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Saturday, February 9, 2013

100%

I saw the allergist the other day. I did not react to wheat on the scratch test, however, when I eat it I still get immediate itching and a rash. All the information I can find says that this kind of reaction is consistent with an allergy so I'm not sure what all this is about. It's frustrating. Maybe I am allergic to an additive or preservative used in wheat products, I don't know. Perhaps it is gluten intolerance, I can't say and I don't think anyone else knows either.

I liked the allergist for once. Most of the allergists I have worked with in the past have been very strange and I find that the allergic paradigm does not work for me as a general rule.

But there was still some weirdness which I have come to expect from this field of medicine and just medicine in general.

I told the doctor, "I did the shots but I am still allergic to cats."

"But the shots are 95% effective," they said with obvious surprise.

"Well I'm the 5%."

I really wanted to say you know, medicine is about 100% of the patients.It's not about the number for whom the treatment is effective, it's about all of us. I feel like when I go to see doctors that they're playing the odds. If medicine says 80% or 95% or 60% of patients will show resolution of their problem then I must, by default, always be in that majority. It's like the other 5% or 40% of patients just stop existing, at least in these physicians heads.

I would think that the attention would be on recognizing those patients who still have problems despite treatment. Instead medicine essentially gives you a pill and denies that it doesn't work. I have seen this over and over again when I have worked with physicians and it is really kind of scary because, if you ever are in that percentage where medicine is not effective, they don't know what to do with you. It's not even part of their thought process. They can't even acknowledge it. There won't even be a discussion of trying different treatments. There's no decision tree for outliers.

The dynamic is very toxic and is the core reason why I have been the one driving most of my medical care. If patients don't push back, this majority medicine will bury them.

So, of course, you know that the allergist gave me another scratch test for cats so that they could prove that I wasn't allergic, except guess what? I am allergic to cats. Still.

Then we had a very interesting conversation because it came up in the allergy testing that I am allergic to fish.

"Should I not eat fish?" I asked. "I've eaten fish without a reaction."

The answer was something about how a positive allergy test doesn't always mean you will have a systemic reaction. Okay fine. So I can eat fish, but I was told I need to cover all my mattresses and pillows in plastic tout suite because of my positive reaction to dust mites. On one hand, the allergy tests can be ignored and on the other hand, I must immediately take action against dust mites.

WTF? Either the tests are accurate or they are not. Pick one. It can't be both.

I argued with the allergist a bit on the plastic mattress covers because I've used them before for years and they made no difference for me. The allergist insisted that I was wrong, but they're the ones who set up the logic: If I can be allergic to fish and eat fish with no problem why can't I be allergic to dust mites yet still not react when exposed?

So let's recap, I'm allergic to fish but I can eat fish and have no reaction. I'm allergic to dust mites and should avoid them even though I have no reaction. And I'm not allergic to wheat even though I continue to have an obvious reaction to it.

Any questions?



1 comment:

  1. What a mess. To be honest I would take back any allergy testing I've had done because in vitro and in vivo are so different. Came back allergic to hazelnuts but was eating stuff with traces fine. I think the testing is semi irrelevant either way and only useful if clinically having a positive definite reaction to one thing and testing confirms. Otherwise, gong show. That's why I'm doing elimination/rotation of everything to sort out what I can do. According to testing the only thing i'm allergic to is hazelnuts. Well I've had anaphylaxis to pretty much everything under the sun which is more meaningful to me! Agree with what you've said

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