Wednesday, January 25, 2006

allergy boot camp

Here we are in the last five of the eighteen minutes pre-Shabbat (what does that make me, a shabbat Mars or a Venus?), and I'm grabbing a sec to write a post that's been percolating for a couple of weeks now.

First off, welcome to my MIL who is now reading this blog. Your presence as a reader is much welcomed, and may or may not influence whether I discuss my sex life. On the other hand, I haven't to date...and now to the main event:

A little while ago, I took both boys to the allergy clinic at our local children's hospital. Alas, our allergist was AWOL that day, for the tawdry excuse of being a new, first-time dad. I was unimpressed. (I was also carrying a present for him, since he's a sweetie and we've been talking about the upcoming arrival of his baby, he's the guy who keeps my kids alive, so there's no real downside to being friendly.) Anyhoo, into the exam room comes Baby Fellow. Baby Fellow (or BF) is a young allergy and immunology fellow* who is carrying what I happen to know is one volume of my older child's three volume medical chart. He hefts this tome, and looks to me for guidance. I explain that we're here for testing and discussion of a possible pinto bean or butternut squash allergy. However, I whisper, the child in question has suddenly decided to take on a temporary (if I have anything to do about it) needle phobia, so we'd need to handle the discussion of testing carefully. With our allergist, this would have been a word to the wise, and handled accordingly. With the BF, this struck terror into his baby heart. I also explained that our allergist had agreed to take a history for our baby, to open a file if not initiate testing for a suspected dairy allergy. At this point, the BF muttered something and fled.

He returned with an attending** allergist - one whom I knew, as it happened, and who had (literally) written the book on his subject. I'd read the book, handed it out to my in-laws, recommended it to others, even watched the Arthur episode for which BSA (Big Shot Attending) had consulted. I sat forward expectantly.

BSA marched in and told us to avoid all legumes and squashes. 'This won't be a problem for you, will it?' he asked, not quite making eye contact. Aware that there was only one correct answer to this question, I nevertheless went for honesty. 'Actually,' I said, 'yes - we eat a lot of beans and -'
'You need to avoid legumes because of the dangers of cross-reactions,' interrupted the BSA, 'for example, he might react to chickpeas. Or in the squash family, he could have a reaction to zucchini.' At this point, the BF started making throat clearing noises, and muttering again. I made eye contact with the BF, and silently noted that yes, it seemed that the BSA had failed to read my son's chart, or at least the portions of which listed a number of positive blood tests for chickpea and zucchini allergy, and especially the portion that described the child's anaphylactic episode with zucchini.

I looked the BSA straight in the eye. 'I see,' I said. And tried to look compliant. Satisfied, the human bulldozer explained that no, we would not be doing testing for my older child today and oh, by the bye, the clinic was much too backed up for him to discuss the baby's dairy allergy with me. Feeling somewhat flattened, I did my best imitation of maternal road-kill and nodded. Riding the momentum of his triumph, the BSA left. The BF looked at me apologetically before fleeing, and I planned a pair of appointments...with my allergist.

As I left, the clinical assistant told me delightedly that clinic was so light today, as everyone had canceled appointments due to our allergist's paternity leave. Realizing how thoroughly I'd been squashed by the BSA, and leaned in and inquired as to whether the BSA would be working in clinic on the days of the boys' follow-up appointments. 'Oh, no,' said the clinical assistant. 'Good.' I said, firmly, and we shared a glance of complete understanding.

*a doctor who has completed internship and residency, and has chosen to do advanced training in a specialty. In this case, in allergy and immunology.

**a doctor who has completed his/her fellowship, and is now the ultimate medical authority, aka minor medical deity. Alas, these idols may also have feet of clay.

No comments: