Written 6/14/14
I have been dreading today for some time. The oral food challenge that would finally confirm whether or not we had a fish allergy. Feeding a food allergic person the offending food in the presence of a doctor is the last step in food allergy diagnosis after skin and blood testing. Some consider it the only true test of an allergy.
Preparation
Here is what I was told to expect. We would arrive at the allergist office first thing in the morning (7:30am to be exact) where they would start with a skin test for the fish. Why suffer through the challenge if a skin test would reveal the allergy? If the test was negative, we would begin the food challenge, feeding Monk increasingly larger portions of fish for about a 3 hour period. If he makes it through all portions without reaction then they would monitor him for a few more hours and then send us on our way with a green light for fish!
I have been dreading today for some time. The oral food challenge that would finally confirm whether or not we had a fish allergy. Feeding a food allergic person the offending food in the presence of a doctor is the last step in food allergy diagnosis after skin and blood testing. Some consider it the only true test of an allergy.
Preparation
Here is what I was told to expect. We would arrive at the allergist office first thing in the morning (7:30am to be exact) where they would start with a skin test for the fish. Why suffer through the challenge if a skin test would reveal the allergy? If the test was negative, we would begin the food challenge, feeding Monk increasingly larger portions of fish for about a 3 hour period. If he makes it through all portions without reaction then they would monitor him for a few more hours and then send us on our way with a green light for fish!
The pure fact that you are about to feed your child something that has landed him in the hospital in the past doesn't sound scary enough?
Throw in a few more criteria.
- Don't feed the child before or during the challenge. Last meal was at 6:30pm the night before.
- Napping? Nope.
- My kid isn't entertained by TV.
So in my head I was imagining about 5 hours stuck in a small office with a toddler who is hungry and sleepy and active yet likely to be completely bored and unentertained by anything I provide. Oh and what's for breakfast? Salmon.
For Real Now
We are in the car at 6:45am and ready to go to the allergist office with empty bellies but Monk still had a smile in his face.
We arrive at the empty office (cause no one schedules appointments for 7:30am unless you have to be there all day!) and get shuttled immediately into an exam room. Our room. Get comfy!
Up first? Skin testing (Want to know more about skin testing? Check out my previous post here.)
Per the usual we have a positive and negative control prick along with one for salmon and one for cod (apparently the gold standard for fish allergies.) Below is a picture of Monk's back during the skin testing.
See that large red hive on the top left? That would be the positive control. The only reaction. Yep, nothing from the cod or the salmon. This was the second skin test for fish that Monk has had. The initial test was given shortly after a salmon dinner sent us to the ER for the first time (read that full story here) and that one too was negative. The negative result meant that we would move forward with the oral food challenge.
By this time my Monk has been pricked instead of fed and was not too happy. In fact, each time the door to our exam room opened, he would start crying. This was going to be five hours of unadulterated hell adventure!
In walks the nurse holding the smallest piece of salmon. Think flea sized. Just as we readied ourselves for whether or not we would see Baby Jekyll or Hyde when tasting the salmon, the nurse discovered a hive. And then there were two. And as I looked over his body I discovered dried blood behind his ears (a tell-tale sign that he reacted to something during the night.)
On went the brakes and out went the nurse and our miniscule bite of salmon. Since he had eaten nothing, been exposed to nothing, we had to assume that the skin test caused a reaction. We believe that he even started reacting from the cooking of the fish, as he had the first time, and that was why his eczema behind his ears had flared and bled during the night. So he essentially failed the challenge before it ever began.
For me the result was certainly a double edged sword. I had managed to avoid a few hours of toddler mayhem in exchange for certified allergy. But on the bright side, a certified allergy is better than a mystery reaction, and it brought us one step closer to completing the allergy puzzle.
P.S. I will say that I was certainly prepared for our stay and had packed not one, but two bags with essentials, new and exciting toys and more. Want a peak into those bags? My "hospital bag" list, or "the list for anyone who will be stuck in a small room with a small child for any period longer than 30 minutes", is shared here.
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