Man Chair

Somebody snuck into his father's man chair...

 

Allergies?? We don't need no stinkin' allergies!

For those who have just joined us, the Gremlin had a bad reaction to peanut butter - I mean some *suspect food* in early December (aren't we all innocent until proven guilty?). I made an appointment with a pediatric allergist for early January to have testing done. The large stack of paperwork they sent me to fill out was rather interesting, hmmmm so what are Gremlin's hobbies? What sports does he play? Has he ever been pregnant? It was actually pretty quick since he has no medical history and the majority of the pages didn't apply to him. Our appointment was at 8:15 a.m. and after a longish wait we were escorted back to the examining room. They took some rudimentary measurements (21 ish pounds and 31 inches tall) and we had a quick visit with the nurse before the doctor came in. I have to admit that I don't mind a longer wait in the waiting room as long as we get to business once we're brought past the lobby door. It's easier to entertain a Gremlin in a large waiting room than a small, windowless exam room. Anyway, the doctor came in and both Bryan and I liked him from the start. He was very pleasant, to the point, and seemed more than happy to take as much time as necessary to answer our questions. He also got props from me for washing his hands in the room in front of us before examining the kid.

It was obvious that he has quite a bit of experience with the wee ones as he managed to listen with the stethoscope, put the otoscope in the ears and even check the tonsils with hardly any protest. His suggestion was both skin & blood testing then compare the two given that both can give false results. We very quickly commenced with the skin testing to all of the big, bad food allergens. It's kindof like the seven deadly sins, though in this case it's the 8 most common food allergens which are milk, egg, peanut, tree nut, fish, shellfish, wheat and soy. Given how much the little dude LOVES milk and wheat thins we were pretty confident on our results there.

If you've never had this done before (which I have), they mark your back with numbers and then use a plastic toothpick type thing which is dipped in the big, bad substance and then scratched on your back. The numbers help them remember which allergen was put where. It doesn't hurt at all and Gremlin didn't seem to mind a bit. He just kept trying to turn his head to see what the nice nurse was doing. We then waited 15 minutes to see which skin scratches turned into mosquito bite type welts. He was happy to play with the assortment of toys I brought while we waited.

I should mention that they do a positive and negative control, the negative control is a scratch with nothing on it and the positive is a scratch with I believe histamine ... something that will DEFINITELY cause a reaction! I remember when I had my testing done in Denver, it was itching horribly while I waited out the 15 minutes! On Gremlin, the positive control quickly turned into a big old raised welt and #3 was also red and visibly raised. After our 15 minutes, the doc returned and can you guess what #3 was??
Peanuts of course.

We also had two smaller possible reactions to catfish and shrimp. Based on these results, we were sent to Children's Hospital to have blood drawn for tests of peanuts, catfish, shrimp and cherries (which he had also eaten for the first time that fateful day and for which they could not skin test for). The blood test looks for IgE antibodies to the substance tested which gives theoretical information on the body's immune response to contact with that substance. It would most likely confirm that our little dude is allergic to Peanuts and help us make the determination on fish and shellfish.

Despite my worst expectations, we were in and out of Children's outpatient lab very quickly. The longest time spent at registration since he was a new patient. The phlebotomist had a big screen TV at Gremlin's eye level with Elmo playing (you can't get better than Elmo for distracting a Gremlin!). When she put the tourniquet on the dude, I saw that he was blessed - or cursed - with veins like mine that don't *pop* very well. She went for the hand which is exactly where I would have gone were I doing the stick. She used a 22 gauge butterfly and quickly had a 2 mL sample. Luckily in my line of work, I don't get too upset about needles going into kids when it's a necessity, but even if I did - she was an awesome and quick stick! He protested just a moment when the needle went in then immediately turned back to the TV in an Elmo-induced trance.

So the not-so-surprising bad news is that he is allergic to peanuts. His IgE result was 18.8 which the nurse said was "pretty high" - oh thanks, that's very helpful! Some quick internet searching of medical literature indicates that for peanuts, 95% of patients with an IgE over 14 or 15 will have an actual allergic reaction when consuming peanuts. Some sources will classify the degree of allergy based on the number, i.e. the higher the number the "more" allergic, but this seems foolish because patients with IgE less than 15 have had life-threatening anaphylactic reactions. Everything I've read says that the blood test won't tell you anything about how severe the reaction is, but is more used to determine the likelihood of having a reaction.

On the positive side, most folks I've talked to with peanut allergic kids have MUCH MUCH higher IgE levels. We also have the benefit of having actually had him eat peanut and see what it does. Our allergist pointed out that yes he did have a big reaction BUT it only involved the respiratory system and his skin and did not involve the gastrointestinal tract. I was actually expecting some major vomiting or diarrhea after the initial symptoms, but it never happened. The reaction also responded nicely to Benadryl which is a good sign as well. For 80% of kids, this will be a life-long allergy, but there is that amazing 20% that grows out of it. (Please, please grow out of it!!!) My research showed that kids who are allergic to other foods and have asthma and/or eczem, seem to have the most problems with food allergies and the greatest chance of anaphylaxis. Since he didn't react to anything else (the shrimp and catfish bloodwork was negative), has no eczema and no asthma or airway issues, I'm hoping he will be one of lucky few who outgrows it.

The "treatment" is to avoid ingesting peanuts ... plain and simple. The doctor will have us return every year to repeat the blood testing and see if the numbers increase or decrease. The doctor also recommended avoiding all fish and tree nuts (peanuts are actually a grain, whereas tree nuts like almonds, cashews, walnuts are *true* nuts) given that if a kiddo has one food allergy they are at greater risk for developing other allergies. It's more of a precaution and not because he will be allergic to them as well.

We asked about having peanut products in the house, and for the time being he didn't think we needed to give up our peanut butter. I believe his exact words were, "you can have your peanut butter feasts when he goes to bed." Obviously we need to be diligent about washing hands and brushing teeth after peanut butter, and if he shows more sensitivity in the future (some kids react to just smelling it) we might have to rethink it.

For an excellent video on IgE and how it is used to diagnose allergies go here:
http://www.kidswithfoodallergies.org/resourcespre.php?id=135&title=IgE_blood_allergy_tests_video

A great site with medical information that is trustworthy about food allergies:
http://www.foodallergy.org/

And the random Gremlin photos have nothing to do with this post but were just some cute pics I wanted to share!!

Donut!

Corrigan had his first visit to the donut shop this morning and he happily tore into a cinnamon sugar cake donut.

Sure it's not healthy, but we're excited anytime he shows interest in food!
--
Bryan D. Jones

www.blava.org/running
jones-baby.blava.org

"When I was your age, television was called books."

CHEESE!

Gremlin can run

It was a nice day yesterday, so the whole family loaded up into the car and went to one of the local trails. Corrigan ran/walked for an entire half mile before we decided he should probably be put in the stroller. He had a great time. He was very independent and was happily talking and waving at everyone else out there. He fell down a couple of times when he got distracted and wasn't paying attention to where he was going, but as you can see that didn't deter him at all.






Corrigan says, "I run fast!"




Time for pictures with Mommy and Daddy.

Video Wednesday

BY popular demand, I present a completely mundane video of today's Gremlin antics. Apologies for the shaky camera work on my part.

That is an empty cracker box he is carrying and normally he stomps his feet like that when throwing a fit or very excited.

Snow Day

I honestly thought that snow in Central Arkansas was a myth, but it started flurrying last night and we still have some snow flurries this morning. I've caught Corrigan at the window several times watching the flakes blowing around out there.

I don't have any delusions that it will accumulate much, but it is pretty to see flakes in the air again. It makes me long for Colorado! Especially when dealing with the complete hysteria of the surrounding population with any sign of real winter weather. Little Rock schools were cancelled today which then led to Corrigan's allergist appointment being cancelled due to their "inclement weather policy." Whatever! We drove downtown and the roads are fine, it's a dry snow and since the ground was already frozen it's not turning into ice. I better get to the store before all the groceries are bought out by those awaiting the next big blizzard :)