Departments

We care for children with a variety of allergic and immunologic disorders, and chronic respiratory diseases. Our highly specialized, board-certified clinicians diagnose and treat everything from the most common to the very rare conditions. Nasal and eye allergies Asthma Hives Medication allergy Chronic sinusitis Angioedema Hereditary angioneurotic edema Common variable immunodeficiency Secondary immune deficiencies Cystic fibrosis Sleep disorders Chronic lung disease in infants and older children Acute respiratory failure Treatments we offer include: Allergen vaccine immunotherapy (allergy shots) Asthma environmental controls and pharmacological controller therapy Intensive antihistamine regimens Biological therapy for hereditary angioneurotic edema Intravenous and subcutaneous immunoglobulin replenishment Aspirin desensitization Desensitization to antibiotics and other medications Our services include: Pediatric pulmonary function testing:We evaluate and follow lung disease in children with a full spectrum of tests, including diffusion analysis, challenge tests, and exercise. Physicians may order a pulmonary function test by calling 203-688-4667. Bronchoscopy:Bronchoscopy is the examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope). Bronchoscopy helps to evaluate and diagnose lung problems, assess blockages, obtain samples of tissue and/or fluid, and/or to help remove a foreign body. Bronchoscopies are performed in the pediatric operating room, and in the Pediatric Intensive Care Unit. Our pulmonologists who perform this procedure have extensive experience with flexible bronchoscopy, including its use in newborns. In many cases, flexible bronchoscopy, which can be safely and comfortably performed under conscious sedation, eliminates the need for an exam under general anesthesia.

At the Yale Pediatric Food Allergy Program, our nationally recognized team of clinicians focuses on the diagnosis and management of food allergy, as well as education and research on food allergy. We are a Center of Distinction through the Food Allergy Research and Education (FARE) Clinical Network, a coalition of top food allergy centers chosen from across the United States. We are a progressive center that focuses on compassionate and personalized care, and we serve food allergic children from throughout the New England and the Mid-Atlantic states. Our clinicians offer a wide array of services including: Specialized food allergy prevention clinics Outpatient in-person and virtual appointments Diagnostic testing Oral food challenges Oral immunotherapy (limited providers) Access to a food allergy child life specialist Access to a food allergy dietician

Yale Medicine serves as Connecticut’s premier primary immunodeficiency center for pediatric and adult patients. Primary immunodeficiencies, also known as inborn errors of immunity (IEI), present with features involving a disruption of the body’s immune system. The alteration of the immune system can lead to various clinical manifestations, including recurrent infection, autoimmunity, hematopoietic malignancy, lung disease, and enteropathy. These conditions are caused by monogenetic and polygenetic defects or epigenetic changes. We focus on the evaluation, diagnosis, and management of patients with primary immunodeficiency through in-depth genetic and immunological laboratory tests. In addition to patient care, our group works through research to help advance our understanding of immunodeficiency.

We provide advanced medical and surgical care for patients with benign and malignant sinus and nasal tumors, as well as disorders of the nose and sinuses, including inhalant allergies, chronic rhinosinusitis, nosebleeds, and nasal obstruction. Our minimally invasive surgical procedures allow our patients to experience shorter recovery times, minimal or no scarring, and less postoperative discomfort.

We provide expert evaluation and treatment to adult and pediatric patients across the entire spectrum of allergic and immunologic disorders. Our board-certified specialists have specific clinical and scientific expertise, and are highly capable of providing comprehensive, thoughtful care from the most common to the rarest conditions. Our physicians meet weekly to discuss the management of complicated cases. Yale has been the site of several key research breakthroughs in the field, including the discovery of new inherited immunological diseases and the development of a crucial understanding of the underlying causes of allergies. We offer comprehensive evaluation of both common and rare allergy and immunology conditions, including allergy skin and blood testing, oral food challenges, drug allergy testing, and contact dermatitis patch testing. We offer allergic rhinitis and asthma care through recommendations for environmental controls and pharmacological controller therapy, and biologic therapies for severe asthma, chronic rhinosinusitis with nasal polyposis, as well as chronic urticaria and hereditary angioedema. We have expertise in management of immune deficiencies with intravenous and subcutaneous immunoglobulin replenishment. We also provide consultations for drug allergy desensitization when needed. Among the conditions we treat are: Allergic rhinoconjunctivitis (nasal and eye allergies) Asthma Chronic rhinosinusitis Food allergy Insect sting allergy Medication allergy Urticaria (hives) Angioedema Hereditary angioedema Atopic Dermatitis Contact Dermatitis Common variable immunodeficiency Secondary immune deficiencies Our service has specific strength in the management of inherited immune deficiencies, with a dedicated service that closely collaborates with experts across other specialties. Through a long-standing collaboration with Yale Laboratory Medicine, patients have access to a broad array of state-of-the-art immunological testing. Our care for children and adolescents includes treatment for: Asthma Our doctors collaborate with colleagues in the Pediatric Asthma Program to ensure that our patients receive comprehensive asthma care, including: Evaluation, diagnosis, and management of childhood asthma for patients with varying degrees of severity Testing for allergic precipitants Mechanical analysis of respiratory function Outreach care at patients' homes when needed Allergy Testing for allergens, desensitization, and immunotherapy Allergic rhinoconjunctivitis Drug allergy Food allergy Insect venom allergy Urticaria (hives), mastocytosis, anaphylaxis Hereditary angioedema Primary Immunodeficiency and Recurrent Infections Testing for antibody deficiency, cellular immunodeficiency, and complement disorders Treatment of primary immunodeficiency diseases, including intravenous immunoglobulin therapy Evaluation and management of recurrent infections, including fungal infections

We offer state-of-the-art evaluation and treatment for patients with a wide range of lung disorders, including asthma, chronic obstructive pulmonary disease (COPD), emphysema, lung cancer, and undiagnosed or general respiratory problems. Many patients come to us with work-related pulmonary disease or with sleep disorders. They might not have a diagnosis, but have symptoms such as persistent or nagging cough, or shortness of breath at rest or with exertion. Our skilled, experienced specialists can diagnose and take care of difficult or unusual problems. The history of our center dates back more than a century, when it was set up through a bequest from Sarah Winchester in memory of her husband, William Wirt Winchester, and their young daughter, both of whom succumbed to tuberculosis. This gift resulted in the establishment of the original Winchester Hospital in West Haven, dedicated to the care of patients with tuberculosis. Today, the Winchester Center for Lung Disease at Yale New Haven Hospital is committed to the integration of cutting-edge patient care, education, and research across the full spectrum of pulmonary disorders. Our specialists are faculty members of the Yale School of Medicine Section of Pulmonary, Critical Care and Sleep Medicine, with national and international expertise in treating even the most challenging lung conditions. The center is continually evolving to meet changing needs. Most recently, in response to COVID-19, the center developed a Post-COVID-19 Recovery Program , which offers pulmonary-focused, multidisciplinary evaluation and care for patients recovering from COVID-19. In addition to our comprehensive general pulmonary practice, we offer the specialty center programs listed below. For more information about any of these programs, call the Winchester Center for Lung Disease at 203-495-2410. Adult Cystic Fibrosis Center Cystic fibrosis (CF) was previously thought of as a childhood disease, but is now considered a chronic disease because more adults in the U.S. are living longer with CF and maintaining good quality of life. The Adult CF Program provides team-based care for adults with CF on both an inpatient and outpatient basis. Our comprehensive program includes diagnosis, treatment, and counseling for sinus, pulmonary, gastrointestinal, liver, nutritional, endocrine, mental health, and reproductive issues. Chronic Obstructive Pulmonary Disease (COPD) Chronic obstructive pulmonary disease (COPD) is an inflammatory lung disease that blocks airflow from the lungs and makes it difficult to breathe. The COPD Program (including emphysema, chronic bronchitis, and asthma/COPD overlap syndrome) provides a personalized treatment plan for each patient to help manage their COPD. Whether patients have mild symptoms, need rehabilitation, or require assisted ventilation, we can help. Chronic Pulmonary Infection Research and Treatment (CPIRT) This program is focused on the leading innovative care and research for acute

Our asthma and airway disease experts offer comprehensive, multidisciplinary treatment for a broad spectrum of conditions including: Treatment-resistant asthma Steroid-dependent asthma Steroid-resistant asthma Environmental and occupational asthma Exercise-induced asthma We frequently take care of patients with chronic cough, asthma that is difficult to control, as well as those whose condition is difficult to diagnose and who may be significantly affected by such co-occurring illnesses as gastroesophageal reflux, sinusitis, or vocal-cord dysfunction. We develop individualized care plans for all patients, with the goal of forming a working partnership with the referring primary care provider. Our skilled group includes three pulmonologists, one physician assistant, asthma nurse coordinators, and pulmonary function technicians trained in asthma education. We work closely with our colleagues in allergy and immunology, otolaryngology, gastroenterology and occupational and environmental medicine to coordinate an efficient and comprehensive process of evaluation for patients with complicated asthma. In conjunction with occupational and environmental medicine specialists, we may perform workplace or home environmental evaluations.

Integrative medicine focuses on the whole person, is informed by evidence, and seeks to complement cancer therapy with appropriate therapeutic and lifestyle approaches to achieve optimal health and healing. Smilow Cancer Hospital’s Integrative Medicine Program provides evidence-based guidance about a wide range of complementary therapies commonly used by cancer patients and survivors. Our program aims to address the serious physical and emotional symptoms often experienced by patients before, during, and after cancer therapy. Our team has expertise in the practice and evaluation of complementary medicine, and can guide patients to make effective decisions on integrative therapies throughout their treatment program and beyond. We collaborate closely with each patient’s oncology care team to provide safe and effective care. Integrative medicine consultations Integrative medicine clinical consultations provide guidance for the safe use of dietary supplements/natural products, acupuncture, massage, meditation, and other complementary therapies. Massage Experienced and licensed therapists are trained in oncology massage, focusing on mitigating side effects from cancer and its treatment. Research has shown that massage therapy may reduce pain, promote relaxation, and boost mood in cancer patients. Appointments may be made by calling 203-200-6129. We accept debit or credit cards for payment. $70 per 60-minute appointment $40 per 30-minute appointment Reiki Reiki is a complementary health approach in which practitioners place their hands lightly on or just above a person, with the goal of facilitating the person’s own healing response. This is to promote relaxation and produce stress-reduction effects. Appointments may be made by calling 203-200-6129. We accept debit or credit cards for payment. $70 per 60-minute appointment $40 per 30-minute appointment Nutrition Consultation The Integrative Medicine team offers guidance from our Oncology-certified Registered Dietitian to help individuals reach specific goals during or after completion of their treatment. Integrative Medicine Nutrition also supports the Supplement Clinic, where vitamins and supplements may be discussed to ensure they are safe and effective. They may also provide guidance on how to optimize their diet and obtain nutrients from foods whenever possible. Group Sessions Gentle yoga Group classes incorporate breathing techniques, physical postures, meditation, and relaxation, adapted to patient needs and limitations. T’ai Chi/Qigong T’ai Chi/Qigong is a centuries-old martial art and energy practice that uses gentle movement through postures to help promote mental focus, breathing, and relaxation. Students are taught the fundamentals of breath work, movement, and postures that develop into the T’ai-Chi form. The benefits are improved strength, mobility, alignment, pain control, and overall physical and mental rejuvenation. Meditation Meditation is a mind and body practice that has a long

The Yale Allergy & Immunology Contact Dermatitis Program serves patients affected by one of the most common causes of both personal and occupational allergic skin diseases: allergic contact dermatitis (ACD). ACD is an immune reaction that typically causes a rash in response to a substance in personal care products, medications, or even diet. Other potential allergic sources include occupational exposures and biomedical implants, all of which can result in chronic and sometimes debilitating symptoms. Identification of the offending allergen is key to the rapid diagnosis and resolution of ACD. Patch testing, in which allergens are placed in chambers held in place with adhesive patches on the back, is the gold standard for the diagnosis of ACD. The testing usually takes place during three visits over the course of a week after the initial consultation is completed. At the first visit, the patches are placed, and a second visit occurs 48 hours later for patch removal. Between 72-96 hours after the initial patch placement, a third visit occurs with a final diagnosis and a physician follow-up. Occasionally, a fourth visit is needed for delayed reads of certain allergens. We have the ability to test to multiple extended allergen series, medications, occupational and healthcare-specific substances, as well as some product brought in by patients. We take a personalized approach to the diagnosis and care of patients with contact dermatitis. From the initial consultation and testing phase, where potential allergens will be determined, a custom patch test prescription is prepared, and, ultimately, allergen identification/avoidance strategies and a treatment plan are formulated.

Penicillin allergies are commonly reported throughout the American population, but yet a small percentage of people are actually allergic to the antibiotic. This can be problematic in pregnant women, who often need antibiotics throughout the course of their pregnancy and after delivery. The Allergy, Asthma & Immunology Care in Pregnant Mothers Program identifies Yale Medicine obstetrical patients who report a penicillin allergy and asks them if they would like to visit an allergist to be tested, with the goal of clearing unnecessary penicillin allergies from their medical charts. Penicillin is typically the first antibiotic medication tried for an infection, and if it can’t be used, medical professionals need to try a broader antibiotic, which has increased risks and contributes to antibiotic resistance. And pregnant women who are believed to have penicillin allergies may have higher rates of C-sections and stay longer in the hospital, in addition to other risks. Therefore, it is key for pregnant women to know if they are actually allergic to penicillin, especially since many people who think they have an allergy either never actually had one or they outgrew it. For patients in the Allergy, Asthma & Immunology Care in Pregnant Mothers Program who agree to be tested, the procedure they undergo is typically done during the third trimester and involves a tiny needle poke of penicillin under the skin. If a rash doesn’t appear within 20 minutes, another poke is given. If the skin is still clear after 20 more minutes, the patient receives an oral dose of amoxicillin, a form of penicillin. The woman is carefully monitored in the office. If there is no reaction, she is cleared of the allergy on her medical chart. The program is led by a board-certified allergy and immunology specialist and a high-risk obstetrician-gynecologist. The physicians work with Ob/Gyns throughout Yale Medicine to educate pregnant women about the importance of allergy testing.