What to Expect in a Pedia-allergologist visit?

[gulaysk]

I find it quite hard to find Aveeno baby lotion in supermarkets. I used to buy from Rustan's supermarket but then hindi rin palagi available. Saan ba ito readily available mga sis?

My 4 yr old has AD and lumalala for the past 2 months. Dra Hiyasmin Lim prescribed Lacticare for his rashes and then Asmalin for his coughs.

I've recently tried organic/all-natural lotions like Oasis baby buttercream but doesn't seem to help relieve the itchiness of my son's rashes. O baka medyo malala na rin kasi ang rashes niya noon. I want to try Aveeno baby again though. Saan pa siya usually available? We're from QC.

Thanks.

[darna88]

mga sis maintenance din ba yung allerkid sa allergic rhinitis

[leletmd]

^ Anti - histamines, such as Allerkid, may be used in the conservative preventive management of allergic rhinitis.

[jojielyn]

We've been to 3 dermatology 2 allergo. but i was amaze kung paano mag handle ng patient si dra. ong of infant jesus. magaling siya. di lang basta basta titignan yung mga lumalabas na allergy. hahanapin niya talga kung anung cause tsaka na lang daw allergy test. turned out may sinusitis baby ko yun daw yung nag cacause ng mga pantal pantal niya. she even cleaned my daughters nose pati ears. kaya lang sobrang haba ng pila and antagal niya sa isang patient kaya medyo matagal.

[j3rz3y]

i brought my son to dr. canlas of makati med, due to cough na di nawawala and he was diagnosed na may asthma. he is now taking up several meds, may follow up check up son ko sa sat. and dr. canlas is suggesting na mag immunotherapy son ko (for dust mites). just wanna ask how effective allergy shot is, and how many times ba ina-administer yung shot?

[leletmd]

j3rz3y: How old is your son? Has he had skin testing na?
Allergy shots are usually given to kids 6 years old and above. The kinds of allergy shots (ex. dustmites, pollens, etc) are determined by results of skin testing correlated with history. For example, if a patient tests positive to 10 different pollens, house dust mites and cockroach but lives in the city and doesn't have frequent exposure to pollens, then the allergist may suggest just giving allergy shots to House dust mite and cockroach and not to pollens.
There are 2 phases: upbuilding and maintenance phase. The traditional upbuilding phase consists of weekly shots for 6 to 8 months, wherein the dose of the shots are increased each visit. The maintenance phase starts once the highest optimum dose is reached and consists of 3 to 4 week intervals of shots for 3 to 5 years.
There are cases wherein the shots can't be given, like if your son has an acute asthma attack or an infection or he had severe reactions to the previous shots. There are corresponding dose adjustments for these situations. The patient is also required to stay for a minimum of 30 minutes (sometimes longer when there are reactions) in the clinic prior to being sent home. This is to see if the patient will develop reactions to the allergy shots he was given.
Are reactions common? Local reactions (pantal like rash on the allergy shot area) are more common than systemic reactions (asthma attacks, anaphylaxis, etc) and they usually manifest during the 1st 30 minutes, which is the reason behind the 30 minute waiting period after each allergy shot session.
Are the shots effective? What allergy shots do is to introduce the allergen to the body in small increasing doses until such a time when the body will no longer produce a reaction against it. In most cases, it is about 80 to 90% effective and you usually see the results within the 1st year of the maintenance phase. Your son may still have asthma attacks, but they are milder and he may no longer need maintenance meds.
Who are the candidates for allergy shots:
a. those whose symptoms are affecting their quality of life (school absences)
b. those who cannot get away from their allergens, especially in the case of those allergic to house dust mites
c. those who develop side effects to maintenance meds
d. those who develop complications (sinusitis, otitis media)
e. those patients with allergic rhinitis who develop asthma

Hope this info helps!

[DV]

^Weekly shots for 6-8 months?  Oh my.  Kawawa pala ang bata dito.

[j3rz3y]

my son is 5 yrs old... grabe 6-8 weeks pala yung shots. wala asthma attack son ko yung ubo at sipon lang pabalik-balik sometimes causing him fever and recently nga may brochitis daw sya, so pwede kaya na hindi ko sya ipa-allergy shots at mag maintenance na lang sya? by the way shots for dust mite yung nirecommend ni doc.

thanks leletmd... your info helps a lot 

[leletmd]

^ Hi, sis! It's weekly for 6 to 8 months, not weeks po...
Sometimes, the upbuilding phase can even take longer than that, depending on how sensitive the patient is.
After the upbuilding phase, monthly sya for 3 to 5years.
You have to complete the 3 to 5 years to be able to have a lasting effect of the shots.
May I know if the recommendation for allergy shots for dust mite is based on your son's skin testing result already?
Also, it is really the parents' or the patient's (in case of adults) choice if they want the allergy shots given or not. Commitment kasi sya. Before you consent to it, dapat sure ka na itutuloy mo.
kasi if you are absent sa visits palagi, mababawasan ng mababawasan ang dosage ng shots at hahaba ng hahaba pa ito. So sayang lang siya...

[j3rz3y]

yes nag skin allergy test na sya, sorry di pala weeks months pala sorry for that, but anyway we have to go back tomorrow for follow up check-up. my konting phlegm pa din son ko until now. nag antibiotic na sya for 3 days (1x a day), seretide, not sure name nung pink and yellow tablet, anti histamine, montelukast and avamys. medyo naawa lang ako kasi dami meds and yet may konting ubo pa din sya after taking those meds for 1 week. kailangan na kaya ng pedia-pulmo? sorry dami tanong just dont know what to do na kasi 

[leletmd]

yes nag skin allergy test na sya, sorry di pala weeks months pala sorry for that, but anyway we have to go back tomorrow for follow up check-up. my konting phlegm pa din son ko until now. nag antibiotic na sya for 3 days (1x a day), seretide, not sure name nung pink and yellow tablet, anti histamine, montelukast and avamys. medyo naawa lang ako kasi dami meds and yet may konting ubo pa din sya after taking those meds for 1 week. kailangan na kaya ng pedia-pulmo? sorry dami tanong just dont know what to do na kasi 

Don't worry, sis. Sometimes, it takes about 2 to 4 weeks for the maintenance meds to have full effect so expected talaga that he'll still be having a bit of phlegm.  I think Dr. Canlas is already managing your son's symptoms very well. Konting tiyaga lang siguro...

[Pretty_ava]

We've been to 3 dermatology 2 allergo. but i was amaze kung paano mag handle ng patient si dra. ong of infant jesus. magaling siya. di lang basta basta titignan yung mga lumalabas na allergy. hahanapin niya talga kung anung cause tsaka na lang daw allergy test. turned out may sinusitis baby ko yun daw yung nag cacause ng mga pantal pantal niya. she even cleaned my daughters nose pati ears. kaya lang sobrang haba ng pila and antagal niya sa isang patient kaya medyo matagal.

sis, yan din dra ng sis ko, we went sa clinic nya and tama ka super haba ng pila ang matagal sya and the skin test is pretty cheap right?    lininis din nya ears and nose ng sis ko, she's 18  yrs old nung nag pa consult kami sa kanya kaya lang medyo strict sya right?  kasi kasama namin ang baby ko nun she was super spoiled and dra ong told me that mali daw pagpapalaki ko kay ava, she even gave me a lesson on how to handle the tantrums ni ava ad i took it as previleged rather than insulto sa akin...

[jojielyn]

yes sis ganun mga doctor sa infant di sila yung mga pedia na will please the patient. pagagalitan ka pa nila. for me ok lang yun kaze magaling talga mga doctor doon lalo na sa bata.

may daughter still have allergies pero sure na sinusitis ang nag titriger ng allergies niya kaze everytime na may sipon siya may mga pula pula sa balat niya. dra ong taught me how to sunction the nose.

[j3rz3y]

leletmd yes you are right! we went back to dr. canlas and thank god may improvement naman daw son ko so binawasan/inalis na yung ibang meds. balik kami ulit after 2 weeks, hopefully madala sa maintenance meds yung allergy nya para no need for allergy shot, he also told me na usually na-outgrow ng kids 8-10yrs old ang allergy, so sana nga my son would be one of the lucky ones.

[leletmd]

leletmd yes you are right! we went back to dr. canlas and thank god may improvement naman daw son ko so binawasan/inalis na yung ibang meds. balik kami ulit after 2 weeks, hopefully madala sa maintenance meds yung allergy nya para no need for allergy shot, he also told me na usually na-outgrow ng kids 8-10yrs old ang allergy, so sana nga my son would be one of the lucky ones.

I highly respect Dr. Canlas but I would have to disagree with the last statement that allergies can be outgrown. Although it is true that certain food allergies can be outgrown (ex of which is cow's milk allergy), allergic asthma and allergic rhinitis, however, are life long diseases. Sure, there may be times (months and years) without any symptoms because you are not exposed to your triggers, but it will still recur in a later age once you get exposed again.
The belief that asthma can be outgrown at the age of 7years old and onwards is a misconception brought about by the wrong diagnosis of asthma in patients with chronic respiratory infections which sound like asthma (most common example: RSV bronchiolitis). Those that are outgrown are actually not really asthma in the first place.
Yung iba naman, akala nawala na ang asthma, e pala may allergic rhinitis na (allergic march from asthma to allergic rhinitis). For these individuals naman, mas active yung allergic rhinitis nila, but if it is not treated correctly, it can trigger the return of the patient's asthma.
There is no cure yet for asthma and allergic rhinitis. Closest na ang allergy vaccines kaya lang nga it's really a commitment. Sana nga makahanap na ng cure. The key is prevention. Healthy diet while pregnant, breastfeeding, probiotics, environmental control, judicious use of antibiotics, etc all help to prevent the development of allergies.

[cocoysmom]

The key is prevention. Healthy diet while pregnant, breastfeeding, probiotics, environmental control, judicious use of antibiotics, etc all help to prevent the development of allergies.

hello sis, doc... i have come across this once nga in an article, forgot where. pero sa doctor's office...yung regarding nga sa probiotics helping the management of allergy. kasama ba dito yung erceflora and OMX? can they be given sa 4-month old baby?

thanks po.

[leletmd]

hello sis, doc... i have come across this once nga in an article, forgot where. pero sa doctor's office...yung regarding nga sa probiotics helping the management of allergy. kasama ba dito yung erceflora and OMX? can they be given sa 4-month old baby?

thanks po.

Hi, sis!
Actually, probiotics should be given early in life to be able to produce the effects of prevention. Both foreign and local studies have recommended the giving of probiotics to either the breastfeeding mom or the baby from the time of birth till 6 months old. In the study of Kalliomaki, et al done in Europe, they gave probiotics to the breastfeeding moms 2 weeks before delivery till the baby was 6 months of age. Their study showed a decrease in atopic diseases in the group of infants given probiotics. 
Giving probiotics early in life ensures that there will be a shift in the allergic pathway towards the non - allergic pathway at a time when the immune system is still developing.
As to the type of probiotics used, according to numerous studies, the best probiotic to use is the one that contains Lactobacillus GG, next is Lactobacillus acidophilus. Foreign studies also state that the effects of probiotics are not enhanced by having multiple strains of probiotics. Some authors even recommend sticking to a single strain probiotic if possible.
Technically, Erceflora and OMX should also work, but I am not really sure if OMX can be used in infants. Erceflora may be used in infants.

[lemonpeel]

san po ba un may murang allergy testing kasi sa iba 5-7t un charge?

[mistiqshannen]

hi me tanong ako..  last tuesday kasi dinala ko sa pedia si baby meron kasi syang mga parang kagat ng pulgas kasi pula pula.. ang dami sa buong braso. sabi nun pedia its kagat daw ng insect na nainfect. she gave my baby 10 mos old baby antarax sorry sounds like its anti histamine plus antibiotic kasi kinamot daw kaya infected na. and desowen. kasi pang third day na its seems wala ako nakikitang progress lalo pa me tumubo na naman sa me shoulder na nya.

saan ko na dapat dalhin ang baby ko sa derma-pedia or allergiologist na?
can you recommend good dr in makati med? if meron nag accept ng maxicare the better.

[marose17]

^ Hi.  My kids' allergologist pedia is Dr. Michelle de Vera.  She accepts Maxicare and other health cards (weekdays only for health card patients).  But her clinic is at Medical City.