That's good, because with sesame, going off to camp would be more if a production.

A bit of an update on dd's non-PN FA's.  She's supposedly allergic to sesame and hazelnut.  This weekend she had fried rice with a good dose of sesame seeds and Nutella, all with not even a hint of a reaction.  While neither are huge doses, she does not seem to be all that sensitive at least.  FWIW.

Dd got back yesterday from her camp. No problems with the food, had a blast.  We'll just keep plugging away with her daily PB and re-evaluate next year.  I'm stressing less about the TNA's, and just not buying things that are contain/may contains or feeding her obviously nutty food out and about.  Seems to be working for us.

Yes, CM, that's what we've been doing with the pecans and walnuts.  I just now have this nagging feeling, wondering if I should be super anal about x-con, etc, in some effort to prevent the allergy from getting worse.  That may very well be me reverting to pre-OIT PA mode.  I don't seem to know what to to with an in-between sort of vigilance. 

I would much prefer to not be super anal.  That is alot of work and alot of stress, and life is pretty good right now.  Dd is going to a new week long sleepover camp this summer.  I'm trying to figure out how spooled up I need to get.  It will be at a college and she'll be eating in the cafeteria for much of it.  She's not an adventuresome eater and would be happy eating noodles 3 meals a day.

Just now seeing this.  Bummer.  Her reactivity to TN sounds similar to DH's.

He doesn't find it 'scary' to live with in the least.  Just annoying.  He also really just asks about high risk foods since his threshold is so high that anything else, he can 'figure it out' with little risk.

So he asks about:
desserts, cookies, chocolates, pastries, salad dressings and salads, and 'crust/crumb' coatings on meat, poultry, and fish.  That's about it.  He also just plain AVOIDS those items that are probably made with his allergen (walnut)-- carrot cake, baklava, and brownies-- no matter what he is told about them.

Thanks, Mac.  So far the TNA's are a nuisance more than anything.  Mildly itchy mouth with nothing more. Goes away with an antihistamine.  I think now it just means we have to go back to asking everyone what's in the food, and I guess reading labels more carefully.  You have the sesame allergy, right?  Any common hidden sources?

I also asked the doctor about portable antihistamines, since the fast melts, etc, were off the market.  He recommended Zyrtec and the like.  Small pills, easy to carry.  Made sense to me.

Oh, wow. I'm sorry.  I thought of y'all today.

Dd had her appointment today.  It went well.  Met the new allergist there.  He was young-ish, very nice, very down to earth.  Discussed dd's recent reaction to her PN dose.  He felt there was a good chance it was precipitated by being outside all day combined with the raw spot on her gums.  Given the reaction he recommended another year on maintenance.  If she is reaction free next year, we try a tolerance test.  No PN's for a month, then eat some.  He was very pleased with her PN numbers.  0.64 now, 5.60 in 2010.

Discussed her new TN numbers.  He thought it might be more of a cross reactivity with environmental allergens and more of an OAS type thing, which would be good since those allergies stay localized to the mouth.  Did a skin prick test for enviros.  Nada. She's not allergic to any of them.  Sooo, new TN allergies. He recommended complete avoidance.  I told dd before the appointment that her blood test showed new allergies but I wasn't sure they were correct since she ate Nutella (a third of a jar in one sitting 2 days ago) without a problem.  She told me her mouth was indeed a little itchy when she ate it.  Argh.  News to me.  So, no Nutella in our house.  No great loss, it has the nutritional value of marshmallows.  The doctor said TN's, fish, and shellfish were the most common late onset FA's.

He said 60-70% of OIT kids seem to grow into complete tolerance but there seems to be no rhyme or reason as to which kids it would be.   

So that's about it.  I really didn't pepper him with questions, and I wasn't really surprised by anything.  OAS and enviro allergies would have been nice, but it is what it is.

Quote from: twinturbo on March 22, 2013, 07:26:11 AM
Unrelated thought, but has anyone ever noticed so many of the top allergens seem to be closely associated with reproductive stages? Eggs, milks, seeds/nuts. Is it that the proteins are more potent or concentrated or otherwise structured differently?

The proteins that make it through gastric breakdown tend to have a reason why they need to be so stable. Seed pod proteins need to be able to pass through an animal's digestive tract.

Just read this the other day:

http://allergynotes.blogspot.com/2013/03/immunotherapy-scit-allergy-shots-and.html

There are 7 cross-reactive allergen families; tropomyosin, serum albumin, non-specific lipid transfer protrein, PR10, profilin, thaumatin-like protein, carbohydrate cross-reactive determinant.

A few of those are muscle/skeletal and a few are defensive proteins that ward off plant pathogens, but the others are reproductive.

Quote from: aggiedog on March 21, 2013, 02:08:11 PM
It wouldn't surprise me, or make me too upset, to find out if dd became less tolerant over time.  It bought her several years when she was younger, less able to self advocate, etc.  She was already contact ana, so if she goes back to even that level, well, we know how to deal with it.  And she has no desire to go out and eat tons of PN's.  She just wanted to safely go to sleepovers, etc.

I really like this philosophy, aggie. Thank you for sharing that perspective it certainly is one to consider.


Unrelated thought, but has anyone ever noticed so many of the top allergens seem to be closely associated with reproductive stages? Eggs, milks, seeds/nuts. Is it that the proteins are more potent or concentrated or otherwise structured differently?

QuoteJust read an AAAAI tweet that said Nutella doesn't contain enough hazelnut protein for a true challenge. FYI.

Wouldn't surprise.  Hazelnut is probably behind sugar and chocolate on the ingredient list.

Quote from: aggiedog on March 21, 2013, 01:15:39 PM
I will probably try the hummus and nutella prior to her appointment though, so I can go armed with that experience, however it turns out.

Just read an AAAAI tweet that said Nutella doesn't contain enough hazelnut protein for a true challenge. FYI.

On a positive note, my son's last hazelnut SPT was completely negative. We're waiting for the RAST, but the doctor was hopeful that the ~12 was truly just a pollen x-ref. Hopefully all your tree nut numbers will turn out to just be passing quirks.

Sorry, mind was elsewhere. I meant pistachio and cashew but almond also came up from negative as well.

Mango-almond would be an odd correlation, though.  More likely with pistachio or cashew.

My oldest child's tree nut has been increasing from negative a few years ago. I know he had almond w/o problem at about 14 months and it was negative even after that. Yet now it's rising but I wonder if it's related to all the mango he eats. We haven't done any OIT.