Monday, August 10, 2009

Happy Birthday (Cake)!

For Christmas, we received a wonderful cookbook full of allergen-free recipes from my sister in law. As excited as I was to receive and pore over this thoughtful gift, I must admit that I've been delinquent in actually putting it to use. I think this has much to do with the fact that, lucky for us, Georgia was young enough this year not to be aware of, or begging for, any of the yummy foods that she was missing out on due to allergies. And, of course, the reality is that she can still eat the vast majority of what we normally eat without any recipe adjustments. But when her birthday rolled around, I figured it was time to break out the book and get to cooking her an eggless cake. Somehow even very young children living an otherwise cake-free life know that on birthdays there had better be a cake, candles, and ice cream! So, here goes nothing....


Barefoot, pregnant, and doing Martha proud. That's the picture of what the cake is supposed to turn out like.


The finished product. Note: the guitars are not part of the allergen-free recipe, but rather a fulfillment of our toddler's cake decorating wishes, (as inspired by another mom's creative avoidance of overly-complicated icing requests).

But did it taste okay?

Survey says: YES!

Here is the book I used:

Note that although the cover says "no eggs, no dairy, no nuts, no gluten," each recipe can be tweaked to take out as many of those offending ingredients as you need to. I did not make the dairy and gluten free version of this cake, but that can be done.

REVIEW:
Quality of cookbook: Excellent. Useful info, great pictures, and easy to follow recipes.

Quality of cake: Very good. No one was turning it down, but I'm not gonna lie; in a side by side comparison with Betty Crocker or Duncan Hines, it would probably not fare well. The cake was quite tasty and I would make it again, but compared to other cakes I've had, it was a bit on the drier and denser side. (I wonder if I cooked it a few minutes too long?)

Quality of icing: Excellent. But I wish there had been more. If I make this again, I will double the icing recipe, so that there's no struggle in icing each layer, plus the top and sides.

Saturday, August 8, 2009

Blood Test Results from Food Allergy Study

They told us it would take about 2 months to get back the blood test results from our participation in the food allergy study, and they were true to their word.

This is science-y stuff, so I'm not even going to attempt to summarize or paraphrase. I'm just typing in excerpts of what they mailed us now:

Interpretation of Blood Test Results

...The purpose of this testing is for an epidemiologic study and not for diagnosis.

IgE is the antibody that causes immediate hypersensitivity to proteins, such as foods or airborne allergens. The total IgE value is a general indicator of how "allergic" a patient is. For example, patients with hay fever (allergic rhinitis) or eczema (atopic dermatitis) may have an elevated IgE level. For total IgE, the lower limit of detection is 2.0kU/L and the upper limit is 5000 kU/L.

The blood tests called "CAP-RASTs" determine the quantity of IgE to a specific allergen. For specific IgE, the lower limit of detection is 0.1 kUA/L., and the upper limit is 100 kUA/L.. Values outside this range will be noted as "<0.1>100 kUA/L." Please note that CAP-RASTs, especially to foods, can be falsely positive. The main limitation of these tests is that a positive result does NOT necessarily mean that the food will trigger symptoms...

POSITIVE BLOOD TEST ALONE DOES NOT EQUAL DIAGNOSIS OF ALLERGY

Sometimes, CAP-RASTs can also lead to false-negative results (although a negative test result generally rules out an allergy)...

In addition, the blood test results do not reflect the severity of an allergy. A higher value does not mean that a reaction will be more severe. Rather, the value reflects the probability that you or your child may be allergic to that particular allergen: the higher the value, the more likely that the result is a true positive....


Mother

Father

Daughter

Allergen tested

Value (kU/L)

Value (kU/L)

Value (kU/L)

Alternaria (mold)

<0.1

1.300

<0.1

Cat Dander

<0.1

<0.1

0.417

Cockroach

0.143

<0.1

0.102

Codfish

<0.1

<0.1

20.871

Dog Dander

<0.1

<0.1

0.110

Dust Mite 1 (Df)

<0.1

1.397

<0.1

Dust Mite 2 (Dp)

<0.1

0.872

<0.1

Egg White

<0.1

<0.1

0.887

Milk, Cow

<0.1

<0.1

0.672

Peanut

<0.1

<0.1

4.182

Sesame

<0.1

<0.1

6.615

Shrimp

0.236

<0.1

<0.1

Soy

<0.1

<0.1

1.148

Total IgE

16.151

23.727

108.137

Walnut

<0.1

<0.1

6.049

Wheat

<0.1

<0.1

4.020


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Okay - me here again. So, my thoughts on what we can take away from any of this:

--One more thing to keep in mind when looking at these results - you can't compare CAP-RAST scores for different allergens and infer that equivalent scores mean equivalent likelihood of being allergic (i.e., true positives). In other words, a 4.0 on peanut may not mean the same thing as a 4.0 on wheat.

--Obviously, we'll have to wait to get in to see the doc this fall for further testing and discussion, but Georgia's egg test result confirms my suspicion that she may have outgrown this allergy. I don't really know how to judge it, but that number looks low to me! I believe it's lower than her score from 2008, which is great news.

--Definitely true what they say about false positives, because I eat shrimp with no problems, and Georgia consumes milk, wheat and soy with no problems as far as we can tell.

--Based on what little I know of Peanut CAP-RAST scores, I am pleased with Georgia's score on that one. It's definitely well below the 95% certainty threshhold. It may indicate that even if she's allergic now that she's among the 20% of people who have a decent chance of outgrowing a peanut allergy.

--Bummer about the codfish score for Georgia. Her reactions to fish started around February or March, which was so weird, because she had been eating salmon with no problem and loving it for about 6 months prior to that. I wonder if or when we can find out which fish she's allergic to? We'll have to ask the doctor about that. I hope she doesn't have to avoid ALL fish forever.

Friday, August 7, 2009

Stuff that Bugs Me

Just saw another online "article" (if you can even call it journalism) about how there's too much hype these days about food allergies....(yawn).

Of course, like an idiot, I also read some of the reader comments.

Here's a common one that gets me, personally: the people that criticize parents of food allergic children, basically saying one of two things:
1) all kids need to play outside more, and if they did, then there wouldn't be so many food allergic children; and
2) if only you fed your kid real food and did some cooking instead of filling them up with pop tarts, fruit snacks, and every other processed creation under the sun, then there wouldn't be so many food allergic children.
[Note: both #1 and #2 boil down to, "I have no sympathy for your child's condition, because it's all your fault.]

Thanks.

Okay, I'm not even saying that there's not a shred of truth in either #1 or #2, because maybe there is, at some societal level, over a number of decades. It seems plausible to me that the American lifestyle and abundance of genetically modified, processed foods in our diets might have some connection to food allergies.

But at the individualized level? Well, that just pisses me off. My daughter has food allergies and she's not quite two yet. I'm sorry, was I supposed to send her out on her own to play outside more during the first 6 months of her life? Especially on the snowy days, right? Babies love that.

And as for the food? If anything, I'm the mom that others make fun of for trying too hard to avoid processed crap. (Not that our family succeeds on that front entirely, but I'm just saying, we at least make an effort.) I kind of pride myself on having avoided pretty much all food (or food-like products, as I sometimes like to call them) that are specifically marketed to little kids. Also, we certainly don't do everything organic, but we do buy a lot of organic foods. I try to cook at home as much as possible. We enjoy buying from the farmer's market all summer. And when our daughter was younger, we boiled foods and made a great deal (but admittedly not all) of her pureed baby food from scratch, for Pete's sake. Oh, and p.s., I breastfed for 13 months, another thing that is supposedly linked to a lower risk of allergies. Due to being diagnosed with an egg allergy around age 1, my daughter basically only knows cookies and cupcakes from books, so excuse me if I'm just a *wee* bit sensitive to the idea that it was my stuffing her with pop tarts that gave her food allergies.

Whew! Bitter rant over. Okay, I feel better now.

Sunday, August 2, 2009

I Wonder...

11 days until my due date.

I wonder if this child will have food allergies or not? So curious about that.

We pray that it will not.

They tell me not to do anything differently - not to eat or behave differently in this pregnancy versus the last. They say there's no good evidence yet that any of it matters.

And yet I find myself wondering what the cause could be. Should I not eat this hummus sandwich from Cosi? What about the peanut m&m's from the vending machine at work that I could not resist - should I not have eaten those? (Beyond the list of other reasons that one might want to avoid them, of course.) What about this soda? Is it the secret evil? What about this supposedly environmentally friendly kitchen cleaner - is it okay to use?

You see how messed up I have become? I'm telling you, I think you would be the same way. It's all such a mental game, these food allergies.

A confession: I desperately want our second child not to have food allergies. First and foremost for its own sake - for its health. But also so people won't think Georgia's allergies are "my fault." That they're something I caused, or something I invented.

Selfish of me to feel that way, I guess. Rather insecure and defensive, I know. But that's how I feel a lot of the time; that's where I am right now.

Hmm.....I wonder... I wonder...