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PostPosted: Tue Jun 14, 2011 1:36 am 
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Joined: Mon Sep 05, 2005 12:53 am
Posts: 375
Location: Alberta
Not sure where to put this ... but I had a VERY interesting appointment with our allergist today. Many of you know that my ds passed a baked milk challenge last year, despite having a huge RAST still (58), and strongly positive skin reactions. He also had an anaphylactic reaction 2 weeks ago to a hot dog, and this is why our allergist wanted to see us.

I noticed that many of you are having challenges, but the allergists are stopping them early if there are any skin reactions. Our allergist has done over 100 peanut challenges now, and many of them still have "cutaneous" reactions, so there are reactions at the skin prick stage, the rubbing on the cheek stage, and rubbing on the lips (itchy, tingly). Most of these kids have gone on to pass an oral challenge. :dungetit He recently had a child who had a "22" skin test (the measurement after the skin prick ... that is HUGE!), and this child still tolerated an oral peanut challenge.

His criteria - while I can't remember the exact formula, involved a drop in the RAST by 1/2. So THAT is why he challenged my ds for walnut and baked milk despite his huge RAST (failed the walnut when he started sneezing at the lip stage, but passed the baked milk despite positive cutaneous reactions all the way through.) He also pointed out that up to 50% of those with positive skin tests can actually tolerate the food just fine. That is why he pushes the food challenges beyond the tingly lips stage ... because those might represent a false positive of sorts.

I asked him if he is going to publish any of this, and he is working on it. However, he is a private clinic, and is not affiliated with a university, so he is working with another allergist (part of the AllerGen group) to try and get things moving.

The other interesting thing he said was regarding the time of year for serious reactions. My ds has had 3 reactions to baked milk now, all were an hour after he ate the food, and during exercise. The 2 from late fall / winter were not as serious, and resolved with Benadryl. The last one escalated rapidly and needed Epi. He said that in spring time, when there are molds / pollens present, any food reaction might progress to a more serious one due to the "other factors" happening around the child. So he reinforced how vitally important it is for any child with a history of asthma and/or environmental allergies to continuously take prescribed corticosteroid inhalers / sprays, even in the absence of symptoms. It just might prevent a poor outcome in the event on an accidental exposure.

For the record, my ds is taking his inhalers / nasal sprays every day as we learned that lesson 4 years ago. He has not had any asthma symptoms or allergy symptoms at all during those 4 years.

And why is my ds having those reactions? The allergist thinks he has developed an exercise-induced anaphylaxis, separate from his "regular" food allergy. Milk is still the trigger. So we are to continue with baked milk, but NOT on any days where my uber-athletic 11 year old will be running around. Not sure how often that will be....(ana from 2 weeks ago was an accident - we were not giving him any baked milk prior to exercise anyways, but I was certain he had those hot dogs before on a baseball night. Now I remember that it was his sister that ate them, not him. But he has been tolerating hot dogs for years now??!! Allergist said we will likely never know for sure if it was the hot dog alone, or the hot dog combined with the exercise since ds will not be eating a hot dog again anytime soon!)

Hope this info gets out there soon so other allergists can get kids moving forward!


Last edited by Momtobunches on Tue Jun 14, 2011 2:05 pm, edited 1 time in total.

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PostPosted: Tue Jun 14, 2011 8:31 am 
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Joined: Wed Jun 17, 2009 9:23 pm
Posts: 129
My son has a very clear history of anaphylaxis in November-3 years in a row. He has very bad grass (rye) allergies and we live in an area where crops are grown. His nasal symptoms are at their worst in nov. when the crop smell is very heavy in the air and when rye grass is at its peak.
Interestingly enough the crops we have around us are-barley, pea's and sunflower-barley and sunflower are things he has had anaphylaxis to-peanut is the other one and this is closely related to the pea. For us-though its not documented in literature well-there is a clear correlation to the pollens in the air and what he is reacting to food wise. ( we dont have pineapple plantations around so I dont know where that one comes from)
For what its worth we keep his nose very well under control at all times-he's recently been started on avamys and its covering his allergic rhinitis and conjuctivitis amazingly. (have gotten rid of the patanol eyedrops as its so effective).

_________________
twin boys-
c-eosinophilic oesophagitis
j-avoids peanut, sunflower, pineapple all ana-sensitised to maccadaemia.pecan.Passed barley (previous ana) last year...out grew egg ana and peanut at 3 years..became re sensitised with ana at 6 years to peanut.


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PostPosted: Sun Jun 19, 2011 2:58 pm 
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Joined: Tue Jun 14, 2011 4:56 am
Posts: 1
Wow, that's really interesting information. Thank you both for sharing.

I am a mom to a little boy with dairy allergy. We've just found out that his RAST has dropped from 24 to 4 in 18 months. Am so thrilled as we were thinking that he wasn't going to grow out of it. The doctor has suggested he comes in for a dairy challenge. I'm based in the UK, and here they put a drop of milk on face, then lip, then drink and stop if there is any reaction at any point. However, I know that he will fail this, even with a score of only 4, as he got some milk on him the other day and he soon after got itchy eyes, a huge red patch, 10 or so small hives around the area, and started sneezing. (He was anaphylactic at score of 23).

I'm really keen though, to do a challenge to baked milk as the theory of it just sounds so sensible. However, it doesn't seem to be very well known over here, so I should imagine I will have to go to my consultant and suggest it and do all the research myself. So, I am wondering if you ladies can share any more info about the baked milk challenges you have done, as I would really appreciate a steer. Eg.

- what recipe for muffins have you used
- do they get the child to immediately eat the whole thing or do they do it slowly - put it on face (?), a bite etc, and then wait for 20 mins in between each step?
- is there anywhere that I can read about the steps in the procedure?

Any info would be gratefully appreciated. Obviously we will do this within the safety of a challenge, but our doctors don't seem to be too clued up on anything apart from raw milk challenge. I really want to make progress, but I know he will fail this, but really hope that baked milk will do the trick.

Thanking you in advance...


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PostPosted: Sun Jun 19, 2011 3:40 pm 
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Joined: Mon Sep 05, 2005 12:53 am
Posts: 375
Location: Alberta
Happily, several of us have posted our experiences in this thread:

http://allergicliving.com/forum/viewtopic.php?f=7&t=5977

It is located in the Dairy / Eggs topic, and there are few other relevant topics there as well - like where to put the recipes of things you have successfully fed after passing a challenge, and also a link to a new study (which you could take to your doctor) from the group in New York who are leading the way with baked milk. It shows that those kids who eat baked milk may be more likely to outgrow their allergy. My allergist thought there was still some bias in their study sample, they "pre-select" their candidates for the trial based on the liklihood of success, but the results are still promising.


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