Thursday, May 06, 2010

milk: it doesn't necessarily do the body good

The day is finally here. Baby’s highly anticipated trip to the allergist’s office was this morning.

I’ve had her paperwork finished for weeks. I’ve had directions to the office printed for that long, too. This week I started quizzing the people with whom I work to see what time they thought I should leave this side of town to get to their downtown office. The average guess was about an hour. I thought that was probably too long, but knowing I would be driving through morning traffic to get there, decided to err on the side of caution and leave an hour before I was supposed to be there. We found it without problem and spent 30 minutes playing in the back seat before we went up early to our appointment.

Today was an exercise in patience. We waited in the car. We waited in the lobby. We waited in our little jail cell waiting room. Wait, wait, wait – possibly the most difficult task while trying to entertain a 13-month old. The one thing I figured out is that I’m pretty sure I’m allergic to waiting.

They showed us into an interview room that was about 7.5’x7.5’. It contained a desk, two roller chairs, and two stationary chairs. There was hardly any room to turn around, much less give baby room to play and wiggle. But we managed. I imagined that was what it’s like to be in prison.

I liked the doctor that we saw. She was knowledgeable, approachable, and good with the baby. We had a long interview to talk about the timeline of things and what we (the PCP) thought was the problem. I showed her the pictures and baby’s RAST scores. (RAST was the blood test we did that tested for an immune response to several common childhood allergens – all of which came back with a reaction less than zero, in other words negative for everything.) I asked several questions and we played show and tell with baby’s skin.

We’ve been tapering off of her antihistamines since last week. Tuesday of this week (almost exactly 24 hours after her last Benadryl) baby started breaking out into welts again. They weren’t as prominent or ugly as last time, but they were red and menacing. But between then and this morning they had almost completely subsided – all that was left were a few pink places.

Baby did not like anybody else to come in the room with us. She was fine with the doctor, as long as she was just talking and taking the history. She did not like the doctor looking into her ears or mouth (screamed bloody murder), or listening to her breathe (she held her breath, then screamed bloody murder). Needless to say, she was also not happy with the nurse who cleaned her arms with alcohol and then screamed enough to make the little girl next door cry in anticipation when they pricked her to test the 21 allergens on her arms.

They tested for Bermuda grass, two different types of dust, cat dander, dog dander, four different types of molds, almond, cashew, egg, cow milk, oat, peanut, pecan, soy, walnut, whole wheat, and a “histamine” control and a dilute solution control.

The process was that they first cleaned her arms with alcohol. Next, they wrote out three columns of numbers on both forearms to label where they were going to test. Next, they pricked each allergen where it was labeled. (I’d just like to say how much I hate having to hold her down when nasty things are happening to her. From what I’d read I expected each little spot to be like a mini TB-skin test, but it wasn’t like that at all. There was hardly any allergen, and the needle was smaller than a diabetic testing needle – very, very, very tiny. I think she was mostly upset that the stranger was holding her arm and she quit screaming immediately after the nurse let go of her arm.) Next, they set a timer for 15 minutes and left us alone to wait.

The doctor came back in and measured each of the areas to determine if baby had any type of allergic reaction to them. First she looked at the “histamine” spot. It had reacted, which was good because that was the control to see what a reaction would look like. It made a little welt. Likewise, the dilute solution did what it was supposed to do – nothing. Each of the other allergens was tested to these to determine if there was a reaction.

Although some of them had minor raised areas, none of them were positive, which means she tested negative for allergies at this time. (Now there is a lot of hullabaloo about prick testing in toddlers at this time. Some people say you shouldn’t do it because it doesn’t really tell you anything. What this told us is that she’s probably not allergic to the things we tested. Not extremely definitive, but more definitive than what we knew before today, which was nothing.)

They gave us a few handouts on hives and another handout about how they wanted us to document things if she broke out again. She told us we could stop the Singulair and Zyrtec daily, but we could give Benadryl or Zyrtec if we needed to do so. She told us we could slowly reintroduce cow’s milk again. She made us a 6 month follow-up appointment; although she said that she doesn’t really want to see us unless we have problems.

Baby fell asleep before we could get out of the parking lot. I took her to day care and expect her to have a great nap this afternoon.

I've called and reported to the PCP. He was okay with her recommendations and wants to be kept in the loop if she breaks out again. I like that he wanted to hear from me and is taking a very active role in baby's care.

For now everything’s just coming up nonallergic roses. (With the exception that baby has had an incredibly long day. She's broken-hearted and clingy sporting red dots on her arms. Day care was quick to report that she was awful this afternoon; I told them that she earned her ability to be fussy today. We hope she does okay tonight, but we won't be surprised if she needs us several times during the night.)

I don’t think this chapter in our life is over, but I’m hopeful that reintroducing milk will be mundane and boring. No matter how it plays out, I’ll keep you abreast on our misadventures into parenthood.


Anonymous said...

So I guess Zoloft will not be moving to TN. There will be a room for her in our new house if needed :)

genderist said...

By the way- that picture was taken with my cell phone. I am SO excited that I can do that!

Molly said...

GG is such a trooper. Yay, regular milk!

Ashley said...

Hmmm... so odd. Well, I guess you have several people besides you all keeping tabs on these allergy issues and welts, which I think is fabulous. I wish they would have found something for your sake, but at least you have a plan of action whsould these issues arise again.

Cerulean Bill said...

"Reported to the PCP". Lets hear it for electronic medical record, shared medical records.... geh.