Testing for Medication Allergies

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.

Comments

[Debbie]

Megan,
I experienced an anaphylactic reaction to yellow jackets in 1992. I almost didn't make it, but thanks to our small community hospital I got the care I needed.

I subsequently underwent allergy challenge tests to see what I was allergic to. The allergist used a miniscule amount of bee venom to get a reaction. I believe it was something like .00001 of a bee sting. I suffered no adverse reaction to the challenge test. I believe your challenge test could safely be done in an allergist's office, provided there is an EpiPen available. However, you would have to check with a board certified allergist to be sure.

Debbie

[Megan Oltman]

Thanks for sharing your story, Debbie. I too have an allergy to yellow jackets and had anaphylactic reactions to stings in 1974, 1980 & 1992. I carry an EpiPen in case of stings. But I also had a series of desensitization injections - actual venom injections - in 1992 - 94, and theoretically could withstand several stings now without reaction.

I guess medication allergies are somewhat different. My allergist in 2003 said it was not safe to do a challenge test for medications. I did not particularly like her or trust her judgment at that point due to some questionable behavior, but she certainly may have been correct on that point. I do have to find a reputable allergist and get more information.