Wednesday, May 5, 2010

'A' Gets an Allergy Test

My daughter has very bad eczema. Depending which doctor we talked to, it seems that this is linked to an allergy. I have allergies so her chances of having allergies, asthma or eczema are high. We decided to take her to the allergist to see what she was allergic to so we could remove it from her diet and relieve her from some of the itchiness.  

We arrived at the allergist and the scratch test was all set up and ready to. They were testing for milk, soy, wheat, eggs and peanuts as these are the five most common allergies in babies. Upon our first question to the nurse she confessed that she was new to the department and would ask another nurse. It made me feel confident that she was smart enough to know when to ask for help and I didn't think to much of it until after the test.

The way the test works is that they load one drop of clear liquid that contains the allergen they are testing for onto a tool that looks like a comb. One prong of the comb for each allergen. They also add a drop of histamine and a drop of saline as controls. It is crucial that they load the comb up with the same pattern that is written on the chart so they know which bump on her back corresponds with what allergen.

After waiting for the fifteen meetings the new nurse came back in and started measuring the bumps on A's back. They measure the bumps and assign a number, 0 being no reaction to 4 being the largest bump that A had.

At this point the more experienced nurse returned and they started modifying the numbers that the new nurse had written down. There seemed to be a lot of confusion but we more focused on keeping our very fidgety, now more than normaly itchy child calm while they measured the bumps.  After a few minutes of fixing and changing the numbers on the chart the chart was an unreadable mess.  We then went across the hall and waited for the doctor.

By the time the doctor arrived the chart had been rewritten.  We noticed that the allergens that they tested for were all of a sudden different on the chart from what they were before.  We mentioned this to the doctor and he grabbed the original chart and corrected the updated chart.  He told us what A is allergic to and what we should do and we headed home.

The test showed that A measured a 4 for eggs, 2 for wheat and milk, and barely a 1 for peanuts.  The first change we were to make was to switch the formula she was drinking (she now gets 50% formula, 50% breast milk) from cow milk to soy based.  We went right out and bought new formula and made the switch.

The next day we realized that there was a hive on A's leg.  The day after she had several hives.  We put a call in to the on-call doctor at our pediatrician's office.

The doctor's only guess was that the test was wrong and that since the only thing we changed was the formula that it was the soy that caused the hives.

We called the allergist the next day and he also felt that the test was not correct guessing that the nurses mixed up two of the items on the test.

WHAT!?!?!??!  Are you kidding me.  Are you telling me that we finally had an answer and now we don't know for sure what she is allergic too.  We only know for sure that she is allergic to soy because of the hives.  And we know that she is not allergic to one of wheat, milk or peanuts.

How can they make a mistake like this?  This makes me so angry that I don't know what else to write.  When I mess something up at work nobody is hurt.  But this is unacceptable. 

You can be sure that next time they give her a test I will demand that I am there for the set up and that an experienced nurse will be performing it.  There is no way that the risk of putting her life in someone else's hands is worth it.

1 comment:

  1. Merin Campbell-BerkowitzMay 6, 2010 at 5:30 AM

    As I sit here feeding your little niece and doing a little web-surfing at 5 AM, I am seething! This is the first I am hearing of this atrocity and, like you, I'm irate. As a student, I always want to support people who are learning or trying to gain experience, but that's no excuse for utter incompetence--especially when it brings harm to an innocent child. I know you guys are short on time, but it might be helpful to write a letter to the practice manager or senior physician. Allergies are no joke and poor A's reaction could've ben much worse/more dangerous. Ugh! I love you guys and I'm so sorry you had to experience that!