Saturday, August 2, 2008

Allergy visit

Wednesday, I took Lukas to an allergist for the first time in two years. After his allergic reaction to peanut butter (after having eaten 6 peanut M&Ms with no reaction), his pediatrician said we should see an allergist.

But by the time the allergist had finished the "new patient" info, it was too late to do the scratch test, so we came back yesterday.

Lukas first had a scratch test 8 days after Natalie's birth (when he was less than 2). That test showed positive for peanut and egg white allergies. That test was also rather traumatic: the clinician actually drew blood with each scratch (they put a drop of liquid allergen for each food on the skin and see if the skin reacts...a reaction looks like a mosquito bite next to the number they've written on the back, to keep track of which reaction goes with which food).

This time I did not warn Lukas about what a scratch test was (he doesn't remember the first one, thankfully). So when the clinician came in this time and said, "Have you told him what we're doing?" I said, "No, I haven't. Lukas, she's going to write on your back, and then she's going to put a little scratch on it. And you have to be still and don't scratch your back."

When she started, I was very prepared to have to grab Lukas to hold him down (why didn't this clinician ask me to hold him down...the last clinician did!) But what a difference a different doctor's office makes! This office doesn't draw blood when they make the's barely a scratch. They used a plastic little thing with teeth like a newborn baby brush to apply the allergen and scratch the skin. I could not believe the difference. I really wondered it the skin would show any reaction, the abrasion was so slight.

You may also remember that Lukas' blood test after his 4-year check up showed no egg and no peanut allergy...that's why we started the oral challenges with peanuts.

But this scratch test showed allergy to peanuts and walnuts. All other tree nuts are ok (though we will avoid tree nuts because there could be peanut and/or walnut cross contamination), and eggs are still ok. But the surprise for me was Lukas' severe allergies to environmental things: mites and grass and weeds. The first allergist did not test for those, but this one did, because Tom is allergic to mites and dust.

We've never noticed Lukas having an allergic reaction to mites or grass or weeds, but his back sure bubbled up with reaction to those allergens. I guess a four-year old can't explain the discomfort of those kinds of allergens (stuffy nose, scratchy eyes, etc.) Lukas has said he doesn't have those symptoms...hmmm.

The doctor recommended giving him Zyrtec at night for a month to see if there is any change...change from what to what? Maybe it will help with behavior? But I thought Lukas' behavior was just typical four-year old behavior that we are working with him to learn to control. He also said Lukas would be a good candidate for allergy shots, but when he's older...they won't do that (shots once a week for a year or two) on a four-year old.

So that's the latest news on the allergy front.


Heather said...

I can't believe the first time he had a scratch test they drew blood! It's not supposed to be so traumatic to have a scratch test done ... geesh!

I'm glad you had a better experience. I had to do allergy shots. I'm glad they won't do them on a 4-year-old --- he can't tell you if he has an allergic reaction to the shot!

Treating the environmental allergens might help his behavior if you think they're related. But in all honesty it's the rare person whose scratch test doesn't reveal an allergy to some environmental things like dust and weeds. That's probably why you've not noticed, in my very humble opinion.

I'm rambling .... :)

Cindy said...

Thanks! Tom's sister mentioned she also shows high reaction to environmental allergens on the test, but rare reactions in the day-to-day test of life.

Now that I've seen another "kind" of scratch test, I am also astonished!