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That's so awful!
And so many of us wouldn't Epi if there weren't any symptoms..... I know I wouldn't.
:-[
Exactly what I was thinking, CandyGuru.
This is the scenario that has left me horror-stricken for the notion that if one just "carried one of those injections" all will always be well.
No, not always. My heart breaks for her family. :'(
That's so awful!
And so many of us wouldn't Epi if there weren't any symptoms..... I know I wouldn't.
:-[
I will say this - many comments made about why peanuts need to be removed from these situations and many people liking and agreeing as opposed to the whole your precious snowflake needs to watch out.
That's so awful!
And so many of us wouldn't Epi if there weren't any symptoms..... I know I wouldn't.
:-[
Our allergist was very clear in his early action plans - she said immediate epi with known ingestion - with or without symptoms. So this was when he was 3, 4, 5, and I think around 6 it stopped saying that. I wonder if that was b/c he would be able to communicate symptoms better as he got older? When comparing notes with others I only ran across a few people who were told that - but ours was clear. I think I'm going to get it back in there.
If that argument held any water at all, it would be a problem for the thousands of allergic people who are on maintenance antihistamines. It's not.
I just left a message with our allergist to change both their plans.
As for the allergist's comment McC, I took it differently. I took it to mean that some clients don't carry epipens, so they go racing into the office with symptoms (giving hives as an example) instead of carrying their epipens. I didn't read that as him trivializing hives. <shrug>
No hives doesn't mean no reaction.
It's very tragic, but the fact is that eating a random unlabeled dessert is not careful. It's as if she had darted out into the freeway. Being careful every other time you crossed the street will not help you in that case.
Putting this link here.
Tragic Loss of Sacramento Teen Reveals Flaws in Anaphylaxis Guidelines
by Dr. Mark Greenwald
[url]http://epicentermedical.com/tragic-loss-of-sacramento-teen-reveals-flaws-in-anaphylaxis-guidelines/[/url]
Well SL, do you have a problem with our promoting the anaphylaxis grading chart as much as we do here? Same thing, different set of criteria for administering Epi.
Well SL, do you have a problem with our promoting the anaphylaxis grading chart as much as we do here? Same thing, different set of criteria for administering Epi.
I haven't seen that the grading chart is based on ONE instance. (Or is this doctor using one instance to get traffic? I'm not sure.)
Either way, he is a doctor, who was not there, never saw the patient, and as LinksEtc said, he's possibly advising against a person's own physician.
The difference between him and the grading chart is that the chart was approved by an organization.
Not to totally derail the thread, but SL I didn't take that doc's blog post rec was based on a single instance. That just proved a good example for him.
Not to totally derail the thread, but SL I didn't take that doc's blog post rec was based on a single instance. That just proved a good example for him.
Previous posts had slightly different advice. This blog post appears to be based on ONE patient that he never met and an instance he did not witness. How many times does a news article get some facts incorrect or incomplete?
Someone (TT?) posted something very similar before Natalie's death about recommendations for administering Epi in a medical setting are not necessarily what's most appropriate for the field.
What he is saying isn't out there, though. Other allergists do say it. And it's interesting. Someone (TT?) posted something very similar before Natalie's death about recommendations for administering Epi in a medical setting are not necessarily what's most appropriate for the field.
Having had the advantage(?) of seeing the allergist decide when to use epinephrine on DS2 in office during an oral challenge for anaphylaxis he went by the book. I've stopped asking when to use epinephrine in the field because it's going to be me there and not him or her. Me with no monitors to let me know what's happening internally. Me with no medical training or medical staff or adjunctive therapies to epinephrine to back me up.
Erik so you are avoiding peanuts, eggs, sesame and tn bases in skin tests alone? They have a high rate of false positives. I would also have the ImmunoCAP test run for those to see if you also see positives there.
There are studies that found 86% and higher of kids diagnosed only by test results are not actually allergic. I would want a food challenge for at least sesame since it is such a PITA to avoid. My son can eat lentils and beans but is allergic to peanuts. not sure the % of kids who are allergic to lentils who are also allergic to peanuts but if it is 50% of less I'd want to challenge that, too.
There are studies that found 86% and higher of kids diagnosed only by test results are not actually allergic. I would want a food challenge for at least sesame since it is such a PITA to avoid. My son can eat lentils and beans but is allergic to peanuts. not sure the % of kids who are allergic to lentils who are also allergic to peanuts but if it is 50% of less I'd want to challenge that, too.
There are studies that found 86% and higher of kids diagnosed only by test results are not actually allergic. I would want a food challenge for at least sesame since it is such a PITA to avoid. My son can eat lentils and beans but is allergic to peanuts. not sure the % of kids who are allergic to lentils who are also allergic to peanuts but if it is 50% of less I'd want to challenge that, too.
Sesame is the only thing we avoid due to test results only. Allergist won't do a challenge because her RAST for it is over 7. He is says sesame is such a potent allergen and won't risk it. We don't have many great allergists on the west coast, but I will take her to national Jewish in CO if she will ever agree to a challenge. Sesame is the one that impacts our life the most. That said, she always hated the smell of it and refused to eat anything with sesame so she could very well be truly allergic to it.
Erik so you are avoiding peanuts, eggs, sesame and tn bases in skin tests alone? They have a high rate of false positives. I would also have the ImmunoCAP test run for those to see if you also see positives there.
"Lessons From a Teen Food Allergy Tragedy"
[url]http://allergicliving.com/index.php/2013/08/22/lessons-from-a-teen-food-allergy-tragedy/?page=1[/url]
When to administer epinephrine to a child having a potential anaphylactic episode in school
Many practitioners in our area instruct patients that if there are no symptoms, the patient should receive diphenhydramine and be monitored closely. However, a teenager died in our area recently after eating a peanut, and she initially had no symptoms
There is no “official recommendation” regarding the issue you present
Personally, if the situation occurs in the school, I usually will suggest administration of epinephrine immediately, regardless of whether or not any manifestations are present.
this is a philosophical decision and varies amongst allergists
I'm so sorry for this family's loss. I read about it when it happened. All FA deaths are tragic, but Natalie's death is particularly terrifying because the family did everything right. After learning of her death, if DS has a known ingestion of peanut, I may epi before symptoms.