Talking Allergies

We had an allergist appointment yesterday, to follow up on our latest RAST tests. One of my sons had only a slight positive for egg white, and was negative for peanut. So good news right?
Only I'm feeling more scared than positive, because the next step that the allergist would like to take is a food challenge for egg, to be followed by one for peanut later.
His recent skin tests were positive for egg white and peanut, with the wheal which developed for egg being particularly large and angry looking, although I know that's not supposed to indicate severity of the allergy, it does make me worried nonetheless.
His last exposure to egg was when he was 2 (so four years ago now). He had grabbed at a piece of lemon meringue pie while at a church social, and got a little bit on his hand. Although I washed it off immediately his hands and ears turned red and swelled, and he was covered in golf ball sized hives.
It's frightening to think of purposely giving him what we've been scrupulously avoiding for so many years. And I'm worried about that positive skin test.
And even if the food challenge is a success, it won't make much of a lifestyle difference for him anyway, we still need to stay egg and peanut free for his brother.
I'm just feeling really nervous about this.

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1 son allergic to eggs, peanuts, green peas, chick peas, lentils and tomatoes
(avoiding tree nuts and most other legumes too)
1 son allergic to eggs, and has outgrown peanuts
Both with many environmental allergies, asthma and eczema

Oh, I am not surprised you are nervous! This is a stressful event. I haven't been through it with my son, but I can imagine the worry. Know you have our support and that the doctors know what they are doing and they will be prepared.

Good luck and let us know how it goes. And ((HUGS)).

Caroline

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son anaphylactic to peanuts

You have to remember that this is done in very well controlled environment and that if there was a reaction, they wouldn't let it escalate much.

I would personnally welcome a food challenge, because once it confirms that there is no allergy, it's one less worry for you and your child, even if he does have to still avoid it because of his brother.

Chances are his brother will also outgrow it too, I think.

Good luck and keep us posted!

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15 year old - asthmatic, allergic to cats, dogs, horses, waiting to be "officially" diagnosed for anaphylaxis
12 year old - asthmatic, allergic to tree pollen and mold, OAS
Husband - Allergic to amoxycillin
Self - Allergic to housework only

Thanks for the kind words. I'm simmering down a bit about it now. I have a hard time trusting doctors in general. We've had some bad or just indifferent experiences over the years, especially concerning our sons' allergies and asthma. And doctors are so busy, it's difficult to be comfortable with someone making life and death decisions concerning your child, who doesn't remember you from visit to visit, then takes a 2 minute glance at your chart and rushes you out of their office as quickly as possible. A food challenge certainly would require a leap of faith .
Anyway, first the allergist is sending us for another RAST test (the lab forgot to include egg yolk last time) and depending on those results he will decide if he wants us to proceed with the challenge.
As far as his brother outgrowing it, it doesn't look good. His IgE levels were very high. And the doctor said that even though they are identical twins, that doesn't mean that their allergies will follow the same course (or even that they will have the same ones, in my guys cases their food allergies have been the same, and they share several environmental ones (dogs, cats, molds), but one has trees and the other dust).
Which is strange, hey? You would think with identical genetics, the same diet and environment that they would respond in the same way?

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1 son allergic to eggs, peanuts, green peas, chick peas, lentils and tomatoes
(avoiding tree nuts and most other legumes too)
1 son allergic to eggs, and has outgrown peanuts
Both with many environmental allergies, asthma and eczema

Do you think the doctor remembers/is fully aware of how much he reacted from just touching egg? I can fully understand hesitating to go through with the food challenge---if you don't feel that you are ready or you don't feel that your allergist is proceeding with a full awareness of the medical history, I'd suggest raising your concerns with your doctor and waiting until you do feel more comfortable. And perhaps with repeat visits to the allergist, the doctor will become more familiar with the situation (unless you decide to find another allergist). I know it takes me awhile to get to the point where I trust my doctors where the allergies are concerned.

But in any case, the "food challenges" (at least the ones that I've undergone) begin with a skin prick test using the actual food (as opposed to the extract used for the skin prick test). . . so if your son is as reactive to contact, no doubt the challenge would stop there. Next, the doctor has the patient put a bit of food under his/her tongue for a period of time before swallowing.

I would agree with Helen, and I've been meaning to post for a day or so. If you aren't comfortable doing the challenge, there's no law that says you have to.

It's been a year since our allergist said my oldest was a candidate for a peanut challenge, but my son doesn't want to (and we'd have to keep peanuts out of the house anyway because of my youngest), so we haven't done it yet.

I realize that having egg would open up more foods, though. (But then maybe not - just re-read your post - you have to avoid it because of his brother. So we're in similar situations.)

Anyway, just wanted to let you know that you do have options, and one of them is to not go ahead with the challenge.

K.

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Karen, proud Mom of
- DS1 (12 yrs): allergic to cashews, pistachios, Brazil nuts, potatoes, some legumes, some fish, pumpkin seeds; OAS
- DS2 (1o yrs): ana. to dairy, eggs, peanuts; asthma

Our daughter just had her annual skin prick test and may have out grown her milk allergy. She too is nervous (we all are).
It is so much to take in and at this time of year, she is just settling into SK and still learning so many life skills (brushing teeth and hair etc). I have told her that we can revisit this topic in 5-6 months. I have told her that the next step is the blood work.
I have the requesition form and she will probably want that done sooner rather than later as she is a curious child.
This should be a life enhancing event. We will do it when everyone is ready.
Good luck with whatever you decide to do.

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Moderator
Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb

Susan, that's (hopefully) wonderful news! Milk is a really hard one to avoid and scary to deal with in a school setting. I'm keeping my fingers crossed for you.

My daughter just had her RAST test done last week. It was a terrible experience getting the blood work. Good thing she doesn't know any swear words because she would have used them!! She told those poor lab techs to leave her alone and that they were bad women and that they should " leave this instant". After it was all done we had to walk out of the little room into the waiting area filled with people who had just listened to all of the screaming.

We are now waiting her results. It is hard because none of these tests are definitive except for the oral challenge. Her egg RAST was low last year but her skin was a huge positive. So we decided to wait. Egg wouldn't change her life much now anyways. My daughter is the same age as yours, Susan I hope her milk RAST has gone down this year. What a difference milk would make for her and us. I have never told her she could out grow this. I don't want her to be disappointed if she doesn't.

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11 year old daughter -- lives with life-threatening allergies to milk, eggs and peanuts; seasonal allergies (birch, maple, ragweed); pet allergies; asthma; and eczema
9 year old son - no allergies

Just to update...we decided to postpone the food challenge until we all feel ready. My son is really nervous about the idea, and so are we, and since we are getting ready to move in 3 weeks, none of us need that extra stress right now.
We also want a chance to see a different allergist first. I just don't feel that we are communicating well with this one, and I want to feel that our doctor has actually LISTENED to my son's case history before proceeding with the food challenge. So the move will provide the perfect chance for a referral to someone else, and a second opinion.
I really liked how Susan said that "This should be a life enhancing event". We will wait until my son is ready (and we feel confident in the medical advice we are getting), so that it can be exciting and liberating, instead of a lot of stress for very little difference in his day to day life.

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1 son allergic to eggs, peanuts, green peas, chick peas, lentils and tomatoes
(avoiding tree nuts and most other legumes too)
1 son allergic to eggs, and has outgrown peanuts
Both with many environmental allergies, asthma and eczema

That sounds like a good decision. Hopefully you'll find an allergist who listens and doesn't rush you out of the office in 2 minutes!

Has anybody on the board ever had to do or have a child do a food challenge? If so, can you share how it was conducted and how long it took, was there a reaction, what was the final outcome, etc.?

I would really like to hear what the experience is like.

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15 year old - asthmatic, allergic to cats, dogs, horses, waiting to be "officially" diagnosed for anaphylaxis
12 year old - asthmatic, allergic to tree pollen and mold, OAS
Husband - Allergic to amoxycillin
Self - Allergic to housework only

Here's our challenge story.

We did our egg challenge with French Toast. RAST was in acceptable range for testing - can't remember what it was as it was almost 10 years ago but we were comfortable with the Dr.'s recommendation that we challenge.. We cooked 1 slice of safe bread dipped in 1 beaten egg mixed with a little water and fryed in butter at home and brought to hospital (Allergy Clinic) to eat. (I can't imagine anyone diving into scrambled eggs who have never had them - I think the french toast is a better idea) !Also brought safe syrup. Started with a piece the size of a pencil eraser. Waited 15 minutes. Then a piece twice the size of a pencil eraser. Another 15 minutes. Then double that amount, etc. until we got to the 1/4 of a piece of french toast (equavalent to 1/4 cooked egg) and then the doctor said he was starting to react. I didn't even see it, but the Dr. noticed the very beginnings. Change in attitude (wanted to leave NOW), glistening eyes, restlessness, very slight sniffles. He said it was the start of anaphylaxis so in went the epi, steroids and another medication I can't remember. We had to wait 4 hours (good thing we brought movies with us - it was the year of Lion King so that was a while ago!). After 4 hours we were allowed to leave, but he did need to be on steriods for 5 days after that. For us, no go. He's 14 now and his RASTS are too high to challenge again. We'll do one more RAST when he's 16 and then that will be it. He's probably a lifer! The only lingering problem - he doesn't like the smell or taste of maple syrup!

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adult son allergic to peanuts, most tree nuts, eggs and penicillin.

Thank you so much for sharing your story mharasym. My daughter will have a food challenge some time in the new year (it was supposed to be this summer but I asked to have it moved up. My daughter is very anxious about not knowing what caused her reactions). I find it reassuring to hear that the doctor was watching your son very closely and noticed the signs even before you noticed or before your son started complaining.

I find it interesting that the RAST was at an acceptable range, yet your son was still allergic. Did your allergist also do a skin test or did he rely solely on the RAST results? If he did a skin test, was it positive?

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15 year old - asthmatic, allergic to cats, dogs, horses, waiting to be "officially" diagnosed for anaphylaxis
12 year old - asthmatic, allergic to tree pollen and mold, OAS
Husband - Allergic to amoxycillin
Self - Allergic to housework only

My allergist doesn't have his patients try the test food right away---first he does a pinprick test with the food the patient brings in---if this test is negative, then he asks the patient to hold a small piece under her tongue for a period of time before swallowing.