高樓低廈,人潮起伏,
名爭利逐,千萬家悲歡離合。

閑雲偶過,新月初現,
燈耀海城,天地間留我孤獨。

舊史再提,故書重讀,
冷眼閑眺,關山未變寂寞!

念人老江湖,心碎家國,
百年瞬息,得失滄海一粟!

徐訏《新年偶感》

2012年1月28日星期六

Dr. Peter Nieman: When should I start testing my kids for allergies?




Question: When should I start testing my kids for allergies?

Answer: Even among allergists there is a debate about the usefulness of doing skin testing prior to one year of age.That’s because the child’s immune system is still developing and the information gathered from these tests may not be very reliable. After age one most allergist seem to agree that skin testing can be done in a useful manner, identifying the underlying cause of allergies.

If there is a serious underlying allergy to eggs or peanuts or if there was an episode of anaphylaxis it is critical to see an allergist. Anaphylaxis can result in the sudden onset of various symptoms including an itchy rash, throat swelling, and low blood pressure. In extreme cases, it can be fatal.

In Canada, there is a national shortage of allergists which can lead to a wait of up to a year for an appointment.

Another option is to use blood tests to search for some allergies. (These tests are known as RAST testing.) This may be an option while waiting to see an allergist. However, it is ideal to see an allergist as soon as possible if the allergy was complicated enough to visit a hospital emergency room.

For patients with a history of serious, undiagnosed allergies the primary care doctor will prescribe an adrenaline kit with instructions on how to use it appropriately. Pharmacists will reinforce the correct use. The more educated parents are in the appropriate use of these kits, the less likely it will be that they may panic or use it incorrectly at a time of need.
Once the adrenaline kit is used, the patient should be seen also in the ER because there could be a further reaction.

In less serious cases, such as the only symptom being red itchy eyes upon exposure to an animal, the long wait of a year will not harm the child.

If a child has asthma, allergy testing is required sooner than later. An allergy may aggravate asthma symptoms and make it harder to breathe. When asthma is well controlled – usually with the appropriate use of medications – it means a child sleeps well at night, does not miss school, can continue to be physically active and does not end up with frequent unexpected visits to the doctor.