Unexpected allergist appointment tomorrow

[~ Vik ~]

We always knew we were going to follow up with our allergist once Dylan turned three to redo blood tests and potentially do food challenges. However, when I booked they were booking into July so we had a while to wait, but I put myself on the cancellation list in the hopes of getting something earlier. Well don't I get a call that they had a cancellation for 1030am tomorrow So I accepted of course, but now am in a panic because I'm not really prepared!

Here's what I want to do/discuss:
- no scratch test, blood test only (even though I have to pay for it )
- is there a way to test for penicillin allergy (I have a severe allergy, dh does not)
- can I test for other nut allergies (we've been avoiding on the allergist's advice but I'd like to know!)
- on what grounds will we do a food challenge? Where would we do it? How?

Anyone else been through this kind of follow up testing? Or a food challenge? (Heidi, do I remember you doing one with Spencer? And I know you've been doing them with E, Vicki) I feel like I'm missing something important, and I hate not being ready for these things... Although supremely grateful that we're not stuck waitin until July!

[MasynSpencerElliotte]

Vikki, as far as our allergist said, pencillin can be done by a scratch test only, but not sure if that is accurate!

We did do a home food challenge, but honestly I would want to do it in office next time so they can see what I am seeing.  We baked cookies with 1 egg and then fed her 1/4 of a cookie, but she has never had a severe reaction and my sister was here with her kids collection of epi pens!

Have to run and check supper, but I will be back!

[~ Vik ~]

Thanks for that penicillin info, Heidi! The only reason I am very anti-scratch test is because I put Dylan through that at his first appointment, only to be told that children with eczema sometimes produce false positive results because their skin is so sensitive In addition to that, they didn't have a sample for mustard so we had to do a blood test for that anyway. So I'd rather just do the blood test and poke him once vs. putting him through the scratch test and then having to do a blood test anyway But if that's the only way to do Penicillin then I might have to reconsider...

[Buntybear]

Remember they have to have exposed to that substance to be tested for it. Here they would do a food challenge for olly on a hospital ward!

[MasynSpencerElliotte]

Remember they have to have exposed to that substance to be tested for it.

Depends on the Dr...ours is very much against testing for things not ingested, but some aren't so strict. 

Vikki, I hated the scratch test and we only had 3 things (control, milk, eggs)...and then ended up with the blood test anyways. It was just the way he said doing the scratch for penicillin that made it sound as if it was the only way, might be worth googling or going on Kids With Food Allergies website to see if anyone knows different.

Has he ever had penicillin?  If not, the test might not be accurate as it would be his first exposure and usually it takes 2 or more to see a reaction (ours was on the 2nd or 3rd dose, and the Dr. pointed out that if I had taken them while pregnant or BF that counted too, but I guess that is a moot point for you!)

Off to music class...more to say, will be back!!

[my3girlsjde]

I Have no info as.I'm still lost on the whole.process but wanted to offer a hug and best wishes for.tomorrow ..

[Mom to M&M]

Yes, penicillin allergy is currently only detectable through SPT (other than real life experience, of course). I'd probably go ahead and have that test done if you are concerned about it given your family history (in fact you may want to have yourself retested too as many patients outgrow penicillin allergy). Skin tests are never fun and I'm not a big fan of antibiotics BUT sometimes they truly are necessary and you don't want to avoid penicillin if you don't have to - often the alternative meds are more expensive and have more side effects.

HUGS. Hope tomorrow goes well!

[MasynSpencerElliotte]

often the alternative meds are more expensive and have more side effects.

Yes, that is so true, one reason I want to get the scratch test for Spencer eventually.  Our provincial drug plan is supposed to cover kids drugs and we should pay only $15 but they won't cover Spencer's.

Honestly, for the foods he has never eaten, even if you test you have no way of knowing if it is a false positive.  The only true way to know if it is an allergy is by challenging the food and either seeing or not seeing a rxn to it.  The tests can give you a better idea of what to try to challenge vs. ones that should be avoided, but I've read that just testing and avoiding all things that turn up positive can lead to eliminating foods that aren't really a problem. Of course then the challenge becomes how you find the nuts to challenge that aren't x-contaminated with the ones he is allergic too!

{{{hugs}}} hope it all goes well tomorrow!

[~ Vik ~]

I never thought about the possibility of me not being allergic anymore! Definitely something to ask Dylan's never been exposed to it at all, but if you count pregnancy/breastfeeding he's been exposed to all the common nuts through me (so almonds, cashews, hazelnuts, walnuts, pecans). Do you think that would be enough for an exposure? We're not planning on doing a whole battery of tests because he's been fine with everything - so just repeats of milk, egg, mustard, and peanut, then I wanted to do specific nuts, and shellfish (another thing he's been exposed to through me only). But it's enough that I definitely don't want a scratch test with the possibility of having to do a blood test anyway, but I would consider it for penicillin.

And Karen, you are so right about the penicillin alternatives I had a thread in health and medical not that long ago when Dylan was prescribed Biaxin for strep throat, YUCK!

[Jimbob]

How did the appointment go?

Kelly x

[Mom to M&M]

I was wondering the same as Kelly - thinking of you!

[~ Vik ~]

Thanks for checking in!  Sorry it took so long to update - After Dylan's appointment on Friday I worked the night shift, then I worked 7am-4pm today and got home and did dinner/bath/bed and am only now getting on properly

The appointment went pretty well.  Did a rough history (given that he hasn't seen Dylan in over 1.5y) about how things have been.  We've been pretty strict but Dylan still does get hives fairly regularly from incidental contact with "something(s)" at daycare, out and about (grocery shopping, the mall, other people's homes), even at home sometimes.  Fortunately, if we can catch it when the hives are just coming out (or better yet, when he's blotchy and red before the hives appear) we're able to wipe him down with damp cloths a few times and can usually avoid having to give him benadryl.  Since his last testing he hasn't ingested any mustard, egg, or peanut/nut products.  We are pretty sure that he hasn't ingested any dairy, but there was one incident months ago when he had eaten pepperoni at daycare that was "may contain traces" and he had some pretty violent vomiting for about 6 hours afterwards.  The allergist also asked if any other allergies have developed, and we explained that he had a severe reaction to dog saliva and is clearly reacting to cat dander/hair as well.

He offered a skin prick test, which I declined, and explained that every blood test we ordered would cost between $20-30 (depending on which one it was).  I made the mistake of saying that I didn't care how much it cost (when truly we are not made of money, and I don't know if my benefits will cover this!) so he ordered:
dairy
egg white
egg yolk
mustard
peanut (5 separate components @ $20ea)
almond
cashew
pecan
hazelnut
walnut
So if my benefits don't cover anything I'm looking at over $300

I asked about penicillin too, but he said that the agent that they use for the penicillin scratch test hasn't been available in nearly 10 years   Apparently it was something that they tested for pretty routinely, but since that agent hasn't been available they would have to send me to Sick Kids in Toronto to do a slightly different test.  He did make a note though in Dylan's file, as apparently there has been talk about making the agent available again, in which case it would be a quick scratch test and we'd know.

So that's pretty much it!  I'm going to take Dylan for the blood tests on Monday or Tuesday (whichever day it's feasible for me to leave work a bit early) and then his follow up appointment is February 27, which was much earlier than I expected.  The allergist said that he would be shocked if the blood results weren't lower for dairy (which was technically a mild allergy before at 0. as that's frequently outgrown, and he thought that egg may even be a possibility.  So we're going to do the tests, discuss the results on the 27th, and then if he feels it's warranted we'll do an in-office food challenge.  He said that with children as young as Dylan he always does any food challenge in his office in case of a reaction.

So there's the news that's fit to print   Overall, I'm happy with how it went, now just going to have to wait and see...  I'm not getting my hopes up, despite what he thinks about the dairy allergy, just because he *still* gets hives at least once a week and the daycare and our home, so I know something's still going on.

[Erin M]

Wow Vikki, just saw this.  Hope that you get some good results. 

[MasynSpencerElliotte]

So if my benefits don't cover anything I'm looking at over $300

Yikes!  So weird what varies from province to province, it was all covered here!  Really hope there are some clear cut results and that the food challenges lead to more foods for Dylan.

Weird about the penicillin...how the heck was my allergist going to do it then I wonder? He did offer at our last appt...

[Buntybear]

Good luck for the results on the 27th. Fingers will be crossed x