We have our annual check up next week - can you help?

[harverina]

So, dd, age 3 has her annual check up at the allergy clinic next week and I want to be a bit more prepared this time as I usually go in, get a little flustered, and leave again with more questions than I started with

The consultant that we see is a paediatrician with an interest in allergies - she is not an immunologist. It is a general paediatric clinic we attend.

Wear attended last march when dd was just shy of 2. She was not tested during our appointment, it was just a consultation to check that there had been no issues since we were last seen and a height/weight check.

Should I expect skin prick tests this time, and if they are not offered should we request them? I am keen to discuss the possibility of a baked egg challenge with her due to reading threads on here where children are still allergic to egg but can tolerate baked egg. Is this reasonable of me? My dd has never had eggs but she had a positive skin prick test to eggs when she was 6 months old.

Also, my dd has only ever been tested for peanut, and no other nuts. I feel that this has left us in limbo a little bit as dh and I avoid all nuts because my dd is not allowed any - I kind of feel like I would like clarification re.What other nuts she may or may not be allergic too. Is this reasonable or unnecessary?

Any help would be appreciated

It's really important to go in there knowing what you want to get from the consultation, especially if it's only happening every 12 months. Why not write down a little list of questions and take it with you. Health care professionals aren't going to mind that at all (unless it's pages and pages long), and expect a consultation to be a two way thing.
I think the thing with eggs in baked products which as cakes is that the longer hotter cooking breaks down the egg proteins making reaction less likely, but it's important to ask your dr before trying. Also do ask about other nuts, it's very important you are sure what she can and can't be eating.
Good luck :)

Yes definitely write a list of questions/issues that you want to raise at the appointment -there's nothing worse than coming out and realising you didn't get to say half the stuff you wanted to! I think it's quite reasonable to ask about further allergy testing whether that's skin prick tests or perhaps blood tests. As for a baked egg challenge, we did this recently in the hospital with DS after our consultant (also not an immunologist, he's a paediatric chest specialist with interest in allergies) did a specific allergy blood test for a certain protein in egg. As the result for this came back low (unlike his result for whole egg which was still very high and he too had never eaten egg), the doctor decided to try the baked egg challenge which DS passed. It might be worth asking about the possibility of a baked egg challenge for your DD and see what the consultant thinks.

The problem with testing for other nut allergies as this point is that if your child is allergic to peanuts, it's safer to avoid all nuts anyway due to the high risk of cross-contamination. Most nuts are processed in the same factories as peanuts so even if your DD isn't allergic to cashews for example, any cashews might be contaminated with peanut.

Thanks

Yeah freefrommum I understand that we have to avoid all nuts due to the high risk of cross contamination, I just feel sometimes that I would like to know if she is allergic to other types of nuts, but actually it's not a test that would change our lives significantly, as we do avoid all nuts (we are a nut free house and that includes cosmetics etc)

Thanks so much on the info re. baked egg challenge, I will ask about that - I remembered your thread and it made me wonder if this would be possible for dd at some point. Have you found a big difference now that your ds can have baked egg? Are you less anxious about "may contains"?

Thanks again

For us the best thing about DS being able to have baked egg is the fact that most wheat free breads contain egg white so it's always been very difficult to find bread/rolls he can eat whereas now there are lots of options. Cake is the other big thing as he can now have wheat and dairy free cakes from most supermarket freefrom sections plus I can make him chocolate brownies etc quite easily (I could never get on with egg replacers for making cakes).

We are in the same position as you regarding nuts as DS has only been tested for peanuts (his result was quite low in comparison to his other allergies but he's never even touched one so the results are not very reliable). As DH is allergic to most nuts (except almonds), we just don't have them in the house.

"May contain" is still a major bug-bear of mine. I made the decision a long time ago to give DS certain things that say "may contain" simply because his diet is already so limited but I do worry about it and always feel so unsure of the risk. I think it's one of those areas where you just have to do what you feel comfortable with.