How My Son’s Food Allergy Was Missed by an Allergist
He was negative on food allergy testing, so why was he
still reacting to tree nuts? This is the surprising
reason.
Part of Chronically Yours: Food Allergy Edition
Updated Oct 26, 2023
By
Lisa Lombardi
“Everyone thinks their child has a food allergy now,”
the pediatric allergist said, his tone an eyeroll.
Like I want my baby to have a food allergy, I thought,
as my then-20-month-old son, Gus, played with his
little plastic animals on my lap. I knew the doctor was
skeptical but I shared our story: We were away for the
weekend when Gus tasted my salad—a mix of greens and
pistachios—and broke out in hives; his upper face grew
puffy. We were here at our pediatrician’s urging, I
explained, to check for food allergies.
“Is he talking yet?” the allergist interrupted. “He
isn’t saying much.”
Yes, I assured him, thinking: Could this specialist
just stick to his specialty?
I watched as he did the allergy skin testing, where a
bit of the potential allergen is pricked just under the
skin to see if there is a reaction. Sure enough, our
little guy’s small back filled up with red, raised
patches known in the allergy community as weals. Yet
the findings were unexpected: allergic to pollen, dust,
cats—but not to any nuts.
“You can go ahead and give him nuts,” the pediatric
specialist advised. This advice went against what my
husband, Dan, and I had witnessed, so we avoided giving
him tree nuts.
Flash forward a year. On a family trip (I swear we
aren’t always on vacation), Gus tried a cashew for the
first time. In an instant, he began clawing at his
skin, itching nothing that we could see, then it
happened, within seconds: Hives appeared, his face
swelled. He coughed and stuck out his tongue, gagging.
While I gave Gus liquid Zyrtec, Dan reached our
pediatrician who instructed us to give Benadryl as
well. Then the pediatrician stayed on the phone and
made sure his reaction subsided in a few minutes; if it
didn’t, we were going to have to rush to the ER.
Back home, we hightailed it to a new pediatric
allergist. This allergist listened carefully. It sure
sounds like an allergy to tree nuts, he said, but let’s
repeat the skin tests. The soft-spoken specialist
stamped my son’s back with allergens. We waited. Hives
big and small sprung up. Ding ding ding! Gus was
allergic to every tree nut this doctor tested for,
including pistachio and cashew. He wasn’t showing as
allergic to peanuts.
“I’m surprised he tested negative to tree nuts just a
year ago.” The new allergist made notes in his file.
“Allergies can change but usually wouldn’t that fast.
I’d like to see his first test report.”
I called and got the report faxed to my office. As I
scanned it, I nearly fell out of my ergonomic chair.
What the… ? They hadn’t tested him for a single tree
nut. The simple grid with check marks showed what they
did test for: everything from feathers to horse hair.
Horse hair? In our densely packed suburb just outside
New York City, he had zero interaction with horses. I
hadn’t mentioned horses; I mentioned pistachios.
In disbelief, I asked our pediatrician to forward me
the letter he had received from this allergist. It
said: We’ve tested your young patient and he is “not
allergic to nuts.”
“Nuts,” meaning “peanuts” but never saying peanuts. The
allergist didn’t spell out that he tested my son for
one type of nut (peanut), which is technically not even
a nut but a legume; and it’s not the food he ate. How
had this highly trained specialist equated pistachios
with peanuts? Surely he knew tree nuts and peanuts were
distinct? And that tree nuts are one of the top nine
most-common allergens.
How did the doctor listen to my story—aka the patient
history—and not test for the food in question? Did he
listen? Or he was so certain he was right about parents
being wrong that he didn’t even hear what the mom
sitting across the desk from him said?
My mistake is the part that still haunts me. I didn’t
get a copy of the first allergy report, and instead
took the allergist’s summary as gospel. But my years as
a health reporter had already taught me that doctors
are human and this is one of the ways medical mistakes
happen. What was terrifying was we went to a pediatric
allergist, and he gave us advice that could have been
catastrophic. We didn’t listen, thankfully … until we
handed our little one a cashew—one of two nuts we have
since learned he is most allergic to. From this day
forward, I vowed, even if I love and trust my doctor, I
will always eyeball the test reports and after-office
summaries.
Still, as a busy working parent with two preschoolers
at the time, I was rushed and trusted the expert.
Something inside my brain changed that day when I
glanced at the boxes he checked and realized what
wasn’t checked.
That night after discovering the faulty testing, I
tucked Gus and his plastic hippo in bed and felt
overwhelmed by our close call. As I hugged him extra
tight, I reminded myself: Our son is safe for a reason;
we listened to what he was telling us. Or, at least,
what his body was telling us—loud and clear.
This article was originally published October 19, 2023
and most recently updated October 26, 2023.
© 2024 HealthCentral LLC. All rights reserved.
|
|