Just over eleven years ago when he was 2 years old Sahil reacted to peanut butter residue.  Over the years, Sahil has tested positive to peanuts, soy  and various tree nuts on blood tests & skin prick tests conducted by various allergists. He has reacted to peanut and soy after ingestion but as far as we knew he had never ingested tree nuts. Yet, despite the high rate of false positives for allergen specific blood tests and skin prick tests we were told to avoid all tree nuts. We now know the common practice of recommending blanket avoidance was incorrect.  We should have been offered oral food challenges to individual tree nuts when he was 2 years old to determine if there were nuts he was not allergic to & incorporate those in his diet in order to prevent allergies from developing.

Today we started what should have been done over 10 years ago:  oral food challenges to tree nuts.

https://www.aaaai.org/conditions-and-treatments/library/allergy-library/oral-food-challenge

Today : Almond

We arrived in Burlington this morning with a bag of Wonderful brand almonds for Sahil’s oral food challenge.  Sahil was nervous & scared; so was I.

His lung function, blood pressure & temperature were measured.

Then he was given gradually increasing amounts of almond about 20 minutes apart.  He had 5 doses in total : 1/8th, 1/2, 1, 2 and 4 almonds.  Sahil ate just over 7 almonds over the span of 2 hours.  He tolerated the doses; he did not have any symptoms.  He passed the almond challenge!

Sahil must now continue to consume 2 to 4 almonds two to three times per week to ensure continued tolerance.  He will continue eating 2 peanuts a day to maintain tolerance to peanuts.  We will return in a month for Sahil to challenge another tree nut.

Dr Mack also spoke with me about Jaya.  He recommended slowing down the oral immunotherapy process for her because of her severe reactions to low doses in July and in early November.  Jaya is to continue the daily dose of 1 mL of milk for the next 3 months and then Dr Mack will let us know how to proceed.