? about allergist view on epi-pen for person with mild reactions

Posted on: Mon, 07/23/2001 - 3:18am
punkinsmom's picture
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Joined: 12/07/2000 - 09:00

I was just wondering if anyone else has had this type of experience with an allergist. Let me start by saying my dd is almost 4. I suspected peanut allergy around 15 months. We kept peanut products away from her but didn't know about may contain so she ate chocolate, ice cream and bakery stuff. RAST tested this past December to confirm peanut allergy. Her only reactions have been a flare-up in her excema usually only on her wrists. I took her to an allergist last month. She was tested for other allergies and has some. I liked the allergist a lot. The doctor is board certified and came reccommended by my doctor and our dermatologist. She told me all the stuff I have read on this site about PA and gave me educational info and suggested I join FAAN. So, the only thing is this: she said that since my daughter's reactions have been mild I do not need to carry an Epi-pen. I questioned her about the unpredictability of this particular allergy. She told me that the research has shown that this is true for very sensative people. They may have anaphalactic reaction one time and a less serious reaction the next. But for my daughter she did not think it was neccessary. She also said that if I feel more comfortable then go ahead and carry it ( which I do). I know a lot of people on this board have dealt with anaphalactic reactions but I was wondering if anyone with mild reactions had been told anything similar by their doctor. Peggy

Posted on: Mon, 07/23/2001 - 3:51am
DRobbins's picture
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Joined: 07/19/2001 - 09:00

Hi, Peggy.
We have been incredibly fortunate that my PA son's reactions have also been mild (just an itchy mouth). His RAST score was .7, which according to the scale given on the lab report barely places him in the "moderate" range.
Both our pediatrician and allergist want us to carry an epipen, which we do at all times. (Well, sometimes we play in the backyard, leaving the epipens nearby in the house.) His kindergarten teacher had a pen in the classroom, the school nurse had an epipen, and an epipen was brought along on all field trips.
Both of our doctors have said that a severe reaction is unlikely, given my son's history and our efforts to prevent exposure, but due to the unpredictable nature of PA reactions, we need the pens just in case.
I think you should go with your instincts on this and always have an epipen available. Worst case is a bit of inconvenience and some wasted money. But your peace of mind and your child's safety are worth it.
FWIW, Debbie

Posted on: Mon, 07/23/2001 - 9:25am
BCUZILUVHIM's picture
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Joined: 03/17/2001 - 09:00

Debbie, I couldn't have said it better!!! An ounce of prevention...I have to agree, having an epi-pen and never needing it makes much more sense than not having one and god forbid need it. My sons' allergist said there is no logic to this allergy. He could give Mike a peanut today and he would have no reaction then give him a peanut next week and it could be lethal. There is no way to know what type of reaction your child is going to have since there are many variables that are in the mix. I would carry an epi and keep a watchful eye. Studies are showing that the earlier the reaction (ie 1 to 1 1/2 yrs old) and the milder the reaction (ie skin reaction only) the better chance you have of being one of the 20% that grow out of this allergy. Unfortunately my son doesn't fit that mold but take heart there is a possibility for you! Keep the epi pen close and keep up the strict avoidance and keep your fingers crossed! Good Luck! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Fran

Posted on: Mon, 07/23/2001 - 10:44am
julieb's picture
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Joined: 07/21/2001 - 09:00

My son was diagnosed with a peanut allergy around nine months old via a skin prick test. The allergist told me that if I ever gave my son peanut butter, he would be in the ER. Thankfully, he has not had a reaction since I've managed to keep peanuts away from him.
But here's the kicker. Because he hasn't had a full-blown attack, the allergist and even the peditrician won't prescribe an epi-pen. They said that the insurance company might not OK it since he hasn't had breathing problems with the peanut allergy. When I persisted, both the allergist and the peditrician said they felt that there really was no need for an epi-pen since I'm with my son all the time (he's now 20 months old).
So, I carry a cell phone in case I need to call 911 and I carry liquid Benadryl in my purse and in his diaper bag and have it on hand in our medicine cabinet. I'm not sure if I need to insist more that I get him an epi-pen but I am looking for another allergist who is more in-tune with peanut allergies and peanut research. Take care. Julie.

Posted on: Tue, 07/24/2001 - 2:33am
punkinsmom's picture
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Joined: 12/07/2000 - 09:00

Thanks for your input. I still carry the Epi and benedryl with me. I am normally cautious by nature so I figure it is better to be safe than sorry. I was just curious about what other doctors have said. Peggy

Posted on: Tue, 07/24/2001 - 2:50am
anonymous's picture
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Joined: 05/28/2009 - 16:42

JulieB,
I am really concerned that you don't have an epi-pen or more for your child. I think it is time to get a different pediatrician and allergist. If this is not an option then you might think about giving a copy of the article written by Dr. Sampson, who is on the board of directors for FAAN, called "What we should do for children with peanut allergies?" I might not have the title just right. But you can fin it in the Journal of Pediatrics Online.
good luck!
C&N's Mom
Alisa

Posted on: Wed, 08/01/2001 - 1:39pm
julieb's picture
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Joined: 07/21/2001 - 09:00

C&N's Mom (Alisa),
Thank you for your advice. I have a thread requesting if anyone knows of a good peanut-allergy-aware allergist in the northwest Chicagoland suburbs. As for our peditrician, I really do like the doctors in the office (it's a group of 6). So, I think the best route is to find a new allergist.
I will definitely look up the article you suggested. It's really nice to know so many kind strangers are out in this world to help. Again, I appreciate your concern and advice. Warmly, Julie B.

Posted on: Sun, 08/12/2001 - 4:28am
williamsmummy's picture
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Joined: 03/26/2002 - 09:00

this is a topic that really concerns me, my son was only prescribed the epi-pens because of my concern , rather than the allergist.
I still think that his reaction although moderate a still a cause for concern. no matter how hard we try , there are going to be accidental exposures . knowing other parents whos children have had more severe reactions than william but still have not been givern the epi-pen , makes me realise that the experts do not have the right to take away a parents right to cover every safety aspect of their childs life, and so for the moment i am content to take the precautions i see fit, so far we have not used them, but the last exposure taught me that every reaction is differant, that different symptoms seem to appear . I am reassured that the egg allergy will fade, but the nut one will always hang around.
my sons reactions to nut are a total of 3,
the first when he was one hives to touch.(mild reaction on piriton twice daily at the time)
second touch again age 4, total body hives to dust on fathers clothes.
3, last feb, peanut bar in mouth (?at school)
s&d, large total body hives , feeling faint and shaking , coughing , itching .
perhaps we could do with one of these experts to just drop us a quick line or two and explain their reasons for or against more clearly. williamsmummy

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