20 December 2010

Peanut Allergy Treatment #2

I have been remiss in posting our progress.  (Blame it on the holiday duties).  
In this post I'd like to explain in more detail the treatment process for the beginning weeks of the program.  

After a patient's "initial day long" treatment the process begins with once per week appointments at Dallas Allergy Immunology.
The goal of the appointment is to increase the patients dose of peanut protein (or the relevant food dose for Egg, Wheat or Milk allergy treatments which are also offered) 
The dose is increased if the patient has successfully tolerated the first dosing amount since the last appointment. 
For Alexander, thankfully all went well thus on December 9th we successfully increased Alexander's dose! 

The process is generally as follows- 
1) Upon arrival for each appointment you fill out a computerized health questionnaire about the patient's recent and current health. (This medical practice is very cautious and thorough in my opinion). I love the computerized record keeping. 

2) Blood pressure is taken.

3) Lung peak flow meter test
4) A doctor or physician's assistant conducts a brief interview about the patient's health then performs a quick exam.
5) A nurse enters the current data in the computer.

6) A physician assistant re-enters the exam room to administer the new "dose" to the patient. Alexander new increased dose is administered.  
This time we receive an increased amount of peanut "dust" again dissolved in grape juice (shown below). 
Alexander takes this orally via syringe (shown on the right side of the photo below).

7) We move to a large treatment room where Alexander stays for 1 hour of observation before he is released.

We go home with a small jar of the desensitizing "peanut/grape juice medicine" premixed to exact specification. For each dose Alexander will extract a precise dosing amount into a syringe and take orally. Alexander must take this dose twice per day and follow the dosing rules exactly.

Dosing Rules-
1)The dose is taken twice per day. 
2) This week's dose must stay refrigerated.
3) Interval between doses must be 9-15 hours apart.
4) The patient must be observed for 1 hours for any signs of a reaction by an adult.
5) No exercise for 2 hours and preferable 4 hours after the dose.
6) Call the doctor if there is any reaction. Or if the patient misses a dose. Or if the patient is sick

Note per Dallas Allergy Immunology "once oral immunotherapy is complete the previously allergic food can be freely included in the diet. To maintain tolerance the food must be eaten daily."

My next post will be Frequently Asked Questions about Peanut Oral Immunotherapy. The Dallas Allergy Immunology website also posts FAQ's for Milk, Wheat and Egg Oral Immunotherapy.


Anonymous said...

Hi Julie,
I can't email you because I don't have Outlook insatalled on my computer. Kudos for your blog and thanks for the info, I have enjoyed reading your son's first-hand experience at Dr. Wasserman. I have an 18 month-old with peanut allergy and have a few years to wait before I even try to take her to see Dr Wasserman for OIT since he only treats school-age kids, but I have hope (slight 20%) that she will outgrow it first. Either way it would be a trek for us to hike to Dallas from half-way across the country (no local allergists will treat us). You are lucky you live right in Dallas! Good luck to your son for completion of the program.

Julie Brice Beiersdorf said...

Hi- Traveling to Dallas for treatment is possible! Numerous families have done it. The furthest travelers were from Iowa. They traveled back and forth each week. I will write a post about this topic soon.
It can be done. Of course your 18 month old does have a few years to wait.
FYI- Dr. Wasserman also treats Milk, Wheat and Egg food allergies.
Wishing you all the best-Julie