Hold the phone, put on the brakes, this is the reason I am not the allergist. I was jumping to all kinds of conclusions based on Max's skin test before seeing the RAST results. I was lamenting him not outgrowing milk. I was fantasizing about french toast. When really I should have just been...waiting. Which is not something I am good at.
So the allergist had good reason for us to come in and review the RAST results and re-do the skin test. To review: Max's skin test two weeks ago resulted in a large positive for milk, a negative for egg and a small positive for peanut (tree nuts were not tested).
The RAST results for milk and egg were complete opposites of the skin test. Meaning the milk RAST was NEGATIVE. Completely. Negative. No detectable levels of IGE. The egg RAST was the same relatively positive number it has been always been. Really hasn't budged. But here is the REALLY good news the peanut showed the same pattern as the small skin test. His RAST for peanut was (drum roll please) .51! It has gone down each year. It really looks like he may outgrow peanut. I almost started crying in the office.
With that info we re-did the skin test. (Max was less than thrilled.) Result was still the same large positive for milk and small positive for peanut. But this time egg was a big old positive. No explanation for why he didn't react two weeks ago.
So where do we go from here. What do we do with these results. For starters looking at his blood test it looks like he has outgrown milk. Yet for some reason his skin is "remembering" the allergy. Dr. B. suggested we schedule a food challenge in the office. We did. March 11th is the date. Yikes!
Dr. B. is more hesitant to challenge egg now and I have to agree. His number is fairly low by RAST standards. Only a 1.54 which falls in the moderate range. But he has been known to develop hives to eggs frying in the room and react to food cooked in a pan formerly used for egg so I think egg is truly a no go.
But peanut! Dr. B. said she could see us challenging peanut in the office in the next year. Even with low numbers and a small RAST peanut is still a tricky one and he could still react. Numbers are in the end really just numbers. They give us an indication that an individual may react but we can never now to what degree until the allergen is ingested and with a risk of anaphalaxis this is tricky business.
So I guess that's it. That's where we are. Whew! It was a really exciting and rather weird day. I'll get to the weird part in a future post.