Saturday, July 11, 2009

1st allergist appt

Ethan's skin was clearing up this week but flared up just in time for our first appt with the allergist. I expected the appt to be a consult but we ended up having skin allergy tests and blood work done. They could only perform about 10 skin tests because his back was covered in eczema. Thankfully he didn't mind the skin test at all. The wait after the skin pricks was long because he was tired and I watched little hives form on his back and shoulders from the allergens. I didn't know which ones were causing a reaction so of course my mind was racing.

He did not show a reaction to milk, soy, wheat, oat, or rice. I was relieved since I've been eating a lot of oat and rice. I still cannot consume milk or soy because while he may not be allergic to them, he has an intolerance to milk and soy protein. His MSPI symptoms are likely caused by an immaturity of the GI system. The allergist listed it as "food protein enterocolitis as opposed to an IgE mediated food allergy". She said that MSPI should resolve itself by the time he is 18-24 months old. She suggested that I do not introduce dairy or soy into my diet if I plan to continue to breastfeed. This contradicts what I've heard about soy protein intolerance possibly resolving between 6-9 months of age. I didn't plan to introduce dairy until he was closer to a year old but had hoped to introduce soy sooner. She also suggested giving him a hypoallergenic toddler formula until he is 18-24 months old since he will not be able to consume whole milk. Some MSPI children are given soy milk or rice milk at a year old. This doctor stated that rice and soy milk do not have enough fat needed for brain development so the formula is recommended.

Ethan's skin tests showed a mild reaction to dogs, which we do not have but he has been in contact with on an occasional basis. The doctor stated that children and staff at his daycare who have dogs likely have dog dander on them so Ethan is being exposed that way as well.

Sadly, Ethan showed a reaction to cats. We are waiting to see what the RAST to cat dander shows before making a decision. While we cannot imagine having to find new homes for our cats, as they are members of our family, we cannot have Ethan suffer or be on long term medication. We're going to work on some other options first before it comes to giving up our cats as a last resort. Our vacuum has a HEPA air filter. We need to vacuum more often. It was suggested that Ethan be in a different room during and for a short while after vacuuming. We also need to invest in a HEPA air filter for our home. We need to keep the cats away from his toys, play mat, etc and out of his room, which is going to be the most difficult. They love to sit on the ottoman in his room. Kylie also loves to join us while we're on the floor with Ethan. Ethan enjoys watching her and most recently has started grabbing for her as she walks by. It's very cute but can no longer happen. We cannot pick up the cats unless we plan to change our shirt afterward. We also need to wash our hands between petting the cats and touching Ethan's face/hands. We already put blankets down while playing on the floor. We'll have to wash those often.

Although he showed a reaction to the skin test for cats I wonder if it really is our cats causing his symptoms. He has been around them his entire life and didn't have any reaction until he was about 4 months old. My SIL has allergy testing performed yearly (I think it's yearly). She usually shows a reaction to dogs but not cats. This year she showed a reaction to cats and not dogs but she is able to live with a cat. I'm wondering why her tests are inconsistent. I keep thinking - what if we find new homes for our cats and Ethan symptoms remain the same?

Ethan also showed a reaction to cockroaches. I wasn't too concerned since we certainly do not have cockroaches in our home. The allergist warned me about reactions when we are in public places.

The scariest reaction was to eggs. I KNEW that he had a reaction when I ate eggs but the confirmation of this allergy makes me angry with our previous pediatricians office. They repeatedly told me that Ethan was too young to have an allergy to eggs. I will be writing them a letter. I feel that my concerns about his MSPI and possible egg allergy were brushed off too many times.

The allergist is checking RAST to egg white and yolk (as well as milk, soy, wheat, and peanut). We will have to carry an EpiPen and have one at his daycare. This will be more of a concern when he starts eating solid food but is already a concern since he is reaching for everything. Just yesterday we had a bowl of cereal spilled because he was interested in it. The concern is not only for eggs such as an egg salad sandwich but also mayonnaise, baked goods, etc. The allergist said that 66-90% of children typically outgrow an egg allergy by school age. She also said that 6-8% of kids have food allergies/intolerances and about 50% outgrow them.

New meds and skin regimen:
-give him a 1/2 tsp of Hydroxyzine at bedtime.
-nightly luke warm soaks, air or pat dry
-immediately after bath apply 2.5% hydrocortisone ointment followed by Vanicream on top
-spray skin with water during the day to replenish before applying hyrocortisone and Vanicream
-apply Bactroban to open areas of skin twice a day

Lots of information and it was an overwhelming day.

8 comments:

  1. WOW, you sure did learn a whole lot! That E sure is a complex little guy. You're really getting somewhere now with this info!

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  2. Yes, it's overwhelming. My allergist (went twice) did no testing at all. He said my baby is too young for reliable testing (i.e. too many false positives). He basically just did a lot of hand-holding and said that there is a good chance, this will all be out-grown. I am hopeful, but I am pessimistic too as I know what a battle it was to "cure" my own atopic dermatitis. It's trial and error and a lot of it is "believe what you see". If your son gets an allergic reaction after being around dogs/cats, then believe it. that's whar the allergist told us...

    I ask people that have too much perfume on or who I know have dogs to not hold my baby because I know the end result will be him sufferring and me sufferring. Maintenance and keeping this in check is a LOT OF WORK

    When I had atopic dermatitis, I used a spray on my dog - it reduces the dander or neutralizes it. You might want to research that. I think it was Allerpet. I'm going to look at my old records to see what it was I used, but it worked for me a bit. I also invested in hepa filters, etc. And, then, slowly my allergy to my dog subsided. I feel that if they are not over-dosed, it's possible to get over an allergy as long as it's not one of those that can cause anaphylactic reactions. That said, your son's comfort is the priority. And,what worked for me prob does not apply...

    my allergist also uses vanicream so i felt good about that. i discovered vanicream years ago via trial & error....one of the few things that worked for me at the time. now, i can use just about anything...no rash! rash free for years now! HOPEFULLY, this will all pass as they grow older.

    my allergist also prescribed topical antibiotics & steroid cream w/daily baths. please keep us posted. i will keep you posted too. today we go to a dermatologist just to see what he has to say...

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  3. went to the dermatologist today - he said that things look okay w/my baby. Said not to overuse the Bactroban (use in a limited fashion only) as a resistance can develop. He did not know anything about vanicream and said he does not like creams because they contain preservatives. He said he likes Aquafor, but then he also told me to use dreft laundry detergent and insisted it did not contain fragrance. I have that detergent, and it has fragrance in it. You can smell it - very strong fragrance. I also called Dreft and they said ALL their detergents have floral-baby-powder fragrance in them and they have yet to produce one w/o a fragrance. Oh well.... Not much help there, but I wish I had gone to him first because the pediatrician put him on oral antibiotics, and my baby was NOT infected. It's like hit-or-miss w/these things and the doctors ...

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  4. Thanks for your responses. I've been wondering how things were going for you. If you don't mind leaving it, what is your name? I've been referring to you an Anonymous. How old is your baby?

    I've been trying to learn more about the likelihood of false positives with skin testing. Our pedi mentioned this as a possibility too.

    Thanks for the heads up about Bactroban. Our allergist suggested applying it to open areas of the skin 2-3x a day for 1 week. The open areas cleared up within 2 days.

    Our allergist suggested Dreft too! I was very surprised as we use a Free & Clear detergent, which I would assume is better than the fragrance in Dreft.

    BTW, I received my copy of Baby Matters and skipped ahead to the section on digestion for now ... interesting info!!

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  5. Poor Little Guy! I can't imagine having to deal with all this. Hopefully he outgrows the allergies!!

    I did have to LOL at Cockaroach allergy testing. :) I didn't even know they tested for that. HA! ;)

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  6. Avoid Dreft! The fragrance in it makes me want to gag. I'm very sensitive (as a former atopic and now in complete remission) so I can sense it's not good for a person w/allergies. Ditto with over-fragranced diapers. I have a bunch of Pampers in a box which I'm not using until my boy is all healed (and then, I still might not use them because of their light fragrance which gives me a headache.) Now, I'm using Kirkland diapers because they don't have as much fragrance and Huggies Organic diapers. The Kirkland diapers - I'm still a bit iffy about because I can smell enough "outgassing" from them that it makes me wonder.... However, it was better than Pampers or the regular Huggies. And, Huggies Organic is okay - no worries about that diaper. I should do cloth, but just don't have the time.

    We have a lot in common. My baby was born at the end of January this year. He is a big guy too - well, actually his head is BIG! ha ha. He is very, very happy. Always laughing and smiling and bubbly. Yours is way more advanced in comparison. 2 teeth already! And, it seems your is doing a lot more. More socialized w/the day-care, etc. Mine has yet to reach for our dog. But, he does watch her. Mine is not into his jumper-roo yet. He can't reach the floor yet and his jumperoo is too big for him. I put a dictionary under him, but then he uses it to launch off of and arches his back trying to extricate himself. I'd love for him to find a fun activity that didn't involve me having to engage him. I need to get some housework/work done! I, too, do not get much sleep.

    I didn't do the in-vitro route, but it was not easy. Long story, but I am older than you so it is harder as you get older to have a baby. Just call me S-Anon. My husband doesn't approve of my interest in blogs. Truthfully, yours and the Metcalfs are the only one I look at - Both of you have a "real" and "genuine" approach to your blots.

    Again, E is ADORABLE! TOOO CUTE! You can tell he's smart, engaged and HAPPY! In "Baby Matters", the author mentions some odd correlations like, atopics are smarter than average (bigger head circumference at birth, etc). I mentioned that to some of my nephews over july 4th, and they were all saying, "well, I'm allergic to peanuts!" and, "I have allergies too!" and "Me tooo" HA HA.

    i just got a Lovey from Snoedel. Mine is not into it yet - he still prefers his teddy bear which is not machine washable (and Made in China which makes me worry too). I think Pantley uses Snoedel loveys too. They are not that interesting, but for me, "machine washable" is important because mine sticks everything in his mouth. His hands get eczema over them too. I'm pretty sure it's related to him puttin them in his mouth, but what can I do? I thought of a pacifier, but that's going backward. The baby cries. got to go...

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  7. I have a sensitive sense of smell as well, esp since my pregnancy. We've had E in Pampers this week b/c he has a yeast rash and I cannot get over the strong scent. We used Huggies organics while on vacation & I liked those better. We love using cloth diapers. I need to find a new detergent but they've been super easy ... although once we start foods, it may be a different story!

    I'm starting to become concerned about E's mattress. It probably sounds neurotic but his head smells slightly like chemicals after his naps.

    You're right, we do have a lot in common! Thanks so much for your compliments! We have friends with babies the same age and it's amazing how differently they are developing in some areas and exactly the same in others.

    I read about Snoedel Lovey's. We're thinking about a lovey too!

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  8. Mattresses - yes, that's a biggie. My husband, who is not a clean freak or neurotic at all, researched this before the baby was born. He wanted an organic mattress only because of mattress outgassing issues (lots of chemicals), especially w/the flame retardant chemicals that are used. I feel physically sick (nausea) when I am on a new mattress so I'm very sensitive. Luckily, we didn't have to buy a new mattress because we got a used one from his sister, and it's already out-gassed. There are companies out there that sell carbon (i think that's what it was) fabric that you wrap around your crib mattress and the put an old sheet over that and tighten it up which is supposed to absorb any outgassing chemicals. I forgot the company name, but I was going to do that even w/the old mattress, but my husband felt the old mattress was sufficiently out-gassed. Anyway, you can buy that fabric, and it might help. Just make sure nothing bunches up and it's secure and tight so the baby can't get hurt/sids, etc. I don't know, but they claim it helps w/absorbing outgassing fumes. Mattress was a big deal to my husband as he was very concerned about a certain chemical used in making things flame retardant. I forgot the details. The chemical name starts w/a "P", if I recall. Anyway, that fabric might be the way to go if you're concerned or replace w/an organic one (ouch - very expensive) or used one.

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