red blotchy face and swollen tongue last night, what to do now?

[mspotatochip]

had to call an ambulance for DS 8 months last night after tea as he turned lobster red and had a swollen tongue. Luckily reaction went almost as quickly as it started. Think it was to either sweet potato or hummus. Agreed with lovely ambulance lady that we wouldn't put him through A&E just watch and GP today.

I have a gp appointment today, going to ask whether he can have piriton and what dose and for a refferal to an allergy specialist. We have strong family history of allergy, excema, asthma and ds has previously had a mild reaction to cows milk. At that point GP wanted to wait and see "what else he reacted to" before referring us but last night terrified me and I want him referred ASAP.

He is covered under Dps bupa through work but we have never used it. How would I bring this up with GP, do I have to say who I would like to see or are we better off waiting and sticking with NHS?

Hi, sorry to hear about your scary experience. I'd say it's more likely hummus as it has sesame in it. DD2 (9 months) is allergic to egg and possibly fish and I asked my GP to refer me privately (because that was quicker). We saw a paediatrician a couple of weeks ago, who has referred DD2 for allergy testing (skin prick) when she's a year old, apparently it's better to wait until then. We are to avoid all egg, but she has said to try her on fish again and have the Piriton handy. The dose should be 2.5mls but better double check with your GP. My GP, incidentally, said he'd rather avoid Piriton under a year old but the paed said that was rubbish and it's even safe for very young babies, they use it at the hospital all the time.

Good luck!

I think I'd take the risk of a small dose of piriton over the risk of a badly swollen tongue! Thanks Feierabend. Did they give any advice on introducing new foods or had she tried nearly everything by then?

we had to wait 6 months for ds's initial appt with allergy clinic.
I would ask what the waiting time is and go private if it was me. The initial appt is important you can alwasy go back to nhs appts .
btw we were given cetirizine bt hopsital for ds as it doesn't make them drowsy

They said when introducing a new food, dab it on her skin first, wait for reaction (10-15 minutes I think). Then touch her lips with it, wait for a reaction. If she's fine with that, put the tiniest bit in her mouth, wait. If she's fine with that, give her some to eat. This is what I am supposed to do with the fish, but I am scared so holding off until she's nearly one!

I will also wait before introducing kiwi and strawberry. And neither of my girls will have nuts before they are at least 3.

We had to do that with DD and egg when she was two. It was scary but she was fine. Refuses to eat egg now though!

How long DID you wait between each step?

not as long as you've been told as i couldn't keep her at the table also had to bribe with choc buttons to get her to let me put the tiny bit of egg in her mouth. But she had had a mild reaction to egg (rash around mouth) when about 1 and then had none on advice of docs until challenge at 2. So I wasn't that worried.

I'm supposed to take her in for a nut challenge at 5 (DP had peanut allergy).

If you can do it under bupa then it will probably be quicker.
We had to go temporarily private to get DS1's eczema sorted out when he was about a year old, and it was all dealt with quickly.
Your GP won't get the hump.

MsPotatoChip, was your DP anaphylactic? How did you get the docs to agree to a nut challenge at the hospital?

Feierabend they suggested it!

I was a bit surprised that they wanted to wait until she is five but they feel we have enough control over her diet to prevent nut intake until then and then you loose control around school age.

DP has never gone as far as anaphylactic but gotten pretty close. We are lucky in that all his other allergies cause skin and digestive rather than respiratory symptoms. Because all of his allergies apart from the nuts were diagnosed via the dermatologists hes never had any input re you need an epipen etc as they are more concerned with his skin.

I'm leaning towards using BUPA to get them both reassessed now as last night really scared me. Mother in law has already given dd a carrot cake with walnut in which resulted in a night of vomiting and diarrhoea.........

I agree that it was more likely the hummus. DD2 had a scary reaction to half a cracker recently that had sesame seeds on. We can't afford to go private but her next skin pricks are in March and after I e mailed the dietitian she added sesame and peanut to the tests as the two are linked.

From now till then I'm going to be fretting about her coming into contact with nuts but hey ho we've done the 'allergy thing' for 16 months now so I've always been careful not to let her have any nutty things.

We used dp's Bupa cover for my dd's allergy testing. You can often see the same specialists as on the NHS but they work a couple of days as private consultants and you get to see them within a few weeks rather than months! You need a referral from letter from a GP, you can either ask to see a specific specialist or ask them for a recommendation.
I definitely recommend using the cover if you can, knowing what your child is specifically allergic to really helps you to keep them safe and helps to relieve the stress and worry. At least you will know what to avoid. Just ring Bupa first because they do have conditions on allergies, which might include registered specialists. Mine was that they would cover skin and blood tests but not any treatments. Which is fine because the Epipens come on prescription from the GP anyway.

waiting lists for NHS allergy test are often long so if you have BUPA its best to use it. I would check who you can see though as consultants "with an interest" (that includes paediatricians unless they are paediatric allergy consultants) are IME (and that of others) definitely inferior. Get the tests done with BUPA anyway.

Vomiting and diarrhoea after eating nuts is not good. In children such symptoms can progress so that later reactions are anaphylactic. In a child who has already reacted to food that to me would mean proper tests as soon as they can be arranged.

Piriton works faster than other antihistamines. Therefore for any severe allergic reaction it is the antihistamine of choice. Other antihistamines are fine when you need something longer acting - so for hay fever, say.

Thank you everybody. GP has agreed to write a private referral letter. He also said something that i believe to be totally wrong "Don't be too concerned the level at which he reacted the first time is likely to be the worst level i.e. any further reaction will not be any worse" I was

Didn't call him on it. he is not my GP of choice (big practice) but its horrid to hear things which as far as I know are plain wrong?

Tatt i didn't ask re dd but I am going to get my head out of the sand and take her to my GP of choice next week and get a referral for her too. She has already seen somebody on the NHS and I would like her to see the same guy as he seemed very sensible, at the time anyway (she was about 18 months offered to do blood tests on the spot but said he wouldn't recommend then would do them if I wanted but quite traumatic said would see her again when she was older).

According to our paediatric allergy consultant nut reactions are unpredictable and can be better or worse next time. Our experience was exactly that. Minor reactions can be followed by an anaphylactic reaction, all to food supposedly nut free as we don't eat 'may contain" products.

In general I believe that reactions to foods tend to vary with the amount eaten but this is not the case for everyone. Some children will also outgrow their problems and if not exposed to the problem food for a time their next reactions may be less severe. So I understand why gps get it wrong, but they do get it wrong!

Blood tests can be traumatic but at the least you need some better advice than your gp.

if you are near london, the current waiting times for refferal are about 8 to 10 weeks , which is much better than it used to be.
glad you have private avaliable.

piriton given for young children, works well for many reactions, and certainly the quicker it is given the better.

however, piriton for a severe reaction is not going to work.

a good book to buy is 'the complete guide to food allergy and food intolerance' by prof bronston, published by Gamlin.

the more you learn about IgE allergies the better able you are to ask the right questions and get the correct support.

We are just outside Guildford Boridewolf. The private insurance doesn't really sit well with me its something we both have through work that we have never actually used up until now! I grew up in ireland where you can be really let down by the public system but to be honest I have never felt that I have waited too long on the NHS. In fact I've just had an appointment for an mri on my shoulder come through in two weeks which is pretty damn good.

I think in this case I have lost confidence with weaning / introducing new foods and feel like I need advice (and even not necessarily tests if they don't think its the right thing right now) as soon as possible.

We had a similar appointment on the NHS for DD after she had a mild reaction to egg and with respect to Dp's allergicness and the peanut allergy potential. We waited about three months for it but it didn't matter as she was older, pretty much fully weaned and it was one / two foods and mild / only potential reaction.

I'd get the diagnosis on your private insurance (as you are doing) and so avoid the initial waiting and also to get a bit of time with a consultant and then once you have a diagnosis and the time pressure is off, get your GP to refer you within the NHS system. We did this, as the trouble with BUPA is that it covers you only for diagnosis, so you don't get the opportunity for the allergy to be monitored, or for re-testing. We're treated by pretty much the same team as we saw privately and the service on the NHS is much more integrated (e.g. we get to see the dietician at the same time as the allergy appointment)