Friday, October 24, 2014

Peanuts & Quacks: The Update

This is another one of those been-sitting-in-drafts-folder posts, that I'm FINALLY getting around to, thanks to forcing myself to post SOMETHING every day this month.

And when I say this one is overdue, I mean like, years overdue. If it were a library book, they would have made me buy it by now.

Back in July of 2012, I posted about discovering that Baby Henry had a peanut allergy, and about the allergist we began seeing who was willing to put Henry in his oral-immunotherapy trial. I got more feedback than I had ever gotten on any post at the time, and so the very next day, I wrote another post, saying thank you to everyone for being so awesome and supportive, and I PROMISED that I would update you on how things went.

Fast-forward aaaalmost 2.5 years.

Thank you for waiting. You have been so kind. I will not make you wait any longer. I'll tell you the end of the story first: with the help of our doctor and the makers of Reese's Pieces, The Hankster did officially overcome his peanut allergy.

Here he is, eating his first ever PBJ at home, on April 13, 2013, about 9 months after starting the therapy:

Hallelujah, am I right?

So, I'm sure for many of you that's enough of an update; Henry is safe around peanuts, praise the Lord & pass the peanut butter.

But, for those of you who care about the details, here's a run-down of how it went.

We started seeing the allergist and did the initial oral challenge test in July of 2012, when Henry was 2 years old. (If you weren't around then, you can read more about how we made the decision to take this therapy route here.)

Here are some things I did know at the time: I knew that the trials had had great, groundbreaking success thus far. I knew that Henry did NOT have one of the more extreme allergic reactions, and so had an even greater chance of success. And, I also knew that I really wanted to at least TRY to do something, anything, other than pack Epi-Pens and live in fear of cross-contamination and anaphylaxis.

What I did NOT know, was that at that time Henry was the youngest child to ever undergo oral immunotherapy for a peanut allergy. UM, GULP, WHAT? Our allergist mentioned it in passing several months into the therapy, and I literally felt dizzy I was so caught off guard.

In retrospect, it was probably a small miracle that I didn't know about that lil' detail, because it very likely might have made me not want to do the therapy, or wait until he was older to do it, and I'm just really glad we did it and it's done. Plus, now he's totally famous. Roll out the red carpet.

I feel silly even referring to it as 'therapy' because other than the initial oral challenge tests and the final oral challenge tests, which took place in Very Serious Watchful Doctor's Offices with a syringe full of epinephrine nearby, this oral immunotherapy business consisted entirely of me handing my toddler candy every day. Which just doesn't feel super MEDICAL, you know?

For the first month, we gave him 1 Reese's Piece every day. (about 600mg of peanut protein)

Then for another month, we gave him 2 every day.

Then for another month, 3 every day.

Then for another month, 4 every day.

Then for another month, 5 every day.

At this point, he was starting to get really entitled about his daily candy fix. And I was also eating a lot of Reese's Pieces with him. Solidarity.

But, doctor's orders, we continued giving him 5 Reese's Peices every day for 6 months.

In April of 2013, we headed back into the allergist for his final oral challenge test. You, know, to see if it worked.

The idea was that repeated, continuous exposure to small amounts of peanut protein would teach his immune system that it was a safe protein, and that it didn't need to react. (This is the same general idea behind allergy shots, btw.) So, in theory, he should now be able to now ingest much larger quantities of the protein with no problem, since his immune system is now super smart and knows not to freak out.

The first thing they did, just like during his initial oral challenge tests, was weigh him and load up a just-in-case shot of epinephrine. (Be still my mommy heart.) Then, they very carefully measured out however many grams of peanut butter is medically required to be declared allergy-free (I don't remember... about two tablespoons worth? a little more?) and then smeared it on a slice of Wonderbread, slapped another slice on top and handed my now-3-year-old baby a peanut butter sandwich.

A PEANUT BUTTER SANDWICH. Guys, I about had a panic attack.

Even though I myself had been voluntarily feeding him peanut butter for months, there was just something about the casual way they handed it to him, and the fact that it was SO MUCH PEANUT BUTTER, I was just absolutely positive we were going to the ER that day.

But nothing happened.

He ate the whole dang sandwich, and then he asked the nurse if she had any other snacks.

And then nothing else happened. Nothing. No hives. No wheezing. No epinephrine. No ER. We sat in that doctor's office for the required three hours and nothing happened.

I said it once, and it seems appropriate to say it again: Praise the Lord and pass the peanut butter!

The way the doctors talk about it is that Henry has 'overcome' his peanut allergy. We don't carry epi-pens anymore, he hasn't had any more hives or swelling since beginning the therapy, and peanuts can safely be incorporated into his diet. He does need to be sure that peanut remains a regular part of his diet (at least once or twice a week,) just in case his immune system might resensitize. This is no problem, since PBJ's are like, the best lunch ever. They did also tell us to take caution with very large amounts of peanut butter, so if he wants to eat a giant slice of peanut butter pie, or be like his mother and eat half a jar of PB with apples and celery and pretend it's healthy, he can, but we should just watch him closely and have Benadryl on hand for the possibility of a mild reaction.

It's so funny how experience works, but at the time, all of this peanut business was SUCH A HUGE DEAL TO ME. I cried when he was diagnosed with an allergy, I agonized over the therapy decisions, I could never sleep the night before an oral challege test, and EVERY time we went up another Reese's Piece, I was jittery and hoverey all day.

And now a few years have passed, and I have to think so hard to remember the details of what we did and when and why and how. Now, I hand Henry peanut butter without even thinking about it. The kid ate a pumpkin-shaped Reese's cup yesterday and the only thing I thought was, "Dang, I want one."

I'm so incredibly thankful that we found this allergist, that he was willing with work with Henry, and that we've been able to avoid all the stress and worry that comes from living with serious food allergies. Well, I'm so thankful when I remember it. Because, honestly, mostly I forget it even happened. Which is probably another thing to be thankful about.

Henry's preschool this year is nut-free because they have several kids with severe allergies, and guys, I can't even tell you how over-the-mooon-happy I am to cooperate. We wash hands and faces before coming into the classroom, I read those snack-food labels like it's my job, and I've nixed peanut butter as part of breakfast on school mornings, just to be safe.

Because, we get it. We feel you. It's scary stuff. We're really, really thankful our kid is safe, and we're more than happy to do everything we can to help keep your kid safe, too.

OH, and that Epi-Pen Jr.? I kept it until we moved. And then I threw it away. With great satisfaction.

Praise the Lord and pass the peanut butter!

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