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For more information about the diagnostic and treatment options for allergies, asthma, and sinus conditions, contact:



Gurdev (Dave) Judge, MD
Board-certified in Allergy, Asthma, & Immunology - Adults and Pediatrics





401 Keisler Drive, Suite 201
Cary, NC 27518
Telephone: (919) 859-5966



10931 Raven Ridge Rd, #111
Raleigh, NC 27614
Telephone: (919) 870-6440



1906 S. Main Street
Wake Forest, NC 27587
Telephone: (919) 562-7195

Preparing for Allergy Season

For Dr. Gurdev (Dave) Judge, allergies and their impact on health and quality of life are a personal matter. “When I was a youngster, I remember very often watching my mother gasping for air, especially at night.  I remember reacting to this scene with utter panic.

A thorough exam by Dr. Judge is always a precursor for treatment of allergies, asthma, and sinus conditions.

“We had a doctor in the village where we lived in India, who came to give my mother medication. She would feel better in a matter of 10 to 15 minutes. I was amazed by all of this. I thought he was the best doctor in the whole world. Later, I came to understand that my mother had allergies and suffered with asthma.”

Dr. Judge took that early fascination with these respiratory problems and turned it into an exceptional career. After medical training, he completed a two-year Fellowship in allergy and immunology at Duke University Medical Center and became double board-certified as an allergist-immunologist and a pediatrician.


As allergy season is upon us, Dr. Judge says it’s important to remember that prevention is key. “The number one way to control allergies is to stay away from what you’re allergic to. This sounds obvious, and it is, but it’s not always easy. If someone is allergic to milk, simply not drinking milk or consuming milk products is easy enough to do. However, many people are allergic to pollen, but most don’t have the option of simply staying indoors for the whole month of April when pollen in the air is at a peak.”

Consider Options

There are other methods of avoiding prolonged pollen exposure to minimize allergy symptoms, notes Dr. Judge: “Change clothes after being outside for a long time when pollen has had a chance to settle on the clothing; wash clothing right away to avoid transferring pollen from items that have been outdoors to clean clothes or furniture; take a shower to remove pollen from the hair; use a saline nasal rinse, like a Neti Pot, to remove pollen and nasal secretions from the sinuses—these measures can greatly reduce the incidence of sinus infections.”

Desensitizing the Body

Immunization therapy— commonly known as “allergy shots”—is a method of desensitizing the body to particular allergens.  Allergy symptoms, even allergic asthma, occur when a person’s immune system overreacts to an allergen, Dr. Judge explains.

“Immunization therapy is the process of slowly exposing a person to increasingly larger amounts of the offending allergen in order to retrain the immune system to react more appropriately when the substance is encountered. Basically, the therapy is working to change the immune response.
“Allergy shots are both safe and effective.” Dr. Judge says. “Most often, I recommend such treatment to patients who do not respond well to medications, have considerable side effects, or who have allergen exposure which is unavoidable.”

Dr. Judge reports that this approach is effective for the treatment of asthma, allergic rhinitis, and insect venom allergies. “In a large study of results of immunization therapy from the Mayo Clinic over a ten-year period, the incidence of adverse reactions was less than two-tenths of one percent—and most reactions were mild and responded to immediate medical treatment,” he says.

“You cannot cure allergies. But patients with allergies certainly have the option of leading healthy and active lives.”

Another method of prevention Dr. Judge promotes is that of strengthening the immune system and lungs through diet and exercise. “Eating lots of fruits and vegetables and drinking plenty of water is important for maintaining a strong body and a strong immune system,” he explains. “Likewise, keeping the body strong through exercise, particularly things like yoga, which emphasizes strengthening of the lungs, is vital. People who practice yoga and Pilates, which incorporate breathing exercises, develop strong abdominal muscles, a strong diaphragm, and develop better breath control. This is of great benefit to those who suffer allergies or asthma causing difficulty breathing.”


Preventative measures such as these should be incorporated into the life of every allergy sufferer, whether the symptoms are mild or severe, notes Dr. Judge. However, for many, these measures alone will not be enough.

Currently, the first-line treatments for typical seasonal allergies are over-the-counter medications like Zyrtec, Claritin, and Allegra. These are antihistamines and can be taken every day or as needed.  Some people feel the need for a decongestant, but these can cause elevated blood pressure and difficulty sleeping, and really should not be used long-term.

“For those with more severe allergies,” Dr. Judge continues, “an inhaler may be necessary to supplement regular allergy medication and preventive measures. This is particularly true for those who may have allergic asthma—a condition in which an allergy to a particular trigger will actually cause an asthma attack where the lungs and airways spasm and tighten causing difficulty breathing, coughing and wheezing. In such cases I may use a long-acting inhaler once daily when exposure to a trigger is likely, to help maintain open airways, and give a rescue inhaler for acute exacerbations.”

Another new and effective option for those with difficult-to-control asthma are biologic medications. “These newer biologics are able to target the specific mechanism causing inflammation on a cellular level, and can be personalized to each patient,” Dr. Judge says. “It’s a new approach to treatment that may completely change the quality of life for those with chronic asthma.” 

Skin tests reveal specific sensitives of patients; for example, one of the test sites on the baby’s back reveals an allergy to milk.

Allergy Testing

Allergies often have an obvious cause: you have no allergy symptoms until you visit a friend with a cat, and suddenly your eyes are itching and watery, you become congested and feel generally miserable. Chances are, you’re allergic to cats. For some, however, allergens can be more elusive— symptoms appearing at seemingly random times with no identifiable trigger or pattern.

“Allergy testing is a really good option for these people,” Dr. Judge explains. “It’s a very safe and effective way to find out what is causing you to suffer, so you know how to deal with it.”

The testing consists of a simple pinprick on the back, systematically introducing various allergens that commonly cause a problem. “An offending allergen will cause a localized reaction on the skin,” he explains. “Some may only be allergic to one specific thing, while others will discover there are a whole host of allergens that have been causing them trouble. These patients—those with allergies to many things or a strong allergy to something impossible to avoid—are ideal candidates for immunization therapy to desensitize them when simple antihistamines are not enough to control their symptoms.”