What to Expect in a Pedia-allergologist visit?

[trustingsoul]

^very helpful ang inputs mo sis leletmd

@sis Prety_ava : wow, skin prick test for 1500 only? buti pa kayo, mine was 7000. hindi pa gano ka visible yung result since may kaliitan yung mga naging pantal..but turned out dami nagko-cause ng allergy..kaya eto, todo iwas ako sa identified allergens..

[DV]

^^Thanks, sis leletmd!  Visit na rin kami sa pedia-allergologist.  For a time I put my baby on an HA diet nga, kaya lang mahina na ngang kumain limited pa yung kakainin.

[ms_guimba]

@ sis leletmd, okay lang. Habaan mo pa. Lol! I'm so learning a lot from you. May vaccine na pala ang allergic rhinitis pero todo injections naman pala. How much ang isang shot? I wonder. Yung eldest ko grabe ang allergic rhinitis. May episodes na 30+ times siya nag-snisneeze. Pero natatanggal naman agad ng antihistamines.

[leletmd]

^ Ha, ha.  I'm glad to be of help.
Allergy vaccines have been around for a long time (almost a century na in the U.S.) but here in the Philippines, it was first introduced when we first had Allergists in the 1970s and the Allergy society was established by Dra. Cua - Lim and Dr. Agbayani.
The cost would depend on how many allergens need to be given, which would depend on the results of the skin prick testing and correlation with history. Some allergens can be mixed in 1 injection like in the case of pollens while some can't be mixed. A patient can have as many as 3 to 4 injections/session or just 1 injection. It will really depend on what are the important allergens and exposure history of the patient kasi kahit naman halos 15 allergens ang mag positive sa skin test, not all of it need to be given as allergy vaccines kung hindi naman regularly exposed ang patient doon sa other allergens. I think your eldest needs an allergy consult also.
Re: your baby's allergic reaction to Prevenar, sa 1st dose ba ito nangyari? The reason I'm asking is kasi if it's Ige Mediated allergy or the true allergic reaction, the reactions don't appear at the 1st dose kasi hindi pa kilala ng body yung vaccine and wala pa syang antibodies against it. Usually sa 2nd or even sa 3rd dose nakikita ang reactions kasi the immune system has already secreted IgE antibodies against the vaccine. My thoughts lang on your baby's history...

[ms_guimba]

^sis, 1st dose pa lang siya nag-allergy although hindi rin kami sure kung dahil sa Prevenar or some other allergen. Kaya natakot din ang pedia ko. Hindi na niya binigyan ng 2nd dose. Mahal din ang Prevenar vaccine. Lol! So parang nasayang yung 1st dose niya. That's why ayaw na rin siyang bigyan ng measles vaccine kasi mas marami rin daw allergic reactions dito sa vaccine na ito according to her.

Matagal na pala ang allergy vaccines. Honestly, I didn't know about it until you mentioned it. I also have a history of allergic rhinitis. Both sides ng family so my kids are not spared.

[leletmd]

ms_guimba: ok, I guess she really needs to see an allergist to check if possible prevenar allergy talaga or due to something else. Re: measles vaccine, there are skin testing and test dosing protocols available for it so it can be done by your allergist prior to giving of the measles vaccine (if skin testing is negative).
With regards to the allergy vaccines naman, sadly, not all doctors are aware of it. Most of the time, patients would only find out about it once they consult with an allergist.

[sweety_paige]

^Thank Sis, learning a lot from you. 

[sweety_paige]

Sis leletmd, hindi ko pa kasi sure kung allergic rhinitis eh, kasi as of now, umiinom siya ng kidz kit 2, pero nung nakita ng ibang doctor yung sa allergy na may brown cirle under the eye sabi niya possible na allergic rhinitis kaya pinapa skin test niya.  Is it really a symptom?  natakot lang ako kasi sinabi niya na it can lead to asthma at madami pa.  Will pm you Sis, okay lang ba?

[leletmd]

sweety_paige: sure, you may pm me.
The brown circles under the eyes maybe allergic shiners kasi. Skin testing is a good way of differentiating allergic rhinitis from other causes of rhinitis like infectious, vasomotor, etc. Also, on and off colds is really not a symptom of PC kaya baka may rhinitis talaga siya...
You can go to this link to learn more about allergic rhinitis:

http://www.psaai.org/page/allergic-rhinitis

[ms_guimba]

^Galing talaga ng thread na ito. Thank you sis! Ngayon ko lang nalaman yung "allergic salute." Ganyang-ganyan ginagawa ng anak ko. Wala ngang sinasabi ang mga pedia about the immunotherapy for allergies. Perhaps your association should do some kind of media campaign. Kahit posters lang. Kasi kapag pedia visits, marami akong nakikitang mga info materials na nakadisplay sa waiting room...Just a thought.

[leletmd]

^ Actually, we do have flyers on asthma, allergic rhinitis, food allergies, etc. It is available in our society office and also in our clinics. About 3 years ago, we also launched the Allergy Club for patients (you can ask your allergist about it when you get to have your daughter checked up). It is a support group for patients and their families. They have lectures, parties and we also have an annual National Allergy Day every July where we hold a day long lecture on allergies and there's a get together for the different chapters of the allergy club. 

[younis]

Help mga mommies,

may dilemma ako... matagal ko na gusto dalhin ang 8month-old daughter ko sa pedia-derma or pedia-allergologist. hindi ko sya dinadala pa kasi sabi ng pedia nya, usually daw ang mga binibigay na ointments have steroids. pinagagamit lang sya ng unscented soap like Oilatum, then ang pinapahid lang namin is Vandol. pero kasi matagal na hindi nawala yung rashes sa legs nya, lalo na nag-a-activate pag nakakamot nya. this time, decided na akong dalhin sya talaga sa pedia-derma or allergologist. alarmed mother na ako eh, kasi as far as i remember, siguro 3months old palang sya meron na sya neto, eh ano na ngayon 8-months na sya meron pa rin hindi naaalis. umiimpis minsan pero hindi nawawala totally.

somebody from the other thread recommended Dr. Michelle de Vera, Medical City.  (Pedia-allergologist), ano views on her?

or may iba pa kayong recommendations po? gusto ko sana yung gradual lang ang treatment sa baby, kung magti-treat naturally muna sana mas maganda.

[marose17]

^ Sis, I find Dr. De Vera very intelligent and articulate.  In the case of my sons, she thoroughly explained her diagnosis (asthma) in relation to their symptoms and the course of treatment she would prescribe and the effects of the meds.  She even taught my yaya how to use the nebulizer properly and efficiently, how to clean my kids' room to effectively remove dust mites and what to do in case they have difficulty breathing.

My friend's son also goes to Dr. De Vera for management of rhinitis.  She is also satisfied with the doctor.

[DV]

Sis leletmd, yung pedia allergologists ba, pwede rin sa adults?  I mean, my husband kasi has allergic rhinitis (at sa kanya rin namana ng baby namin yung atopic dermatitis), sabi ko baka pwedeng isang doktor na lang tumingin sa kanilang dalawa para mas ma-relate ng doctor yung allergy histories?  Good news din sa kanya na may vaccines available na pala. 

Sorry, can't view the site that you mentioned dahil iba ang browser ko.  Who's a recommended pedia allergologist at St Luke's kaya?

Thanks a lot, leletmd!  Helpful posts!

[younis]

^^ay grabe, d daw tumatanggap ng healthcard si Dr. De Vera pag saturday 

[ms_guimba]

sis leletmd, that's good to know that may comm materials pala ang society niyo. Siguro I'm just in an area na walang mga ganyan pa. Lol!

May allergic ba sa temperature changes? I was wondering. Kunwari, allergic sa lamig or sa init. I have a cousin that develops rashes pag masyadong mainit. I think my daughter develops the rashes after she takes a bath or after I take her to an air conditioned room. I'll try Oilatum to see if it's the soap. Dove Unscented gamit ng baby ko.

[leletmd]

Sis DV: yes, allergists are trained to see both child and adult patients, regardless of whether IM or pedia ang specialty to begin with. 
There are lots of allergists na in St. Luke's. To name a few, there's Dr. Felicidad Cua - Lim (she's one of the founders of the society), Dr. Sandy Ortigas (he also handles reproductive immuno patients), Dr. Agnes Andaya (also in UST), and Dr. Eden Macalalag. Oh, also Dr. Lara Aleta, but she handles more repro immuno patients.
You can try Dr. Eden Macalalag. She holds clinic Mon to Fri at 1 to 3 pm at rm 1104 South Tower of the Cathedral bldg. Her Saturday clinic is by appointment.

Ms_guimba: yes, you can develop reactions to extreme weather conditions, even to stressful situations which causes a person to sweat. That is called cholinergic urticaria. With atopic dermatitis, sweat is a also an irritant kaya bawal mapawisan ang patients na may AD. Their skin will be very itchy pag pawis.

[ms_guimba]

^sis, I understand now. Kung sa lamig meron din po ba?

[leletmd]

ms_guimba: yup, in cholinergic urticaria, you can develop rashes in extremes of weather, either very hot or very cold. Sa AD, ganoon din. Cold temp can make the skin dry, which makes the skin itchy. Pag nagscratch ang bata or na-rub lang ng konti ang skin, ayun na, rashes will develop.
There's also such a thing as cold urticaria, pero ito, even cold drinks is a no-no. The throat and airways can swell kasi as a reaction to the cold temp of the drinks.
By the way, if your child has AD, the key to treatment is moisturizing the skin often with a fragrance free moisturizer. So that means a 2 to 4x a day application of the lotion or the moisturizer. Also, no scrubbing the skin, especially during bath time.
Hope this helps...

[sweety_paige]

Example pag allergy ba ang isang kid, hanggang pagtanda dala niya na nun o nawawala din?