Our Services

Allergy and Asthma

At St. Joseph Health Medical Group, our board-certified allergists and immunologists specialize in preventing, diagnosing, and treating immunodeficiency disorders such as asthma and allergies in both adults and children.

We evaluate and treat all allergic conditions. Our focus is on prevention and management, and we educate our patients in effective techniques for strengthening the immune system, treating allergic disease and related conditions, and getting a handle on symptoms.

Our comprehensive practice is supported by state-of-the-art Rosch immunotherapy technology that empowers our patients to take control of their treatment and speed up check-in times and shot delivery. We assess and treat asthma, allergies, hives, eczema, sinusitis, post nasal drip, sneezing, itching, stings allergies, drug allergies, and immunodeficiencies. We procedures such as allergy shots, breathing treatments, corticosteroids, skin tests, patch tests and spirometry.


Our patient-centered approach puts you at the heart of what we do. Our aim is to provide consistently excellent, personalized care to help enhance your quality of life and provide you with the comfort and support you need to manage and treat your asthma, allergies, and immunological conditions. Our specialists work collaboratively to design a uniquely tailored care program that suits your specific circumstances.

We are committed to ensuring that each and every interaction is led with compassion and respect and that every individual is provided with the best in evidence-based treatment that modern medicine has to offer. We understand that you want to get back to your normal life as quickly as possible. Our goal is to provide you with all the tools and support you need to do just that.



Q: What is Asthma?

A: Asthma is a chronic condition of the lungs that causes the airways to swell and narrow, triggering shortness of breath, coughing, wheezing, and difficulty with normal breathing. It is not known exactly why some people develop asthma and others do not, but it is likely that a combination of genetic and environmental factors contributes to its development.

Q: What kinds of tests are available at St. Joseph Health Medical Group for asthma?

A: Tests that measure lung function, such as spirometry, are used to measure the narrowing of your bronchial tubes and the flow of air in and out of your lungs. Peak flow readings are also used to gauge the strength of your exhalation. If the readings are lower than normal, this may indicate that your lungs may not be working properly. If you have already been diagnosed as asthmatic, lower than average peak flow readings may also indicate that your asthma is getting worse.

Q: Are there different kinds of asthma?

A: Asthma is typically classified according to severity and the classification will help your doctor determine the best path to treatment.

  • Mild intermittent asthma occurs up to two days per week and two nights per month.
  • Mild persistent asthma occurs more than twice a week but no more than once a day.
  • Moderate persistent asthma occurs at least once a day and more than one night a week.
  • Severe persistent asthma occurs on most days and more frequently at night.

Q: Can the specialists at St. Joseph Health Medical Group help me develop a plan to manage my asthma?

A: No two cases of asthma are the same, and while it cannot be cured, the symptoms can be managed and controlled. Our asthma specialists will work with you to design an action plan that fits your individual needs.

An asthma action plan outlines the considerations and steps that need to be taken when an asthma attack is occurring. It describes the various symptoms to help you and those around you measure the severity of the attack, and understand what steps need to be taken to provide relief. It will also include details such as:

  • Your specialist's name and contact information;
  • Emergency department phone number;
  • The medications you take, how much you take, and when you should take it; and
  • Information about ‘quick relief’ drugs, to be used only used in case of emergency


Q: What is happening when my body has an allergic reaction?

Allergies typically develop when our immune system negatively reacts to a substance, such as pollen or bee venom, that usually does not bother other people. The immune system protects us from illness-causing organisms that invade the body, but in people with allergies, the immune system identifies certain materials as harmful, even though they are not. The system then reacts by producing antibodies, which may cause the skin to inflame, and affect the sinuses, airways and digestive system.

Q: What types of substances could be causing my allergies to act up?

A: There are thousands of different allergens, and people who suffer from allergies tend to be sensitive to more than one substance. Comprehensive allergy testing by a trained allergist/immunologist can identify the specific causes of an individual’s allergic reactions. There are airborne allergens, such as pollen and pet dander. Some people are allergic to insect venom or latex rubber. There are also food allergens and allergies to some forms of medications like aspirin and penicillin.

Q: What are the most common airborne allergens?

Pollen, mold, dust mites, and pet dander are among the most common allergens, causing reactions when the microscopic particles or organisms are breathed into the body.

Pollen is a powder-like substance produced by flowers that enable them to reproduce. During spring, the amount of pollen in the air tends to be at its highest and many individuals will begin to suffer from symptoms such as a runny nose, sneezing, coughing, and blocked sinuses, which indicate that they may have an allergy to pollen. This type of allergy is also called hay fever. Household mold, which is commonly found in damp places such as bathrooms and kitchens, releases small microscopic spores into the air, which also act as irritants, initiating symptoms similar to that of hay fever. Dust mites are microscopic organisms that live in household dust. A house dust allergy typically produces symptoms that are similar to a pollen allergy or asthma. These tiny creatures can be spread through household dust from bedding, carpeting, and upholstered furniture. You cannot rid your home of them, but you can reduce their numbers by regularly washing linens and covering mattresses and pillows in dust-proof covers.

Allergies to furry pets like cats and dogs are also very common. The pet hair itself is not allergenic, but it collects the animal’s dander (dead skin cells), urine, and saliva. The otherwise harmless proteins in these substances are what produce the allergic reactions. Pet dander, urine, and saliva that settles on clothing, furniture, and household surfaces can in turn collect other allergens like pollen and dust. The allergens can cling to surfaces like walls, curtains, upholstery, and clothing, and retain their strength for long periods of time. When you pet or groom the pet, the allergens become airborne, and when areas where the allergens have settled are disturbed, the allergens lift into the air and circulate throughout the house.

Q: What is a food allergy and what makes it different from a food intolerance?

A: A food allergy is an abnormal response triggered by the body’s immune system when a particular food is eaten. Food allergies can cause serious illness and in some instances can be fatal. So if you have a food allergy, it is vital to work with your allergy specialist to understand what foods trigger your allergic responses. In some cases, a food “allergy” may not be an allergy at all, but instead a minor intolerance. Food intolerance is more common than food allergy. With a food intolerance, the reaction is not caused by the immune system but rather by the gastrointestinal system, although the symptoms may be similar.

Q: What are the symptoms of a food allergy?

A: If you are allergic to a particular food, you may feel an itching sensation in your mouth after eating it. After the food is digested, it may cause diarrhea, vomiting and or abdominal pain. When the allergen is absorbed through the walls of the stomach and GI tract and into your blood stream, it may cause your blood pressure to drop, and hives to develop on the surface of your skin. When the allergen reaches your lungs and throat, it can cause your air valves to swell and tighten, making it hard to breathe.

Q: What types of food cause allergic reactions?

A: The most common food allergens include nuts (such as peanuts and tree nuts such as walnuts), eggs, fish, and shellfish (such as lobster, crab, crayfish, shrimp, and oysters), soy, and wheat.

Q: Why have peanut allergies become prominently featured in the news?

A: Peanuts and tree nuts are the leading cause of anaphylaxis. Anaphylaxis is a severe reaction to allergens that occurs within seconds of coming into contact with the allergen. This type of severe reaction, also known as anaphylactic shock, causes the wind pipes to close, and in some instances violent reactions such as vomiting, to occur. Anaphylaxis needs to be treated right away with epinephrine.


Q: My child has itchy skin? Is that a sign of eczema?

A: Itching is one symptom of eczema, but eczema is more severe than a simple rash. Eczema, also known as dermatitis, is a group of chronic conditions that cause the skin to become irritated and inflamed. It is common in children, but people of any age can have it. Besides causing discomfort, it can be a nuisance that leads to scratching, which typically worsens the problem. The causes of eczema are linked to the skin's inadequate response to an allergen. In addition, eczema tends to be hereditary. This means that it is more typically found in people with a family history of the condition.

Q: What are the most common forms of eczema?

A: There are several types of eczema, with symptoms that range from itchy skin, to oozing blisters, to rashes and dry, scaly skin:

  • Atopic dermatitis, the most common type of eczema, causes the skin to itch and dry out in patches
  • Contact dermatitis is a rash that usually appears after coming into contact with an allergen
  • Seborrheic dermatitis causes scaly, dry patches to occur typically in the scalp
  • Nummular dermatitis causes large round sores
  • Stasis dermatitis causes fluid to build up in the lower legs
  • Dermatitis herpetiformis causes itchiness and the formation of blisters and bumps

Q: How is chronic eczema treated?

A: When properly diagnosed, eczema symptoms can be effectively managed. The allergy and immunology team at St. Joseph Heath Medical Group will partner with you to develop a personalized eczema management program that may include oral medications, skin creams, and light therapy.

Care and Treatment

The Allergy and Asthma specialists at St. Joseph Heath Medical Group offer leading-edge treatment for the management of, and care for, all allergic conditions.

Often the best course of action is to avoid the allergen. If you can keep from coming in contact with the substance that makes you react, you may get enough relief to not need medicine.

If you have a pet allergy, the first strategy is to avoid contact with pets or their living areas. Keep pets out of your home or bedroom, and regularly clean areas shared with pets or in which their dander may collect. If you have a food allergy, don’t eat or touch that food. For hay fever, keep windows closed during spring and fall, when pollen is usually worse (although it is always there). Further reduce exposure by washing pollen out of hair and clothing, keeping the bedroom tidy, and regularly washing pillow cases and mattress covers.

Some allergens, such as pollen, mold spores, and dust mites, cannot be completely avoided, no matter how clean you keep your house or how hard you try to keep out of their path. But complete avoidance is not necessary to improve your symptoms; the goal is to reduce your exposure to the level required to give you relief.

When avoiding allergen exposure fails to bring sufficient relief, the allergists/immunologists at St. Joseph Heath Medical Group have the experience and expertise you need to best solve the problem. An appointment with us is the starting point for identifying the cause of your symptoms and the road to relief.


We may recommend medication either over-the-counter or through prescription to prevent your symptoms or to treat your symptoms. A full discussion of your medical history and any medications you may be taking is crucial to determining which allergy medicines, if any, may work for you.

Over-the-counter (OTC) and prescription medications for allergy and asthma that may prove effective include fast-acting nasal decongestant sprays and antihistamines, and corticosteroids. It’s important to talk to your doctor about potential side effects or interactions with OTC allergy and asthma medications, which can include high blood pressure, insomnia, and rebound swelling of the nasal lining.


Xolair (omalizumab) is a widely prescribed drug for the treatment of asthma. If our allergist/immunologist thinks that Xolair could be effective in your case, we’ll consult with you about the benefits and risks, discuss how long you may need to take it, and propose a course of treatment.

Allergy Shots

Allergy shots, also known as immunotherapy, is the only therapy that can modify or eliminate an allergic response. Medications can at best reduce or prevent symptoms. Allergy shots have been used safely and effectively since the early 1900s. It is a way to increase the body’s natural resistance to the substances are provoking the allergic reactions. Through a carefully controlled program of injections, the allergic patient’s body becomes resistant to the substances that a non-allergic person’s body recognizes as harmless. Small, purified extracts of the allergen are injected once or twice a week to stimulate the body’s immune system to safely fight the allergy. The doses start out small and are gradually increased over six to eight months to a maintenance level, at which time the injections occur less frequently. Many patients feel better right away, although immunity does not develop immediately. After three to five years or less, some patients no longer need injections, while other patients may need to continue treatment for a longer period.

Some patients may be candidates for RUSH immunotherapy (RUSH IT), an accelerated therapy program for allergies. Through RUSH IT, the doses are administered more rapidly than in traditional immunotherapy. Before recommending RUSH IT, our specialists assess your overall health and administer a series of skin tests to identify the allergy triggers. After following a medication regimen for around three days, patients return to our office for a daylong series of injections, all under the close personal supervision of the allergist/immunologist and a physician assistant. Patients go home the same day after a period of observation. The injections taper off in frequency over the following weeks, until they are needed only around once every three to four weeks. RUSH IT can be a quicker alternative to conventional allergy shots, offering faster relief, fewer shots, a quicker arrival at the maintenance dosage, and greater convenience with fewer office appointments. Talk to an allergist/immunologist at St. Joseph Heath Medical Group to see if RUSH immunotherapy is right for you.

Our state-of-the-art immunotherapy program is supported by Rosch technology. The Rosch program is an advanced allergy extract and injection management system. It also features an automated patient booking system that allows patients to simply swipe an identification card on arrival, instantly notifying our specialists of your arrival and what allergies and treatments you require on your visit. The Rosch system also assists our physicians in creating a scheduled treatment program to assess your needs and track your progress.

This innovative technology means waiting times are minimized and registered patients no longer need to go through the work of making individual appointments, as the system automatically sets up appointments for you. It will also help you to stay on top of your treatment by sending regular progress updates and appointment reminders directly to your mobile phone and or email if you so choose. But our supportive staff is always just a phone call away.

Allergy Tests

At St. Joseph Heath Medical Group, allergy testing begins with a discussion of your symptoms and your medical history. If it appears you may have an allergy, our doctors may give you a physical examination and ask to perform additional tests. We use a variety of testing methods including patch tests, skin prick and skin injection tests, blood test, and spirometry.


Patch Test

Patch testing involves applying small samples of allergenic substances to small patches of the skin to check for an allergic reaction (contact dermatitis). Extracts from common allergen substances such as latex, fragrances, medications, hair dyes, preservatives, metals, and resins are applied to small patches which are then placed onto the skin. In some instances, a reaction will occur within minutes but in other cases, where the reaction is not severe, it may take up to 48 hours. Once the patch is removed, any irritation at the patch site may indicate an allergic reaction and is investigated.

Skin Prick Test

A skin prick test, also known as a scratch test, is used to identify allergic reactions to more than 40 different substances. It is a painless procedure that involves a lancet prick that has been exposed to the various substances, which is then used to penetrate the surface of the skin gently. You will typically only feel a small prick like a mosquito bite. If there is an allergic reaction to any of the substances, then a little red bump, similar to a mosquito bite, will form at the site where the lancet prick touched your skin. A reaction to a lancet prick substance can typically be diagnosed within 15 minutes.

Skin Injection Test

A skin injection test takes about 15 minutes and involves injecting a small amount of the allergen under the skin. This test is typically used to check for allergic reactions to medications such as penicillin and to check for reactions to insect venom such as bee stings.

Specific IgE Blood Test

If you have a skin condition that affects skin testing, or if you are taking certain medications, a blood test may be preferable. Our doctors take a blood sample and send it to a testing facility, where allergens are added to the sample and the resulting antibodies are measured. Our doctors receive and analyze the results to make a diagnosis, although-as is the case with skin tests--a positive result does not conclusively mean that your symptoms were caused by the tested allergen.


Spirometry is a common test used to assess how well your lungs are working. It involves breathing out as quickly as you can into the nozzle of an apparatus called a spirometer. You may then be asked to breathe out as slowly as possible. The spirometer will then measure the effectiveness and pressure of your breath.

Additional Support & Resources

Health Calling is an online resource that can help you find a wealth of information regarding general health and wellness, as well as information regarding allergies and asthma. St. Joseph Health also offers a Health Library covering a range of conditions and topics related to lung conditions and disorders.

View Our Locations

ENT - Otolaryngology

Allergy & Asthma

Ear, Nose & Throat

ENT - Otolaryngology

  • 1100 Trancas Street
    Suite 210
    Napa, CA 94558
  • (707) 251-3608
    Monday – Friday 8:30 AM – 5:00 PM

Meet Our Providers

Gregory C. Barkdull, MD (707) 444-8863
Otolaryngology (ENT) (Board Certified)
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Office :
St. Joseph Health Medical Group
2350 Buhne St.
Suite C
Eureka, CA 95501
Joyce H. Colton House, MD (707) 251-3608
Otolaryngology (ENT)

Mon - Fri: 8:30 a.m. - 5 p.m.

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Office 1:
St. Joseph Health Medical Group
1100 Trancas St.
Suite 210
Napa, CA 94558

Office 2:
108 Lynch Creek Way
Suite 7
Petaluma, CA 94954
Madeleine S. Ramos, MD (707) 269-9549
Allergy and Immunology (Board Certified)

Mon - Thurs 9 a.m. - 12 p.m. , & 2 p.m. - 5 p.m., Fri 9 a.m. - 12 p.m.

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Office :
St. Joseph Health Medical Group
2504 Harrison Ave
Suite C
Eureka, CA 95501