What to Expect in a Pedia-allergologist visit?

[sleepy_grfld]

i'm glad that i came across this thread. thanks to sis ms_guimba who i think is my kababayan since i'm from guimba, n.e. also. thanks also to sis/dra leletmd for the answers/comments.

about a week after my baby was born (december 2011), she had rashes on her face. when we went to her pedia, she suggested to change baby's soap. but the rashes didn't go until she prescribed elica. nawala naman 'yung rashes. when my baby turned 5 months, she had rashes again on her face and (butlig-butlig) on her arms.last monday when we brought her to her pedia, her pedia prescribed cetirizine. sabi ng pedia, i-observe muna kung mawala sa cetirizine. kung hindi, mag-e-elica uli si baby. last night, i came home with my baby having insect bites on both her legs. sabi ng yaya, hindi alam kung ano kumagat. maliliit lang daw yung mga kagat nung una. pero pagdating ko kagabi, malalaki na, almost 1 inch in diameter yung pula at may parang tubig pa sa gitna (kasinglaki naman ng munggo). dito sa bites, bactroban ointment ang ipinapalagay ni pedia.

with these, kailangan ko na ba ipatingin sa allergologist si baby? in between nung first week at 5 months kasi, nagkakarashes din siya pero nawawala din. napapansin ko siyang lumalabas pagkatapos niya maligo o magpunas. madalas na lagi niya ini-scratch eyes niya. pansin ko din na madalas siya may sipon. if yes, can you please recommend pedia-allergologist in/near fairview? thank you so much.

[leletmd]

doclelet pls pa recommend naman ng pedia derma or pedia allergologist for my 20 month old son..parang may mamaso/empetigo sya na dumadami hndi na nga po makatulog ng maayos..we're from araneta ave quezon city so sana yun nearby hospitals lang sana.. thanks po

Try Dr. Nenita Alberto at Capitol Medical Center. She's one of only 2 derma allergologists here in the country. She also has clinic at Rustans Medispecialist clinic.

@sleepy_grfld:
What is the pedia's official diagnosis?
Also, what is the character of the rashes? Is it butlig and not pantal? Magkaiba kasi ang 2 types of rashes na yon.
If she responds to the cetirizine then that's a clue that it's allergic in nature.
If it has been going on for quite some time then it's time to bring her to an allergologist for evaluation.

[sleepy_grfld]

thanks for the prompt reply doc lelet.

in answer to your questions: nung check-up last monday, ang sabi ni pedia, allergy po pero hindi niya masabi kung saan.

yun pong nasa braso at nosebridge ay mga butlig. sa likod at ibang areas ng face, pantal. napansin ko po na pag ini-scratch niya eyes niya, nagfo-form ng semi-circular red line sa eyes niya (mula kilay (inner) hanggang gitanang baba ng eyes/eyebags. (sorry po, hindi ko masyado ma-describe.)

napansin ko po na uminom siya ng cetirizine nung monday, mas kuminis siya tignan pero bigla pa ring lumalabas yung rashes. sino po marerecommend nyo allergologist near fairview? thanks po.

[leletmd]

Medyo broad na diagnosis ang allergy. Wala bang sinabi kung skin asthma or atopic dermatitis siya? Ano ang sinabi ng pedia na possible cause?
Since medyo broad ang diagnosis, I think it would be better if you consult na an allergologist for a more definite diagnosis. You can try to visit Dr. Hiyasmin Lim sa FEU Fairview. She's a past president of the Philippine Society of Allergy, Asthma and Immunology.

[sleepy_grfld]

wala po sinabi kung anong klase o kung anong cause. sige po, we'll visit na lang dr. lim. thanks doc.

[hyder0926]

my 21month old son has urticaria.. we are now under medication.. my son is taking benadryl & prednisone..
he has major flare ups but it also goes away shortly after taking benadryl. he is given benadryl every 6hrs at 7ml & prednisone once a day at 10 ml for 5 days..

will need to see an allergologist soon.. because i want to know what causes his allergies.
can you recommend an allergologist from St Lukes QC? how much yun panel testing?

[marose17]

^ Dr. Michelle De Vera and Dr. Eileen Cua-Lim

[hyder0926]

^ Dr. Michelle De Vera and Dr. Eileen Cua-Lim

Thanks Sis Marose!

we might visit them 2 weeks from now.. i just hope his urticaria clears up by then.. anybody know how much un skin test sa allergologist? i'm considering to have one with my son kasi..

[meandmyhoney]

hello sissess,

after mamaso meron pa rin marks sa pamangkin ko at insect bites . ano po kaya soap / lotion para matanggal mga marks. thank you.

[momai]

nakapag pa check na kami kay dra. perez sa megaclinic sa megamall. gusto niya ipa skin test ang anak ko. pero di pa namin napagawa. ilang days/weeks po ba dapat pwede i-skin test kung napainom ng alnix?

actually 2 nights na ulit na allergic rhinitis yung anak ko. sa madaling araw, nagigising siya kasi barado ang nose niya. hindi daw makahinga. pag ba ganito pwede muna bigyan ng alnix? malamang sa july pa namin mapagawa ang skin test eh.

thanks

[queldultra]

Thanks Sis Marose!

we might visit them 2 weeks from now.. i just hope his urticaria clears up by then.. anybody know how much un skin test sa allergologist? i'm considering to have one with my son kasi..

sis hyder, around 3K to 5K po sya per panel. meron po kasing panel for inhalants at meron din for food.

[queldultra]

Try Dr. Nenita Alberto at Capitol Medical Center. She's one of only 2 derma allergologists here in the country. She also has clinic at Rustans Medispecialist clinic.

@sleepy_grfld:
What is the pedia's official diagnosis?
Also, what is the character of the rashes? Is it butlig and not pantal? Magkaiba kasi ang 2 types of rashes na yon.
If she responds to the cetirizine then that's a clue that it's allergic in nature.
If it has been going on for quite some time then it's time to bring her to an allergologist for evaluation.

you may also want to try dr. ruth reyes, pedia allergo sya. she's connected with sta. teresita general hospital.

[hyder0926]

sis hyder, around 3K to 5K po sya per panel. meron po kasing panel for inhalants at meron din for food.

Thanks Sir Queldultra!

[leletmd]

nakapag pa check na kami kay dra. perez sa megaclinic sa megamall. gusto niya ipa skin test ang anak ko. pero di pa namin napagawa. ilang days/weeks po ba dapat pwede i-skin test kung napainom ng alnix?

actually 2 nights na ulit na allergic rhinitis yung anak ko. sa madaling araw, nagigising siya kasi barado ang nose niya. hindi daw makahinga. pag ba ganito pwede muna bigyan ng alnix? malamang sa july pa namin mapagawa ang skin test eh.

thanks

The child has to be off anti -histamines for 1 week before skin testing. Otherwise, the skin test results may just be negative.
I suggest you go back to Dr. Perez for follow up since your son is having symptoms again. Medications kasi should only be given after a thorough history and check up. Hindi ka naman niya pipilitin magskin test sa son mo if he is having symptoms and if you are not yet financially ready so I hope you won't be afraid to go back to her for follow up.
Follow ups are very important to assess response of the patient to the management given.

@hyder0926:
Skin test price would depend on the source and number of allergens used. It would be best to ask your allergologist regarding the price since hind pare-pareho ang price ng skin test and number of allergens used.

[hyder0926]

^ Thanks Sis leletmd..

my son is now symptom free since thursday or 2 days after being given benadryl and prednisone..
do i still need to bring him to his pedia?

[leletmd]

^ I suggest that you follow up even if the symptoms have resolved/cleared up.
The next step is to find out what caused it to prevent recurrence.

[iristacey]

this thread is so informative. i am learning so much.

hi doc lelet, just have a question. my 4-month son is breastfed but is showing GER symptoms (arching of back, feeding difficulty, feeding small frequent meals) but was given levocetirizine HCl by pedia-gastro for observation for a month. i searched it and it appears na for allergic rhinitis sya. though si baby parang laging barado nga ilong kapag gabi. we have to observe daw for a month muna then that's the time she will be more aggresive daw on treatment.  now i am quite confused if i have to bring him to a pedia-allergologist or bring him to a different pedia-gastro or retain muna the meds. we have a very strong history daw kasi ng allergies sabi ni doc. thanks in advance.

[leletmd]

^ What was the reason daw behind giving levocetirizine?
Aside from the intestinal symptoms and the clogged nose, wala na siyang ibang symptoms like skin rashes? Pure breastfeeding ka or mixed feeding?
Levocetirizine is a 2nd generation anti - histamine. We use it for different kinds of allergies like atopic dermatitis, food and drug allergies, urticaria as well as allergic rhinitis.

[iristacey]

^pure breastfeeding po ako, he drinks pumped breastmilk when i am out for work. she observed na very small scratch lang, nagiging reddish na agad. same with me. i thought normal lang yun. i also have greatly removed milk/dairy from my diet (but at times, may tikim tikim ng cake and eat bread in small quantities). even chocolate drinks and coke, ganun din tikim tikim na lang, like a sip or 2. pinakamarami na yung 200ml glass. i tried drinking natural cocoa (tablea) the other day but i saw rashes on baby's face (slight lang) so i won't drink it again na talaga. his rashes are very small lang and would normally disappear the next day if i eliminate the common allergens on my diet. then i also avoid most gas-causing food like cabbage. yung normal staple food ko usually includes malunggay, kalabasa, kamote, fish, potatoes, carrots and lean meat. praning much na nga ako sa food intake ko eh. all for my baby. btw, i have a hyperacidity so i also avoid too much caffeine (no coffee na ako since i gave birth), spicy foods, too much oils/fried food. i am just confused why this was given but nevertheless, i had my baby drink it anyway. i just really want to relieve baby kasi he just seem to be avoiding feeding and prefers to feed while sleeping.

[leletmd]

^ The best person to answer the question as to why the levocetirizine was given is the pedia gastro kasi siya ang nagbigay ng medicine. I suggest you clarify it with your pedia gastro para malinaw sa iyo as to why your baby is being given levocetirizine.
Based on the history you gave, it is possible na hindi lang GER or intolerance ang problem ng baby mo. Since there are skin manifestations, it is possible na he is also developing allergies from your food intake. Pag sinabi kasing food elimination, hindi pwede ang tikim tikim. With food allergy, even just a little amount of food (kahit nga food na dumampi lang sa spoon na nagamit mo) can cause a reaction so dapat total elimination.