Asthma, Asthma, Asthma

May is National Asthma and Allergy Awareness Month and Gramercy Allergy is all about Asthma this month.  We take that seriously at Gramercy Allergy and Dr Jennifer Collins, a top allergist in New York City, is here to help you!

Facts about Asthma

• Asthma affects over 24 million Americans and 330 millionpeople worldwide have asthma; that’s 7.4% of adults and 8.6% of children, or 1in 14 people, according to the CDC.  

• Symptoms of asthma and allergies peak around this time. 
• Asthma is a condition in which the airways from the nose and mouth to the lungs become inflamed and sensitive to substances. Asthma occurs in bouts known as asthma attacks. The airways swell and narrow, causing difficulty breathing. In severe cases, asthma can be fatal.

How Do You Know You Have Asthma?

Symptoms of asthma include
·        Trouble breathing (shortness of breath or rapid breathing)
·        Recurrent coughing
·        Wheezing
·        Tightness in the chest
·        A night time cough that wakes you from sleep

·        If you’re worried you may have asthma see an allergist. An Allergist is a specialized doctor to treat allergies and asthma.  Dr Collins is an allergist practicing in New York for over 10 years.  

Picture Credit.

What triggers asthma?

•  Allergens: Asthma caused by allergies is called allergic asthma. When the immune system thinks a foreign substance (for example, inhaled pollen) is harmful, it will release immunoglobulin E (IgE) which leads to inflammation of the airways and an asthma attack. Common allergens include pollens (like tree, grass, and weeds), animals, mice, roaches, and dust mites.  Make sure to get a skin or blood test at your allergy doctor to find out what you’re allergic to!
• Wearing a Mask: Wearing a mask can trigger an asthma attack.  Make sure you have your albuterol with you 
• Irritants: Have you noticed symptoms of asthma whenever you are using cleaning products, tobacco smoke, or strong odors? Irritating particles in the air, such as from smoke, pollution, or strong odors, can exacerbate already inflamed and sensitive airways. These irritants are not allergens but can trigger a severe attack.
• Exercise: have you ever noticed symptoms of asthma whenever you are physically active? During exercise, people will breathe through their mouths instead of their noses. Because the nose warms and moisturizes air, air that enters through the mouth is cooler and dryer. If the air is already dry and cool outside, it can trigger narrowing of the airways (called bronchoconstriction). Talk to your allergy doctor to help manage exercise-induced bronchoconstriction.
  
•   Respiratory illnesses: do you have a persistent lingering cough from a cold or flu? Asthma may be caused by infection of your respiratory system. This is the most common cause of asthma in children.

What should you do If You Suspect You Have Asthma?

·        See your doctor or allergy specialist.  Gramercy Allergy and Asthma, New York City’s premier Allergy office is here to help!  You can schedule an appointment here.

·        Get Tested.  Know what your triggers are.

Over the month of May, Gramercy Allergy and Asthma, will be writing about topics specific to asthma so stay tuned to learn more about asthma.

We'll be including interesting facts about asthma, asthma and the gender gap, and ways to treat difficult asthma on our Facebook page and twitter. You can find us @gramercyallergy and https://facebook.com/gramercyallergy

Want to get more involved?

Share the Asthma and Allergy Foundations Allergy Awareness ribbon on your Facebook page or visit the Asthma and Allergy Foundation of Amercias webpage for more information.

Want more specific advice on treating asthma in New York?  Visit our website http://www.gramercyallergy.com or click here to schedule an appointment online.

@gramercyallergy

#1in10#TackleAsthma?#Asthma

 

Is Your Asthma Getting in the Way of Your New Year's Resolution?

Is Your Asthma Getting in the Way of Your New Year's Resolution?

                                 


                                     
                                          

When walking my dog early morning in January, I'm always struck by the increase in the number of people heading to the gym.  It seems like the streets are almost crowded with yoga and exercise gear. Where were these people a few short weeks ago?   It's no surprise to hear that exercising more is one of the top three resolutions that Americans make according to a YouGov 2017 survey

In January, most hit the ground running (literally!) but for some maintaining that new years resolution isn't just about will power.  What if you have the desire to exercise more, but get really sob cough and get winded easily when doing so.  Could asthma be getting in the way of you goal of exercising more?   

I'm always surprised when I hear patients tell me that they aren't good at exercise.  Exercise can make anyone short of breath, but for many it can trigger an asthma attack. 

Some quick screening questions tell me that they might be suffering from a form of asthma known as exercise induced asthma.  

What is exercise induced asthma? 

• A form of asthma where lungs become tight during asthma
• As many as 90% of people who have asthma have a form of exercise induced asthma
• For teenagers and young adults, exercise induced asthma is the most common cause of asthma symptoms. 

What are symptoms associated with exercise induced asthma?

Do you have cough, chest tightness or SOB associated only with exercise?

• Does going outside on a cold day trigger a cough?
• Are you sensitive to cold temperatures and dry air? 
• Does air pollutants (tobacco smoke car pollution, and air quality issues) trigger symptoms?

                                            

Do you suspect you have exercised induced asthma.  Are asthma symptoms getting in the way of your exercise goals for 2020?  

Please let us help.  

Need help managing your asthma?  Please visit click here to schedule an appointment. We will help you get to your next exercise goal.  Follow us at @gramercyallergy for allergy friendly tips!

Want more help for Asthma and Allergies?  Gramercy Allergy and Asthma is an expert in treating all forms of asthma and allergy.  Schedule an appointment with us.  Dr. Jennifer Collins, MD,a Castle Connolly Top Doctor  We are ready to help you with your asthma.  Gramercy Allergy specializes in treatment of asthma and allergies in New York City  

Halloween and Food Allergy- What is the Teal Pumpkin Project?

Halloween and Food Allergy

·        Did you know that one in 13 children under the age of 18 years of age are affected from food allergies?

·        This number is only on the rise and according the Centers for Disease Control and Prevention since 1997-2011, food allergies have increased by 50%.

·        Sadly, we don’t know why these numbers are increasing. 

·        Children with food allergies often feel left out and isolated as it’s difficult for them to “share” food.  Halloween proposes a particular challenge for parents with food allergies.  The candy filled pumpkin offered up with generosity and fun is a perilous bowl of potential threats for those with food allergies.

·        Candy typically may contain milk, egg, soy, peanuts, tree nuts and latex, some of the most common causes of food allergies.

What is the Teal Pumpkin Project™?

·        Launched as a national campaign by Food Allergy Research & Education (FARE) in 2014, the Teal Pumpkin Project™ raises awareness of food allergies and promotes inclusion of all trick-or-treaters throughout the Halloween season. 

           AMAZINGLY! Last year, households from 50 states and 7 countries participated in the Teal Pumpkin Project™ by putting out a teal painted pumpkin to signify that their treats were “food allergy safe”. This year, you can be part of an even bigger movement by joining 100,000 households pledging to participate in the Teal PumpkinProject™!

Gramercy Allergy and Asthma Took The Pledge Have You?

What Do You Have to Do To Participate in the Teal Pumpkin Project™?

·       Place a teal painted pumpkin outside your home or a sign signifying you have non-food related treats available to trick-or-treaters.

·       Take the Pledge!

     Join FARE and 100,000 other households across the USA in providing allergy free treats. 

·       Want to download a sign?  Visit the FARE website http://www.foodallergy.org/teal-pumpkin-project/downloads#.VgFbFt9VhBc

What are Some Easy Ideas for Non-Food Treats to use for the Teal Pumpkin Project™?

·        Glow sticks, bracelets, or necklaces ·        Pencils, pens, crayons or markers ·        Bubbles ·        Halloween erasers or pencil toppers ·        Mini Slinkies ·        Whistles, kazoos, or noisemakers ·        Bouncy balls ·        Finger puppets or novelty toys

·        Coins ·        Spider rings ·        Vampire fangs ·        Mini notepads ·        Playing cards ·        Bookmarks ·        Stickers ·        Stencils

How Can You Get More Involved with Food Allergy Awareness?

Participate in the FARE WALK For Food ALLERGY- and Help us Say Farewell to Food Allergies. 

Visit the FARE Website

Need help managing specific food allergies?  Please visit click here to schedule an appointment. We will be posting more in the days leading up to Halloween.  Follow us at @gramercyallergy for allergy friendly tips!

Want more help for Food Allergies ?  Gramercy Allergy and Asthma is an expert in treating AERD.  Schedule an appointment with us.  Dr. Jennifer Collins, MD,a Castle Connolly Top Doctor  We are ready to help you with your eczema.  Gramercy Allergy specializes in treatment of food allergies in New York City  

* "The TEAL PUMPKIN PROJECT and the Teal Pumpkin Image are trademarks of Food Allergy Research & Education (FARE)."

Halloween and Food Allergy

Gramercy Allergy and Samters Triad (Aspirin Exacerbated Respiratory Disease) -AERD Awareness Day Sept 26, 2019

Tomorrow, September 26 marks the 2nd annual Aspirin Exacerbated Respiratory Disease (AERD) Awareness Day.  Gramercy Allergy hopes to  help educate our patients on this often misdiagnosed disease, and spread the word.  

Think you might have AERD?  Please come in, Gramercy Allergy and Asthma can help. 

What is Aspirin Exacerbated Respiratory Disease (AERD) or Samter’s Triad?

• Patients with asthma and sinus disease can have reactions to these drugs and are diagnosed with Aspirin Exacerbated Respiratory Disease (AERD). This is also known as Samter’s Triad.
• Typically patients will have asthma, nasal polyps and allergy to aspirin. You don’t have to have all three diseases to have Samter’s Triad.
• A majority of patients also experience respiratory reactions to alcohol and an impaired sense of smell.
• As many as 7-10% of persons with asthma may have Aspirin Exacerbated Respiratory Disease (AERD). In patients with severe asthma as many as 15% of patients have AERD. If you have both asthma and nasal polyps the disease may be as high as 40% according to studies.
• The diagnosis of AERD is difficult and many patients are undiagnosed. The first ever AERD Awareness Day was September 26, 2018
• They undergo recurrent surgery for nasal polyps or chronic oral steroid use for their asthma.
• Many think that avoidance of aspirin or NSAIDS will prevent the disease, but THIS IS NOT TRUE.
• AERD can start at any age and is an acquired condition. It may be slightly more common in women then men.

What Are Symptoms Associated with Aspirin Exacerbated Respiratory Disease/Samter’s Triad?

• Nasal congestion
• Wheezing, chest congestion
• Severe poorly controlled asthma
• Recurrent nasal polyps.
• Facial pain and pressure
• Flushing and/or a rash
• Nausea and/or abdominal cramping
• Loss of sense of smell/taste
• Adverse reactions to alcohol
• General feeling of malaise

How Do you Diagnose Aspirin Exacerbated Respiratory Disease/Samter’s Triad?

• Your doctor may suspect you have AERD based off of your history.
• The gold standard for diagnosis is an aspirin challenge. THIS SHOULD ONLY BE DONE UNDER THE SUPERVISION OF A HIGHLY TRAINED ALLERGIST. Dr Jennifer Collins, MD and Dr. Meng Chen are both experts in Samter's Triad (Aspirin Exacerbated Respiratory Disease) and here to help you with your diagnosis and treatment.  
• An aspirin challenge is performed to evaluate if you have an allergy to aspirin non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen.
• Patients with AERD may benefit from aspirin desensitization followed by twice daily aspirin therapy.
  
  Want more help for Aspirin Exacerbated Respiratory Disease ?  Gramercy Allergy and Asthma is an expert in treating AERD.  Schedule an appointment with us.  Dr. Jennifer Collins, MD,a Castle Connolly Top Doctor  We are ready to help you with your eczema.  Gramercy Allergy specializes in treatment of AERD in New York City  

3 Fast Tips on How to Beat Springtime Eczema #Allergy

Springtime eczema is one of the most common complaints coming into my office this time of the year.  Kids and adults alike are itchy and scratchy all over. High levels of tree pollen for many can trigger itchy skin changes.   Rapid changes in temperature and humidity that are classic for NYC can trigger an eczema flare leaving families feeling helpless, sleepy  and ITCHY.

Classic areas that eczema appears are the areas of elbows and behind knees.


What can you do to help get skin back under control and possibly even prevent an eczema flare this NYC summer?

• MOISTURIZE, MOISTURIZE, MOISTURIZE
• Keeping skin well hydrated will help prevent an eczema flare
• Stay hydrated with plenty of water (avoid juices and sugary beverages)
• Bath daily in warm water and avoid strong soaps
• Make sure skin is covered in a good moisturize when still wet
• Pat dry leaving a layer of water on the skin that you can trap into the skin with a moisturizer
• STOP THE ITCH SCRATCH CYCLE
• Have a plan to stop scratching.
• Talk about what to do to prevent the itch and stop it.  Early moisturization can often prevent a flare.
• Send a plan to school with the National Eczema's School Kit 
• Keep emollients like Vaseline, Crisco, Aquaphor of Vaniply in the refrigerator; the cool temperature applied directly to itchy inflamed skin will stop the itch.  Wrap inflamed areas in wet cool paper towels before applying emollients. 
• Use topical steroids and oral anti-histamines if needed.
• Your doctor may advise topical and/or oral antibiotics if skin becomes infected. 
• Get into an oatmeal-Epsom salt bath
• Place dry oatmeal and Epsom salts in a cheese clothe or other porous material, tie tightly, and place under running water.  Oatmeal has natural anti-inflammatory compounds that will help soothe irritated skin.
• TRY TO IDENTIFY TRIGGERS
• See an allergist to help you identify the cause and trigger of the eczema
• Tree pollen can trigger eczema. 
• Rinsing after being outside is key to preventing pollens from sticking to the skin.
• Potential causes may be foods (milk, eggs, and nuts are the most common), lotions, sunscreens and detergents, and skin allergy to dust mite, summertime weeds, and animals.
• Contact dermatitis (an allergy to chemicals in personal care products) is an often overlooked cause of eczema.  
• Identifying other triggers can help you prevent future attacks.  Your doctor may recommend patch testing, a way to look for chemical allergy. 

Want more help for eczema in NYC? Gramercy Allergy and Asthma are experts in treating eczema.  Schedule an Appointmentwith us.  Dr. Jennifer Collins, MD,a Castle Connolly Top Doctor  or Dr. Meng Chen, MD We are ready to help you with your eczema.  Gramercy Allergy specializes in treatment of eczema in New York City.  

Want to read more about eczema- Check out the National Eczema Foundation 

Gramercy Allergy's Five Best Tips To Beat Springtime Allergies in New York City

   


April showers bring about spring flowers, but also stuffy noses, itchy watery eyes, and terrible allergies for the more than 17 million allergy suffers in the United States.

This time of the year, everyone is trying to stay ahead of the pollen counts and prevent symptoms so they can enjoy spring rather then being sick from it.

Here are Gramercy Allergy's Five Best Tips to Help You Beat Springtime Allergies in New York City

1) Know What You Are Allergic Too

• Do you feel like you're allergic to everything?  "When it comes to allergies, knowledge is power when it comes to allergies," says  Gramercy Allergies Dr. Meng Chen.  Being tested for allergies will help you predict before you start feeling sick from symptoms. 
• Testing for allergies is done by putting droplets of different allergens on your arm/back.  You'll have a local reaction.  "By knowing what you are allergic to you can direct therapy in a specific way, rather then thinking you're allergic to everything" says Dr. Chen .  

2) Be Prepared Before Heading Outdoors

   

• Don't think you have to say no to that picnic in the park or the soccer game after school, taking medications before you head outdoors is often pivotal in preventing an allergic reaction.  Most allergy medications work best if you use them before the allergy exposure.

3) Get Tech Savy with Your Allergies

• Downloading an allergy app is an easy way of literally keeping pollen levels at your fingertips.
•  Some of Dr. Jennifer Collins's favorite allergy app like Zyrtec AllergyCast, WebMD Allergy, WeatherBug Poncho: Wake Up Weather will help keep you prepared for what the week has ahead of you pollen wise
• These are perfect for travel where you might not know what you're heading into. 

4) Rock out your inner moviestar with sunglasses

 

• Not only will they keep you fashionable, they'll protect your eyes from the high pollen levels flying around the city.
• "Look for ones with large lens to offer the most protection" says Dr. Meng Chen. 
• Sunglasses act as a physical barrier to help protect eyes and were shown to help reduce overall needs of medications in a 2013 Turkish study.  

5) Scrub a dub dub.

      

• "Shower at night to wash the pollen off your hair and body.  This is key to keeping pollen out of your bed and continued exposure while you sleep," says Dr. Jennifer Collins, MD.  
• If you don't have time to do a full shower, make sure you wash your face and brush your hair well before heading into bed. 

Gramercy Allergy hopes these tips help you enjoy the Spring!

Want more directed tips on springtime allergies?  Visit our www.gramercyallergy.com to schedule an appointment or call us today 212-679-3574 

Like us at https://www.facebook.com/gramercyallergy
Follow us @gramercyallergy

Welcome Dr. Meng Chen!

Gramercy Allergy and Asthma is excited to welcome Dr. Meng Chen, MD to our practice.  Treating both adults and children, Dr. Chen is an expert the field of hives (urticaria) and angioedema, food allergy, aspirin exacerbated respiratory disease, drug allergy and recurrent fever disorders. 

Dr. Meng Chen’s practice style focuses on delivering high quality patient-centered care. She believes that carefully listening to a patient’s concerns and providing education and counseling are key cornerstones of a productive and meaningful healthcare experience.  She works diligently with you to find solutions so you can live your best life, allergy free.  She treats you the way she would treat her family and believes is best accomplished by truly caring for the patient.  She also prides herself in timeliness and efficiency.

Dr. Meng Chen, MD brings southern charm with a west coast feel to New York City.  She is originally from Beijing and grew up in both Charlottesville, VA  and San Francisco, CA.  She is a recent graduate from the University of California, San Diego and Rady Children’s Hospital where she completed her Allergy & Immunology fellowship under the guidance of national leaders in the field.  Prior to that Dr Chen completed her undergraduate studies at the University of California, Berkeley where she studied Immunology.  She received her doctorate of medicine from the University of California, San Francisco.  She completed her Internal Medicine residency at the University of California, Los Angeles.  

Outside of work, she enjoys spending time with her family (husband, a sweet toddler, 2 cats, and dogs).  They all enjoy hiking together and exploring New York City.  She enjoys yoga and cooking. 

Milk and Egg #Allergy – Can My Kid Eat Cake?!

Milk and Egg Allergies – Can My Kid Eat Cake?!     
By Dr. Meng Chen, MD

Food allergies are on the rise, especially in children.  Cow’s milk and hen’s egg allergies are common culprits in young children.  The good news is that studies have shown that about two-thirds of children who are allergic to cow’s milk and hen’s egg can actually eat them when they are cooked into a baked good, such as muffins and cakes!  In fact, eating these goods on a regular basis may help speed up resolution of the allergy.  Plus, it can significantly improve your family’s quality of life and expand dietary options. 

How do I find out if my child can eat baked goods?

• Come into GramercyAllergy  for a thorough evaluation.  GramercyAllergy  will go over your child’s history of reactions to milk and egg and determine what testing is most appropriate.
• Testing can include skin testing and bloodwork to help determine whether your child will likely be able to eat baked goods.
• If the testing indicates there is a good chance that your child can eat baked egg or milk, GramercyAllergy will recommend an in-office oral food challenge.  During an oral food challenge, we feed your child a baked good in graded doses under careful monitoring and observation.
• If your child passes, we will send you home with instructions on how to incorporate baked goods into the diet! 
• GramercyAllergy recommend coming into the office for a full evaluation rather than trying baked goods at home as serious reactions can occur.

Tips if your child can already eat baked goods

• -Eat baked goods at least three times a week
• -Make sure the products are cooked all the way through!  Undercooked batter can trigger reactions
• -It is important to avoid other forms of milk and/or egg that are not mixed with batter and heated extensively.  For example, watch out for frosting!
• -Follow up at GramercyAllergy so we can monitor your child’s food allergies over time.  There is a good chance that your child will outgrow milk and egg allergies.  Regular follow up helps us provide guidance on when it might be appropriate to test if they have outgrown their allergies!

Does your child have a milk or egg allergy?  Need more specific help?  Please call GramercyAllergy  or click here to schedule an appointment to determine if your child might be able to consume baked goods!

You can follow us on facebook and @gramercyallergy for more specific advice.  

Spring time #Allergy in #NYC

Do you have questions about spring time allergies you've always wanted to ask?
Now's the perfect chance!

Tomorrow between noon and 2PM I'll be on NYU's Doctor radio with Dr. Max April, a pediatric ENT, talking about springtime allergies. 

 Call with questions tomorrow  877 NYU DOCS (877-698-3627) 

Food Allergies and the Holidays: Tips for being a guest this holiday season.

Thanksgiving is one of my favorite holidays- it marks the start of a holiday season of many communal feasts.  For the 15 million Americans who suffer from food allergies, it can mark the start of a stressful period.  All those dishes with potentially hidden food ingredients.

If you have food allergies, getting the invite to go a  new home is scary.  You have to confide in your friends information about your health and potentially something that can make you very sick.  Having food allergies shouldn't stop you from enjoying the generosity of others.

Here are 5 easy tips to deal with food allergies during the holidays:

1) Communicate

• Give your host ample time to make substitutions to the menu by telling them clearly your allergies. Bring it up one time and then avoid constant reminders about your allergy
• Find out what the menu will be and if they are planning on cooking with something that causes a food allergy

2) Offer to help

• Offer to bring the salad, stuffing or dessert.  This are foods that often have multiple ingredients that can be difficult to identify.
• If your allergy is especially difficult to avoid, then offer to bring food for yourself.
• There are easy substitutions for milk, eggs, and nuts available.  
• Milk- any of the milk substitutes (coconut milk, rice milk, soy milk, almond milk, oat milk etc) can be used 1:1 in any recipe.
• Eggs- applesauce and banana's are great substitutes for cookies and cakes.
• Nuts- keep them on the side, or make 2 dishes 1 with and 1 without.
• Here's a great website for more information Cooking with Food Allergies

3)  Educate yourself

• Sit down with your allergist and put together a specific plan on what to do if there's an accidental ingestion.
• Consider foods that might have hidden ingredients (cocktails, baked goods, stuffing, mashed potato etc..)

4) Be prepared

• Be sure to have an epinephrine auto-injector in your bag along with an anti-histamine.
• Consult with your allergist about recipes and ideas on how to approach the situation.
• Know where the closest hospital is in case there is an accidental ingestion.

5) Enjoy yourself

• Trust those around you to take your allergy seriously.  
• Don't let your food allergies spoil the holidays. 
• Here's to your good health and those around you 

Need more specific help?  Please call the office or click here to schedule an appointment

You can follow us on facebook and @gramercyallergy for more specific advice.  

5 Fast Facts About Fall Asthma, Allergies and Eczema

Changing fall leaves and rapidly changing temperatures, make most people forget about fall allergies and potential triggers of allergies eczema and asthma.  Here are 5 fast facts to keep in mind this fall to keep your allergies and asthma under control.


1) Mold and Ragweed pollens are triggers of Fall asthma. 

• Decaying leaves, high humidity levels  increased rain and warmer temperatures keep mold spores and pollen levels higher for longer periods of time.
• Get tested so you know what your potential triggers are, which fall weeds you might be sensitive to and learn about mold spores.
• Following pollen counts before you head out doors to enjoy the sceneary may help prevent an asthma attack.

2) Loving the Indian Summer?   This keeps pollen and mold spore levels higher for longer periods of time.

• Fall plants and pollen producers pollinate starting in mid August.  Levels can remain high until the first frost.  
• Pollen on the ground is blown up on windy days creating a burst of pollen and mold spores in the air that can trigger asthmatic symptoms. 

3) Love the fall colors, hay rides, and trips for apple picking?  These activities are prime for exposure to mold spores.

• Most fall time mold comes from decaying plant life including leaves, and fruits.  Wet hay is the perfect place for mold to grow.
• Make sure you use your inhaler or bring with you the next time your heading out for these classic fall time actvivities

4) Feeling a bit more winded from running outside? Fall is a great time to start a running program but can trigger exercise induced asthma.

• Rapid changes in temperature and humidity are the perfect triggers for exercise induced asthma
• Symptoms include mild shortness of breath, chest tightness, and a cough after running or exercising outdoors.
• Persons with a history of childhood asthma are more likely to have symptoms brought on by exercise
• See your allergist if you suspect you are having these symptoms for a check up.
  

5) Is your skin a bit more dry and itchy? October is National Eczema month for a reason.  Fall is a common trigger of eczema.

• Eczema, an allergic skin condition, affects over 30 million Americans!
• Dry skin triggered by changes in temperature and humidity levels can trigger eczema to flare. 
• Increasing your skin care regimine with extra moisturization and help prevent a flare up.
• Want more information about eczema- Check out the National Eczema website.

Gramercy Allergy hopes these tips help you enjoy the Fall!

Want more directed tips on allergies and travel?  Click here to schedule an appointment, or visit our www.gramercyallergy.com

Like us at https://www.facebook.com/gramercyallergy
Follow us @gramercyallergy