To the allergist we go!

Last Thursday morning Ella and I made our first trip to the allergist. Ella’s allergies have always been a problem – she has been taking antihistamines (started with Allegra, then Zyrtec, now Claritin) since she was 15 months old, and Singulair and Nasonex were recently added to her daily regimen. Her allergies just get worse as she gets older. Last spring, summer and fall we pretty much couldn’t go outside at all because her nose would instantly start running, her eyes would start tearing, then turn bright red and get itchy, then swell up and stay dark and swollen for a few days. It’s been terrible. Around Christmastime she had about a month when these attacks, particularly involving her eyes, would happen 3-4 times a week. Before, this would happen right after she had been outside around allergens or near a dog or cat, but it started happening when there was nothing we could think of that would set her off. I suspected an almond allergy so I stopped giving her almonds. Then she had her 3 year checkup and Dr. Bindner added Singulair and Nasonex to her daily routine and referred us to Dr. Damin at Kentuckiana Allergy. This was about a month ago, and since then she has only had one allergy attack and that was when she was around a cat. So it appears that Singulair and Nasonex have been helping, but we still needed to see the allergist to nail down exactly what all she is allergic to and discuss shots as a treatment.

We talked a lot about her appointment to get her prepared…she does much better in these situations when we discuss everything and she knows what will happen and why. We talked about Dr. Damin and that he was a nice doctor like Daddy and would help her with her allergies and her itchy eyes. We talked about how she would get “pokes” on her back. I would poke her back with my fingernail to try to give her an idea of what it would feel like. (in a playful way, of course!) She seemed about as prepared as she could be for a 3 year old who was about to get about 50 sticks in the back. :( After arriving at the office we discovered that they had a playroom. One of the nurses gave her Hello Kitty stamps on her hands and turned Mickey Mouse on the TV for her so she was excited about that. We’re off to a good start! Then another nurse called her back. Ella immediately asked her what her name was…Ella asks everyone their name…then said, “I don’t need a shot.” “Oh me,” I said. “It’s going to be a long morning!” The nurse laughed and agreed. They checked her height, weight, blood pressure and temperature. Ella was a little on edge but let her do what she needed to do Then Dr. Damin came in. Of course the first thing Ella said to him was also, “I don’t need a shot.” *Sigh* We went over the MASSIVE amount of paperwork I had filled out the night before involving her entire history of allergies. The paperwork had stressed me out. Ronnie made fun of me and said I was being waaaay too particular about it. But Dr. Damin was glad I had been so thorough, I got the impression that most people probably give up before they complete it all. I wouldn’t blame them! He looked in her ears, throat and nose and said her nose looked like the classic nose of an allergy-ridden child. After we talked about everything he said the nurse would be back in soon for the testing. Then he pointed out that they had a TV with a VHS player in the room and movies to choose from so we headed to the bookshelf to pick out a movie. This made Ella super excited. The first thing she grabbed was Snow White. It came on TV the other day and I DVR’d it for her, so that one was fresh. I also grabbed Cinderella since it is a story she is familiar with but she had never seen the movie. She decided on Cinderella first and by the time I finally had it rewinded (rewound…? it’s been a long time since I’ve used a VHS!) the nurse was ready to start. We stripped off her shirt and I sat in a chair with Ella in my lap. She was straddling me and I had her arms under my armpits so she couldn’t squirm or reach for her back. I tried so hard to get her engrossed in the movie while they nurse put a ton of lines and letters on her small little back. Then they began. After the first few pokes Ella said, “Ouch!” Then, “Don’t do any more!!” Then it turned to bloody murder screams. By the time they were done I think I was as upset as she was, but thankfully the nurse went really fast so it didn’t take too long. For poor Ella I’m sure it felt like an eternity! She calmed down very quickly after they were done. They told me to keep holding her arms so she wouldn’t scratch, but she did great and never tried to touch her back after I explained why she couldn’t, so I didn’t have to continue to restrain her. I took a picture of her back with my phone and sent it to Ronnie. It looked rough…I don’t think I will post it. The nurse came in to check on us, then at 20 minutes she came back to analyze the results. While she wrote down the results she explained to me how the process works. It is actually really, really neat. I decided that if I were going to be a doctor of some sort I would really like to be an allergist, ha ha. They first stuck her with histamine…which everyone reacts to…to make sure that she has a reaction and nothing is in her system that would alter the results. They had told us to stop giving her Claritin one week prior to the testing so it wouldn’t interfere. But lots of drugs have antihistamines in them so sometimes people have one in their system and don’t even know it. They also stuck her with saltwater, which shouldn’t cause a reaction. But sometimes, particularly in fair skinned, Caucasian females, people react to just the poke, so they compare the reaction to the saltwater to the other reactions to see which is a reaction from just the poke and which is a reaction from the allergen. Maybe that makes sense…I thought it was cool!

While she had lots of reactions, there were a couple of spots other than the histamine that clearly had the worst reactions. While she measured one of them I said, “I bet that one is cat.” She told me that she actually didn’t have a reaction to cat, but she could still be allergic. I thought that was odd, since generally Ella can just think about a cat and her eyes will swell up! After she wrote down all the results she cleaned off Ella’s back and sprayed it with anti-itch medicine. A few minutes later she came back into the room and said, “You’re right…she is HIGHLY allergic to cats.” That’s what I thought. Unfortunately she came back a few minutes later with a row of syringes. Crap. They had mentioned that if some of the results were unclear they might have to poke her arm using needles to get the stuff a little deeper for a more clear reaction. This part was no fun. After going through all the pokes, the last thing Ella wanted to see was a metal tray with items on it that look like they would hurt. I had to hold her really tight while they gave her 6 pokes in the arm. Some of the spots bled a little so she was freaked out, but also really interested, in the blood. She immediately asked for a bandaid and after those results were documented the nurse brought her a Little Mermaid sticker, a bracelet and 2 bandaids – one was a yellow crayon and the other had Bugs Bunny on it. I think she felt really bad for making Ella scream twice! They were friends again after that. They waited 20 more minutes and then came back to document those reactions, then Dr. Damin returned to go over the results and discuss treatment options.

Out of 48 pokes, she had 20 reactions: Cat, Dog, Almond, Mold (Fusarium, Mucor, Rhizopus, Curvularia, Pullaria, Grain Smut, Grass Smut, Phoma betae), Tree Pollens (Mulberry, Sweet Gum, Oak, Walnut-Hickory, Birch), Grass Pollens (Timothy Grass, Orchard Grass, Fescue, Bermuda Grass). Her strongest reactions were to Cat, Oak, Orchard Grass & Bermuda Grass. Thankfully the paper they gave us listed the month that the tree and grass pollens are the worst. Dr. Damin was surprised that she had reacted to almond. It was a slight reaction so he said to start slowly with almonds and see how she does. A couple of days ago she found some cocoa roast almonds in the pantry and asked for some. I told her she could have a couple, but of course she ate probably 10 and had no reaction. Either she isn’t truly allergic or the new medicines she is on are keeping her from having a reaction. He thinks that the random attacks she has been having with her eyes are due to cat dander. He said that the eye itching and swelling is a classic reaction to cats and that it could happen anytime she is around someone with cat dander on them. Then he went on to talk about cat dander...it's really, really gross. He said it takes 6 months for cat dander to break down. It just hangs in the air. He said you can clean as much as you want but it won't get rid of cat dander unless there is a full cleaning of the HVAC system, new carpets, etc. He encouraged us to medicate Ella before she is going to be around a cat, and we already do that. He went on to say that whenever we go to buy our next house, if a cat has lived there it wouldn't be worth it. He said if it was like our dream home then we would have to have the house completely cleaned, all of the air filters and HVAC, new carpet installed, etc. If not, she would be miserable. Wow. It really makes sense with her eye attacks. Most mornings we go to the YMCA and a lot of her attacks were happening around that time. I would feel very confident betting that some of the ladies who she hugs and is close to probably have a cat at home and the close contact is setting her off. We have friends with cats who have come to our house, and after Ella has been sitting in their lap she will start rubbing her eyes. Crazy cats.

We then discussed allergy shots for Ella. Since adding Singulair and Nasonex have been helping her a lot I thought maybe we would be able to avoid it. Because she really has been a lot better. The reason we chose this particular allergist was because her pediatrician said that he was very conservative and wouldn’t recommend shots unless he felt it was absolutely necessary. He felt it was absolutely necessary. I shouldn’t say that…he didn’t put it in those words, but he HIGHLY RECOMMENDED that we consider allergy shots. He said that if it takes 3 daily allergy medications to keep her under control and 2 others to supplement when she has attacks, she needs some relief. Good point, doc. I didn’t really understand how allergy shots worked until he explained it. I always thought it was just a treatment for symptoms, like medication, but allergy shots are actually similar to a vaccination and help your body to develop immunity against allergens. You receive small injections of your allergens and build up your dosage over time. As time progresses your shots are spaced out more. It’s usually a 3-5 year process but most people feel better 3-6 months after beginning shots. We will more than likely go that route. I need to make a phone call to our insurance company to see how much will be covered, because allergy shots are expensive. He compared it to getting a set of braces. I’ve been putting off that call because I would normally prefer to have my toenails yanked off than talk to the health insurance company. Her doctor knows the situation we are in with Ronnie completing residency, and he mentioned that if we would have better health insurance when he starts a new job in July than it would absolutely be ok to wait until then. He said that even if we started now it wouldn’t be enough time for them to really help her in the upcoming allergy season. So that is the route we will probably end up going. I hate to put poor Ella through shots but anyone who is around her much knows how much she suffers from her allergies, so we want to do what we feel is best for her in the long run. If we can get her allergies under control at a young age hopefully they won’t be as brutal on her as she is older and doing more things. Both myself and Ronnie have dealt with allergies all our lives and know it can really interfere with daily activities. So hopefully Ella will soon have some relief!