Saturday, January 10, 2009

The Inconsiderate Allergist

I carried my one year old baby into a small, bright waiting room. A smiling young receptionist greeted me. I began retelling why I was bringing my baby in to see the allergist, but she interrupted me when she remembered our phone conversation of a few days before. She gave me the usual types of forms to fill out and we waited in the waiting room that was otherwise empty at the time.


Soon we were ushered into an exam room where I sat in a straight back chair and held baby Dal on my lap. There was high exam table with its white paper cover, a rolling stool, and a small metal cart. The doctor came in and introduced himself. After some health history questions and my short recitation of baby Dal's reactions to foods, Dr. Lee confidently suggested that we test for egg white, egg yolk, dairy, peanuts (legumes), tree nuts, tomato, and citrus. Dal would get seven small scratches on his back, a different extract would be placed on each scratch, his skin reaction would be watched and timed for 15 minutes, and then a neutralizer would be applied and the extracts would be washed off. Any food substance he was allergic to were expected to cause a hive on the spot where the extract was applied. The strength of the reaction would be judged by the size of the wheal or hive. This is how I understood it.

I held my baby on my lap in his little diaper as the scratches were made and the extracts applied. I wanted to hold him close or wrap him up because I was concerned that he would be cold and uncomfortable in a cool exam room in only his diaper. But Dal sat still and quiet, looking around the room, and endured the scratching and dabbing on his back without complaint.

Then the nurse set a timer and told me not to touch his back during the testing. She warned that he might become a little uncomfortable if we got a reaction. She left the room and within seconds Dal started to squirm. Red splotches were already starting to appear and grow on his tender back. He began to writhe and whine as the red splotches started to swell. Three had appeared almost instantly, then a fourth, then two more splotches. Within a couple of minutes, the splotches had become large wheals - raised, angry red, hives. Dal began to cry.

The nurse popped in and asked, "Everything OK?"

I said, "No. He already has large hives and he is getting very uncomfortable."

The nurse stepped in and looked at Dal's back. She made an inaudible comment and said,
"Okay, just hold onto him, I'll be right back."

Dr. Lee shortly appeared and had a look. He made a vague sound of surprise and checked the time. He told the nurse to go ahead and stop the test at 10 minutes. A moment later he said, "Go ahead and get that stuff off of him."

As the nurse neutralized the extracts and cleaned them off, Dr. Lee left and then came right back with two other of his office staff. He wanted them to see the size of the wheals that had appeared on this baby after only about 5 minutes. They made their sounds of exclamation. Then the receptionist poked her head in the room. Dr. Lee was quietly, but excitedly telling her what was happening with "this baby".

At this point, I'm looking at my whimpering baby with huge, angry hives spreading over most of his back and thinking, "If that doctor brings ONE MORE person in here for show-and-tell, I'm going to kick him in the shins!"

The diagnosis was that Dal was severely allergic to egg yolks and whites, peanuts, and dairy. He was also mildly allergic to citrus and tomato. He did not appear to be allergic to tree nuts.
On a scale of 1 to 4, with 4 indicating a severe reaction, or large hive, Dal was given 4++ for egg, dairy and peanut, and 4 for citrus and tomato. I left with strict instructions about avoiding these substances entirely. Even skin contact with these foods was not recommended. He gave me a written report on the diagnosis and told me he would mail a letter to Dal's regular pediatrician. Dr. Lee said that most likely I would not need to come back for at least a year or two. Dal would probably not outgrow his dairy or egg allergy for at least that long. In a couple of years, he could be retested to see if he was outgrowing any allergy. He would not outgrow the peanut allergy.

2 comments:

  1. oh how difficult. You can't have a dairy free household can you? What about preschool. Geez that's tough.

    btw, we'll have to swap recipes one of these days.

    ps one of my bloggy friends, Rhema's Hope, is like us - one typical with allergies, and one atypical without allergies
    see link: http://rhemashope.wordpress.com/2008/09/18/hope-allergies-and-autism/

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  2. cutest baby ever on the picture and how awful they made him go through that. i hate it when doctors "call in" others to have a look. I once had that at the ginaecologist in switzerland....enough said.....

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