Thursday, September 5, 2013

Immunologist Appt #3


We made a day trip to Houston yesterday for another appointment with Rapunzel's immunologist at Texas Children's. We left at 7am and got to the hospital at 11:30. Just enough time to scarf down some lunch and make our 12:00 appt.

I knew there would be a lot of waiting, so we came prepared with some schoolwork.  Love her "I don't want you to take my picture" face. 



The doctor came in and let us know that we'd first be doing a scratch test with extracts and actual foods for: corn, peas, and oranges.  

They brought in someone from Child Life to help her during the test. She did great!



This is after only a couple of minutes.  I didn't get another picture afterward because she was getting uncomfortable, so I got up to hold her hand. 



After the test was over, the doctor returned to go over the results.  They did scratches for pea extract, fresh pea, orange extract, fresh orange, corn extract, fresh corn, and boiled corn.

To Erica's chagrin, she is still allergic to peas. Big time. In the doctor's words, "quite possibly anaphylactic to them.". Both the extract and the fresh pea scratches swelled up substantially. Got it.  No peas. She didn't need to tell me twice!

Orange was inconclusive. The extract reaction was just ever so slightly positive, but the fresh orange was negative. She said if we wanted to attempt a food challenge on our own at home, she would be ok with that. We're thinking about it, but still avoiding orange for now. 

Corn was baffling. Of the 3 scratches for corn, one reaction was very large, one was borderline (but still positive) and one was negative.  Not enough evidence to rule out the corn allergy. And because there was a positive, we couldn't attempt the food challenge today. So, next time we come in, we'll be focusing on this.  We'll do another scratch test for corn - this time with corn on the cob and corn syrup. And possibly the food challenge. 

I was very confused about her testing positive on the skin tests, yet her blood tests coming back mostly normal. The doctor explained that we can't rely on one test over the other. Instead, we use all the results to paint a bigger picture of her allergies.  She also explained that just because her numbers do not indicate a possible anaphylactic response, does not mean that it's not a true allergy. Rapunzel has not experienced an anaphylactic reaction before, but her extensive stomach aches and general unwell feeling after ingesting an allergen are still definitely signs of an allergy, and are even sometimes referred to as slow anaphylaxis. 

I will admit that I became a little lax about what Rapunzel ate when we ate out this summer after her last appt, but my eyes have been reopened and I will continue to be diligent about what she eats!

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