More medical updata
Aug. 3rd, 2007 01:57 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
drwexWe cut because we care. Nothing icky under the tag, just not cluttering up pages with details.
Had a chat with the recommended allergist this AM. Despite my fears he had indeed reviewed the case file. He said "interesting" a lot, which seems to be doctor-code for "I have no idea what's going on here." Barto apparently produced a very thorough three-page-single-spaced write-up of her work with me. This contrasts well with the half-page summary letter she sent me.
Reister admitted that Barto had covered all the bases he could think of. He'd really like to get a serum tryptase during an episode but since I'm not going to provoke one and since I'm avoiding the probable triggers that may not happen. He admitted that "idiopathic anaphylaxis" is a bad diagnosis to put down but he says he really has no idea what happened to me.
He's also sort of unhappy that my previous serum tryptase came back high-end-of-normal; he says the symptoms I'm showing are all consistent with mastocytosis except for the tryptase level. On whatever scale they use he'd expect a mastocytosis case to be around 20 and I'm at 8.5, which is more consistent with someone who has systemic environmental allergies. The only way to be 100% sure at this point would be a bone marrow biopsy, which is PAINFUL and not something we'll be doing, thankyouverymuch.
We discussed the situation around a severe challenge to the immune system can bring on all kinds of weird reactions and it's fully possible that's what happened and that it'll just get better on its own. He totally disbelieves my hypothesis for the 2001-02 episodes, claiming that people don't have allergic reactions to bacteria.
The next step is to do a 'specific challenge' step. This is somewhat problematic as it turns out that tomato allergy totally bypasses the normal igE mechanisms (chocolate allergy does, too - nobody knows why). Basically, no test in the current repertoire will show up a tomato allergy. He was unfamiliar with eggplant (like, I had to describe the vegetable to him!). The plan is to attempt a direct scratch test with these - apparently they do this on a semi-regular basis. We'll bring in a bit of tomato and a bit of eggplant, extract some juice and apply directly to scratches, then measure the result. This should be entertaining.
Depending on what is found from this, he may have me referred downtown to Beth Israel; apparently there's someone on staff there who's a national expert on mast cells and the things that involve them.
Had a chat with the recommended allergist this AM. Despite my fears he had indeed reviewed the case file. He said "interesting" a lot, which seems to be doctor-code for "I have no idea what's going on here." Barto apparently produced a very thorough three-page-single-spaced write-up of her work with me. This contrasts well with the half-page summary letter she sent me.
Reister admitted that Barto had covered all the bases he could think of. He'd really like to get a serum tryptase during an episode but since I'm not going to provoke one and since I'm avoiding the probable triggers that may not happen. He admitted that "idiopathic anaphylaxis" is a bad diagnosis to put down but he says he really has no idea what happened to me.
He's also sort of unhappy that my previous serum tryptase came back high-end-of-normal; he says the symptoms I'm showing are all consistent with mastocytosis except for the tryptase level. On whatever scale they use he'd expect a mastocytosis case to be around 20 and I'm at 8.5, which is more consistent with someone who has systemic environmental allergies. The only way to be 100% sure at this point would be a bone marrow biopsy, which is PAINFUL and not something we'll be doing, thankyouverymuch.
We discussed the situation around a severe challenge to the immune system can bring on all kinds of weird reactions and it's fully possible that's what happened and that it'll just get better on its own. He totally disbelieves my hypothesis for the 2001-02 episodes, claiming that people don't have allergic reactions to bacteria.
The next step is to do a 'specific challenge' step. This is somewhat problematic as it turns out that tomato allergy totally bypasses the normal igE mechanisms (chocolate allergy does, too - nobody knows why). Basically, no test in the current repertoire will show up a tomato allergy. He was unfamiliar with eggplant (like, I had to describe the vegetable to him!). The plan is to attempt a direct scratch test with these - apparently they do this on a semi-regular basis. We'll bring in a bit of tomato and a bit of eggplant, extract some juice and apply directly to scratches, then measure the result. This should be entertaining.
Depending on what is found from this, he may have me referred downtown to Beth Israel; apparently there's someone on staff there who's a national expert on mast cells and the things that involve them.
