Friday, November 14, 2008

More on the Oral Food Desensitization Program

Yesterday I talked with one of the nurses at the office of the allergist who just began conducting the program. She said they have had four kids complete the program and they have another handful in process right now and they've "really had no problems at all" with it and all of the kids are able to tolerate significant amounts of their allergen. I told her Ainsley was just turning 4, and she said that ordinarily they like to take older kids (5+), but that we could bring her in and they could evaluate her maturity level to determine whether she would be willing to follow the program (basically, they just want to make sure the child won't fight taking the solution three times a day). Ainsley is very mature for her age, so I am optimistic that she would qualify.

I told the nurse that we were interested in both the egg and the milk program because Ainsley is allergic to both. She said that we could probably do both, one at a time. She also said that they are expecting to implement the same type of program for peanuts next summer. In other words, the potential exists that Ainsley could receive the treatment for milk, eggs, and peanuts, and could conceivably develop tolerances to all three of the foods in the next couple of years. I honestly can't imagine what that would be like! Then we would only have to worry about her tree nut allergies.

After speaking with the nurse, I called our allergist's office to get his opinion on this. I had to leave a message with his nurse. I tried to explain the program as best I could on the message. She called me back and said she had talked with the doctor and that what I had described sounded like an oral food challenge and that Ainsley's numbers are way too high for an oral challenge. I responded that I wasn't talking about an oral food challenge, but instead a treatment program that involves administering a minute amount of the allergen to build up a tolerance over the course of time. Unfortunately, she didn't seem to understand what I was talking about, and said, "Well, the doctor wouldn't recommend it."

After talking with Dave, we decided to write a letter to our allergist and attach the materials we received from the other allergist's office explaining the program. We asked in the letter that our allergist contact one of us to talk about it. Hopefully he will get back to us in the next week or two.

It's funny, now that I know this treatment option is available and pretty much ours for the taking, I am filled with so much doubt and anxiety about it. I have prayed for this type of thing, and now I am hesitant. My biggest worry, of course, is that Ainsley would have a reaction to the allergen doses. Another worry is that this treatment could somehow prolong her allergy -- in other words, what if she would naturally grow out of one of her allergies in the next few years, but by giving her some of the allergen, it will cause her allergy to hang on longer, even though she would be able to tolerate the food? There is nothing so far to support any possibility like that, but I would still like to talk with the doctor more about it before agreeing to the treatment.

The chief difficulty with this treatment, as I see it, is that, after the child develops a tolerance, the doctors recommend you keep feeding the child the food on a regular (daily) basis so that the child will keep up the tolerance. So you would really never know if your child actually outgrew the allergy on his or her own without stopping the food for a while and then introducing it to his or her diet again.

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