Onours I am pretty sure we just wrote that there was positive results with spt and caprast testing as well as reaction history. Those 3 things were also mentioned in the letter from the allergist. I personally did turn in test result scores and reaction history to help *prove* that I wasn't kidding on any level. But if you don't have to supply *proof* or even don't feel comfortable, I think just a signed letter/statement from the allergist holds it's weight in gold. Good luck!!!
edit, the above info was for the 504 evaluation, not just for the allergy action plan, like Gail stated, that was just a form outlining the *action* taken during a reaction.
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Chanda(mother of 4)
Sidney-8 1/2(beef and chocolate, grasses, molds, weeds, guinea pig, hamster & asthma)
Jake-6 1/2(peanut, all tree nuts, all seeds(sesame, sunflower, poppy, pine nut) beef, chicken, eggs, coconut, green beans/all beans, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-4 (peanut, tree nuts, milk, soy, egg, beef and pork, cats, dog, guinea pig, hamster, grass, mold, dust mite and EE)
Savannah-1 1/2 (milk, beef and egg, dog(avoiding peanuts, tree nuts, strawberries, seeds, legumes and corn)
[This message has been edited by chanda4 (edited September 03, 2007).]

I have a kindergarten student this year whose entrance physical stated a "mild allergy" to peanuts. In April when I 1st became aware of this per the Mom, I asked her to have the necessary forms completed so we could have a plan in place for the 1st day of school. Not done. I spoke with the Dad this week and he said his daughter had not been tested but their concern was because the older sister has asthma and nut allergies. (Some of you that avidly follow the threads may remember that I asked for help re: a similar scenario last year.) The information on the kindergarten physical per the doctor was stated based on the mom's info that said child had a minor rash after eating something with nuts. I resent forms last week and again asked for verification...this is what I'm trying to verify. A doctor should not write a confirmation like that without testing. In the meantime, all emergency and prophylactic procedures for the child's safety have been enforced. Please, any one out there who is a nurse at a school...are you having this same cart before the horse problem. You are also going to ask about a 504 plan and you may remember that our district does an IHP and not a 504. Don't ask me why that is because I don't have an answer. Any way...any comments/suggestions with the issue itself?

Oops. We were posting at the same time.
Quote:A doctor should not write a confirmation like that without testing.
Huh? Our allergist (highly regarded + board certified in both pediactric allergy and pulmonology + teaching at a top 5 medical school) made this exact recommendation to us regarding our younger daughter. . . [i]without testing.[/i] And even after he conducted testing that indicated 'negative', he still recommended that we avoid.
Why can't a physician give his recommendation to treat the child as food allergic until said physician determines the child should undergo testing or if he belives testing is questionable?
ETA: Paulette, with all due respect to you and your profession, I'd have major issues if you did not fully support my physician's recommendations regarding my child.
[This message has been edited by Gail W (edited September 03, 2007).]

that would be like the case with my 4yr old, he's entering preschool and I wasn't sure how *diligent* to be about PA....he has been tested 3 times now(caprast) and all negative...but the allergist said to avoid, continue to avoid just like his brother.....so in that case, it was the allergists recomondation to avoid, to treat him as allergic for the time being. I don't think in his case I would ask for a 504 though, but I also don't know how the school would avoid contact with peanuts/tree nuts without one, I'd have to look into that a bit more.
Luckily(well, I consider it lucky because we found out prior to any reactions)....last month, one last caprast prior to preschool, it came back positive to peanut, cashew and walnut.......then he had a contact reaction in Target(had to call 911....but I am chaulking it up to a nut of some sort)....but now I know I'll need a 504 once he enters Kindergarten and I guess *now* we'll have test results and one mystery anaphylaxic reaction to back us up!
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Chanda(mother of 4)
Sidney-8 1/2(beef and chocolate, grasses, molds, weeds, guinea pig, hamster & asthma)
Jake-6 1/2(peanut, all tree nuts, all seeds(sesame, sunflower, poppy, pine nut) beef, chicken, eggs, coconut, green beans/all beans, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-4 (peanut, tree nuts, milk, soy, egg, beef and pork, cats, dog, guinea pig, hamster, grass, mold, dust mite and EE)
Savannah-1 1/2 (milk, beef and egg, dog(avoiding peanuts, tree nuts, strawberries, seeds, legumes and corn)

I know people who have children who have rashes after eating a food and think the allergy is "mild". Really, there is *no* way to tell what future reactions will be. Reactions can and do vary in strength from mild to very severe and even life-threatening from one exposure to the next. There is absolulutely no way to tell what future reactions may be like. It is kind of like being pregnant. Either you are or you aren't. either you have life-threatening food allergies or you don't. (Well, there are other food-related conditions, too, but that's a different story.)
I would say this sounds like a case where the parents do not know much about food allergies yet. I know of a school in MA that tells parents such as the ones you described that they *must* get their child tested and give the school the results. I think a school can require this in order to cover themselves so they know to take proper precautions. I would treat a child who got hives or a rash from eating peanuts or tree nuts the same way I would treat a child who had anaphylaxis to eating them--I would keep the child away from exposure and have epi pens ready and trained staff.
Best wishes.

to Gail W and the ETA at the end of your response...you must not have read my comments to the end where I indicated that an emergency plan and prophylactic measures are in place despite the parent's request. Was there an insinuation here?

Quote:Originally posted by paulette816:
[b] to Gail W and the ETA at the end of your response...you must not have read my comments to the end where I indicated that an emergency plan and prophylactic measures are in place despite the parent's request. Was there an insinuation here?[/b]
paulette816, perhaps I misunderstand you and I hope you will clarify. I am confused by this statement:
Quote:Originally posted by paulette816:
[b]The information on the kindergarten physical per the doctor was stated based on the mom's info that said child had a minor rash after eating something with nuts. I resent forms last week and again asked for verification...this is what I'm trying to verify. A doctor should not write a confirmation like that without testing.[/b]
Is your concern that the child's history was reported by the parent? That isn't uncommon, is it? I mean, unless there was emergency care documented in the child's medical records, *all* information resported to a child's physician is from the parent, isn't it? My daughter's physician has not ever been present to witness any of her thirty-some contact reactions. My daughter's "history" is basically what I have reported to him. Just like this child. . .
Or is your concern that the physician is not performing his medical duties?
Quote:[b] A doctor should not write a confirmation like that without testing.[/b]
On what do you base this assertion? (My allergist disagrees, FWIW.)
I'm confused as to why you need 'verification' of what the physician has provided on the child's physical exam form. It sounded to me as if you [i]questioned his judgement [/i]and were seeking a means to 'validate' it? Please correct me if I am mistaken.
[This message has been edited by Gail W (edited September 03, 2007).]

Quote:Originally posted by paulette816:
[b]I have a kindergarten student this year whose entrance physical stated a "mild allergy" to peanuts. In April when I 1st became aware of this per the Mom. . . [/b]
The physical exam forms were turned in upon enterance and you first became aware of the allergy 8 months later?
Oy.

To Gail W...in April I was aware when the mom registered the student as they have preliminary forms to fill out. The k physical is not due til the start of school. Mind you...she was given all the necessary forms in May and she has another daughter in our bldg. with asthma and allergies so she knows the drill. I feel it was certainly correct for her to give that information re: a rash. to the pediatrician. What I have a problem with is that the doctor put that on the form as though it was a confirmed allergy. We don't know that it is an allergy without testing do we? Any one could come in to the school and advance any health agenda just because they thought it? Is that what you are saying...I'm confused...don't there have to be guidelines? I feel that the doctor can't state that the rash is an allergy without substantiation. Please read my posts thoroughly as you are not interpreting them correctly I don't think....but thanks for your interest anyway.

A reaction after eating something is a gold standard as compared to any type of allergy testing.
Perhaps the insurance didn't cover the testing? Not totally necessary to test if there is history of known reaction. Did the dr prescribe Epipen?
I'd recommend going the conservative route and assuming the child has the allergy. If you doubt it and she has a reaction at school, how is that going to look?! I wouldn't assume any allergy to peanuts and/or tree nuts is mild. Reactions get worse over time.
I also don't think worrying about "OVERDIAGNOSIS" (in your unqualified opinion) is relevant.
I have a younger DD, after two kids that are food allergic. Because we knew what we were doing to AVOID with DD, she has NEVER tried peanut/treenuts. That was the recommendation of two top allergists. Younger sibs should be watched closely and with one known reaction and allergic siblings, that is pretty signficant.
[This message has been edited by TwokidsNJ (edited September 03, 2007).]