Author Topic: Annual allergy appt (Read 3409 times)

CMdeux · « **on:** October 27, 2011, 03:39:29 PM »

Are we the only ones that take two hours for this...

a) DD has only been off cetirizine a week, so we were sort of JUST inside the SPT window as far as Dr. Awesome is concerned. Still. Discussion led to testing for: dil. flu vax, egg, almond, hazelnut, and-- just for gee whiz value and because we'd never done it-- cashew.

Yes... those who know DD's history probably can see where that last one is heading. DD's never had a KNOWN reaction to pistachio, either-- but her skin test to that one was extremely spectacular. Enough so that she was used for "show-and-tell" for "extensive local reaction with pseudopods" for anyone that hadn't ever seen that in person...

Oh, and of course, (+) and (-) controls.
b) Flu shot?? Well, a larger study has finally been done with inclusion of kids with anaphylaxis history-- though, in his opinion, few of them, even, are likely to have DD's kind of history... so tyvm, he WILL test her ahead of time... but he also felt that we can PROBABLY do it.

c) concerns with orthodontia? Eh-- probably not a big connection between dermal allergies to METALS and topical allergens with the atopic package that predicts asthma and food allergies. Statistically, in fact, there is something of a NEGATIVE correlation, interestingly. (Yes, Geek Doc, there, understands that I find this sort of thing kinda cool)... this is where I also quipped that hey-- I guess I just got lucky that way, or something. He said that a family history is apparently much more telling, however-- adn advised low allergen MATERIALS for orthodontia and also using the 'shortest treatment time appropriate.' Good-- he's on the same page as the dental professional team, then. Whew.... four doctors, this has taken so far, and they haven't even DONE anything to her yet.

d) So far so good on the egg dosing-- and he agreed that the VERY conservative approach that we've used during this last year of immunotherapy has been a success and a smart move.

e) Oh, and wooHOOO-- no more allergy injections! Six years and a couple thou... but oh, what a difference!!

Opted NOT to test mold. She didn't SPT (+) the last time, but we have a LOT of history to suggest she's allergic. It isn't like it will change anything either way-- so no reason to test.

Pretty much no real reaction on either control.... which isn't ideal, btw, since it can make it hard to know what the (+) control means-- and subsequently, what (-) results on tests means...

or on the flu vax, hazelnut or almond (though with almond we know that we're dealing with an allergy since we've got convincing history and cross-reaction Hx, even). He thinks that we can challenge Hazelnut-- which DD really wants to do.

The egg was another story-- still very, very positive. (about 8mm?)

The cashew.... oh boy. Within SECONDS, her entire arm had turned red-- and within about five minutes, she had reddened (but flat) hives UP her arm and was sniffling and itching ELSEWHERE on her body.

Ultimately, the wheal on that one was about the size of a half-dollar, and the flare... um... well, it made her forearm swell a bit, and her entire arm from wrist to above the elbow was bright RED. She also had, as noted, hives elsewhere.
Topical antihistamine took the edge off, but some of the low level systemic stuff continued...

After that, he checked the flu vax with an intradermal test and (-) control...

but at least ten minutes into THAT one, we had her take a zyrtec. (He wants to double-dose her for a few days, btw)

Then, she got her first flu shot!!!!

And so we waited another thirty minutes.

She still has a hive the size of a quarter on her right arm from the cashew. We are keeping a close eye on her for any kind of biphasic symptoms, too-- and will probably piggyback an additional dose of benadryl on top of the zyrtec this evening just to be on the safe side.

DD felt like a pincushion, and we were there for almost three hours...

but hey-- all in all, it's been a GREAT day. GOSH, I

our allergist and his nursing staff.

Even the cashew.. meh. Not like that one was a surprise. Though I confess that I'm pretty glad she hadn't been off antihistamines for longer ahead of that one-- and so is the allergist... I think she'd have been epi'ed without that residual antihistamine in her system.

Oh well.

CMdeux · « **Reply #1 on:** October 27, 2011, 04:12:28 PM »

So.

NOW I need to come up with a 'challenge' food.

Nutella....

except that we KNOW that DD is highly allergic to some OTHER treenuts.

Allergist wasn't sure just how free of XC it was, when I asked-- suggested that he figured that I "could definitely check into that question."

(I think he meant it in a good-natured way...)

Anyway, I've got a couple of weeks.

This one can probably be an open challenge, at least-- though a jar of Choc. Soybutter and one of Nutella would make life just grand, there is no doubt.

PurpleCat · « **Reply #2 on:** October 27, 2011, 04:47:15 PM »

Not at all. On Monday, we will be at the allergist for a minumum of 2 hours just for the flu vaccine. Interdermal test, if all ok after a good 20 minutes, vacine, and then they will watch her and her vitals. They won't let us leave until they are sure DD is perfectly fine.

When we go for testing, we are there a good 3 hours at least. DD is also highly reactive and she skin prick tests leave welts and flares like I get from mosquito bites. It looks so painful, but doesn't hurt. It itches like crazy and when they finally put the cream on her arms after all the watching and measuring, there is such relief on DD's face.

Sounds like your DD was a trooper!

My DD would love to outgrown Hazelnut. She so wants real rootbeer! I doubt she will outgrow any of her nuts though.

Great you have a good allergist that you and your DD trust and enjoy spending time with (I mean if you have to be there - it might as well be interesting!).

AllergyMum · « **Reply #3 on:** October 27, 2011, 07:55:44 PM »

Oh my, what an appointment. The cashew reaction sounded very uncomfortable, and I am glad that the reaction finally reduced. How is she doing now?

Interesting information about orthodontia.

Good luck with the challenge Hazelnut. How long is the wait for that appointment. Hopefuly not to long.

mom2AnH · « **Reply #4 on:** October 27, 2011, 08:32:46 PM »

wow. We've had that long of appointments before but our allergist is who (for right now) also manages H's asthma and he so brilliantly once had an asthma attack IN HER OFFICE. Zoiks!

Anyways .... I doubt we'll be able to do testing any time soon with H again. He had a blood draw a couple of weeks ago for Sesame (which reminds me, i've never heard back, so I need to call them back) and he very nearly passed out. His anxiety is COMPLETELY out of control.

Macabre · « **Reply #5 on:** October 27, 2011, 10:21:09 PM »

Oooh--sounds like some great findings!! Especially for the flu vax!!

With Nutella, I don't remember that there are other tree nuts XC. I would have to look and maybe call, but it was Blue Diamond that we held off of for almonds until we knew he wasn't allergic to cashews or pistachios (because I never could remember which one BD also processed--we just did both).

Nutella can add some cool new dietary things--like a "quesa"dilla with it and slices of banana (so we do that with crepes, but I'm thinking it would work with tortillas. Also: a tortilla with nutella spread on it and wrapped around a banana.

Maybe check further to make sure you're not confusing them with Blue Diamond?

GingerPye · « **Reply #6 on:** October 28, 2011, 12:03:27 AM »

Wow -- terrific visit!!

DD had her first flu shot about 10 days ago. She did fine!!

eggallergymom · « **Reply #7 on:** October 28, 2011, 08:01:18 AM »

Wow! That is a ton of good information, and the fact that she could get a flu shot is HUGE!
All of this makes me wonder about my DD's allergist, though. He said there's "no point" in testing her until age 12 or so, given how high her IgE levels were in the last round of blood testing (just before the biphasic anaphylaxis last year.) He doesn't think she's going to outgrow this allergy, and thinks the bloodwork at age 12 would confirm that. I, of course, am the eternal optimist and hope that even if she doesn't every completely outgrow it, there might be a time when she wouldn't anaphylax if there was an accidental exposure. She also has plenty of seasonal allergies, but he's never pursued those beyond telling us to give her Zyrtec. You all seem to have more thorough docs.

CMdeux · « **Reply #8 on:** October 28, 2011, 10:01:35 AM »

Update--

DD didn't have any kind of biphasic symptoms from the cashew reaction-- but she STILL has a very distinct flare where that particular test was and is starting to develop eczema on the site.

I think that rather than confusing things with anything processed, for NOW, I'll probably approach the challenge with local in-shell nuts. After all, I can probably just walk around the neighborhood and pick up a handful at this time of year. LOL!

eggallergymom, has your doc discussed the possibility of a baked challenge once your dd reaches adolescence? That was our 'break' point-- because we didn't want to tamper with anything unless she truly was NOT outgrowing on her own (and boy-- she wasn't)... but he also felt that the newest research coming out of Duke and Sinai supports the idea that even kids like mine (and yours?) may be able to tolerate extensively heated protein well enough to do home dosing with care, and thereby improve tolerance over time. We waited, though, because it also isn't (yet) clear if oral immunotherapy might tamper with the natural extinction of an allergy, and obviously, with milk and egg, MOST kids will outgrow them naturally by mid-adolescence. So we waited until we were reasonably sure that DD wasn't in that group. (This seems similar to what some other members' physicians have done with baked milk, too-- waiting until the child in question is 11-14 years old.)

On another, related note, we had a screw up at our house last Friday (so just 24 hr after DD quit taking zyrtec) where the pizza place put a to-go container of BOTH marinara and ranch dressing in with our breadsticks-- DD grabbed the marinara, and I checked to make sure that the ranch was well-sealed and not 'drippy'-- but I'm guessing that the sequence went "grab and fill ranch, close" then 'grab and fill marinara, close' and then put both into the box-- because DD spent an hour vomiting about two hours later. Yes, I know this is a considerable delay-- but for a trace egg ingestion, it fits her pattern very well. ANYway. She's clearly still allergic-- doc was surprised by just HOW big her skin test still was. Oh well. We've moved in the right direction, and that is the important thing.

AllergyMum · « **Reply #9 on:** October 28, 2011, 11:08:24 AM »

Quote from: eggallergymom on October 28, 2011, 08:01:18 AM

Wow! That is a ton of good information, and the fact that she could get a flu shot is HUGE!
All of this makes me wonder about my DD's allergist, though. He said there's "no point" in testing her until age 12 or so, given how high her IgE levels were in the last round of blood testing (just before the biphasic anaphylaxis last year.) He doesn't think she's going to outgrow this allergy, and thinks the bloodwork at age 12 would confirm that. I, of course, am the eternal optimist and hope that even if she doesn't every completely outgrow it, there might be a time when she wouldn't anaphylax if there was an accidental exposure. She also has plenty of seasonal allergies, but he's never pursued those beyond telling us to give her Zyrtec. You all seem to have more thorough docs.

So many doctors so many different ways of looking at testings.

My sons MFA all are really high and he is contact reactive. Our allergist still blood tests every 10 months. (It was every 6 months when he was younger)

yellow · « **Reply #10 on:** October 30, 2011, 08:33:09 PM »

It took us 2 hours at the allergist for D's first flu shot. Not even a regular appt! Just to do the flu shot.

I've spent 3hrs at appts before. I've always assumed that MFA kids have longer appts.

catelyn · « **Reply #11 on:** October 31, 2011, 07:48:19 PM »

That cashew rx was what Helga had to the hazelnut spt. It was her hand to her armpit that turned red.

We have an appt with a new allergist next monday. Sigh. I've been sticking my head in the sand over it but I have to get my stuff together this week.

TwoDDs · « **Reply #12 on:** November 02, 2011, 02:57:34 PM »

Thanks for sharing all you heard. I was particularly helped by the metal mouth information.

catelyn · « **Reply #13 on:** November 03, 2011, 07:55:50 PM »

Helga seems to have the metals allergy. Her ears blow up with anything with the exception of sterling sliver. She even rx to MY good gold peal earrings that are at least 14k (bought by a rich former boyfriend at a VERY expensive store).

Sticking my head in the sand about the teeth. I must be part ostrich.