Today was the day that all the little guy's hard work was put to the test. I know he has been worried about it all week in his little mind. He just hasn't been himself this week. He had to be off all antihistamine medications for a week before the challenge so a reaction to the peanut would not be masked. Coming off of his Zyrtec is always hard for him because his allergies always flare up. Each day off of it he gets a little more stuffy. This morning he woke up with a little cough, so of course I was worried he may be getting sick, but turns out it was just from his allergies. So between allergy trouble, missing school due to weather/holiday, and worrying about the challenge, the little guy has had a hard week.
We arrived at clinic this morning around 930. The goal today was to complete 5 different doses, all measured out in powder, ranging between 2-4 peanuts per dose for a grand total of ~15 peanut equivalents. The little guy already had a big breakfast so I gave him a granola bar to eat before his dose. The allergist took his vital signs, listened to his lungs and then he started his doses. He started with 2 peanut equivalents. He did seem to have a little flushing and didn't quite seem himself after the dose. He never complained of anything so we just kept close watch on him. After about 20 minutes his symptoms seemed to subside. The little guy had to wait 30 minutes inbetween doses, so he was busy drawing houses to pass the time. Thirty minutes after the first dose, it was time for another! We brought lots of snacks along, so before each dose he would eat a small snack. Each dose was a large amount of powder, so it required him to eat a lot of applesauce with each dose. The second dose was around 3 peanuts. This dose seemed to go smoother for him and I didn't notice the facial flushing. Once again, he went back to drawing and we waited out another 30 minutes. The time did seem to pass quickly, but the little guy did seem to grow weary of all the sitting. Finally dose #3 came and he ate another dose of around 3 peanuts. Once again this dose seemed to go o.k. The fourth dose he decided to mix with chocolate pudding. This dose was closer to 4 peanuts. He got a little burst of energy from the chocolate, so while we waited out that 30 minutes we used the magnet on our iPad cover to see what all he could find that was metal around the clinic. He is studying magnets right now in kindergarten, so that kept him entertained. Finally the time came to eat his final dose of around 4 peanuts that would put him at 15 total peanuts for the day. He decided to eat the last dose mixed in applesauce because the pudding gave the powder a weird taste. By the last dose you could tell that he was feeling "different" from eating all the peanut. He made it through without having a allergic reaction, but you could tell that he acted differently--sort of like how he used to act when he first started the study. After eating the last dose, we had to stay in the clinic another 2 hours so the allergist could observe him for any allergic reaction. We were there for a good 5 hours, so he was definitly wiped out by all the stress when we were done. And so was I!
The last part the allergist and I tried to sneak in on him was the blood work to check his IgE level for peanut. This is important because if his IgE to peanut is now below 15, since he passed the challenge, he would do a strict peanut avoidance for a month and then go back to clinic and re-challenge eating 15 peanuts and see if he can pass again. This would show he has achieved desensitization, and the study would be complete. If his blood level is not below the 15 mark, he would keep eating around 3-5 peanuts a day and would go back for lab work every 3-4 months until his IgE reached that level to do the peanut avoidance phase. Needless to say he started a major meltdown when he heard he was up for a blood draw so after much coaxing and pleading we were not able to convince him otherwise. Since he had been through so much already we conceded and I will take him next week after school for round two of fun.
So here we go! He made it to a point that I was never sure he would be able to get to. Another little boy was at clinic today and he was having to drop out due to severe stomach pain when eating even small amounts of peanut despite taking the stomach medicines the little guy used. That made me realize just how blessed we are that the little guy was able to continue. It is hard to believe that eating 1/300th of a peanut used to make him vomit and today he was able to eat 15 peanuts. As a mom I feel so lucky that I now have a little reassurance that he is a little safer now for reaching this point.
He still cannot eat large amounts of peanut--his daily goal is still everyday to eat 3-5 peanuts. No more powder though! He will have to get used to the taste of eating real peanut foods. Did you know that 1 tsp. of peanut butter is the equivalent of 5 peanuts?? It is no wonder people have such severe reactions to peanut butter the first time they eat it if they are allergic. It is very concentrated! His first try at the real thing will be peanut butter M&M's. It will seem so strange to give him something real like that. To avoid it like the plague for so long and then pop open a bag of candy and give him 4 or 5 M&M's will be very odd indeed!
Today was my birthday. And what a birthday it was.
to be continued...
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