|It's all smiles and laughs when there are no needles involved!|
Last month we visited Ryken's and Callan's allergist for a yearly check-in. My kids hate this (what kid wouldn't?) but this is always something I secretly look forward to. Will they have outgrown anything?
Ryken had only previously tested positive for allergies to peanuts and macadamia nuts and for the past two years, I focused testing on milk and peanuts. The last time I had retested for all nuts was three years prior. I realized I should be retesting him for all nuts every year because new allergies do spring up. And I was pretty certain he had developed an allergy to walnuts because he complained of an itchy mouth and abdominal cramps after having a tiny sample last spring. It was easy to make the choice to retest Ryken for all nuts and milk. Since we do the IgE antibody test, which requires a blood draw, there is no extra pain.
I have a couple of reasons for choosing the blood test over the skin prick. First of all, I like to see if Ryken's IgE levels are going up or down throughout the years. It can be a sign of worsening or diminishing allergies. Having his blood drawn is no fun for Ryken. Secondly, the blood test is safer as it does not expose Ryken to the allergens. With more exposure to an allergen, a person's allergic reactions can intensify. Ryken is already known to be severely allergic to milk and peanuts so I didn't want to risk making things worse. Don't get me wrong, though. The blood test is an easy choice for me but not for Ryken. It took me a good 5-10 minutes of talking, begging, and finally bribing him to be brave to go through with it. The results were worth it: we found out that Ryken's severe milk allergy is holding steady, his peanut allergy has worsened considerably, and he is now mildly allergic to walnuts, pecans, and hazelnuts.
As for Callan, we had discovered the year before -- after some frozen yogurt followed by a trip to the ER-- that he has mild allergies to milk and almonds. The allergist and I thought it was best to retest him for all nuts and milk since he hasn't had any oral challenges since. I elected to have skin prick testing done on Callan. From what I gathered, neither the skin prick and blood IgE antibody tests are free from error and both definitely have their benefits. The biggest benefit for me in Callan's case was that he could avoid a blood draw which he was petrified of. I figured that since Callan's allergies were mild, that we would try skin prick testing and, hopefully, it would be the less uncomfortable route.
Skin testing involves scratching or pricking the surface of the skin with extracts from potential allergens. Doctors literally draw and number a grid on your skin (usually on your back so you can't scratch at it) and prick you with extracts from whichever allergens need testing. Skin tests are often used because they offer results quickly and fairly accurately and, again, kids can avoid the terror of the big needle prick from a blood draw.
When Callan's skin test was administered, the big size of the wheal made it apparent that his milk allergy had worsened. He was so uncomfortable during the test and I found that I had to wrap my arms around him to prevent him from scratching. Callan also reacted to cashews and mildly to peanuts -- surprisingly, no reaction to almonds or halibut. We slowly started giving him almond milk and then roasted almonds. No reaction! Woo hoo! Almond milk is back on the table!
While it will take some serious convincing and negotiating for new toy cars, I'm certain that I want to do blood IgE antibody testing for both of my kids in the future. I'm a numbers person and I like seeing how the IgE levels change over time. Also, I want to minimize any direct contact with allergens since now it is clear that both of my boys have serious milk allergies and that they have developed more nut allergies, with Ryken's peanut allergy at an alarmingly severe level now.