How cautious is your allergist?

Posted on: Mon, 02/19/2007 - 2:12am
bethc's picture
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Do you find that allergists are pretty likely to consider possible allergies and test for them?

I'm beginning to think that my children's allergist thinks I worry too much, and that he doesn't think it's really necessary to investigate suspected allergies. He's gone along with me in doing the testing, but it hasn't really been his idea. I do agree that it isn't desirable to test everyone for every allergy. But when there are suspicious symptoms?

My PA DD has had a variety of symptoms that I started to wonder if they added up to a latex allergy (swelling under Band-Aids, eczema under elastic, hives around the mouth after blowing up a balloon [although there were other possible explanations for that], allergic symptoms from banana, watermelon, and kiwi). So I talked to him, and he thought it was probably not anything other than oral allergy syndrome, but since I wanted to, he did a blood test. It came back mildly positive, so we're retesting after 6 months.

I brought in my younger 4YO DD, who only has a known allergy to penicillin, to talk about whether we should do some further testing for food allergies on her (at her physical last year, she had a basic food allergy panel done, but it didn't cover all nuts). I'd prefer to have this sorted out before I register her for kindergarten shortly. She has had 2 episodes of hives after eating, but we've never figured out why. Once was after a bakery cookie. She doesn't eat peanut or nut products because we don't have them at home anymore and I also wanted to delay introducing them to her. So the allergist's opinion was that she probably doesn't have any food allergies and that I could just feed her new things without worrying about it, but if it was making me lose sleep at night (as he put it), we could do a RAST for nuts. So we did and just today I found out that she tested negative for all the tree nuts. (Yay! But now I'll have to feed her some in the next 6 months to know for sure.)

This is leaving me wondering if this is a usual approach for an allergist. I know that family practice Dr.'s and pediatricians don't usually worry about food allergies much. My concerns were brushed off there for years, despite the fact that my DD did in fact have PA. But I think that with our tremendous family history of allergies and with some actual symptoms to make us wonder about new ones, well, wouldn't an allergist think we should sort this out as safely as possible? I understand that you don't really know if someone has a food allergy unless they eat the food and react.

It's been a long road to understanding PA, and I've finally got enough caution instilled in me about that. In fact, this allergist helped me understand that PA is really dangerous and that I have to take serious precautions. But I don't know if I've really gotten too suspicious about allergies or if our allergist just isn't very worried about it if you don't come in having experienced an obvious reaction. And after all, they're people; they have their own attitudes, too.

[This message has been edited by bethc (edited February 19, 2007).]

Posted on: Mon, 02/19/2007 - 4:03am
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Joined: 05/28/2009 - 16:42

We haven't had the best experience with any of DS's doctors- pediatrician, dermatologist, or allergist. We just finally saw an allergist for the first time last November. Pediatrician didn't recommend us to one despite the fact that DS has MFA's because he thought we (he?) could handle it.
The allergist hasn't been much more help. I suspect that DS is allergic to berries and kiwi in addition to his other allergies. Also he reacts to Desitin/ Balmex, Gatorade, Soda's (not that we allow him to have them), and some other things. Recently we've started to suspect Barley. He's had hives from all of these except barley- GI symptoms and eczema. Our allergist didn't want to test for anything more than what he's already been + for plus nuts. He says he's just likely to outgrow them and testing for more would be overkill. I argued him on the subject and that's how we got nuts tested for (- luckily, although never previously introduced or in our house.) So now I have a long list of things that we avoid even though we are not sure if he's allergic to them or not.
The first time we went to see Allergist I told him what we had removed from our house due to DS's sensitivity of having around- sesame, wheat, and eggs. No peanut in home either. He told us that there was no reason that we would have to change the entire family's diet for DS's allergies and that we could bring some of these items back into the house. Of course we didn't, we removed them for a reason. At this point I'm convinced he really did think that I was an over-reacting Mom. After the skin test though he had an entirely different attitude. He said that given DS's sensitivity to certain foods, especially wheat, that we were right to remove them and that we should consider not putting him in daycare, even brought up kindergarden (DS is 1). However he still doesn't want to test for the other foods.
Were moving soon though so hopefully our next allergist can be a little more helpful.
IMO I don't think people skills is a requirement when it comes to allergists. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Posted on: Mon, 02/19/2007 - 10:29am
lmw's picture
lmw
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Joined: 11/12/2005 - 09:00

I am now not too impressed with DD's allergist.
When we first saw him, 13 years ago,when DD was 7, for environmental allergies, I felt he was good. At the next appointment,a year later, we mentioned the itchy throat to raw fruits and vegetables and to certain nuts. He tested, for what nuts, I don't know, and she came up positive to almonds and hazelnuts.
Avoid those nuts, was his advice, he did give us epi prescription and said to get DD a medic alert bracelet.
A little over a year ago, DD started reacting to peanuts. The allergist tested for peanuts, and a few other nuts. Positive to peanuts, and a couple of other nuts. Again, he said to avoid only those.
A couple of weeks later, we were back, I wanted the rest of the nuts tested, after a reaction to macadamia nuts. More positive tests, and NOW he says to avoid them all.
He is well enough known in our city, shares office space and writes papers with one of the more well-known children's allergists here. I was surprised at the fairly 'un'cautious attitude he has. Sort of a 'if they bother you, don't eat them' kind of thing.
Of course, the last 2 appointments, DD went in alone at the beginning, she was 18, so I only got to talk to him at the end, and mostly because I insisted on asking MY questions. DD still lives at home, and I wanted to know what was going on.

Posted on: Mon, 02/19/2007 - 10:56am
Peg541's picture
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Joined: 12/29/2002 - 09:00

We are lucky because our allergist has TONS Of allergies and is crazier than we are so he has TONS of information and really loves to talk.
He usually sticks around for a bit Q & A during a visit.
Peg

Posted on: Tue, 02/20/2007 - 1:23am
bethc's picture
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Joined: 04/18/2005 - 09:00

Peg, you're so funny: he's crazier than you are! Sounds like you've got a good one who understands it personally.

Posted on: Tue, 02/20/2007 - 1:55am
Peg541's picture
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Joined: 12/29/2002 - 09:00

Funny. He loves the sound of his own voice and considers himself a great teacher so I just go along with it and ask ask ask. We hardly see him now but he's been helpful.
Of course when he diagnosed DS so many years ago (17 years ago!) he did not talk about epi or anything and it took more than a year for me to understand how serious this was, from my own research.
Peg

Posted on: Thu, 02/22/2007 - 2:45am
momll70's picture
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Joined: 09/26/2006 - 09:00

My son's allergist is very caucious. My son's school nurse knows his drill which makes me feel more comfortable about him being in school.
My allergist (who is nice - but that doesn't mean anything) thinks I'm not allergic to peanuts. I showed a light allergy to them and he tries to tell me I probably reacted to a different nut (which at that time I wasn't reacting to them). Now I'm allergic to tree nuts. I know I'm allergic to peanuts because I feel like I'm choking after I ate peanuts from the shell, peanut butter, etc. I have also become more sensitive to may contains. I don't care how low my test is I am avoiding and don't care to know how low or high my # is. He also doesn't believe I'm allergic to bitter greens (could be arugula or something else they put in these types of salad). He thinks it was the walnuts (which then I was not allergic to - I ate them in chocolates and out of the shell with no problems why would I react to them in salad and not other times? And I ate this type of salad another time w/o nuts and tried to eat around what I thought was arugula and I still reacted. My tongue swells and my lips swelled. They can't test for salad greens. This kind of upsets me and even though he knows I'm a highly allergic individual he tells me that he can see I'm a nervous person. I'm highly allergic to seasonal allergies and also severe to shellfish. I'm a 4+ to trees, grass, mold, ragweed so I break out in hives and my throat starts to close up. Gee, why am I so nervous. Sometimes I want to see another doctor but I know what to avoid and when I go back I may ask to see his partner who is a really good doctor.
I also told him I was allergic to aspartame and he gave me some free samples of fastmelt antihistamines (they contained aspartame). I have MFA (too many to list) and I understand that even a doctor who reads my chart can forget some of the things by the time he is done reading the list.
I just go for epi-pen prescriptions. He's close to a hospital too incase something were to happen.
[This message has been edited by momll70 (edited February 22, 2007).]

Posted on: Sun, 04/01/2007 - 1:39am
saknjmom's picture
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Joined: 04/02/2003 - 09:00

Quote:Originally posted by lmw:
[b]I am now not too impressed with DD's allergist.
When we first saw him, 13 years ago,when DD was 7, for environmental allergies, I felt he was good. At the next appointment,a year later, we mentioned the itchy throat to raw fruits and vegetables and to certain nuts. He tested, for what nuts, I don't know, and she came up positive to almonds and hazelnuts.
[/b]
itching to raw fruits and vegetables can be cross reactivity where if you are allergic to certain pollens, certain vegetables and fruits cause reactions.
I'm actually looking into this b/c lately my son has had some trouble with certain fruits.
Here is a small chart I found. Allergist had three pages of cross reactive foods the other day. it is also called oral allergy syndrome.
Pollen
Potential Cross-reactive Foods
Ragweed Bananas, melons (watermelon, cantaloupe, honeydew) zucchini, cucumber, dandelions, chamomile tea
Birch Apples, pears, peaches, apricots, cherries, plums, nectarines, prunes, kiwi, carrots, celery, potatoes, peppers, fennel, parsley, coriander, parsnips, hazelnuts, almonds, walnuts
Grass Peaches, celery, melons, tomatoes, oranges
Mugwort Celery, apple, kiwi, peanut, fennel, carrots, parsley, coriander, sunflower, peppers
Alder Celery, pears, apples, almonds, cherries, hazelnuts, peaches, parsley
Latex Bananas, avocado, kiwi, chestnut, papaya
[This message has been edited by saknjmom (edited April 01, 2007).]

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