Sunday, August 21, 2016

Allergy Testing--Round 3

You may remember that Jackson is allergic to peanuts. We hadn't seen the allergist since 2014 when his blood test showed significant improvement and promise of his body clearing the allergy. So we continued the wait and see approach and decided to retest in two years. About a month ago, we took him for follow-up testing and both the skin test and blood test showed promising results, so his doctor thought it would be time for an actual peanut challenge.

We brought him to the doctor on Friday, where they started with repeating the skin test.


Now this time, the skin test indicated a bit more of a reaction than was there a month ago. It is apparently not uncommon to see some variability in the results. His doctor said that if he had seen those results at the visit a month ago, he wouldn't necessarily have recommended the peanut challenge, but we could proceed if we wanted to. He explained that the skin test and blood test really only provide a range of probability as to whether or not someone will experience allergic symptoms, rather than a yes or no. The challenge also provides a somewhat quantifiable way of determining just how much his body can tolerate as well so that we know how vigilant we must be in avoiding exposure (for example, is one peanut going to cause anaphylaxis or should he just not be eating PB&J sandwiches?) So we decided to proceed with the challenge.

As it turns out, after spending four years telling someone that peanut butter is basically poison, it's somewhat difficult to convince him to eat it. According to Jackson, peanut butter tastes disgusting (can you imagine???) But after much drama, he ate one teaspoon and was doing fine. He said his stomach hurt a little, but with him it's hard to tell what's real and what's psychosomatic because his anxiety and fear often manifest as a stomach ache. The worst part was the boredom with all the waiting between rounds. He played on his tablet, we played hangman, and watched lots of funny cat videos.


The second phase was for him to eat a tablespoon of peanut butter. He refused to eat the straight peanut butter so they brought out the big guns. A Reeses Peanut Butter cup! I wish I could go to the doctor and eat a Reeses, but it wasn't so appealing to poor Jackson. He slooooooooowly ate half of it and was okay, but then he decided to just get it over with and ate the second half in one bite and promptly started vomiting. And sneezing. And all sorts of sick. And then he got super sleepy and all but passed out in his chair. Poor baby.

But as traumatic as this all was, there is good news! His results indicate a pretty high threshold in the world of food allergies. He ate basically 2 teaspoons without any kind of reaction. And when he did react, his body promptly voided the allergen and then 30 minutes later he was perfectly fine. He never showed any signs of respiratory trouble, hives, etc. The other good news is that peanut butter has a very distinctive taste...it's hard to mask in any way and Jackson doesn't like it. So if he were to encounter it in a cookie at a birthday party or something, I feel very confident that he would not eat enough to cause a serious reaction. We don't have to worry about trace amounts or incidental exposures. This is all very reassuring! We will still have an epi-pen, just in case, but his doctor said that our risk of having to ever use it is exceedingly low. And on the bright side, I can still steal all of the peanut butter candy out of his Halloween loot!


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