Is your pediatrician helpful with FA?


My pediatrician office is a large practice where you see 1 of 5 drs. For well visits you can choose the dr; but for sick visits you are assigned to whoever is available that day.

It annoys me that the drs seem to forget that my boys have food allergies. I even asked that they "flag" their charts so the drs stop asking "so there are no allergies right?"

They also have not been helpful in FA management. They just passed us off to an allergist and there is no coordination of care. And the allergist doesn't provide much continuity of care -- he has the "yep, they have food allergies, here's an Epi Pen, see you in 3 yrs" approach.

I started learning about 504's and realized I have no drs on board with us. I've been "going it alone". I have seen a hopefully better allergist. But the pediatrian's lack of support and forgetfullness is bothersome. Just wondered if this is common or not. Trying to figure out if I should change practices.


On May 8, 2006

Truthfully I don't engage our pediatricians in management of my son's FAs. However, the two senior doctors in the practice who have known him since he was born are extremely mindful of them. They ask about them at each visit, and make sure he's carrying his epipens. The third doctor is fairly new to the practice and has only seen him a few times so it really hasn't come up. (This week she's getting a crash course in how allergic he is as she's trying to find an antibiotic to treat his strep!)

I think most people find their pediatricians pretty clueless when it comes to managing FA's. A few weeks ago my neighbor's DD had her first really bad tree nut reaction, and her pediatrician told her to just give her benadryl. Hours later she was still getting hives, and I told her to take her to the ER for steroid treatment (contrary to the MD's advice). Sure enough, while they were in triage she became short of breath and had a massive biphasic reaction. Thank heavens they were already at the hospital. I don't think this is that unusual.

I think there have been other threads on this topic - try a search.

I hope you can find another allergist you are more comfortable with. They can be great allies.


On May 8, 2006

While I'm happy with our pediatrician in all other areas, we have the same situation. I try to discuss a FA issue with him, and his canned reply is about epi-pens, with an occasional patient story thrown in. Our allergist forwards all reports to him, but I think he feels it's not his "area of concern." KWIM?

On May 8, 2006

My pediatrician is awesome. She has always been so supportive of our food allergy issues. The girls have big red stickers on the file to indicate their allergies. My ped hung our support group fliers in her office and even went with me to FAAN's conference. She will even refer some of her patients to me for support!! I don't know what I'd do without her!

On May 8, 2006

We belong to a Kaiser HMO and they do very well with coordinating health care for a complicated case like my son. He has eczema and asthma and is highly allergic to peanuts/tree nuts. He is also a type 1 diabetic. And he is 4 yrs old. All the drs. are in the same building that we see and they know each other. You wouldn't believe how helpful that is when we has to go on meds that affect his diabetic care, etc.

I wouldn't hesitate to recommend my HMO to you. Perhaps check into HMO care if you have that option.

On May 8, 2006

Our general practitioner is not particularly well-versed in atopic diseases in general... but he definitely knows his limitations and gives fairly liberal referrals for specialist care. This is great for us, as he is therefore aware of family history and is able to provide better care to all of us as a result.

I actually blame the lack of understanding with our daughter's first physician (a pediatrician) on his suggestions that we try highly allergenic foods or arguments over when to start solids, etc... Any doctor who treats one of us needs to have an awareness of just how strong that atopic profile is, and also needs to know the high risks for other serious conditions. But we don't expect specialist care from our GP.

Our allergist is in the same building as our GP, and I must say that this is also a bonus. Frankly, DD's allergist handles more of her care than our GP-- but our GP handles DH's diabetes very well, as this is an area of specialty for [i]him[/i].

Our HMO on the other hand, can be a major PITA... especially about formulary drugs for children... they keep telling my that Zyrtec is non-formulary and we should try Allegra tablets. With my 45 lb six year old. Uhhhhhh... that isn't an approved drug in this age group, guys.... [img][/img]

Anyway. I wouldn't expect expertise from a GP, and as long as you have a good working relationship with them, I wouldn't worry about it too much. You could ask if it is possible for your family to see one of two doctors-- that way you have better odds of seeing someone who is familiar with you even when you are ill.


On May 16, 2006

My son's pediatrician is a great doctor and is the head dr. at our local hospital for pediatrics. BUT, I have found that I prefer to let him handle the stuff not related to FA or Asthma. We see an allergist for those things. Once, my son was sick (which aggravates his asthma), he prescribed a lot of steriods and i was a bit taken back. I took him to allergist that day and was given a much less aggressive treatment that worked. I have also seen pediatricians of friends and family really overdo the asthma meds in my opinion. The food allergies just don't really come up during visits to pediatrician. There is a red sticky thing in his chart which alerts to allergies. Where do you live in NJ? I use Dr Perin who has an office in Teaneck & Wayne. He is fantastic.