To push for an EpiPen?

[Blueeberry]

Allergy mums assemble!

DD (19) started to react to peanuts a few years ago - never severely though, she would just get a bit itchy and things would settle on their own. Cross contamination wasn’t an issue either, she just couldn’t eat a physical peanut so it was never difficult to avoid the allergen. Over the past few months these reactions have really worsened - within minutes of eating anything even mildly cross contaminated her lips/tongue will swell + redden, itchy hives will come up and she’ll have almost immediate vomiting/diarrhoea. She has admitted to me that her throat has felt tight/hard to swallow on occasion. As she’s an adult now, at uni and busy solo travelling she tends to double dose on antihistamines and get on with things but the reactions/level of sensitivity are now worsening to the point that she’s becoming scared this will turn into full blown anaphylaxis. She can’t even be in the same room as peanuts being cooked/eaten without coming out in hives.

We’ve got a referral to a private allergist in a few weeks for testing. I’m sure she’ll be positive in terms of skin prick testing but I’m worried that they won’t feel that she warrants an EpiPen for it as she hasn’t yet had anaphylactic shock. Am I just being a stressy mum or would you push for one ‘just in case’?

Any experiences/advice very welcome

My DD was diagnosed with nut allergies as a baby and has so far never had an anaphylactic reaction but we were prescribed an epi pen. Initially we were told we wouldn’t get one but I asked the consultant and they prescribed it. It’s always worth asking.

The most important thing your daughter can do is act quickly if she thinks her throat or breathing is affected. Antihistamine won’t stop a severe reaction. We have always been told to call an ambulance if we are worried and the hospital will never begrudge an even suspected reaction.

I have a food allergy. Never had anaphylactic issues but it’s really unpleasant and quite scary. I was tested a few years ago by Guys who asked my gp to prescribe an EpiPen. I think your DD needs one especially, if she vomits. Taking an antihistamine is slow and ineffective if she vomits it back up before it’s absorbed.

I was prescribed them based on describing my symptoms and a skin prick test. I think from what you are describing she could already be experiencing anaphylaxis so I would get Epi Pens as soon as possible. You need to replace them every 13-18 months or so when they expire.
https://www.anaphylaxis.org.uk/about-anaphylaxis/anaphylaxis-signs-and-symptoms/

Dd was tested due to increasing reactions (not to food) results showed a clear strong reaction and she got was then prescribed an epi-pen despite never having had an anaphylactic shock. That said dd couldn’t avoid her allergen and your dd presumably can?

I wouldn’t worry too much since with the symptoms you describe, she’s going to react strongly enough to the prick test the immunology team will do, to merit EpiPens. In the meantime, she must be very careful about food. Eg many takeaways could be cooked using peanut oil.

Yes, you need to insist.

My own DD was diagnosed with a food allergy when she was 2. Given her age she had annual further tests because at that age allergies can get worse, or go away. But she was prescribed EpiPens at 2 on the strength of the prick test reaction. Now she’s 7 we were told at the last test that this isn’t going to go away, it’s a serious allergy for life and they’ll see her again in a few years when she’s old enough to learn to administer her own EpiPens.

We’ve never had to use the EpiPen.

Hi my DD has a peanut allergy and was given an epi pen as she also has mild asthma. Apparently it made her more likely to have a serious reaction. Does your DD have asthma? If so maybe worth trying to push for one in those grounds.

Yanbu. She needs an epi-pen as soon as possible.

I've never had to use my DC's epi-pen as we are incredibly careful. He won't do things like backpacking travel though, it would be too stressful.

OP, anaphylactic shock isn’t the same as anaphylaxis.

In the US skin and gastrointestinal symptoms together after food would be classed as anaphylaxis. In the UK not so, unless other symptoms too. Eg If she has any breathing difficulties with the above it’s anaphylaxis…does the lump in her throat cause this? My guess is you could be describing anaphylaxis already.

I’d definitely be looking for an epipen especially as she’s reacting to trace amounts. (Not a medic but DC has anaphylactic reactions to peanuts too).

ETA Asthma does make things worse

Yes, absolutely! No two reactions are the same and a severe reaction can happen at any time.

How is she managing to be exposed to her allergen so regularly? Reactions getting worse with each exposure is very common.

They can get worse, they don’t necessarily get worse. They vary for lots of reasons (amount of allergen, your health at the time etc) and can be unpredictable which is one of the reasons they’re dangerous.

It’s too slow anyway in the case of a serious reaction.

I'm not really sure why you're waiting for a specialist. Maybe it's different in the UK. I'm in Ireland and a GP wouldn't hesitate to prescribe an EpiPen in these circumstances.

Also, she really needs to avoid anything that could be cross-contaminated OP. She needs to be careful around what she eats now and not rely on antihistamines.

Stay away from foods when she’s not sure of ingredients. Plainer food is often safer than things like curries (unless you have an ingredient list).

Many of those allergic to peanut are also allergic to lupin so avoid that too until she’s tested maybe.

Yes push for one - we actually ended up getting them prescribed because the nursery (which we didnt end up sending her to) wouldnt let dd attend without one despite her allergy being egg based....

You can have anaphylactic reactions to egg though I’m not sure what symptoms your DD had.

Why is she going to a private allergist instead of a few weeks rather than her GP right now?

I wouldn’t imagine you’d need to push for one. My DC had one long before he’d ever had symptoms as severe as your daughter.

You’d have more chance of winning the lottery than getting through to our GP surgery. She had an urgent referral to an allergist via an online GP on our health insurance. I don’t know about you but we certainly wouldn’t get an NHS allergist appointment within 2 weeks in our part of the UK!

She had spoken to our NHS GP after her first more severe reaction & they were spectacularly useless - there’s just no point

Sad. But true.

Swollen tongue and difficulty swallowing are signs of anaphylaxis so she does need an EpiPen. (I work in this area and we would prescribe EpiPens with those symptoms).