Bubba’s allergy testing began when she was less than a year old. For years her testing was done hodge-podge style as a result of mystery reactions or in our quest for a better allergist. Each new doctor had different insights, new concerns, and ordered their own testing. I hear from many readers that their allergist (or often their pediatrician) says you can not test for food allergies until a certain age. Though there is no magic number, there are inherent risks in testing (such as over or under inclusiveness). For us, early testing was successful and also extremely helpful. That said, if I had to do it over again I would have chosen to limit blood testing (no more than annually) and to have requested that all her allergens be tested each time. In her four years, Bubba has had five blood tests and nine skin prick tests. We have tested a total of sixty-five allergens, monitored her Vitamin D levels, and followed her total IgE. There is a lot to keep track of for this allergy mama!
So where are we now?
The idea that there is no ‘cure’ for food allergies, a potentially life-threatening condition, is a tough pill for any allergy parent to swallow and I am no exception. I am don’t-take-no-for-an-answer, I-can-talk-my-way-into-anything human. After spending years watching Bubba’s allergen list grow it has been extremely gratifying to watch her IgE numbers and wheal measurements drop. Each food challenge that we’re able to schedule and pass feels like we’re accomplishing something. And indeed we are. Bubba has passed challenges for soy, pineapple, chickpea, and baked egg. Her newfound tolerance for baked egg is of special significance because of the research demonstrating that ingesting baked egg (when safe) can accelerate resolution of the entire egg allergy. After only a few months of eating baked egg ‘therapy’ muffins, Bubba has been cleared for all home-baked cakes, cupcakes, and breads made with egg. The guidance we were given was no more than two eggs per recipe and a minimum one cup of flour per egg ratio. Soon we will progress to food with shorter cooking times – cookies, brownies, frozen pancakes/waffles, and finally homemade pancakes/waffles. Bubba was also cleared for pastas so we’ll be experimenting with homemade dairy-free ravioli soon. Yum!
Additionally, Bubba’s most recent testing shows she has likely outgrown her allergies to cumin, mustard, and nearly all legumes. WOOT WOOT! We have been approved to expose her at home to these foods and will be scheduling a food challenge for green pea. This is HUGE! Who cares about a little ‘ole green pea? Well for starters, Bubba had two anaphylactic reactions to them. Also, those little suckers appear in nearly every vegan cheese and tons of other dairy and egg alternative products. Daiya here we come!
With so much success it is hard to not want more. I have been eager to find out if a baked milk challenge might be appropriate for Bubba. Like egg, milk contains different proteins, some of which are not heat stable. We have been watching Bubba’s IgE number to casein (the heat stable milk protein) drop and it recently fell below the ‘optimal cutoff point’ according to Dr. Anna Nowak-Wegrzyn’s study. Additionally, on her most recent skin prick test the wheal for milk was smaller than the wheal for egg. One study suggests SPT results are most accurate in predicting outcomes of a baked milk challenge.
After meeting with a new allergist at the Children’s Hospital of Philadelphia, we got approval to challenge baked milk. Wish us luck! We will be doing the challenge in a hospital setting because it will be a higher-risk challenge. If Bubba passes we will begin baked milk ‘therapy’ cupcakes and hopefully progress to products with lower cooking times/temperatures just like we did for egg.
We will continue to stringently avoid peanuts, tree nuts, shellfish, sesame, and a few other allergens which have shown their remarkable staying power.