Allergies or illness?

  Hi! Thank you in advance for answering this question.
  My daughter is two years old.  She is allergic all milk and wheat products.  
  Her reaction to milk is very severe.  My daughter also has periodic
  outbreaks of severe hives extended from her chest to her face, hands, and mouth,
  followed by severe coughing( hard enough to make her gag) runny nose,
  and her eyes swelling up.  The cause of these outbreaks are unknown at this
  time.  My child's allergist is reluctant to do allergy testing on her because
  she is so young (He did do the wheat test though).  My daughter had an extrmely
  violent reaction to a cat.  She was rushed to her doctors immediately and
  given benedryl.  She had a difficulty breathing.  This incident happened nine weeks
  ago.  She had a very violent cough with this attack.  She still has a cough today
  (nine weeks later).  She coughs at night, when she runs around, and when
  she laughs hard.  Her doctor had me try dimetap and triaminic, but these meds did not seem to
  help.  Her allergist decided to put her on Zyrtec and she has been on
  it for a month.  Her cough has not improved.  Her doctor told me to give her delsym.
  That does help her cough at night.  However, the day time coughing is still
  there.  He told me to increase the delsym by 50% and add dimetap as well.
  Both her allergist and her doctor have gave me these instructions over the
  phone.  They insist they do not have to see her.  She has had this
  cough for nine weeks with little improvement.  No one has listened to her
  chest in these nine weeks. She has been very tired the past few days and is running a slight
  temp  barely 100.   I am worried that she may have something else that is being overlooked.
  Should I change docs or demand they see her?  Her cousin, who she plays
  with frequently, has walking pneumonia.  He had the exact same symptoms
  that my daughter has.  My doctor insists that she could not get it from him.
  Is this possible?  Does it sound like she may have this or asthma, or a viral
  infection?  Is it normal to have this cough for this many months?
  Thank you for your time,
  Rae

[HFHS.RN-AM]

Dear Rae,
Often children of this age who have multiple allergies have asthma as well. It goes undiagnosed because the only symptom is cough, that seems to last for days on end, is worse at night, and does not respond to cough medicine as expected. With asthma, the airway narrows and becomes inflamed, as well as fills with mucus . These responses occur in response to some sort of trigger, whether it's allergies, a virus, a change in weather, or exercise. The cough is the child's attempt to keep the airway clear of mucus so she can breathe easier. It is ineffective though because the airway remains narrowed and inflamed. Other medications are needed to open the airway (broncodilators) and stop the inflamatory process (steroids or cromylyn). Antihistamines like those in Dimetapp will decrease the mucus somewhat but dont get to the root of the problem. 2- year olds receive this medication through machines called nebulizers, which make a mist of the medications that are inhaled and work directly where the problem is. If your pediatrician is not knowlegable about asthma treatment, check with your area children's hospital or a university teaching center for a name of someone who is. With proper treatment, children with ashma can lead normal, full, and active lives.
About allergy testing....doctors do not like to do skin testing on a child of this age, first because of the discomfort, and second because of the difficulty in getting the child to cooperate with the procedure. The doctor can order serum testing, which involves a blood test. This is very expensive, but in your child's case, may certainly be indicated.
I would suggest getting an epi-pen (bee sting kit) to keep with your child at all times as your child's reactions are so severe that her airway may narrow so much and so fast (an anaphylactic reaction) that treatment will be difficult.
Good luck.
HFHS.RN-AM
*KEYWORD: allergy, asthma, reactive airway disease, anaphylaxis