by Liisa It could be worse. That has been my mantra when it comes to my older son's possibly life-threatening, always manageable, but oh-so-annoying health conditions.

Before I get into the meat of my story, let me introduce myself – I'm Liisa. I'm the mother of two boys, ages 5 and 7. I am thrilled to be able to contribute to Kids in Capital on health and medical topics. In the spirit of this blog, I am going to make things personal, taking you on our family's journey to stay healthy and happy.

Part 1

In the summer of 2008, my three-year old son vomited immediately following a bite of his first-ever peanut butter cookie. We had kept him nut-free until then. My husband has an allergy to cashews and the doctor had advised us to wait until his third birthday.

We were referred to an allergist by our family doctor. Three months later, during a gruelling afternoon wherein the skin scratch test showed very little, but the blood test showed something more, we would learn that my son had a peanut allergy (and my little son would learn that sometimes moms lie (“it's not going to hurt much, just put your arm out”).

We were told that his levels of IgE were low and there was a good chance he would grow out of this allergy. We could retest in a year. If the test was still positive with low IgE, he could go on to do a food challenge (i.e. eat peanuts and see what happens). In the meantime, we were to carry epi-pens for him, avoid ALL nuts and traces of nuts and maintain a nut-free home. You never know whether the next reaction could be an anaphylactic one with peanuts.

Part 2

Eighteen months later it was time for the next allergy test (on April Fool’s Day no less). Much googling for journal articles on diagnosis of peanut allergies in children gave me hope. We had experienced no further reactions. I looked forward to the results and to good news.

My son did not look forward to the appointment the way I did. He was convincing in his argument that testing was not necessary since he did not care for peanuts and nuts, and would not need to eat them now or in the future.

We prepared well for our trip to the allergist. My husband and I were both there for extra distraction and mutual moral support; we brought a treat for morning snack, and a promise of a toy store visit after the appointment.

The good news: We didn’t have to go for a blood test - what a relief.

The bad news: As we sat and read stories for 15 minutes, we glanced periodically at our son's arm. It was clear that the second “P” (indicating peanuts) on his arm was lighting up with a nice hive, a 6mm hive to be precise.

At that point we were, and would likely remain, a nut-free family. Our younger son, then 3, would also be tested as there is an increased likelihood of peanut allergy in siblings of allergic children.

We were glad to know where we stood, glad it was peanuts, an allergen that is common and simple to manage in North America. It could be worse!

Our allergist answered some of our questions and gave us some tips:

1) He recommended getting a Medicalert bracelet. We did though it was tough getting him to keep it on. We found disposable bracelets from Mabel's Labels that he was happy to wear when he was at birthday parties or occasions when his family was not with him.

2) We could eat at restaurants as long as we asked about the food; if a restaurant gave us the “we can't guarantee” speech, we must be absolutely sure we had an epi-pen with us.

3) Though he was not allergic, almond butter (even with the peanut-free label), was not okay. This would be too confusing for him and for others. We should keep it simple and say absolutely no nuts or nut products.

4) We should go back in a year to test again.

Part 3

Late 2011: My son was now 6 years old. We visited the allergist again for the third round of testing in 3 years. The continued absence of reactions gave me hope that perhaps there was no more allergy.

We grabbed his Star Wars sticker book and off we went.

After a brief consultation, we went into the exam room for the drops and scratches, which this time would include environmental allergies. Shortly after the nurse left the room, my son began to feel uncomfortable itching in his arm:

He reacted strongly to cats. We don’t have a cat. No biggie.
He reacted to peanuts, not strongly but still significantly.

This time medical science had something new for us – a blood test (privately funded at $180) that can type an allergy to predict the likelihood of a systemic (i.e. anaphylactic) reaction. The test isolates the different types of protein in the peanut and the reaction to each.

In studies, there are certain proteins which have little association with anaphylactic reactions and certain proteins which have strong associations with anaphylactic reactions.

If there was no reaction to those proteins with the strong association to anaphylaxis, we could move to a food challenge.

Hope!

I hypothesized that he hadn’t had any reactions because he had the mild type of allergy, and now we could identify it.

Two weeks later the call from the allergist’s nurse came…He only reacted to one protein, the one to which 90% of those who have had anaphylactic reactions were positive.

[Insert expletive]

We had been doing a good job of keeping him nut-free and would continue to do so.

It could be worse!

Epilogue

My younger son was tested and has no allergies. He enjoys nutty treats when we are out of the house and away from his big brother.

My husband and I continue to go on “peanut dates” which include Vietnamese food with oodles of peanuts and peanut sauce, followed by a movie wherein we consume peanut M&Ms like they are about to be discontinued.

We are due to return for testing this month. I have put it on hold to deal with other more pressing concerns, but it will be done sometime in early 2013. The allergy diagnosis was just the beginning of what I have now learned is called “the allergic march”. In future posts I will describe the asthma and anxiety that followed.

If you suspect a food allergy in your child, talk to your family doctor. Only a medical doctor can diagnose an allergy. Diagnosis includes a patient history, skin prick test, and possibly a blood test and/or food challenge test.

References and Resources

Anaphalaxis Canada anaphylaxis.ca

Allergy/Asthma Information Association www.aaia.ca

Allergy Safe Communities www.allergysafecommunities.ca

CSACI (Canadian Society of Allergy & Clinical Immunology) www.csaci.ca

CAAIF (Canadian Allergy, A

sthma & Immunology Foundation) www.allergyfoundation.ca

Ontario’s Sabrina’s Law www.ontla.on.ca/web/bills/bills_detail.do?locale=en&BillID=135&isCurrent=false&ParlSessionID=38:1

The Complete Peanut Allergy Handbook by Dr. Scott Sicherer (available through online retailers)

Liisa is mom to 2 boys, ages 5 and 7. She is a medical writer and a book lover. She blogs at FitforKid.net andLittleBookLovers.Wordpress.com.