ADVENTURES IN TESTING AT COEM — The View from An Allergy Tester’s Chair
By Ann Felder, Allergy Testing Supervisor
“But I can’t be allergic to chicken; I eat it all the time.”
Substitute chocolate, pizza, or any other food people love, and you have a comment we hear all the time when patients are being tested for foods. If they don’t feel sick immediately after eating a food, they are quite certain they cannot have a sensitivity to it. Food reactions vary. One patient might feel irritable, another might feel “out of it,” still another might experience headache or joint pain. It is even more difficult to see the relationship of food to reaction when the symptoms appear hours later, or even the next day. Sometimes a look of amazement will come over a patient’s face when he or she experiences that peculiar sensation they had after dinner last night when they are tested for celery or lettuce. Occasionally a mild expletive escapes their lips.
Even members of our staff sometimes fail to recognize food reactivity. A young lady on our staff who was a very conscientious worker sometimes had to miss work because of a migraine. One morning she came in obviously suffering with one of her headaches. After her supervisor learned that she had had popcorn the night before, she was tested for corn. We neutralized her to corn (tested her with several different dilutions of corn until we found the right dose), and prepared an extract of corn for her which relieved her headache.
Not only foods cause unusual reactions. Inhalants often cause what many people call “hay fever.” If sneezing, watery eyes, itchy nose are not experienced, many patients fail to realize they may be allergic to dust, molds, animal danders, or pollens. One of our patients came in complaining of periods of unexplained sadness and uncontrollable weeping. After listening to the circumstances surrounding the onset of her symptoms, Dr. Lieberman suspected that mold might be bringing on her attacks. Sure enough, when she was tested for a particular mold, she began weeping. When neutralized to that mold, the attack subsided.
Another patient was subject to seizures during which she could move only her eyes. During testing one allergen, a common fungus found on skin, hair or nails, provoked the seizure behavior. When the neutralizing dose (the dilution her body tolerated) was found, she was able to move normally.
We also neutralize patients to bacteria and viruses. The most extraordinary example of viral neutralization occurred when a patient came in to the office in a wheel chair because he had developed paralysis. Dr. Lieberman believed he had somehow been exposed to the polio virus. After finding the neutralizing dose to the polio virus, the patient improved and the paralysis eventually went away.
Even though we rely heavily on the skin reaction to determine the correct treatment dose for each allergen, we also consider the symptoms a patient may experience while being tested. These symptoms open patients’ eyes to what may be causing their reactions, and let the patients know that they are important participants in the treatment process.
“Johnny is a loveable child most of the time, but sometimes…”
An adorable child sits on the stool to be tested. When given a provocative dose of a particular allergen, that sweet child becomes a vicious animal, screaming, kicking, biting, hitting and running around the testing room endangering anyone who gets in his way. When the neutralizing dose of this same antigen is administered to the child he once again becomes sweet and adorable. Although the preceding description is an extreme example of what we see when testing children, the Jekyll and Hyde reaction is fairly common among our young patients.
Violent behavior is not the only kind of reaction seen when a child is tested. When reacting to one dose, the child may fidget and squirm and be unable to respond to simple questions. The neutralizing dose allows him to behave appropriately. Another child may be friendly and sociable on a good dose (neutralizing dose), but silent and withdrawn on a bad dose. One young patient made friends with everyone in the testing room, but when tested with a bad dose, she crawled under the table, frightened and tearful. Many children who have difficulty paying attention and behaving appropriately in school see great improvement with desensitization for allergies. Addressing nutritional deficiencies and other health issues also helps them overcome socialization and academic problems.
“My child hates needles and will not allow you to stick him (or her).”
Success in testing and treating children with allergies may depend upon the attitude of the parent(s) accompanying the child. At our office we do not believe in forcing the child to undergo skin testing (or any other potentially painful procedure) because we want the patient’s experience to be as pleasant as possible. We do not want the child to be afraid to come to our office. Fortunately, our method of allergy testing is not as painful as one might think.
Children are often less than eager to participate in any activity that involves needles, but if they can be persuaded to sit still for the first stick, they are usually able to tolerate the procedure. Once they experience the actual sensation and realize that the pain, if any, is momentary, most children will cooperate. The first time I tested a two-year-old girl, I was amazed by her willingness to let me stick her again and again. Yes, she shed a few tears, but once she got past her initial fears, she was a very cooperative patient. Was she an anomaly? No. A parent who transmits love and understanding along with the confidence that nothing bad is going to happen to the child, and who is matter-of-fact about the testing going forward, is far more likely to have a child who can be successfully tested.
In the end, both the parents and their child benefit, as the appropriate allergy extracts produce very positive changes in their child’s health and behavior.
If you are interested in learning more about The Center’s individualized allergy testing for your child or yourself, please call our office at (843) 572-1600 and speak with our New Patient Coordinator.
ABOUT THE AUTHOR:
Ann Felder has had a “View from an Allergy Tester’s Chair” for the past 14 years at the Center for Occupational and Environmental Medicine. Her extensive experience with children (she is also a former teacher) has helped make her very successful as an Allergy Tester and the Center’s Allergy Testing Coordinator. Allergy testing and appropriate desensitization through individualized extracts are a key part of getting well for many of our patients.