Katzen takes a listen.
"You sound really, really clear," he said.
He then has Pechie take a breathing test. The results come back fine too.
"Probably 85 percent of what you do is routine and easy. Fifteen percent requires more thought, more time, more energy, detective work," Katzen said.
An allergy test turned up negative for Pechie. He doesn't have allergies or asthmas. But for some people, more digging is needed.
"The new issue now is an inflammation of the esophagus, sometimes associated with food allergies. It's happening in kids and adults, sort of a combination of allergy and GI," Katzen said.
And some food allergies are unusual.
"I've seen food allergies to lettuce, sort of odd foods you don't normally think of people being allergic to," Katzen said.
But the big thing right now is tree pollen.
"Tree pollen season is usually the busiest time of the year for any allergist in New England," Katzen said. "We have nasal steroids, we have antihistamines, nasal antihistamines, Montelukast. They all work to block the allergies."
And there's something new for specific allergies.
"There's some new oral treatments for grass and ragweed that are just coming out now. They'll be effective. You have to start them 12 weeks before the season," Katzen said.
It's no wonder allergists in Southern New England remain busy.
Katzen said he enjoys his work and he's being recognized by his peers for it. He was recently named a top allergy doc in Rhode Island Monthly, an honor bestowed on him every year since 1994.
"You can't do it alone," he said. "You need an office staff that is responsive to patients' needs, scheduling patients and you know, thoughtful and caring to them, and communicates with the primary care doctors about what we're doing."
Katzen is one of four top doctors in the field of allergy and immunology. The others are Drs. John Zwetchkenbaum, Anthony Ricci and Russell Settipane.
For a complete listing of all 168 top doctors in Rhode Island, pick up the current edition of Rhode Island Monthly magazine.