Thursday, October 6, 2011

Food Challenge Results

I wish I could say that Luke's peanut challenge went really well.  That he passed it with flying colors, and that I'm sitting here enjoying a peanut butter and banana sandwich to celebrate.

But I can't.

What I can say though, is that nothing dramatic happened, which is a huge win in my book.  No Epi-Pens were used in the dramatization of this story.

We got to the third serving of peanut butter.  They started out giving him a small amount on the tip of a tongue depresser, and smeared it on the inside of his cheek.  Fifteen minutes later they checked his blood pressure and checked for hives, everything was good.

A few minutes later we moved on to the second dose, this time a bit of peanut butter on a spoon.  He LOVED it.  Licked it like it was an ice cream cone, asked for more.  I was so excited, thinking it was a good sign.  Fifteen minutes later, another blood pressure and hive check.  Everything looked good.

Again, a few minutes later, they brought in the third dose.  This time it was a bit of peanut butter, I would estimate about 1/4th of a teaspoon, spread on a mini Saltine cracker.  Luke was in heaven eating that thing, and I was even more excited.  The nurse promised him more when she came back.  So we sat there, coloring, waiting for the fifteen minutes to be up.  Then he sneezed.  Sneezed again.  And I could see his nose was starting to run.  It caught my attention because his previous serious reactions both started with sneezing and nose congestion (along with vomiting).  But I told myself it could easily have just been an innocent sneeze accompanied by a runny nose.  

Then the scratching started.  First his shoulder, the top of his head, then his chin.  By the time he scratched his belly I was concerned, so I lifted his shirt.  Sure enough, he had two hives right above the waistband of his pants.  As I was looking him over, I saw another one pop up on his neck.  I panicked fought the urge to run out of the room yelling for the nurse.  By the time she came back, another one was next to the original one on his neck. They checked his blood pressure (it was fine) and looked him over.  The doctor declared the food challenge a fail, and it was stopped.  He was given a mega dose of Benadryl (which made him one sleepy boy), and the hives slowly disappeared.

So, no peanut butter for another year, we'll re-test then.  The doctor feels that he has a good chance of outgrowing the allergy, we're just not there yet.  She thinks that his reaction today, compared to how he reacted to a similar amount of peanut butter 18 months ago, is a good sign that he's in the process of outgrowing it.  Although that doesn't mean we can assume any other reactions will be similar.  A reaction is not an indicator of future reactions.  You can go from a very mild one, like he had today, to anaphylactic the very next time.  This is also an excellent example that you can't rely on blood test numbers to determine what, if any, reaction someone will have to an allergen.  Luke's blood test number for peanuts was negative, yet he still reacted.

As for the egg issue, she was puzzled with his reactions.  70% of kids with egg allergies can handle baked in egg, which is what he had when he had the two reactions (one to cookies, the other to homemade corndogs).  So she wants us to try baked in egg and see what happens.  I'm baking cookies tonight, the same one he reacted to.  If he vomits again, we're to stop and let her know.  If he doesn't vomit, she wants us to try it a few times.  If he vomits, we'll have an in office food challenge for eggs, I'm assuming baked eggs.  Figures my kid would be the one that can handle cooked eggs, but not baked!  (Baking an egg changes the proteins, which is where the allergen is, and because of this, most kids can handle eggs if they're baked at a certain temperature for a certain length of time)

Domino's was another puzzle for her.  I think we pretty much determined that there must have been some kind of cross contamination there.  They have a white pizza sauce that contains egg, and I'm thinking maybe that got on the bread sticks somehow (same cutter maybe?).

Finally, she doesn't think he had an allergic reaction to the topical medicine.  And the thought is that maybe he never had scabies.  She thinks it was a viral infection, and it caused him to break out in hives.  If he had reacted to the medicine, he would have been covered with hives everywhere that it touched, and he wasn't.  It covered a good portion of his body, but not even close to everywhere that it touched (I put it on him from head to toe, as the directions said).  And no, I'm not disappointed at all to learn that he probably didn't have scabies.  I'll take that information any day!  I itched for two days thinking that we were all covered in scabies.

So that's it.  A fail, and some interesting information.  The good thing is that it's not life altering for us, unlike how it was when we first learned of his peanut allergy.  We'll continue on as we have for the last 18 months.  We were looking forward to learning that he had outgrown the allergy, but dealing with it is very doable.  


  1. Melinda, is it at all possible that there is another ingredient in the cookies that could be causing the problem?

  2. Hi Colette - All of the other ingredients are ones that we've used in other recipes before and since the reaction, so I don't think so.