Saturday, May 19, 2018

Noah's Allergy Diagnosis

When Noah was about 18 months old, we had already found out that he was allergic to dairy milk (an allergy he’s since grown out of), so I had been giving him soy milk or almond milk.  One morning, I only had a little bit of either, so I combined them in a cup.  I had this weird feeling that something bad would come of this.  Later that afternoon, he laid down in the grass at my mother in law’s house and started throwing an old pile of leaves into the air with Michael.  The boys let the leaves fall down on their faces.  Aaron picked them up that day.  When they got home, I picked up Noah who was screaming (this was semi-normal) and I knew something was wrong.

His eyelids were swelling.  I checked his ears—they were swelling too.  I lifted up his shirt and he had a rash on his back.  I frantically called my mom as I put Noah in a cool bath.  She said she was on her way and to go ahead and call the pediatrician line.  Did I mention this was on a Friday at 4:30pm?  The receptionist was super helpful and said they’d be ready for us.

By the time we got to the pediatrician’s office, Noah’s lips were the slightest blue.  They raced us to a room and administered the “rescue” dose of Benadryl.  We were told to wait in the room until they could see an improvement.  We waited about 20 minutes.  During this time, the doctor asked us if anything odd had happened that day.  I told her about the combined soy & almond milk.  And I told her about the pile of leaves.  She said to avoid all soy, all almonds, and that he might be allergic to dirt spores under the leaves—so to avoid throwing leaves in the air. 

When the doctor could see that the Benadryl was working, we were released and told that I’d have to give the rescue dose for a full 24 hours (yes, waking him up in the night to make sure he got it).  I was given breathing sounds to listen for if his body was in distress.  I was scared out of my mind.  But at least I knew the rescue dose of Benadryl.

We avoided all almond products and soy milk.  We didn’t think about avoiding food with soy—I guess we had never paid attention to how far permeating the presence of soy is in so many common foods (Ritz crackers, Slim Jims, chocolate chips for example). 

We avoided letting Noah throw leaves into the air, or stand downwind of anyone raking a pile of leaves.  He got in the way once, and again came home with his eyes rolling back in his head.  A rescue dose of Benadryl was given and we met my mom at the hospital where she works, but he was fine when we got there, so we were able to head back home.

He had briefly tried a cashew when he was about two and a half years old.  He just put it in his mouth and spit it out, saying he didn’t like the taste.  He had some sort of reaction that day—a rash or a red mark by his lip or something—which led me to believe he was allergic to cashew.

Last summer, my mom brought me a veggie and nut tray shortly after I was diagnosed with gestational diabetes when pregnant with Avery.  Noah picked up a cashew, touched it to his lip, then put it down because he didn't like it.  His lip instantly swelled.  I gave him the rescue dose of Benadryl and watched him carefully for the rest of the day and overnight.  I'm so so glad he didn't swallow it!  This confirmed to me that he was allergic to cashews.  

At his four-year-old check up at the beginning of this year, I told the doctor that I would like him to be checked by an allergist and have an epi-pen.  Since Michael was in school, I had seen his class make little projects like trail mix which included cashews, etc.  And I knew that the "peanut butter and jelly sandwiches" in the cafeteria were not actually peanut butter due to the prevalence of peanut allergies these days.  I knew that the "peanut butter" was actually nut butter-- but was that almond butter?  Cashew butter?  Sunflower butter?  Who knew, and would I take their word as gold anyway?  Probably not.  All I knew was that I wanted Noah to be allergy tested before he begins kindergarten in August of 2019.  The pediatrician agreed with me 100%.  Their office referred me to the local allergist that my husband uses.  




In April, I took Noah to his appointment.  I had to pay out of pocket for the skin prick test, but I wasn't leaving without it-- so, it didn't really matter what it cost me.  I got to look at a sheet of allergens with the doctor and select cashew and almond specifically, and we selected the grids showing dust mites, grass, tree, mold, dirt spores, etc and the grid showing peanuts, tree nuts (to also include cashew and almond), soy, eggs, milk, wheat, shellfish, etc.  Noah had to lay still on his belly for 15 minutes while the allergens did their work.  We stayed entertained by watching garbage truck videos on YouTube on my phone.  I took a picture right after the pokes, and then halfway through the test.  





I didn't take a picture at the end, but the results were way worse than they even were just halfway through.  They gave him Zyrtec right away upon completion of the test. 

By the test, Noah is allergic to grass (very much) and trees (not mold or dirt spores), dust mites, eggs, soy, peanuts, tree nuts, and almonds and very much allergic to cashews.   Upon further investigation of my own (since I was shocked at being told he was allergic to eggs and peanuts), I found that if something shows up as negative on a skin prick test, then it's most likely an accurate "negative."  However, if something shows up as positive on a skin prick test, then it's not entirely accurate.  

Therefore, since we have been feeding eggs and peanut butter (not together-- gross) to Noah for years now, we're not super set on eliminating those foods.  We are careful with them though.  He doesn't like plain peanuts, so we aren't purposely introducing them, but we let him have peanut butter if he wants (which is rare for him to want it).  The doctor said that the further something is removed from it's natural source, the fewer allergens are left.  So, it's not a good idea to let him lick cookie dough because of raw eggs, but eating eggs that are baked into cookies, etc, and even eating scrambled eggs is fine. 

We do read labels even more now.  We used to focus solely on nutrition facts, for Michael's sake in determining the carb count.  But now we look at labels for that, and for the bold words underneath the ingredients that say "Contains"  or "May Contain."  The FDA requires companies to state ingredients that are common allergens (milk, soy, wheat, peanuts, tree nuts, etc) if the item contains it.  It is optional for companies to state that a product "might contain" an item, but we are finding many companies put this information on there-- probably to legally cover themselves in case an allergen really is present.  My least favorite is stating that something was processed in a plant that processes tree nuts, or processed on equipment that processes tree nuts.  

We have found that our favorite pancake mix "may contain" tree nuts, so it's out.  Some brands of muffin mix "may contain" tree nuts, so they're out.  We're finding that it's safer to make things on our own.  

For soy products, he's okay if he has a tiny bit of soy-- like from a Ritz cracker.  But if he had Ritz crackers, then three little SlimJims (which have soy listed three times in the ingredients list), and some chocolate chips (which also have soy), then he'll get a rash on his neck or back of his knees which is very itchy to him.  We give him Benadryl when this happens, and we try to limit his consumption of multiple soy products close together. 

A different form of the epi-pen was ordered.  It's called the Auvi-q and it's kind of shaped like a cigarette box (I don't smoke and never have, but this is a shape very recognizable to most people, so it's easier than describing it as a 3-D rectangle or a squashed cube).  This will be for when he has an allergic reaction to any food item and is having difficulty breathing.  For rashes, etc, we can just give Benadryl or Zytrec.  

The auvi-q comes with a trainer pen in each box so we can practice just so we're better prepared in case we ever need to use the real pen. 





If he's outside playing in grass and begins to get a rash or sneeze or get watery eyes, etc, we will bring him inside immediately and give him the rescue dose of Benadryl.  

We give him a daily dose of Zyrtec to help him combat things before they start (mainly relating to grass and soy since we avoid tree nuts at all costs).  

I carry around Zyrtec in my purse and we have the Auvi-q pens stashed in varying locations so that one is always around us if needed.  

Our transition from carpet to hardwood tiles in the main living areas of our home (which also happened on the same weekend as the allergist appointment) will also help keep down the present of dust and exposure to grass remnants getting trapped in the carpet fibers. 

He'll go see the allergist again in a year.  We're told he'll probably outgrow most of these allergies by the time he's 8, but tree nuts are the last allergy to leave the body, and he might be allergic to them forever.  




This new diagnosis is hard to wrap our heads around sometimes.  We already have a lot on our plates in dealing with Type One for Michael, and now we add in this for Noah.  After I nurse Avery in the middle of the night, I go into the boys' room to check on both of them and make sure they're doing okay overnight.  

I pray that Avery will remain healthy.  I'm supposing that Noah will have his own medical plan at school when he starts in the 2019-2020 school year.  I'm trying not to already be nervous.  






Gosh,  I love my kiddos so much! Thank you, Lord, for blessing me with taking care of them despite the physical fears.  

Until Next Time, 
Much love, Reba


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