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Posts Tagged ‘allergy challenge test’

Testing for Medication Allergies

October 13th, 2008

Long story ahead.  I’ve been trying to get tested to get more information about the specifics of my medication allergies.  I’m allergic to ibuprofen, likely all aspirin derivatives (NSAIDs) and possibly also acetominophen. Long story which you may have read here, 2 near-death anaphylactic reactions to Advil, hives from Tylenol, swollen lips from an aspirin-based product, yada-yada.

My allergist suggested at the time (nearly 6 years ago) that since all these reactions happened within a few months, when my system calmed down I might not be allergic to everything. But said allergist would not do challenge tests on me for the medications for fear of liability, and she was also a screaming nasty unprofessional person whose sorry butt got fired.

Lo, 5+ years of living without these meds later, my headache specialist would like me to get tested for aspirin and acetominophen to see if we can expand my available Migraine medication options. My primary doctor told me 6 months ago that he thought he could do such a test in his office. The idea would be that I would actually ingest a small controlled amount of the drug in question and the staff would stand by to save me if I started going into anaphylaxis. Sounds like fun, no?

So last week I went to talk to my primary doctor about doing said challenge tests in his office. He
discussed it with me in more detail. He wanted to find a less dangerous way and proposed testing my blood for antibodies to the chemicals involved. This indicates whether there is a sensitivity, but I asked him, “Does having a sensitivity tell you whether the body would react anaphylactically?”  He went off to research it and concluded that no, it wouldn’t. I just got
a call back from his nurse saying there was no way to test except the “old-fashioned” challenge test, and they felt that could only be done in the hospital with a crash cart. So I should find an allergist who would admit me as an inpatient and do the test in the hospital.

Is this back to square one? I’m imagining calling allergists’ offices and saying, “hi, I’m looking to make an appointment see if the doctor would be willing to put me in the hospital, give me something that might kill me and then stand by to save my life! Oh and by the way, I really am counting on my life being saved! Want to take me on as a patient?” The fact that I am about to switch insurance makes this all more complicated.

I’m actually going to call Dr. G (headache specialist) and see if he might think
an allergist associated with his hospital would do it. At least then it would be one doctor asking it of another instead of some crazy-sounding patient?

I’m not particularly upset here or anything, just kind of rolling my eyes. Nothing’s ever simple, is it? It’s a wonder any of us ever have time to do anything other than wade our way through our medical issues!

– Megan Oltman
Still living aspirin-free!

Aspirin image courtesy of Ritcharnd Moskow; magic pill image courtesy of [O*] ‘BharaT; map-maze image courtesy of David Bleasdale.

Tags: allergy challenge test, aspirin, headache specialists, ibuprofen, medication allergies, Migraine treatment, NSAIDs
Posted in Medicine, Rant | Comments (3)

Update on my Headache Specialist Visit

July 13th, 2008

If you’ve been wondering, I do think all the preparation I did paid off.  I met with my new headache specialist for over an hour on Tuesday, and I liked him.  He seems knowledgeable, up on current research, is respectful, takes his time, listens, answers questions.

He took a little over an hour with me. He is starting up the headache center for UMDMJ (University of Medicine & Dentistry of NJ) and RWJ (Robert Wood Johnson) University Hospital. The center has been open
less than a year. Right now he spends half his time with general neurology patients while they build the headache & Migraine practice. He plans to do headache medicine exclusively and wants to have an iv center here eventually. He said about 80% of his HA patients have chronic daily headache or transformed migraine. He is very concerned about preventing chronic pain in someone like me who hasn’t developed it yet.

Some very good news for me – when I talked about an emergency plan, he said to come to the ER at RWJ. They will contact him or the neurologist on call and will have my chart and a protocol for me. It’s about 15 minutes further to this ER as opposed to 20 to my nearest one, but I can cope with that. It’s a huge load off my mind to have an emergency plan.

We talked about preventives – he gave me the choice of starting them now or giving it a few months to see if my current success holds (2 mild migraines last month – see my post on Recent Success). I decided
to wait. He wants me to continue exercising every day, get 8 – 10 hours of sleep per night, and he wants me to add physical therapy for neck-strengthening exercises and get neck massages. If the headaches

increase again I can call him and he will start me on preventives. I will be seeing him again in mid-September.  I’m planning to do a lot of reading up on medication options before that time. Other issues – he wants me to get an ENG to test whether my vertigo is positional vertigo or Migraine related (MAV). He thinks from my description it is probably positional and they can correct that in the office. If it’s MAV
triptans could be a problem so I hope I don’t have it. My medication options are so limited already I sure don’t want them limited further!

He would also like me to do a challenge test with aspirin – I’ve talked to my primary physician about doing that in his office. (For those of you not familiar with my saga, I have a life-threatening allergy to ibuprofen, and that is in the same drug family as aspirin, naprosyn, all the other nsaids.) This is an allergy challenge test – to see if I react to the drug. The
staff would be standing by to save me if I have a reaction. The idea makes me very nervous. But if I am not allergic to aspirin it expands medication choices quite a lot. I need to think hard about whether I am willing to take that risk. He’d like to be able to give me naprosyn for when I can’t use a triptan – he also says because it’s longer acting
it’s less likely to cause rebound headaches than the triptans.

I left his office and developed a 2 day migraine – I think the drive and parking in the blazing hot sun did me in.  But I’m happy to have a good doctor on my team!  Since the appointment I have scheduled physical therapy, called to schedule an ENG, and ordered prescription sunglasses to deal with the summer sun.  I hope I’m on a roll!

– Megan

Hospital image ©2008 Robert Wood Johnson University Hospital, aspirin image courtesy of Ritcharnd Moskow.

Tags: allergy challenge test, headache center, headache specialist, migraine associated vertigo
Posted in Managing, Medicine | Comments (1)