Tuesday, July 28, 2009

I Wanted to Smack the Nurse

Yesterday was the Pumpkin's appointment with the allergist (because of her reaction to peanut butter). We don't know anything for sure at this point, but we are treating her as if she has a peanut allergy. It turns out that Londo's perception of the Pumpkin's reaction to peanut butter was different from my perception. He did not see the red blotches I noticed, and he thought it faded more quickly than I did. In order to get a more accurate diagnosis of her allergens, the allergist wants her to get blood work done to test for peanuts and other tree nuts. I will bring her to the lab (separate office) for the blood test tomorrow or the next day, and we'll get the results a week or so after.

So that's the big news.

(This was also the first time I have gone somewhere without the Pookie. I had pumped 3 ounces of milk a few days ago, and I left the Pookie with the nanny and the pumped milk. They did great. He turned 6 weeks on Sunday. I can't believe people go back to work at this point. I really feel for them. I had trouble being away the 2.5 hours we were gone. Luckily, I have over another month before I go back. But I do hope to get more little breaks as I continue pumping in the next few weeks.)

The appointment itself was very frustrating. And now I'm going to vent.

Being so lively and full of energy, the Pumpkin does not sit still in waiting rooms. We, her parents, know this full well. We also knew that we'd be in a general allergist's office, not one geared toward children. So we let her run around outside the office in the building's hallways, where no one was and she could go up and down stairs to her heart's content. This was all expected, so this was not too frustrating for us. The waiting for over 30 minutes was frustrating, especially considering the appointment was at 9:30 in the morning when I had assumed they wouldn't be too backed up being so early.

Eventually, the nurse called us back to a room. She said our room wasn't ready, but she was bringing us back to another room until our room was ready. So she called us back because... We were uncomfortable in the waiting room? She was happily running around outside the waiting room. We were going to be seen shortly? We waited in the two different rooms for at least another 30 minutes. But whatever.

The nurse took us back to the room. The Pumpkin came back fine and was looking around, taking it all in. She was doing fine. And then, the nurse said, out of nowhere, "Nothing we are doing in this room will hurt."

WHAT? What the heck did she say that for? My daughter has no problems with doctors. She has no problems with new places. She does not anticipate needles or un-comfort with doctors at this point.

Londo and I tried to cover it up by talking quickly about other things and distracting her. However, this nurse said it again! I'm guessing she was trying to be reassuring, but she. was. not.

The Pumpkin started becoming apprehensive. She started getting this nervous look on her face. It didn't take long for her to start crying and needing to be held. Sure enough, the Pumpkin said, "It's gonna hurt!" She said it a few times.

While she was getting pretty upset, we moved on to answer the nurses questions. She kept trying to ask the Pumpkin and engage her, like about how old she is and what our dog's name is. It wasn't helping. We got the nurses questions answered and at the end of that portion, the Pumpkin again said it was going to hurt. And the nurse said (I kid you not), "I wonder why she thinks that!" I. Was. Livid. (On the inside.)

So we waited in this first room for a little while until the same nurse took us to our room, which was now ready. She weighed her and measured her height. The Pumpkin was upset during this, but we got it done. Then the nurse left the room, but left the door open. Let's see, we have a very upset toddler who thinks she's going to get hurt in a room she was just moved to... and the nurse leaves the door open. Um, hello?

Our pediatrician referred us to this place, so I thought they would have an inkling of how to work with kids. The doctor wasn't bad, once he finally saw us. He apologized for the wait, saying that it wasn't usual to have a wait like that, especially on a Monday morning. We had the Pumpkin mostly calm by the time he came in, thanks mostly to a pen and paper and the Pumpkin's love of drawing. She was still apprehensive with him and a bit fussy, but mostly she was sick of being cooped up in a room. We were able to answer the doctor's questions and hear what he had to say while bouncing her in our laps or holding her in our arms... but just barely.

They didn't do the scratch or prick test on her, which was good because she never would have sat still for that. We brought our portable DVD player and some DVDs for her in case she did have to have that (Stacy, thanks for that suggestion). Even though we didn't do the test, we put on a show for her while the nurse showed us how to use the EpiPen and we watched a video about living with allergies. It mostly held her attention until we got all the paperwork and information we needed and packed up. Oh, and the nurse did come in and out of the room with paper and other things, and she kept leaving the door open. Drove. Me. Crazy.

I think it would have gone much better if that stupid nurse had any idea of how to deal with a toddler. I seriously could not believe what she said and how she tried to interact with the Pumpkin. This woman was clueless. I'm guessing she either never had kids or had them a long time ago and forgot how to deal with them.

Not only was Londo totally pissed off at that nurse, but he was not that thrilled with the doctor. As I understand it, he was frustrated that the doctor seemed to have his mind made up that she had the peanut allergy without really seeming to investigate whether or not she had it. But as Londo and I discussed after the fact, it was probably because most people who come in already have seen a reaction, so he can start from that point. The reaction I described fit in with an allergic reaction, so he jumped right to that. However, when I realized that Londo and I had different perceptions of what happened, I made sure Londo also described his perception to the doctor. At that point, the doctor did say that instead of just being okay with having the blood test done, he really wanted it to be done to see what it would tell us.

So now I have to go get the Pumpkin's blood taken at some lab. That should be fun. And I'll have to do it by myself because Londo can't take more time off work right now. I will have to leave the Pookie again, which I can't do until I pump more milk. Hopefully I'll be able to pump soon and take her in the next day or two. We really want to know what it will tell us. Even if we get a false positive, it will be something more to go on besides one reaction that we parents perceive differently.

5 comments:

Becoming Mommy said...

Actually, I like your allergist better than ours and his thought process makes more sense.
Based off what I've found out, toddlers seem kind of iffy in allergy testing--more so than adults. A lot of false reports in both directions so a lot of doctors treating the very young will go based off of reports from the parents vs. testing (but will test anyway) and will try treatments that work exclusively in allergies first and see if that works (especially since many treatments like benedryl and claritin are very very safe).
I'm sorry Pumpkin has developed such an awful one as peanuts!

BisBink said...

See if you can make an appointment at the lab you are taking the Pumpkin to. I know you are able to make an appt. at Quest Diagnositics. I bet other labs take appointments as well. You jump to the front of the line that way, instead of waiting for who knows how long. It is a life saver especially with little ones.

paola said...

It is more likely you will get false negatives rather than false positives ( this was told to me by a pharmacist and not an allergist however) as the child is under 5. My son has atopic dermatitis and his dermatologist has advised us to have a blood tests for allergies too, but warned us they can be inconclusive due to his age ( 4.5). She suggested waiting until he is a little older. Confirm with the allergist.

Anonymous said...

The earlier you get to the lab the better OR just wait until an hour after lunchtime. I have to get blood drawn often and those seem to be the best times.

Sorry the nurse was such an idiot. I've had issues with medical staff and drawing blood from Monkey before. It's one thing when they flub it up with you but another when you're watching your child go through it.

persephone said...

Hi, this is the first time I've clicked over to your blog - which is hard to believe, because you seem to comment on all the other blogs I read! - so please forgive me for leaving unasked-for advice the very first time I comment.

My son's peanut allergy started out much the way you described: a small rash around the mouth. I think we gave him Benadryl, I'm not even sure; it might have gone away by itself. We did fine for the next year or two by just carrying around an epipen, and not giving him anything with nuts or peanuts listed in the ingredients. We still had peanut butter in the house, in fact. We just cleaned our hands & mouth after we ate it.

Then we went to a (terrible) allergist, who did one skin test and concluded my son was not allergic to peanuts. He ate one spoonful of peanut butter, had a full-blown anaphylactic reaction, and is now so allergic he can't even be around TRACE amounts of peanuts - which don't legally have to be listed on the label. We've had to turn our pantry and our lifestyle upside down. And if he just hadn't had that second exposure to peanuts, his allergy might still be mild.

I assume our allergist is the only idiot out there, but just in case: if your daughter tests negative, and Londo wants to try giving her peanuts again - PLEASE make sure you get further testing to confirm, or else do a food challenge, where a small amount of peanut is eaten under monitoring at the doctor's office. Don't try it at home.

Good luck!

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