Bubba’s Allergy Update

Starting School and Failing Her Peanut Challenge
It’s been been quite some time since I posted. Ironically it was one of the busiest allergy periods we’ve ever had. The end of the summer marked Bubba finally being diagnosed with environmental allergies (basically the entire outdoors) which provided a much needed explanation for her random bouts of hives, terrible sleep, and general itchiness. Thankfully a simple daily antihistamine seems to be making her much more comfortable. Summer was also my time to prepare for Bubba to enter elementary school. Traditionally, allergy parents meet with school administrators to create a 504 plan for any necessary accommodations. We chose a private school. Federal civil rights protections for students with disabilities (504 plans) apply to public schools and to many private schools (those that receive federal funds). My understanding is that the standard used in evaluating the level of accommodation required under the law differs between public and private schools. I did not put any further research into the issue however because I was so happy with my meetings with Bubba’s school administrators. The principal, nurse, and her teacher were all so knowledgeable, supportive, and flexible. They seemed open to any accommodation we thought necessary and committed to doing whatever was needed to keep Bubba safe and included. If I felt my concerns weren’t take seriously I would have pursued whether we could obtain a formal 504 plan.

But what about the ‘allergy table’ issue? As I discussed in a prior post, we decided to do an oral food challenge to peanuts to determine what extra school safety precautions were necessary. The good news was that it took a lot of peanut for Bubba to react. This helped ease some of ours fears about Bubba accidentally being exposed to small amounts of peanut on the bus, in the lunchroom, or on the playground. The bad news was that once Bubba started to react it was bad. An anaphylactic reaction is, of course, much less frightening in an allergist’s office with epinephrine at the ready. But it still sucks. About two hours into her food challenge, Bubba started to complain about stomach pain. I took her to the bathroom in case it was gas or just a mild GI issue. Within minutes she was on the floor in the fetal position crying because her belly hurt so badly. I brought her back to the exam room and we called for the allergist. Bubba began coughing with increasing frequency and severity until her voice was gone. This happened very quickly. Bubba cried when she saw that she was going to have to get a shot of epinephrine, but gave a relived ‘oh’ when she felt the thin syringe needle as compared to the higher gauge Epi-Pen she’s had before. Less than three minutes later Bubba’s voice was back, bellyache was gone, and she was asking for the iPad. God Bless epinephrine. About 20 minutes later we thought the reaction had passed so I stepped into the hallway to call my husband and fill him in. My mother-in-law was with us so she stayed in the room. By the time I came back Bubba’s torso and groin were covered in enormous hives. We called for the doctor and she gave another shot of epinephrine. This time my trooper didn’t even flinch. I promise this kid is way tougher than me. And certainly more motivated by stickers.

The Egg Challenge
After doing Bubba’s annual allergy testing this fall (skin prick only this time) we decided to schedule food challenges for both eggs and milk. Her wheal size (reaction to the test) decreased significantly for both. She had been eating baked egg for almost two years at least 3 times a week. Bubba was uncharacteristically nervous for her egg challenge. She was worried about failing again. Stickers were enough to get her to the allergist’s office, but it took a LOT of persuading to try her first bite of egg. She wasn’t crazy about the taste, but said it tasted like “chicken.” She passed her egg challenge which is AMAZING. I wish my dad could have been around to hear about it. He passed away a few years ago having remained egg-allergic his entire life. We have tried feeding Bubba all sorts of yummy egg dishes at home including scrambles, cinnamon french-toast, hard boiled eggs, and meatballs. She will try them and hasn’t had any reactions but she dislikes all of them. Except mayonnaise, which she likes on everything. That’s my girl.

Upcoming Milk Challenge
How could you not want to continue that success?? Well, testing for milk makes us WAY more nervous. Or maybe just pessimistic. Milk has been Bubba’s nemesis since she was an infant. She got eczema when I drank milk while breast-feeding. Her first Epi-Pen was after drinking milk in a sippy cup (mistakenly filled my her Number One Mom). Her second and third and fourth Epi-Pens were all for milk too. Once was because a cooking spray had ‘butter flavoring’ which I did not understand to mean containing dairy. Another time was because she accidentally had a bite of a s’more containing Hershey chocolate. She had epic vomiting episodes after yogurt touched her tongue, after chocolate milk touched her tongue (relatedly – paramedics in Disney are super fast), and after she stole a sippy cup from her baby brother. She’s gotten hives from getting milk on her skin. She’s gotten an itchy throat from inhaling cheese dust during snack time at camp. In short, milk has not been her friend. So why challenge it, you ask? Well her IgE level for casein (the allergenic milk protein that does not break down when baked) has gone down, her skin prick wheal size has gone down, and she’s been successfully eating baked milk for a year. I believe in my heart and soul she will outgrow her milk allergy. And when she does I can’t wait to see the world open up in front of her. I want that for her as soon as possible. So instead of waiting till we’re 95% certain she’ll pass, we’re comfortable challenging milk when we’re ‘mostly’ sure. That doesn’t mean we won’t be nervous as heck though. Wish us luck next week.

We already feel tremendously blessed to have gone from 37 or so allergies down to peanuts, tree nuts, milk, sesame, and shellfish.