Bryan had an appointment with his allergist at the beginning of August, and for the first time, we came away with some potentially good news. At first, things looked the same- his blood tests all came back with extremely high IgE levels for all of his allergens. (And for those who don't live in this world of allergy terminology, that basically means the likelihood of an allergic reaction is extremely high.) However, our allergist told us that even with the high IgE numbers, she wanted to try a skin test for egg, and if that came back clear, she would want to follow up with an oral food challenge with egg. Wait a second... what did she just say?
Several studies recently have shown that a high percentage of children over the age of 6 who test positive for an egg allergy may still be able to tolerate certain foods that contain egg in them- namely baked goods. Heat has a tendency to denature proteins- basically, change their structure. And when you bake an egg at a temperature of 350 degrees or higher for 30 minutes or more, the protein structure of the egg changes enough that, for some egg-allergic children, their immune system no longer recognizes the protein. Which means that their body no longer attacks that protein- thus, no allergic reaction. So the child is still allergic to egg itself- no omlettes or scrambled eggs. BUT if the egg is in a baked good that has been baked at the proper specifications- again, 350 degrees or higher for 30 minutes or more- the child can eat it safely.
So we did the skin test for egg. (Again for the allergy-uninitiated: the skin test, like the IgE blood test, can tell you the likelihood of an allergic reaction, and it is often used to confirm the results of the blood tests. Neither test, however, can determine the potential severity of a reaction.) I watched my son's skin very carefully for the ten minutes it took for the test to develop, expecting the huge welt to appear as it did the last time we did skin testing... and nothing happened. It came back clear. Wow.
Armed with a negative skin test for egg, our next step is an oral food challenge, scheduled for September 30. Basically, we are going to sit in our allergist's office for at least 2 hours that morning, watching Bryan eat a brownie. A brownie that I will have to make with one egg (and no milk, peanuts, tree nuts, or sesame), baked at 350 degrees or higher for at least 30 minutes.
I'm still kind of trying to process everything. I know that there is a very real possibility that we go into the food challenge, and Bryan could still have an anaphylactic reaction. And to be perfectly honest, not a whole lot will change since, beyond monitoring for his other allergies, the egg specifications are pretty strict. But really, this is the first time in 6 years that we have had anything resembling good news with his allergies. And that glimmer of hope is definitely something I am holding on to.
Friday, August 26, 2011
Tuesday, July 5, 2011
(School) Year-End Recap
So, we have been out of school for a month now, and I realized that I was really bad about blogging this past year. But in a way, that was kind of a good thing because really- there wasn't a whole lot to blog about. For the most part, Bryan's year in kindergarten went really well. Bryan's kindergarten teacher was fantastic- she was really attentive and checked with me on pretty much everything. Bryan's class had a "Fun Friday Snack" every week, and she usually e-mailed me each month with a list of the snack items that were coming up. We would work together to figure out ingredients that would allow Bryan to have the same thing as everyone else, and when it simply wouldn't work, I sent a separate, similar snack for Bryan. For the special days that had activities that involved food, like the holiday party and Valentine's Day party, we met in person to go over the party menus. Whenever there was an activity that involved food of any kind- gluing macaroni noodles, or playing with rice- she contacted me ahead of time, just to make sure that it was something Bryan could touch. And I was so grateful for that- it made me feel much more at ease that she was taking his allergies so seriously.
I will admit, the system wasn't without its flaws. When we met before school started, Bryan's teacher and the Assistant Principal agreed that Bryan could sit at the end of the table each day so that the teachers on duty would know where he was, and that they would try to make sure no one with peanut butter sat near him (knowing that the other allergens would be much more difficult to monitor for). It wasn't until January, however, that I found out that policy wasn't being implemented. At that point it seemed picky to make a big deal out of it, since he had been fine for the 4 months up until then. But I was kind of disappointed. I also got calls from the nurse's office pretty regularly because Bryan had red itchy eyes or was sneezing uncontrollably. Those kinds of reactions are hard to pinpoint as food allergy reactions vs. seasonal allergy reactions, but the remedy was the same in either case- administer Bendadryl and keep an eye on him.
And there was also the playdate. Bryan had a friend over to play one day, and so his friend's mother invited Bryan over the next week. I had talked to her casually about Bryan's food allergies before, and she was a preschool teacher who had allergies in her school, so I figured everything would be okay, and I decided to try not to be "scary mom" this time around. I talked to Bryan ahead of time- he had his snack at home, and we talked about how he shouldn't eat anything, that he should say "No thank you" if they offered a snack, but that he could ask for water if he was thirsty. And when I dropped him off, I showed Mom how to use the Epi-Pen and told her that Bryan had already had snack, that he wouldn't need to eat anything while he was there, and left it at that. And when I came to pick him up an hour and a half later, they were sitting at the table eating Ritz crackers.
As I have mentioned previously, plain old Ritz crackers are technically safe for Bryan. And when I talked to Bryan at home about what had happened, he said he asked Mom to read the label to make sure they were safe. And while I was glad for that, it wasn't what we had discussed- neither for me and Bryan nor for me and Mom. And so I realized that I was maybe giving Bryan a little too much responsibility for now, and that I do in fact have to be "scary mom" when it comes to these things. Lesson learned.
All things considered, though, these were minor incidents to have to deal with. No major allergic reactions, no major backlash from other kids or parents. We all survived relatively unscathed- and to me, that was a major accomplishment.
I will admit, the system wasn't without its flaws. When we met before school started, Bryan's teacher and the Assistant Principal agreed that Bryan could sit at the end of the table each day so that the teachers on duty would know where he was, and that they would try to make sure no one with peanut butter sat near him (knowing that the other allergens would be much more difficult to monitor for). It wasn't until January, however, that I found out that policy wasn't being implemented. At that point it seemed picky to make a big deal out of it, since he had been fine for the 4 months up until then. But I was kind of disappointed. I also got calls from the nurse's office pretty regularly because Bryan had red itchy eyes or was sneezing uncontrollably. Those kinds of reactions are hard to pinpoint as food allergy reactions vs. seasonal allergy reactions, but the remedy was the same in either case- administer Bendadryl and keep an eye on him.
And there was also the playdate. Bryan had a friend over to play one day, and so his friend's mother invited Bryan over the next week. I had talked to her casually about Bryan's food allergies before, and she was a preschool teacher who had allergies in her school, so I figured everything would be okay, and I decided to try not to be "scary mom" this time around. I talked to Bryan ahead of time- he had his snack at home, and we talked about how he shouldn't eat anything, that he should say "No thank you" if they offered a snack, but that he could ask for water if he was thirsty. And when I dropped him off, I showed Mom how to use the Epi-Pen and told her that Bryan had already had snack, that he wouldn't need to eat anything while he was there, and left it at that. And when I came to pick him up an hour and a half later, they were sitting at the table eating Ritz crackers.
As I have mentioned previously, plain old Ritz crackers are technically safe for Bryan. And when I talked to Bryan at home about what had happened, he said he asked Mom to read the label to make sure they were safe. And while I was glad for that, it wasn't what we had discussed- neither for me and Bryan nor for me and Mom. And so I realized that I was maybe giving Bryan a little too much responsibility for now, and that I do in fact have to be "scary mom" when it comes to these things. Lesson learned.
All things considered, though, these were minor incidents to have to deal with. No major allergic reactions, no major backlash from other kids or parents. We all survived relatively unscathed- and to me, that was a major accomplishment.
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