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Mother and Son “Bonding” at the Allergist

Tristan and I went to see a new allergist together. We both needed some testing done and I figured it would be easier for him to see me go through the tests first and realize it was no big deal. He thankfully didn’t remember the last time he went, two years ago, when they did a skin test, followed by a blood draw – ouch.  This time the doctor was nice, but a little condescending, and more than once mentioned that I should relax and have a glass of wine. Huh? Did I seem that frazzled and distressed for this stranger to suggest during our first meeting that I needed to unwind? And I thought I was all organized and put together – after all, I had a full page (front and back) divided by sections on eczema, allergies and asthma, for Tristan’s past treatments and reactions. I let the doctor’s comments about my stress levels slide and tried to discuss my list with him. Like the dermatologist we met with months ago at the children’s hospital, he agreed that Tristan’s eczema wasn’t from food allergies. I read him the full list of food items that make him flair-up. He said it was strange and he couldn’t explain it. Interesting, isn’t he an allergist? And he still agreed he should be tested for food allergies, probably since I mentioned he reacts by getting really itchy and sometimes breaks out in hives from certain foods.

According to the Food Allergy & Anaphylaxis Network:

“Food allergy occurs when the immune system mistakenly attacks a food protein. Ingestion of the offending food may trigger the sudden release of chemicals, including histamine, resulting in symptoms of an allergic reaction. The symptoms may be mild (rashes, hives, itching, swelling, etc.) or severe (trouble breathing, wheezing, loss of consciousness, etc.)….. Parents should become familiar with the early signs of allergic disease such as eczema, hives, repeated diarrhea and/or vomiting in reaction to formulas, wheezing, and talk to a doctor about those symptoms.”

Based on FAAN’s statement, it seems Tristan may have “early signs of allergic disease” in the form of eczema to some allergens (gluten), but more of a true allergy to other things (hazelnuts, walnuts, soy, casein) when he breaks out in hives or gets intensely itchy. Thankfully, he’s never been anaphylactic. We had already determined a lot of his triggers, but we wanted to confirm them with the allergy tests.

Not much has improved over the years, allergy testing still hurts.

The doctor was taking notes as I was recapping Tristan’s history. He then had us wait for the nurse to start the testing. I went first, as planned, and it was not pain-free. So, I did my best not to flinch as the nurse pricked the skin on my lower arm 12 times. I asked her why they didn’t use the device that pricks multiple locations at once and introduces the allergens at the same time. She claims it wasn’t as accurate, but I do recall it hurting quite a bit less.  I could deal, but could Tristan? He did pretty well for the first few pricks, but cried for the rest and quickly recovered when it was done. I was worried he’d get too itchy from a reaction, but he only reacted to one allergen in the test, hazelnuts, and it didn’t seem to bother him. It was a good thing because I had left our ScratchMeNot mittens at home.

Based on my first skin test reactions they conducted a more detailed test on my upper arm. This time they injected the allergen under my skin with a needle seven different times. This definitely hurt. Tristan could see it in my face. I turned to the nurse and told her I couldn’t put him through this next phase of testing. She actually told me to lie and tell him it didn’t hurt. Just a little white lie as she put it. Nope, sorry, won’t do it. So, Tristan’s skin testing ended after the first round.

From skin and blood testing results two years ago, he reacted to walnuts only, but this time walnuts appeared to be fine. It really boggles my mind that he can react within seconds of eating a food with a red rash on his face and/or incredible itchiness immediately after eating certain foods, but that the same food does not appear as an allergy in testing. I just don’t get it. FAAN claims that this kind of reaction is an allergic reaction, so why doesn’t it display as a positive reaction in a skin prick test? It seems food elimination diets are the only true way to determine all allergies and eczema or asthma triggers, if they are food related. I’m a huge fan of elimination diets, having gone through it with Tristan. It’s difficult, but the results, if done right, are usually quite clear. I’ll definitely go into this more in a future posting.

So, the results from the skin test are:

Jennifer – highly allergic to grasses, trees (mostly birch), rag and other weeds

Tristan – allergic to hazelnuts

Next step is to test Tristan’s blood for IgE antibodies for walnuts, almonds (since he has reacted to those in the past) and hazelnuts.

10 Comments Post a comment
  1. I’m glad you did not let them do the second test on Tristan! This is from Dr. Wood’s book “Food Allergies for Dummies” under “Poking around with skin tests”…
    “Your allergist may use any of the following three methods:
    […]
    “The allergist inserts a small amount of the food extract into the skin using a small needle. This method, called intradermal skin test, is rarely, if ever, indicated for food allergy diagnosis.”

    From what I have read, this is because of the increased risk of a more severe reaction. I read a case study about systemic reactions to skin testing, in general, and though they are not common, they were much higher for intradermal vs. skin prick.

    I do agree with you, though, that when you are not dealing with anaphylactic allergies, it seems like elimination diets are the way to go, because testing might provide leads, but it will not always be conclusive.

    Like

    September 6, 2012
    • Yes, agree on the skin prick tests. Why do you think Tristan’s allergies aren’t showing up in the blood tests though?

      Like

      September 7, 2012
      • I wish I knew…it’s a real mystery to me, why some show up and some don’t. I think I have talked to/heard about someone in every different category…Someone whose child’s IgE was high, yet did not react…whose IgE was low, yet did react…who shows ZERO IgE, yet reacted…whose blood test was positive, yet skin test was negative…whose blood test was negative, yet skin test was positive…I really don’t know why this happens. I think some of it has to do with how each test was done…(Did they use fresh extracts for the skin test? What kind of lab method did they use for the blood test? Did they do a component test, or a whole antigen test?) There are so many variables, I think it can be hard to compare, sometimes. Sorry, I know I’m rambling a bit, but it is such a mystery, as I said…I wish it was easier to pinpoint the causes of eczema, that is for sure…

        Like

        September 7, 2012
  2. Lynn #

    Oops, that’s crazyallergymama.blogspot.com. I haven’t looked at it in so long I forgot the address. 🙂

    Like

    October 26, 2011
  3. Lynn #

    I came across your blog through the UFAN list and am looking forward to following your blog. My almost 4 yo has eczema, allergies, and asthma too. (I wonder if we live closeby!). I started an allergy blog to document his story too, but I got lazy about keeping up with it (I have a homeschooling blog that was taking up way too much time). But, you can read my son’s story at crazyallergymama.blogger.com.

    Like

    October 26, 2011
    • Hi Lynn, I just checked out your blog – great stuff. I wish you’d continue writing, but I know how time consuming it can be, especially since you have another blog to manage as well. Let me know if start up again and I’ll add your link to my blogroll.

      Yes, dealing with allergies stink and it looks like we have a few in common – dairy, gluten and some nuts. But, it’s great to hear stories and to know we’re not all alone in this battle! Thanks for following my blog.

      Jennifer

      Like

      October 27, 2011
  4. Kim Molee #

    Hey Jennifer, so sorry to hear about this! Sounds stressful for sure. I grew up with Eczema and still have it as an adult, so I can relate. Hang in there. 🙂

    Like

    October 24, 2011
    • Thanks Kim! I didn’t realize you have eczema. No, it’s not fun at all. Eric and I get it a little too, but no where near the severity of Tristan’s. I hope Cameron stays clear of it!!

      Like

      October 24, 2011
      • Kim Molee #

        So far he’s okay with his skin, but mine started around age 9. Mine is triggered by stress and weather changes. I’m glad you’ve found solutions for Tristan. He’s a beautiful little boy and Chloe is adorable!!! 🙂

        Like

        October 25, 2011
      • I’m sure Cameron will be just fine. It’s good to hear from you!

        Like

        October 25, 2011

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