Catching up pre-OIT

Warning... long post. A couple things i've been late to update on but wanted to get documented before we begin our OIT (Oral Immuno-Therapy) adventure.

March - May 2018
1. Sesame challenge scheduled! (march)
2. Almond reaction (4/15)
3. Discovered Dr. Kim (4/17)
4. Sesame challenge passed! (4/18)
6. Environmental panel (5/3)
5. Met with Dr. Kim (5/21)

1. The allergist called (sometime in March?) to say they have added a new doctor (https://www.fnapc.com/directory/people/show/david-anmuth/) to the practice and were able to move up a whole bunch of food challenges (so much for Feb 2019)- scheduled for April 18th 2018. A little confusion on what to actually bring for food to challenge with... more on that with #2 & 4 below.
But this is fantastic news!

2. Working up to the sesame challenge, Andi had still been getting over some wintry viruses with breathing treatments and low grade fevers. One of the days i decided i wanted to get her used to eating chocolate frosting (because i planned to mix chocolate frosting and chocolate tahini for the food challenge).  I put the chocolate frosting on teddy grahams and it was a hit (she's so picky about everything including chocolate).  So it dawned on me to mix in some barney butter for almond exposure-remember she had tested negative in October- with the chocolate for this treat.  I did just that.  After one teddy graham worth- she said her tongue felt funny! (YIKES!) and didn't eat the second one.  So fine, no splotches, no swelling- I'm watching her like a hawk ready to epi.  She stopped complaining and everything seemed fine.  Then a few minutes later she vomited... another sign, but no further symptoms and they were not overlapping.  Luckily nothing else happened and she was fine, although i was watching her intensely the rest of the day.  So it appears that almond was a false negative on the skin test... more on this with #6 below.

3. I was starting to explore the options of driving to Philadelphia every two weeks to get Andi started on OIT. It appeared from OIT101.org that this is the closest city (or VA beach).  I started searching the FB allergy groups for people that did the drive from NOVA to Philly to read about their experiences, time commitment, etc.   The day before the sesame challenge (4/17) someone sent me a private message to let me know there was a Dr in Chantilly VA (like a mile from where i work EVERYDAY) who is doing OIT. I was floored.  I immediately started investigating, and the same woman added me to a NOVA OIT FB group. Wow. I called right up the next day (after the sesame challenge) and scheduled our first visit.
Dr. Kim (not the same Dr. Kim from my UNC post) practices at Allergy Partners of Northern Virginia in Chantilly.
I feel like we had won the lottery able to get an appointment in just a few weeks!!

4. sesame challenge 4/18
We arrived to see Dr. Anmuth, all prepared with coloring books (adult coloring books for my stress levels) and an iPad with movies. I had called the office to clarify on what food to bring (the paper said sesame cracker but that made zero sense as a way to control exposure to sesame for a challenge).  They said some kind of tahini was fine.  So I found chocolate tahini on amazon and we went with that. chocolate tahini and chocolate frosting mixed on a teddy graham, small amounts measured and brought to us in a plastic spoon every 15 mins. Eventually we went straight choc tahini on a few graham crackers.  Andi ate ALL of it!!! Every 15 mins for like two hours. She had zero reaction, passed with flying colors. I was floored and amazed that my picky eater downed all that food!!!  she is cleared for sesame no restrictions. Dr. Anmuth was very nice. I mentioned the almond incident from a few days prior.  He thought avoiding until we could talk to Dr. Miranowski again/test again would be best. He mentioned that if her seasonal allergies were in high gear she could have a flare to almond due to that (and test negative other parts of the year) as one possible explanation.

5. 5/3 we saw dr. miranowski a few weeks later for environmental panels for Leni and Andi.
Leni- almost all negative (slight tree) except cats and dogs!!!
Andi- a few moderate tress, slight cat.  Threw egg, peanut and almond on there. Almond was positive this time, ugg.  She mentioned the egg went down a bit and she'd like to do a scrambled egg challenge in 6 months.  I mentioned we were starting OIT for peanut and we could do egg in a year if OIT for peanut went well, she agreed.

Check out Leni's welts for Cat and Dog (27 & 28)... advised to give benadryl if attending b-day parties and such with dogs present.  Leni did NOT enjoy the 30 skin pricks :/  I should have had brave Andi go first.

Poor little Andi with some environmental trees.  Clearly her Almond, Peanut and Egg across the top are visible.

6. We met Dr. Kim on 5/21.  I had prepared Andi's allergy medical history in an easy-to-read table, because that's the kind of person I am.  I knew what info he would want, and what we would need to discuss to see if she was a good candidate (I knew she was), and he agreed it was perfect and he had all the info he needed and was comfortable starting her in the program.  Her blood and skin tests were pretty recent and didn't need repeating currently.  Rich and I read over a few procedures, protocols and agreements.

Side note 1- Dr. Kim mentioned that he is not on OIT101.org yet because he wants to have a lot of success rates under his belt.  This is referred to "private practice OIT" or PPOIT for peanut.  The FB groups are quite weirdly strict on these "rules" around if your Dr is listed or not. He mentioned that he has had high success rates so far and was very optimistic.

Side note 2- Dr. Kim went to listen to Andi's lungs and i explained the poor thing is not very good and blowing out... he runs out and comes back with a PINWHEEL.  This man is a GENIUS. Of course she blew the pinwheel and he could listen to her lungs. AMAZED.  He earned our trust right there. why couldn't the pediatricians known this simple trick???

We decided to wait until July to start- finish up the school year and get into a new groove. July 11 is day 1 to get the base dose before bi-weekly visits for updosing.
I got approval to work from home 1 day per week to accommodate a flexible schedule to handle the appointments over the next year (for that I am so thankful).
We are reaching my goal of doing OIT prior to entering public school (yesssssss!!!)
We are about to embark on a stressful journey that will hopefully eliminate MUCH future stress and it will be well worth it.

I think that's it for now.  I hope to do a blog for day 1 of OIT and then updates through all of those phases.  She should be eating 8 peanuts per day by this time next year!!

Clinical Trial Research

If I didn't advocate for my own kid, who would?  I would go to the ends of the earth to do something to help my daughter.  I would drive her to a clinical trial as needed to get her treatment to desensitize her allergy.  I am hopeful for the peanut patch to get FDA approved so that our local allergist can prescribe it.  Here is a story about some of my latest research on this effort:

SO! A friend of mine saw a flier in her allergy office about peanut patch trials and sent it my way (THANK YOU Dawn!)

So I did some googling, and eventually figure out i need to look at www.clinicaltrials.gov.  I find the EPITOPE study.  If you have some time, look around that website a bit, it's interesting.

https://clinicaltrials.gov/ct2/show/NCT03211247?recrs=abdf&cond=Peanut+Allergy&cntry=US&age_v=3&rank=6

It (initially) showed only three places doing the EPITOPE study, with study leads and their contact info.

Mount Sinai Medical Center, NY

Arkansas Childrens, AK

UNC, Chapel Hill, NC

The Mt. Sinai location matches up with my google search on Jaffe Food Allergy Institute from the flier. 

I decide to email the three doctors.  I get Dr. Kim from UNC Chapel Hill to answer a few questions for me.  I ask about other locations closer to DC possibly doing this study.  He reached out to DBV Technologies (the company doing Viaskin Peanut Patch) and realized there was actually 7 places involved with the study and they were surprised to actually see only 3 listed on the clinical trial site.  (so I just checked and it now lists the 7 places... YAY for me pointing out an error on a gov website).  John Hopkins should be involved and he puts me in touch with the clinical trial manager.  

JHU writes me back and asks for my daughters name, birthday, address, list of allergies we avoid.  They let me know that for any future trials they send a letter to the families on the list who qualify.  After that they conduct a lottery (because there is so much interest).  ANYWAYS, because of my due diligence, and the helpfulness of a Dr at UNC that answers emails, I have Andi on a clinical trial list at JHU.  

Dr. Wood is the Director of Pediatric Allergy and Immunology at JHU.  A friend of a friend saw him and said he was wonderful.  He also wrote Food Allergies for Dummies.

I'm hopeful that my efforts can make a difference for her.  I'd really like to get her the peanut patch or in an OIT trail before she enters the school system. 

THEN just yesterday i see this news: 

http://mentalfloss.com/article/531530/new-peanut-allergy-patch-could-be-coming-pharmacies-year

and

https://www.bloomberg.com/news/articles/2018-02-14/peanut-allergy-patch-will-get-fda-review-despite-failed-trial

She will be 4 in July, and the patch looks like it will available later this year for ages 4-11.  

When i asked about treatments like this, our Dr said she will only do something FDA approved.  Other doctors doing OIT are doing non-FDA approved treatments and closest ones to us would be Philadelphia or Virginia Beach... possibly too far to do Dr. appointments.  So I think our best bet is the patch later this year, or getting into some type of trial.

ALSO: Shout out to Judi who reminded me to check out ROTTEN on Netflix.  Episode 2 is called "The Peanut Problem".  While it leaves out a lot of things, it's an excellent look at the food allergy epidemic and how scary it can be.  It's definitely worth checking out.

Sour Grapes! (cross contamination)

Back on 1/26/18 Andi had a minor reaction to eating grapes, and we have narrowed down to a probable cross contamination.

She was eating her grapes first, as she usually eat her fruit first at dinner.  She complained to me that her throat hurt, so i had her take a break eating.  Later i urged her to eat her pizza but she didn't really want it, so i told her to at least finish her grapes.  She proceeded to eat more of them, gag, and vomit.  She had very flushed/pink cheeks but was otherwise acting fine, no hives.

I realized that a few nights earlier she had woken up gagging (i thought she was going to vomit) but I was able to get her some water and back to bed.  I think she had been eating the grapes.  Thank goodness we never put any in her lunch that week.  I called the grocery store to find out if there were any bags of peanuts anywhere near grapes in the produce section ( we order our groceries and curb side pick up).  They said no, but could not guarantee, because items come shipped together all jumbled up in one big truck.

I figure because grapes have a very "open" type of bag, and people can reach their hands in directly on the produce to make the bags different weights, etc. we were looking at possible cross contamination.  We quit grapes for a week or so.  I figured a grape allergy was highly unlikely because she'd been having grapes her whole life.  I got purple grapes next and we tried those with no problems, and eventually re introduced green grapes as well.

Annual Visit ... Continued

So a bit of good news from the blood draw.
Anything less than 0.2 is negligible, so almond and sesame are very low.
We heard back from the nurse at the allergist office... she said our Dr would like us to try almond at home (based on our history and previous discussions) and they would like to do an in-office challenge for sesame.

First the peanut looks slightly worse, and egg looks around the same.  Unfortunately the peanut is still very serious.  The "class" doesn't really describe the severity of the allergy, but the likelihood of an anaphylactic reaction.

Almond at home... I purchased Nuttzo butter which has like 7 different nuts and seeds in the butter including almond. They have another kind with peanut but it's made in a separate facility.  I have so far snuck the butter under some cream cheese on her bagel.. she didn't really like it. She's so picky she even hates nut butter substitutes that i have tried in the past.  I have also snuck Nuttzo into a strawberry banana smoothie.  So far so good (I secretly want to say YAY but want to wait a bit longer to make sure we have continued success). We will do it early in the morning on a weekend when we have no immediate plans.. so that we can monitor.  I hope it continues to go well and we can reintroduce tree nuts in our home.  Although Andi will still only be allowed to have nuts that were not processed in a facility with peanuts, which is pretty limiting still.

Sesame challenge... the appointment list is FIFTEEN months out. That's right, our appointment is in Feb 2019.  With the knowledge that appointments get canceled all the time and there is a waitlist and we will likely be seen at some point this year.  A "challenge" is when the allergist monitors your consumption of the allergen in the office in case there is a reaction.  They will recommend this when your skin and blood testing shows close to negligible.  Her sesame still had a hive this time while the almond did not.  I'm hoping we can eliminate sesame, it will open the possibility of more breads and stuff like that, although again still items that are not from a facility with peanut.

Tough luck on growing out of the unbaked egg and peanut so far.  Hanging in there.

We have also been going through some challenges with Andi and PFAPA syndrome.  That is for a whole different type of blog.  It's an auto inflammatory condition that is causing her to have high fevers that are cyclical (ours are every 3-4 weeks).  We just had our 7th fever in 6 months.  Luckily those tonsils and adenoids are coming out in December.  *send all the good vibes*

Here is the blood work, nearly 2 years apart, for comparison:

        

New challenge: Exposing Reyna to peanut and egg in the house. Not mentally there yet.

Annual Allergy Check-Up

Today was a our annual visit to our allergist.  We went this month so that i could get Reyna checked out before we start solids.  It also works as a good time to get Andi the flu shot, which she has to do at the allergist because of the egg allergy.

So Reyna checked out well! So far negative skin prick to peanut, almond, sesame & egg.  We will start giving her food soon and the allergist wants us to make sure she gets eggs and peanut exposure which will be tricky to do in our peanut-free house!  going to have to make a little zone for her and do it right before bath or something!!

For Andi I asked about other tree nuts as well, because i want to start getting some tree nuts that are safe for her to eat.  Luckily she was still negative to cashew, hazelnut, pecan, pistachio, walnut.  The GOOD NEWS is that the almond was negative! The sesame was also "smaller" this time!  Egg was about the same and peanut was actually a bit worse, which is sad.

Here are the measurements from last year and this year:
(one is the size of the hive and one is the size of the overall redness)

 

So since we had good news with the almond the Dr suggested a blood draw to test her IgE levels to see what comes back on the almond, and I guess if it comes back ok we might do a food challenge.  Being able to eat tree nuts would help somewhat, although shared facility for peanuts is the biggest challenge.  

Since it's my only day off with Andi for the foreseeable future, I took her right over to the lab for a pediatric blood draw.  The guy was definitely on the B team. Not good. in fact she's never had such a horrible blood draw. he tried twice and i wanted to punch him in the face so bad.  another guy came in and got it.  she was a slight bit dehydrated but still. 

so skin pricks, flu shot and blood draw... I got her an ice-cream from Chick Fil A... she earned it!! She was one exhausted kid and I am one exhausted momma!

Emergency Action Plan

So what food allergy reaction symptoms should you look for?  and if something happens, what do we do?  Well, we keep our EpiPen in a special thermal bag inside the diaper bag, it's easy to find.  We also keep expired back up pens on top of the refrigerator.

This handy guide provided by FARE (Food Allergy Research & Education) is what we follow:

https://www.foodallergy.org/file/emergency-care-plan.pdf

I couldn't get an image of a .pdf to show up in my blog, so you'll have to click the link to see it.

It says for ONE MILD symptom, you can monitor and do an antihistamine (like Zyrtec)
For ONE OR MORE SEVERE symptom or MORE THAN ONE MILD symptom, give epinephrine and call 911.

Mild Symptoms:

NOSE
Itchy or runny nose, sneezing

MOUTH
Itchy mouth

SKIN
A few hives, mild itch

GUT
Mild nausea or discomfort 

Severe Symptoms:

LUNG
Shortness of breath, wheezing, repetitive cough
SKIN
Many hives over body, widespread redness

HEART
Pale or bluish skin, faintness, weak pulse, dizziness
GUT
Repetitive vomiting, severe diarrhea

THROAT
Tight or hoarse throat, trouble breathing or swallowing
OTHER
Feeling something bad is about to happen, anxiety, confusion

MOUTH
Significant swelling of the tongue or lips
OR A
COMBINATION
of symptoms from different body areas. 

Why call 911?  Need to make sure the epinephrine is working for the reaction and that secondary reactions can be treated quickly (i.e. biphasic reactions).  Also, heart rates need to be monitored after epinephrine is given.

Sometimes we get the question, "So have you ever had to use the EpiPen?".  Thankfully we have not (although we should have during her initial encounter with peanut).  Not having used the EpiPen does not make her allergies less severe. It's a life threatening medical condition and thank God we have not had another reaction that has required it.

How does this affect us?  We are always in that mode of "ready to act".  I'm always on edge during mealtime (especially if we are not at home).  While the kids are eating, I'm always glancing over at them to make sure they look okay.  The tiniest little skin irritation or red spot is hyper analyzed to make sure it's not a reaction.
Or at the playground, for example, I wonder if another kid has recently been eating peanut butter crackers and has now touched all the playground equipment. What if Andi touches that and then rubs her eye or licks her fingers? You just never know.  That is the type of thing we are required to think about constantly.

Thanks for reading, let me know if you have any questions about our emergency action plan.

A history

It has become apparent to me that I need an easier way to document/share Andi's food allergy history and management with family members and caregivers.  Sometimes when learning about food allergies it's hard to understand/believe when you haven't seen everything first hand, so I wanted to document her reactions, doctor's appointments, check ups, and protocols here.

This is a journey.  I hope it ends with Andi growing out of her food allergies.  Or maybe we will get to do a peanut patch or even oral immunotherapy (OIT) which has been having great success.  I'm sure things will get even more fun when she "can't have that" and enters the school system in two years.

I will probably share this blog eventually, because I know so many other parents are going through the same thing.  Sometimes my Facebook support group is the only thing keeping me sane, otherwise the anxiety of managing allergies can be overwhelming.  1 in 13 kids now has a food allergy.  Older generations are not used to the sensitivities and precautions for keeping people with food allergies safe.  Every time I ask for accommodations from family, friends and restaurants I hope I am educating one extra person... it can save lives.  (same thing with car seats, but that's a different hot topic!)

Summary list of significant dates/ages/event so far: (time just FLIES by)

2015/05/25- 10 months old - Scrambled Egg

2015/07/09- 11 months old- First allergist appointment

2015/12/05- 17 months old- Peanut butter

2016/01/07- 1 year old - blood test results

2016/06/02- 1 year old- Allergist check up

2016/08/06- 2 years old- Hummus (sesame)

2016/08/09 - 2 years old- Allergist follow up

2016/08/13- 2 years old- Almond

2016/12/08- 2 years old- Allergist check up

2017/12/x- 3 years old- next expected allergist check up


Description and pictures for each event:

2015/05/25- 10 months old - Scrambled Egg
Out to breakfast at Leesburg diner.  Suspected first time ingestion of scrambled eggs.  I had given her eggs previously but she always swatted them off the table. Our first indication of a picky eater!  She started rubbing her face and crying so Rich brought her out to get fresh air. When we paid the bill and walked outside it was apparent she was having a reaction.  I had only ordered her plain scrambled egg.  It was a holiday so everything was closed. We monitored her for swelling and breathing issues (none) and her hives (face only) subsided within about 2 hours.  We did a pediatrician appointment and got a referral and i did some research on local allergists and booked an appointment.

2015/07/09- 11 months old- First allergist appointment
Doctor asked what she had/hadn't been exposed to yet and tested for nuts and fish/shellfish because i was uncertain.  But I know she had no problems with milk, wheat and baked egg.  She encouraged us to give food with baked egg daily to help her outgrow the egg allergy.  Milk and egg allergies have a high % kids who outgrow.  Doc gave a prick/scratch test (doesn't hurt) with positive histamine (+), control (-), a handful of different nuts, egg, fish and shellfish.  Surprisingly (now) her nut pricks were negative at this time. Egg was the only positive.  Things we are not allowed to give her now include anything with undercooked or stove top cooked egg (scrambled, pancakes) as well as the need to check sauces and dressings (like mayo, ranch, etc.).  She can have baked egg like in processed foods or baked goods cooked at 350 for 15-30 mins. (High temperatures break down proteins in milk and egg only.  Some people can handle milk and egg allergies baked and some cannot).  Allergist seemed to imply a connection with egg allergy to nut allergies when she urged us to expose Andi to nuts as much as possible (my picky eater wasn't having it).  Seemed stressful but manageable.  I started joining some Facebook community groups for parents of food allergic children.

As I had been learning there are 8 top allergies that need to be labeled for on food product in the US. These include dairy, egg, wheat, soy, peanut, treenuts, fish, shellfish.  Manufactures are not required to label for shared processing equipment or facilities.

2015/12/05- 17 months old- Peanut butter
Running short on time for breakfast, I fed the girls a piece of bread with peanut butter for breakfast.  I folded the bread in half, hoping Andi would eat it without seeing the peanut butter (she never wanted it. I have no idea if she had ever ingested any in my past attempts to expose her).  She had eaten 1 or 2 bites from the sandwich. I was about to run out the door for a running clinic at the triathlon club and Rich and I noticed her lip looked swollen.

Remembering her mild reaction to egg, we reached for the benadryl and gave her a dose. We assumed it would be similar to her egg reaction.  She was negative to peanut before so we were really confused as to why it was happening.  We had an EpiPen but since her swelling went down we didn't use it.  Plus we were still rather uneducated and probably scared.  [knowing what we know now, this incident would have called for use of the EpiPen immediately and a call to 911].  I told rich to call me if anything changed and I ran out the door for my hour class (stupid me).  He called me after an hour and said she had all these weird symptoms and seemed to be not getting better.

When i came home she had been itching inside her ears so much they were scratched/bleeding.  It was like an instant cold. Watery, itchy eyes, sneezing, coughing. Wasn't sitting right, so I ran her over to the ER.  [in addition to the swelling, the following symptoms were a multiple system reaction and required the use of EpiPen, which we didn't realize at the time- did you know a lot of devastating stories end like this?].
ER agreed it looked like a food allergy reaction and wanted to give more benadryl. OK.
So as were were sitting there being monitored (hours after initial ingestion of the peanut butter), she had a biphasic reaction, first her ears turned bright red and a few mins later I noticed she broke out in hives all over her body.
Thankfully she did not swell again/have breathing issues (probably being masked by the Benadryl).
ER required to give her steroids to recover.

Left ER avoiding ALL NUTS until we could be seen by her allergist.  This was very close to a trip to NH for the holidays. Explaining this to everyone was exhausting, but still rather a new concept to both us an everyone else.

2016/01/07- 1 year old - blood test results
Before we saw the allergist we went in for a blood draw (not fun for my baby). We met with her to discuss the results.

What she told me confirmed what i had read online.  That blood results showing the "classification" are practically meaningless and there are no real ways to classify the severity of the allergy.  But the specific reaction to the "IgE Ara h 2"meant that she was at a VERY HIGH RISK of ANAPHYLACTIC reaction to peanut.  I will probably post at another time about the different blood testing for nuts.  There is about a 20% chance for outgrowing peanut allergies at some point.
Also note that her almond blood test was "equivocal/low" meaning the allergist thought it was nothing.
Encouraged exposure to other nuts as long as there was no risk for CROSS CONTAMINATION with peanuts.
No shared facilities or shared lines for peanuts.
That means reading labels and looking for the "May contain" or "Made in a facility with" statements.
If those statements are not on there, they are not required to disclose, so you need to call/research.

New things that are a NO for Andi:
Avoid all asian food/restaurants.
Avoid ice cream parlors (ice cream facilities share lines AND the parlors use a lot of nut toppings AND the dippers are constantly going in and out of different flavors).
Avoid bakeries- tons of shared equipment.  (No birthday cakes from grocery stores).
Obviously watch all candy, etc.
When eating out ask about product ingredients as well as risk for cross contamination in kitchens.

I later read that egg and peanut allergies typically go hand-in-hand for some reason.  Hoping not to add anymore to the list because i've been reading about families that have one or more kids with multiple severe allergies.  Not sure how i would eliminate dairy, wheat, soy and even meat and other obscure allergies.  At least her school was egg and nut free.


2016/06/02- 1 year old- Allergist check up
Routine 6 month check up. Andi hates vegetables and onto of allergies I was starting to worry about her pickiness of foods and thought that her avoiding things meant she was somehow allergic to it.  So they pricked her for broccoli because the girl will not touch it.  Negative :)
Peanut and egg were still significant.  Reco see her again in 6 months.

2016/08/06- 2 years old- Hummus (sesame)
So. We went to CAVA in Ashburn.  It's like Chipotle but Mediterranean instead of Mexican.  She had chicken and falafel and pitas with hummus on her plate.  She was being picky (surprise).  After the meal we went to target and noticed that she had some slight blotchiness on her face.  I suspected she had touched the hummus and then touched her face. I called CAVA to confirm they do not have any risk of cross contact with eggs or nuts.  I went online to look at all of their ingredients and made a complete list of what was on her plate and in her food. I made an appointment with the allergist.

This was a contact reaction, not an ingestion reaction.  No idea how sensitive she is if ingested.  Can't even really tell in the picture but her left eye is a bit red and there is some slight red splotchiness going on.

2016/08/09 - 2 years old- Allergist follow up
Doc agreed likely hummus and either chick pea or sesame.  Ground sesame is "tahini" and is a main ingredient in hummus and a lot of Mediterranean/ Middle Eastern food. They actually didn't have a prick test for chick pea but they did have one for sesame, so figured it was worth a shot, and it was positive.  Good to confirm but SO frustrating to add to our list.

1. Positive histamine, 2. control, 3. sesame

I also mentioned to the doctor that i suspected an almond allergy.  I had accidentally splashed her cereal with almond milk (what I use) instead of the 2% and she had some ever so light splotches on her face.  I had previously put almond flour in her muffins with no incident. The allergist said our blood test was negative and to go ahead and try exposure to almond again.

2016/08/13- 2 years old- Almond
So I took that advice and gave her cereal with almond milk.  This reaction wasn't anaphylactic but different symptoms and spread out: Minor blotchiness on her face that subsided within like 20 mins.  Later ate a fruit squeezy pack and then threw up (I think) and she was super grumpy for the rest of the day and I think even had a loose stool.  These were all very different reactions from egg and peanut, thankfully not as severe as peanut.

So we decided to avoid almond until her check up in december to confirm.  I had no rush since we were already avoiding peanut and her school was nut-free.

2016/12/08- 2 years old- Allergist check up
So the last time we saw the doctor for the 6 month check we pricked for Almond (confirmed), Peanut, Sesame and Egg.  None seem to have "improved" or subsided. I think the egg was just ever so slightly smaller.  The peanut hive was on her back for days.

So this is Andi's allergy history thus far, learning things daily. It's a struggle and stress to educate others but we are just trying to keep her safe at all costs.

We JUST returned from Andi's (& Reyna's) first airplane flight.  We were able to medical pre-board in order to wipe down her seats.  In addition to people snacking on nuts when flying, Southwest still serves peanuts on their flights, but were very accommodating for us and didn't serve nuts with an allergy on board.  I will have another blog post about my experience with that and dealing with allergies while traveling.  Coming soon.

Ideas for future posts:

Updates on reactions/appointments

Links to educational material

Food Allergy Action Plan (types of reactions, when to use the EpiPen)

Peanut proteins, blood tests, etc. and related information

What she CAN have/safe snacks

Traveling with food allergies

Holidays with food allergies

THANKS FOR READING AND HELPING TO KEEP OUR DAUGHTER SAFE!