Eggs, and Preschools, and Birthday Parties, Oh My!

There's quite possibly nothing more boring to read than blogging about blogging, but please bear with me for a moment. The problem with this blog is that I don't get around to posting my occasional post-worthy allergy thoughts, so they accumulate. After time passes, none seem important enough to post, or maybe they do, but then it's too daunting to write them all up, or I worry that it will all come across like I'm allergy obsessed because suddenly I have 6 allergy posts in 6 days? I don't know - clearly I'm over thinking all of this and just making excuses for what boils down to procrastination, so with no further ado, here is a dumping of some of these accumulated thoughts, boiled down as best as I can get them:

FAQ: How is the introduction of baked egg going?
Short answer is that it's going great - Georgia's been tolerating homemade baked goods without any reactions. Longer answer is that, as exciting as it was to be able to get started on introducing eggs to her diet, we've fallen off course in terms of following the doctor's protocol for introducing more and more egg. We haven't yet jumped on to the pancake step, because how am I supposed to think of recipes for getting her up to 1/4 of an egg per serving in her tummy three times a day? No, really -- that was a serious question -- does anyone have any suggestions? A serving of cornbread really only has about 1/8th of an egg at most, so I'd have to double the portion size and serve it at breakfast lunch and dinner to get us there. With cupcakes, I'd have to give her even MORE, because each cupcake would have less egg. I'm about ready to say screw it, things have been going fine, let's move on and try the pancakes.

FAQ: What is the rationale behind the introduction of baked egg? Is the idea that she is building up a tolerance to eggs?
Good question, but no, it's not about building up a tolerance to eggs. My lay person's way of explaining this is that baking the eggs at a high temperature ever so slightly changes the shape of the protein that she's allergic to, just enough that when she eats it her body no longer recognizes it as an allergen (i.e., her immune system stops treating the food in question as a dangerous invader that it needs to fight). I'll post a link to the relevant study sometime.

Ugh. Preschool.
Georgia will be old enough to attend in the fall. Aside from anxiety I have about taking that next step of having to trust Georgia and a bunch of other people (teachers, kids, etc.) to keep her safe, I've also been dreading just having the allergy conversation with the folks at the preschools we've been touring. Well, she got accepted to one, and the way it works is you accept and say you're going to attend while you wait to hear back from the others -- apparently this is pretty standard around here. So, we had our first allergy conversation with the preschool that she is, as of today, supposedly attending. (Can you tell I still have my fingers crossed about coming off the wait list at another one? For geographic proximity reasons, that's all.) I'll be positive here and say that the conversation went about as well as one could hope for. The woman giving the tour assured us that it would be no problem, that other children at the school did have food allergies so they were accustomed to dealing with it, and that we could leave EpiPens in the school office or with the classroom teacher, etc.. On the other hand, I have to be honest and say that even when given a pretty good answer, I felt like there was no possible way this woman could understand the fear that an allergy parent has. Because even when EVERYONE (parents, teachers, etc.) all have the best intentions, people sometimes make mistakes. I couldn't help but see the bowls of snack mix in the kindergarten classroom that we walked by and just start to worry. Georgia will be barely 3 years old when she starts preschool. Can I really hope to drill it into her head that she cannot share snacks with other kids? I think they have "snack parents" at this school that trade off bringing food in for snacks. I am hoping that we can get Georgia on a regime of just eating her own personal food rather than the provided snacks, even though the snack parents will be told not to bring things with nuts. Partially because in my opinion I can't really ask them to look out for any ingredients including nuts, fish, and sesame. (Although, how many preschooler snacks have a fish ingredient, right? I wonder about all of the DHA (fish oil) that's getting added to more and more things these days, though. Not sure if Georgia would have a problem with that or not.) But if we have Georgia just eat her own food, then will all of the other parents question why they're even being made to have to deal with my kid's food allergy and therefore just stop reading ingredients? (If she were in 4th grade, that might make sense, but I think at the preschool level it's still important to keep all those sticky pb hands and nut-crumbs, etc. as far away as possible - there's too much risk of contamination and sharing.) Is it time for me to just start trusting a little more, even though that might mean exposing my child to greater risk? I want to protect her (as any parent would). I have to balance that against the idea that I can't protect her from everything forever. Ugh. You can see I'm already going around in circles about this mentally. Broken record here, but can I just say for the one millionth time that it sure would be nice if a test for the severity of my child's allergies existed, so that I might only have to worry that she'll get a mild case of hives at school rather than worrying about something potentially fatal.

Other allergy parents
I feel comfortable discussing food allergies in this forum, but generally speaking I'm uncomfortable with it as a conversation topic. I guess I'm insecure, because I always assume the other person I'm talking to is judging me in some way - either judging me for having a child with food allergies (i.e., they must be assuming it's my fault!) or judging me for how I'm dealing with it (i.e., they probably think I'm being overprotective!). At a recent birthday party, though, it occurred to me that I'm perhaps even more uncomfortable and insecure about discussing food allergies with other food allergy parents. Isn't that awful? Aren't these the very people that should understand where I'm coming from the most? Yes, that is true. And I'm always happy to find them, except that there's no handbook for how to deal with children's food allergies, so I'm always a little bit dumbfounded as to how to address the fact that we don't all deal with allergies the same way. Perhaps the issue is that no one's way is the one and only "right" way, and yet I just so want to be doing the "right" thing, whatever that is. So anyway, at this particular birthday party, the allergy mom was allowing her peanut and tree nut allergic child to dive right into a bakery-bought cupcake with crumbled chocolate cookie as a topping while I was making Georgia have some more fruit and promising her that we'd get her a special treat later in the day instead. (I know, I'm horrible - I really should start bringing my own stuff to these parties, but I keep forgetting and then it's time to head to the party and we're usually running late already. Fortunately she's just young enough to still not really care about missing the treats, so I've been getting away with this.) I just sat there watching this other kid with her cupcake wondering, "Am I doing this all wrong? Am I being too uptight?" The mom in question happens to be a work friend of mine, so I was able to ask her whether her child still had food allergies. Answer - "Yes, but her allergies aren't severe - it would just be like hives or something. " Hmmm...already a different response than what our allergist would ever say. So I said, "But doesn't it make you nervous that one reaction isn't really predictive of the next? You know, that it could be hives last time, but um, something far worse the next?" (Don't want to say anything too terrible around the kids!) Answer - "I didn't know that. Our allergist never told us that." Hmmmm....for various reasons, I already had the impression that their allergist isn't the best. (My friend had even told me as much before.) But this is all very frustrating to me! Why aren't the allergists telling everyone the same set of information? Let me just tell you the two conflicting thoughts going through my head at the time: (1) Ugh! Other allergy parents that are not as vigilant as us are not helping our cause (see preschool discussion above). If she's walking around acting like possible nut ingestion is no big deal (she actually wants to try to "build up a tolerance" for her daughter by exposing her to more and more nuts (at home), despite her allergist having told her that that's not a good idea right now and her husband disagreeing with her as well), then how am I supposed to get other parents and school officials that come into contact with folks like her to understand that when my kid shows up, I expect them to take the whole allergy thing much more seriously?, and (2) Maybe she is the smarter one here. Because maybe if we look at our lifetime happiness levels, and the lifetime happiness levels of our children, her approach of being WAY more relaxed about food allergies and less protective will result in so much less anxiety and mental stress for her and her family that any medical consequences of the increased number of allergic reactions potentially resulting from her approach will be outweighed by the fact that they just didn't worry so much! I mean, I can guarantee you that she's not off thinking about this birthday party right now, writing a blog entry about it! : ) Maybe this is a case where ignorance really is bliss.
Anyway, it's like I want to go with conclusion #2 and just relax, but I can't get my mind to stop slipping back to the, "Yeah, that's all fine and well, but what if she DIES?" thoughts. You know what I mean? Ugh. Again, have I mentioned lately my annoyance with the fact that they cannot yet test for the severity of one's allergies?

Another reaction
Last week I picked up a loaf of bread at our neighborhood food co-op. The ingredients passed inspection, but Georgia ended up having a minor (skin) reaction to it. We think it was sesame, because other available loaves did include sesame as an ingredient. I feel like I should've known better, like my gut was telling me at the time not to buy the loaf because of those other loaves. But what does this mean? That we can only buy from national producers that can give me a better allergen statement, and we can never buy the farmer's market type stuff? Maybe. I don't know. I'll be doing a separate post later on my frustration with labeling.

Okay, that's enough dumping for today.

Operation Pancake

For anyone who's interested, here's the protocol for phasing baked eggs into Georgia's diet that they sent us home with, verbatim. (I'm not sure why I'm posting this in so much detail, maybe so I'll remember it years from now? The lawyer in me also now feels compelled to add that I'm not posting this as a suggestion that anyone else try it. Talk to your doctor - duh.)

Home Introduction of Baked Egg

It has been determined that it should be safe to introduce egg in a baked form into your child's diet. If your child experiences any possible reaction or concerning symptoms, stop the food and contact us for further instructions. Once your child has clearly tolerated baked goods with 1/8 to 1/4 of egg per serving, you can add similar products up to three servings a day, as well as commercially prepared baked goods that are otherwise safe. The following is a genreal plan for the introduction of baked egg - you can do this as often as once a day to start, although you can also progress as slowly as you like and do this over weeks or months rather than days:

• Begin with any baked egg recipe - cookies, cakes, muffins, cupcakes, brownies - and use one egg for a recipe that makes 12-16 servings. Your child can have one full serving to start, therefore will get 1/12 to 1/16 of an egg to start. You can also use a recipe with 2 eggs and give one-half serving.

• If there is no reaction to these products, you can increase so that your child can get up to 1/4 egg per servings.

• If these products are tolerated with no signs of a reaction, you child may have them up to 3 servings a day.

• After two to three months, you may introduce pancakes or waffles.

• You can then contact us to discuss the possibility of introducing straight egg if you desire. Up until this point, you also need to continue to avoid mayonnaise, custards, ice creams, meringues, and other foods with concentrated, less cooked eggs.

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!

Don't Count Your Chickens Before They Hatch

Or your eggs before you've eaten them, as the case may be.

So much for my motherly intuition! Georgia failed her egg challenge. (Um, did you read my last post? Well, don't I look like the fool!)

Silver lining here is that she may be able to eat eggs in baked goods, so at least some good news came out of yesterday's appointment.

Full story later when I have time to report.

IS EVERYONE AS EXCITED AS I AM?! No? Okay, anyway...

Scrambled eggs and french toast? Bring it.

Tomorrow is the egg challenge, and I'm so excited!

We've tried to prep Georgia with just enough facts to prepare her for what's in store. For a two year old, that means keeping it really simple. I know she's soaking it all in, though, since she started telling the grocery store clerk about her allergist appointment as we were checking out with our carton of eggs.

Also, I don't want to scare her about it. But if anything, my concern has been more the opposite -- not trying to hype it up too much. I've had to control the urge to express extreme excitement, as in, "We'll go out for cupcakes afterwards to celebrate!" I'm so confident that tomorrow is going to go well that I kind of have to remind myself that there is at least the possibility that she'll have an allergic reaction.

Here's to hoping that my motherly intuition is spot on in this case.

Thoughts on H1N1 and French Toast

Unless you're living in a cave, you know that flu scare is in full swing this year. There's the seasonal flu, and then the dreaded H1N1, a.k.a. swine flu, and if you were pregnant this year (like I was), or have a baby under six months old at home (like we do now), then you're officially high risk and should probably get yourself and your whole fam-damily vaccinated a.s.a.p.

How do I sum up my conundrum succinctly?

-Georgia's allergic to eggs, so she can't get the regular seasonal or swine flu vaccines;
-But she's testing so low on the RAST scale that she's scheduled for a food challenge for eggs in January;

-In the meantime, we've got an infant at home that we should be going the extra mile to protect from swine flu.
-Basically, this leaves me wondering, what is the greater risk? Georgia having an allergic reaction to eggs, or June getting the swine flu?

You see what I'm saying? I mean, we're following doctors' orders and all, so we are NOT feeding Georgia eggs on our own - we are waiting for the medically supervised food challenge - and we are not getting her swine flu vaccinated until she passes the food challenge. However, I'm just saying that we sometimes wonder whether this protocol makes 100% sense, given the possible dire consequence of June getting the swine flu, and given the fact that the allergists must believe that Georgia's probably not allergic to eggs at this point, otherwise they wouldn't have recommended that she do the food challenge.

In semi-related news, they called from the allergist's office to say that we are supposed to bring our own food to the food challenge, and specifically that we are supposed to make FRENCH TOAST to bring. Something about that just cracked me up. "Hi, I'm just calling to remind you of your daughter's appointment and to make sure that you know how to cook french toast. Will that be a problem?"

Then, a few days later, we show up at my sister's house for Christmas Eve brunch, and what is she serving but french toast! Suddenly it just seemed so odd to be heading off to a doctor's appointment in January to feed Georgia french toast, when I could've just given her some right then and there on the spot.

Again, we did not do that. We are following the doctor's instructions. I do not recommend that anyone else out there perform food challenges at home with respect to allergens that they've been told to avoid. All I'm saying is.......well, you can appreciate the weirdness of this stuff, right? The oddity of going through such formalities (like a 4 hour doctor's appointment) to eat french toast, when it's right there available on your table.

A date with the devil(ed)

Finally! An appointment!

January 12th.

Bring on the eggs.

My bets are on Georgia.

Waiting...

The good news: Based on Georgia's latest RAST score, she's eligible to do a food challenge for eggs, and if she passes, she'll be declared no longer allergic to eggs and may eat them to her heart's content. Yea!

The bad news: This food challenge has to be done supervised, at the allergist's office. Fine. But we can't get an appointment! All slots are booked up for November and December, and we are on a waiting list. A waiting list to try eating some eggs???? Argh!

A little frustrating. But I suppose, if you have been avoiding eggs this long, what's another couple of months? No biggie.

We are following the doctor's orders and not trying this at home. She'll just have to wait until next holiday season for pumpkin pie and Christmas cookies, I guess.

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.

"Being Treated as Allergic" vs. "Allergic" (and also: why I'm not convinced Georgia's allergic to eggs)

Okay, this is a subject that is still confusing to me.

Medical testing for food allergies is notoriously inaccurate in that it gives a lot of false positives. So, if someone gets a positive skin or blood test, how do you know if it's an indicator of a true allergy or just a false positive? Well, you rely on whether the person has had a reaction to actually ingesting that food. If so, then you can feel confident that the positive test result is accurate. If not, then there's a very good chance that it was a false positive.

Fine, but what about if the person hasn't ever even tried the food in question? Seems you might just feed it to them to find out if they're allergic, but it's not that simple because that can be quite risky. My understanding is that they (the doctors) look at a couple of factors: (a) the age of the patient, and (b) the numeric result of the RAST (blood) test.

Age of Patient: I could have this wrong, but I think that in some cases, based on the age of the patient alone, the doctors will not proceed with a food challenge or suggest that the child eat the food, because it is safer to just wait and have the patient re-tested in a year. Whether a food challenge may be in order is something that gets considered when the child is a little bit older.

Numeric Result of the RAST test: For whatever reason, each food has a different scale on the RAST test - (this is what I've been told, anyway). So, maybe egg ranges from 0 to 10, but peanut ranges from 0 to 15, and apple ranges from 0 to 12, or something like that. (I am making these numbers up, they may be more like 0-100, but that's not important.) The score on the RAST test is not considered to be an indicator of the severity of the allergy. You could score a 1 for peanut, and so long as it's a true positive and not a false positive, you may have the same allergic reaction to peanuts as someone scoring a 15 on the peanut scale. However, the score on the RAST test is believed to correlate with the degree of reliability of a positive result. So, for instance, if someone scores a 14 on the peanut scale, maybe that means the doctor is 95% certain that that's a true positive rather than a false positive, whereas if someone scores an 8 on the peanut scale the doctor may feel that there's only a 70% chance that that's a true positive. (Again - I am making up the numbers here just to get down the general concept.)

What a mess, right? Because in the end, even though the degree of certainty from the test results varies depending on the person's score, the person who scored an 8 (or a 1 or whatever for that matter) might very well actually be allergic to the food in question.

So, bringing this all back to Georgia....
In her case, she scored just barely high enough on the RAST test for eggs that the doctor did not feel comfortable letting us do a food challenge for eggs. In other words, her numeric score gave the doctor just enough certainty that the positive result was a true positive that she doesn't want to chance a bad reaction by feeding Georgia any eggs. So, we have been instructed to eliminate all eggs from Georgia's diet and are following the doctor's orders on this.

I have my doubts that Georgia is actually allergic to eggs. Maybe that is wrong of me to say, but I am just being honest. I say this because of 3 things: (a) prior to allergy testing, she had previously eaten cooked egg yolks without any observable reaction [granted, it is the protein in the egg whites, not the yolks, that people are allergic to, but given that we had separated these eggs by hand prior to cooking the yolks for her, I somehow doubt we actually removed every single egg white particle perfectly in the process of separating, so she probably ate some, right?], (b) she had birthday cake when she turned 1 without any observable reaction [although, admittedly, there are studies out there showing that some people with egg allergy can tolerate eggs cooked at very high temperatures - like in baked goods], and (c) the fact that her RAST blood test result for egg was just barely high enough for us to miss the cutoff point at which the doctor would've considered her eligible for a food challenge for eggs. So, I could be wrong, obviously, but I'm just being honest and saying that in my heart of hearts I do not think that Georgia is actually allergic to eggs. My hope is that when we go back in the fall of '09 for additional testing that Georgia will test even lower on the RAST test for eggs and will be cleared for a food challenge, and that my doubts of her egg allergy will be proven correct, (or, if she is actually allergic to eggs now that she will have outgrown the allergy). All of this said, we are not idiots and are therefore following the doctor's orders to a T. We do not feed her any eggs. We describe her to others as allergic to eggs and expect them to treat her accordingly - because the doctor has told us that she is - simple as that.

Anyway....getting back to the whole testing thing....
Georgia was not tested for poppy seed allergy when we had her tested for allergies in the fall of '08 (good Lord, why would she be? poppy seeds, for cryin' out loud?!), but several months later she later had a reaction to poppy seeds, so I had to call the allergist about that. During this phone call I asked a few more questions about the testing and got some clarification. My question was basically: "Is Georgia allergic to peanuts? Because I know she tested positive for those, but she has never eaten them, so how do we know?" (i.e., how do we know that these weren't false positive results?)

Answer (paraphrasing here, obviously): She scored an 8.19 on the RAST test for peanuts. At this level, judging only from the RAST results, (since she hasn't eaten any peanuts yet (except via breastmilk) or had any known reaction to peanuts), it is "probable but not certain" that she is allergic to peanuts. Her RAST score does not put her into a category where we could say with above 95% certainty that she is allergic to peanuts. But based on the probability that she is allergic, we are advising you to delay introduction of peanuts to her diet. If, one day, she is able to score below a 5 on the RAST test for peanuts, and she is at that point over 3 years of age, then we will probably do a food challenge for peanuts to find out for sure. Until those criteria have been met, it would be too risky to do a food challenge. (Peanuts being notorious for causing the most severe of reactions, like anaphylaxis, in those who are allergic.)

So, to sum up: since Georgia has never eaten a peanut (except via breastmilk) or had a known reaction to eating a peanut, the allergist might technically say that Georgia is "being treated as allergic" to peanuts rather than saying that she is certain that Georgia "is allergic" to peanuts. But from a practical standpoint, this is a distinction with no meaning. Either way, the point is that she can't eat anything with peanuts. So everyone, including the allergist, would/should just call her "allergic to peanuts" for simplicity's sake until it's been proven otherwise, (which unfortunately, it sounds like we can't even hope for happening until she's at least 3 years old).

EDITED 8/12/09 TO ADD: Since writing this post, I've learned a little bit more about the RAST testing, and I don't think I explained it quite right here. My understanding is that the scale is the same for each food, it's just that for each food there is a different point at which the doctors will say with 95% certainty that you are allergic to that food. So, for instance, a score of 4.5 for shellfish and a score of 4.5 for peanuts may not mean the same thing as far as the chances that each result is a "true" positive. This post from 8/8/09 explains it a little better, I think.