Food Allergy Support

Welcome => Welcome and Introduce Yourself => Topic started by: EmilyAnn on March 07, 2013, 12:34:42 PM

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Title: Son just diagnosed PA/TNA
Post by: EmilyAnn on March 07, 2013, 12:34:42 PM
My son David will be 5 in June. When he was about 6 months old he started having issues with eczema. When he was 11 months old his pediatrician referred us to an allergy specialist. She did a skin test and he tested positive for dust, mold, cats, dogs, and every pollen they tested for. He did not test positive for any foods. When he was 2 1/2 we went back for another skin test. The results were all the same. He has dealt with severe eczema and environmental allergies his whole life, but never had a reaction to any foods.

Then on December 23, 2012 we were at my grandmother's house having Christmas dinner. David was 4 1/2 at the time. He was eating and told me his mouth hurt. I looked in his mouth and everything looked fine. A few minutes later I looked up and his lips were very swollen! I told him to take a deep breath, looked at his tongue to make sure it wasn't swelling, and had him drink some water to make sure he could swallow. He seemed to be breathing ok so I gave him some children's Benadryl chewables and took him into the living room to watch him closely while the rest of the family finished dinner. After a little over an hour the swelling had gone down and he looked and acted normal. Everything he ate that night were things he had eaten before, the exact same meal he had a month earlier at Thanksgiving and every Easter, Thanksgiving, and Christmas since he started eating solids.

So I kept giving him Benadryl every 4 hours through the night and stayed up all night watching him breathe. The next day (Christmas Eve) I called his pediatrician and she called the local Walgreens and called in a prescription for him to get a 2 pack of epi-pen jrs. We were not sure what food caused the reaction, but it seemed like the pecans on the sweet potato casserole were the most likely culprit. A couple of days after Christmas I called the allergist to make an appointment and was told they couldn't see him until March 4th.

So, this past Monday I took him to the allergy specialist and she did a skin test. This time she only checked for foods and not all of the things he had tested positive for in the past. he tested him for cashew, almond, English walnut, peanut, pecan, Brazil nut, hazel nut, cow's milk, egg white, and soybean. He tested positive for cashew, English walnut, peanut, pecan, and hazel nut.

I feel like she didn't give me much information. She told me what he was allergic to and asked if I had any questions. Of course I couldn't think of any at the time, but now I feel like I have a million questions!
Title: Re: Son just diagnosed PA/TNA
Post by: Jessica on March 07, 2013, 01:04:12 PM
I'm sorry but I'm glad you've found us. Keep in mind that sometimes, too much knowledge can be very scary. It will get easier. Ask away.
Title: Re: Son just diagnosed PA/TNA
Post by: CMdeux on March 07, 2013, 01:09:24 PM
Hmm-- yes, I remember that feeling of "What?  That's it??  Why aren't you telling me what I need to know??"  and wondering (feeling overwhelmed, truth be told) what I didn't know, and how my kid was going to be paying the price for me learning things the hard way. 

It's a terrible feeling.


Some suggestions from my memories of that first adjustment period:

a) review the anaphylaxis grading chart so that you know WHAT kinds of symptoms need to be raising "is this an allergic reaction?" red flags in your head.  It's inevitable, but you'll be spending a lot of time in the next few months/years trying to figure out when something is illness and when it's allergy.

b) Know when to use those Epipens.  Ask your doc for guidelines there-- and look up best practices from FAAN, etc. so that you know that your allergist's advice seems solid and current.  Knowing the difference between local reactions, local reactions which are impacting essential parts of the body, and systemic reactions is key here.    The reaction that you describe is in that middle zone-- it's possible that it was elicited by contact, but because it was in an area which can cause airway impairment, it still needs to be watched/treated aggressively (which you did!  YAY, you!!!).

c) Medic-Alert bracelet for your child.  This is so that he doesn't always have to speak for himself if, heaven forbid, you can't do it for him. 

d) begin learning about what this will mean for school and other activities where he isn't in your care-- and begin planning for those things.  He should NEVER be without an adult that knows how to treat a reaction with epinephrine. 

I'll answer your other specific questions in the other thread.

A very warm welcome, by the way.  I'm sorry that you needed to find us, but I'm glad that you have.   :heart:
Title: Re: Son just diagnosed PA/TNA
Post by: EmilyAnn on March 07, 2013, 06:48:38 PM
What is the anaphylaxis grading chart? can you post a link?
Title: Re: Son just diagnosed PA/TNA
Post by: rebekahc on March 07, 2013, 07:50:22 PM
Hi and welcome!  Here's a link to a page that includes a link to the Anaphylaxis Grading Chart.  http://foodallergysupport.olicentral.com/index.php?action=page;sa=Welcome
Title: Re: Son just diagnosed PA/TNA
Post by: EmilyAnn on March 07, 2013, 07:57:25 PM
thank you!

so was his reaction in December only a grade 1?
Title: Re: Son just diagnosed PA/TNA
Post by: PurpleCat on March 08, 2013, 07:45:40 AM
Hi!  and Welcome!  Stinks to be here, but it's a good place to be!

I did not bother looking at the grading chart to answer your question.  I just want to put this out to you.  If he's allergic, he's allergic. 

I had a waitress last week say to DD, "well if you are only a little allergic to sesame you can try this" - I looked her square in the face and said "There is no such thing as a little allergic!  You either are allergic or are not allergic!"  Next thing I knew the restaurant manager was at the table apologizing and assuring me that the kitchen understood and the food would be safe.

Reactions are not predictable.  How your child reacted in December may not be how he reacts if there is a next time.


It surprised me that even today, allergist still don't arm their patients and families with information.  You are just left trying to figure it out as you go along.   That is a very uncomfortable place to be and I was in your shoes about 10 years ago.  Some of the same people who are here helped me navigate our journey and still do!

I don't know how that can change, but have often thought allergists should be required to have nutritionists who specialize in food allergies on their staff.  But off my soap box now.

No question is too small, no question is dumb....just ask.  One day at a time.
Title: Re: Son just diagnosed PA/TNA
Post by: LinksEtc on March 08, 2013, 11:24:42 AM
Welcome EmilyAnn  :bye:

I just wanted to make sure that your allergist gave you a "Food Allergy Action Plan".
This is an example from FAAN/FARE (some allergists have plans that may be somewhat different):
http://www.foodallergy.org/files/FAAP.pdf

I've really learned a lot from this group ... it's a good place to find help and support.
Title: Re: Son just diagnosed PA/TNA
Post by: EmilyAnn on March 08, 2013, 01:25:15 PM
Welcome EmilyAnn  :bye:

I just wanted to make sure that your allergist gave you a "Food Allergy Action Plan".
This is an example from FAAN/FARE (some allergists have plans that may be somewhat different):
[url]http://www.foodallergy.org/files/FAAP.pdf[/url]

I've really learned a lot from this group ... it's a good place to find help and support.


Nope, she did not give me an action plan at all. She gave me a paper with the test results and told me to look up foodallergy.org. That's all. I really left the appointment feeling scared and overwhelmed.
Title: Re: Son just diagnosed PA/TNA
Post by: Macabre on March 08, 2013, 02:05:52 PM
Okay--something else to consider:  your child may not be allergic to all those foods if your doctor only used a skin prick test.  SPTs have a high false positive.

A blood test (ImmunoCAP) is a more reliable test--and used in conjunction with an SPT is more helpful. Of course, the only thing that can truly diagnose a food allergy is reaction history.

Still, it could be that your son is only allergic to peanut but the pecan he ate was cross-contaminated (you'll see that as XC here) with peanut. There are very few peanut free pecan companies.  Or he could really be allergic to all those things.  And at this point, that's the assumption you should make.

However, I would ask for a blood test when you next visit your allergist.

Is this a board certified allergist? Of course, even they can give little info or not operate according to best practices. It's awful, but we see/experience it too often.

Some things you should know about labeling: it's not as helpful as it needs to be.  Companies only have to label for the top 8 allergens if they are actual ingredients. However, some children have reactions to trace amounts that can remain on equipment--even if the manufacturer says they clean well.  Manufacturers are not required by law to label for shared lines--just actual ingredients.  Some companies label "may contain."  Just believe them. Some of that labeling is CYA, but at this point, just believe them if it says may contain.

However, know that just because a label doesn't say it contains the allergen doesn't necessarily mean that it 100% doesn't. 

Some companies are known for labeling for shared lines:  General Mills, Keebler (Keebler may be a GM brand), Pillsbury, Hershey.

What our allergist told us:
No Asian food unless you make it yourself (most all restaurants don't fully clean the woks, and the cashew or peanut or sesame or shellfish protein remainPF Chang, and they are good abotu serving folks with food allergies--but at this point, I'd just stay away from all Asian restauratns)

No ice cream parlors

No chocolate unless you know it's safe
 
No bakery items

Carry the epi everywhere (at least two). Make sure you don't let it be exposed to extreme cold or heat. 

----------------

I am glad you found us.  I hope this resolves some of your kiddo's eczema issues. 
Title: Re: Son just diagnosed PA/TNA
Post by: Jessica on March 08, 2013, 02:44:54 PM
For peanut, there's component testing (the Uknow Peanut test) that is supposed to be more accurate even than immunocap. Not as many doctors do it yet though.
Title: Re: Son just diagnosed PA/TNA
Post by: Jessica on March 08, 2013, 02:46:25 PM
btw my dd's allergist believes that skin testing is the gold standard and he would not do a blood test. He said the skin test is more accurate. Not saying one way or the other, but that is what we're dealing with (him not even considering that it may not be). She has had positive skin tests 3 times and there are some that tested positive, then negative, then positive (almonds and brazil nuts).
Title: Re: Son just diagnosed PA/TNA
Post by: EmilyAnn on March 08, 2013, 03:10:34 PM
The allergist we saw is supposed to be the "best" in our area. She has a REALLY long wait just to get an appointment. I think it is something like 4 months or more for established patients and even longer for new patients. Could his pediatrician do the blood test?

The allergist did say tests my not be very accurate because he is still young, but she said a blood test would not give us any more info than what we have now. She also said it is a very expensive test. Would the blood test combined with the results of the skin test be the most accurate?

Title: Re: Son just diagnosed PA/TNA
Post by: CMdeux on March 08, 2013, 04:18:39 PM
Maybe not, maybe so.

Our rule of thumb is to ask "if the results said _____, what would it mean to us?  What would it change?"

If the answer is "nothing" or even worse-- "it would make things worse, because then we'd wonder if we shouldn't do _____, but we wouldn't KNOW what the right thing is..."

well, in those cases, we've found over time and with bitter experience, it's PROBABLY better to leave those things alone, by and large.

I guess what I'm saying is-- consider what you'd do if that blood test showed VERY HIGH IgE levels.  Would it change things in your mind?

Maybe. Would that be the rational and right response? Maybe, again.  That's one to discuss with the allergist.

If they were zero, though... <thoughtful>

would you be willing to try challenges?  Would your allergist?  Would your son?  I'm guessing that at this point in time, you probably are thinking not.  So in that case, the information wouldn't change a thing, right?


I'll add that while a RAST is certainly not free, and clearly your son is going to need to have epinephrine around either way... avoiding peanut can be fairly expensive all by itself, when you amortize not being able to buy contaminated (less expensive) products over several years.  It gets even MORE expensive if you get stuck "providing treats" for playgroups and the like in order to reduce risk for your child.


Title: Re: Son just diagnosed PA/TNA
Post by: hezzier on March 08, 2013, 10:55:00 PM
The allergist we saw is supposed to be the "best" in our area. She has a REALLY long wait just to get an appointment. I think it is something like 4 months or more for established patients and even longer for new patients.

And she may be  the "best" for environmental allergies, but not have a lot of experience with food allergies.  Not all allergists are created equal!!  Do you have a larger city near by that might have more options?
Title: Re: Son just diagnosed PA/TNA
Post by: EmilyAnn on March 08, 2013, 10:58:53 PM
The allergist we saw is supposed to be the "best" in our area. She has a REALLY long wait just to get an appointment. I think it is something like 4 months or more for established patients and even longer for new patients.

And she may be  the "best" for environmental allergies, but not have a lot of experience with food allergies.  Not all allergists are created equal!!  Do you have a larger city near by that might have more options?

She was in a larger city. I have to drive an hour to get to her office. There are probably not any allergist in my very small town. I can look and see if there is anyone in the other big town nearby (opposite direction of the one we went to.) How can I find out is an allergist specializes in environmental allergies or food allergies? I just went with the doctor everyone recommended to me and her website don't say anything about the kind of allergies she specialized in.

The website says "She joined xyz Allergy and Asthma in 2005, immediately following the completion of her Fellowship in Allergy and Immunology in Philadelphia.  She earned her BS in Biology from Duke University and completed her Medical Degree and Residency training at SUNY Stony Brook.  Dr. W is Board Certified in Pediatrics as well as Adult and Pediatric Allergy and Immunology."

Then on another page it says "Skin testing is usually preferable because it is simple and less expensive than serum samples performed in the laboratory.  Skin test results are available almost immediately and are more sensitive than the lab (RAST) test.  We use the Greer Pick as a testing device.  This is a 6 pronged applicator, similar to the TB tine test. These tests can be interpreted within 20 minutes.  The assistant will grade the test depending on the size of wheal and redness, in relation to both the positive and negative controls. Intradermal tests are performed if the scratch tests are negative."
Title: Re: Son just diagnosed PA/TNA
Post by: LinksEtc on March 09, 2013, 08:02:51 AM
EmilyAnn,

It's totally your decision, but you might want to edit the above post for privacy.  It's easy to plug a quote like that into a search engine.

I am wondering if this might be an option for you
http://pediatrics.duke.edu/divisions/allergy-and-immunology

The fact that you weren't given an action plan is a red flag to me ... This is pretty standard these days.  Sometimes "the best" in something, is not the " best" for you and your particular needs.  Finding an allergist who you connect with, and who is knowledgeable, will make a huge difference as you start on this journey.

 :grouphug:


-----

I can edit my post if you want also.
Title: Re: Son just diagnosed PA/TNA
Post by: EmilyAnn on March 09, 2013, 10:05:22 AM
EmilyAnn,

It's totally your decision, but you might want to edit the above post for privacy.  It's easy to plug a quote like that into a search engine.

I am wondering if this might be an option for you
[url]http://pediatrics.duke.edu/divisions/allergy-and-immunology[/url]

The fact that you weren't given an action plan is a red flag to me ... This is pretty standard these days.  Sometimes "the best" in something, is not the " best" for you and your particular needs.  Finding an allergist who you connect with, and who is knowledgeable, will make a huge difference as you start on this journey.

 :grouphug:


-----

I can edit my post if you want also.


I did think about that before posting last night, but I think the only info anyone could get from that is that I live in a city an hour away from a big city in NC. Right?
Title: Re: Son just diagnosed PA/TNA
Post by: CMdeux on March 09, 2013, 03:32:29 PM
For now, that probably doesn't seem like that big a deal...


but as you go along, it might be later.  :)  Friends, neighbors, and family have a way of finding us here.... and (unfortunately) so do those who might be looking for less desirable/helpful reasons, like that nasty woman at the homeschool co-op, or the guy that told us to bug off at the HOA meeting...  school principals.... etc.

It happens.  Also, as your kids get older, they become more desirous of anonymity, which is something that most of us never stop to think about when they are preschoolers!  I first joined up with this community when my DD was just two years old.  She's almost 14 now, and she's <gulp>  a member here, herself, now. 

Most long time members handle that need for privacy in one of two ways:

a) let all of the identifying stuff hang out there, and NEVER share anything-- ever-- that you wouldn't shout out in front of your own house.  No vents, no ranting, nothing less than flattering/nice about EVERYONE in your life, and everything you encounter.

b) Keep some details very private (location, gender, names, birthdates, identifiers of your occupation/employer/faith community, etc) and then let all the stuff you CANNOT have out there in real life hang out.  Rant/vent away.  And believe me, there WILL be people who will do things that make your live much harder than it needs to be, and you WILL want to scream. 

The latter tends to be a bit more sustainable in the long haul as our kids age into adolescence, but both are viable solutions.  Also, worth noting that some communities (support) skew toward less anonymity and some toward more, and some toward VERY young cihldren, some toward young adults.  We tend to be about school-aged kids and adolescents on the parenting side, and multiple food allergies on the adult side.



Title: Re: Son just diagnosed PA/TNA
Post by: LinksEtc on March 09, 2013, 05:59:24 PM
Also, it wouldn't surprise me if allergists lurk here once in a while ... it's just something to keep in mind.

Sorry, I didn't mean to take this thread off track.  It will take some time to get a handle on this allergy stuff ... take it a step at a time ... focus on the basics first like recognizing the symptoms of a reaction, knowing how to use the epi, & learning to recognize allergens on the food label.
Title: Re: Son just diagnosed PA/TNA
Post by: CMdeux on March 09, 2013, 06:06:18 PM
 :yes:


Get into the habit of EVERY label-- EVERY time.

I've been doing this for well over a decade at this point, and I still make mistakes.  Usually, since there is a second pair of eyes on things (DD's) the number of reactions that result from those mistakes is low... but the very fact that I can make them and bring things that are unsafe into my home accidentally after all this time is disturbing-- I'm not that kind of person (the kind who is casual about errors and doesn't worry about making mistakes).

It's very easy to skip that step of flipping the package over before you put it into your cart-- all the more so with products that you trust, or those which look more-or-less identical to them.
Title: Re: Son just diagnosed PA/TNA
Post by: EmilyAnn on March 09, 2013, 09:16:23 PM
I posted somewhere else asking if people knew where I could buy a small backpack for my son. I said needed something small enough for him to carry and it only needs to hold clean underwear and shorts, a cup of water, and his epi-pens and Benadryl. This one woman started lecturing me on how dangerous it is to let him carry around an epi-pen and Benadryl.

I have a small case (looks kind of like a make-up bag) that has 2 epi-pens, 4 children's Benadryl fast melts, and a card with info on it. I would put that case in the backpack along with the other things. This one woman kept telling me it was so dangerous for me to have any kind of medicine in a backpack for him to carry around. The plan is for ME to keep track of the backpack and hand it off straight to another adult (Sunday school teacher, grandparent, whoever he is going to be with.) Is it really that dangerous? She said other kids could get a hold of it and take the medicine or stick themselves with the epi-pen. It seems to me like it would be the easiest way for him to keep all of his stuff together. And even if I am in the same building, if he were to have a reaction every minute would count, right? So the time it would take for someone to walk to the sanctuary, find me, and us get back to his classroom would be minutes wasted.  And if the adults watching him are not responsible enough to keep other kids from messing with his bag (which would be hanging on a peg up on the wall) they are NOT someone I want to leave my child with anyway!
Title: Re: Son just diagnosed PA/TNA
Post by: Mfamom on March 10, 2013, 08:46:18 AM
a lot of times too, environmental allergies like (grass, pollen etc) can produce false positive on spt for tree nuts.
Title: Re: Son just diagnosed PA/TNA
Post by: CMdeux on March 10, 2013, 10:50:25 AM
My daughter has been carrying her own epipens ON her body since she was not quite three.

In all of that time, she has NEVER allowed another child to handle them, though she will 'show' them to others sometimes if they are curious. 

I find that this particular argument is usually made by people who really don't have a great understanding of what this device is, nor of why it is important to carry it on/near the allergic child.  Mostly, our kids regard those epipens as:  a) yes, a pain to carry around everywhere, but b) a revered/sacred item because they are a kind of talisman of safety-- for real.

Any child that has experienced a scary reaction and understands cause-and-effect will NEVER make the mistake of allow others to handle them casually.    JMO, but the Canadians often have kids self-carry much younger than Americans typically do-- and I think that they have the right idea here.  Just like with a medic-alert bracelet, they ought to feel vulnerable and just... wrong... without them on.

My daughter has always had input into what she wanted her "carrier" to be like.  She's worn them in a small cross-body bag most of her life.  It's hands-free and keeps her from setting them down and leaving them (which, yes-- she's done, especially when she was about 7-8yo... plan ahead and put contact info IN that bag).  Some kids like belt carriers or fanny packs which can be more or less hidden under an untucked shirt or jacket.
Title: Re: Son just diagnosed PA/TNA
Post by: Mfamom on March 10, 2013, 04:41:36 PM
i missed the point about a child having the epi pen on his/her person the first time through.
first, that really isn't anyone else's business and it is very dangerous for YOUR child to be without his Life Saving Medications! 
My ds has carried his since he was in 5th at school and has had it on his person during times I wasn't with him.  He never allowed anyone access to it (mostly because he takes his allergies very seriously)
there are carriers designed for epi pens.  there is a thread here with links to different companies.
Title: Re: Son just diagnosed PA/TNA
Post by: SilverLining on March 10, 2013, 08:32:53 PM
I posted somewhere else asking if people knew where I could buy a small backpack for my son. I said needed something small enough for him to carry and it only needs to hold clean underwear and shorts, a cup of water, and his epi-pens and Benadryl. This one woman started lecturing me on how dangerous it is to let him carry around an epi-pen and Benadryl.


My son has been wearing his epi-pen in a belt around his waist since he was 3 or 4. 
Title: Re: Son just diagnosed PA/TNA
Post by: EmilyAnn on March 10, 2013, 09:50:41 PM
one of my other sons has a well-child visit tomorrow. I think I will ask the pediatrician then if we can get a blood test done in their office and if so I will go ahead and get one scheduled. I was going to wait until his 5 year check up, but I think I need to know now. If it is true that the skin test has a high false positive rate I want to compare the results of the skin test to a blood test. I want to protect my child as much as I can, but I don't want to restrict him more than I have to if he is only allergic to tree nuts and not peanuts (or something like that.)
Title: Re: Son just diagnosed PA/TNA
Post by: CMdeux on March 11, 2013, 10:40:17 AM
Yes, with a brand new baby, you're going to have a LOT of things to manage at once.  It would be really wonderful if a peanut allergy weren't among them.  (I can hope, right??)

But if it is, it's also better to know that you're not worrying for nothing, too.  His dislike of peanut products is probably not a very good sign, unfortunately.  Many kids who become/are allergic have that same aversion to them. 
Title: Re: Son just diagnosed PA/TNA
Post by: Macabre on March 12, 2013, 04:05:34 PM
Fwiw I have posted freely about the allergist we saw when it was outside of our Virginia city for instance, once we started going to Wesley Burks at Duke I had no problem sharing that. (He is a FA guru and top notch and is now at UNC Chapel Hill) and that we had been accepted into an oral immunotherapy trial with Scott Commins at UVA. I'm not going to rant about them publicly, not that I had reason to. We had to drive to see both docs.

I just make sure I always keep a few bits of info to myself, and I do fine. Besides-- I've become FB friends with a lot of folks here and have met a number in person. :)

With regard to self carrying, it depends on the kid. My son started totally self carrying at 9, but I wish we had started in Kindy, because as he carries the Epi pouch that kept was in his teacher's desk to music and gym, he lost it a few times. It wasn't second nature to him to have it for a long time.

He would have done fine wearing it in a belt at that age--better actually. But it depends on your child.
Title: Re: Son just diagnosed PA/TNA
Post by: lakeswimr on March 29, 2013, 10:28:59 AM
The allergist should have given you a clear written plan for what to do in case of a reaction and when to use the epi pen.  About all plans would call for giving the epi pen for mouth symptoms and for lip swelling.  That can mean the person is in danger of swelling spreading to the throat that could block breathing.  I think the ana grading chart is interesting but I personally prefer a clear written plan that says if x happens do y, etc.  If you google the phrase, 'faan emergency action plan' you will find a pretty standard plan.  I understand your allergist is the best in your area.  It might be worth driving, even a few hours, to a better allergist.
Title: Re: Son just diagnosed PA/TNA
Post by: Ra3chel on April 01, 2013, 07:01:25 PM
For now, that probably doesn't seem like that big a deal...


but as you go along, it might be later.  :)  Friends, neighbors, and family have a way of finding us here.... and (unfortunately) so do those who might be looking for less desirable/helpful reasons, like that nasty woman at the homeschool co-op, or the guy that told us to bug off at the HOA meeting...  school principals.... etc.

It happens.  Also, as your kids get older, they become more desirous of anonymity, which is something that most of us never stop to think about when they are preschoolers!  I first joined up with this community when my DD was just two years old.  She's almost 14 now, and she's <gulp>  a member here, herself, now. 

Most long time members handle that need for privacy in one of two ways:

a) let all of the identifying stuff hang out there, and NEVER share anything-- ever-- that you wouldn't shout out in front of your own house.  No vents, no ranting, nothing less than flattering/nice about EVERYONE in your life, and everything you encounter.

b) Keep some details very private (location, gender, names, birthdates, identifiers of your occupation/employer/faith community, etc) and then let all the stuff you CANNOT have out there in real life hang out.  Rant/vent away.  And believe me, there WILL be people who will do things that make your live much harder than it needs to be, and you WILL want to scream. 

The latter tends to be a bit more sustainable in the long haul as our kids age into adolescence, but both are viable solutions.  Also, worth noting that some communities (support) skew toward less anonymity and some toward more, and some toward VERY young cihldren, some toward young adults.  We tend to be about school-aged kids and adolescents on the parenting side, and multiple food allergies on the adult side.

A few of us also have (known to the admins) sock-puppet accounts we use for more sensitive topics. It's not exactly condoned, but the folks here do understand the need for confidentiality--and that sometimes protecting that means compartmentalizing information under multiple handles.