Anyone know - at what point do they do Rast v.s. skin for PA?

Posted on: Mon, 02/28/2000 - 5:41am
ColleenW's picture
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Joined: 02/28/2000 - 09:00

I have called a few allergist to find out about the testing they do and they all say they do the skin prick testing for food allergies. They don't even mention the rast test. When I bring it up they say that they don't do it very often because it's soooooo expensive. What's the story. All you guys seem to be getting the rast test. Is there some criteria one must meet - age, reaction etc before they want to do it? It seems to me like a blood test would be much better than chancing a reaction. Is the rast test always reliable or does it give false positives or negatives sometimes? What's the story? Anyone know? COnfused

Posted on: Mon, 02/28/2000 - 11:05am
DMB's picture
DMB
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Joined: 02/22/2001 - 09:00

pWere you just asking about allergy testing in general or did you specify peanut allergy testing? My son has been pa since he was 12 mos and had his first anaphylactic reaction at 18 mos which at that time we made our first visit to the allergist. He didn't want to do any allergy testing at that visit because of my son's age and because it was obvious that he was reacting to peanuts. He's now almost 3 and he just had his first allergy testing done. The allergist didn't even consider doing the skin prick test due to the severity of his past reactions to peanuts. His first and only suggestion was to have the cap/rast blood test./p

Posted on: Mon, 02/28/2000 - 2:27pm
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pMy youngest daughter has had eczema since birth. When her Allergist gave her skin scratch tests at age two almost everything came back positive. Later I read in FAN that children with eczema often have false positive results on skin scratch tests. I had to have a RAST done (which can give false negative results). I am still awaiting results, however I had to incure the cost of both types of testing./p
pMy older PA positive daughter has never had a skin scratch test for peanuts, we know she is allergic and will not take the chance of a reaction. The doctor tryed to talk me into one but I insisted on a RAST. When she scored a 6 on the test (the highest the scale goes) I think were both glade we went with the blood test./p

Posted on: Tue, 02/29/2000 - 1:04am
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Joined: 02/17/1999 - 09:00

pHi, I am in Canada where it is highly unusual for RAST testing to be done. Skin testing is thought be be more accurate according to the allergists and doctors' associations that I contacted after reading on these boards about RAST testing. I am not an expert on that. My allergist has said that she will do RAST testing if we want it but it will not add anything to what we already know. My son is severely peanut allergic and all skin testing is done in the hospital. He has been tested twice at age 2 and 4 and will not be tested again until perhaps he is a teenager. We decided that whether or not it is more or less accurate, it gave us the information we needed so we left it at that./p

Posted on: Tue, 02/29/2000 - 5:07am
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Joined: 08/04/1999 - 09:00

pI'm not sure what the rast blood test is. We went into Mt. Sinai to see Dr. Sampson, and he did some blood work, but he called it an anti IGE blood test. Are they the same? My daughter also had the skin testing done (first), but some of the positives on the skin tests came back negative in the blood work. What's the difference between RAST and anti-IGE? Michele/p

Posted on: Tue, 02/29/2000 - 11:05am
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pMichele-br /
"I have no clue what the difference is. I know I'm getting frustruated right now with all the red tape I'm going through trying to get my PCP to give me a referral to an allergist. You see they want to keep the business in house and they have an internal med guy who specializes in pulmonary stuff but happens to do allergy testing on the side. He did my origional testing which was a skin prick test but only for outdoor stuff, like grass, pollins, dogs, cats etc. When I inquired at the time re- food testing he said they didn't do it. (Meaning at the clinic HE worked at.) So after this reaction Saturday- I tell my PCP who referred me to this IN House guy that he said they don't do food testing in house and he says he needs to speak to the guy- as if to say- Well I need to verify that. I think the clinic has some kind of protocol thing where the doctors aren't allowed to refer out to other specialists unless they make sure they can't do whatever it may be "In House" Sure don't want the money going elsewhere [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img] It's so frustruating. My insurance requires a referral from my PCP and won't let me self refer unless it's an OBGYN or Eye doctor. Sorry- I started venting and never answered your question. I know when I get a REAL allergist I'll ask that question. I'm allowed to switch PCP's up to 3 times a year and I've never switched but if this keeps up I'll find one who'll refer me and jump ship. It's too bad because I've been with this clinic all my life and really like the doctors but this is for the birds./p

Posted on: Wed, 03/01/2000 - 7:42am
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Joined: 02/23/2000 - 09:00

pWe have finally visited an allergist in reference to our son's peanut allergy and other yet undetermined allergies. The dr. was prepared to do the skin test, but then she noticed how sensitive his skin is to touch and pressure. At that point, she wrote up an order for a RAST since she didn't want to misread the skin test. However, she wants us to wait a few weeks before we have the RAST since he recently had a reaction to peaunt. I'm not sure which one is more accurate -- it seems like everything I read gives opposing views. I find it to be quite frustrating.../p

Posted on: Fri, 03/03/2000 - 12:59pm
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Joined: 03/01/2000 - 09:00

pAt 18 months of age, my p.a. child had eczema so bad she did not have a clear spot on her body so the allergy doctor did a RAST blood test. Yes, it was expensive. He tested for items in the high sensitivity group (milk, eggs, peanuts, strawberries, etc.) It was around $350. She was in the moderate range then. At age five he did the skin prick test and RAST, she was off the chart on both. So allergic we were told that she would die in minutes if she swallowed a whole peanut. He told us the skin test is more reliable but the RAST does give you a number to work with. That was two years ago. Recently I recommended this doctor to a parent at church with a 4 year old who turned out to also be life-threatening p.a. He would only do the skin test, not RAST. I don't know why he handled this differently. I can only speculate (maybe did not want to traumatize the child with a blood test. I will always remember how she screamed both times, maybe her insurance was different, maybe he felt it wasn't necessary). Only he knows. She didn't know to ask about it./p

Posted on: Sat, 03/11/2000 - 1:58am
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Joined: 02/19/2000 - 09:00

pMichele: the anti Ige is the result of the RAST test. How licky you got to see Samson, he's part of the solution guys. With luck they'll find the answers.br /
FYI IMMUNOGLOBULIN E (IgE)br /
A class of antibody normally found in very low levels in humans, but found in larger qty in people with allergies and certain infections. Its protective role is unknown, but evidence suggests it is the defense against parasites.br /
It is considered the only anti body responsible for classic allergy symptoms.br /
Hope that helps you understand better./p
pAfter reading your HMO insurance stuff boy am I glad I live in Canada. We don't have these problems where I live.I ask for the referrals and I get them, end of story. Anyway, aren't you paying them? Shouldn't they do what you ask, cause your paying. I swear, i'd be finding a new doctor and fast./p

Posted on: Sat, 03/11/2000 - 2:51am
ColleenW's picture
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Joined: 02/28/2000 - 09:00

pCanada:br /
I did find a new doctor. I fired my old one.br /
As far as the ins. is concerned- I have had good luck with my insurance co. up until this point. I've had all three pregnancys and prenatal care covered 100 percent. Didn't even have to pay a copay. I have had all my allergy test's and shots covered 100 percent. It's the doctor's office that's being a pain. No matter which ins. co I have- they don't want me to see a doctor other than one in their own clinic so that they can keep the money in house. If I had a different ins. co and saw the allergist on the side it might pay-- but only 80 percent- I'd have to pay the extra 20 percent. That's shots/tests/ pregnancies etc. And then I'd still have to deal with less than adequate care from the lousy clinic for the rest of the stuff. They kept telling me stuff that didn't jive with the allergy clinic- things that led me to believe that I didn't need to see an allergist. The only reason I questioned it was because of the cocky and lax way the Dr. treated me after my reaction. It led me to start digging and when I did I found out that stuff they've been saying/doing all along is not in line with the way allergist/immunologist think. For instance they had me getting cortisone shots yearly for relief from seasonal allergies (A BIG NO NO- according to immunologists!) The stuff recks your immune system and should be used rarely with caution. My NEW doctor just drew blood to see what kind of damage that might have done to my system. If you get too much of the stuff- your body adrenal gland doesn't work right anymore. So I am actually thankful that I had an insurance company which paid me to switch to a better doctor because if I hadn't I wouldn't have been asking for a referral which is what brought on the Dr's refusal for the referral which in turn caused me to start questioning the doctor's motives in the first place.br /
Anyways - Wish me luck- Friday the 17th is the big day- I get tested for ALL all over again plus the food allergies. My daughter too. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] Colleen/p

Posted on: Sat, 03/11/2000 - 8:15am
canada's picture
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Joined: 02/19/2000 - 09:00

pColleenW: this should serve as a lesson to anyone about doctors. They are not god, and any doctor who doesn't want a second opinion on his/her diagnoses is seriously wrong to think that they are doing the patient a favor. As patients you have a right to seek a 2nd or 3rd opinion. Good luck on the testing./p

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