I thought that people with genuine celiac disease were mostly happy about the hypochondriacs. They vastly expand the market for gluten-free food, which gives the people who actually need to eat gluten free a better, tastier selection of edible food.
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Not directly related to penicillin, but tangential.
My mother can’t get a flu shot. Not because of the vaccine, but because most (all?) are cultured with eggs. That is the part she is deathly allergic to. Which of course makes me wonder if the *cillin allergy is more closely related to the manufacturing process.
Or just paranoia, I really don’t have any data. I mostly suggest a benadryl, a small glass of Merlot, and Breaking Bad. Repeat till unnecessary.
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Not if the false coeliacs result in waiters and chefs rolling their eyes and ignoring the flour in the gravy, say. It happens.
ETA But, yeah. Your point is valid nonetheless. Just self-diagnosis of stuff that as a result can cause harm to others pisses me off.
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Ah. That sounds like a recipe1 for unpleasantness.
1Pun intended.
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Yeah - as I said there’s a grain of truth in what you say. 
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There are eggless versions but they are not easily available. Or necessarily cheap.
But I had the same thought which is why the “only cover generics when available” stance pisses me off. Some people need a specific formulation due to the fillers. Anecdotal, yes, but I have experienced that, reacting badly to one brand and not another. But just like people are willing to blame the last thing they ate for their food poisoning, they assume it has to be the active ingredient in the medication, versus the colouring agent used.
Humans are (as a whole) a very gullible/non-rational species
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Yet another thing that wouldn’t exist with a real patient records management system like every other civilized country. It baffles me why we insist on storing your medical history inside your own brain.
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Half a day for an allergy test is actually quite fast, since the typical subcutaneous prick test is just a first step. Properly testing usually requires IG determination results, and the tests in in most cases would be done in external labs.
Also, the immune system is a fiddly thing indeed, and chances are that allergies differ in their strength based on your overall health, including your hormonal status. Stress hormones, e.g., can level-up your immune response under certain conditions, AFAIR, in ways which make the latter determination of the cause of an allergic response exceedingly difficult.
A quick prick test if you have any reaction to penicillin should give your doctor a first idea. If you however already have shown reactions possibly linked to penicillin like described in this thread by others, any doctors on their right mind will not take the risk in case of any necessary treatment with antibiotics, anyway. So no point even doing the prix.
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I had been told since childhood that I was allergic-- the story was that I was given 'cillin while in the hospital and had “an immediate reaction” but was given benedryl to stop it. It has always been in my medical record. Fast forward 45 years, and my primary doc asked if I would be interested in testing to confirm the allergy. The testing was covered by my insurance, and took only a couple of hours. The testing determined that I was not in fact allergic. Interesting consult with the allergy doc afterwards-- she explained that studies have shown that many “allergies” to antibiotics were actually reactions to either 1) combinations of drugs given concurrently 2) other ingredients/additives or 3) symptoms of the illness that the 'cillin was meant to be treating (rash, etc). She also said that since I’d not had any 'cillin-family drugs that they would be mega effective for me.
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This test is extremely prone to false positives. It’s was a giant pain in the ass when I worked food service because you’d get people claiming an allergy to things that… frankly, are highly unlikely. It was often the case that after discovering that their list of allergies closed off a ton of food options that they’d relent and admit they regularly ate food and brands containing the supposed allergen, and they simply didn’t know it was in the food. These people often had a skin test in the past and took numerous false positives to mean they were definitively allergic to certain foods. We’d usually downgrade these allergies to “sensitivities.” But it’s doubtful this was even true. You’d walk into patient rooms and see them eating food family had brought in that was indisputably full of the supposed allergens as they complained about the hospital not having a wider food selection for people with XYZ allergy combinations. (I mean, they would get food, there just wouldn’t be great variety.)
So if it’s like that with food, I can only imagine what it’s like with medications.
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I’m in the same boat, but my allergist (I have other allergies that are definitely real) discussed it with me and it would be very hard to test. If you break out in hives the instant you take the stuff then everyone knows you are allergy. If you got a rash creeping up your leg after several days of exposure? The only test involves taping a big patch to your back and not showering for a week.
This point is definitely true; though in this specific case Team Medical(or, perhaps more importantly, Team Insurance) has a role to play.
It’s pretty easy to end up with a ‘penicillin allergy’ in your history without much personal involvement, or even knowing exactly how it happened; and once it gets into your history, there isn’t anyone whose job it is to remove it(and being the doctor who gave penicillin anyway, despite a noted allergy, and triggered an actual allergic response would probably be unpleasant); and “Sure, I’ll just get a specialist referral and try to find an in-network allergist who can get me an appointment before I receive treatment for this infection here, no problem…” is a ‘said nobody ever’ statement.
If somebody petulantly refuses a test, or insists that the results be ignored, because their allergies are just part of their identity and how dare you tell them otherwise or something; I’m deeply unsympathetic; but if you want possible allergies to be verified before being acted on; you’d better have things set up so that getting the test isn’t a ridiculous waste of time, money, or both; which it will be if you can’t get it as part of the visit where the antibiotic is being prescribed.
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This is tough enough with a single payer healthcare system because, as you say, it’s just not on people’s to-do list (though I hope that given the press this has been getting some family doctors are asking patients with listed penicillin allergies about it). In a healthcare system where a money-person has to be involved in the decision to get tested, there’s just virtually no way it can happen.
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I think this is a tough one. My husband’s allergist said it is highly likely that he is allergic to penicillin and was so concerned she recommended that he inform his doctors and never take the chance of trying it. He is also sensitive to medications…all medications, his body just metabolizes them differently. His allergist had to put him on kid doses of his allergy meds because his body reacted so strongly to them. He had surgery for kidney cancer and the doctor asked about allergies to medications and I explained this to him. He and the nurses looked at me like I was crazy. After the surgery, he said I wasn’t kidding and to make sure to alert doctors in the future, which just cracked me up because they always think I’m crazy. He had the earliest morning surgery slot and it took him all day to wake from the anesthesia. For every hypochondriac out there, there is another person whose body is just plain weird.
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I know what this is like. I have a condition that they’d normally give medication for, but I reacted badly to every medication on the market, so they are just monitoring me to see if I’ll one day need surgery. I’ve had life-threatening side effects from 2 of 4 anti-depressants I’ve tried, and somewhat scary side effects from a third, and the one I’m on I’m on a starter dose.
On the other hand, I’m nearly immune to pain killers.
Bodies are weird.
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I’m no immunologist; and any time atypical immune responses get involved things get real hairy, real fast, so I don’t know if this is technologically impractical/impossible; but if they really want to do better verification of drug allergies, it seems like either making it a part of routine checkups(for someone who has one on the chart but no documentation of any remotely recent test); or something you could administer during the same visit where you are writing the prescription.
If Team Insurance isn’t cooperating; and you end up with a ‘and this is how we bill people who try to see a specialist’ smackdown; there is absolutely no way you are going to sell someone on the value of carefully checking up on a possible allergy rather than just using a different drug family; but even if the financials work out; lining up a specialist appointment to address the possibility that you might not actually be allergic to a drug that you may or may not even have reason to consider taking in the next few years is…pretty optimistic.
Hopefully, there is some sort of clever single purpose assay that can be administered relatively quickly and easily without expertise beyond what you’d have in an ordinary doctor’s office; but I don’t know how realistic that is.
It sounds like for some people testing is quite easy and quick, but if you had a delayed reaction like the one I had it’s really terrible. I said it hardly seemed worth it (thing taped to my back for a week) when all the bacteria are going to be immune to penicillin in a decade anyway. We had a good laugh.
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From my friends with celiac it seems like a mixed bag. There’s a lot more options for gluten free food these days. But its a lot harder to determine which of the gluten free foods are safe to eat. Apparently most of your gluten free trend foods don’t hit the medical standard for being safe for those with celiac. Sufficiently low in gluten, and not made from anything gluten bearing enough to claim gluten free. But trace levels high enough to make a lot of celiac sufferers quite ill.
So you’ve got a lot more options. But its a lot more work to find out what’a actually safe. Can’t just trust a gluten free label anymore. Add that to the eye rolling, pissy response from some restaurant workers who are hard pressed with constant bizarre claims of impossible food intolerance and gluten fears from the non-ill. And I’ve been told they’re eating better but getting sick more often.
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