Follow Up Appointment: the Result

We went to hospital today for a combined appointment for the girls: E2′s follow-up appointment and E1′s allergy test. The pediatrician had realised that his secretary had scheduled separate appointments one week apart and, aware that it takes us about an hour to get to the hospital, he very kindly arranged to have them combined. I am relieved to report that it was a much smoother day than our last appointment.

We saw the nurse first, to have both girls’ allergy prick-tests. E1 was being tested for egg; E2 for banana, tomato, avocado, and latex. The nurse pushed E1′s sleeve up and carefully wrote five sets of characters down her arm with a ballpoint pen.  She turned to me, stunned — she knows very well that you’re not allowed to write on your skin with pens! Then the nurse carefully put a dot of liquid next to each pen mark. E1 found this intriguing and looked at me in wonder, then at her arm, then back at me. The nurse said, “And now, we pop the bubbles,” as her assistant tightened her grip on my daughter’s arm. She pulled out five sharply pointed metal pieces, and swiftly jabbed each one through a dot and into the skin. E1′s face suddenly registered shock, and then quickly squeezed tight and her eyes went red with tears. She looked to me and I tried to reassure her that she was ok, but as she turned back to watch the metal pricking her arm, her face was frozen mid-sob and the tears rolled quietly down her cheeks. But I was so proud of her — she didn’t scream, she didn’t pull her arm away. She cried quietly, and bravely kept her arm in place, because she’d been asked to. She’s two-and-a-half. She’s a remarkable girl.

When it was finished, her bravery left her and she sobbed loudly and buried herself in my shoulder. I rocked her for a moment or two, and then settled her in the push-chair so that we could do the same to E2. I was all ready to dole out more loving reassurance but, amazingly, the baby hardly seemed to realise she was being injured. This child, who has spent most of the last year complaining about everything within a 20-foot radius, smiled blissfully at the nurse’s assistant for the entire time she was being stabbed with various allergens.  I was stunned.

Ten minutes later, E1′s arm was bright red and welting impressively. The doctor told me that any welt over 5mm was considered to be a “properly” allergic reaction — hers were 9mm, 10mm, and 14mm. He said we are ensure she doesn’t eat egg of any sort — either on its own, or as an ingredient in sauces and mayonnaise, or cooked into cakes and biscuits — for at least a year, and then we should have her prick-tested again. He also kindly suggested that he would have the hospital dietitian ring us to discuss her diet.

E2′s arm was very calm by comparison. The only welt was in reaction to the avocado, and even that was only 4mm across. She had no reaction at all the banana or the latex, which surprised me greatly, given how much she had struggled after eating banana and how red her hands had been under the latex squares. The pediatrician and I discussed her diet and her reactions to various foods. I explained that she’d begun scratching her face as soon as we’d given her yogurt, and he felt that indicated clear reaction to dairy, even though they hadn’t tested for it. He said we should ensure she has no dairy for the next six months, and then try it again carefully, watching for a reaction. He also said that, for the next year at least, we should ensure she doesn’t eat avocado (as she had reacted to it), and also not give her any nuts or eggs (which will be easy to do now that we have to avoid them for her sister as well).

Toward the end of the appointment, E1 started coughing wildly, so hard as to nearly make herself ill — something she started doing last night — and then her breath became wheezy and laboured. Still anxious from the trauma of her surprise stabbing, she crumpled into immediate sobs and came straight to me for comfort. The doctor listened to her chest with his stethoscope while she looked at me wide-eyed and alarmed in case this new instrument had a similar surprising sting. I held her hand and told her it was ok, but she never took her frightened gaze off my face. When he was done listening, he diagnosed a case of croup. I explained that she’d woken up crying with it several times the night before, struggling to breathe. He gave us a prescription for a mild steroid to reduce the swelling in her throat, so that we have it in case we need it tonight.

And just before we left, he weighed E2 again: 7.886kg (17lb 6oz), a gain of nearly 400g (14oz) in a month, which means she has remained on the 9th percentile.  The doctor is satisfied with that gain, and feels that she has simply found “her place” on the chart. As he said, she’s clearly a well nourished and thriving baby — and I have to agree — so he felt there was nothing really to worry about.

I am so relieved to have E1′s allergy properly diagnosed and to have a course of action. And, although it surprised me, I am very pleased that E2 isn’t allergic to bananas and latex, and very pleased that she has put on some weight. We will stick to careful diets for both of them for now, and then see how things are in time. Most of all, I am just grateful that we walked into that hospital with worries that were so minor, compared to what some parents have to deal with, and we walked out with fewer worries than we went in with.