This Year's Visit to Mt. Sinai

[GoingNuts]

DS went to Mt. Sinai for testing two years ago, and all his skin tests were strongly positive, as were his rasts - with the exception of almond.  He was totally disinterested in doing a challenge for almond then, and that hasn't changed.

Because of the strength of the skin reactions last time, Dr. Nowak (love her, BTW) didn't feel it was worthwhile to "torture" DS and make him itchy and miserable by repeating what had already been done - with the exception of chick pea and lentil.  She felt that his RAST was low enough for those that it would be worth re-testing.

Skin test on both were negative!!! 

Because he has a history of airborne reaction to chick peas (hives from the smell of falafel cooking) she wants to proceed cautiously.  If his RAST remains low, she said he could do a food challenge for it.    Visions of my favorite marinated chick pea recipe are dancing in my head, LOL.

Additionally, she suggested that since he has had no reactions whatsoever in 8 years (knock wood, poo-poo-poo), that he might be a good candidate for the new component test, which tests which protein component you are allergic to.  She suspects that many of his allergies, particularly to soy, are probably birch-related and that he may be able to eat may contains safely.

Since this is not yet FDA approved, it would cost $150.  I was willing to do it, but DS wants to wait a year to mull it over.  I think he's pretty comfortable with the way he manages his life now, and the thought of changing things up so soon before going off to college is scary.  Fine with me.  But the thought that this may be a possibility is beyond my wildest dreams.

We'll wait and see what the RAST shows. 

BTW, she is also encouraged by the fact that his seasonal allergies haven't been particularly bad this year.  He's been off Allegra in anticipation of this visit, and has had only minor symptoms.  Normally this time of year he'd be flat out miserable, even with Allegra. 

And, to cap it off, Mr. Softee was right outside the parking garage, and we had our first Mr. Softees of the season.  Bonus!  Back to the healthy eating tomorrow.   

So, a productive day.   

[MandCmama]

  Great news!

[CMdeux]

   <---- there's your dancing chickpea, GN!!



That is fantastic news!!  At the very least, it's a lot less worry during this first year, huh?  I'm so thrilled for you.     Oh, and your DS.  Happy for him, too.  LOL.

[GoingNuts]

ROFL!  She didn't say this in front of him, only to me - one of the reasons she strongly suspects that his reactions have been birch related is that it is highly unusual for someone with truly severe PN & TN allergies to go 8 years without a reaction.  Especially keeping in mind that he attends a B&M school, with no accommodations such as food-free classrooms.  She still wants him to strictly avoid as he has been doing.

Mind you, he has had some pretty severe airborne/contact reactions in the past.  Maybe his immune system has just matured?  Maybe the contact reactions were just due to his extremely reactive skin (blonde, very pale, etc.)?    Maybe we're just totally off base and have just been lucky for the past 8 years?  All possibilities.

Whatever it is, I'll look forward to next year. 

[catelyn]

Fingers crossed for him!

Helga has the severe birch thing going on.  We were at a parade yesterday and being out in the pollen gave her hives all over her face and the pollen count is low right now.  Ugh.  Its so hard to tease apart.

[Mfamom]

Thanks for the update, Amy. 
I know my ds so allergic to birch and that was apparently causing a lot of false positives for tree nuts.
I am so interested in this component test.  My ds had ana at 4 years old from PB.  They only did spt 2 weeks later to confirm.  When he was 7, 9 and 11 RAST showed negative for peanut.  SPT still showing huge wheal. 
So, this test would be helpful in my ds case?

That is great to hear with the chickpeas!!! 

Also, I understand what you're saying about him mulling it over.  My ds considers his allergies "part of him" as funny as that sounds. 

[Mookie86]

Wow, what a promising appointment!  Such great news.  I am so happy for you and him! 

[Janelle205]

Interesting to hear about the birch allergy connections - I have a really, really bad birch allergy.  I wish my soy allergy was birch-related, but unfortunately, I consistently have nasty GI allergy issues when I get 'soybeaned'.

I wonder if the birch cross-reactivity is why I think that walnuts taste like burning itchy yuck though...

[GoingNuts]

Birch is the devil.  I am sure of it. 

[MommyOfTwo+1]

Sounds like a GREAT appt!!!!! WOOHOO!!

[becca]

   Yeah on the chickpea and lentil!

Interresting to read she does not want to challenge almonds.  we might be in the same position.  Need to revisit an allergist, after a neg almond, but some + tree nuts. 

Good news, though!

Becca

[GoingNuts]

Got the blood tests back yesterday - no real surprises.  A couple of things came down a smidge - soy and almond (which was low enough to begin with that she suggested a food challenge last year - he wasn't interested).  Not terribly significant, especially since sesame was still quite high.  Pine nuts looked negative, which was a surprise.

So...

If he wants to do it, they said they would do a food challenge on chick peas and lentils.  He doesn't seem all that eager.  I guess since hummus is still off limits he doesn't see the point.   He could  eat falafel, but only if we make it at home.  Meh.

Hopefully next year he'll want to do the component test.  That could be very interesting.

[my3guys]

The component test does sound very interesting, GN.  Thanks for posting about it!

I'm also very curious how birch allergy can play into testing, DS has every seasonal allergy possible...I'll have to ask about that the next time we go.

[GoingNuts]

A lot of the allergens, especially soy and some of the tree nuts (if I remember correctly), are highly cross-reactive with birch.  So are apples and carrots, which give me fits this time of year.

In essence, the current tests like RAST and Immunocap can't distinguish which of the many proteins in a given food we're allergic to, only that we are allergic to the food itself.  If it's really birch he's allergic to, and not the major PN/TN/soy proteins, then he may be less likely to experience anaphylaxis, and may never get anything more than hives and itching.  Which may mean he could safely eat may contains.  maybe.

This is based on the fact that he is highly reactive to birch, and it's been 8 years since his last reaction (knock wood, poo-poo-poo) despite not having special accommodations in school and eating outside of the home. 

So, we shall see.  Another year to see how the component test shakes out in terms of reliability seems prudent to me.