BLOG: Guiding Little Monkeys; by Mama Monkey!

imageThere are over 50 OIT family blogs published in our “Research & Learn” library. They contain the journey of that family in OIT–some are in clinical trials, and others are in private practice with board-certified allergists. All the blogs are fascinating to read, full of wisdom and knowledge unique to that family’s journey.

While there are a few “main” OIT protocols (which are more similar than different), there are other allergists like Dr. Randhawa who create their own protocols and highly customize them for every single patients. Unique the whole way! Where we see differences in Dr. R’s protocols is usually a higher dose than most other doctors, and long-term he moves patients away from daily dosing, to a few times a week or even once a week to maintain their desensitization.  Dr. R also allows the “no exercise” rule to be lifted for many of his patients–true FREEDOM from their allergies!


Then on to this week! We made the long drive again for what we hoped would be a very important updose. Dr. R did not fail our expectations on that one. We went into the office and increased to 10 grams, or approximately 15 whole peanuts. Thankfully, Big Monkey gladly ate all 15 with a small helping of chocolate ice cream (thank you Dr. R for having a lot of big guns in that hospital peanut kitchen!). No, there are no photos of this because when I am with Big Monkey in Dr. R’s office, my main concern is having a safe and successful updose as well as talking to Dr. R about the future and our plan (it seems to change every time we go in, so this is important).

What is so important about 15 grams? Well, it is considered our “maintenance dose.” This means we will no longer be doing bimonthly updoses. We will stay at this dose for about 3-4 months to let his body adjust. It was still a huge jump from where we were at, so we will be watching him closely for the next few weeks, but if all goes well, then things start to change. In one month, I can begin to wean Big Monkey off one of his daily antihistamines. His nasal spray and second antihistamine should soon follow. That is the biggest change for now. It seems like something small, but a medicine free child would be absolutely wonderful! I think the best quote of the day was when Dr. R said (in response to my asking if we could dose in peanuts, m&ms, peanut butter, whatever), “Sure. If you want to order Thai food and have that as his dose, go for it. Just don’t let him consume more than his current dose.” Really?? Talk about freedom. Of course, even bigger changes are coming this summer.

So if the next 3-4 months are uneventful and we have no reactions, then we will return and challenge to a higher dose. There may actually be two more challenges involved, or we may just jump to the higher dose at the next visit. I believe it all depends on what happens over the next few months. These challenges are similar to the updoses we have been doing all along, except they are much bigger jumps with no small increases in between. Ideally, the 3-4 months on this maintenance dose will prepare Big Monkey’s body for the larger dose  (yes, I am purposely leaving the specific grams off of this public post for a number of reasons).

Regardless of which of the two doses we reach at the next visit, the next change will be losing the rest period following our daily dose. Currently, Big Monkey takes a dose and then must remain calm for 60-90 minutes. This means not doing anything that gets his heart rate or body temperature up (no running, jumping, tantrums, hot showers, or outside in the heat). Most of the time we complete our school work during this period of time. It’s not much of a problem during the school year, but come summer, it will become a bigger issue. The freedom we have gained so far means that Big Monkey has a lot of plans this summer (i.e. camp) and it will be nice to not have to wake him up at 5:30 a.m. to dose in time to complete the rest period before camp starts. I know Big Monkey is looking forward to not having this restriction any longer.

When we hit the larger dose (I am so hoping it is next time), then things change yet again for the better! Here is a recap of the accomplishments we will have made at that point: no longer contact reactive, no longer need to worry about cross contamination (so items made in the same facility, on the same equipment), no longer doing bimonthly updoses, and no longer observing a rest period. Basically, other than consuming a specified amount of peanut every day and avoiding any additional peanuts, Big Monkey will be like a regular non-food allergic six year old. So how can it get better than this? How about we make him even more like a regular non-food allergic six year old by removing the need to eat a specified amount of peanut every day and by saying he’s allowed to eat peanut products at will? That’s right, we’re talking full inclusion into his diet.

So after passing the large challenge, Big Monkey will be required to eat that dose once a week. That’s right, once a week! Then after that he will need to eat something like a granola bar or two somewhere throughout the rest of the week. I believe he will also be allowed to eat any other peanut products that he wishes (maybe not on the day that he has to consume the giant amount of peanut protein, but trust me, even the biggest peanut butter lover would not want to consume much more than what he will need to eat in that one day). Just thinking about this makes me want to tear up with joy. My son at age 6.5 years will finally be allowed to eat ANYTHING HE WANTS!

He will always be required to carry an epi-pen (likely for the rest of his life), but he will eventually have no memory of the days where he couldn’t eat the cupcake at the birthday party, gather the Halloween candy from the pinata, eat at a restaurant because it uses peanut oil, enjoy an ice cream because they use the same scoop in all the barrels, fly on a plane without wiping down every surface first (although I may still do this as I have now seen first hand that planes are gross), or leave the park because some kid decided to consume a peanut butter sandwich on the play structure. He will never be bullied because he is the food allergy kid. He will never have to ask a girl to brush her teeth before kissing him (or ask if she’s had any peanuts in the last 12 hours). He will not have to live constantly looking over his shoulder wondering if today is the day that somehow he might slip up or that something might get by him and send him to the ER, or worse. It sounds like a doom and gloom outlook, but the truth is, it happens. But hopefully all this means that from here on out, it will never happen to us. Instead, I can worry about him deciding to jump off a roof, ride a motorcycle, go cliff jumping, or some other equally horrifying to your mom activity. And today, I am thankful for that possibility and wish that every single food allergy parent out there could have the same thing. Hopefully one day, they will, and we will have been a very small part in the large number of patients needed to make this reality for everyone.

Congratulations, Baby! You are the bravest little person I know and February 17th, 2015 marks the first day of entirely different options and opportunities in front of you.

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