We traveled to Houston on early Friday morning to have dd allergy tested at Texas Children's Hospital. The hospital is very impressive... new, clean, and spacious. But it's a teaching hospital so we had to go through everything twice- once with a fellow and once with the doctor. Inbetween we waited and waited and waited. We were at the hospital a total of 5 hours. Dd was bored and tired, dh and I were starving and tired. It was a very long day.<br><br>
First we discussed what foods would be tested. We had brought several foods (per request of the doctor) that we suspected and that they didn't have at the hospital. Unfortunately we were only able to use 3 of these because of the size of dd's back. In total 9 foods were tested: egg, milk, wheat, soy, corn, tomato, almond, rice, and peanut (and 2 controls: histamine and saline). They had special ordered small disks to put the food on so that we could test more foods- usually the disks are the size of quarters, but hers were the size of a watch battery. The foods were made into pastes and applied to the disks, which were stuck on a piece of medical tape. The tape was then placed on her lower back where it remained for the next 48 hours. Dd didn't mind this process at all.<br><br>
The doctor felt that it was important to limit the number of foods tested so that her upper back remained open for further prick testing. She wanted to test several contact/inhalant allergens as well. These included cat, dog, 2 kinds of dust (including cockroach), and a mold mix. Previously when we had dd prick tested for foods she didn't even notice. This time the nurse really dug the pricking instrument into her skin, making her bleed and scream. It was pretty terrible, but over quickly and she fell asleep in my lap for the next hour, not even waking 20 minutes later when the nurse came in to measure the results. Dd was negative for all of these allergens.<br><br>
On Sunday we removed dd's patches and thought that the skin looked uniformly pink from pulling the tape off, but not irritated from the actual allergens. As instructed we didn't wash her during this time, so she got pretty dirty. However, her eczema actually improved drastically over the weekend. The patches of skin that had been open and oozing (no steriods allowed 2 weeks prior to testing) were completely closed and fading. We are not sure what caused this, but it could have been the lack of bathing or the humidity. We are planning on bathing her less often to see if this helps.<br><br>
On Monday we took dd back in to the hospital to have her patches read. Fortunately we were not there for nearly as long this time! Her back had faded and both of us thought that none of the allergens had reacted. We were wrong! She tested ++ (strong positive) to wheat and + (weak positive) to egg and corn. All the rest were +/- (doubtful). It wasn't just the reddness that mattered, but also "infiltration" and papules- in otherwords, they could <i>feel</i> the positive reaction. The doctor's official recommendation is wheat elimination for 2 weeks followed by a three day challenge* (if her skin clears). If the skin doesn't clear, she recommends ending the elimination and treating with steroids, creams, etc. Our plan is to start the elimination after the holidays so that I can enjoy some great food for a few weeks. If her skin doesn't improve, I will consider also eliminating egg and corn for 2 weeks after that. I am still determined to find a way to control her skin without steroids.<br><br><a href="http://www.flickr.com/photos/jaimeeandbrian/2102123268/" target="_blank">Check out a picture of her back from each day here.</a><br><br>
I asked the doctor: if her skin doesn't improve with these food eliminations and since she tested negative to common inhalants (via the prick), what would she put her money on? Like our previous allergist she said she's really too young for pollen allergies. She also said that contact allergens (like detergents, etc.) almost always manifest where the skin is touching the irritant, not in localized patches like dd's eczema. You can see where this is going... Basically she said, "we aren't very smart." She never answered my question.<br><br>
I have to admit that I'm excited at the prospect of a positive result, but I am fully aware that it could be a false positive. I'm also not looking forward to a wheat-free diet, but it's a limited time. So, there you have it! Bring on the eggs and dairy (for now...)<br><br>
*I want to point out that the doctor told me in order to challenge a delayed allergy you must eat the food each day for three days. A reaction should appear within this 72 hour period, but if your dc is ebf it may take as long as 5 days! I did not know this when I was challenging previously. Rrrrr...
