Wednesday, July 10, 2013

Cutie's Trip to the Allergy Doctor

About 2 weeks ago Cutie woke up with a rash and hives on random parts of her body.  My mind immediately tried to search for what may have caused this.  I checked her face and mouth to look for signs of swelling.  We were all clear there.  I gave her a Benadryl and sent her to daycare.  I spoke with her teacher to explain what we were seeing and what out plan of action was. 


Since our two older children have food allergies, of course my first thought was that a food had caused this.  We had Almond Crusted Chicken the night before, but Cutie has had almonds and almond butter before without a problem.  Additionally, she has been tested (when she was 1 1/2) for the top food allergens and was cleared of having a food allergy.  Plus, the fact that the rash/hives didn't arise until the next morning, and that it lasted for 2 days, lead me to think it wasn't food related.

But what was the cause?  My next thought was that it was something in the environment.  GirlyGirl has a variety of environmental allergies for which she takes a daily Zyrtec.  I had given Cutie Benadryl 3 times in this 2 day period, but it didn't seem to help.  Her rash/hives were migrating to various parts of her body, but they didn't go away completely.  Hydrocortisone helped reduce the rash, but, again, it didn't eliminate it completely. 

I thought this was worth a trip to the doctor.  Of course, we are ultra-sensitive to any kind of skin reaction due to our family history.  I'm pretty sure that I know more about allergies than our pediatrician (no offensive to him, it's just not his specialty), so I decided to go to a specialist. 

For Bubs' allergies we went to a nearby children's hospital for two reasons.  First, our local allergy clinic does not have the best reputation.  Second, I wanted to go to a place that specialized in kids.  We have had a great experience there the several times we have visited. 

For GirlyGirl's reaction, I wanted to take her to the children's hospital as well.  But it was a four month wait to get in, and I wanted answers quicker than that.  I figured that since I was already well versed in food allergies and all I needed was a test, I would suck it up and go to the local allergy clinic.  Unfortunately, they lived up to their reputation.  I had to push for a blood test, and their bedside manner left much to be desired.  But we got the blood test for peanuts along with an environmental panel that exposed a whole slew of additional allergens, including dog (we have an indoor yellow lab).  So at least we got some results to work with. 

So when this came up with Cutie, I didn't want to wait four months.  With pictures in hand, we paid a visit to our local allergy clinic today.  I explained our family history and current situation.  Again, I was unimpressed and left feeling very frustrated!

I explained that we have had her tested for food allergies.  He thought that was completely unnecessary since she hadn't had any kind of reaction to any foods.  I told him that I thought it was warranted for my peace of mind and her safety due to the fact that my two older children have severe food allergies!  He continued to disagree.        

He ran through a whole list of questions with me regarding possible allergens she could have been exposed to, including food, insect sting, latex, meds, as well as things like heat, pressure, sun, etc.  He told me that since there was no known exposure and that sometimes people get unexplained rashes, that no test was needed.  I told him that I already knew that the rash was not caused by any kind of known exposure, and that I also already knew how to treat it.  The reason for my visit was to find the cause.  He explained that he didn't think it was anything in the environment because those types of allergies also involve respiratory symptoms and/or runny/itchy eyes.  But the rash had to come from something!

The allergist did not want to run tests at this time because there was no known exposure to an allergen and because people often have idiopathic rashes that come and go.  He thought we would get some false positives that would confuse things even more.  But rashes/hives are not normal.  There is a reason why our bodies would act like this.

I didn't push the issue too much.  I did explain that I am well educated about allergies, and that I pretty much already knew everything he was telling me.  Again, the reason for my visit was to find the cause  of the rash.  As he droned on, I began to wonder if actually knowing the cause would change anything for me.  We know how to handle it and what to look for.  We already have all the meds on hand.  So I decided that for this single incident, I wasn't going to push it too much more.  I spoke my piece, and he still recommended against testing. 

I debated whether it was worth paying a visit to my pediatrician since I know he will order testing if I ask for it.  But I think for now we will wait.  If it happens again, I will ask for testing so we will know exactly what to avoid.  And since I'm 99.9% sure it isn't food related, and since it's not life-threatening, I think it is safe to wait.

So while I left his office today feeling very frustrated, I have calmed myself down a bit this evening.  Most of my frustration stemmed from the way the doc talked to me, like I was an idiot, even after I told him how familiar I am with allergies.  He was also very condescending about testing her at this time.  If you are an allergist, please be aware of your audience and be kind to your patients' concerns.

For now, we don't know any more today than we did two weeks ago.  I guess we'll just take it one day at a time.
 

2 comments:

  1. I agree that the most frustrating part is a condescending attitude from a physician!

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  2. I'm curious to know if this incident repeated and/or if you figured out what was causing it. My LO had rashes similar to this sometime back, and recently had another attack of the rashes along with puffiness of the face, hands and feet. I'm not sure what it is yet. As with you, our doc didn't think it was anything the first time around and did nothing. This time he referred us to the allergy clinic, but we haven't been there yet. Just like you, i'm not able to figure out any specific food that might have caused this and am a bit worried in general till we figure this out.

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