REACTIONS DURING ORAL IMMUNOTHERAPY

Reactions During Oral Immunotherapy (OIT)

I have been procrastinating writing this post. I have some serious anxiety happening since we have made the transition from suspension to actual peanuts. My heart pounds and my hands shake every damn morning when I give her the peanut dose. We are up to a 1/4 of an actual peanut. I find feeding Sosi her allergen terrifying. After each dose, I go through our morning routine but it is like a 2 hour fuzz in my day. These two hours I try not to sit and stare at Sosi and project my worry onto her. The last thing I want is for her to start fearing peanuts after we have come so far. Sosi understands that peanuts and milk can make her, “very sick” or “itchy” but we have kept the true severity of her allergy to ourselves, for obvious reasons.

Each dose is carefully weighted, by me, and then stored up high away out of reach. Her dosing schedule increases every two weeks, so just when I am feeling somewhat comfortable with a dose, we increase it.

I think my recently sparked anxious feelings started when Sosi had a reaction during her initial introduction to an actual peanut at the doctor’s office. Thank goodness it happened there because I likely would have melted into a pile of mush at home. About 10 minutes into her dosing, Sosi’s top lip started to swell in the middle. It looked almost like a tiny bee sting but it didn’t get any larger than the size of a dime. It totally freaked me out though because she hadn’t had any reactions to the suspensions. We alerted the nurses who quickly grabbed the doctor to come in for a quick check. Apparently this type of reaction is quite common if there is any type of split in the skin on the lips (which there was). It is similar to the reaction caused by the skin tests. After about 15 minutes the lip bump disappeared and Sosi was actually none the wiser. She didn’t even mention the lip but did ask why I was staring at her without blinking – lol!

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So continuing on with our journey, we had a successful up-dose at the paediatric allergists office this past week. We up-dosed to 1/4 of a peanut and all was well, I think her one cheek looked a little flushed but the office was a little warm, so nothing really notable.

Fast forward to yesterday morning where Sosi had a reaction to her peanut dose. It was considered minor and it did not require medicinal intervention but none the less it has really thrown me off. It took me a long time to fall asleep last night because I was so worried about this mornings up-dose. Right now we are having a chill morning in bed watching Netflix while I continue to offer her food in hopes that this will stop a repeat of yesterday.

My concern was about a weird reaction that Sophia had yesterday morning about 20 minutes after her peanut. She started spitting, so we went to the sink where she continued spitting for about a minute and then started crying. Usually she spits before she barfs, so I asked her if she was going to be sick and she said “no”. Then we washed her hands and wiped her face, she started to cry harder and said her stomach hurt. I thought maybe she was upset because I was clearly not hiding my worry at all by this point. I raced her outside for a quick change of scenery where we looked at the pool and talked about the clouds and whether there would be rain or not. Thankfully, she didn’t mention anything once we had cooled off. She did not experience any other issues or symptoms during the day. It was just such an unexpected reaction since she had already had three days at our current dose without any reactions.

Thankfully Sosi’s doctors emailed me back very fast last night (yup on a Saturday) since I just could not get the episode out of my mind. It was thought to be a sort of oral symptom with nausea and to continue with Sophia’s current dose. So what did I learn from this situation? I need to make sure Sosi has a full stomach before and during her dose. Yesterday morning she was not that hungry so she opted for a banana and a granola bar. Each morning she does usually eat more items like toast, SosiCakes, muffins, and maybe a smoothie as part of the peanut dose. So moving forward, we will make sure to fill her belly up with each dose. Time will tell if this keeps her nausea under control, I really hope it does. We also have her antihistamine on hand and of course her two epi-pens in case we need to medicate her at any time.

We are in the last third of her treatment plan, so we will continue to push forward, under doctor supervision of course. We made it through today’s dose and the two hour mandatory quiet period,. She was content with no visible signs of an upset stomach. I am really hoping for no more reactions but feel it is important to write about what we have experienced for those considering OIT as an option.

I am now off to read OIT articles, bake muffins, and enjoy the rest of the day with my little fam jam.

xo, Mel

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