When you don't know the allergy, what do you do?

[portocall]

My son does have an appointment with an allergist on Feb 22nd, but until then, I am not sure what to do. Up until now, and he is 10, we haven't had any problems with food.

In October, my son was rushed to the emergency room by ambulance from school because they thought he choked on a chicken nugget and it was caught in his throat. Once there, he passed the cotton ball test so he was cleared to go and they told him to be careful while eating chicken nuggets. He was very embarrassed.

Fast forward to last week. The school doesn't often serve chicken nuggets and for the first time he ate them (school kind, he had them since at home) and sure enough, back into the nurses office with profuse vomiting. Since a stomach bug was going around, I just brought him home, but he complained about his throat feeling tight. As soon as I loaded up my three children in the car to bring him to the hospital the incident was over and all was fine so I decided to wait until I could bring him to the pediatrician.

The pediatrician thinks he might be developing a nut or other allergy that is becoming severe enough that anaphylaxis is a high probability. My DH has a severe egg allergy, so the nut wouldn't have rolled too far from the tree so to say. But in the meantime, what do I do that I haven't already done? This is very scary to me. I have liquid benedryl at the ready, both in my purse and in the medicine cabinet. I removed all store bought anything with nuts in the ingredients as well as the may have nuts label. He can't eat anything fried from anywhere except home. I am going to start packing his lunch to control the intake. But I really didn't realize how little we have exposed him to nuts in the past. I don't really care for peanuts so it wasn't much to remove. But am I not thinking of something? We aren't even sure that nuts is the true culprit, I am already vigilent on the eggs because of my DH, but what if it is something else entirely. I am almost scared to feed this child now . I mean I am, but I am sure I am driving him insane with the "how are you feeling" comments after every bite. I am sure I am overreacting, but I never have dealt with anything like this before. Any advice would be welcome.

 

[Christine]

I think, for now, you are doing all you can.

I honestly don't think nuts are the culprit based on what you've posted. It is just the chicken nuggets doing it. If there was an unknown nut allergy, many other things could have set it off.

It could just be something specific to those chicken nuggets. The best thing you can do is go to the cafeteria and at least get the label from the offending chicken nuggets so you can take it to the allergist. He's had a reaction two times to these nuggets so you need to see the label.

In the meantime, pack lunches.

 

[mickeymedic]

If the doctor is concerned about anaphylaxis, I'm surprised he didn't prescribe an Epi Pen. The only thing I can recommend is liquid benadryl. (Liquid because its easy to swallow even if the throat is getting tight, and it absorbs fairly quickly.) If he starts to have an allergic reaction again, give him the benadryl as soon as possible and head for the emergency room. Or, better yet, call 911. Thats what the EMTs and Paramedics are there for.

 

[luvmy3]

Is there a way to find out the indredients of the chicke nuggets at school, and also were the same sides served as the last time. That may help narrow it down.
My ds was diagnosed with a severe tree nut allergy last year. He was also diagnosed with an allergy to soy and sesame. These are all things that he could eat in the past. He can tolerate soy, which is in almost everything in one form or another.
If I were you, I would feed him only foods that you know he has never had a reaction to, and ones that are low risk for (any) food allergy until you get him tested.

 

[Christine]

Also, just a tip: If your child takes ANY kinds of allergy meds (benadryl, zyrtec, etc) on a regular basis, stop taking it about 5 days prior to your appointment. They may want to skin prick test your son for allergens. If he's been on an antihistamine, they won't be able to do it. I'd hate to see you have to wait for another appointment.

 

[abdmom]

Eggs would be my first suspect, with Dad's allergy and because of the breading on the nuggets.

 

[laurie31]

My first thought was that maybe the chicken was fried in peanut oil, but with the severe egg allergy in the family, I think the breading might be the more likely culprit.

I agree with packing lunches until you see the allergist.


ETA - abdmom - I guess great minds think alike - lol. That's what I get for taking so long to type up a reply!

 

[pigletgirl]

Yeah, better stick with grilled chicken. Hope you get answers soon.

 

[puffkin]

I too don't think it is a nut allergy. It sounds like it is something in the breading for this nugget. I agree about trying to get the ingredient list from the nuggets before the appointment. I assume you don't serve anything with egg at home (due to DH). Can you go through his lunch calendar and see if any other foods might have egg in it, because obviously if they do and he didn't react then it is probably something else. I can't think of many school foods that would have egg though....

Also, I may be wrong, but I don't think that schools typically fry nuggets. Aren't they usually baked? That would rule out the cooking oils.

 

[Christine]

Also, I may be wrong, but I don't think that schools typically fry nuggets. Aren't they usually baked? That would rule out the cooking oils.

I agree, they don't fry. I believe that the types the schools use are VERY processed. I bet when you get the ingredient list, there are lots of things in them which is probably why you need to get the list before you see the allergist.

 

[portocall]

Thanks for the tips. The reason the doctor thought it was nut based is because the nuggets are frequently fried in peanut or canola oil prior to being packaged, so that they can be baked crispy. He has eaten with no problems scrambled eggs, but you are right that I am super vigilant with eggs and products containing eggs already. I did get the ingredient list for the chicken nuggets to bring to the doctor, and it does say that they may contain peanuts and tree nuts, and canola oil but nothing about eggs in plain english
ETA: I can't read most of the ingredients in these chicken nuggets, but they sure have a ton of salt and sugar!

 

[Christine]

Thanks for the tips. The reason the doctor thought it was nut based is because the nuggets are frequently fried in peanut or canola oil prior to being packaged, so that they can be baked crispy.

People who are allergic to nuts can eat canola oil with no problem. It is not made with any type of nut oil. Rarely, do manufacturers of mass produced, cheap food use peanut oil because it is expensive.

He has eaten with no problems scrambled eggs, but you are right that I am super vigilant with eggs and products containing eggs already. I did get the ingredient list for the chicken nuggets to bring to the doctor, and it does say that they may contain peanuts and tree nuts, and canola oil (combo of corn and peanut oil) but nothing about eggs in plain english

Again, canola oil is not made with peanut oil. Also, for the record, while most peanut allergic folks avoid peanut oil, it is actually quite rare for a person with that allergy to have a reaction to peanut oil that has been processed/refined in the U.S. We use heat processing here which destroys all peanut proteins (allergens). Peanut oil processed overseas is a different matter as is can be "cold pressed" leaving the allergens/proteins intact.

Your biggest concern is actually the "may contain traces" statement. They are telling you that they process those nuggets on equipment or in a factory where they process nut products. This doesn't mean they actually have nuts in them though. Many manufacturers have placed that label on their foods knowing full well the food does not contact nuts but they want to cover their butts.


My son had an egg allergy when he was younger and he could not eat straight-up cooked eggs for awhile. He could eat cakes, breading, etc. with no problem. He finally grew out of that and eats eggs with no problem now. I would agree that eggs are probably not your issue here.

 

[luvmy3]

Thanks for the tips. The reason the doctor thought it was nut based is because the nuggets are frequently fried in peanut or canola oil prior to being packaged, so that they can be baked crispy. He has eaten with no problems scrambled eggs, but you are right that I am super vigilant with eggs and products containing eggs already. I did get the ingredient list for the chicken nuggets to bring to the doctor, and it does say that they may contain peanuts and tree nuts, and canola oil (combo of corn and peanut oil) but nothing about eggs in plain english
ETA: I can't read most of the ingredients in these chicken nuggets, but they sure have a ton of salt and sugar!

I can't imagine a chicken nugget breading recipe that doesn't have eggs in it, and I think because eggs are a high risk food for allergies it would have to be listed as an ingredient. Of course, I'm rarely surprised by the mystery of school cafeteria foods
Once he goes in for testing, you will know for sure and until then it sounds like you are doing the right thing.

 

[Christine]

I can't imagine a chicken nugget breading recipe that doesn't have eggs in it, and I think because eggs are a high risk food for allergies it would have to be listed as an ingredient. Of course, I'm rarely surprised by the mystery of school cafeteria foods
Once he goes in for testing, you will know for sure and until then it sounds like you are doing the right thing.

Believe it or not, there are!!

Many, many years ago when we were dealing with the egg allergy, we had no problems finding fried chicken products without eggs. The easiest were the highly processed foods because they could find all sorts of *other* ingredients to mimic a crispy coating. They didn't the expense or trouble of eggs. I think there was even a type of KFC that my son could eat.

 

[luvmy3]

Believe it or not, there are!!

Many, many years ago when we were dealing with the egg allergy, we had no problems finding fried chicken products without eggs. The easiest were the highly processed foods because they could find all sorts of *other* ingredients to mimic a crispy coating. They didn't the expense or trouble of eggs. I think there was even a type of KFC that my son could eat.

I wonder if schools use ones without eggs because of allergies.

 

[turkeymama]

I'll reiterate what others have already said. I don't think it sounds like a nut allergy. Exposure to peanuts is hard to limit when you aren't trying. And if he has eaten eggs with no problems, it probably isn't that either. Honestly, it could be any number of things. I'm amazed at what some people have allergies to. DD (9 1/2 years old) is deathly allergic to dairy, something she should have statistically outgrown years ago.

Also, just to reiterate, do not give him Benadryl or any other antihistamines within a few days of his appointment, unless of course he has another episode and you have to treat a reaction.

I would take that chicken nugget label to the appointment, just in case the doc wants to see it as a reference. Unfortunately, I have found that I am much better informed about some food allergies than the previous 3 allergists DD has seen. They are great at testing and treating, but not so hot at giving advice on how to manage the allergy other than to tell patients to limit exposure to allergens. I'm sure you are probably already familiar with ways to control food allergies, but there are several websites that we've found helpful with my daughter. The best one so far is the Food Allergy and Anaphylaxis Network.

Good luck. I know how frustrating it can be when you aren't sure what the culprit is.

 

[Christine]

I wonder if schools use ones without eggs because of allergies.

I think if that were the case, they wouldn't be using nuggets that said "may contain nuts...".

I think nuggets without egg product in them are the norm.

 

[englishteacha]

I don't have much to say except good luck! I had a crazy allergic reaction to something last spring. We're not sure what it was. All I know is that I ate a pumpkin whoopie pie from a bake sale, and a while later I was swelling up like a Macy's balloon. I was itchy, red, horribly swollen. I took a lot of benadryl and went straight to the doctor, where they gave me more benadryl and watched me for an hour to see if I returned to normal. We're still not sure what caused the reaction, and as it was a bake sale whoopie pie, I don't know what was in it, or if something else triggered the attack. I'd had a minor reaction to something unknown a week or so prior, and this one was horrible enough for the doctor to give me an epi-pen, just in case. I've had no other reactions, haven't had to use the epi, but it's scary to not know what caused the reaction for sure. One thing we did link to the first reaction was the massive amount of hand sanitizer the students were using. It was right when the scare about H1N1 happened, and every kid had their own bottle of sanitizer and were slathering it on all day. Mix that many fragrances and chemicals together and someone with a chemical sensitivity (ME!) will have a reaction!

 

[portocall]

I will be bringing the label to the allergist. Thanks for the heads up about not giving him benedryl a few days prior to the appointment since I am anxious to figure out this puzzle sooner than later. Whether it be eggs, nuts, or something else, I don't like not knowing what "IT" is. In the meantime, we are going to work with what the pediatrician thinks may be the chief suspects of eggs or nuts and avoiding all super processed foods until I hopefully have an answer. He has already had minor reactions (read rashes) to penicillin, grass, mosquitoes, and suntan lotion. This is the first time it is over something he has eaten.

 

[golfgal]

I can't believe the allergist couldn't get you in sooner . I would have his dr call and see if they can get you an appointment, like tomorrow!!