February 22, 2014

Update on Tree Nut Allergy

We have had an eventful couple of weeks in the allergy department.

At Abby's 5 year well check we talked about her allergy in kindergarten this fall. That led to me making a follow up allergy appointment to ask the many questions I have about keeping Abby safe in public school. My questions with the allergist prompted him to skin test allergy for tree nuts.

We have a very strong PEANUT allergy and that hasn't and will likely never change. However, last summer after doing bloodwork, we were told Abby was allergic to TREE NUTS. We found it strange since she drank almond milk daily, including the morning of the test. The numbers were "weak" but present, so we cut out tree nuts.

Last week we did a skin test for the many tree nuts out there (pecans, almonds, walnuts, cashews, sesame, etc). This is what her back looked like. Note that #9 is histamine and it should be the biggest reaction.

Her skin test showed a "weak" presence of allergy to walnuts, cashews, and almonds. They are #1, #3, and #4 above. So, we made the decision to do a food challenge in his office. He was 98% sure she was not allergic but felt safest testing her in his office in small amounts increasing to larger and doing one more skin test.

We started with 1 cc of almond milk, waited 15 minutes then 2 cc, then 4 cc then 6 cc. She was so excited to have it... after the initial fear it would make her sick. No reaction!

So, Marcus ran to the store and grabbed a can of cashews. She ate 1/2 of one, then 2, then 4 with 15 minute intervals in between and nothing happened! Hooray!

We can happily eliminate tree nuts from her allergies and it is now just peanuts! The peanut allergy is still major, these nuts measured 3 and under on blood tests and her peanut number is over 100. And we likely won't give her many tree nuts since they are processed with peanuts and fearful she'll accept a peanut on accident. But, we know almond milk is okay and we don't have to be as fearful around the many tree nut desserts.

We are still trying to balance what is reasonable with the school and what is safe for Abby as she enters kindergarten. I have had numerous conversations with the nurse, our pediatrician and our allergist. So far, we have resolved 3 major issues and have one hurdle left. Will you join us in praying that we can convince the school to have kids wash their hands after lunch? 

Kids will still have nut foods at lunch (she'll sit at a nut free table) and if they don't wash their hands the peanut oils could be placed on shared objects and if Abby contacts them she could get a rash/red eyes. She wouldn't go into full anaphylaxis if she didn't ingest the nut; however, anaphylaxis starts as a rash/red eyes and not giving an Epi Pen soon enough can be tragic. So, we will have to Epi her and call 911 if she shows those symptoms from touching peanut oil or rely on the judgement of the school to determine if it is just touch or ingestion. It is a scary place to be. Hand washing would eliminate the possibility for us. 

As a side note, we did learn that anti-bac gels do not remove peanut oil from the skin. It must be soap and water or wipes like baby wipes. We'd happily provide baby wipes to Abby's class as a solution; however, after lunch she is cross mingled with kindergartners from numerous classes for things like music, PE, art, etc. So, it would be more difficult and is also riskier since she won't be returning to her desk with her teacher during the high risk hour after lunch.

We'll keep the conversation going and look for more solutions!

If you are curious about our peanut allergy discovery, click here. My sweet girl was a puffy red mess!

1 comment:

His Doorkeeper said...

I understand how you feel about Abby entering kindergarten and washing those hands. My granddaughter Harper is allergic to peanuts and will start school this August and I am a little worried about reactions to her allergy! Praying they have no problems!! Abby is a cutie!


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