Seeing allergist who gave conflicting advice than GP. Need brainstorming and advice. - Mothering Forums

 
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#1 of 9 Old 03-19-2010, 06:15 PM - Thread Starter
 
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Summary here....

Dd was sick w/sore throat, slight off/on fever, achey,extreme fatigue combined with inability to sleep since AM of March 5.

Strep tests negative. Mono negative. CBC negative.

March 16 dd breaks out in hives on top of hands, top of feet, next to mouth. This contunues off on for 36 hours. Sore throat is gone by end of day.

March 18 dd breaks out w/hives that spread up her arms and covers left side of face.

Dd is now having constant panic attacks, not sleeping as she is afraid she will die in her sleep of airway closing.:-(

March 19(this AM) dd breaks out in hives that travel from hands up both arms, top of feet, ankles,face, shoulders, and back. Thay vary in size and shape, color is either red or white.

Our tub clogs very easily, so we are strictly shower people here. Other than an epsom salt bath, is there anything I can do to give her relief?

Dd is 13yo.

>>Inserting important info for allergy forum.....

The only thing new to dd was soap-from sensitive Dove to Ivory, but dd hadn't showered in two days prior to her breakout.

The AM of her breakout she only ate foods she's eaten tons of times, BUT, when she was 3 a friend forgot I didn't allow dd to have PB, and fed her a PB sand for lunch. Dd immediately broke out in a rash around mouth and on neck. Peanuts were strictly kep away from her (and out of my BM as i was still n ursing her then) and out of our home. When dd was 9 she ate PB at a friend's house, and had no known reaction. She's never preferred PB, until about six mos ago-she's eaten more PB in the last six mos than ever in her life. I see this as a red flag.

What she ate that AM-
Walnuts
Almonds
Sunflower seeds
Pumpkins seeds
Mini-choc chips
Craisins(I know, I know)
Banana

DD has known allergy to molds and grass(tested when she was 5 yo).

QUESTIONS!

Is there a problem w/ me asking the doctor to do both a RAST and SPT at the same appt. on both dc? Ds gets very carsick, so as long as we are driving an hbour away to this allergist, I want to check as much as possible.(DS is 8yo and allergic to fish(not sure which kind), eggs, coconut, and other things we aren't sure of-possibly basil and citrus?)

We are on the waiting list to see an allergist an hour away. The allergist doesn't want dd to have ANY antihistamines for 5 whole days before he tests her. So, if I get the phone call, say, Monday AM, off we go. But! We cannot give dd something to ease her itching. (That I know of-see my comment about my tub and baths.) Advice?

Also, I asked GP for a script for an epi-pen, and she said no, get it from the allergist. Well, we would be NEW to the allergist, and the last I knew of, docs don't prescribe to someone they haven't seen. The problem(other than the obvious) is that dd is having multiple panic attacks, which includes her chest and thraot tightening. Each time that happens, she freaks more that her airway is closing-thus her fear of falling asleep. Advice?

Dd's anxiety and panic are out of control(mine is getting there!),and she's not only refusing to sleep, but iks now refusing to eat as she thinks she may be allergic to everything(her exact words). Anyone who knows anxiety and panic knows that suffer can have very illogical thoughts. Advice?

Thank you.

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#2 of 9 Old 03-19-2010, 07:42 PM
 
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Normally the RAST and SPT would not be done at the same time. The RAST allows a large number of items to be tested at once. Then often what is tested for the SPT is based on the RAST results. For example, if something is really high on the RAST, there is no need to SPT. But maybe they will do both at the same time if they want her antihistamine free for her appt.

But I since the RAST is a blood test, is there any way your primary would be willing to order it now? Or maybe the allergist even before they see your dd? That may give you some answers before your appointment, and will save time later so you don't have to do it later. AND save you a second trip to the doctor avoiding some car sickness for your dd. If you explain about the long drive and the car sickness, maybe they will order this for you now. Also the RAST can take a couple of weeks before you get the results back.

I'd call and ask for the RAST to be done while you wait for the appt. Maybe the results can be in before the appt.
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#3 of 9 Old 03-19-2010, 08:02 PM
 
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Originally Posted by lnitti View Post
But I since the RAST is a blood test, is there any way your primary would be willing to order it now? Or maybe the allergist even before they see your dd? That may give you some answers before your appointment, and will save time later so you don't have to do it later. AND save you a second trip to the doctor avoiding some car sickness for your dd. If you explain about the long drive and the car sickness, maybe they will order this for you now. Also the RAST can take a couple of weeks before you get the results back.

I'd call and ask for the RAST to be done while you wait for the appt. Maybe the results can be in before the appt.
This is excellent advice and you should definitely try to do it.

Our allergist will do both RAST and SPT at the same appt if we want, but dd is a returning patient. She orders the RAST once a year and everytime we see her she asks if there are any foods I want tested with the SPT. So, sometimes she gets both at the same appt.

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#4 of 9 Old 03-19-2010, 10:25 PM
 
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Oh no. I responded to your other thread from a perspective that this was viral and not allergic. Now that you added the allergy information that's a little more concerning. Hmmmm...I'd pester that GP for an epi. Tell her you think this was an anaphylactic reaction to nuts or another unknown allergen and it would be potentially life threatening for your daughter to wait until you can get in with the allergist next week for an epi. We had an anaphylactic reaction and ended up in the ER. The next morning I called the pediatrician who called in an epi prescription and set us up with an allergist. My son was on zyrtec (and steriods due to the anaphylaxis) when we saw the allergist. We just had to wait for SPT. We were nearly certain it was nuts at that point anyway.

I don't know of anaphylaxis risk lasting this long. However, hives can keep going well after a reaction. She can't be skin prick tested accurately, though, with ongoing hives and skin reactions. She's too reactive. So the avoiding antihistamine is making her miserable and is unnecessary in my opinion. She has to avoid all nuts (trace and otherwise) and seeds until you know if this was allergic. She may be getting cross of seeds or nuts now. There is a lot in our food supply (all bread and cracker products are sesame contaminated for example). Eat home prepared meals until you know (chicken, potato, carrots for example).

I'd do the zyrtec and see the allergist anyway and just explain that with ongoing skin/hive reactions you couldn't test now anyway and she was miserable. I would not take no for an answer on the epi. I'd make a nuisance out of myself until I had it. I suppose you could try calling the allergist and explaining that she had a probable anaphylaxis episode and you have an appt. next week but want an epi now in case it happens again. But your GP is medically negligent for telling you to wait a week imo. Risky on the doctor's part from a lawsuit standpoint should something happen. I would push for an epi.

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#5 of 9 Old 03-20-2010, 06:23 PM - Thread Starter
 
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Quote:
Originally Posted by lnitti View Post
Normally the RAST and SPT would not be done at the same time. The RAST allows a large number of items to be tested at once. Then often what is tested for the SPT is based on the RAST results. For example, if something is really high on the RAST, there is no need to SPT. But maybe they will do both at the same time if they want her antihistamine free for her appt.

But I since the RAST is a blood test, is there any way your primary would be willing to order it now? Or maybe the allergist even before they see your dd? That may give you some answers before your appointment, and will save time later so you don't have to do it later. AND save you a second trip to the doctor avoiding some car sickness for your dd. If you explain about the long drive and the car sickness, maybe they will order this for you now. Also the RAST can take a couple of weeks before you get the results back.

I'd call and ask for the RAST to be done while you wait for the appt. Maybe the results can be in before the appt.
Thanks! That's helpful to know about the "order of operations!"

Great news! The allergist's nurse called around 6 last night, and said for us to just take dd(not ds!) and be at their office Monday AM!! So, no need to request the RAST first...

(We are keeping the other appt for ds-and possiblky me,too.)

Quote:
Originally Posted by Therese's Mommy View Post
This is excellent advice and you should definitely try to do it.

Our allergist will do both RAST and SPT at the same appt if we want, but dd is a returning patient. She orders the RAST once a year and everytime we see her she asks if there are any foods I want tested with the SPT. So, sometimes she gets both at the same appt.
Thanks!

Quote:
Originally Posted by sbgrace View Post
Oh no. I responded to your other thread from a perspective that this was viral and not allergic. Now that you added the allergy information that's a little more concerning. Hmmmm...I'd pester that GP for an epi. Tell her you think this was an anaphylactic reaction to nuts or another unknown allergen and it would be potentially life threatening for your daughter to wait until you can get in with the allergist next week for an epi. We had an anaphylactic reaction and ended up in the ER. The next morning I called the pediatrician who called in an epi prescription and set us up with an allergist. My son was on zyrtec (and steriods due to the anaphylaxis) when we saw the allergist. We just had to wait for SPT. We were nearly certain it was nuts at that point anyway.

I don't know of anaphylaxis risk lasting this long. However, hives can keep going well after a reaction. She can't be skin prick tested accurately, though, with ongoing hives and skin reactions. She's too reactive. So the avoiding antihistamine is making her miserable and is unnecessary in my opinion. She has to avoid all nuts (trace and otherwise) and seeds until you know if this was allergic. She may be getting cross of seeds or nuts now. There is a lot in our food supply (all bread and cracker products are sesame contaminated for example). Eat home prepared meals until you know (chicken, potato, carrots for example).

I'd do the zyrtec and see the allergist anyway and just explain that with ongoing skin/hive reactions you couldn't test now anyway and she was miserable. I would not take no for an answer on the epi. I'd make a nuisance out of myself until I had it. I suppose you could try calling the allergist and explaining that she had a probable anaphylaxis episode and you have an appt. next week but want an epi now in case it happens again. But your GP is medically negligent for telling you to wait a week imo. Risky on the doctor's part from a lawsuit standpoint should something happen. I would push for an epi.
I got the epi pen!!

And...the nurse for the allergist called yesterday around 6 to say that she is squeezing dd in first thing Monday AM. I have taken photos of the hives, will bring her entire history.
But-you say she is too reactive? Hmm. The nurse knows this, and this allergist specializes in hives/skin reactions as well as asthma-related allergies. She did say I could go ahead and give dd benedryl as our GP suggested, but honestly, the last time I did that it had NO effect on dd at all-if anything if wired her anbd kept her up longer-byt she was still miserable.
Now I'm even more confused. I wonder if he wants to see her hives, and won't actually do the testing? Praying we are in good hands with this guy. He is in HIGH demand, so that's usually a good sign, right?
Thanks for helping.

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#6 of 9 Old 03-20-2010, 06:25 PM
 
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But you wouldn't be able to have a RAST while still on antihistamines either, can you? I thought you had to be off them for 5 days previous to either test for a more accurate test.

Also, you can get hives from nerves as well (I used to get them when I had to stand up and talk in front of a group). So if the first one was an actual reaction (say, to the peanuts) then if she's nervous about having another reaction, then she could be getting the hives since then to just about anything. I'm not saying one (or more) of them wasn't allergic, I'm just saying all of them might not be. A friend of ours got hives last year due to something, and then started getting them every time she ate. She was getting more and more nervous to eat (8yo). When they brought her to the allergist and tested her, she wasn't allergic to anything, and the hives stopped. So I think it can be both.

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#7 of 9 Old 03-21-2010, 01:14 AM - Thread Starter
 
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But you wouldn't be able to have a RAST while still on antihistamines either, can you? I thought you had to be off them for 5 days previous to either test for a more accurate test.

Also, you can get hives from nerves as well (I used to get them when I had to stand up and talk in front of a group). So if the first one was an actual reaction (say, to the peanuts) then if she's nervous about having another reaction, then she could be getting the hives since then to just about anything. I'm not saying one (or more) of them wasn't allergic, I'm just saying all of them might not be. A friend of ours got hives last year due to something, and then started getting them every time she ate. She was getting more and more nervous to eat (8yo). When they brought her to the allergist and tested her, she wasn't allergic to anything, and the hives stopped. So I think it can be both.
Well, either way I'm not giving her an anti-histamine, simply b'c they didn't work when she was having a huge outbreak. She's has several today, and is coping w/o meds.

Dd *is* afraid of eating AND sleeping. But, I have explained to her that her diversion to eating is illogical. I get her fear of sleeping(afraid of airway closing), but she is currently sleeping rifght next to me as dh is now sleeping in her bed. I check on her constantly. Different symptoms for everyone I guess?

Thanks for brainstorming, sharing!!

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#8 of 9 Old 03-21-2010, 01:52 AM
 
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But-you say she is too reactive? Hmm. The nurse knows this, and this allergist specializes in hives/skin reactions as well as asthma-related allergies. She did say I could go ahead and give dd benedryl as our GP suggested, but honestly, the last time I did that it had NO effect on dd at all-if anything if wired her anbd kept her up longer-byt she was still miserable.
Now I'm even more confused. I wonder if he wants to see her hives, and won't actually do the testing? Praying we are in good hands with this guy. He is in HIGH demand, so that's usually a good sign, right?
Thanks for helping.
You can't get an accurate skin prick allergy test in a child with current skin reactions (such as hives). That's what I meant by too reactive. If Benadryl were helping her there was no reason not to do it because you wanted to have a skin prick. And my understanding (per our allergist) is that antihistamines have nothing to do with RAST (blood) tests so it wouldn't interfere with that. The skin/hives/reactivity don't matter for RAST testing either--it's just a blood test. So if the benadryl were helping-I get that it doesn't/these hives might not be allergic if benadryl doesn't do a thing for them--I was saying there was no reason not to do imo.

I'm so glad you got in fast and hope it's very helpful!

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#9 of 9 Old 03-21-2010, 02:51 AM - Thread Starter
 
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You can't get an accurate skin prick allergy test in a child with current skin reactions (such as hives). That's what I meant by too reactive. If Benadryl were helping her there was no reason not to do it because you wanted to have a skin prick. And my understanding (per our allergist) is that antihistamines have nothing to do with RAST (blood) tests so it wouldn't interfere with that. The skin/hives/reactivity don't matter for RAST testing either--it's just a blood test. So if the benadryl were helping-I get that it doesn't/these hives might not be allergic if benadryl doesn't do a thing for them--I was saying there was no reason not to do imo.

I'm so glad you got in fast and hope it's very helpful!
I hear what you're saying. Good-grief, we need a degree in children's allergies, don't we?? I am BEYOND confused!! I'll keep this appt, bujjt am still not giving dd any benedryl, as both dh and I are convinced it just wired her last time, and gave her no relief. Otherwise, I'd be dosing it out every 4 hrs.

Thanks for replying. I super appreciate it.

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