<p>So kiddo is around this summer (has an internship and summer job that allow her to live at home…yay). She’s an allergy/asthma kid. I knew she had some lung issues over the school year – was diagnosed w/pleurisy twice, had 3 treated cases of bronchitis (lots of prednisone over the winter, poor thing), but it’s become quite obvious that her asthma control isn’t great these days. Her primary care doc has been the one taking care of her, and has had her on Asmanex, Zyrtec and Singulair, and she has been using her rescue inhaler a LOT. </p>
<p>Had eczema as a kid, that’s mostly cleared. Was allergic to milk as a baby, but outgrew that one. So her (and her dear mother’s) main concern is her breathing. She’s incredibly fit, but now can’t make it up 2 flights of stairs without losing her breath. </p>
<p>She has a referral to a great asthma/allergy doc this Friday, and their first step is full allergy testing (which she’s never done). She and I are thinking she’ll probably be a mass of welts, but not sure how that will impact best treatment for the asthma itself. </p>
<p>First, what can anybody tell me about allergy testing itself? Is it as miserable as we’ve heard in the past? (She’s already a cranky beast, as she’s not allowed to have any antihistamine for this next week…here in the allergy-ridden Midwest…). How long is a person uncomfortable after the testing? Looks like they may use her back as a site. She’s planning to drive about an hour afterward to another event – will she be safe/comfortable enough to drive alone? (I’m thinking wretched allergic reactions…). What else is up with a full asthma workup? </p>
<p>Sigh…it would be nice if she could breathe…</p>
<p>I’m not sure my D’s experience applies to your D. My D didn’t have the magnitude of symptoms your D has. But here is what’s been done:</p>
<p>For my D, the Allergy Specialist gave about 60 pin prick’s on her lower back, each one with a different possible allergen. Shotgun approach basically. DD had significant reactions to a half-dozen or so, and further pin prick tests were run. When the results of follow-up tests were in, the Allergy Specialist created a series of “potions” which were made up of the allergens that bothered DD most. The “potions” started out weak, and every six weeks were strengthened. The entire series takes a year or more.</p>
<p>After the allergy testing, the kiddo can have Benedryl and other meds to help reduce allergy symptoms. The testing itself does NOT make the patient drowsy. Taking meds to reduce itching MAY cause drowsiness. </p>
<p>One thing I didn’t notice is whether your kiddo is doing regular nasal wash with saline and also taking nasal steroids. Those can really help reduce allergy symptoms and have few side effects. One other thing–since she’s using her rescue inhaler so much, ask her doc about stepping up her meds, adding a maintenance med like Advair, Symbicort, or another. </p>
<p>If it were my kid, I’d also have her evaluated by a Pulmonologist. The number of lung problems she’s had seems VERY high for one year (and we are all asthmatics and allergic in our household of 4). Something more may be going on.</p>
<p>I was allergic to dairy as a baby. Imo you ** don’t** out grow food intolerance/ sensitivity, , although your symptoms may not be as overt as when it was first noticed.</p>
<p>Id go to a naturopath or an allergy doc who will do an elimination diet to determine what symptoms are linked to what substances.</p>
<p>Good point about the saline wash, HIMom. She’d used saline drops in the past, but don’t think she has in a while. Sadly, nasal steroids give her MASSIVE nosebleeds. But maybe the saline can get her through the next week. I do think her meds need changed. She had tried Advair a few years ago, but it gave her a horrid cough – she’s my complicated beastie.</p>
<p>NewHope33 – are the shots helping with asthma, or allergic symptoms?</p>
<p>emeraldkitty – do you still have issues if you come across dairy? Kiddo does not that we know of (unless it’s migrated to the asthma?). I was quite allergic to eggs, peaches and apricots as a child, and since my teen years have not had any problems that I can see – used to be guaranteed hives/eczema with exposure, now I tolerate them well. I’ve seen a lot of changes in my personal world with what I can now tolerate without issues, have seen my seasonal allergies ebb and flow. </p>
<p>I guess I find it interesting (and kind of get it) that allergy testing is the first step (obviously, allergy and asthma are kissing cousins) when she is hoping to find the right way to have control of her asthma symptoms.</p>
<p>My D had full allergy testing on her inner arms. The worst was the 15 minute wait for the welts to show up. Hint - take a coffee stirrer or pen cap because you can run it around the pin prick areas and that gives some relief to the patient. She was fine afterwards, they put some lotion on to help with the itching.</p>
<p>Perhaps another drug would help too, there are lots in the arsenal. My D had a bad reaction to Advair, so she is now on Flovent during allergy season. Her asthma was only viral induced and produced a nasty cough, but not real shortness of breath, so I am not as much help there. It doesn’t seem right that she can’t do steps. D’s allergist always asks about her fitness and if she can run etc easily.</p>
<p>IMO, the allergy docs are much better to manage this than the primary care. How have her pulmonary function tests been? That is usually the first indication something is not right.</p>
<p>I didn’t like Advair so I’m using Asmanex instead. My doc wants me to do 2 puffs once a day if my symptoms aren’t bad, but I should raise it to 2 times a day if I’m using my rescue inhaler regularly. They really don’t want you relying on a rescue inhaler!</p>
<p>I had shots, years ago, and it did take the edge off of my seasonal allergies. I’ve heard that the younger you start them, the more effective they will be. Good luck to your D. If she starts a series of shots, she can use lidocaine before and ice before and after to make them more bearable. For me, waiting around in the office for 20 minutes after the shot was what drove me crazy.</p>
<p>Based on my own D’s experience–which I acknowledge is hardly a fair assessment–I’ve become very skeptical of the allergy testing/allergy shot business (yes, business–it provides a nice stream of income to the allergists). D went through the testing process (I don’t recall it being particularly problematic, and she was a big complainer back then) and then a long course of allergy shots, which meant weekly visits tapering very slowly to biweekly, sending the serum to overnight camp with her, etc., all with the allergist’s expressed goal of avoiding the development of asthma. Well, she developed it anyway, still has nasal allergies to a bunch of stuff and pretty much sniffles her way through life, despite trying a variety of medications. Her asthma is petty well controlled with Advair (when she remembers to use it), but exercise can still bring on an attack and the need for her inhaler. She also had ezcema on her hands in the winter for years, but fortunately it has almost disappeared recently. I’ve reconciled myself to the idea that there are no miracles in this field, and so long as my D is not going to the emergency room unable to breathe, we should be content. </p>
<p>I wish more research was being done on why allergies and asthma are plaguing our kids. When I was in school, I knew exactly one girl with asthma (badly controlled in those days–she was a weak, sickly child) and never heard of allergies. (I still don’t know anyone my age with asthma.) Now these diagnoses are rampant among children.</p>
<p>In our household, we’ve had allergy skin testing multiple times on three of us. Only S and I were willing to do allergy shots. S would wheeze and react very badly from each allergy shot, no matter how diluted, so the allergist eventually decided to give up. I had allergy shots 2x/ week for over 18 months and was still having lots of allergy symptoms until I went to National Jewish and had them do carefully supervised allergy shots–20+ shots in a week, which got me up to maintenance dose. Thereafter, I only needed two shots once a month. I did that for 7 years and eventually stopped and now take one Zyrtec every day. The allergy shots helped, but the Zyrtec is fine and I couldn’t face having to build up to maintenance dose again when I got a new batch if serum. </p>
<p>In Europe, they give sublingual (under the tongue) concentrate of allergy serum. I wish it would come to the US with FDA approval. That seems a much better and easier approach. </p>
<p>The Pulmonologist can do a thorough eval and help tweak and optimize her treatment. There are lots of meds other than Advair, including Symbicort and many inhaled steroids. I take one called Qvar, and have been on it for 13 Yeats now. </p>
<p>Of the patient is under 18, you may need a pediatric Pulmo, which is rarer (our state has one or two).</p>
<p>When S had his allergy testing, in elementary school, they did the map on his back and all the pricks. He was allergic to many things, so many of the spots had reactions. Immediately after the test, they gave him Benadryl and we put Benadryl cream all over his back. They also recommended he wear 100% cotton the rest of the day. I don’t think this will help your D, but we distracted him with many, many packs of Pok</p>
<p>Sounds like one of my kids. Yes, the childhood skin testing was miserable and I basically gave kiddo benadryl for a day or two afterward so they would just sleep it off. Years later, when kiddo was a teen, the doctor did blood testing. They took some blood, sent it to the lab and we were told of the results-- nothing on the skin. I believe they were done this way to avoid a life-threatening reaction. I am lukewarm on how much good any of the allergist visits did: 1- kiddo’s allergies are so bad that kiddo is not a candidate for allergy treatment and 2- the docs tend to test for things that we already knew were serious allergens (like pollen) instead of testing for food allergies which were harder for us to figure out. </p>
<p>Have you tried a steam vaporizer? We found some relief with one into which I put Kaz or Vicks. </p>
<p>I would also recommend a pulmonologist. I don’t know if doctors ever send asthmatics to respiratory therapists out-patient but my kid really benefited from respiratory therapy whenever kid was hospitalized.</p>
<p>My 3 kids and my husband had the tests on their backs. All 5 of us have asthma. Only my husband ended up with a bunch of allergies. He has been getting allergy shots for several years now. Honestly I’m not sure if they help him or not.</p>
<p>Food allergies are very tough to test for. Blood testing for them isn’t reliable. Elimination diets are tedious and difficult. It is claimed that true food allergies are rare anyway. </p>
<p>Skin testing is most effective for pollens and other environmental triggers. At National Jewish, they told us skin testing was the gold standard for environmental allergens. Blood testing can be done for environmental allergens and have some reliability. </p>
<p>Some folks DO have allergic asthma while others don’t. Many do find they breathe better when allergies are optimally controlled.</p>
<p>My D was hospitalized with her asthma at least once a year and was in ER every single month until the age of 6. At age 6, they did allergy testing and started her on shots. She hasn’t been hospitalized for asthma since. She does use Symbicort and takes daily Zyrtec too to keep it all under control. She still uses the rescue inhaler occasionally, especially this time of year, but this was the time of year she used to have to be hospitalized. </p>
<p>It is possible that she has had all these lung issues over the past year due to allergies. My D’s doctor explained that her immune system was working so hard to deal with the allergens that she couldn’t fight off other things so she as sick a lot. The frequency of her other upper respiratory illnesses did decrease after the shots.</p>
<p>It’s possible that her dorm is more dusty or has mildew/mold that exacerbated her symptoms while away at school. Or, if she’s in a different part of the country, there may be different pollen than she was exposed to at home. </p>
<p>I do know they put Benadryl cream on her back after her allergy test. I believe they gave her some orally too. I get very drowsy on Benadryl and wouldn’t want to drive after taking it, personally. That could be a consideration about whether she should drive herself.</p>
<p>OP, I’m concerned that your daughter’s symptoms are so significant that walking up the stairs are a problem. It seems to me the priority is to get her medical condition stabilized and then do the allergy testing. </p>
<p>My daughter’s allergy/asthma picture is similar to your D’s during the winter. She did have allergy testing and it was pretty much clean. But, the testing was done in North Carolina and her problems are worse in New England where she goes to school. Her triggers are viruses. So, every time she gets a cold, she seems to need Prednisone. Of course, there are no vaccines for viruses. It is so frustrating for her. She and her friends will have the same cold and they all get over it while she is headed to the clinic several times.</p>
<p>My D1 had asthma that flared up terribly at school too. The culprit was unairconditioned, carpeted dorm rooms. It wasn’t terribly hot where she was, but they would have to sleep with the windows open and all that pollen would drift in and then she would need her rescue inhaler first thing in the morning. </p>
<p>She moved into an off campus apartment with hardwood floors and a window AC unit and the problem was solved.</p>
<p>Our kids too do better living where there is no carpet and no 2nd hand smoke drifting in to irritate their system. Newer places seem to be better for D in terms of reduced allergy symptoms.</p>
<p>I’ve had allergy testing (skin pricks on back or arms) 2 or 3 times in the past 35 years. As others have said, it is supposed to be most accurate for environmental sources of allergy. I’m highly allergic to pollen, dust and molds. I did allergy shots for 5 or 6 years once, which did help considerably. My latest allergy doc (we moved) tested me and told me he could start me on a program of allergy shots, but he thought that taking 1 zyrtec per day (generic available for $16 for a year’s supply at Costco) would be just as effective. That’s what I’ve done.</p>
<p>As for the test itself, the doctor’s office will want to make sure that your D does not go in to anaphylactic shock because of the allergy testing. So they will want her to stay in the office under observation for a while - perhaps 30 minutes or so - after the tests are all done and will most likely give her an antihistamine of some sort after the testing is done. I was always bugged at having to wait around after getting my allergy shots, but if they accidentally give you a higher dose of the allergen than intended, or you just have a bad reaction, they don’t want you to go into shock after leaving the office. As others have mentioned, I would be less worried about discomfort when driving than the possible effect of a potentially large dose of antihistamine - the newer non-drowsy antihistamines are much better in that regard, but they still can make some people sleepy and they usually recommend not driving after taking them until after you are used to their effect on you.</p>