Blood Test

We went in for the blood test yesterday. I had to try a new lab because our insurance no longer covered the one we had been using. No big loss, they weren't that great.

Things went well. Max started crying when I told him where we were going so I did what any good Mom would do. I bribed him. I told him if he was brave we could go to Target afterwards and buy him something new. And we went over ways to be brave and stay calm. Be still, take big deep breaths. The front desk people at the lab were actually friendly and had a sense of humor! And the lab tech, though initially had a hard time finding a vein, distracted Max enough while it was going on that he stopped crying and talked to her. All and all easy in easy out. Even Owen sat patiently with his back against the wall quietly watching as he always does.

We then went to Target. As we were walking up to the store Max realized he was still holding his Clifford (you know, the big red dog) and asked that I take it back to the car. I got them on the sidewalk and told Max to hold onto Owen while I ran back to the car (it wasn't far away). As I turned back to look at them. I saw Max had pulled Owen way over to one side away from the street and protectively had his arms wrapped around him. Owen in turn had his arms wrapped around Max's waist. Sometimes the amount of love they have for each other brings me to tears.

Down We Go

We finally made it to the allergist today to make up the appointment that was cancelled in January. No matter how I go into testing I always come out feeling down. I think on some level I always go in hoping for a miracle. Hoping that he will test negative and we will leave the office skipping with joy.

We scratch tested milk, egg, and, for some reason, strawberry. Max is never well behaved at the allergists. I can understand this. He is anxious and he hates the scratch test almost more than the blood test. It is itchy and uncomfortable and Max has a very low tolerance for pain. There was lots of drama as he lie there writhing around, yelling that his back itched. He asked me to take a picture of his back.

In this first one the protein extracts are still on his back and I think make it look worst than it is. For those of you who haven't been through this procedure, the allergist puts a drop of the suspect protein on the patients back then "scratches" it. In our allergist case, she uses these little bristles and presses firmly into the skin. Then we wait for 15 minutes for the hives or wheals to rise. The nurse then comes in and uses a clear ruler to measure the size in millimeters.

The second picture is after the nurse has wiped away the extracts and rubbed a little hydrocortezone on to quell the itching. I think Max's skin was extra sensitive today. It was really dry with some patches of eczema. If he would let me put lotion on him it might not be so bad but he runs away screaming if I even suggest it.

When she started measuring the first one I asked if it was the control (one of the pricks if always histamine to assure that the skin is indeed reacting). She said no it was the milk and then showed me where the control was. The reason I think Max's skin was extra sensitive today was because the control was almost as large as the milk. Egg was larger and peanut, unfortunatley, the largest. I think I was disappointed with the peanut size because it was so small last year.

In any case, three positives. The allergist said it was good news because the milk scratch was smaller than last year so if his blood work comes back negative than we can oral challenge milk again. She even said we could try it at HOME but would need to stop at the first sign of anything happening.

So I need to get on the horn and schedule a blood test somewhere. I'll let you know the results.

Food Allergies in the News

Yesterday the Today Show featured a segment on food allergies and the New York Times ran a story on the same topic. In a nut shell (ha ha), the story focuses on false positives that come from the skin and blood testing done to diagnose food allergies. I have mixed feelings about this story. Yes, false positives are possible. In the years that we have been going in for testing we have had false positives for rice, soy and strawberries BUT the allergist (and we have seen several) always goes back to the history, "Has your child reacted to this food in the past?" I have even had an allergist say "Reaction trumps testing."

I realize there may be bad allergists out there and for those out there seeing their pediatrician to diagnose their child's allergies I say go see an allergist, preferably one who has experience and knowledge diagnosing food allergies. BUT for the most part, the parents and children I know get diagnosed as the result of a previous reaction, generally a scary one.

A few months ago Max's school sponsored a presentation by FAAN regarding food allergies. Toward the end of the discussion period one parent spoke up about how her child had been misdiagnosed as having multiple food allergies and they had to avoid all these different foods. She was angry and very verbal about her situation. If I was her I would have been angry too. She obviously got a doctor who didn't know what they were doing if they did not take her child's history into account. I spoke up and talked about Owen's diagnoses and how though he had a low positive on testing, an oral challenge resulted in him receiving epinephrine. I could have also talked about Max and his peanut challenge last summer. I spoke up at that time because I didn't want people walking out of that presentation thinking that testing results in a lot of misdiagnoses.

The Today Show did emphasize that people do have food allergies. They are real. And if a food allergy is suspected food challenges should only be done with the supervision of a doctor. But I can't help feeling that a back lash has begun. At the end Matt Lauer said this information could be very freeing for some families. What he didn't say is that when it comes to dealing with family and friends this story could make things more difficult. Can't you just see Auntie Betsy saying "Oh, let's just give him a little bit of peanut butter (cheese, bread, pecan, insert your allergen here) and see what happens."?