Doctors are not infallible, and it's important that we know it even if they don't. The intuition of a father or mother is often worth as much as the education and experience a doctor has, and we should not be afraid to assert ourselves on behalf of our children.
About a year ago my oldest (previously non-allergic) daughter was on Augmentin for pneumonia and developed hives. The doctor at the emergency room told me to give her Benadryl and finish off the last 4 days of the prescription. I was a little shocked at this advice, but I thought for a moment and then said, "I guess as long as I have her sister's Epipen right next to me, I could give her another dose of this." The doctor left the room for a moment to consult with another pediatrician, and returned with a prescription for a different antibiotic.
This doctor's clinical knowledge initially interfered with her ability to make a reasonable decision in this situation. She had learned in medical school and in practice that children sometimes develop hives when they have a virus, influenza, or other types of illnesses. Most likely, my daughter's hives were caused by influenza, which is also what made her susceptible to bacterial pneumonia and led to her treatment with antibiotics in the first place. However, on the outside chance that the hives were from the Augmentin, any doctor worth his salt would change the prescription. Her attitude reminded me of the saying, "Shoot first, ask questions later." My preference, which was honored, is to avoid anything that might be causing the hives and later have an oral challenge.
Since we haven't done the challenge yet, I don't know if my daughter is really allergic to amoxicillan or not. But I am grateful that when I persisted, the doctor listened to my concern and gave my daughter a new prescription. Changing antibiotics certainly didn't hurt her, and continuing Augmentin could have been disastrous. When dealing with doctors, remember that they are people and they make mistakes too--if you feel uncomfortable, push until you get the answers you need. No one is completely infallible!
Thursday, May 27, 2010
Saturday, May 22, 2010
Peanuts first...eggs next...then what?
Reading another allergy mom's post about her child's recent allergic reaction has sent me on a trip down memory lane. Sophie has been blessed to have had no serious reactions for the past 2 years. In fact, her last one was in the allergist's office when we did her peanut challenge in 2008.
Sophie was 6. Her recent tests showed a decline in the peanut and egg antibodies, and our allergist asked her about doing a couple of challenges. Initially, she declined. You may think this is funny, that she was calling the shots, but it is her body and she is the one who suffers if she can't eat what other people eat, so I am inclined to weigh her opinion heavily on these matters. He talked a little more (I had already said it was up to Sophie) and convinced her to try a peanut challenge. She stated that she would only be willing to do the egg challenge if she passed the peanut challenge.
We used peanut butter for the challenge. With the first few doses, she had no problems. No itchiness, no redness, no gasping. After we'd been there about an hour, she got a bigger dose--2 teaspoons if I remember correctly. She was okay for about 10 minutes after she ate it, and then she exploded. Well, not literally, but almost; she projectile vomited a couple of times in a row and then began a rapid-fire sneezing routine. I remember so clearly holding a trash can in one hand and a handful of tissues in the other, doing my best to help Sophie, while the doctor was scrambling around and said to me, "Well, this is 2 body systems, respiratory and digestive. That's anaphylaxis." We both looked at the Epipen sitting on the counter.
Sophie stopped vomiting for a minute, long enough to take some Benadryl. The Epipen stayed put. When she vomited up the Benadryl, the doctor fingered the Epipen and commented aloud that Sophie hadn't sneezed for a couple of minutes. Sophie's body began to calm down--maybe some of that Benadryl stayed in her long enough to do some good, or maybe she was the recipient of a miracle (well, I know that to be true either way), but she stopped vomiting and sneezing. Within an hour, she had taken both Zyrtec and prednisone without vomiting and we were able to go home.
That was 2 years ago, and yesterday Sophie told me that she has no intention of having an egg challenge, since she hasn't passed peanuts yet.
Sophie was 6. Her recent tests showed a decline in the peanut and egg antibodies, and our allergist asked her about doing a couple of challenges. Initially, she declined. You may think this is funny, that she was calling the shots, but it is her body and she is the one who suffers if she can't eat what other people eat, so I am inclined to weigh her opinion heavily on these matters. He talked a little more (I had already said it was up to Sophie) and convinced her to try a peanut challenge. She stated that she would only be willing to do the egg challenge if she passed the peanut challenge.
We used peanut butter for the challenge. With the first few doses, she had no problems. No itchiness, no redness, no gasping. After we'd been there about an hour, she got a bigger dose--2 teaspoons if I remember correctly. She was okay for about 10 minutes after she ate it, and then she exploded. Well, not literally, but almost; she projectile vomited a couple of times in a row and then began a rapid-fire sneezing routine. I remember so clearly holding a trash can in one hand and a handful of tissues in the other, doing my best to help Sophie, while the doctor was scrambling around and said to me, "Well, this is 2 body systems, respiratory and digestive. That's anaphylaxis." We both looked at the Epipen sitting on the counter.
Sophie stopped vomiting for a minute, long enough to take some Benadryl. The Epipen stayed put. When she vomited up the Benadryl, the doctor fingered the Epipen and commented aloud that Sophie hadn't sneezed for a couple of minutes. Sophie's body began to calm down--maybe some of that Benadryl stayed in her long enough to do some good, or maybe she was the recipient of a miracle (well, I know that to be true either way), but she stopped vomiting and sneezing. Within an hour, she had taken both Zyrtec and prednisone without vomiting and we were able to go home.
That was 2 years ago, and yesterday Sophie told me that she has no intention of having an egg challenge, since she hasn't passed peanuts yet.
Friday, May 21, 2010
Pregnancy and Allergies
An email from a reader got me thinking today about when I was pregnant after having one child with food allergies. I was worried about the new baby developing food allergies like Sophie's. But I was terrified that she would have allergies that Sophie didn't have--and make our list even longer! I talked with our allergist and he gave me some recommendations based on the current research. Nothing is guaranteed, but it worked out for me--Maggie doesn't have any allergies at all. What are your thoughts on pregnancy and food allergies? Did you have a specific plan to avoid allergies? Did it work?
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