Allergist Appointment, November 2014

What a crazy week!  If you're here just for the recipes, feel free to skip this post entirely!

I spent all day Monday and Wednesday at an amazing opportunity to hear Emily Rubin (I'm a groupie!) speak about Emotional Regulation, how to implement strategies in the classroom and how deficits in emotional regulation have a huge impact on children with Autism.  GREAT STUFF! #nerdySLP

Tuesday was Logan's dreaded allergist appointment for his skin testing.  His last skin testing was done in March of 2013 and it was a pretty traumatizing experience for him that he still talks about! At that appointment, they did a scratch test where he had to be physically restrained and it was all very upsetting. I had no idea that there were much better and easier methods out there!

Let me rewind and give you a brief summary of Logan's allergies.

1.  9 months old - reaction from eating hummus.   Tested positive for sesame allergy.
2. 11 months old - reaction from eating cookie with almond extract.  Tested positive for almond & tree nuts.  Told to avoid peanuts as well. At this point, we only avoided the actual allergens as ingredients. We paid no attention to cross-contamination whatsoever (and boy, were we lucky!)
3. 3 years old.  Tested positive for sesame, tree nuts and now added peanuts.
4. 3 years, 9 months.  Anaphylactic reaction to cashew residue in a thoroughly washed OXO container. Required epi 12 hours after exposure along with ambulance ride, breathing treatments in the ER and hours of monitoring.  36 hours after exposure, woke up with full body hives and was taken straight to ER and given epi pen in waiting room when he began wheezing.  Steroids, breathing treatments and now very strict avoidance of all allergies including cross-contamination (made in a facility with, made on shared equipment with and calling companies to find out about allergen practices)
5. 3 years, 10 months.  At a Halloween fair, bit into a Butterfinger bar and was epi'd immediately. [Will tell full story at a later date] and avoided anaphylaxis (ambulance ride to ER, monitoring, etc).
6. 4 years, 3 months.  Skin scratch testing.  Told he was still allergic to peanuts, tree nuts and sesame.
7. 4 years, 9 months. Anaphylactic reaction. Source (at the time) unknown.

We pretty much thought we were destined to a life of company-calling, allergy-avoiding and mommy-worrying.  Then along came Dr. Randhawa.  I heard about him on an amazing and supportive allergy mom group on Facebook.  I heard that he was an incredible doctor with multiple degrees and certifications and that he took kids as young as Logan to do OIT (oral immunotherapy).  After doing some research and waiting over 5 months for an appointment, we finally got in!

The good news was that he was just as incredible as they all said.  The bad news was that NONE of the services would be covered under our insurance. We have an HMO plan with NO out-of-network coverage. Dr. Ranhawa happens to be in Long Beach, CA which is about a 90 minute (without traffic) drive... definitely out of our network!  I knew though in my heart that we had to make this work.  I signed up to work summer school (from 35-39 weeks pregnant!) to cover as much as I could. [Unfortunately, I didn't make it all the way as I had my little monkey man at 37 weeks!]

At our first appointment, we discussed an overwhelming amount of information.. half of which I can't recall without my allergy binder in front of me.  The plan was to start with bloodwork, move to skin testing then patch testing and make our OIT plan from there.

Bloodwork was a NIGHTMARE.  Will save that experience and those results for another post. What we did find out is that he has a class 6 (highest) allergy to DUST MITES.  To be allergic to dust mites, you need a blood level of .38 or higher. His was over 100!  We theorize that this was the cause of his most recent anaphylactic reaction which we could not link back to any ingestion or exposure to any of his food allergens. Under doctor's orders, we started him on a daily nasal spray (Omnaris) and daily antihistamine (Xyzal).

Tuesday was skin testing. I automatically assumed it would be scratch testing again; but, I was mistaken. When we got there, Logan was nervous. I could see it in his face.  When they asked him to take his shoes off to get his weight and height he looked up at me and nearly started crying saying, "I keep my shoes on!"  I could tell he was just trying to take control in a situation where he felt fearful. The nurse was so kind and patient with him. With a little coaxing, we made a game to see how the numbers would change with his shoes off and on.  After the vitals were done, the beautiful and sweet Brandi came out to talk to Logan about the testing. She showed him the small prongs that would be used and let him decide if he wanted them on his back or arm. He ended up choosing his back after a little "eeny meeny miny mo" (or however you spell that!).  He was given the chance to hold the prongs and even press them on himself, me, the nurses, etc.  He felt comfortable and secure. He climbed onto my lap and let the nurse do the testing!  I was so happily surprised with his actions! After the allergens were placed, he then started crying. He was ITCHY!  What a terrible feeling of being so itchy and not being able to scratch.  

This photo is just after test administration.


 This photo is about 10 minutes into testing.
                                  

The test came back negative for almond, English walnut, hazelnut (filbert) and pistachio.  Slight positives came back for Brazil nut, cashew and pecan. Clear positives came back for peanut and sesame.  What this photo shows are allergies to peanut and sesame. You're supposed to have a reaction to the histamine which acts as a positive control. To the right of the histamine is saline which acts as your negative control. Between peanut and the histamine are a bunch of negative results and in a column next to those are some mildly positive results for tree nuts.  

After the testing, we've made a fun little routine of heading to In-N-Out for burgers.  Logan loves a cheeseburger with just meat, cheese and bun. I happen to love mine with onions and extra pickles along with french fries seasoned with some salt and pepper.  After that, we take a trip to the local dollar store and Logan gets to pick out a few toys depending on how well-behaved he was at his appointment. This time he got to pick FOUR toys! I was so proud of him :)