Help me put the puzzle together?

[CMdeux]

Hmmm.   Well, it's never been a regular staple, let me just say.  The last box we had must have been close to a year ago.

[Frosted Crunch]

Kudos to your doc for ONLY testing the suspected ingredients and not doing a huge panel of foods.    I would suggest calling the doc who did the testing and asking if RAST testing for those same ingredients plus other legumes and peanuts would be advisable to help narrow down the culprit. Skin testing won't really be accurate if your DS has recently taken benadryl and steroids.  Our allergist wanted to wait 6 weeks after DD's big reaction to let the steroids fully get out of her system and allow her body to return to "normal" before she did skin testing.  I don't think the blood testing is affected, though.

I edited my post and added the bolded part, but you had already quoted and were responding.  Didn't want you to miss it...

Interesting. His last dose of benaryl was the wednesday before. so 2/9. Thats something to think about.

[YouKnowWho]

I'm pretty sure Cinnamon Toast Crunch has a peanut warning on it


DD has eaten it on occasion-- no warning and she's super-sensitive, so it really does seem okay. 

I was thinking it was pretty recent because they came out with a PB variety??  Maybe I'm thinking of something else...



Hmm - don't see it listed on their website, though.

As of two weeks ago, our local boxes didn't have a warning.  I thought better of purchasing it though but more from a crap cereal standpoint, not allergies.  Was tough to leave it because it was half off LOL

[CMdeux]

Kudos to your doc for ONLY testing the suspected ingredients and not doing a huge panel of foods.    I would suggest calling the doc who did the testing and asking if RAST testing for those same ingredients plus other legumes and peanuts would be advisable to help narrow down the culprit. Skin testing won't really be accurate if your DS has recently taken benadryl and steroids.  Our allergist wanted to wait 6 weeks after DD's big reaction to let the steroids fully get out of her system and allow her body to return to "normal" before she did skin testing.  I don't think the blood testing is affected, though.

I edited my post and added the bolded part, but you had already quoted and were responding.  Didn't want you to miss it...

Interesting. His last dose of benaryl was the wednesday before. so 2/9. Thats something to think about.

BUT...

also note that in my post after Rebekah's, I noted that the robust response to the positive histamine control is a pretty good indicator that his histamine response wasn't significantly impaired.

Hard to be truly certain, of course.  How much time (hours) had elapsed after the final dose of diphenhydramine (benadryl)?  The half life is variable, ranging from 2.5~5 hours in kids this age.  A lot depends on the dose you were using, as well.  A high dose (or repeated dosing) obviously takes longer to clear.

[Frosted Crunch]

Let's make this puzzle more complex (answers in bold! )

I'm pretty sure Cinnamon Toast Crunch has a peanut warning on it


DD has eaten it on occasion-- no warning and she's super-sensitive, so it really does seem okay. 



Okay, might be time to investigate his school environment for any recent changes; new carpeting, new cleaner, new... well, new anything, I guess.

He says he only gets wheezy/tight throat/ squeezes at the house, it's typically at bedtime. It's been happening several times during the day the past few days, and he's gone hoarse once.

My DH was allergic to green beans as a kid.  He didn't develop a serious allergy to them until he was about six years old.  Just noting that.  It can happen.  In his case, it was probably secondary to his soy allergy, but it is possible that it might have been the other way around.  It's odd that soy would be completely negative in someone with any legume allergy.  Often it is falsely positive in anyone with any other legume allergy.  What other sources of soy has he eaten over the past year?  Asian food?

We eat sushi quite often, and my favorite way to prepare green beans is sesame oil, and sesame seeds.


Prepared food (of any kind)?  I'll bet you that 90% of what is in your freezer and pantry has soy in it in some form... does he often complain of feeling bad or just seem "off" relative to other kids his age?  Those are big tip-offs for an allergy to a common and ubiquitous food. 

Not really. That's why it's so bizarre. My DD does this however, and she was just allergy tested (+ for Peanuts and sweet potatoes, and some random trees as well)

Also-- do know that tree pollens are quite different from the seed storage proteins which are common allergens in legumes.  So it's very very unlikely that a legume allergy (to a seed-storage protein) is responsible/related to the pollen allergies.

Has he eaten sesame in any kind of quantity?

Nope.

  Other seeds?

He likes PB, and the nut mixes from the stores. He's never had a reaction to them though.

  What were OTHER people eating during the meals and the superbowl party?

It was a potluck, so lots of other random stuff. He had a few chocolate chip cookies (i brought from my house) and the chips and hummus.


That oat skin test number seems a little out of line with the others.  Does he eat oatmeal?  Yes. He LOVES oatmeal. Cheerios?  Yep, he's a huge fan. Lots of oat products. Oatmeal cookies.

What R said is true, but on the other hand, the above shows quite a robust reaction to the histamine control, so the results are probably accurate.  Here's his back: The largest is the histamine.

Honestly, your timeline doesn't lead me to much aside from cinnamon or another spice/additive of some kind.  I'm not sure it's necessarily a food that you're looking for...     Sometimes it's tempting to look at foods and try to find correlations for reactions, but they aren't always there.  Environmental triggers can cause pretty severe reactions, as well.

Yeah, i haven't a clue. I'm a total newb to all this allergy stuff.


You are correct-- this is quite the puzzle!!  I'm sorry that the answer isn't much more clear.   

It's alright. I'm used to puzzles. sigh.

[GingerPye]

Were the green beans plain when eaten, i.e. didn't have butter or margarine on them?  I'm just thinking about soy, possibly.  I haven't read word for word here yet ---

I think someone suggested keeping a diary.  Def do that.  Notate everything you can think of.

[Frosted Crunch]

Were the green beans plain when eaten, i.e. didn't have butter or margarine on them?  I'm just thinking about soy, possibly.  I haven't read word for word here yet ---

I think someone suggested keeping a diary.  Def do that.  Notate everything you can think of.

Our regular green bean recipe is one of two:

THIS ONE: http://www.skinnytaste.com/2011/11/roasted-parmesan-green-beans.html#more

Or just green beans on the stove with sesame oil and sesame seeds.

[Frosted Crunch]

Oh, and his usual dose of benadryl is 2tsp. I'm using the walmart equate generic brand.

[CMdeux]

ooooo-- same time of day is probably a HUGE clue.


Of course, the question is... what does it mean??


Ughhh.


Okay-- bedtime routine at your house looks like... what?

(Begin maybe about an hour after dinnertime, or around 2h before "lights out" time and run through as much detail as you can-- who does what, and in what order.)

bath?

pets going in or out?

sibling routine?

other parent does.... what... while bedtime parent is running through the routine?

[GingerPye]

Well, the garlic in that green beans recipe jumped out at me .... but then you say the other time the green beans had sesame.  Hmmm.   Nope, not clear-cut at all.   

[Frosted Crunch]

ooooo-- same time of day is probably a HUGE clue.


Of course, the question is... what does it mean??


Ughhh.


Okay-- bedtime routine at your house looks like... what?

ha. My kids go to bed at 6:30 for the littles (age 4 and 6) and ds1(kid in question) stays up until 7:30.


Typical night: Dinner at 5:30-6ish
Bath every other night. (he uses suave kids shampoo/bodywash) (the other nights he plays games on the computer)
I put the other two to bed, while DH watches Ds1 (usually watching something on TV)
Book
Turn on heat blanket
Bed.



(Begin maybe about an hour after dinnertime, or around 2h before "lights out" time and run through as much detail as you can-- who does what, and in what order.)

bath? Suave shampoo and body wash

pets going in or out?

We have an almost 1 year old yellow lab. he goes in and out 39084239083293 times a day.

sibling routine?

They both use the same body wash, (except DD's HAS to be dora princess) and they have the same routine, but they go to bed earlier.

other parent does.... what... while bedtime parent is running through the routine?

DH usually spends time with Ds1 while i'm putting the other two to bed.

maybe I should note that the dog has allergies too? He's allergic to chicken, and something else. he's always getting skin infections 

I use vinegar and water mostly for cleaning, with the occasional windex antibacterial multi surface.

[Frosted Crunch]

Well, the garlic in that green beans recipe jumped out at me .... but then you say the other time the green beans had sesame.  Hmmm.   Nope, not clear-cut at all.   

we use lots of garlic. It's in almost every recipe We've had in the past 3 months.

[CMdeux]

Oh, and his usual dose of benadryl is 2tsp. I'm using the walmart equate generic brand.

Okay... 2 tsp is approx. 10mL... I seem to recall that the children's benadryl is formulated at 12.5 mg/tsp....

That's a pretty hefty dose for a 7yo, but I'm assuming that you've cleared this one with your doc.

To clear a single dose that size well enough that our allergist (he's a good one, btw) would consider skin testing "very" accurate would require the med clearance to reach perhaps 1% of the original dose.  He'd want at least five days, probably.

Younger kids have faster clearance times, but that dose is pretty large for anyone under about 90 lbs.

[CMdeux]

Any correlation between bath night and non-bath nights and the allergic symptoms?



I'm also going to toss this one out-- how hot is the bathwater?  If it's warmer than "tepid" that may make hives worse-- or even provoke them in some kids.


Is your DS generally happy enough about going to bed?  Or would he MUCH rather stay up later?  Is it possible that some of what he's been reporting is psychosomatic?  Maybe the initial reaction got him attention that he liked, or he (subconsciously, even) figured out that you let him stay up later as a result of being worried about him?

[Frosted Crunch]

Oh, and his usual dose of benadryl is 2tsp. I'm using the walmart equate generic brand.

Okay... 2 tsp is approx. 10mL... I seem to recall that the children's benadryl is formulated at 12.5 mg/tsp....

That's a pretty hefty dose for a 7yo, but I'm assuming that you've cleared this one with your doc.

He'll be 8 in a month. He's almost 75lbs. But yes, that's what they have written on all his sheets.

To clear a single dose that size well enough that our allergist (he's a good one, btw) would consider skin testing "very" accurate would require the med clearance to reach perhaps 1% of the original dose.  He'd want at least five days, probably.

Younger kids have faster clearance times, but that dose is pretty large for anyone under about 90 lbs.