I'd just ask "why not" perhaps, but diplomatically, of course...

and if she isn't comfortable conducting an in-office food challenge, would she MIND if you tried it with someone who IS?  It sounds as though you are well-situated to find another allergist who would be happy to do an in-office challenge for baked egg. 


We value our relationship with our allergist tremendously, and while I might seek a second opinion, I'd never go behind his back to do it for fear of damaging that relationship.  KWIM?

Related to my weekend post in "Main"- I have sooo many questions dancing in my head (along with the sugar plums)!
First, a little description of our allergist.  She is local, wonderful with children, and really, the only local allergist I know of that deals with food allergies.  She appears to keep current with the latest research, but her office practices don't seem to reflect that (ie: she said to challenge RAST and SPT both would have to be negative). She also is only in the office 3 days/week.  Knowing that she had a recent difficult struggle with breast cancer, her age, and her limited office hours, I can see her retiring in the near future.  This prompted me to pay more out of pocket for the PPO my employer offers.  My thought was, when the boys were older I'd want to see someone more aggressive, but in the meantime, if she retires I can travel to one of the relatively close teaching hospitals (CHOP, Hershey, Hopkins).
Soooo....what age to most allergists offer a challenge? C will be 3 in March. He is very verbal, but I don't know if he would be able to communicate subtle symptoms.

If my allergist doesn't seem to think that this unexpected exposure is relevant, is it time to move on?

What other questions should I be asking?

suevv
Member
Posted: 07.19.2010 at 02:11:22

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Sorry - I just saw this. We did baked and (and milk) at home on allergist's instruction. I have no idea what his criteria were - but here are DS's numbers (two numbers listed are for 2008 and 2009 results; he is 2.5 yrs old): Egg - 1.43/6.90; Milk 16.3/7.00.

As you can see his egg number went UP significantly at his second test. But the allergist told us to try baked egg, we did, and he has been just fine. He has also been fine with baked milk, though he had an accidental exposure to yogurt a few months ago and reacted so I know he is still allergic to straight milk.

Good luck - hope it works for you as it has really helped with our diet!!

Sue

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AllergyMum
Member
Posted: 07.15.2010 at 08:06:11

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07.14.2010 at 04:04:59, maeve wrote:

Quote07.14.2010 at 12:36:28, CMdeux wrote:

QuoteI think that I recall that from a conversation with our allergist, AllergyMum...


I think that the 50% pass value is about 7 kU/l on a RAST.

But I don't know if that is baked/not.  I'm assuming that it is probably highly cooked.

Our doc is a research afficionado, though, so he definitely READ/heard it somewhere from someone that has done the number-crunching somehow.

I'm pretty certain that Dr. Wood's office will not challenge unless there is at least a 50% potential for passing.  I seem to remember this being the case with DD's sesame challenge, but they felt confident enough that she would pass that they told us we could try it at home.  I, however, didn't want to be the bad guy if things went south so I pushed for the in-office challenge (this was noted as mom being afraid to challenge at home).

Like you I would rather people think I was an afraid Mum that to do a challenge at home. 

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DS - Dairy, Egg, PN, TN, Drug allergies

http://allergymum.blogspot.com/

Canada

maeve
Member
Posted: 07.14.2010 at 04:04:59

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07.14.2010 at 12:36:28, CMdeux wrote:

QuoteI think that I recall that from a conversation with our allergist, AllergyMum...


I think that the 50% pass value is about 7 kU/l on a RAST.

But I don't know if that is baked/not.  I'm assuming that it is probably highly cooked.

Our doc is a research afficionado, though, so he definitely READ/heard it somewhere from someone that has done the number-crunching somehow.

I'm pretty certain that Dr. Wood's office will not challenge unless there is at least a 50% potential for passing.  I seem to remember this being the case with DD's sesame challenge, but they felt confident enough that she would pass that they told us we could try it at home.  I, however, didn't want to be the bad guy if things went south so I pushed for the in-office challenge (this was noted as mom being afraid to challenge at home).

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"Oh, I'm such an unholy mess of a girl."

Virginia, US
DD: eggs, peanuts, tree nuts; OAS to cantaloupe and cucumber

AllergyMum
Member
Posted: 07.14.2010 at 02:54:46

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07.14.2010 at 01:08:32, Bunny wrote:

Quote07.14.2010 at 12:36:28, CMdeux wrote:

QuoteI think that I recall that from a conversation with our allergist, AllergyMum...


I think that the 50% pass value is about 7 kU/l on a RAST.

But I don't know if that is baked/not.  I'm assuming that it is probably highly cooked.

Our doc is a research afficionado, though, so he definitely READ/heard it somewhere from someone that has done the number-crunching somehow.

That is the same info my doc -- who works at a research hospital -- told us.  I think it is for baked egg, but our doc's experience is that more than 50% can pass the baked egg challenge with a RAST of 7 or lower.  He thought DS had a good chance to pass with a RAST of 8, but that turned out not to be the case.  We had the distinction of being the first "fail" among all his patients that he challenged for baked egg.  Bummer. 

So frustrating.  My DS had been going down from a high of 1.9 as the highest number with a low of 0.73 last year (he was 2 yrs old last year).  However when we tested this year he was a 9.  This year's test was taken only 3 weeks after a anx reaction (to dairy we believe) that resulted in terrible eczema for over 3 weeks, so perhaps that is why the number jumped (maybe just wishful thinking).  As DS was only 2 last year so we decided to wait till he was a bit older to food challenge in hope he might outgrow this year like he had the previous year when the numbers for oat & peas had the same decreasing pattern & he outgrew them..... I feel like kicking myself cause looking at his numbers perhaps he might have passed last year if we would have pushed it, but we really wanted to give him a chance to outgrow himself.  Hopefully you understand what I am saying as I feel like I am talking in circles with myself.

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DS - Dairy, Egg, PN, TN, Drug allergies

http://allergymum.blogspot.com/

Canada

Bunny
Member
Posted: 07.14.2010 at 01:08:32

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07.14.2010 at 12:36:28, CMdeux wrote:

Quote
I think that I recall that from a conversation with our allergist, AllergyMum...


I think that the 50% pass value is about 7 kU/l on a RAST.

But I don't know if that is baked/not.  I'm assuming that it is probably highly cooked.

Our doc is a research afficionado, though, so he definitely READ/heard it somewhere from someone that has done the number-crunching somehow.

That is the same info my doc -- who works at a research hospital -- told us.  I think it is for baked egg, but our doc's experience is that more than 50% can pass the baked egg challenge with a RAST of 7 or lower.  He thought DS had a good chance to pass with a RAST of 8, but that turned out not to be the case.  We had the distinction of being the first "fail" among all his patients that he challenged for baked egg.  Bummer. 

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7 year old DS with LTFA to peanuts, tree nuts, eggs and flax seed.

CMdeux
Moderator1
Posted: 07.14.2010 at 12:36:28

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I think that I recall that from a conversation with our allergist, AllergyMum...


I think that the 50% pass value is about 7 kU/l on a RAST.

But I don't know if that is baked/not. I'm assuming that it is probably highly cooked.

Our doc is a research afficionado, though, so he definitely READ/heard it somewhere from someone that has done the number-crunching somehow.

« Last Edited by CMdeux 07.14.2010 at 12:37:36 »

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"To travel hopefully is a better thing than to arrive." -Robert Louis Stevenson

USA

AllergyMum
Member
Posted: 07.14.2010 at 12:33:17

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07.14.2010 at 07:57:05, hk wrote:

Quote
That's interesting.  I had no idea that a RAST under 5 is considered low enough to consider a challenge (baked or otherwise). .

I wonder if anyone has ever done any research on what number the majority of people have when passing a baked challenged?  Or if each doctor bases it own their own practice history?

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DS - Dairy, Egg, PN, TN, Drug allergies

http://allergymum.blogspot.com/

Canada

Bunny
Member
Posted: 07.14.2010 at 11:51:07

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DS had a baked egg challenge last summer when he was 5. His RAST was around 8 and his SPT was positive. But the doc said most kids he challenged with those numbers passed. Unfortunately, my DS was not one of them. He failed on the first bite. Itchy mouth, nausea, a few blotchy/hivey spots on his face and then he threw up about 2.5 hours later.

Saw the doc again this summer and he said he wouldn't even draw another RAST until next year because there was no way that DS would go from failing on the first bite to passing the baked challenge in the space of one year. So there was no reason to draw RASTs this year -- nothing is likely to have changed enough to justify it.

Good luck with your challenge.

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7 year old DS with LTFA to peanuts, tree nuts, eggs and flax seed.

hk
Member
Posted: 07.14.2010 at 07:57:05

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That's interesting. I had no idea that a RAST under 5 is considered low enough to consider a challenge (baked or otherwise). DD's RAST for egg has always been slightly under 5. Still, I am absolutely certain she would not pass a regular egg challenge. I'll have to discuss the idea of a baked egg challenge at our appointment in October. She told me last night that she thinks she's going to get rid of one of her allergies this year. I hope she's right.

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7 yo DD - TN, PN, egg, sesame, avocado, flax, fish, cherry, mango

maeve
Member
Posted: 07.14.2010 at 06:37:05

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DD's RAST for egg last year was 6.43 (down from 11.6) the previous year. We were told she could do a baked egg challenge, and it's scheduled for January 2011.

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"Oh, I'm such an unholy mess of a girl."

Virginia, US
DD: eggs, peanuts, tree nuts; OAS to cantaloupe and cucumber

DoubleAs
Member
Posted: 07.13.2010 at 08:21:00

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My son is scheduled for a baked egg challenge later this month. He is 7 and his latest RAST is 1.23 for egg (the lowest it has ever been). Two years ago, his previous allergist suggested an actual egg challenge (not baked egg) because his RAST was under 5. He failed that challenge and was Epi'd due to extreme gastrointestinal discomfort -- though he did eat almost an entire piece of French toast before he began reacting. I'm feeling hopeful about the baked egg challenge. His allergist thinks that if he can tolerate the baked egg regularly, new studies seem to suggest he'll be more likely to outgrow the allergy.

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TwoDDs
Member
Posted: 07.13.2010 at 12:02:26

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We are tentativly scheduled for a baked egg challenge in February. When rasts were done 10/09 - DD was a 7.18. Over five years her rasts have been steadily dropping from a 50.17, 28.1, 17.8, 14, 7.18 - doctor indicated that she will likely be ready for a baked egg challenge after next rast. Her skin tests went negative two years ago as well. I believe the criteria is under 5 for baked.

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AllergyMum
Member
Posted: 07.13.2010 at 08:53:10

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For those who have done a baked challenge or spoken with their allergies about a baked challenge, what was the criteria the doctor used to see if a baked challenge could be done.

I am really curious about what blood numbers people have had & have done a baked challenged - and passed or not passed.

We see DS allergist at the end of the month and I do want to speak to him about baked challenge for Egg & Dairy - his criteria & his take on them & the likelihood of my DS being about to do so now or in the future.

Any input you can share about your experience would be much appreciated.

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DS - Dairy, Egg, PN, TN, Drug allergies

http://allergymum.blogspot.com/

Canada