Peanut Allergic Teenager EATS PEANUT

It's Alexander's "Peanut Day". January 27, 2011. Today my son Alexander, a peanut allergic child, is going to eat 1 entire peanut. 

The peanut must be average size. Not small and not large. We are ready. I have shelled peanuts the night before in preparation for today's visit to the doctor ( click here to read my "Shucking Peanuts" story )."Peanut Day" as we have named it, is an important milestone in the treatment Alexander is receiving at Dallas Allergy Immunology. Why a milestone? We both feel the ability to successfully eat a whole peanut with no adverse reaction is a miracle for a person with a severe peanut allergy. 

7:35 a.m. We enter the car to drive school prior to our appointment at 10:15. Fearful I might forget to place the jar of shelled peanuts in the car, I had done so last night. To my amazement no sooner than the car doors shut to the car Alexander remarks, "do you have peanuts in the car?"  He could smell the peanuts right through a glass jar placed in a bag in the back seat of the car.

10:15 a.m. We arrive for our appointment and follow the normal weekly routine. Alexander fills out a questionnaire detailing his current health.

Next the nurse checks his height, weight and blood pressure. 
A peak flow meter test is conducted. What is a peak flow meter test?  
This test is conducted on Alexander every week and measures a his maximum speed of expiration (his ability to breathe out air.) It measures the airflow through the bronchi and thus the degree of obstruction in the airways. Peak flow readings are higher when patients are well, and lower when the airways are constricted.  I like this quote I found on the internet "a peak flow meter test for asthma is like a thermometer for a fever. Both are tools to help monitor what is going on in your body." 


Alexander does have occasional asthma; however, we did not realize the silent nature of his condition until Alexander took a Pulmonary Function Test last September to measure how well his lungs were functioning in preparation for this treatment. 
His lung function was only 60%.  See my "Roadblocks" post for those details.
Today Alexander had his "personal best" peak flow measurement of 470. Progress!


We are led into the Exam Room 1 our usual room.

The nurse arrives and enters Alexander's health data in the computer.

The nurse asks me to give her a peanut. In this case I have prepared a harvest. She places the jar of peanuts on the desk and a timer next to the jar. 

While we await the arrival of Angela Gallucci, P.A. for Alexander's exam, we prepare for a possible dose of a whole peanut. Alexander has a routine he likes to maintain. Since he really dislikes the taste of the peanut doses, he must have his "pink lemonade chaser" at the ready. I buy a can of pink lemonade in the break room and he is all set.

Pink Lemonade serves as a chaser after each peanut dose to help eliminate the taste

As we wait I ask Alexander what he is feeling. He says, "I don't want to do this". I ask, "Why?" "Because I don't like the taste (pause) but the result will be good." 

I am sure he is a bit nervous although he did not show it.

Ms. Gallucci arrives and reviews Alexander's medical results entered into the computer.

She asks him for details as to why he could not increase his dose last week from the 500 mg capsule to a full peanut. Why the delay? 

He explains, "I had a cold and my stomach was been bothering me. I skipped a dose. The next morning I tried to take my dose. It (the peanut taste) makes me start to gag in the first place so I threw it up". Click here for details on what had to be done.

Angela Gallucci, P.A.

The exam proceeds. Ms. Gallucci says it is very important to establish a baseline in case he has a reaction. (Not very comforting). Thankfully his exam results are great.

Now it is time for the big moment. She presents Alexander with the jar of peanuts and asks him to select one of average size.

He must have felt she was asking him "pick your poison".

Alexander contemplates his selection of a peanut

He carefully selects the winning peanut. Not too big and not too small.

Then Alexander smells the peanut-his disdain for the odor of peanuts is intense

10:47 a.m.- He did it!  Alexander successfully eats his 1st Whole Peanut.

"What do you think?" Ms. Gallucci asks. 

Alexander replies, "It's different."

She asks, "It taste's better than the peanut flour doesn't it?"

Alexander says, "Yes. It's not as strong as the peanut flour."

"Congratulations! There you go!" says Ms. Gallucci smiling.

I hear Alexander gargling with the pink lemonade. I laugh. He smiles. Finally!

Now we wait. We adjourn to the patient observation area for 1 hour. I am required to stay with him the entire time to watch for any signs of a reaction. 

The hour passes. No reaction. Whew!

We depart for school as if nothing important has ever happened. Back to the routine. 

Surreal in a way as this was one of the most important moments in his life.

Later at home I ask Alexander for his thoughts on eating a peanut. Quietly he says ,

"I didn't like it but I can handle it!"  

Alexander's grandfather texts him "how did it go eating your first peanut?". Xander replies, "yuckish, but I'm alive so it's all good."

That says it all. 

People with these types of food allergies live under the pressure of a constant threat. An ominous mostly invisible danger of peanuts lurking in places they cannot see or detect.  Click here to read Where Is the Peanut Hiding?

If you have any questions please feel free to post a comment below and I will be happy to reply. Thanks for joining us on our journey!

Here is an informational link on treatment for Peanut, Milk, Egg and Wheat food allergies, Oral Immunotherapy Overview at Dallas Allergy Immunology

Share your food allergies stories. Email your stories to salt.light.truth@gmail.com and I will post them on the blog.  There is a world out there waiting for help or encouragement.

Shucking PEANUTS for Alexander's Big Day

I can barely believe it myself but in a few hours Alexander will get to EAT A PEANUT!  
Click here to see prior post regarding treatment delays

In preparation for this momentous occasion I was instructed to arrive for our weekly appointment at Dallas Allergy Immunology with my one whole peanut.
I asked "what kind of peanut?" Do I buy a jar of Planters roasted peanuts and use one of those peanuts?

If so, what size? Peanuts vary from small to jumbo sized. Of course the Planters option would have been way too easy. Unfortunately Planters peanut brand is cross contaminated with almonds. Alexander's blood test leads Dr. Wasserman to think my son may have an allergy to almonds therefore roasted peanut that is in a shell. That turned out to be quite an endeavor.

Last week I bought a bag of roasted peanuts in the shell.

I did not want them in the house but the garage was not an option due to the temperature. I placed the bag of peanuts in a gallon size freezer bag and then into 2 layers of plastic bags. I wanted to seal off the peanut fumes. I stashed the peanut package in the back of the closet where it loomed undetected for a week.

Tonight I shucked peanuts or is that called shelling peanuts? (I think corn gets shucked).
Either way I thought "what am I doing? I am endangering my child with the fumes alone."

I sequestered myself behind closed doors in the laundry room and removed the huge bag of peanuts from it's wrappings. I opened the bag of peanuts and the fumes were strong. In order to minimize peanut debris and peanut dust from escaping into the room I used a large plastic shopping bag and proceeded to shell the peanuts at the bottom of the bag. That proved difficult.

Carefully shelling at the very bottom of a large bag

It took a lot of shelling to result in only a few whole peanuts

Shelling was an challenge. It's not easy! The shells crack and send pieces of shell everywhere. Extracting a whole peanut intact has a success rate of 25%. Just when I thought "yes I got a whole peanut" it split in half.  And so does the next peanut and the next....Seriously!  I need Whole peanut.

It was actually quite comical. Picture a scene from the I Love Lucy Show.
The peanut dust is flying everywhere! My hands are covered in peanut dust. The dust had lodged itself under every fingernails. I should have worn gloves! I then creep out of the room to retrieve the plastic gloves from the kitchen, touching nothing along my path. Of course I find an empty glove box!

I am totally contaminated. Where is the lent roller when you need it?  I want to burn my clothes. I wore the wrong clothes for the project. Black corduroy pants and a black sweater which probably sucked up peanut dust. I have a broken wrist and I realize my black Velcro brace probably smells like essence of peanut.

I am a walking danger zone for my son.   Next time I'll wear a hazmat suit!  
There must be a better way.

Click here for Peanut Oral Immunotherapy FAQ's. Very informative.

Share your food allergies stories. Email your stories to salt.light.truth@gmail.com and 

I will post them on the blog. 

There is a world out there waiting for information, help or encouragement.

Here is my meager whole peanut "harvest"

Food Allergy and Anaphylaxis Management Act Becomes Law in the United States

Food Allergy and Anaphylaxis Management Act Becomes Law

The Food Allergy and Anaphylaxis Management Act (FAAMA) was passed into law! This is a major achievement.

This legislation was added into a Food Safety Bill approved by the U.S. Congress during the lame duck session on December 21, 2010. It was signed into law on January 4, 2011 by President Obama. FAAMA, which was written largely by FAAN (the Food Allergy & Anaphylaxis Network), was introduced in 2005 to coincide with FAAN’s inaugural Kids’ Congress on Capitol Hill. This legislation was never acted upon all those years. 

This bill was supported by Sen. Christopher Dodd (D-Conn.), whose daughter has a food allergy, and Rep. Steny Hoyer (D-Md.), who has a grandchild with a food allergy.

What does this mean for those with food allergies?

The federal government will create voluntary, national guidance materials for managing food allergies in our nation’s public schools. These guidelines should make it easier for schools, day care centers and related entities to create and implement policies that will protect students with food allergies.
This law will not supersede state laws. The FAAMA guidelines are to be used as a complement to existing state guidelines or laws

I found the following details on the No Nuttin' website as follows:

"Here is the official summary of the ACT which was introduced in February 2009:
Requires the Secretary of Health and Human Services to develop and make available to local educational agencies, schools, early childhood education programs, and other interested entities voluntary guidelines to develop plans for individuals to manage the risk of food allergy and anaphylaxis in schools and early childhood education programs. Directs that such guidelines address:
(1) parental obligation to provide the documentation of their child’s allergies;
(2) the creation of an individual food allergy management plan for each such child;
(3) communication between schools or programs and emergency medical services;
(4) reduction of exposure to anaphylactic causative agents;
(5) food allergy management training; and
(6) administration of epinephrine.
Allows the Secretary to award matching grants to assist local educational agencies in implementing such food allergy and anaphylaxis management guidelines."
http://www.nonuttin.com/blog/archives/604

I am sure many of us with children who have serious food allergies have struggled with schools and camps to try and ensure a safe "food allergy friendly" environment. 

It is a constant struggle and hopefully this new law will truly help the situation many of our children face at school. 
The level of precautions that schools currently take to protect children with food allergies vary wildly. Direct parental advocacy and involvement at their local school is often vital for creating food allergy policies and procedures coupled with anaphylaxis plans.
It is critical that schools and day care centers have careful procedures in place, train staff and strictly follow those procedures. 

Many children have died from exposure to food allergens in schools. In December a 13 year old Chicago girl with a peanut allergy died after eating Chinese food at a school party. I will write a post about these tragic deaths in the future.

Read about this new law by following the links below. 

http://www.foodallergy.org/page/food-allergy-and-anaphylaxis-management-act-becomes-law

http://www.allergicchild.com/legislation.htm

http://www.dietsinreview.com/diet_column/12/food-allergy-and-anaphylaxis-act-passed/

Dose Delayed No Whole Peanut Yet

If you are new to this blog, todays post details a problem my son Alexander encountered last week with his peanut oral immunotherapy treatment. 
See my prior post "Delay in Eating Whole Peanut Probable"


True to my suspicions Alexander was not allowed to increase his peanut dose to 1 whole peanut. 
Here's why.
Last week Alexander skipped his night time dose due to nausea. The next morning he reluctantly followed the doctors instructions and took half of his 500 mg dose. Unfortunately Alexander vomited up the dose. I called Dr. Wasserman and his instructions for my son were as follows:
1- drink some clear liquids.
2- After 1 hour try to eat some crackers.
3- after another few hours try ingesting a half dose of the 500mg capsule.
4- if successful then take a full dose that night


If you are wondering how one ingests half of a dose, read on.
For his half dose Alexander emptied the entire 500 mg capsule of peanut flour into a glass of blueberry IZZE Sparkling Juice and stirred it thoroughly. Next as directed by the doctor he poured out half of his peanut "cocktail" into the sink then proceeded to drink the remaining amount.
This worked perfectly. No problems. That night Xander took a full dose dose of 500 mg of peanut flour in capsule form. 
He was back on schedule at least for the moment.


Dr.Wasserman decided not to increase Alexander's peanut dose for another week. 


Voila no eating his first whole peanut for my boy- not yet.
My opinion is really of no consequence; however, I agreed (silently of course) with the doctors decision. 
My "mothers instinct" had spoken to me saying "BAD IDEA". 
It made no common sense to me to hurry the treatment just to stay "on schedule". Caution should be the byword. I believed that a sick child with his immune system now lowered should not have it stressed further by increasing the dose of a food to which he is highly allergic. 


I had not conducted any online research on this topic when the next morning my friend Stacey Hanley sent me an email with some related information. Her son Nate has already successfully completed the desensitization phase of the same treatment Alexander is receiving. Nate is now able to eat Snickers candy bars. Yikes!  I will write her interesting comments in my next post.


For now the "Countdown to 1 Whole Peanut" has begun again.
Thursday January 27th Alexander hopes to be allowed to increase his dose to 1 Whole Peanut!

Delay in Eating Whole Peanut Probable

Probable delay in eating 1 Whole Peanut. Alexander is due this Thursday, January 20 to have his peanut dose increased from 500 mg of peanut flour in capsule form to 1 Whole Peanut. We have been counting down the days to this momentous occasion.

See my prior posts 
"3 Days Until 1 Peanut" and 
"Countdown to 1 Whole Peanut"
This past weekend Alexander started having a runny nose and sore throat. 

My thoughts rambled..."could this be a slight reaction due to the 500 mg peanut dose?" 
or "is this due to seasonal allergies caused by a change in the weather?  
Nasal and asthma symptoms in Alexander are often triggered by weather changes. 
"Perhaps attending an extremely cold soccer game last Friday night wearing only a thin hooded sweatshirt might have started the whole thing". 

Very cold night to watch a soccer game in a hoodie

He seemed to get a little better until last night when after playing in a soccer game he said "I feel sick to my stomach. I think I ate too much at lunch." He proceeded to eat very little dinner. 
When the time came to take his peanut dose he said "I can't do it". The thought of it makes me want to throw up anyway and my stomach is already gurgling."  

Hmmm- what to do?  
Tell him he must take the dose? 
The dosing instructions we received from Dallas Allergy Immunology for the peanut desensitizing treatment are very precise. The patient is to avoid any deviations from the dosing schedule. If a dose is missed for any reason a call is to be placed to the doctor.


Alexander pleaded with me not to take his peanut dose so I called the doctor's answering service. 
Dr. Wasserman returned my call and he agreed that Xander should not take the dose. 

His instructions:
Skip the dose. Take a half dose in the morning followed by a full dose in the evening. 
We followed those instructions. 
My son was very happy he did not have to take the peanut dose.

Dateline this morning- Xander still feels sick to his stomach. We requested he take the dose anyway. Of course he threw it up immediately. 
Alexander really dislikes the taste of peanuts and almost gags any time he takes a dose. 
He always managed to ingest the dose successfully in the past; however,this time an already queasy teenager plus the dreaded peanut taste was the perfect combination for a return trip of the peanut dose. 

Stay tuned to find out what happens next....

3 DAYS UNTIL 1 PEANUT

The days are ticking down until Alexander eats his 1ST WHOLE PEANUT! 
Last Thursday January 13th Alexander's dose was increased from 250 mg of peanut flour encased in a capsule to 500 mg of peanut flour. If he tolerates this increased dose, Alexander will eat 1 WHOLE PEANUT this Thursday morning!


Hopefully there are only a few days left to take the dose in a capsule which per Alexander is "kind of a pain". Every last bit of peanut flour has to be scraped out of a small capsule into the liquid of your choice. 
 Alexander perfected the method. The peanut flour is mixed into the liquid. He then drinks his smelly "cocktail". Next more liquid is poured into the same glass then stir and drink. 
It's also important to rinse your mouth and swallow to remove all peanut flour from that area. 
Per Xander " it's like using mouthwash and then you swallow it."
See my post "Peanut Allergy Treatment #3 and #4 for information on the peanut flour filled capsules. http://justalittlepeanut.blogspot.com/2010/12/peanut-allergy-treatment-3-and-4.html


The only possible "hitch" (ie-complication) affecting the decision to increase the dose this  Thursday is the runny nose Alexander has developed this week. 
We believe the runny nose is due to the weather change and sitting outdoors in cold weather watching a nighttime soccer game without a warm coat. 
We will have to wait till Thursday to see what Dr. Wasserman advises.


Tonights peanut flour "cocktail"?  
Knudsen's Just Cranberry Juice (very strong flavor) mixed with the peanut flour from the capsule. Alexander pinches his nose to reduce the flavor and makes very unhappy noises as he chokes down the elixir. He chases it with fresh squeezed tangerine juice to DROWN OUT the peanut taste. His dad comments " you'd think he was swallowing ... (I must censor the comment). Suffice to say Xander is not liking the flavor of peanuts!

Peanut Allergy Treatment #5 -A New Peanut Dose

Alexander is getting closer to eating his FIRST PEANUT! 
The countdown to 1 whole peanut continues.  January 20th is "P-DAY"


On January 6th, 2011 for Peanut Allergy Treatment #5  Alexander received his new dose of 175 mg of peanut flour in capsule form. 
I noticed this dosage amount was not on the dosing schedule I originally received so I asked physicians assistant (PA) Angela Gallucci about the inclusion of a 175 mg dose.  
Ms. Gallucci is the primary PA in charge of the Food Oral Immunotherapy (OIT) program at Dallas Allergy Immunology.  


The schedule given to me when we began treatment is shown below. 
The chart shows all the doses to be taken after Day 1 of treatment (which is an all-day affair).  Follow the link below to read my post entitled "Peanut Allergy Treatment Day 1" for those details.
http://justalittlepeanut.blogspot.com/2010_12_02_archive.html

Ms.Gallucci told us a new 175 mg dose was only added recently. 
I asked why?
She explained that all the dose increases for a peanut patient up the 100 mg dose had been a doubling of the prior dose. The increase from 100 mg to 250 mg was more than double.

The new "intermediate" dose of 175 mg was added because the jump from a 100 mg dose to 250 mg dose had caused a few reactions in patients. 
Now all patients who tolerate the 100 mg dose successfully will take the 175 mg dose and then proceed to the 250 mg dose.


We appreciate this conservative approach. 
Alexander was only the 4th peanut patient to receive this intermediate dose.  He tolerated this dose perfectly with no problems. We were told the other patients who received the 175mg dose also had no reactions.


It is reassuring to observe that the Food Oral Immunotherapy peanut program offered by Dr. Wasserman appears to be closely evaluated on an ongoing basis with adjustments made as needed. We are pleased with Alexander's results.


Our entire family is very thankful a peanut allergy treatment is available.

United States Peanut Allergy Treatment

I have been asked where peanut allergy treatment is being offered in the United States so I asked Dr. Wasserman of Dallas Allergy Immunology. He currently treats my son Alexander for his peanut allergy. Alexander began treatment on December 2nd. Progress to date has been smooth. See my prior posts for details.
Dr. Wasserman knows of only 3 places in the U.S. offering treatment for peanut allergic patients.


1- Dr. Richard Wasserman Dallas Allergy Immunology.
See "Helpful Links" for the website. 972-566-7788.


2- Dr. Lyndon E. Mansfield in El Paso,Tx. 915-532-2663


3- Dr. James W. Baker in Lake Oswego, Oregon. 503-636-9011


Note- there are also clinical trials are being conducted in the U.S. and the U.K.


I hope this information is helpful.

Research Peanut Allergy CURE in the U.K.

Research for a peanut allergy "cure" is ongoing around the world.  "Cure" may be the wrong word to described the near-term hoped for results.  From what I've read thus far the current "treatments" being offered (including the treatment Alexander is receiving) and the hoped for future treatments will result in a patient being desensitized so they can tolerate peanuts. This is a fantastic result in my humble opinion.  Alexander would be able to tolerate ingestion of peanuts and....
-not worry about cross-contamination 
-eat cookies off a tray mixed with peanut butter cookies
-ride on an airplane next to someone with a bag full of peanuts 
-sit with his friends eating peanut filled snacks
-eat in a Thai restaurant
-travel to Asia (lots of peanuts in the food in many Asian countries)
The list is endless. You get the idea.


Information in several articles leads me to believe that treatments for peanut allergy may or may not result in a technical "cure" over time for the allergy itself but there is not enough data to know at this point. 


Below are links to several articles written about the research conducted in the U.K. by doctors at Cambridge University. The articles from 2009 and 2010 provide information on a small pilot study that was successfully conducted and the current research being conducted by a team of doctors from Addenbrooke's Hospital in Cambridge, England. The current study will follow over 100 children ages seven to 17 over the course of three years. This is the largest trial of its kind in the world.


http://www.cuh.org.uk/addenbrookes/news/2009/feb/peanut_allergy.html
http://www.politicsdaily.com/2010/02/22/parents-rejoice-peanut-allergy-cure-within-sight-british-stud/
http://www.naturalnews.com/029103_peanuts_allergy.html 
http://www.examiner.com/parenting-in-washington-dc/new-study-offers-hope-for-children-with-peanut-allergies
http://www.dailymail.co.uk/health/article-1252804/Cure-peanut-allergy-Technique-used-tackle-reactions.html


See my prior POST entitled PEANUTS TO CURE PEANUT ALLERGY for a video on research at Duke University.
Over time I will post links to news articles on peanut allergy research studies including articles on the research conducted by Duke University and Arkansas Children's Hospital under the direction of Wesley Burks, MD.