Precise Dose for Peanut Allergy Treatment- Oral Immunotherapy

Now that Alexander's peanut allergy treatment has progressed he is having his peanut dose increased each week.


Date Dose     Amount     Frequency     Total Peanuts per 24 Hours
Jan 27          1 Peanut    Twice per day         2
Feb  3           2 Peanuts    Twice per day        4
Feb 10          3 Peanuts    Twice per day        6


Feb 17          4 Peanuts    Twice per day       8
Feb 24          5 Peanuts    Twice per day      10


I need to shell more peanuts
Why does Dr. Wasserman required to buy in-shell peanuts and shell them myself?
He is being cautious. Unfortunately, Alexander may be allergic to Almonds so we must avoid possible cross-contamination in processed peanuts.
Click here to see my post "Shucking Peanuts for Alexander's Big Day".  
Alexander's dosing amount is very precise! Each peanut must an an average size peanut. Not too big and not too small. 
To obtain an average sized peanut from an in-shell peanut is hard to accomplish. This morning my son requested I provide new peanuts because only large peanuts remain from the first batch I shelled.
We are so thankful that due to the peanut allergy immunotherapy treatment our son is able to actually Eat Peanuts safely! 
I will happily shell the peanuts for him.
As I set about the task again, I experience the same issue that occurred the last time I shelled peanuts. The first few peanuts split in half. I shell a few more and their size is too large.

In an odd sort of way I now have a Dr. Jekyll and Mr. Hyde relationship with peanuts.
They scare me but I need them. Shelling these peanuts is like panning for gold. 
If a peanut pops out of the shell and falls into the sack of peanut shells then I have to sift through the shells and peanut debris to find the golden nugget, a whole peanut.


Once I dropped a perfect peanut specimen into the sink. Ugh! I thought about saving it. 
I wiped it off carefully but I came to my senses thinking "what has been in that sink?"
Yes, I tossed it into the trash.
So what is my shelling "success rate"? Curious, I decided to calculate the yield from my harvesting of the in-shell peanuts. Here are the details-
1) I shelled in batches of 10 in-shell peanuts. Each peanut containing 2 shelled peanuts for a total possible yield of 20 peanuts per batch.
2) I shelled 7 batches for a total possible yield of 140 peanuts.
3) My harvest averaged 7.28 peanuts that were perfectly whole and average in size 
out of 20. 
4) Rate of success in obtaining "perfect peanuts" only 36%.
At this rate I will be doing a lot of shelling.


I thought perhaps the quality of the in-shell peanuts I purchased was inferior in some way.
The shells are hard to crack, the peanut dust flies everywhere and the peanuts break apart.
At Dr. Wasserman's today I shared my story with another Mom of a peanut allergic child. She tried shelling peanuts. Same issues. Then she bought peanuts from a different source, Albertson's Grocery store in Dallas and the shelling experience was better.
So I will be heading to Albertson's.

After 2 hours of work my "Total Harvest" was only 88 Average Size Whole Peanuts, 
32 unusable Extra Large Peanuts and a Jar Full of Half Peanuts also not useable, or so I thought.

Alexander's dose was recently increased 4 Whole Peanuts per dose for a daily total of 8 Whole Peanuts.  The next dose will be 5 peanuts per dose or 10 total per day.
My peanut supply will not last long.
I have a plan to solve the challenge. I will conduct a science experiment to determine the average weight in grams of an average size shelled peanut.
Watch for that post. The results will save you a lot of time if you need to shell peanuts as part of a peanut allergy treatment program.


I am so thankful that Alexander's peanut allergy treatment is proceeding so well. 

Low-Allergy Peanut Being Developed in United States

Here is a novel approach.  A low-allergy peanut is being developed by the U.S. Department of Agriculture.  Researchers are working to develop a new breed of peanut. The properties 900 different peanut strains of peanuts have been examined as part of the process. Whew! 
Good news. The new peanut is not genetically modified. It is produced through traditional cross-breeding.


Why develop this new low-allergy peanut?
Here is an excerpt from a Time Magazine article-

"Researchers are hopeful that a low allergy peanut could be incorporated into allergy treatment programs aimed at building patients' resistance, and could potentially help eliminate the cross-contamination issues on manufacturing production lines and during food preparation in restaurant kitchens."

Perhaps in a future generation growing up eating "low-allergy peanuts" we would see a reduced incidence of peanut allergy. Who knows?


For people already allergic to peanuts it seems logical that a low-allergy peanut might enable them to consume some low allergy peanut products without a reaction. 
I am not a scientist but these possibilities make common sense to me.


According to the Time article the target for public availability of a low-allergy peanut is 2-5 years. 
I think this is a great idea. I hope it is successful.


The peanut oral desensitization treatment our son Alexander is currently receiving for his peanut allergy is a real breakthrough for those allergic to peanuts.
Currently treatment is offered in only a handful places in the United States.
It is proceeding very well thus far. 


Alexander started treatment on December 12, 2010. He is now consuming 8 peanuts per day as his "dose". His dose increases each week. 
More details are available in other posts on my blog.


Click here to read my post "Peanut Allergy Treatment Day 1"

Click here to read Time Magazine article published in June 2010  "Designing a low-allergy peanut?"
Click here to read an article from BBC Health News on the low-allergy peanut

PEANUT,MILK, EGG ALLERGY TREATMENT EXPLAINED

Our son Alexander is being treated for his peanut allergy as Dallas Allergy Immunology (DAI). The treatment is desensitization using oral immunotherapy. Click here to read "Peanut Allergic Teenager EATS a Peanut".

 Treatment is also offered for Milk, Egg and Wheat allergies. 
(UPDATE Feb 2012- Soy and Tree Nuts treatment now offered)

To learn more about treatment for these 4 food allergies read the following excerpt printed in green is from the DAI website

DallasAllergyImmunology is pleased to announce a new oral immunotherapy program that provides a long-term solution for wheat, egg, peanut and milk allergic patients. At the end of this 5-6 month program patients with wheat, egg, peanut or milk allergy will be able to consume these foods with no allergic reactions. The program introduces minute doses of wheat, egg, peanut or milk in solution over a period of three to four months. The program then progresses to small doses of the whole food for an additional two to three months, resulting in tolerance to these foods allowing the children to consume wheat, eggs, peanuts and/or milk without any adverse reactions.

We have a number of children who have graduated from the program and are now eating eggs, and peanuts or drinking milk without reactions. This program is designed for a child of school age or older who will be old enough to understand the reasons for participating and be actively engaged in the process.

Click here for detailed information on the Dallas Allergy website.

I will regularly post on this blog -

1)  information on Alexander's progress as his continues his Peanut allergy treatment.  

2) research on food allergies

3) information on Egg, Milk and Wheat allergies and their treatment

4) relevant news

5) helpful links

6) food allergy news out of Europe and other countries 

7) whatever I can think of that may help or be relevant to the subjects mentioned above

Click here to go to our Homepage. Click the FOLLOW button at top of the right section of the blog to keep up with all the news. 
You can follow us on TWITTER http://twitter.com/PeanutBlog

I pray this information is encouraging and helpful to you- Julie Brice Beiersdorf

Peanut and Food Allergy TESTING RESULTS for Alexander Over the Years

Several readers have asked about Alexander's testing results especially for Peanuts. Below are the results of all testing. Here is the story...


Alexander was diagnosed with a PEANUT ALLERGY at 22 months old. 

Alexander 2 years old

How did I discover this? 
I had given my son a tiny taste of peanut butter. I remember exactly where we were standing- in the kitchen by our pull out pantry.
I put a tiny bit of peanut butter on a spoon (I love peanut butter). Bending down I gave sweet little Alexander a taste.

IMMEDIATELY he said his tongue tingled. I told him to "spit it out" which he did.  I think I also wiped off his tongue.
I instinctively thought "this may be an allergy". I have zero allergies (happy me) so I did not have any personal experience in the matter.

I made a few phone calls to seek a recommendation for an allergist. We chose to see Dr. Ruff, a local allergist.  I think he conducted only a "scratch test".  Alexander tested "positive" for an allergy to peanuts. What to do?

We were instructed to strictly avoid peanuts.       (Click here for "C'mon Man" post)
I thought "that's it?  That is all we can do to help someone with a life-threatening allergy?"  There was no treatment for this allergy!

Not true any longer. Thankfully a Peanut Allergy TREATMENT is NOW available.
Alexander is being TREATED  for his peanut allergy. 

For more information click here to read about our "Peanut Allergy Treatment Day 1"
On January 27th he ate his first whole peanut!   Click here to read about it.

Alexander selecting his 1st Peanut to Eat

When he was younger Alexander tested positive to an allergy or intolerance to a host of other foods- but that's another story.
I have not included that information in the testing results below.


Let me know if  this information is helpful by posting a Comment for all to see.  What you have to say may be helpful or encouraging to others.  Let's get the conversation started.  Perhaps we can get a helpful dialog going.


Dr. Wasserman      Blood Testing Results       9/20/2010
PEANUTS
IgE              >100 kU/L     class VI

IgG4             19.40 ug/ml  Class III    * class III range 7.51-31.00

IgE                    
ALMONDS    7.34 kU/L  class IV
PISTACHIO  1.13  kU/L  class III
WALNUT      .36  kU/L  class II
PECAN         .34  kU/L  class II
CASHEW       .31  kU/L  class II
HAZELNUT   .26  kU/L  class II
SHRIMP      <.o5 kU/L  class 0

Dr. Ruff          Blood Testing Results           7/23 2008
PEANUTS        IgE             >100 kU/L     class VI

SHRIMP     .37 kU/L      class 1
Dr. Ruff       Food Allergy Testing Panel Results- Scratch test   7/23 2008
PEANUTS     Reacted
Nuts            All including Almonds were NEGATIVE
Soy              Reacted
Wheat          Negative
Shrimp         Negative
Shellfix Mix   Negative    same result for Lobster, Scallop, Crab, Oyster, Salmon


Dr. Johnson    Blood Testing Results        3/22  2002

PEANUTS       

IgE                 >100 kU/L     class VI

HAZELNUT  18.18 kU/L   class IV

WALNUT        1.55  kU/L  class III

SHRIMP          . 10  kU/L  class I

Two Peanuts and Super Bowl - Both New for Peanut Allergic Teenager

Alexander, our peanut allergic teenager successfully completed a week of EATING 1 peanut twice per day!
Amazing.
His first dose was 1/1000th of a peanut.

Only last December Alexander began treatment for his life threatening allergy to peanuts. Click here to Read my post "Peanut Allergy Treatment Day 1" for more details.

His treatment has been without incident barring one delay before we even began the program.  Read "Roadblocks" and
one delay during treatment. Click here to read "Dose Delayed No Whole Peanut Yet"

Once again Alexander's dose has been increased.
The dose increase was from 1 to 2 Whole Peanuts given twice per day.
He is tolerating this new dose well.

Yesterday we were fortunate to attend Super Bowl XLV.

Alexander has recently become more comfortable about the danger posed by food in these settings.


As anyone with food allergies knows the allergic food, in our case peanuts, can be hiding in the most unlikely food.  Sauces, cookies, pie crust, chili and salad are only a few examples of places peanuts could be used as an ingredient yet often undetectable.
Even trace amounts of peanuts can be life threatening.

I have a large list on the my blog with more items- read my page "Where is the Peanut Hiding?"



Now that he is eating 2 Peanuts per dose twice a day, Alexander is getting a little too comfortable about his level of protection.
He didn't even think he needed to take his EPIPEN to the Super Bowl. Yikes!
I insisted we take 2.

As time goes on I will know more about the "protection" provided by the treatment. Yes, he obviously has increased tolerance and a base level of protection.
After all he is eating 4 Peanuts a Day!  Hurray.

If you have any question please post a Comment on the blog and I will be happy to respond.

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

I will post them on the blog.

After all there is a world out there waiting for help or encouragement.

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/