Thursday, October 20, 2011

Seeking Medical Help or Advice

Seeking medical help when you think your child has food allergies or intolerances can become quite complicated, if you let it.  Diagnosing allergies becomes even more complicated when your child is still an infant.  It's important that you do your homework first and remember that the process may take months to resolve.

I can not stress enough how important it is to keep a food journal for you child for at least 3 days, before you bring your case to the doctor.  When I say food journal, I mean a journal that includes everything your child eats, the time they ate it at, and a record of any symptoms you may be concerned about, when they occur, and for how long.  The journal must also include all bowel movements, their consistency, and frequency.  Note when symptoms improve or worsen.  Study your journal and highlight any patterns you see.  If there are no patterns, still bring it to your doctor, he/she may find them.

When you feel confident that you have a case, make an appointment with your pediatrician, and discuss your concerns.  Always remember a parent knows their child best.

Your pediatrician may choose one of several directions to pursue, if he is concerned that your child has an allergy problem.  His choice may be greatly influenced by the child's age.  Infants and children under the age of two can be very difficult to diagnose.  Allergy testing can be false positive or false negative.

Remember a doctor diagnoses by symptom.  As they obtain information, they must be sure to eliminate every other option.  Sometimes they do this first, before even referring a child to an allergist.  Two out of three of my children, were referred to a gastroenterologist before seeing an allergist. Both were infants.  Both children ended up receiving upper endoscopies to rule out other digestive issues such as celiac disease etc...  One child was sent to another specialist to have a swallowing study done to ensure that his mouth was working correctly.  The first test all of them received was a barium study.  Each baby was fed a bottle of this thick white powdery liquid.  Then, x-rays of their stomachs were taken to determine if the liquid was moving through their digestive tracks correctly.  Acid reflux is diagnosed using this study.  During the barium study it was discovered that one of my children had a hiatal hernia.  The referral may not be to a gastroenterologist, but to another specialist depending on your child's symptoms.  There may be other tests involved.  Be patient with the process, as frustrating as it may be.  Eventually, there will be results!

When discussing food allergies in regards to my other child, my pediatrician immediately ordered blood testing for their allergies.  He explained it may not be accurate, but it would be a start.  That child was 2 years old.  The blood tests did show some allergies.  He was then referred to an allergist.

In other cases, the pediatrician may feel confident that he can handle it in house.  When one of my children, just two weeks old, was having significant problems with feedings, our doctor did a simple stool test in office. It was discovered there was blood in the urine and that he had a milk protein allergy.  His formula was changed and that was that.

Once your child has been referred to an allergist, be prepared for more testing.  If blood tests have already been done, you may avoid that, but most often, and in fact all cases with my children, more testing will be done.  Most likely it will be skin prick testing.  It's not fun, but doesn't hurt as much as one might think.  (I've gone through it myself.)  If skin prick testing isn't enough, some doctors move forward and try to test for intolerances, feeding the child an item that will prompt the reaction specified.

Receiving results is bittersweet.  You learn what's been causing so many problems with your child, but now there's a set of new problems.  What do I feed my child?  Worst case scenario, you receive no answers and move on to another specialist.  It took doctors 15 months to diagnose my son with all of his allergies.  Keep in mind that specialists always have waiting lists and it may take anywhere from one to six months to get an appointment.  As long as your child is thriving (gaining weight and growing) there will be no rush to have your child seen unless a reaction is quite severe, in that case, you go to the hospital immediately.

As an end to this article I must make note, if you child is experiencing SEVERE symptoms, as noted in the previous article, do not wait to seek medical assistance.  There are times when doctors in the hospital will diagnose an allergy due to it's severe symptoms, and then will refer you to an allergist.

Questions and Discussion

1.   What was your journey like as you went through the process of getting your children diagnosed and treated? Any stories of heroic pediatricians or specialists out there?

2.   This all sounds really intimidating and overwhelming, but it has helped us to know other people have gone through it.  This gave us confidence in ourselves. Any words of advice for anyone reading who might be just starting out?

2 comments:

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