Diary of an At-Home-Food-Challenge

Note: There are two to three actual "days" between each day recorded as I decided to start out giving him something every two to three days.

Day 1 - After soliciting advice from other parents I settled on starting our challenge with Kellogg's Nutri-Grain Bars which contain non-fat dry milk. I broke off a piece and asked him to have a bite. Much drama and face making. He finally puts it in his mouth the whole time making yuck faces. I only get one bite in him. He says "Watch me closely Mom. In case I get sick." Yeah, like I didn't want to just sit and stare at him with the Epi in my hand. After a while I asked if he was itchy. Yes, he said. I little spot on my knee here and on the back of my hand....
"Are you itchy in your mouth, throat or lips?" "No." No hives or vomiting followed. I breathe a sigh of relief.

Day 2 - I try a Nutri-Grain bar again. I can't get more than one bite in him. No reactions.

Day 3 - I decided to switch tactics in order to get him to eat more. I make Bisquick biscuits using 2% cow's milk. He eats the entire biscuit and asks for another. I laugh and tell him we will need to build up to 2 biscuits. No outward reactions.

Day 4 - I do biscuits again. They seem to have already lost their appeal. He only eats half of one. No reaction.

In between Day 4 and 5 the weather heats up, the pollen starts to fly and Max spends most of the weekend outdoors. The windows are wide open and everything in the house is coated in a fine green dust. Saturday I notice Max's face looks puffy.

Day 5 - Already tired of making biscuits I buy some plain Goldfish Crackers. Max looks terrified at the thought of eating Goldfish Crackers. Have I really instilled this much fear in him. I explain I can't always make biscuits. These aren't the cheese kind they just have milk baked in them. He eats two, thinks about eating a third but doesn't. His face looks horrible.

By Monday (yesterday) morning his face is so puffy his eyes are becoming slits. His cheeks are red and rough. I call the allergist. Though it is probably pollen related she asked that we postpone the challenge as we cannot tell right now what he is reacting to. So there ends the food challenge and thus began the frantic me, closing up the house yesterday, turning on the air, vacuuming, dusting, mopping, and changing bed clothes. I'm exhausted.

I gave him Claritin and Nasonex last night. He already looks better.

Ace of Cakes

Today Max requested a Bakugon shaped cake for his Bakugon themed birthday party. I pondered how this would be possible and thought of Ace of Cakes (awesome TV show) and fondant. Then wondered if fondant was allergen free. Apparently it is just sugar and water. Then I found this recipe for fondant. And now I am pondering if I can really make a Bakugon cake ala Ace of Cakes. Hmmm. What a challenge. Problem is I will be coming off of 5 1/2 weeks of an intense teacher training course. Will I be up for a challenge the end of July?

Milk Challenge

To begin with challenge days are hard because we have to get Max up at 5:30am to eat breakfast because he can't eat for three hours before the challenge. So by the time we got to the doctor's office at 9:00 am he was hungry and cranky already.

After the first dose (approx. a teaspoon) he immediately started complaining that his tongue itched, his throat hurt, he felt sick. But...there were no hives, his tongue and throat were not red and irritated. There were no visible signs of a reaction. So the question became whether this was anxiety. It is partly my fault. I did not prepare him well for this. I asked a couple times if he would be disappointed if he didn't pass the challenge and I can imagine, for a six year old, telling him to avoid something his whole life and then asking him to eat it can be anxiety inducing.

In any case, he didn't want to continue with the challenge. We let him make that call. The doctor gave him Benedryl and about an hour and a half after arriving we left. However, because his numbers are so low we are going to approach the challenge a different way. A couple times a week I am to give him baked goods that contain milk product. Milk baked into things breaks down the proteins. We will do this for three months and re-do the blood test. If the RAST number spikes he will need to go back to strict avoidance.

Bad news? Good news? I don't know. I do know that no matter how much I prepare MYSELF for the disappointment I always still am. I feel like hanging my head and sobbing. Even though I went in soooooo pessimistic I still wished deep deep down that it would work. That I would have one less allergy to worry about.

Birthday Planning

Max is always planning his birthday party. He switches themes on a weekly basis. After a viewing of Toy Story he suggested a space theme and said we could serve the special cheeseless pizza I make for Max and Owen. I laughed and wondered out loud if other children would like cheeseless pizza. Max said "Why wouldn't they?" I replied that most kids were used to only eating their pizza with cheese and I wondered what they would think of pizza without cheese. Max simply said "Well, if they don't like it they can just bring their own." There was no malice or sarcasm in what he said, just a statement. Because this is what he knows; when you go to a party you bring your own food! Makes me ponder what he has learned about hospitality.

Puts a whole new face on BYOB or should I say BYOP!

PS. Speaking of cheese, wish us luck. Milk challenge tomorrow!

The Numbers

We got the numbers late last week and then I misplaced them so I had to call the allergist back yesterday to get them again. So here's my little chart from when we first started blood tests to now.

2004 Egg 1.45 Milk 2.71 Peanut 1.61
2005 Egg 1.10 Milk 2.36 Peanut 1.80
2006 Egg 1.34 Milk 0.90 Peanut 1.09 Cashew 2.67 Pistachio 3.40
2008 Egg 1.59 Milk >.35 Peanut 0.51 Cashew 1.40 Pistachio 2.08
2009 Egg 2.86 Milk 0.17 Peanut 0.49 Cashew 1.63 Pistachio 1.55

Dr. B. started off saying that the results were a little disappointing but after getting the news I didn't think it was all that disappointing. Maybe she was hoping for more negatives than I was. She did say it was unfortunate that we had to switch labs as different labs run different types of RAST tests. One runs the ImmunoCap and the other the CAP FEIA (I don't remember which runs which). But as we have moved over the years, switched allergists, etc, I couldn't tell you which year or what lab used which type of test. All I have is the numbers. Dr. B. said the numbers could vary though from one test to another.

Looking at the numbers there is a definite downward trend with all Max's allergens except one. Egg. I asked if that was an indication he wouldn't outgrow egg and Dr. B. responded that his body just seemed to be a little stubborn (possibly like his whole little being.)

I think Dr. B. was most disappointed with the milk as though it is less than .35 it is still there. She rescinded the at home challenge but did say if we wanted we could do an office oral challenge if I didn't think it would be psychologically hard on Max if he didn't pass as we wouldn't challenge than again for another year. I got the feeling with a positive (no matter how small) blood test and a still fairly large skin test positive, the doctor is thinking he won't pass a challenge.

So I told Max I had his blood test results back. He very adult like turned to me and said "So, what do they say." I said milk was low but still positive and he could challenge again but would he be disappointed if he didn't pass? He said "No, I'd be okay. " "So do you want to do it?" I questioned. "Yes" was his reply.

I made the appointment yesterday for March 31st. Though I sometimes question whether I like this doctor, I have to say it is great not having to wait too long for appointments.

Blood Test

We went in for the blood test yesterday. I had to try a new lab because our insurance no longer covered the one we had been using. No big loss, they weren't that great.

Things went well. Max started crying when I told him where we were going so I did what any good Mom would do. I bribed him. I told him if he was brave we could go to Target afterwards and buy him something new. And we went over ways to be brave and stay calm. Be still, take big deep breaths. The front desk people at the lab were actually friendly and had a sense of humor! And the lab tech, though initially had a hard time finding a vein, distracted Max enough while it was going on that he stopped crying and talked to her. All and all easy in easy out. Even Owen sat patiently with his back against the wall quietly watching as he always does.

We then went to Target. As we were walking up to the store Max realized he was still holding his Clifford (you know, the big red dog) and asked that I take it back to the car. I got them on the sidewalk and told Max to hold onto Owen while I ran back to the car (it wasn't far away). As I turned back to look at them. I saw Max had pulled Owen way over to one side away from the street and protectively had his arms wrapped around him. Owen in turn had his arms wrapped around Max's waist. Sometimes the amount of love they have for each other brings me to tears.

Down We Go

We finally made it to the allergist today to make up the appointment that was cancelled in January. No matter how I go into testing I always come out feeling down. I think on some level I always go in hoping for a miracle. Hoping that he will test negative and we will leave the office skipping with joy.

We scratch tested milk, egg, and, for some reason, strawberry. Max is never well behaved at the allergists. I can understand this. He is anxious and he hates the scratch test almost more than the blood test. It is itchy and uncomfortable and Max has a very low tolerance for pain. There was lots of drama as he lie there writhing around, yelling that his back itched. He asked me to take a picture of his back.

In this first one the protein extracts are still on his back and I think make it look worst than it is. For those of you who haven't been through this procedure, the allergist puts a drop of the suspect protein on the patients back then "scratches" it. In our allergist case, she uses these little bristles and presses firmly into the skin. Then we wait for 15 minutes for the hives or wheals to rise. The nurse then comes in and uses a clear ruler to measure the size in millimeters.

The second picture is after the nurse has wiped away the extracts and rubbed a little hydrocortezone on to quell the itching. I think Max's skin was extra sensitive today. It was really dry with some patches of eczema. If he would let me put lotion on him it might not be so bad but he runs away screaming if I even suggest it.

When she started measuring the first one I asked if it was the control (one of the pricks if always histamine to assure that the skin is indeed reacting). She said no it was the milk and then showed me where the control was. The reason I think Max's skin was extra sensitive today was because the control was almost as large as the milk. Egg was larger and peanut, unfortunatley, the largest. I think I was disappointed with the peanut size because it was so small last year.

In any case, three positives. The allergist said it was good news because the milk scratch was smaller than last year so if his blood work comes back negative than we can oral challenge milk again. She even said we could try it at HOME but would need to stop at the first sign of anything happening.

So I need to get on the horn and schedule a blood test somewhere. I'll let you know the results.