Gabriella's Allergist Appointment

Hanging out at the mall play place after her appointment

Today was a doctor visit day. After Juliana’s appointment we headed across town to see Gabriella’s new allergist. We saw an allergist last summer shortly after we discovered Gabriella’s life threatening peanut allergy. I wasn’t impressed with that allergist and so our pediatrician recommended this one. This guy is a Board Certified pediatric allergist and asthmaologist. Ok, so "asthmaologist" isn't really a word, but he had all sorts of credentials.

I liked this guy quite a bit. We discussed not only food allergies, but environmental allergies and asthma. Gabriella’s asthma has been reasonably easy to keep in check. Mostly she gets upper respiratory infections that lag on and the wheezing accompanies those. We use the nebulizer about every other month, on average. The allergist told us that they no longer give an official asthma diagnosis before three years old. He said that for her age he wasn’t too concerned with the amount that we need to use the nebulizer, but if next winter goes about the same way then they will officially diagnose her asthma and they will possibly want to treat it a bit more aggressively.

I did ask the allergist questions about Juliana’s food reactions (via breastmilk) and he said it did sound like allergy issues. He said he would be happy to skin prick test her as well so that we have more answers. If it is food allergies, then he said I’m doing the right things. He also advised sticking with the very conservative food introduction guidelines when it is time for her to start solids. He also said that with babies they re-test at 6 month intervals because they can outgrow these things so quickly. I guess I’ll need to talk to the pediatrician again about getting a referral for Juliana. I’m not sure if I want to do it soon or wait until she is six months and possibly get a slightly more accurate picture. Juliana may just have MSPI.. Milk/Soy Protein Intolerance and that won't show up on allergy testing (and usually goes away on its own.)

Oh and the Allergist earned brownie points with me by praising my ring sling. He noted how Juliana’s leg’s were spread apart at the hips and asked me if I knew that this positioning was good for her hip development (I did know this and it is one reason why I am not a fan of the Baby Bjorn and other similar front packs) He said that she will never have hip development issues (like hip dysplasia) and noted that in places like India and certain African counties where moms carry their babies in cloth carriers they don’t see the hip development problems that we do here. Chalk one up for the cloth sling.

OK… back to allergy testing…

He did three panel skin prick tests with eight items each that included basic food and indoor environmental allergens. It was surprisingly quick and easy. He just pressed each panel to her arm and it did all eight tiny pokes at once. I think it was a bit irritating, but not truly painful.

For food allergies- He did test peanut, despite the history of anaphylaxis. I was a little surprised they would give her the exposure and questioned him a bit, but he assured us it was fine to test. This one was obviously a blaring positive. Milk was the only other positive and it was “barely” positive. This was pretty exciting to us because last year when she was SPTed for milk (and only milk) it was a huge positive. They don’t test shellfish or tree nuts before age three.

For environmental allergies- Cat was the only positive. Dog, dust, mold, cockroaches and I can’t remember what else were all negative. I thought this was pretty great news. Outdoor environmental allergies (pollen etc..) will be tested after she is three.

Because the milk was such a “barely” positive we were given instructions for a “food challenge.” She was to get 1 tsp. (watch for reaction) then increasing amounts in 30 minute intervals. We were given a sheet that told us what amounts to give at what times and had places to record any reactions. The allergist told us she had a very excellent chance of passing. We went home excited and nervous and decided to just go ahead and start the trial. I gave her the first teaspoon of milk and she said it was tasty. Less than 10 minutes later she was scraping her tongue and said that she didn’t like cow’s milk because it made her tongue feel funny. The hives and just a tiny bit of lip swelling followed that. We gave her benadryll and things cleared up. So much for that hope! We’re keeping an eye on her and we’ll call the allergist back in the morning. She'll go back in six months.