Let me just start by saying that I fully recognized that my family and my son, are truly blessed. As we were sitting in the exam room, prepared for, and waiting for his almond challenge to begin, I realized that this was our 5th food challenge. Five food challenges, and only one he “failed”, which was a complete surprise. Not many food allergy kids get this privilege.
There are so many words to describe the feeling of a food challenge as it begins: exciting, scary, encouraging, nerve-wracking, and unbelievable. In the picture below, as the first bite of a formally forbidden food is being eaten, my hands were sweating even though I was smiling at him. I have been always nervous at this stage, even though blood tests tell me that it’s safe for him to eat certain foods.
A quick word on blood tests. I asked our awesome allergist why he has never done any skin testing to determine my son’s food allergies. His response was that since we already have multiple very low positive blood test results, that skin testing is just going to show the same thing, or he’d have no skin reaction at all. So far, blood tests for us have been accurate and reliable, however, I know that this is not the case for all. I do know that if we would do skin testing for dairy and peanut, that we’d have some definite welts to measure on his back.
When it was time to begin the food challenge, the allergist brought in just 1/4 of an almond. Fifteen minutes later the “dose” was doubled to 1/2 an almond. Then 1 almond. Then 2 almonds. Then 4 almonds. Every time the dose was increased, I couldn’t help but think, “Is this the amount that is going to push his little 30 lb. body over the edge and cause him to start coughing with hives around his mouth?”. We started at 9:15 and by 11:15 N had eaten a total of 7 3/4 Blue Diamond almonds. It was so freeing to relax as we were given the all clear to go home. It was exhilarating to watch my son enjoy a food that has been strictly off limits since before it was safe for him to even eat as a toddler. The funny part is, is that when the allergist and nurse would leave, N would try and convince me to slip him an extra almond or two from our extra container in the exam room. It’s eye-opening how a young child has no fear at times and just lives in the moment. Now, if I could just do that myself….
As I was giving live updates on Mom Vs. Food Allergy’s Facebook page, someone asked how we got to the point of doing an almond challenge. Truthfully, N has never had high blood test results showing a strong allergy. We have, however, always strictly avoided all tree nuts (except coconut) because of possible cross contamination with peanut. As of November, the almond result was 0.47. Anything above 0.45 requires an in office food challenge. Anything 0.35 and lower is eligible for an at home food challenge. Like I said earlier, we’ve never done skin testing. Some allergists swear by it, and that’s their only method of testing. Some allergists do both, like ours, just not for my son and his particular situation. Is not doing skin tests wrong? No. Is not doing blood testing wrong? No. I do believe that every patient is different and I trust our allergist, just as you hopefully trust yours, to make that well educated decision on what is best for the allergy sufferer in your family. Simply put, blood testing has thankfully been accurate in our situation and it is reliable. So, since N is getting a little older and can identify the difference between an almond and a peanut (and other nuts), we felt is was safe for us to introduce almonds to his diet.
Well, almonds. Welcome to our house and our diet. We’ve been wanting to include you for a long time now for your amazing health benefits. I can’t wait to incorporate your nutty taste into smoothies, baked goods, and trail mixes.
Why did we choose Blue Diamond Almonds for the food challenge? Blue Diamond Almonds are peanut free and there was no cross contamination issues with any of N’s other allergens (dairy, egg, carrot, pumpkin, celery, strawberry, or raw tomato). There is a possible cross contamination with other tree nuts, but that’s not really an issue for us as we’ll be challenging more tree nuts in the future.
Your turn! Tell us about your food challenge experience and how it went-I’d love to hear your food challenge story!