oral challenge

Posted on: Fri, 01/31/2003 - 4:35pm
doreen's picture
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Joined: 06/23/2001 - 09:00

Our allergist has suggested an oral challenge for my daughter. I am livid. Her skin test was slightly less, but her blood test was slightly higher than two years ago. He told me it was "low," whatever that means. So, when the other doctor called to tell me the scores I got that the blood test was a 4, just as it was two years ago. I think I need a new allergist. This is the same guy that told me to get rid of my cats when both of my kids were tested -- my son tested a 2 and my daughter tested negative. I don't know how I feel about that, but this is ridiculous.

Am I wrong? He never wants to give me test scores. I know they are just a guideline and many people take them a little too literally. There is so much misinformation out there. I tell my friends that I don't want her exposed so she'll outgrow it and they doubt me saying she should be exposed to it. Well, I have been wondering if she's outgrown it, however, I have no basis for that. I can just see that she is not as sensitive as she used to be.

Then I thought maybe we could just have him put some on her cheek. As far as I've ever seen she's never reacted to touch. All this after I fought with my inlaws at Christmas. Can you imagine what their reaction to this would be?

[This message has been edited by doreen (edited February 01, 2003).]

Posted on: Sat, 02/01/2003 - 12:57pm
Chicago's picture
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Joined: 04/21/2001 - 09:00

Why don't you get a new doctor? You obviously don't trust this one (understand why) and if you switch you can just ask that your child's files be transferred? I would think they would include the test results or if they have been recent the new doc could get them from the testing agency (my ped. is now using some outside service for all blood work due to some stupid insurance deal - but they still keep records.
You really need to have someone you can work with here - even if it means driving / paying for the right doc.

Posted on: Sat, 02/01/2003 - 1:03pm
doreen's picture
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Joined: 06/23/2001 - 09:00

Well, two things, I was really wondering if anyone would consider a food challenge under these conditions?
I am close enough to hunt down Hugh Sampson -- does he actually see new patients? I think you're right Chicago about paying and driving. I'll do what it takes, especially since we kindergarten is only a year and a half away.

Posted on: Sun, 02/02/2003 - 1:47am
Peg541's picture
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Joined: 12/29/2002 - 09:00

You stay strong and refuse all oral challenges. My husband is a doctor and believe me they are not gods. They are as flawed as the rest of us and an oral challenge in an allergists office is nonsense!
Are you using the allergist for environmental allergies as well? That would make it imossible to do a long drive.
DS, DD and I had allergy shots for seven years, sometimes three times a week since we are all big time environmentally allergic. Luckily the allergist was right here in our town because it would have been awful any other way.
Peg541

Posted on: Sun, 02/02/2003 - 1:52am
erik's picture
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Joined: 05/15/2001 - 09:00

I know I would never consider an oral challenge to peanuts. My family doctor had mentioend the idea to my parents when I was a kid but we all said "definitely not". Even though I had a VERY relaxed comfort zone (as you will note in my posting today in the "comfort zone" thread), and oral challenge is way too risky when you are talking about peanut allergies.

Posted on: Sun, 02/02/2003 - 12:55pm
doreen's picture
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Joined: 06/23/2001 - 09:00

Thank you, I felt strongly that way, but, as Peg said, to stay strong sometimes it is hard.
My kids have not tested positive for environmentals yet, but I know they are there. We've never actually had an asthma diagnosis for either, but am prepared someday for both kids.

Posted on: Mon, 02/03/2003 - 1:50am
caryn's picture
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Joined: 11/20/2002 - 09:00

My son tested 4+ on a skin test and the blood test - Rast not cap rast - came up below .35 - the doctor originaly wanted to do an oral challege - right now we go for another skin test tomorrow - then he said next would be an intradermal skin test then a food challenge.
It has only been 3 months since he was diagnosed - what do you think???

Posted on: Mon, 02/03/2003 - 4:54am
Peg541's picture
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Joined: 12/29/2002 - 09:00

My son tested 4+ on the skin test, scratch test. The allergist said he would never do an intradermal on him because it would be too dangerous. Now when you combine that with an oral challenge, my feeling is run don't walk! Away that is......
I would not feel safe with an oral challenge outside of an ER or ICU setting. And I'd refuse even that. Better to treat your child like he is PA than to lose him proving he is PA.
Peg

Posted on: Mon, 02/03/2003 - 12:35pm
doreen's picture
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Joined: 06/23/2001 - 09:00

Wow caryn your situation sounds stranger than mine. How can they propose this three months after diagnosis? Get a new allergist, and well...
This is what I always thought I would do about food challenge ... if she had two tests below a class 1 and two negative skin tests then I would consider a food challenge in a hospital. I always thought my allergist was the type that would handle it the same way. I am really surprised to find differently. When he didn't tell me about my son's cat scores I thought it was just because he didn't think I would take it seriously. He told me later and it was higher than I thought it was, but I didn't know he wasn't going to tell me any of the other scores either. I never thought he'd suggest a food challenge so suddenly, and in his office.
Now, just wondering, how and why was your son diagnosed? I feel as Peg does (better to assume PA then risk the other choice), but I needed to verify my thinking here.
[This message has been edited by doreen (edited February 03, 2003).]

Posted on: Mon, 02/03/2003 - 9:11pm
becca's picture
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Joined: 05/22/2001 - 09:00

Personally, however low, if there is any detectable allergy, skin or blood to peanuts, I would not challenge. As long as there is any indication of the slightest sensetivity, I would wait for 2 sucessive negative tests then consoder an oral challenge. Even then, I would be in no hurry to feed dd peanuts. Might just be nice to go for an ice cream to get a non-nut flavor and not worry(meaning just to stop worrying about the cross contact, like eating next to kids at school, too)! becca

Posted on: Tue, 02/04/2003 - 2:37am
caryn's picture
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Joined: 11/20/2002 - 09:00

Well we went to the allergist this morning and redid the skin test - my son was another 4+ for peanuts and positive for 5 other tree nuts as well - ranging from 1+ to 3+ - the doctor said okay he is definitely allergic to peanuts and tree nuts - no more testing til he gets ready for school - he is only 2 1/2 now.
He was diagnosed PA after 11 ear infections from a constant runny nose - we chose allergy testing over tubes. After getting rid of all nut and peanut products(and yes there were plenty) in our house(he hadn't eaten any yet) he has been free of the runny nose and ear infections since the diagnoses. (3 months). That is until he spent quite a bit of time at grandmas this week and I noticed the ant traps - I called and they contain peanut butter!
This is our second allergist - the first sent us away with an epi pen jr but no info and would not do blood testing.
thanks for all your advice - I am so glad the food challenge was not considered this morning - my husband said to call him at work if the doctor suggested it!!

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