1st doctor visit.....

Posted on: Sat, 02/09/2008 - 6:10am
Mom2angels's picture
Joined: 02/07/2008 - 20:14

Hello! This is brand new to us. My daughter has has peanut butter at least 15 times and never had a problem until a few weeks ago. She spit a cracker out that had peanut butter spread on it. Well, everywhere it came into contact with on her skin was red and very itchy. She rubbed her eye with her hand and even the sclera in her eye was red. We gave her Benadryl and it resolved within 15 minutes. We called her pediatrician and she referred us to an allergist. Well, we went to the allergist and he did a SPT for peanut and a few other legumes. Well, the peanut was positive, but the other legumes were negative. He basically gave us an epi pen and said I'll see ya in a year. We asked him a million questions, but I still feel clueless. The allergist himself has a peanut allergy and has since childhood. I asked the doctor about foods that share equipment with peanut products and he said, of course there was a chance, but he eats those products, and the risk is low---though there's still a risk. My daughter's SPT was rated as "moderate". We basically have no idea what her reaction might be if she ingested peanut butter, but we know how her skin reacts to coming into contact with it. Any ideas? What do other allergists do at your kid's appointments? My husband and I are both nurses, but have not worked with food allergies like this. Any input? Thanks in advance.

Posted on: Sat, 02/09/2008 - 6:50am
Krusty Krab's picture
Joined: 04/20/2007 - 09:00

First of all, I'm sorry about the diagnosis.
Secondly, IMO, I think eating may contains is a pretty risky behavior and I'm actually sickened by the allergist's speak about it. Maybe I'm just drawn to allergists who rather, are on the very cautious side when discussing the eating of items that potentially have allergens in them. It's just not worth the risk IMO. Whether you allow your child to eat them, it's totally up to you. It's your comfort zone. And oh yes, there is indeed risk, a very real risk, just ask the people who have reacted to may contain products. Again...it's up to you. FYI there are also blood tests available that are useful when you don't want a skin prick test. The SPT introduces the allergen into the skin, alot see this as an uneccessary exposure, when a blood test is available.
Your child appears to be 'contact sensitive'. Have you thought about whether or not you will take PB out of your home? Alot of people do, some don't. PB is a pretty sticky thing and can remain on surfaces. Did your allergist review with you how to handle instances like contact reactions, did your allergist go over what to do if your child should ingest? FAAN has a plan you and your doctor can fill out that is very explicit on what to do if something happens. It's a great tool for the school as well. It's a Food Allergy Action Plan. If you haven't discussed these things with your doctor, you may want to. Information is very powerful.
Major rules, read labels well!!!!, your epi pen and benadryl goes everywhere, everyone who cares for your child knows the symptoms of a reaction and knows what to do and how to do it.
And of course, breathe....it's tough at first, but you can do it!!!

Posted on: Sun, 02/10/2008 - 5:30am
lakeswimr's picture
Joined: 02/01/2007 - 09:00

Food allergy reactions can change at any time. Past reactions do not predict the severity of future ones (as you can see since your child didn't used to react to peanuts and now does). Peanuts are the #1 cause of food allergy fatalities and a child who reacts to peanuts, even mildly, is at risk for a life threatening food allergy reaction to peanuts in the future should ingestion occur (and unfortunately accidents do happen no matter how careful we are.) So, it is good you have an epi pen. You really should have at least *two* epi pens since one might fail (rare but can happen) and they are finding a significant % of people need at least a 2nd shot. Also, the epi only buys you 10-20 min to get to the hospital so if you are further away than that you may need more than one epi.
I recommend Dr. Young's 'The Peanut Allergy Answer Book' (2nd edition). it's excellent. Also, Linda Coss's book on taking care of your child with life-threatening food allergies is excellent.
Your allergist is wrong--your child should not be eating may contains/shared equip/same facility products or any other product that has a warning label on it because the FDA study showed a significant % of products that have these labels *do* contain allergens. Yes, it is only about 7-20% of something but that is a 7-20% chance of eating enough allergens to have a reaction. Not smart! It bugs me that allergists give this kind of stupid advice that goes against the state of the field.
Not only this but the standard advice of all food allergy organizations is that if you are allergic to either peanuts or tree nuts that you avoid both because most are processed on the same equipment. Of course, if you are sure you know of a source of tree nuts that is not cross contaminiated with peanuts and your child has been eating them just fine that is a special case but otherwise she should avoid tree nuts as well including may contains, etc.

Posted on: Sun, 02/10/2008 - 12:25pm
Mom2angels's picture
Joined: 02/07/2008 - 20:14

Thanks for the input, and invaluable advice. Yes, we removed peanut butter from our house, as well as any other peanut products--I think we had a trail mix. I was also shocked to hear our doc tell us that, statistically, it should be okay to consume "may contain traces" of products. My husband is so much more laid back about this whole thing. I'm so worried that I don't feel like I'll be able to really relax about this---EVER. I've been so upset about this. I'm not sure if the doc wanted to make us feel like this isn't gonna consume our lives, or what, but I am on guard.
He also said that the reactions are typically the same with each ingestion. He's had a peanut allergy since childhood and said his reactions are identical each time---and always have been. My personal research tells me differently. How confusing is it to have the physician, who specializes in this life-threatening aspect of medicine, give us this information. I think I'd like a 2nd opinion.
In your experience, do most docs do a RAST test at the first office visit? Well, thanks again.

Posted on: Sun, 02/10/2008 - 8:52pm
nicolimom's picture
Joined: 02/04/2004 - 09:00

Hello. My doctor ordered the cap-rast test for my son , after my son had a bad reaction to the skin prick test to peanuts in the doctors office. My son luckily only needed benadryl there to take care of it. The caprast was to check for other food allergies b/c I did not want to go through the prick test again.
And I hate to disagree with the doctor, but my son's reactions are almost always different, sometimes hives everywhere, another time maybe an eye that swells shut. Most of my son's reactions have been contact reactions, too, as luckily we have only had 2 or 3 accidental ingestions so far(he was dx'd at 3, and he's 9 now).
Good Luck :)

Posted on: Mon, 02/11/2008 - 9:25am
celiam's picture
Joined: 01/29/2008 - 06:25

My son had a skin test in the doctor's office and then was sent for a RAST test. He was tested for peanuts and other tree nuts with the blood test.
My son was recently diagnosed with a peanut allergy and in all of my research I have read that each allergic reaction is different. It's nice to have a doctor who knows first hand about having a peanut allergy, but he may be one of the lucky ones who has not had a severe reaction. I don't take any chances with labels, if peanuts "may" be in a product we stay away from it.

Posted on: Mon, 02/11/2008 - 10:43am
SkyMom's picture
Joined: 10/27/2001 - 09:00

mom2angels, I replied in your other post before this one. Whoa! I can't believe your allergist told you that may contain etc. is safe to eat, as well as reactions are all similiar. I sincerely hope that his other patients research elsewhere like yourself. Like others have already said, these are very dangerous comments to make to newly diagnosed patients and their families. Please refer to the post I bumped for a study in regards to may contain or made in a facility items. The above posts are perfect examples of what great resources the people here are.

Posted on: Tue, 02/12/2008 - 2:45am
niche's picture
Joined: 02/05/2007 - 09:00

Ok to me that is unbelieveable and I would definitely get a second opinion.
when you state he tested for legumes - which exactly peas and beans etc? if so is she currently consuming these with no problems? If so most allergists wouldn't test these - with the possible exception of lupine. If a patient has been consuming something with no problem for some time - most would not test for it unless there were unexplained reactions etc.
A couple of thoughts, I didn't see how old your daughter is, has she had all other treenuts with no problems ingesting? If not I would have her tested for those as well, just in case.
I really recommend the bood understanding and manageing your childs food allergies by Scott Sicherer. He is and works with the top Dr's in the field and the book is very informative.
Most of what I have read definitely states staying away from may contains and processed on. He said statistically ok - well when it's my kids life and when I read the stats on the link the other poster mentioned - that is not ok with me.
Also most everything I have read states that allergies are very unreliable as far as being able to predict the next reaction. My sons reactions were very different.
Sounds to me like he might be going off of life experience vs. actual medical data.

Posted on: Thu, 02/21/2008 - 12:13pm
NoPeanutsPlease.com's picture
Joined: 02/22/2007 - 09:00

I tend to agree that the advice that 'may contains' is not necessarily serious is very risky. We avoid those products, though our daughter is anaphylactic. That being said, there is no way for you to predict the severity of a future reaction and it is prudent to completely avoid 'may contains' products.
Also, you mentioned that you removed peanut butter from your house ... woe is the day that happens! I was a HUGE organic peanut butter fan and the only thing I have found that is a replacement is [url="http://nopeanutsplease-com.blogspot.com/2007/05/sunbutter.html"]Sunbutter[/url] . You should pick some of that up, but to avoid confusion I would recommend that you not feed it to your daughter. Some people avoid bringing it into their home altogether to avoid confusion, but we felt that wasn't necessary. To each his/her own ...
My only other suggestion is to get a pediatric allergist. That has worked out very well for us.

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