Allergist Visit

I couldn't bring myself to make an appointment with Sam's pediatrician, so I called his allergist Dr. Hunt instead and lucky for us they'd had a cancellation that very morning. I took him right in. I wanted to ask Dr. Hunt's advice about the various blood tests and which I should be saving for. There are so many, and they range from $89 to over $1,000. He said that I should hold off on the blood test and instead we should take advantage of Sam's "flare-up" to put him on a course of Orapred (which is more steroids, but internal instead of a topical cream). He said that would clear him right up and if I brought him back in seven days he'd take advantage of the clear skin and do a skin prick test then. I reminded him that we'd tried for four months last fall to get Sam clear enough for a skin test, we even used the oral steroids once, but then I remembered that I'd also had Sam on antihistamines at that time and the allergist had forgotten to tell me he needed to be off antihistamines for four days before being tested. So I'd brought him in, beautiful skin, ready for the test, only to be disappointed because I'd given him antihistamines that morning! This time, we are just doing the oral steroids and nothing else so we should be good to go. I am crossing my fingers.

I also related our experiences with walnuts and peanuts since Sam's last visit and the allergist agreed we should have an EpiPen Jr. on hand, just in case. The epipen is for children and adults who have anaphylactic symptoms to certain allergens. If Sam's reaction was that severe with just a tiny piece of walnut (it was not even a half of a nut that he ate), if he ever got hold of a food containing a substantial amount of tree nuts it could be life threatening. The pen has a plunger needle that you literally plunge into the thigh through the clothing if the child starts to have a reaction where he is clutching his throat and can not breathe. From epipen.com:

What are the symptoms of an allergic emergency?

Symptoms of an allergic emergency vary, but those involving the skin (hives, itching, skin redness) are most common. A majority of cases also involve swelling of the lips and tongue as well as the airways (tightness in the throat, shortness of breath). Fewer reactions involve the gastrointestinal system (nausea, stomach pain, vomiting, diarrhea), the cardiovascular system (fast heartbeat, chest pain, low blood pressure), or the central nervous system (headache, confusion).

How does epinephrine work?

The drug product in the EpiPen Auto-Injector is epinephrine. Epinephrine by injection is the treatment of choice for allergic emergencies (anaphylactic reactions) because it quickly begins working to reverse symptoms of an allergic emergency. It constricts blood vessels to increase blood pressure, relaxes smooth muscles in the lungs to reduce wheezing to improve breathing, stimulates the heart (increases heart rate), and works to reduce hives and swelling that may occur around the face and lips.