be monitored in the office.

DRUG CHALLENGE

For drug allergy testing, the patient may be given a prescription the morning of their test and sent downstairs to the Pharmasave to have it filled. They will then take the doses of the drug in the office and be monitored until a cumulative dose is reached.

We book these early morning or early afternoon due to the potential length of the appointment. A limited number of challenges can be done in a day, so rebooking may delay testing considerably.

Pulmonary function testing in Victoria is done at the Royal Jubillee Hospital 

Royal Jubilee Hospital 

1952 Bay Street

Royal 4

Victoria, BC V8R 1J8

Phone: 250-519-1642

Royal Jubilee Hospital on Google Maps

If you need to cancel or rebook your appointment, please call the booking office at the above number so that your spot can be given to someone else.  This helps to keep wait times lower for everyone. 

Please make sure to review the instructions for the test that is requires, as instructions differe depending what you are being tested for. 

Pulmanory Function Testing/Spirometry Instructions 

Royal Jubilee Hospital Parking Map 

Royal Jubilee Hospital Site Map

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OTHER LOCATIONS FOR PULMONARY FUNCTION TESTING 

Cowichan District Hospital - PFT Instructions 

Nanaimo Regional General Hospital - PFT Instructions

Nanaimo Regional General Hospital -  Methacholine Challenge Test (MCT) Instructions  

If you are prescribed year-round allergy shots, here are some management tips to help you with your treatment. 

Duration of Treatment: 

The duration of treatment is approximately 5 years, but this may vary from patient to patient. Initially this will start with several months of weekly shots before moving onto montly maintenance shots. 

It may be some time before patients notices improvement of their symptoms, and antihistamines can be used in conjunction with immunotherapy as needed. 

When to order more serum: 

It takes about 4 weeks for serum to be received, so ensure that when your vial starts to get low you contact our office to arrange a refill prescription. 

Annual Reassessments: 

All patients on immunotherapy should be reassesed on an annual basis.  We cannot authorize any prescriptions if the patients has not been seen over a year or longer. 

Patients who are on preseasonal allergy shots will be prescribed serum before the start of the allergy season. This is a series of approximately 12 injections given before the onset of the pollen season. Injections should be completed in the early spring in order to be effective for the upcoming pollen season.

If a patient wishes to do preseasonal immunotherapy the following year, they should arrange an appointment several months in advance due to our long waitlist.

Patients on any form of immunotherapy should be reassessed every year during the treatment.

Grass tablet therapy should be started early in the year in order to be effective for the onset of grass pollen season.

Patients will be given the first test dose in the office to ensure it is well tolerated and are asked to wait 30 minutes in the office afterwards. Patients may experience itching in the oral cavity that should start to dissipate within the 30 minutes.

Patients needing to return for another year of therapy should book in advance due to the high demand.

Patients on any form of immunotherapy should be reassessed every year during the treatment. Treatment is done for 3 consecutive years.

Birch tablet therapy should be started in the fall in order to be effective for the onset of birch pollen season.

Patients will be given the first test dose in the office to ensure it is well tolerated and are asked to wait 30 minutes in the office afterward. Patients may experience itching in the oral cavity that should start to dissipate within the 30 minutes.

Patients needing to return for another year of therapy should book in advance due to the high demand.

Patients on any form of immunotherapy should be reassessed every year during the treatment. Treatment is done for 3 consecutive years.

Patients who are prescribed dust mite tablet immunotherapy can be started anytime.

Patients will be given the first test dose in the office to ensure it is well tolerated and are asked to wait 30 minutes in the office afterwards. Patients may experience itching in the oral cavity that should start to dissipate within the 30 minutes.

Patients on any form of immunotherapy should be reassessed every year during the treatment. Patients will be on therapy for about 3 years.

Patients who are prescribed oral immunotherapy will have the prescriptions sent to the Victoria Compounding Pharmacy, where the protein capsules are compounded. The capsules should brought to the office, where an initial dose will be administered under supervision. Once it is ensured that it is tolerated well, the patient will take a daily protein capsule for a month at home. At that time, the patient will return to have the next updose in the office to ensure it is tolerated well and to resume daily doses at home. Monthly appointments to ramp up the dose under observation will be repeated until the maintenance dose is reached.

Patients must remain on the protein capsule daily to ensure effectiveness in avoiding a fatal reaction to nut exposure. This is not a cure.

Patients on any form of immunotherapy should be reassessed every year during the treatment.

     https://foodallergycanada.ca       

Helpful information and resources for patients living with food allergies. 

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     https://www.skinsafeproducts.com   

A searchable database of ingredients in products for avoidance of contact allerrgies. Free and premium available. 

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     https://www.theweathernetwork.com     

Weather, including pollen counts for allergy sufferers. 

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   https://www.healthlinkbc.ca   

Health information for British Columbians, including registering to find a family doctor. 

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   https://www.islandhealth.ca/virtual-care 

Information on options for virtual care, including list of virtual care clinics.  

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