Wednesday, June 23, 2010

A Successful Food Challenge!!

She did it!!  Abigail consumed all 9 doses of peanut flour today with no reaction!

I don't even know where to start.  There's so much to tell.  First though, I want to thank Dr. Kim and our RN's, Alice and Jan, for ensuring that Abigail's day was as pleasant as possible given the agenda.  I'd also really like to thank all of our family, friends and you guys, my readers, for keeping us in your prayers today.  God was listening!  I still can't believe it.  Depending on whether you use 240 or 300 milligrams as the average peanut size (there are mixed standards), Abigail ate the equivalent of 8 to 10 peanuts today.  Our family has much to be thankful for!

We started at 8:00 a.m. with the dreaded saliva test.  For whatever reason, Abigail hates spitting in that tube.  Next they did the skin prick test, and the results were better than 4 months ago.  With the use of numbing cream the insertion of the I.V. didn't hurt.  I wonder if Abigail has a future as a nurse because she always watches and even helps change the test tubes during the blood draw. With all of that out of the way, the Benadryl pre-measured and Epi Pens handy, she ate her first dose at a little after 9:00.

The first dose is just 5 milligrams.  Our doctor says it's uncanny and wonders if it's some sort of protective instinct, but the kids usually can taste even that minute amount.  She did, but said confidently that it was the oat flour. Ten minutes later, she ate the 2nd dose, 10 milligrams.  The doses continued, some met with a curled nose and followed by a drink of water, but she took them all without hesitation.  They were mixed with cinnamon applesauce and went from 5 milligrams to 15 milligrams, 50 mg, 100 mg, 250 mg, 500 mg and then 1000 mg.  By this time I had also smelled the mixture and hid my disgust.  Also, by this time, she had consumed the equivalent of 3 1/2 to 4 peanuts.  Dr. Kim was 99.9% sure that she was getting the peanut protein (remember it's double blinded and could have been the oat flour) so I was getting a little antsy.  Before each dose increase, they checked Abigail's breathing and skin for symptoms.  The next dose was 1500 mg and the final dose was 1580 mg.  Each of those doses were the equivalent to 2 1/2 to 3 peanuts each.  She coasted through.  I didn't allow myself to be super excited yet.  I didn't want to be disappointed if that did turn out to be the oat flour.

We had a 2 hour lunch break.  After Abigail had eaten her favorite, bagel with cream cheese, her stomach started to hurt a little.  It didn't stop her from eating her chocolate pudding or playing her Nintendo DS so that was a good sign.  Later that afternoon, I realized that she was still under the impression that she had eaten the oat flour which makes me wonder if it was a nervous stomach over the next challenge.

At 1:30, we started the process again.  For a change, the Dietitian mixed the flour with vanilla yogurt which worked well.  It was fun to watch Abigail's light bulb moment when she looked at the remaining 3 doses and then looked at the doses of Benadryl and exclaimed that she hadn't needed those.  You could see her realization that she was making it through with flying colors.  We finished those last 3 doses and by 3:00 were finished.  After final confirmation from the Dietitian that she had indeed had the peanut flour first and seeing the report that she was getting the real thing and not the placebo, there was some celebrating!  Abigail's was the 35th food challenge in the Peanut SLIT Clinical Trial.  She was one of 9 that was able to take all of the doses.

So, what's next.  We continue doing exactly what we've been doing the last year.  She'll take her drops daily, we'll continue to eat peanut and tree nut free and continue to avoid all chances of cross-contamination.  We go back in 3 months for a "check-in" visit and to get more drops.  At 6 months, we go in for labs, at 9 months we're back for another "check-in" visit, and at 12 months, another food challenge where they double the dosages she received today.

Again, thanks so much for all of your prayers and well wishes.  It has been a wonderful day!