Allergy Appointment

Caleb had an allergy appointment this afternoon. Just to refresh everyone's memory, Caleb hit the allergy jackpot in our family. He started having terrible eczema when he was just 4 months old, he had his first allergic reaction to food when he was about 6 months old, when his face broke out in hives after chewing on my fork after I had eaten some coffee cake at my parents' house (coffee cake had both milk and walnuts). When he was 8 months old, he tested positive for allergies to milk, peanuts, tree nuts, wheat, and eggs--everything they tested him for except soy! Fortunately he never reacted to wheat, so we started giving him that again at 18 months, and he outgrew his egg allergy by 3 (whew!). But everything else has stayed. The only tree nuts he is allergic to are pecans and walnuts. He can have pistachios, almonds, and cashews. He's never had hazelnuts or been tested for them. His last skin testing was done . . . several years ago. I actually just spent much fruitless time going back through old blog posts trying to figure out when it was, but I never could find anything about it. Hmmmm. Anyhow, he was still very allergic to all his food triggers, as well as about every tree but cedar, and also grasses, dust mites, and cats.

Caleb's eczema has thankfully pretty much gone away, but he does still have seasonal allergies. As I posted here, his asthma is doing much better as well. I feel like we are really regulating it well, but also that his body is sort of maturing out of it. So all in all, Caleb's allergies and issues are not taking up so much of our time and energy anymore!

But I have been wondering about his food allergies, and where exactly he stood on those. I had asked for an allergy referral last June, but the doctor (who we had never seen before and haven't seen since!) said Caleb didn't need to see one, so he wasn't going to give the referral. Grrr. I was going to make an appointment with a different doctor, but then we thought we were moving, and I ended up doing nothing. But thepulmonary lady gave us a referral, although I had to schedule the appointment at Walter Reed, which is quite a hike in for us.

Caleb has had 2 incidents lately. One was actually a non-incident. After Bible study one Friday several weeks (months?) ago, Caleb wanted to eat some caramel popcorn balls someone else had brought. My caramel popcorn recipe doesn't use milk, so I told him to go ahead, and I'd make sure it was okay. I never did ask (whoops!), but the lady later told me how easy it was to make these delicious caramel balls. You melt caramels--which I know have milk in them! But Caleb NEVER had any sort of reaction! Wow!

The other thing happened last weekend when we were in PA for the family reunion. Sunday afternoon when we were over at Bob's parents' house, Bob's mom offered me a "pecan cookie" They were in a tub from a grocery store, and they looked a lot like little star sugar cookies with icing. I ate one, and then she took them outside, where the menfolk were all playing cards. I hollered out the door, "Caleb can't have those!" but as it turns out no one heard me. A little while later Caleb appears inside, pale and looking sick. He had eaten a cookie (does no one but me READ the labels?!?!), and his tongue was all tingly. I quickly gave him a benedryl, but he had eaten a whole (bite-size) cookie, so I wasn't sure that would be enough. Obviously we have epi-pens, so I was ready, but thankfully he was just really nauseous. He never did throw up, however. I did have to give him one more benedryl though. So really it was a much more mild reaction to pecans then he has had in the past.

I related all this to the allergist, and we also discussed his seasonal allergies. Although he is suffering a lot less, he takes Zyrtec year-round. The doctor was encouraging us to try allergy shots for his allergies. That sounded worth pursuing at some point, but Caleb is in no way, shape, or form ready for 22 weeks of weekly shots, and then monthly shots for 3-5 years. And I am not ready to drive to Bethesda for them!

The doctor just did a small panel of skin tests on his arm--milk, pecan, walnut, and peanut. Caleb was not stoic, to make an understatement. He quivered and moaned and had big tears rolling down his cheeks--before the tech even touched his arm! Then while we were waiting the 15 minutes to interpret the results, he really carried on in the hallway, with more moaning, groaning, and tears. Good grief. I really don't have a lot of sympathy for him, esp. in a hospital where there are many, many wounded veterans facing much more serious pain and problems. So I told him to suck it up, and eventually he did calm down a bit--after drawing tons of attention from other random patients waiting!

So the results were: walnut had a huge wheal--several cms. Peanut was the next largest, but I think it was smaller than it was last time. Pecan had a medium-sized wheal--which made me glad it was a pecan cookie he ingested, as opposed to a walnut one! But the big surprise was that milk was a very, very small wheal! The doctor sent us off for a blood test (you can imagine how thrilled Caleb was at that, but he managed to get through that as well), so we should have those results in 2-3 weeks. If his blood levels are lower than they were in Jan. 08, which is when he last had those tested, then the doctor was going to recommend bringing him in for a milk challenge. I am just not sure he has outgrown this allergy, so I'm not getting my hopes up. But he is obviously a whole lot less senstivie, and that is wonderful news!