How Would You Deal w/This Allergist.

[lakeswimr]

Hi Cricket!

I think you are very smart with how you are thinking about the emergency plan.  I would stick with your old plan.  It is pretty standard.  The new allergist's plan is not safe in my opinion.  I would print out the the FARE emergency action plan and the old FAAN emergency action plan if you wanted to show your new allergist how far his plan is from standard.  Waiting until someone has breathing trouble can easily mean waiting too long. 

I didn't read all the replies but I skimmed CM's and I think I agree with her.  I'm in a rush.  I wanted to say that it is common to brush off minor symptoms of a reaction to rule out psycho somatic reactions.  The reaction you describe, although systemic, sounds minor to me.  I guess it depends on how bad the stomach pain was.  It would have put us in a watch and wait position if it was minor.  DS had stomach pain for part of his milk challenge and we continued until he had throat tightness at which time he got the epi and his symptoms were gone in seconds.  That's pretty standard for a challenge in office (we were in hospital).

The food allergy fatality this summer is extremely unusual.  Anaphylaxis that happens that suddenly is pretty much unheard of.  My son's allergist did not change our emergency plan as a result of hearing about that fatality.  He said in all his many years of practice he hasn't ever heard of anaphylaxis happening the way it is reported to have happened and feels strongly that if a reaction is going to get bad people will have time to use the epi meaning we will see the systemic reaction and have time to use the epi. 

I would be honest with the allergist that you want to follow your old emergency plan all the time including during a challenge and as long as he agrees to that you could try.  Something like 80% of egg-allergic kids (maybe a bit less but a high percent) can tolerate baked egg so it could be worth doing.  Those who can eat baked egg are much more likely to outgrow. 
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BooandBriMom--pushing through stomach aches in things like your baked milk *may* lead to EOE so I'd talk to your allergist about that if you haven't already.  That said, I know someone who pushed through and now her child isn't allergic to milk or egg anymore.  But my son's allergist said he would recommend stopping totally if it caused stomach aches because there is research showing a tie to developing EOE/EOS, which would not be good at all.

[booandbrimom]

BooandBriMom--pushing through stomach aches in things like your baked milk *may* lead to EOE so I'd talk to your allergist about that if you haven't already.  That said, I know someone who pushed through and now her child isn't allergic to milk or egg anymore.  But my son's allergist said he would recommend stopping totally if it caused stomach aches because there is research showing a tie to developing EOE/EOS, which would not be good at all.

Any history of EoE was an exclusion criteria for the FAHF-2 study. They talked about it at length. Still better than anaphylaxis IMO.

It's a delicate game, to push hard enough that you know it's not psychosomatic and that you're actually making progress, but not to push so hard that you end up with worse problems. As CM said, it's experimental. It's not for everyone. I think knowing your/your child's tolerance for risk is very important with all this stuff.

[lakeswimr]

You have to go by what  your allergist recommends.  My allergist would stop your child from continuing if there were stomach aches due to what he says is a risk of developing EOE.  His opinion is that that is worse than a regular egg allergy.  Then you end up with both an egg allergy and EOE.  As I said elsewhere, I know someone who pushed through and her child crossed off two allergens from a long list.  It is a risk. 

[lakeswimr]

You are right, though, that there is risk in not doing it, too.