Allergist Redux

We are going to be seeing one of our previous allergists again soon, probably the first one (long story, but getting a copy of the records and his notes was extremely helpful). He wants to see my records of Baby E's reactions and surrounding circumstances and do another round of testing for the one-year follow-up.

Also, he feels that being on Zantac, as she was for the last round of tests (the ones that were negative), could affect the test results. So this time she'll be off the Zantac as well as other antihistamines for at least a week before testing.

I'm going to ask if he'd be willing to consider doing prick-to-prick testing instead of using standardized extracts for the fruits and vegetables, since that's supposed to be much more reliable for many non-top-8 foods.

If after all that he still feels it's inconclusive that Baby E's reactions are really caused by these specific foods, I plan to ask if an in-office food challenge would be appropriate.

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None of her reactions have been life-threatening, so if the allergist and pediatrician agree (the pediatrician is a definite believer in E's allergies, and is very conservative and cautious in his approach to dealing with them) it seems as though a controlled in-office challenge may be an acceptable risk.

If Baby E eats corn or one of her other problem foods and has no reaction, we can assume that something else is causing the symptoms (maybe something that just happens to be in almost everything that contains corn :) ) or that she has outgrown the issue, or that her issues are dose-related delayed reactions. Any of those results would make life dramatically easier.

If Baby E has a clear, significant reaction, then having an allergist convinced and being able to point to the challenge will be helpful in many ways. For one thing, it would hopefully put a stop to a lot of the crazy-making. The allergist would become a huge advocate for getting the accommodations Baby E needs. And it would probably be a lot more convincing to doctors. If she is going to have a bad reaction, it would be much better to do it in a controlled clinical environment with someone right there who could handle it.

I really can't blame well-trained professionals for questioning a parent's perception of a child's food reactions in an environment where misunderstanding of allergies and intolerances is rampant. I've rather frequently had parents tell me their child is allergic to milk because they threw up once after eating ice cream and they've never given their child a dairy product since, or that sleepiness or gassiness after eating a specific food must be an allergy, or that their child is allergic to a medicine because they experienced a standard side-effect of that medication. No wonder doctors roll their eyes when I say that I think Baby E reacts to calcium citrate grown on corn.

Another possibility would be that a food challenge would show us that Baby E's reactions to larger amounts of pure corn are no more serious than her reactions to tiny amounts of corn derivatives. Even if we verify that she does react to both the derivatives and the corn itself, knowing that she reacts the same no matter what the amount or type of corn product would be huge. We would no longer have to be quite so cautious. We wouldn't be so afraid.

Right now we tend to think that if her reactions to things like calcium citrate with no detectable corn protein in them are that bad, eating a corn chip might kill her. Living in fear is not fun, and the extreme level of caution we're currently taking is certainly something we would rather not do if it's not necessary. We'd still try to avoid the foods if there was any kind of allergic reaction, of course, but we would be able to relax a bit about things like being in places where corn chips were being served.

Either the first or the last option would make our lives significantly easier and less stressful, that's for sure.