think ds had an ana reaction

[texaspeach]

ds, 11 mo, had some of my eggs this morning. he immediately broke out in hives on his face/head and chest. we went up to take a bath and he vomited not 10 minutes later. I gave benadryl immediately and watched his breathing while I waited for our ped to call back. his breathing was/is fine so we're seeing the dr today. the nurse said it did sound like anaphylaxis. he seems fine now, he's taking his morning nap on my lap.

he has had egg before (I know we should have waited, I'm kicking myself ). we had the rast for the top 8 2 months ago and egg was not a hit (he is allergic to wheat but not ana) - I know there can be false negatives. he also ate 2 bites of some apricot/banana/pear/apple sauce - he's had all those before too.

what do I ask? I know we need 2 epipens. should I ask to be referred to an allergist?

[JaneS]

Yes, 2 body systems reacting at same time equals anaphylaxis. In his case it was skin (hives) and digestion (vomiting).

Yes, you need 2 Epipen Jr's with him at all times. We keep ours in an insulated bag, it cannot be under 55 or over 85 degrees (I think those are correct temps).

Learn about biphasic reactions:
http://www.foodallergy.org/page/anaphylaxis

Ask your Ped but yes, an allergist is probably warranted. I would think first before doing a skin prick test. At early ages of reactivity I'm not so sure this doesn't expose their blood to other allergens.

[JaneS]

And top 8 should really be top 9, including sesame. It is the fasted growing ana allergy now and the only one my DS has had a reaction to, so just be aware of sesame seeds and hummus.

[sbgrace]

I also want to emphasize learning about biphasic because kids can survive an initial anaphylaxis and then go into second (usually worse) anaphylaxis in the next few hours. My son's first anaphylaxis was biphasic. I had not clue. So your baby wasn't necessarily ok just because the first attack was over. And read up on signs as well--you would use the epi the moment a second body system was involved. Epis are most effective early into the reaction. Most kids who die got an epi but too late and too late, to my surprise, is pretty early in the reaction. So you won't wait for breathing or shock or whatever. Our procedure is epi pen and 911 for any two body systems or any known exposure to tree nuts or sesame with any symptom. Sesame is a horror to avoid and has high ana potential so I'd treat it however you chose to tree tree nuts, peanuts, and the like with an allergy prone kid.

[texaspeach]

thankfully I knew about biphasic reactions from hanging out on this forum I've been reading here since ds was about 2 months old and we suspected milk protein intolerance. this forum is why I knew that he was having an ana reaction - hives + vomiting - and not somehting else.

so we got a 2 pack of epipen juniors. however, the doctor we saw (who is also the one that dxed his penicillin/penicillin allergy but not our regular dr) was sort of vague when I asked her abut when we needed to use the epipen. I asked when we should use it - if we should use it when it was apparent there was an anaphylactic reaction or what and she said "youw ill know" so I asked if she meant only when there was respiratory involvement and she said yes. but that doesn't sound right to me. we see our regular doc in a month - he is apparently "the guy" in this practice when it comes to allergies so we'll talk about it more then. I also got the names of some ped allergists and will call to make an appointment soon (mainly for DH because he is freaking out about this and needs some education, he doesn't really trust the internet) but ds will probably be 18 months before they can see him.

I just wanted to confirm that he did show to be nonreactive (0 on a 0-5 scale) to egg two months ago. it was either a false negative or he has become sensitized since then

thanks for your advice this food allergies thing really, really stinks.

oh, one question - since ds has one anaphylactic food allergy, and another nonana food allergy, that means he is more likely to develop other food allergies. obviously I am not introducing peanuts or treenuts to him, but *I* eat them (pecans, as a sub for glutinous grains), and have milk now. ds has yogurt a few times a week and has been ok with it. would you avoid all the big allergens or continue to eat the things that have been ok? we have been avoiding sesame too, I forgot to ask if it was included on the panel last time

[JaneS]

FWIW, my DS's only ana reaction was pretty much as you described your DS's to be. And our allergist, the well known Michael Young of The Peanut Allergy Answer book, has us go the Epipen at *any* sign of an allergic reaction. Even if nuts or sesame (the ones he is positive to) is eaten and there is no physical sign yet.

I went to a FAAN conf. a few years ago and they were emphasizing that there was no risk to the Epipen so you shouldn't hesitate to use it. It's a common misconception to wait and see if the reaction is "bad enough" and like Rachelle says, sometimes that is too late.

I'm not sure what you are asking... whether you should avoid top 9 all together?
If he is intolerant to a food and you are nursing but continuing to eat it?

[momofmine]

That's interesting, I didn't realize there was no risk to the epipen. I reacted very badly to epinephrine. It made my heart race, I felt dizzy and weird and it took a long time to come out of it. That has been my concern, since that is how I react. I'm not sure if that means I am actually allergic to epinephrine (is that even possible?) or if I am just hypersensitive to it.

[momofmine]

About biphasic reactions, I have wondered a lot about whether or not this is like a rebound reaction when the Benadryl wears off. For example, if Benadryl wasn't given, would the biphasic reaction happen? I guess it's an unanswerable question though.

[sbgrace]

Originally Posted by momofmine

About biphasic reactions, I have wondered a lot about whether or not this is like a rebound reaction when the Benadryl wears off. For example, if Benadryl wasn't given, would the biphasic reaction happen? I guess it's an unanswerable question though.

Well, it happens with epinephrine administration in the hospital too (and second doses are needed when it happens) so I think it's something else? it's certainly not just a benadryl issue as kids with anaphylaxis are I would hope getting much more than benadryl. At any rate, son's biphasic was without benadryl because we handled the initial reaction so poorly.

[texaspeach]

sorry about the incoherent post - that's what happens when I post precoffee. I was wondering about whether I should eliminate milk from ds's and my diet, and avoid all nuts myself (we are not giving him nut products). for now we are still offering him yogurt with no reaction and I'll continue to have dairy, but I think I'm going to go ahead and avoid nuts - that's pretty easy for me to do.

is there no risk to epinephrine? the drug information didn't sound like there was no risk - especially since the epipen jr we got is dosed for kids 33-65 lbs and ds weighs 21lbs. I thought it was just that the benefit of the epi out weighs the risks of anaphylaxis

[JaneS]

Originally Posted by momofmine

That's interesting, I didn't realize there was no risk to the epipen. I reacted very badly to epinephrine. It made my heart race, I felt dizzy and weird and it took a long time to come out of it. That has been my concern, since that is how I react. I'm not sure if that means I am actually allergic to epinephrine (is that even possible?) or if I am just hypersensitive to it.

It's adrenaline so that is a fairly normal reaction. They said this is not risky per se... it doesn't damage the body or the heart, it's just uncomfortable if you get a lot.

A reaction that's severe could mean you have low vitamin C to clear it. Next time take a lot of C afterward when reaction has well passed. Vit. C clears a lot of toxins out of the body more quickly... adrenaline that's released in panic attacks can respond to high C dosing and also novocaine after dentist appt. C will make your fat lip go down faster, very useful). C also clears histamine too.

Or do you have adrenal fatigue issues?

[JaneS]

Originally Posted by texaspeach

sorry about the incoherent post - that's what happens when I post precoffee. I was wondering about whether I should eliminate milk from ds's and my diet, and avoid all nuts myself (we are not giving him nut products). for now we are still offering him yogurt with no reaction and I'll continue to have dairy, but I think I'm going to go ahead and avoid nuts - that's pretty easy for me to do.

is there no risk to epinephrine? the drug information didn't sound like there was no risk - especially since the epipen jr we got is dosed for kids 33-65 lbs and ds weighs 21lbs. I thought it was just that the benefit of the epi out weighs the risks of anaphylaxis

Maybe you should do a dairy free trial and then reintroduce and see if you notice anything just to ease your mind. Ususally when you strictly take out a food for a significant amount of time and reintroduce, the reactions are clear. It's like there's a low level tolerance to everyday exposure but it gets heightened if you take out and then put back in.

Not sure what you tell you on the nut deal. There is conflicting advice:
http://www.ncbi.nlm.nih.gov/pubmed/19000582

Nut allergies suck. And sesame is even worse.

You know he's very likely to outgrow the egg allergy.
http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

It was this study that prompted the FAAN presentation -- hesitation because of perceived risk of using the Epi was shown to be a problem
http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum

[Koalamom]

I had no idea that seaame was a common allergen. I was going to make hummus and put tahini in it, as my kids have never had both. They are both fine with all nuts except peanut and it gives diaper rashes. Should I skip the tahini for them, and what tastes like it to use in hummus?

[texaspeach]

JaneS - thanks for the info! it's hard to research with a little that must be held 95% of the time we were strictly dairy free, avoided obvious and hidden dairy, until DS was 9.5 mo - we trialed dairy at that time and it passed, no rashes or weirdness but I'mnervous about him suddenly becoming allergic. I know that can happen with anything though. I am keeping close tabs on our diets and taking out anything questionable (banana, broccoli and avocado are questionable) and not introducing new things for a while

bluebirdmama, when I make hummus at home I usually just leave the tahini out because we never have it on hand. I add in other strongly flavored stuff, like roasted bell pepper, roasted garlic and a ton of lemon so the tahini gets lost anyway.