It's Been Another 6 Months

I can't believe it's already been 6 months since Abigail's last appointment for the Peanut Sublingual Immunotherapy Clinical Trial. It was time for another trip to Durham, NC, and the Duke University Hospital. This particular visit marks our two year anniversary in the program. Just 365 more days of daily drops, one more 6 month blood work appointment, two more food challenges and we're done. Unofficially anyway. There will still be follow-up visits to monitor her desensitization.

Another visit down!

You can tell from this picture that Abigail is just thrilled to be back. Upon our arrival, we were just a little confused. "Clinical Trial Research Unit" was no longer labeled on the front doors. At first we wondered, if in the last six months, they had moved the unit to a different part of the hospital. This small sign was all there was to announce that yes we were still in the right spot. They now share this hall with another cancer unit and it got top billing on the big double entrance doors.

This visit, like the rest, started with weight/height measurements and the application of numbing cream on both her arms. She then had to spit in a tube (her least favorite part of the visit) and sit through a skin prick test.  This test is no longer as uncomfortable as it used to be.  The skin reactions are now minimal, and her back doesn't itch near as much.

Abigail's doctor marking where the skin will be pricked.

Final results.  Some swelling at highest dosage (on top left).
Minimal swelling at the remaining pricks.

Here is a link to pictures of Abigail's last two skin prick tests.  There have been visable changes each time.  She also had 6 vials of blood drawn and then it was time to say good-bye to Dr. Kim.  His Fellowship at Duke is over, and he has accepted a permanent job in Chapel Hill.  We'll miss seeing him on our visits.  He was fabulous with Abigail and extremely patient in answering all of my many questions.  There is already another doctor assigned to continue Phase I of the Peanut Immunotherapy Sublingual Trial.  We did not get to meet her at our appointment.  While we were having our visit, she was busy doing a food challenge with the very first patient in Phase II of this trial.  I'll follow up on details of that trial in a different post.

So, what's next?  Daily drops, a report on Abigail's IgE results from this visit and a 6 month lab appointment in January 2012.  Starting in December of this year, the first participants in our trial will be starting their end of study food challenges.  When we go back to Duke in January, we'll be updated on those results.  Then in June, Abigail will have her food challenge.  If she can tolerate it, she'll be given the equivalent of 20 peanuts.  Assuming there are no issues, and I'm not expecting any (she tolerated the full 10 peanuts at her food trial last year), we'll be asked to not give her the drops or any peanut product.  After 6 weeks, she'll be given a food challenge again to see if she can continue to tolerate the 20 peanuts.  If so, we'll then introduce small amounts of peanut into her diet and/or continue the drops.  That's yet to be determined.  And, just as important, if she tests negative again to tree nuts, I'll be able to again purchase products manufactured in facilities using tree nuts.  Even better, her doctor felt she'd be able to pick up a can of any type of tree nuts and just munch.

While a year seems so far away for Abigail, I look back at how quickly the last 2 years have flown by, and how much progress she's made.  I'm looking forward to the conclusion of the study.  What will I blog about then?