Lala's DS-- passing a peanut challenge and REDEVELOPING the allergy

[CMdeux]

Yep-- to me, as well.

I'm really hoping that doesn't happen to DD, in fact, and it worries me-- she ate eggs more or less normally for a couple of months, but now her tolerance seems lower again.   

[PurpleCat]

Oh no!  What kind of symptoms is she having? 

[CMdeux]

Really awful eczema.  Her legs are a MESS. 

We don't really know if it's egg or some combination of things, but the eczema hasn't been this bad since she was 8-12mo.    She's also developing a fresh aversion to the smell of eggs cooking, which had gone away.   

[PurpleCat]

I can relate to both of those symptoms.  They don't happen to my DD for baked egg, only direct egg.

Even right now, DD does not want to be around when eggs are cooked.  It's not an "I don't like the smell reaction, I believe it is a flight to safety reaction"  I air out the house if I cook any for the boys.

Ditto for my DD with egg exposure and eczema....I could not believe what gorgeous skin DD had when egg left her diet!

I hope there is no other progression of symptoms for your DD.

[justme]

Unfortunately the more people I meet in the allergy community the more I have to link to thread ☹️  I am glad I documented it, though.

[spacecanada]

This is my husband's biggest concern about the possibility of me doing a food challenge - that I will pass the IOFC and then have a reaction at home when reintroducing the food, or developing the allergy again, especially since my allergies don't appear on tests.  I read through some of the articles linked in here and had some questions:

- In the experience of members here, would an allergist increase the final dose of an IOFC if a patient requested it?  To make the final dose, or total combined amount allergen eaten in the challenge, close to what might be considered a normal dose for an average person.  Or, should that already be best practice?  (My challenge would be for potato, which could be a very large 'normal' dose when considering eating a whole jacket potato as a dinner, for example.)

- How long did it take people here to redevelop their allergy once they passed an IOFC?  Is the timeframe fairly consistent, or is it all over the place?  (Just curious if there's a point where one could successfully declare the risk of redevelopment unlikely.)

I'm trying to be as level-headed about this as I can, without freaking out too much (online, anyway).  I tried looking for a thread on IOFC questions alone but couldn't find one. 

[LinksEtc]

This is my husband's biggest concern about the possibility of me doing a food challenge - that I will pass the IOFC and then have a reaction at home when reintroducing the food, or developing the allergy again, especially since my allergies don't appear on tests.  I read through some of the articles linked in here and had some questions:

- In the experience of members here, would an allergist increase the final dose of an IOFC if a patient requested it?  To make the final dose, or total combined amount allergen eaten in the challenge, close to what might be considered a normal dose for an average person.  Or, should that already be best practice?  (My challenge would be for potato, which could be a very large 'normal' dose when considering eating a whole jacket potato as a dinner, for example.)

Just from my experience, some allergists are more open to patient requests than others.  I would probably talk to the doc and communicate your fears and let the doc know that this would help you to feel more confident about introducing the allergen at home if you pass the challenge.

- How long did it take people here to redevelop their allergy once they passed an IOFC?  Is the timeframe fairly consistent, or is it all over the place?  (Just curious if there's a point where one could successfully declare the risk of redevelopment unlikely.)

My daughter had very minor symptoms during the challenge, but it was judged to be a "pass".  She then reacted at home when we fed her the allergen 2 or 3 days later.  She continued to react at home when we fed her sesame.  Earlier this year, she had another challenge and she passed and has been doing great since.  I think that there were about 5 years between the challenges.  She has been eating lots of sesame with no problems.

I'm trying to be as level-headed about this as I can, without freaking out too much (online, anyway).  I tried looking for a thread on IOFC questions alone but couldn't find one.

My understanding is that the vast majority of the time, if you pass a challenge, then you are not allergic ... and the allergy usually does not come back (for people who have gone through OIT, they may have a greater risk of symptoms returning).  What happened to my daughter was rare, and the symptoms she did have were mostly mild.

There are always risks and benefits with any medical procedure, but generally speaking, IOFC are usually pretty safe and they can free you from having to avoid foods and improve your quality of life.  Unless you have symptoms following a passed challenge, I wouldn't worry about the rare possibility of redevelopment ... but I understand that this might be easier said than done, especially with everything that you have been through ... some counseling might help with the stress you are feeling.   

Best wishes.

[spacecanada]

Thank you, Links.  Your comments were very helpful and reassuring.  The allergen we are considering challenging (potato) is the one that stresses me out the least, yet restricts me the most (due to being non top-10), so I think I will do the challenge.  I just need more time to process all my lingering thoughts and questions before I actually go ahead and schedule it. 

[PurpleCat]

SC, from a Mom's point of view.....if you do challenge (and it is worth it if you can eliminate an allergen), after, listen to your gut instincts and your body's signals. 

DD and I had a sense egg was not gone, but the medical folk said it was just her fears and worry, she was fine cause she passed.  Yes, she actually did eat more egg than originally planned at her challenge.  After, those little gut issues kept getting bigger and we should have listened to those.  Her body was talking.

It's like when we say here, reactions trump testing.

So challenge and then listen is my opinion and advice.

[spacecanada]

Thank you, PC.  That makes a lot of sense.