CONFIRM YOUR APPOINTMENT

You may confirm your appointment by clicking on the following link:

CONFIRM/CANCEL APPOINTMENT

Please include patient name, date/time of your appointment, and select whether you are confirming or cancelling. 

If you are cancelling and wish to rebook, please contact the office to set up a new appointment.

Please include your email address, which will be put on your file for appointment reminders.  We will copy and paste into your chart, so do ensure that it is correct.

November 11, 2022

RE: MASKS

BC COVID-19 SELF-ASSESSMENT TOOL

IMPORTANT NOTICE TO PATIENTS REGARDING THE COVID-19 PANDEMIC

At this time, patients must use a medical mask in healthcare facilities. If you do not have a medical mask, one will be provided to you for your appointment. 

If you are exempt from wearing a mask, you must present a note from your doctor.

Social distancing is impossible during allergy testing, physical exam, and allergy shots.  Due to the nature of our practice, there may be other at-risk patients in the office, such as patients with respiratory disease and immune deficiencies. 

You may also upload it directly to us via encrypted file transfer.  UPLOAD FILE HERE

FOR ALLERGY SHOT PATIENTS:

When you come in for your scheduled allergy treatment appointment:

• Please attend your appointment as scheduled.  If you arrive too early or late where it runs into another patient's appointment, you may be asked to wait outside the office so that we can ensure social distancing or your appointment may be rebooked if you are too late.   
  
  

• Please wear a mask upon entering the office. A medical mask is mandatory at this time, and you will be provided with one if you do not have one. 

• 
  
• Ensure you have been self-isolating and maintaining social distancing recommendations before attending the office.
  
  
• Run through the COVID-19 Self-Assessment Tool before attending the office.
  
• While we missed seeing you and its nice to catch up, please minimize conversation when getting your injection with Dr. Lee to avoid potential spread of droplets when speaking.   
  
  
• If you are stable on immunotherapy and you have a family doctor, Dr. Lee may discuss the option of getting your shots done at your GPs office to ensure you can get your injections in a more timely manner.   

If you have missed some immunotherapy injections due to this closure, Dr. Lee will adjust doses as necessary to help you resume treatment and will make recommendations for further treatment. 

Everyone should minimize unnecessary trips outside of the home and practice social distancing. We must flatten the curve to help our hospitals and hospital staff deal with COVID-19 (SAR CoV-2). 

For more information, please visit

 

http://www.bccdc.ca/heath-info/diseases-conditions/covid-19

COVID-19 WORKSITE PLAN

1. Limiting the numbers of patients in the waiting room; only patients and guardian  (if applicable) will be allowed entrance.
   
   
2. No further drop-in appointments for allergy immunotherapy; all appointments must be booked.
   
   
3. Mandatory hand hygiene.
   
   
4. Having patients stay in vehicle until appointment time, if required.
   
   
5. Require patients to self-screen with COVID-19 assessment tool prior to appointments.
   
   
6. Plexiglass barrier between patients and front-office staff.
   
   
7. Enhanced disinfection of waiting room/front office.
   
   
8. Disinfection of high-touch areas in allergy testing room between every patient.
   
   
9. Increased airflow/HEPA air filtration in all exam rooms.
   
   
10. Physician will wear medical masks as well as goggles or face shield (and other PPE if required) during medical appointments.
    
    
11. Mandatory masks for patients. Anyone who is exempt from wearing a mask must present a note from their doctor or appointment may be rescheduled to telehealth appointment.
    
    
12. No penalties for rebooking appointments.

INFORMATION ON COVID VACCINE EXEMPTION AND DEFERRALS

The goal of your appointment with an allergist will be to help facilitate safe vaccination.

Currently in British Columbia there are no vaccine exemptions, only deferrals. Individual physicians and nurses are not permitted to grant deferrals. Deferrals are granted by the Ministry of Health/Public Health by a committee.

Be aware that issues surrounding COVID 19 are changing rapidly and current evidence about allergies and vaccinations may change in the future. 

Please refer to the following if you wish to read more about COVID-19 vaccinations and allergy.

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COVID-19 Vaccine Testing & Administration Guidance for Allergist/Immunologists from the Canadian Society of  Allergy and Clinical Immunology

COVID - 19 and Food Allergies

APPOINTMENT CHECKLIST

• Within 24 hours of appointment, self-screen with the BC COVID-19 Self-Assessment Tool

https://bc.thrive.health./covid19/en

• Rebook your appointment or switch your appointment to telephone if:

        * Your screen is positive.

       *  It has been less than 10 days since onset of symptoms if you have contracted COVID.

• Mandatory masks are required; you will be provided with a medical mask if you do not have one.  If you cannot wear a medical mask, please contact our office to rebook or to change to telephone appointment if appropriate. If you are exempt from wearing a mask, a note from your doctor must be presented. 

• Once you have completed the history form, option to transfer it electronically to our office (encrypted file transfer).

SECURE UPLOAD     

Once you have clicked the link, click blue UPLOAD FILES box on the right-hand side of the page and follow screen instructions.

Upload is complete once the check mark appears next to your filename.

If you have trouble filling and transferring the form electronically, you may do so in office, but be aware that this is an additional contact point. Pens and clipboard are sanitize between patients. 
No antihistamines for 5 days prior to any allergy testing.

• Only the patient being seen (with one guardian, if applicable) will be allowed in the office.

    Thank you for your cooperation to ensure your safety and safety of other patients (which may include people with lung disease and low immune systems) and office staff. 

HOW TO FIND US

Lansdowne Professional Centre located on the southwest corner of the Shelbourne Street and Hillside Avenue intersection, across the street from Hillside Shopping Centre; there are three gas stations at the other three corners of the intersection.

We are on in the Landsdowne Professional

Centre II building on the third floor in suite 315.

On Shelbourne Street, facing the intersection of Hillside Avenue and Shelbourne Street.

The entrance of the underground pay parkade is on the opposite side from the parked vehicles.

**Please note that the Landsdowne Professional Centre is two separate buildings (Landsdowne Professional Centre and Lansdowne Professional Centre II) that are joined together.  Each building  has an elevator and is accessible to each other via a passageway connecting both buildings with the address of the buildings at the top of the doorways.

Our office is located right outside the elevator on the third floor of the 3066 side of the building in the southwest corner.

PARKING

We recommend you use the underground parkade. It is $2 for two hours. Parking on ground level in front of the Pharmasave at 1641 Hillside is 30 minutes only and is patrolled.

Please note, we cannot be responsible for parking tickets due to failure to obtain pay parking, nor are we responsible for any parking violations arising from use of the parking lot at the adjacent shopping centre.

HISTORY FORM & FILE TRANSFERS

The link below will open up our PDF history form. 

You may UPLOAD your history form through our secure encrypted file transfer link before your appointment.

Please use the above link to upload any photos that you are asked to send. If you send photos, please make sure that your photo filename have your name so that we can identify you from other patients.

PLEASE WAIT A FEW SECONDS AND YOU SHOULD SEE THE SPINNING ARROWS NEXT TO YOUR FILENAME AS IT IS BEING UPLOADED. ONCE THE SPINNING ARROWS TURN INTO A CHECK MARK, YOUR UPLOAD HAS BEEN COMPLETED AND IS BEING SENT TO OUR OFFICE.

Need more help? For detailed uploading instructions, please see our link below.

TREATMENT SCHEDULE AND ONLINE IMMUNOTHERAPY BOOKING

We have decided to carry on with booking appointments for immunotherapy due to the increasing number of patients on the treatment.

We will not be returning to drop-in times. 

You may call the office to book an appointment, or we now have limited spots available for online booking through the link below.

BOOK IMMUNOTHERAPY APPT ONLINE

Please note that this link is for IMMUNOTHERAPY ONLY. All other appointments, whether in-office or by phone, must be booked with the office staff directly in order to ensure the correct amount of allotted time on Dr. Lee's schedule.

Please do not book more than THREE immunotherapy APPOINTMENTS AT A TIME online due to the limited openings available.  Patients who book more than three appointments ahead may have the extra appointments cancelled in order to give everyone a chance at the spots and will be asked to contact the office to book future appointments.

Office staff have the ability to book appointments that otherwise may not appear  as openings on the schedule as we tend to book IT patients in small groupings throughout the day. We recommend booking your next injections at your appointment.

General Treatment Hours for

ALL TYPES of Immunotherapies:

We generally book immunotherapy treatments onsite between:

 Due to the social distancing required, our schedule may not always be as flexible to ensure we do not have too many patients in the office at a given time.

Please be seated in the waiting room for

30 minutes after

EACH injection(s)

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Please note Dr. Lee will not be accepting allergy shot patients on the following dates:

 HOURS OF OPERATION

Hours of operation generally are Monday to Friday with closure on all statutory holidays.

The office is open for scheduled appointments during the hours listed below.

Monday 9:00 - 4:00

Tuesday 9:00 - 3:00

Wednesday 8:30 - 4:00

Thursday 8:30 - 4:00

Friday 8:30 - 4:00

For immunotherapy hours, please see TREATMENT SCHEDULE.

Telephones are answered between 9:00 to 12:00 and again from 1:00 to 4:00 pm. If you get our answering machine, please do leave a message and we will return your call. Please note that due to high volumes of calls at times, messages left may not be returned on the same day.

______________________________

Office Closures

REFERRALS/WAIT TIMES

 A referral letter is mandatory and should be sent from the referring office directly to our office. An appointment will not be booked without a referral.

We are not set up for e-referrals and accept referrals by fax only.

PLEASE NOTE THAT WAIT TIME FOR A ROUTINE APPOINTMENT IS APPROXIMATELY 11-12 MONTHS. 

Specialized procedures may have longer wait times.

Wait times are subject  to change.

Once your appointment has been arranged, you will be contacted approximately a month prior to your appointment date. An appointment may be left on voicemail or via email, so please ensure that the contact information that will be provided from your referring doctor is up to date.

Appointments must be confirmed or they may be cancelled.

We have had some reports of the appointment confirmation emails going into people's SPAM folder.

If you have not seen us for 6 months or more, you will need a new referral, in accordance with Medical Service Plan guidelines.

If existing patients have been recommended to have a reassessment in one year or more, you will need to obtain a new referral in order to have another appointment arranged. We usually make this request in the last consult letter to the referring doctor, but following up with the referring doctor may be necessary.

NEW PATIENTS

Please use dark ink when filling out the history form so that our scanner will be able to read it.

RETURNING PATIENTS

If you have been to see Dr. Lee before, please ensure that your contact information, family doctor etc. is up to date at the front desk. 

AUTOMATED REMINDER CALLS

We are aware the wait time for all appointments.

While we are pleased to offer a reminder call/email service for your upcoming scheduled appointments, please be aware that reliability is not 100% as all calls are computer generated and are vulnerable to technical issues.

Patients will get two opportunities for automated reminders. Our system will generate a voice call and email five days before your appointment and email/SMS three days before your appointment as we require 48 hours for cancellation/rebooking. You may be reminded more than once depending on what information is registered with us. If you do not have email or a cell phone number, then you will just receive one telephone call. 

If you confirm or cancel on the first day, the system should avoid calling the second time.

Patients are ultimately responsible for remembering their own appointments.

Here are some friendly tips that may help you:

• Be sure the primary contact number with us is up to date (the system will only call the primary number)

• Be sure to check your voice mail frequently, if you are not available to answer the call, the system will leave a message if your voice mail box is available at the time.

• If a patient picks up a call, they should be saying “Hello” just like anybody normally would; that triggers the voice detection software to play the message. If a patient just picks up their phone call and does not say anything, it may not trigger the message to play and there would only be silence.
  
  

SKIN SCRATCH TESTING

• To make the most of your visit and having to rebook your skin scratch testing, please do not take any antihistamines such as Reactine, Allegra, Claritin, Aerius, Atarax or Chlortripolon 5 days prior to the appointment.  If an antihistamine in required, you can use Benadryl only (diphenhydramine) up to 24 hours prior to your appointment.
  
  

• Medications with antihistaminic properties such as tricyclic antidepressants such as amitriptyline, nortriptyline, etc., should also be discontinued prior to the test. (Please always check with your prescribing physician before discontinuing any medications). **We are unable to provide a large list of medication that contain antihistaminic properties; please contact your prescribing physician or speak to a pharmacist for advice. 

• All other medications including pseudoephedrine, prednisone, asthma treatments, nasal sprays, topical cream or eye drops, or regular allergy injections may be continued.
  
  

• We can do most common food (nuts, dairy, wheat, seafood etc) and aeroallergen (grass and tree pollens, mold) testing with extracts that we have in the office.
  
  Feel free to bring to your appointment any other food items you suspect may be causing you an allergic reaction such as fruit, vegetables, spices, alcohol, processed foods. 
  
  

 PATCH TESTING 

Patch testing is done to test for contact allergens.  The testing includes 80 different causes of contact allergies and are things found in common household and heath and beauty products.

The link below lists all the substances that will be included in your patch test.
 
North American 80 Comprehensive Series

• Patient must attend all three scheduled appointments (Friday, Monday and Tuesday). 
  You will get 8 patches placed on your upper back on your Friday appointment. Patches will need to be applied to clean, dry skin, so a shower before you attend this appointment is recommended.  Avoid applying lotions to the area.
  
  For men who may have excessive hair, this can cause the patches to not adhere properly, so shaved skin is recommended for best results. As irritation may occur from shaving and may make the result difficult to read, we recommend shaving a week prior to scheduled appointment.
  
  

• The patches should stay in contact with your skin all the time until the doctor has taken them off at your follow-up visit.

• Patches must stay dry while they are in contact with your skin; you must refrain from taking showers and baths while the patches are on; only sponge bath is recommended.

• Avoid excessive sweating
  

• The use of antihistamines will not affect patch testing and can be used to relieve any possible itching.  However, if you have recently been put on oral or injectable steroid, please inform our office prior to your testing date as it may affect the accuracy of the test.

• Be mindful when you change your clothes while the patches are on; loose tops are generally recommended. Dyes in some of the patches may stain clothing.
  
  

• Patches will be removed on the following Monday.  Final results will be read approximately 24 hours later on Tuesday after any irritation from adhesive has calmed, and information on any positive results will be provided to patient. 
  
  

  If you have arranged to send in photos, please  note that we need 8 photos, one of each patch.

  
  

• A positive patch test is a red or pink, itchy, often raised area at the site where a substance was applied.  This usually disappears after a few days. A strongly positive patch test can sometimes cause a local blister. Example photos will be shown at your appointment. 

 PENICILLIN TESTING

• As there is an initial scratch test, no antihistamines for 5 days prior to the appointment (see SKIN SCRATCH TEST INSTRUCTIONS)

FOR PRENATAL PATIENTS:

Penicillin scratch testing is scheduled according to availability of penicillin and due dates of patient.  We try to schedule patients at least a month or longer before due date for the skin test. In many cases, the challenge portion of the test my be done on a separate date closer to 37 weeks' gestation to coincide with completion of group B strep testing.

PAYMENTS

• NO debit card or credit card payment accepted

• Cash is acceptable but it has to be the
  exact amount, as we DO NOT carry any change in the office.
  
  

• Cheque and money order are also acceptable.  

• Payment has to be made at the beginning of the appointment on scheduled date for the test; a receipt will be provided.

• There is a $20 charge for no-show or if a
  48-hour notice was not received for all cancellation and rebooking.

 ORAL CHALLENGE TESTING

Patients may be asked to come in for a challenge appointment. This may be to a food or a drug. The duration of these tests is usually about 2 to 2-1/2 hours and once the testing has commence 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 amounts of the food throughout the morning until a reasonable amount has been eaten. Patient will be monitored regularly in the office. 

DRUG CHALLENGE

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

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These appointments are always booked in the morning at 9:00 a.m. on select dates with most patients being discharged by 11-11:30 a.m.

As we can only see one challenge patient per day, these spots do fill up quickly.  Rebooking a challenge appointment can result in significant delay and may require a re-referral. 

PULMONARY FUNCTION TESTING

ROYAL JUBILEE HOSPITAL

Royal Jubilee Hospital Google Map

Pulmonary Function Testing (PFT)  -  60 minutes

Spirometry - 30 minutes

Methacholine Challenge Test (MCT) - 60 minutes

For maps of the hospital and parking, please see below.

 ________________________________________

OTHER ISLAND LOCATIONS FOR PULMONARY FUNCTION TEST

Cowichan District Hospital - PFT instructions

Nanaimo Regional General Hospital - PFT instructions

Nanaimo Regional General Hospital - Methacholine Challenge Test instructions

 YEAR-ROUND

SUBCUTANEOUS IMMUNOTHERAPY (ALLERGY SHOTS)

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

When to order more serum:

How to order more serum:

PRE-SEASONAL IMMUNOTHERAPY

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 be re-referred in the late fall/winter so we can arrange the next season's serum in time. We usually make this request in the consult letter to the referring doctor, but patient's should follow up with their doctor to ensure timely re-referral. 

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

GRASS-TABLET ORAL THERAPY

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

Patients will be given the first tablet in the office to ensure that it is well tolerated and are asked to wait 30 minutes in the office afterwards. Patients may experience some itching in the oral cavity that should dissipate within the 30-minute time frame.

Patients wanting to return for another year of grass tablet therapy should be re-referred late fall/winter in order to ensure early booking in the year following to start therapy for the next season. 

We make this request in the consult letter to the referring doctor, but patients should follow up with their doctor to ensure timely re-referral.  

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

BIRCH TABLET ORAL IMMUNOTHERAPY

The birch tablet immunotherapy is started later inthe year around October/November.

Patients will be given the first tablet in the office to ensure that it is well tolerated and are asked to wait 30 minutes in the office afterwards. Patients may experience some itching in the oral cavity that should dissipate within the 30-minute time frame.

Patients wanting to return for another year of birth tablet therapy should be re-referred late/spring or summer in order to ensure booking for the fall to start therapy for the next season.

We make this request in the consult letter to the referring doctor, but patients should follow up with their doctor to ensure timely re-referral. 

This treatment is done for 3 consecutive seasons.

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

DUST MITE TABLET ORAL IMMUNOTHERAPY

The oral tablet immunothearpy can be started any time, and the first test dose is done in the office. 

Patients will be on the therapy consistently for about 3 years, and should be re-referred for annual reassessement.

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

RESOURCES

 TEACHING

We are grateful for the opportunities to assist health care professional trainees work under our guidance.

Dr. Lee is a Clinical Associate Professor with the Division of Clinical Immunology and Allergy at University of British Columbia.

Patients may be seen by medical trainees such as medical students, residents or fellows.

MOA STUDENTS

From time to time we will be providing opportunities for practicum placements for students who are graduating from the Camosun College Medical Office Assistant Program.

We thank you for your patience while we help to train these students for the duration of their practicum experience.