Allergy treatments

GauzeGuy

Pre-takeoff checklist
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GauzeGuy
Long story here, so I'll condense it as much as possible.

I've had occasional sinus symptoms for some time, but very transient and mild in nature. I've never sought treatment until this year nor had a formal dx of sinus issues.

After getting my medical this year, I started developing more significant sx of a sinus issue (post nasal drip, sore throats, major congestion, occasional dizziness, etc). I saw my NP and received an rx for amoxicillin, with was ineffective. I then saw a ENT PA who went with Augmentin (ineffective) then decided to try Levaquin (also ineffective). After than, she decided to get a CT of my sinuses to see what the deal was. The CT showed nothing remarkable -- a bit of sinusitis, a tiny septal deviation but nothing that would provide an clear answer for the symptoms. The PA then recommended allergy testing as another possible answer for the symptoms, which I did today. I reacted to most all environmental things, my forearm is still nicely swollen.

Anyway, that would make sense as the more significant symptoms started in the spring and are taping off with the fall. I decided to continue with treatment, since obviously this is not going to get better and the resulting fatigue, dizziness, etc, is causing quality of life issues.

My concern is that while I know the allergy injections are fine with the FAA, what has been recommended to me are oral drops on a bid basis. It was mentioned to be that while the drops are considered safer than the injections, anaphylactic reactions are not unheard of so an Epi-pen would be prescribed. Based on this fact I had planned on grounding myself for a week or so, until I'm completely sure that a reaction is not going to happen. That having been said, will that be sufficient -- are all allergy therapies good to go per the FAA, or do I need to revisit treatments with the clinic?

As a final concern, while I did not deliberately withhold anything from my medical since I only how have a clear answer as to what was going on until now, is there anything I need to do with respect to my medical, now or in the future? Again, the most significant issues and all medical visits occurred only *after* my medical was issued...
 
Okay, answered part of my own question.

Guide for Aviation Medical Examiners:
V. PHARMACEUTICAL CONSIDERATIONS
 For conditions controlled by desensitization, AME must warn the airman to
not operate aircraft until four hours after each injection.
 Sublingual immunotherapy (SLIT) used for allergic rhinitis is not
acceptable

So, going to the injections now.

Still, my question remains that since I'm going to be required to have an Epi-pen, is the 4 hour guidance sufficient even after the first injection? I know that generally 30 minutes following an exposure to an allergen is usually enough to rule out anaphylaxis, though even that is no guarantee...
 
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