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Author Topic: What to Expect in a Pedia-allergologist visit?  (Read 169456 times)

ms_guimba

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What to Expect in a Pedia-allergologist visit?
« on: November 01, 2009, 06:34:38 pm »
Hello, mga sis! My pedia recommended that I consult a pedia-allergologist for my 1 year old. Her skin is very sensitive and we can't pinpoint the exact causes of her allergies. Could you share with me your experiences when you've consulted a pedia-allergologist? Here are some of my questions:

1) Do we need to prepare anything before we consult her/him? We're from the province so I want to go prepared. I don't want unnecessary trips. Kawawa din ang baby while traveling.

2) Skin prick test din ba for babies?

3) What's the price range for the tests or PF's?

I'd appreciate any advice or input. Thanks!


sweety_paige

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #1 on: November 01, 2009, 11:35:42 pm »
Yung doctor ng two year old ko binigyan siya ng gamot and pinalitan yung sabon, then 2nd na balik, gamot plus lotion then sabi na i-try yung allergy test, may kamahalan kasi sa kanya yung allergy test eh, ito yung test na may pinapatak patak sa likod ata ng bata.  Mura daw yung test sa may UP, hindi ko lang masyadong natandaan, kasi gumaling na siya sa gamot at lotion eh.

mdy

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #2 on: November 01, 2009, 11:49:49 pm »
^^Nun 1st visit namen ng son ko (Feb 2007) kay Dra. Cuajunco usual checkup lang naman. Dala ko baby book lang nya. Tapos 2nd visit yun allergy skin test. Pa-prick yun sa likod tapos may ipapatak. Mejo matagal lang yun procedure. Re: price, 5500 yun binayad ko plus pf of 600. Pero nun 1st visit 800 yung consultation fee.

sweety_paige

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #3 on: November 02, 2009, 12:04:37 am »
^Sis, yung 5500 ba complete na set yun? 

ms_guimba

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #4 on: November 02, 2009, 12:06:35 am »
Thank you so much for your answers. I was wondering, does the skin test hurt? Parang naaawa kasi ako sa baby ko kapag ipiprick....

sweety_paige

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #5 on: November 02, 2009, 12:07:30 am »
Sabi ni doktora hindi daw masakit yun.

mdy

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #6 on: November 02, 2009, 08:24:13 pm »
^^yup. 36 aeroallergens and 54 food allergens yun tinest sa anak ko.

@ms_guimba: sabi hindi daw pero feeling ko meron pa din konting pain tapos nakakangalay yun position kaya hindi maiiwasan hindi umiyak ang bata.

leletmd

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #7 on: November 02, 2009, 09:00:32 pm »
ms_guimba : let me try to answer your questions:
1)   Do we need to prepare anything before we consult her/him? We're from the province so I want to go prepared. I don't want unnecessary trips. Kawawa din ang baby while traveling.

A: Prepare copies of your baby’s medical record. If she has a baby book, bring it with you. Take note of when the rashes started, what areas were affected and all medications given (oral and topical, ex. creams and lotions) given by your pedia, how long it was given and if it helped clear away the rashes or had no effect. If you had pictures of the rashes, that would also be helpful to bring. Make a list of all the food your baby has been given, including milk. Was she breastfed? For how long was she breastfed? List down all suspected non-food triggers. Take note of your family history, particularly allergies, asthma and allergic rhinitis. Take note of your environment in the province. Is it dusty? Do you have pets/plants/grasses/empty lots?
Also, bring the referral letter from your pedia. It should show the pedia’s diagnosis for your baby’s skin sensitivities and the current medications she is taking/using.
Usually, the first visit consists of a lot of history taking, physical examination and evaluation. The procedures like skin prick testing usually come on the 2nd or 3rd visit. This will also give some time for rapport/trust building between your child and the doctor. Kasi, if your child will be undergoing a procedure on the first visit pa lang, then baka ma-trauma lang siya.
Expect that you will be asked to follow up.

2) Skin prick test din ba for babies?
Yes, the youngest age at which a skin test can be done is 3 months of age. This is based on a local study done in PGH. As to if your baby can undergo skin test on the 1st visit to the allergologist will depend on the following factors:
a.   Is she taking anti-histamines?
Patients have to be off anti-histamines for at least 1 week before a skin prick test can be done. Why? If she is on anti-histamines, the test will just be negative so you’ll just be wasting time and money.
b.   How is her skin condition, particularly the back area where the test will be done?
If her back has a lot of rashes, then it might be better to wait for such a time when the back is free from rashes. For adults, the skin prick test can be done on the forearms. This can be an alternative site for your child, too, in case the back is really full of rashes.

The allergen panel that will be tested for your baby may be different from the allergen panel that will be tested for an adult. It will depend on the exposures of your child.
The skin prick test, per se, is not painful. It can be very itchy, though. Normally, the placing of allergens will be finished in 10 to 15 minutes, with the results read after another 15 minutes, but with children, the test takes longer because there is the fear factor and the ngalay factor that we have to take into consideration. This is why it may be better to postpone the test till the next 2 or 3 visits para at least at ease na ang child sa doctor vs yung 1st visit pa lang, prick test na kaagad.

3) What's the price range for the tests or PF's?
PFs range from 400 to 1000, depending on where.
Skin prick tests may range from 3000 to 15,000 depending on where and how many allergens are tested.

From what province are you? Here is the website of the Philippine Society of Allergy, Asthma and Immunology. There is a listing of members (9 pages in all) and clinics (baka lang hindi na updated ang sked). You may be able to find an allergologist nearer your province than Manila.

www.psaai.org/members

Hope this helps. Good luck!  :)



ms_guimba

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #8 on: November 03, 2009, 09:10:03 am »
^Wow, sis! Thank you so much for this info. I feel so much better. Kasi the fear stems from the fact that I have no idea what this is all about.

I'll follow what you have told me. And thank you so much for the link. I'm from Nueva Ecija.

leletmd

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #9 on: November 03, 2009, 10:55:00 pm »
^ You're welcome, sis. :)
Since you're in Nueva Ecija, the nearest to you would be Dr. Donna Duque in Dagupan. There are also 2 allergologists in Pampanga (Dr. Gina Ponio and Dr. Beatrice Vicente), but none in Tarlac. All 3 allergologists are UP PGH trained. 

helloSK

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #10 on: November 03, 2009, 11:15:43 pm »
hi ms guimba, share ko lang.. yung daughter ko super sensitive din skin niya. nagkaroon ng eczema yung face niya, surroundings ng eyes, nose and mouth niya.. yung eyes niya hindi na maidilat talaga.. at halos parang kulay dilaw na yung face niya sa dami ng eczema..naka 3 pedia din ako but gumaling lang siya dun sa 3rd, ang binigay lang medication sa kanya was before maligo linisin ng NSS Irrigation Solution and pahiran ng thin amount ng Elica ointment.I swear, in 2days time nagkaron ng big improvement ang face niya and after a week, makinis na siya. un nga lang binigyan din siya antibiotic and may maintenance siya ng Zaditen.

Mas sobrang sensitive pa ba dyan ang baby mo? 

ms_guimba

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #11 on: November 03, 2009, 11:34:46 pm »
^Oh, so sorry to hear about your baby, sis. I'm glad she's all better.

Ang baby ko naman, makagat lang ng insect, sobrang laki ng pantal. Tapos, rashes din sa likod at sa legs na hindi ko alam ang cause. Ang pinakanakakatakot was when she was vaccinated ng Prevenar, 1st shot. Nagkarashes din siya at sobrang irritable. So hindi na siya binigyan ng second dose kasi natakot pedia ko. Wala pa daw case ng Prevenar allergic reaction ever. So ngayon, measles vaccine niya, ayaw nang bigyan ng pedia ko kasi natatakot siyang magkaroon ng allergic reaction. So she asked me to consult a pedia-allergologist first before she gives the vaccine.

^^sis leletmd, thank you for letting me know about the pedia-allergologists near my area. Siguro yung Pampanga-based na lang ang pupuntahan ko, mas malapit kesa sa Dagupan. Although 2 hours lang naman ang Manila because of SCTEX. I'm trying to document my baby's allergic reactions. Ayokong walang masabi kapag ask ng dr. Hehe.

mai_mia

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Re: What to Expect in a Pedia-allergologist visit?
« Reply #12 on: November 04, 2009, 04:36:42 pm »
sa allergy test ba makikita din ang cause ng allergic rhinitis? my 10 month old daughter kasi has this eh.

leletmd

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #13 on: November 04, 2009, 05:16:38 pm »
Mai_mia:
Allergy skin prick tests may be done for the following diseases: asthma, allergic rhinitis, atopic dermatitis/skin asthma/ezcema, food allergies.
The panel will consist of different inhalant (pollens, house dustmite, etc.) and food allergens. The panel for infants may be different from adults because of the limited exposure of infants.
It is a useful way of finding out what your allergic triggers are.

sweety_paige

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #14 on: November 04, 2009, 08:57:35 pm »
^Sis leletmd, possible kaya na i-request sa doctor na pili lang yung inhalant na ilalagay since yung mga kids hindi naman ganon pa ka -expose, pareho lang kaya ng rate?

leletmd

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #15 on: November 05, 2009, 01:00:47 am »
^ Sis, how old is your child? Kasi, it will depend on the age of the child and the allergologist doing the skin prick test.
There are some allergologists who believe that a full panel should be done at all times while there are those who will do a selected pediatric panel for kids below the age of 2 y.o.
The selected inhalant pediatric panel usually consists of indoor allergens and selected pollens because scientific studies show that indoor allergens are the main causes of inhalant allergies in children less than 2y.o. due to lesser outside exposure. Cost for the selected panel will be slightly cheaper.

Pretty_ava

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #16 on: November 05, 2009, 01:31:22 am »
share ko lang sisses:

my sis and i went to a pedia allergologists last week at Holy Infant hospital in Dapitan, near UST.

Dra. Remedios Ong ang pedia/allergologist..my sis is 18 yrs old and nag skin test sa kanya is only 1500 plus consultation fee na 500.

madaming syang patients na kids.  she is so accomodating and may pagka old fashioned si dra.

di daw masakit ang skin test sabi ni sis, pero syempre dalaga na kasi sya.  they found out na sa ipis sya allergies and dust ang nagti trigger ng allergies nya. matagal ang procedure inabot kami ng 1 hour yata, di pa kasama yung pag hintay namin...ika numbe 9 kasi kami nung time na yun.


DV

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Re: What to Expect in a Pedia-allergologist visit?
« Reply #17 on: November 05, 2009, 10:23:19 pm »
Paano nalalaman kung may peanut allergy?  Kailangan bang magpa-check sa pedia-allergologist p pwede nang i-consult sa regular pedia?

My baby has atopic dermatitis at bawal ang nuts among many other food, although ngayon I give her some food na highly allergenic (like chicken and tomato) para ma-challenge ang immune system nya at para rin hindi magkulang sa nutrition.

Now I'm thinking of giving her peanut butter na but before I do I'm wondering if she doesn't have peanut allergy.  Fatal kasi yun di ba, hindi lang basta nagkaka-rash?
« Last Edit: November 05, 2009, 10:32:07 pm by DV »

sweety_paige

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #18 on: November 05, 2009, 10:27:46 pm »
^ Sis, how old is your child? Kasi, it will depend on the age of the child and the allergologist doing the skin prick test.
There are some allergologists who believe that a full panel should be done at all times while there are those who will do a selected pediatric panel for kids below the age of 2 y.o.
The selected inhalant pediatric panel usually consists of indoor allergens and selected pollens because scientific studies show that indoor allergens are the main causes of inhalant allergies in children less than 2y.o. due to lesser outside exposure. Cost for the selected panel will be slightly cheaper.


Thanks Sis, 3 year old na siya eh, gusto ata ni doktora full panel, find it super expensive kasi eh... Example lang ha, pag allergy sa dust, meron pa bang solution dito?  Siyempre all around us yung dust di ba?  pag hindi nagamot, anong possible mangyari?  Kasi hindi pa talaga sure kung may rhinitis, sana tama term ko. Atchaka ito lang ba yung possible na solution para malaman [textspeak!] kay rhinitis?  Thanks

leletmd

  • Guest
Re: What to Expect in a Pedia-allergologist visit?
« Reply #19 on: November 05, 2009, 11:49:24 pm »
DV: Sis, peanut allergy can only be diagnosed through skin prick testing to food allergens. Only Allergists are trained/has the expertise/licensed to do skin prick testing. It can not be done by a regular pedia.
Not all peanut allergy is fatal, but it is life long. Once diagnosed to have peanut allergy, you have no choice but to avoid it. In the US, though, they have started giving allergy vaccines to patients with peanut allergy.

Sweety_paige: At 3 y.o., I would also recommend a full panel testing to inhalant allergens (madami na kasing exposures ang 3 y.o), but not to food allergens if Allergic rhinitis is the only problem and your baby has no previous history of possible food allergy.
With regards to the value of skin testing: First, you are able to find out what your allergens are so it is easier to avoid than to do avoidance of everything allergenic. For example, kawawa ang mga batang with atopic dermatitis na nilalagay sa hypoallergenic diet (in reality, wala naman talagang hypoallergenic diet.). But once the child with AD has undergone skin testing to food, it is easier to avoid/exclude the positive food allergens so the child doesn't get deprived of the other types of food.
Second, your other query regarding dust allergy. In reality, dust is not an allergen. It is an irritant. It is the dust mite that lives in the dust inside the house that causes the allergy. Dust mites are the real allergens.
In case, exposure can not be avoided, for patients 6 y.o and above, allergy vaccines to dust and other inhalant allergens may be given. Allergy vaccines are given for cases of allergic rhinitis and asthma. It is available here in the Philippines. Again, only allergists are licensed/trained/has the expertise to give allergy vaccines. It is a long process of desensitization (weekly upbuilding injections for 6 to 8 months then monthly for 3 to 5 years) but it is the closest thing we have to a cure right now for allergic rhinitis and asthma.
Because, if it is indeed allergic rhinitis and/or asthma, it is life long.
Sorry napahaba na ang post ko, he, he  :)

 

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