Progress, We Have Progress!

Big news in the PFMama household!

B had an allergist appointment this morning: she had a skin prick test (which my crazy daughter thinks is worse than a blood draw - go figure).

We were hoping for a smaller reaction than last year...and we got it!

She still reacted, but it was reduced enough for us to talk about food challenges (yes, even with a positive result - with a negative RAST, our allergist was ok to move forward now since her wheal size has reduced significantly over the years).

The doctor gave us the option to do it right away, but after weighing the pros and cons with him, we decided to wait until the fall to give her body a little while longer to gear up and (hopefully) grow out of the allergy.

So we're so excited! We're still avoiding just as diligently as we have been, but to see a possible end on the horizon is great.

I hope your Monday was just as good.

G

Preparing for the RAST Test

For the last two years, Bella has had a Skin Prick Test (SPT) instead of a blood test to determine her food allergies.

The first year, she was allergic to peanuts, almonds, and walnuts.

Last year, she was allergic to just peanuts. Whew, no tree nut allergies! Of course, we haven't challenged the tree nuts with an oral challenge in the doctors office, so we're still avoiding them.

So that brings us to this year. Next month, Bella will go in for a RAST (also called the CAP-RAST) test. What exactly is that? I thought you'd never ask! Here's a brief statement from the NIH:

The RAST (Radioallergosorbent test) is a laboratory test performed on blood. It tests for the amount of specific IgE antibodies in the blood which are present if there is a "true" allergic reaction.

So basically (I'm not a doctor here), they take your blood and in a lab mix it with allergens to see if your blood reacts. Here's another link to an extensive overview of the RAST test.

Is it "better" than a Skin Prick Test? Not necessarily. As I understand it, both are good indicators of allergy, but for some folks the skin test isn't preferred due to eczema, medication interference, and the risk of exposure to the allergen. But our allergist, who's on the faculty at Stanford Medical School, wants to do it to see the levels in her blood as they react to Peanut. According to the AAAAI, the level of the CAP-RAST test may help predict future food allergy reactions to these foods. I've read lots of differing experiences with this, so I'm on the fence about how much faith to put in the results.

The RAST is very new territory for me, and I'm trying my hardest to understand it, and why it's necessary. But I feel that I should do it - that it's my responsibility as a parent to know just HOW allergic she is. Not that it will make a bit of difference in our diligence in avoiding nuts.

Did any of you decide not to do a RAST even if your doctor ordered one and just stay with a SPT? I'd love to hear from you either in the comments or via email.

And I must admit, I'm VERY nervous about her getting her blood drawn. I've been a blood donor for years, so needles don't bug me, but how do I explain to her that she's getting an 'owie' on purpose? I hope I don't break down in tears in the lab! I'm not sure I want to just surprise her with a blood draw without any notice - it seems a little harsh to me. On the other hand, I don't want her worrying about something that will only take a few minutes and will hopefully be fairly painless for her.

So how I am going to restrain my feisty (and strong) 3 year old? How can I help her in this situation? Bribing with a trip to ToysRUs will definitely happen, that's for sure. But do you all have any other ideas? I'd love to hear them.