told by allergist to \"let it go\"

Author:
Updated:
Original:

My son saw his allergist today. As mentioned in previous posts, he has had 2 contact reactions, one in May, one in July. May was in school after sitting at a table with children who had eaten peanut butter; the second at a supermarket after handling a shopping cart. I believed he was having some psychosomatic symptoms after the second episode because the poor thing was scared. His symptoms were itchy tongue, feeling like his throat was closing, and chest tightness, along with "just feeling different".

Before I even mentioned the psychosomatic symptoms to the doctor, he said, "just let it go". He does not believe my son's reactions were from peanuts! I asked him to explain why the school nurse saw that his throat was swollen along with his eyelids and why did it happen while sharing supplies with kids who had eaten peanut butter. His response "I don't know, but I do not believe it was peanuts". He said if he ate a Reeses cup, I would feel different. He does not believe a reaction would be caused by peanut residue. He said there could be an earthquake, it doesn't mean this building would fall down. Some would, but this one might not!?? He said, "I could probably go to his room tonight while he is sleeping and open a jar of peanut butter or rub some on his arm as long as he didn't eat it, and he would be fine".

He said that I should give him Benadryl when he says his throat is closing and "let it go". I said, "I should give Benadryl and wait until he has trouble breathing to give him the EpiPen"? He said "No, he won't have trouble breathing unless he eats peanuts".

He kept saying to my husband "you agree with me right?" My husband half agreed. I agree that my son has some anxiety over the allergy, but I absolutely do not agree with this doctor! I spent 4 years trying to get my husband to realize how serious this allergy is. When my son had the 2 reactions, my husband finally realized the danger. Now, this doctor tells him otherwise!

Please someone tell me if am I out of line here or is this doctor a complete idiot? Does anyone out there understand where this doctor is coming from? If you see his point, please fill me in. I left the office in tears.

Also, I asked for him to be tested since he hasn't been tested in 2 years. He said no need to be tested. We know he is allergic. The tests would be positive again. Just don't feed him peanuts or tree nuts. I am usually not this critical of people and I have never argued with a doctor in my life until now. [img]http://uumor.pair.com/nutalle2/peanutallergy/mad.gif[/img]

On Aug 15, 2006

Many >>>Hugs<<< to you!

ARGGHH! Just like with Peds, Allergists can be cut from different cloth. Some are aware, some are not. Sounds like yours is one of the latter. Time to go shopping. (Do you know anyone else w/ PA or MFA in your area? Better to have a referral from a parent, than hit or miss.)

BTW, I saw my Allergist after an inhalant reaction earlier this year. It was mild but scared me, just the same. I asked him, "Is this real? Or is it just anxiety?" He said, "There is quite a bit of anxiety that comes into play with any allergic reaction."

Your son needs to know that you believe him, no matter what. Even if his anxiety is flaring (with good reason, I might add), some allergic symptoms can last *for several days* following a reaction. This is why they often advise Benadryl/steroids for several days.

It sounds like your Allergist has labelled you and your son.

So sorry, Daisy

On Aug 15, 2006

I agree-find a new allergist. My dd's allergist TOLD us to stay away from people eating nuts/peanut. He told us that he had several patients that reacted from residue/traces/smell at school (all kids-he's a pediatric allergist). He also wrote a letter for us to give my inlaws that said to keep her away from residue-they didn't listen but we just quit going there for holidays and get-togethers. Anyway I wouldn't trust your allergist.

------------------ ============== [b]~Gale~[/b]

On Aug 16, 2006

I would find a new allergist. This guy sounds like an arrogant, uninformed, not someone I would like treating my child!! His saying that you could put it all over him while he is sleeping is half the battle we have in educating people about the ways people can have a reaction. I would change doctors quickly.....

On Aug 16, 2006

I see you are in Massachusetts. I am too. I took my son to an older well known allergist who is respected in his field. I was not impressed and ended up going to another doctor who we like much better.

When I asked the doctor about traces of nuts and calling companies, his response was "It's like the line in the middle of the road. You stay on one side of it, but sometimes you have to cross it. You don't call the highway department to make sure it is there." My first thought was-you cross the line in the middle of the road, you could get hit head on! I never went back.

Find someone else.

On Aug 16, 2006

It is time for you find a new allergist!!! Our first one was a real jerk, but the only Ped allergist in the small town we used to live in. He actually told me that my son would probably be allergic to milk too. Which about freaked me out b/c he eats yogurt all the time. One of his main food sources. My new allergist where I live now said no allergist can predict what allergies a child will develop. Good luck to you and ALWAYS follow your mother's intuition!!!

On Aug 16, 2006

I wouldn't *necessarily* say that you need to find a new allergist . . . it depends on the overall relationship. If the allergist is generally very good on other issues, I'd stick with him. *BUT* just know that when it comes down to it, trust what you see happens to your child with your own eyes rather than listening to the dr.

there's stuff in the medical literature about severe contact reactions . . . but i think that a lot of allergists see that very small study by Sicherer & co. superseding all the previous anecdotal evidence in the literature about severe contact reactions. That isn't good science because one person's allergy is not the same as another . . . what we might have is 1000's of different levels of reactivity and each child might have a different threshhold. SO if you have a sample of, say, 20 kids you can't guarantee that they are going to be representative. (And the Sicherer article recognizes that what they found would be true for the *majority* of kids . . . the study obviously didn't recognize *all*.)

Anyways, it *is* better to have a doctor who makes conclusions more based on her/his clinical observations rather than blocking clinical observations out because they aren't attested to in the medical literature.

*But* it is really hard to find one like that. Most of them are likely to dismiss patient's concerns if it doesn't seem to match up with what they think they know from the medical literature.

I've just learned to accept that I'm not going to be happy with my doctors all the time . . .but I trust them on some things. So I research everything and try to figure out when to believe them and when not to.

(just to give a recent example in my family: father had elevated enzyme levels suggestive of major liver problems. we researched the high blood pressure meds . . .sure enough, it is a common problem with people who take these meds. Some doctors have a real block against acknowledging that medications they prescribe can cause problems. The doctor was *certain* it wasn't the meds. *But* since my father was adamant about going off them the doctor prescribed something else. The enzyme levels are now going back down and the GI doctor said it is probably the medication as nothing seems to be wrong and he is improving.)

If you go to a lot of doctor's appointments, stuff like this is just bound to happen. Thank goodness for the internet!

On Aug 16, 2006

We go into BBoston - Childrens. We like our allergist, FWIW, though we're 'status quo' in our journey, so theres not much she can do for us. Email me, and Ill give you her name, if you want.

Jason

------------------ [b]* Obsessed * [/b]

On Aug 16, 2006

Well. I'm more concerned about the effect this allergist's words are going to have on your husband. [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img]

I think the difficulty all along is that contact and airborne reactions may not be reported as often as ingestion reactions - although truth be told, I don't know what Anaphylaxis Canada does with the information when I do report a reaction. [img]http://uumor.pair.com/nutalle2/peanutallergy/confused.gif[/img]

I would find a new allergist and more importantly, I would trust your *gut* instinct.

I can't even begin to imagine a doctor saying something about coming into my child's room with peanut butter. [img]http://uumor.pair.com/nutalle2/peanutallergy/mad.gif[/img] However.

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

------------------ If tears could build a stairway and memories a lane, I would walk up to heaven and bring you back home with me.

On Aug 16, 2006

I agree with CSC. You have just had an "expert" express that you and your son are both just imagining things... [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img] In fact, this was contributed to real marital woes during the two or so years when everyone thought [i]I[/i] was making it up... or "looking" for a problem that wasn't there. It took time for our allergist to get on board, but he was [i]never[/i] as obnoxious as yours.

In my own experience, until you [i]see it with your own eyes[/i] you tend to be very very skeptical, especially of aerosol triggered reactivity. Because it is rare among allergies.

But the other concern I have is that not only is this allergist creating problems within your family, he is not going to be any help to you with school issues whatsoever. He may even be undermining you when you need his help most.

Find a new allergist. Your son deserves to be treated seriously. [i]HE[/i] is the real expert on his own allergy, and I'm shocked that your allergist doesn't see it that way.

On Aug 16, 2006

I don't like how he was trying to get your dh on his side. Weird. I emailed you. Wondering who you see! Wondering if I have the same allergist or not!

becca

On Aug 16, 2006

I reread the original post--I didn't notice the part about the dr. trying to get your husband on his side. definitely switch doctors! even if your husband totally agrees with you and was only trying to placate the dr. under pressure . . . obviously this dr. has gender issues.

On Aug 16, 2006

Totally agree, Corvallis Mom. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] My DH didn't "get it" until our son almost died from an anaphylactic reaction (he didn't see his first one). Previous to that, I was the hysterical (if you will) Mother. But man, once he saw it with his own eyes, he "got it" and "got it" as well as my son and I. It did definitely create difficulties in our household. [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img]

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

------------------ If tears could build a stairway and memories a lane, I would walk up to heaven and bring you back home with me.

On Aug 16, 2006

Sacena, could you give us the name of your allergist so those of us in your area can avoid him? (Although I'm giving serious thought to avoiding our pediatric allergist, too, for his lousy bedside manner.)

Thanks, Debbie

On Aug 16, 2006

Debbie, I think we see the same guy!? I was curious too. But dd likes ours, and he is good, but I find him a bit condescending to me, and I have to push him for details(numbers). But, nothing like the above incident! becca

On Aug 16, 2006

Becca and Debbie-do you go to his office in Concord?

On Aug 16, 2006

Most of the kids I know with PA have exhibited the same symptoms as your son from contact reactions. Some have had the epi and some just beni. I would change allergists and leave it at that. You know what you are talking about and dealing with. He does not. Sorry this happened.

On Aug 16, 2006

I am sorry that he made you second guess what you are doing to keep your child safe. One thing I have learned in all of this is to trust your instincts. No offense to the hubby's out there, but there is something to say about a Mom's intuition that can be spot on. I too agree that you need an allergist who does not pooh pooh your concerns. The fact he tried to get your husband to pick a side speaks volumes about his lack of understanding of the family dynamic and food allergy. Anxiety in itself can have real symptoms, so a peanut reaction or not it should not simply be "let go". I wish you luck. Samber

On Aug 16, 2006

Quote:

Originally posted by becca: [b]Debbie, I think we see the same guy!? I was curious too. But dd likes ours, and he is good, but I find him a bit condescending to me, and I have to push him for details(numbers). But, nothing like the above incident! becca[/b]

Becca, the doctor I was thinking about, my son's allergist, is at Children's Hospital. (We see him in the Lexington office.) I don't care for him one bit, and I'm thinking about taking my son elsewhere, especially since things are pretty much status quo right now.

My allergist is in Concord, Dr. Moody. I like him, both personality wise and care-wise. He is a bit conservative in my view, but that's okay. Much better than the opposite!

I used to see his partner, Dr. Twarog. But his condescending manner offended me, so I am no longer his patient. But the phrase Turtle used about the line in the middle of the highway struck me as very similar to a phrase Twarog had offended me with over a decade ago, so that's why I was wondering if her child's allergist was Twarog or perhaps my son's annoying allergist from Children's.

--Debbie

[This message has been edited by DRobbins (edited August 16, 2006).]

On Aug 16, 2006

I am so sorry that happened to you! I would definitely find a new doctor. This allergy is stressful enough, adding a non-supportive doctor - OF ALL PEOPLE - to the mix is just too much.

After reading several posts on here about different docs, I am so glad I have mine! He's as paranoid as I am!!! ;-) We saw him last week and he confirmed my plan to homeschool - he said you just can't trust other people with your PA child.

------------------

On Aug 16, 2006

Wow! Thanks for everyone's replies. I love this web site. It's great to have so many supportive people [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] I'm glad to hear that it wasn't me with the problem, but the doctor's.

I wonder why these doctors chose their profession if they don't have a good bedside manner.

I will probably go to Children's Hospital or one of the satellites. I will stay away from Twarog. I know Michael C. Young who wrote the Peanut Allergy Answer Book is from Children's, but it would probably be difficult to get an appointment with him. I went to one of his discussions and I really liked him.

Like some of you mentioned, this may cause more arguments with my DH. I don't know how many arguments we had due to him not bringing the EpiPen wherever he went because they weren't going to eat anything. [img]http://uumor.pair.com/nutalle2/peanutallergy/rolleyes.gif[/img]. When it was time to use the Epi, he didn't even know how!

For those of you who wanted to know who the doctor is, I will say he is from Medford, MA I don't know if I should post his name. You may E-Mail me if you want to know his name.

I've been feeling miserable all day today, but I feel much better after hearing from all of you.

Thanks again and stay safe!

On Aug 16, 2006

Run, don't walk, to another doctor, and don't feel bad about it. My dd has only had one reaction, and it was from touching a very tiny amount of PB. Contact can definitely cause a reaction!

Also, I'm a physician and can testify that some doctors are better/more educated/more open minded about certain topics than others. Someone may be a world expert in one aspect of the field, but not "get it" in another. For me, I also want my patients to be comfortable with me. If they aren't then the whole dynamic is just off. Find someone you like, someone that takes you and your dd's allergy seriously.

------------------ Lori Jo,

Rose, 7-31-02, PA Beatrice & Georgia, 8-14-99

On Aug 16, 2006

DRobbins, I have a friend who sees Dr. Moody and has such an open rapport with him. I want to ask to see him, but it is awkward! I just want to feel comfortable when I ask for the test numbers, not like I do not "need to know."

Another classmate of dd's, new to our town, saw the other Dr. in that practice, I forget her name, and also really likes her. becca

On Aug 16, 2006

Thanks Lori Jo. Thanks for the advice. It helps knowing that you are a physician. I'm glad you understand my situation. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Aug 17, 2006

Quote:

Originally posted by becca: [b] Another classmate of dd's, new to our town, saw the other Dr. in that practice, I forget her name, and also really likes her. [/b]

You know, since they rotate which doctor is in the office on a given day, I've never even seen the female doctor in the practice, and I'd forgotten that I've seen her name on their sign. I think she must have joined the practice in just the past couple of years. I wonder if I could switch my son from the guy he's seeing at Children's to her...

--Debbie

On Aug 17, 2006

The mom that really likes her, switched from Moody, actually, but I hear nice things about him. She just found she could really ask all her questions and had a good rapport with her. This mom has 2 children with MFA, and has lots of questions and was quite overwhelmed and felt like she got good time and was heard. She also says she has been very empathetic, which is a nice touch!

I do find it to be a practice with a good reputation and good care, I just hear differing opinions on personality issues between the differing members of the practice(LIke you and I have). So I guess it is giid if they are all different. Someone for everyone. becca

On Aug 17, 2006

In general, for anyone who has an allergist like this, I say switch on PURE PRINCIPLE. I wouldn't give someone like this a cent of my money. What if you need him later - heaven forbid - to testify? Work with the school? Etc. This one would testify about how you have stuff all in your head. Also, why reward someone obviously so misinformed and arrogant financially? Just my thoughts.

On Aug 17, 2006

Yikes - I don't know how I missed this earlier. Run - don't walk - to a new MD. That attitude is inexcusable.

Let me give you our MD's attitude as contrast. (While I'll admit he didn't educate us beyond telling us to avoid peanuts, he has been totally supportive and on-board in every other sense.) When my son had an airborne peanut reaction on a plane, and then another airborne reaction to falafel cooking (he's also sesame and chick pea allergic), our allergist put down what he was writing, looked my son in the eye and told him to never, ever leave the house without his epipens. Period. He was surprised by the reactions, but he didn't doubt them. He took it very seriously, and made sure my son did too.

What really troubles me most about your MD's attitude is that it could cause your son to doubt himself and make him hesitant to speak up when he's experiencing symptoms.

Thank heaven you're in the Boston area, and not someplace with few providers. I hope when you switch, you let him know why. Heck, he's not my doctor and [b]I'm[/b] tempted to. [img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img]

Amy

On Aug 17, 2006

Speaking of reactions on airplanes, the doctor did mention it at the visit. He said some people worry about airplanes, "So what if someone 6 rows down is eating peanuts". [img]http://uumor.pair.com/nutalle2/peanutallergy/eek.gif[/img]

I mentioned that we had tickets for a Red Sox game, but I gave my son's ticket up after he had the contact reaction at school. The doc said "it just wouldn't work, it just wouldn't work". Was he contradicting himself or maybe thinking I would be to nervous? I don't know what he meant, but I didn't want to ask because, by that point, I was ready to pop him one!

I'm sure there were many other things that he said that I just don't recall, either by blocking it out or I didn't even hear him because I was in shock.

Yes, I will let him know why I am switching doctors and I will also let the pediatrician know once I'm able to discuss it without getting all teary eyed. They'll be thinking of me as "crazy lady".

As for my son, I don't think he was affected by the jerky doctor. I told my son that he was not a good doctor who doesn't know about peanut allergies and he said things that weren't nice. I'm glad he realizes that Mom will always believe him and keep him safe [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Aug 18, 2006

Quote:

Originally posted by sacena: [b] His response "I don't know, but I do not believe it was peanuts". He said if he ate a Reeses cup, I would feel different. He does not believe a reaction would be caused by peanut residue. [/b]

It's a shame that there's not more data available to physicians about contact and airborne reactions. I agree with Amy that there are allergists out there who are willing to work with you. My allergist is another excellent example. Given the lack of data, he created his own clinical touch challenge. I wish he would publish it.

From here: [url="http://uumor.pair.com/nutalle2/peanutallergy/Forum1/HTML/004077.html"]http://uumor.pair.com/nutalle2/peanutallergy/Forum1/HTML/004077.html[/url]

[i]Re: Mariah XXXXXXXXXXX DOB: XX-XX-XX Patient ID#: XXXXX Date of visit: 8/21/03

Dear Dr. XX,

We saw Mariah for a modified challenge to environmental exposure to peanut.

As you know, Mariah has severe peanut allergy with a past RAST value of greater than 100KU/L. There have been some episodes at school when she has gotten upper airway symptoms when presumably in contact with peanut butter. This has been approached by having a peanut-free table with good success; however, as Mariah has grown older, she has become excluded because of the peanut-free table, and she wishes to see what would happen if she ate at a table previously covered with peanut butter but then wiped clean.

Mariah arrived and went into the examining room where the small table for physician writing had been smeared with peanut butter and then wiped clean with dish soap and water. She sat at the table and started to draw with a marker. The room clearly smelled of peanut butter. Within ten minutes of arrival, she had nasal stuffiness and dark circles under her eyes. Then she had hives develop under her eyes and developed some conjunctivitis in her right eye. These findings remained stable and did not progress to any further symptoms. Because of the possibility that Mariah may encounter objects such as magic markers that have been held by children with peanut butter on their hands, we extended the challenge to give her sequentially magic markers that were smeared with peanut butter and then cleaned with first alcohol, then dish soap, and then just with a paper towel. As this challenge proceeded, she developed some swelling of her upper lip unilaterally (on the contralateral side from her unilateral conjunctivitis), and had red spots that were not typical urticarial lesions. over time, Mariah continued to sit at the table and draw. The symptoms did not increase to other areas, but resolved spontaneous. No treatment was given for any of the symptoms described.

Throughout this challenge, Mariah's peak flows remainded stable at a personal best of 280. Her blood pressure and pulse remained stable. She never had any respiratory signs other than the mild sniffling.

As time went by, there was an ongoing discussion about Mariah sitting at the regular lunch table. Mariah was excited about this possibility. Mariah's mother will will revise the food allergy action plan for the school eliminating reference to minor symptoms such as those seen during the challenge, prompting treatment with Benedryl or going to the school nurse. Mariah will be given latitude as to when she feels need of help. I believe Mariah is mature enough to handle this responsibility.

We did not evaluate Mariah's asthma today, but she reportedly has had no symptoms.

Impression: 1. Peanut allergy, severe by past history and RAST. 2. Environmental challenge designed to be similar to what might occur at school. 3. Mariah clearly had signs and symptoms during the challenge, but these were limited to the upper airway and did not progress, but, in fact, resolved spontaneously, even with ongoing exposure in the setting.

Plan: 1. Mariah can sit at a regular lunch table, assuming it is cleaned with dish soap and water before she sits down. 2. Mariah's mother will revise the action plan for the school, and we will sign off. 3. Regular visit for asthma upcoming and scheduled.

Sincerely, XX XXXXX, M.D.[/i]

Just wanted to add my thoughts re: reactions caused by suggestion. IMO, they are as 'real' as a reaction caused by the allergen because the symptoms are just as 'real'. Symptoms are symptoms, regardless of the trigger. If your allergist was suggesting that your son was having 'psychosomatic' reactions, did he refer you to a medical professional who could help your son? I'm not questioning that your son actually had a reaction from contact with peanuts, just questioning your allergist's approach to your son's care.

[This message has been edited by Gail W (edited August 18, 2006).]

On Aug 18, 2006

Thanks for sharing that again, Gail.

Our allergist also has seen similar symptoms with our daughter (also RAST >100) from aerosol exposures to very very small amounts. (Far too little to smell) We suspect that it may have been a snack consumed by a staffer or from the espresso kiosk in the main lobby of the building.

But he's seen them, and it made a beleiver out of him. We've also met him half-way, however. Like Gail's daughter, we've had to realize that such exposures ALONE are not likely to provoke full-blown anaphylaxis (though symtoms may technically be 'anaphylactic' since they involve multiple systems). Therefore, we now allow DD to decide when she wants to medicate or leave the area (for the most part). But we also take it as a warning that we're in an inherently unsafe environment. (And 'ingestion' is possible in those situations if she touches her eyes, mouth, or nose.)

So our allergist doesn't think it "doesn't happen" or is "psychosomatic" in any way-- but he does think that it isn't truly dangerous. I'm not so sure it isn't, but we agree to disagree. My daughter is the expert. On that we [i]do[/i] agree. And I wouldn't have it any other way.

On Aug 18, 2006

Good points. . . . especially that 'ingestion' could occur through mucosal membranes, such as the nose and eyes.

As to how serious that can be, I think it's just unknown. So I tend to err on the side of caution as long as my independent 'tween allows me. I think it's possible that a contact reaction [i]could [/i]develop into anaphylaxis under certain conditions (such as an already compromised immune system). I mean, I don't think my allergist would sign his name to a statement that it was "impossible". [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img]

On Aug 18, 2006

Just wanted to apologize for my original post . . . I think I was totally wrong. I think that adults can put up with bad advice from doctors if the doctors are generally good in other respects. . . but where children are concerned you really want the doctor to support your efforts for keeping them safe.

On Aug 18, 2006

You made some good points too, LisaM. It was actually due to that Sicherer article that my allergist decided to create his own "contact challenge". He was very familiar with the study and it's limitations. (The study placed PB on the subject's back. How likely is it that your child will come into contact with peanut butter on his/her [i]back[/i]? Children come into contact with peanut resdue on [i]their fingers[/i], and then transfer it to other places on/in their bodies, as Corvallis Mom pointed out.)

On Aug 18, 2006

Quote:

Originally posted by Gail W: [b](The study placed PB on the subject's back. How likely is it that your child will come into contact with peanut butter on his/her [i]back[/i]? Children come into contact with peanut resdue on [i]their fingers[/i], and then transfer it to other places on/in their bodies, as Corvallis Mom pointed out.)[/b]

This ties in with our allergist's comments following Ian's "contact" reaction at the age of 2. Ian had played with 2 other young children who had, unbeknownst to any of the adults in attendance, eaten PB sandwiches shortly before. He developed labored breathing, and it took some detective work to figure out the cause. When I described the incident to our allergist, he said that it probably started as a contact reaction, but very well may have become an ingestion reaction because of the age of the kids and the propensity for them to put their hands in their mouths. If the allergen is transferred from the skin surface to the mucosal membranes, a contact reaction becomes an ingestion reaction. We still need to treat the reaction, regardless of how it occurred. It just helps in setting boundaries when you can figure out the events leading up to the reaction.

On Aug 18, 2006

Quote:

Originally posted by Gail W: [B]You made some good points too, LisaM.

Thanks! And Gail W. and Corvallismom, any chance of your allergists writing up a case study on what *they've* observed in their clinical practise? That would sure help a lot of people whose doctors roll their eyes at the mention of contact reactions that are more than localized and inhalation reactions.

I found it *very* interesting that the old guidelines published by Canadian allergists about dealing with allergies in the classroom mentioned the possibility of severe contact reactions as a reason for not allowing peanuts in the classroom the younger grades. Those references along with the recommendation of banning peanuts in some contexts have entirely disappeared from the new version of the guidelines . . . I think the Sicherer article is to blame.

If anyone should go to an allergist, it is my youngest sister but she won't go and I think it's mainly because she gets so upset when people don't take her allergy seriously.

There *is* this discourse out there about the allergic patient . . . the allergic patient so the story goes is either overly cautious to the point of being paranoid or is not cautious enough. (The first allergist I saw in Toronto seemed to think this. I just thought it was him until I heard it elsewhere as well. I've also seen comments like this in print.)

I think views like this are what make some visits to the allergist rather trying. . .

On Aug 19, 2006

Good question Gail.

No, the allergist didn't advise us to see a medical specialist about my son's symptoms. I think he just doesn't believe in contact reactions and he didn't want to hear anything otherwise. His advice was just let it go.

I do believe that he had contact reactions. I think he touched something with residue then rubbed his eye or mouth or something. I believe they were true reactions. But, he is always asking me to check his throat whenever we go in public where I know there could have been no exposure. I think this is a psychosomatic reaction. I think it is because he is so afraid of having another reaction. He is getting better as time goes by, but if he is still feeling like this in a month or so, I will take him to his pediatrician again and see if he needs other services.

On Aug 19, 2006

Do you have a camera that you could carry with you? It might be handy to 'document' the contact reactions with photographs. You could give the photos to your allergist and ask that s/he place them permanently in your child's medical record/chart. (Keep a set for yourself.)

A picture is worth a thousand words. The photos were also extremely helpful working with the school staff.

On Aug 19, 2006

We had a simialr experience. The first allergist we went to said he was positive that my daughter was not allergic to mac nuts. I said, well then what caused the anaphylactic reaction she had? He claimed I exaggerated the response and he could see no evidence that she was allergic to them, except a mild positive on the blood test.

I went to another allergist, who skin tested all nuts and verified that mac nuts was the only one. He thought like I did - if it wasn't mac nuts, then we should find out what did cause the reaction. He said it is totally possible to have a low test result but have an anaphylactic reaction. The other allergist disagrees - he thinks low RAST numbers mean low/no reaction.

In a nutshell (pardon the pun!) some allergists are much better than others when it comes to food allergies.

It's worth noting (I think) that the first allergits we went to specialized in environmental allergies (mold, animal dander, asthma, hiv related issues), the second one we went to specialized in food allergies.

On Aug 21, 2006

I usually do carry a camera with me to take pictures of my son and his friends or relatives. I never thought of taking a picture of a reaction. I would probably be too worried to think about taking a picture. I will not go back to that allergist again anyway. If he doesn't want to believe us, then it's his problem. I just hope he doesn't cause any harm to anyone with his lousy advice.

I know he specializes in environmental allergies. I am going to check and see if he has any expertise in food allergies and also if he is a pediatric allergist.

On Aug 22, 2006

I agree with the others... run don't walk to another allergist. My son has had 2 anaphalactic reactions to contact with residue. Once from a computer keyboard after his Daddy had played a video game the night before after eating a mini candy bar w/peanuts and the second reaction was while playing basketball with some other boys who had eaten a reeses cup. He has had several other contact reactions that were not anaphalactic, one just a month or so ago. In each of these cases he had NOT eaten anything, so it had to have been contact.

HTH, Valerie

On Aug 22, 2006

Valerie, What symptoms did your son have with his anaphylactic and nonanaphylactic contact reactions? In which cases did you give EpiPen?

I know everyone is different, but I'm just wondering how bad my son could have gotten if I didn't give the EpiPen when I did. Maybe Benadryl would have done the trick. I just didn't want to take the risk. I didn't see his initial symptoms the first time EpiPen was used as he was in school.

The reaction he had last year involved hives all over him. We gave him Benadryl and went to the ER where they gave him steroids and observed.

On Aug 22, 2006

My allergist's general recommendation is to take the epipen at the first sign of a reaction.

That isn't his recommendation for me because I have so many allergies and have frequent minor reactions . . . he advises me to take the epi whenever I have a *systemic* reaction. Hives over my entire body count (but a few hives don't). *Any* trouble breathing = an epipen moment. I personally don't take it if my mouth or throat are slightly itchy and/or I have a small hive or two. . . but if I threw up + had throat itchiness I would definitely take it.

So--regardless if one follows my allergist's general advice or his advice to people like me, hives over a large area of the body are definitely an epi moment.

Edited to add: I would take the epi if my throat and mouth were *seriously* itchy and I wasn't certain what I was reacting to.

[This message has been edited by LisaM (edited August 22, 2006).]

Related