Tuesday, November 20, 2012

Most dreaded doctor's appointment of the year

Sorry for the few posts this month - I'm afraid it will be sparse until after the holidays since things are already turning to pure chaos in our house.

I'm sure you think this post is going to be about Cate but its not, its about Lucy.  Since Cate was born I have been to more specialist doctor appointments then I knew existed.  The cardiologist, pulmonologist, geneticist, dermatologist, and the ENT all require appointments at least annually for her.  Sometimes it can be inconvenient to take her out of school but I never dread the appointments.  That is not the case with Lucy's annual appointment with the allergist.  We found out about Lucy's allergy to dairy and eggs on her first Thanksgiving day - so she was about 8.5 months old.  She had been exclusively breast milk and finger foods up to that point.  On that day I decided to feed her some of the pumpkin pie that I had made myself - she tried a couple little bites but did not like it, thank goodness.  Within a few minutes I could see her face was getting pink, within 15 minutes her lips were puffy but she never had breathing issues.  I called the doctor's help line and was sent for benedryl.  We gave her that and within the hour she was looking much better.  I thought it was the spices or pumpkin and the next day gave her a yogurt puff with the same results.  I was pretty sure by then she was allergic to milk and a blood test the pediatrician did confirmed that plus added egg to the allergy.  We were sent to an allergist for a more comprehensive skin test (skin tests are believed to be more accurate) since they didn't have enough blood to test for every many things.  The first allergist appointment wasn't too bad.  They did four panels I think - each one testing for ten items and we got big hits on egg and dairy with nothing else of concern.  She recovered fast and although the appointment took a long time she was really good and it went smoothly.  The worst part of that first appointment was the laundry list of things she couldn't eat and the fact they could not give me any indication if this was a lifelong condition or she would grow out of it.  So they sent us home with lots of info and prescription med for moderate reactions and an epipen in case of serious reactions involving breathing difficulty.  I was so nervous I wouldn't be able to feed the poor child!  But in the years since I've figured out lots of things she can eat with no problem and either special recipes or acceptable substitutes for the foods she can't eat.  I do have to take a cupcake to birthday parties and make her special dishes during family dinners but its all doable with a little time and preparation.  The other thing they sent us home with was a reminder card to come back in a year.  That is the worst part!!  Every year the appointment has gotten hard to deal with as she becomes more aware and anticipates what is going to happen.  This year was horrible.  She didn't even want to let them take her blood pressure.  We got through the prelims and I told them that I felt we were missing something, that she was often puffy and had itchy eyes even when we know she hasn't had any exposure to milk or eggs.  So the doctor added two panels with the most common environmental allergy triggers - a couple types of trees, a couple types of grasses, cats, dogs, mold, 2 types of dust mites, and roaches (ewwww!) - in addition to the dairy and egg tests.  So what a panel entails is a 8 or 10 pronged grid about the size of a credit card with tips that are like a sharp pencil.  Each one has been dipped in a liquid version of the allergen.  They write with a marker on Lucy's back for identification then make her lay down on her tummy.  She was totally non-compliant but eventually I convinced (read bribed) her to do it.  They then press the panel onto her back with enough force to make a dent but not to really pierce the skin - so uncomfortable but not really painful.  Lucy came off the table crying like we'd cut her.  But of course we weren't done - the milk and egg had to be done separately so I had to hold her down while the nurse put drops on her back then pressed another tool into them.  Now Lucy is crying so hard she is hiccuping - still not done.  Now I have to make her lie relatively still without touching her back which is getting itchier by the minutes for 15 minutes.  She cried some, was almost distracted by a show on the ipad and was very unhappy - she kept saying "wipe it off, wipe it off".  But we finally made it and the nurse came back in to evaluate.  Each allergen that caused a reaction had a mosquito bite like bump - the worse the reaction the bigger the bump.  The only environmental allergens that Lucy reacted seriously to were both dust mites and those spots were at least as big as a nickel each.  She had moderate reactions to dogs and roaches but nothing on the most common grasses and trees.  Her milk and eggs were still serious but to me they looked a little smaller than last year - last year they were almost quarter size if I'm remembering correctly, this year more like dime size.  So we have to encase Lucy's mattress and pillow in a dust mite barrier, get rid of the carpet in the playroom, and vacuum her room more often.  Those little things should temper this allergy quite a bit.  The milk and eggs remains the same - don't eat them!  Actually he said we can continue to experiment with its that have a small amount dairy or eggs in a cooked form - so muffins or cupcakes maybe.  We already know she does well with fried things like chicken nuggets plus most bread (unless it has an egg wash) and munchkin donuts which have some milk/egg in them.
I'm off the hook until next year which will probably be even worse yet because she will actually remember the process not just be wary of the office.
She looked cute though -

1 comment:

  1. I found your blog via another blog. My middle son goes every year as well to his allergist. He has a lot of food allergies but thankfully through the years (he is now 7) he is beginning to grow out of a few and we are marking them off of his list. Some will always remain but as he is getting older he is able to help me out and make sure he doesn't eat something he isn't supposed to. Good luck!