Wednesday, January 13, 2010

Georgia's egg challenge (a.k.a., "worst playdate ever")

So, here's the rest of the story about yesterday's failed egg challenge at the allergist's office.

First of all, in a stroke of amazing coincidence, one of my best friends, Maggie, and her family were there at the same time that we were. I mean, what are the chances that she, who lives in the suburbs, would get an appointment to bring her son to the doctor in the city, at the same time and on the same day and in the same pediatric allergy practice as us? Do you have any idea how long it usually takes to even get an appointment there? Given the expected long length of these appointments (thus requiring backup help for child entertainment), and the importance of the information to be conveyed and the opportunity to ask questions, both of our husbands were also in attendance at these appointments, as was Maggie's daughter, Anna, a favorite playmate of Georgia's. Beforehand we joked about how hard it can be in our busy lives to find the time to get together and how maybe we should just meet up like this more often. Of course, that was before Georgia failed her egg challenge and Maggie's son Abe got sent home with a diagnosis of a peanut allergy! I'm joking about it being the worst playdate ever, though, because it was still nice to see familiar faces and for Georgia to have someone to play with for a while during the FIVE hours that we were there, most of it cooped up in a little exam room.

I don't want this to be the wordiest blog post ever, so I'm going to cut to the conclusion and then back up and give you the recap in bullet point form. Conclusion: Georgia had an allergic reaction during her egg challenge, so she's still considered allergic to eggs, but since the reaction was (a) relatively slow to develop, (b) not extremely severe, and (c) occurred after eating a pretty large amount of egg (about a full egg and a half), they think that she is "well on her way" to outgrowing egg allergy and that she may be able to tolerate eggs in baked goods. We were sent home with specific instructions about how to safely attempt to phase baked egg into her diet. (More on that in a later post.)

Now, the play by play:
  • Arrive. They take Georgia's vitals. We hand over the 1 egg scrambled and 1 piece of french toast prepared with 1 egg that we had been instructed to bring along.
  • Challenge consists of feeding Georgia ever-increasing quantities of this food at 15 minute timed intervals. After each interval, her skin, breathing and blood pressure are checked before more food is given.
  • First "dose" = 10% = about 2 bites of a piece of french toast.
  • Next "dose" = 20% = about 4 bites.
  • She seemed to be doing great, showing no signs of a reaction to the egg. We thought she'd pass with flying colors and that we'd get out early.
  • More "doses" of food. Eventually they added about a teaspoon of scrambled egg to the mix.
  • Last "dose" = she was told to eat the remainder, so a few more bites of french toast and a couple of bites of scrambled egg. We were then put on a half hour wait period, so we went out to the waiting room with Georgia's friend Anna to give the girls some more space to run around and toys to play with. That's when things started to get weird.
  • Anna was getting into the toys. Georgia was playing well at first, but then we noticed that she was coughing every few minutes - not like a coughing fit, more like a clear your throat a few times type of thing. Hmmm, we thought....probably nothing...just coincidental timing...maybe she was coming down with a cold? Her cheeks, which were a bit pink before the food challenge even started (due to the cold winter winds and uber-dry heat of our home), seemed to be growing redder, but we wondered if we were imagining that or if she was just getting flushed from playing around. She started rubbing her ears, which also grew red, but it took us a while to notice that. The truly odd part was that she kept saying, "Can I go to sleep on those chairs?" and then went over and laid herself across a few of the waiting room chairs and began sucking on her fingers, her normal self-soothing routine for going to sleep. It wasn't even close to her nap time.
  • To show you just how convinced we were going into the egg challenge that she'd pass it, we somehow deluded ourselves into the belief that all of these symptoms meant an oncoming cold, not an allergic reaction. We took her back to the exam room to be checked out.
  • They agreed that it was theoretically possible that this was a cold starting. They decided to wait a bit more before giving her any Benadryl to stop the reaction, to see if it would progress (like an allergic reaction) or not (like a cold, which would obviously take much longer to develop and worsen).
  • By about 15 minutes later, she had broken out in an eczema flare over most of her body - her chest, back, stomach, legs, hands, wrists, etc. She had hives on her hips, knee caps, wrists, and maybe some tiny ones a few other places. She was occasionally sneezing. She was scratching herself but not complaining of being itchy. Actually, she seemed fairly oblivious to all of this and did not complain of being bothered by the reaction, even though she was acting kind of weird
  • Benadryl was given to stop the reaction. A 1 hour wait period began, so that they could make sure that the reaction had subsided before letting us go. It took a while for the symptoms to subside, but they eventually did.
  • We went home. Georgia ate lunch and went down for her nap. She slept so long we eventually had to wake her up to keep her on some semblance of a normal schedule. By the time she woke up from her nap, her skin looked much better. By her bedtime, her cheeks weren't even pink. You never would guess that any of this had happened. We gave her 1 tsp of Benadryl at bedtime as instructed by the allergist.
So, there you have it. In retrospect, it is kind of funny that we would even kid ourselves into thinking that she had spontaneously caught a cold in the middle of her allergist appointment, seeing as how we were there for a food challenge with the known possibility of an allergic reaction. Duh! Call it hopeful optimism or denial, whichever you prefer.

The egg challenge was a big bummer in a number of respects. We really had been hoping to cross at least one of Georgia's food allergies off of the list, just to make it more manageable. Also, it is never fun to witness your own child going through something uncomfortable (and potentially dangerous) like an allergic reaction, not just because of the presently occurring reaction, but also because of what it means for her future. Although I'm sure she'll learn to live with her allergies, we just so wish that she didn't have to grow up dealing with any of this stuff.

So, that was the bad part. However, as mentioned above, based on Georgia's reaction yesterday they think she may be able to tolerate baked eggs. From a lifestyle perspective, this is hugely positive news. As my sister pointed out, two year olds are a lot more likely to be running across cupcakes and cookies than scrambled eggs.

More on the "Baked Egg Study" and the doctor's protocol for introducing baked eggs into Georgia's diet in a later post. Bye for now!

1 comment:

Susan said...

That's so crazy that y'all were all there at the same time!! At least it sounds like Georgia is making progress w/ the eggs. Hopefully she'll completely outgrow that allergy soon.