Elizabeth had mentioned that when she ate pecans or walnuts, her lips and mouth felt “weird.” I was hesitant to pursue it, considering how infrequently we eat pecans or walnuts: nut allergies are taken so seriously, I didn’t want to get her sent to the Nut Table in the cafeteria if all she had was a little bit of a skin sensitivity and could easily just avoid the nuts that caused that reaction. I also wondered if she might be imagining it, and it seemed like she’d had too few exposures to even start making a connection.
But when it happened when she had a tiny bit of pecan from a piece of candy, and when she immediately asked “Did that have pecan or walnut in it??” just based on the reaction she was having, and when she added “it feels like there’s a lump in my throat” to her symptom list, I thought I’d better mention it to the doctor at her annual check-up a couple of weeks later.
He ordered a blood test to screen for an allergy, and I don’t really understand how it works but anyway he called us and said it showed allergies to both pecans and walnuts, and an IgE of 247 (he said 100 would be considered high), and that earned her a referral to an allergist; her appointment is next week. I don’t know if this means she IS allergic to pecans and walnuts, or if it means she screened as being POTENTIALLY allergic, but there is no way I’m going to Google nut allergies. The allergist can tell me what’s going on.
On one hand, I have an “Oh, great, here we go” feeling. On the other hand, I’m glad to be going this route: the doctor we’re seeing does asthma as well as allergies, and Elizabeth already has a diagnosis of “let’s call it reactive airways for now, but if this continues we’ll want to look into whether it’s asthma,” and this IgE thing apparently relates to both allergies and asthma, so it’s nice to be Working On This if it’s going to turn out to Be Something.
But now I regret saying no when the doctor who did her tonsillectomy said he could do allergy testing while she was out anyway. I felt at the time like he was just trying to upsell, and maybe he was, but in retrospect it would have been nice; I had the scratch test done as a child, and I remember it being weepingly uncomfortable—like having 100 mosquito bites on my back and not being allowed to scratch them. It would have been nice to be unconscious.
Well, but at the time I’d also thought, “Wait, is it good for her to maybe have an allergic reaction to something while she’s already under anesthesia for the first time?,” and I guess I still do wonder about that. And I don’t think I would have enjoyed worrying about the tonsillectomy recovery AND about the newly-discovered-and-previously-unsuspected (at that time) nut allergy, and she was enough of a cranky mess after surgery without adding 100 mosquito bites, so perhaps it’s better this way after all.
My son had allergy testing done earlier this year after struggling with asthma for a few years. He was diagnosed with Reactive Airway Syndrome as a toddler and he began to have so many coughing fits that they just upgraded it to asthma. Anyway, the allergist prescribed some cream that the nurse rubbed on his arms before doing the testing. His back itched a bit, but the shots on his arms didn’t bother him at all. Maybe your allergist can prescribe the same kind of thing for Elizabeth? I sure wish I’d had it before my allergy testing!
Well, shoot. But isn’t it nice to know she’s old enough to notice her own symptoms? No? Reaching for that silver lining over here.
Good news/ bad news:
Good news: the skin test is painless — takes a second, a positive result is just a mosquito bite-like reaction.
Bad news: based on the reactions she’s had, history of asthma-like symptoms, plus the bloodwork (and my experience as a parent of a pecan/walnut allergy kid), she does have a pecan and walnut allergy (those two nuts are very closely related).
Good news (again): we’ve been dealing with this for 5 years and it is a very containable allergy, unlike egg, dairy, or soy, which can be anywhere. We avoid bakeries unless they are designated “nut free” because of cross-contamination, have constant conversations with my now 7 year old about what to ask when he’s getting food from someone other than immediately family, and always have Benadryl and Epipens on hand. He still gets disappointed when he can’t have what everyone else is having and Halloween and birthday parties are treacherous, but it is manageable.
It’s potentially very scary, but the great news is that Elizabeth is old enough to be responsible (we had a toddler who would put anything in his mouth).
Good luck – and sorry to welcome you to the club.
We went through the same exact thing with our daughter. The poke tests didn’t bother her too much, and they put calomine lotion on right away. We were pretty sure about the tree nut allergy and just wanted to get it confirmed one way or the other. We were not prepared to find out she’s also allergic to Dogs and cats (we have a cat). The nurse also thought she might be showing a reaction to dairy and eggs (yikes!) but thankfully the doctor said that was probably just her sensitive skin reacting to being scratched. You’ll get the joy of carrying an Epi-pen everywhere from now on, but it’s pretty manageable. Good luck!
Ren has asthma and a nut allergy! I am not an expert AT ALL, but I can tell you what I know. The blood test shows potential for allergies but is not conclusive, so she may not have a nut allergy. If your kid has asthma, she probably has a high IgE anyway, which makes it even harder to tell anything from the blood test. The allergist will be able to tell you conclusively if she is allergic to anything. Ren did the scratch test at 3, and he was fine. I was worried about how uncomfortable it would be, but even though he ended up w/ some really bad allergic reactions, he did great, and it was super easy. I hope Elizabeth finds it easy too.
I guess I should also not that the allergies and asthma have been really easy to deal with. Neither affects Ren’s life (or mine) at all. Quick puff of an inhaler before bed, carry an epi pen with us when we go out, the end.
Hey, at least she got to go away to camp without adding nut allergy/epi-pen to your list of worries! My kids 5 & 2 both have peanut allergies, as do about 1/2 the kids I know. Seriously HALF. I have to admit it DID change my life quite a bit when we found out about my son when he was 3, almost 3 years ago now. We had to purge our house of everything that could be nut-related (not just nut products – for example, any opened jelly, for fear of cross contamination) we stopped getting Thai food :( and almost ANY chocolate candy. We avoid places where nuts are (ballparks, circus, that aisle of the grocery store) and read every food label twice. Even things like breads, cereals, vitamins, lip balm, all have nuts in them. I predict it will go better for you since Elizabeth is old enough to recognize her symptoms, read labels herself, and unlikely to forget or deliberately eat something she shouldn’t, just because she wants a cookie, or whatever, unlike most 2 or 3 yo’s. They do have GREAT new epi-pens that are easy to carry and calmly talk you though how to use them (AUVI-Q), they are very reassuring, much better than the ones we’ve carried around until now. Good luck!
I hope the allergist has clear cut answers and the allergy test is easy as possible!
She does have an allergy to walnuts and pecans (you should assume all tree nuts, by the way). As someone else pointed out, it’s more manageable than an allergy to dairy or eggs or even peanuts. Until you see an allergist, you should carry some kids Benadryl with you at all times. That can calm down a reaction before it gets serious. And teach her not to accept chocolate from ANYONE. EVER.
You will end up with an Epipen. The sooner you can train her to carry that and her Benadryl with her wherever she goes, the better. You want, when she is a teen, that she be so used to having that little bag/hip pouch on her, that it will feel weird to go out without it.
Good luck! Things will be fine, it’s just a little extra work.
My 14 (almost 15) year old has a peanut allergy. It’s totally manageable. Don’t go down the Google hole of doom, though. Your commenters have offered some great advice and anecdotes so far.
I can’t think of anything to add to the already helpful comments other than we’re here for you and I am SO PROUD of Elizabeth for telling you what was going on in such a clear, informative manner.
My husband’s allergic to hazelnuts, macadamia nuts, and chestnuts. While we have to be careful of mixed nuts, and bread and candy (many of them have OMGSEKRITHAZELNUTS!!!! in them), it doesn’t really affect his life at all. I mean, he can’t eat most of the chocolate his family brings back from Europe, we don’t keep Nutella in the house, he can’t eat chestnuts roasted over an open fire (and has to examine stuffing ingredients) but… it’s basically a non issue. He also doesn’t react to any other nuts at all. Granted, these nuts aren’t as common as pecans and walnuts, but still.
We’ve been operating under the assumption that our kid also has nut allergies (mostly bc husband’s family has a bunch of nut allergies as well, to the same nuts he reacts to) and have dealt with it by… not feeding him hazelnuts! Although I’m going to ask about getting a nut test at his next doctor’s appointment. (he had a standard allergy blood test that didn’t show he was allergic to anything but I don’t think they tested for nuts). Kiddo is four now, which is a huge relief because he can TELL US when something is wrong.
Her symptoms sound like how my apple & honey allergy began. The doctor said because of the location of the symptoms (mouth) to practice “Better safe than sorry” so I do.
From what I’ve read along the way (since at the school to current) it sounds like they’re often outgrown so there’s that.
I wouldn’t beat yourself up about the allergy testing. I agree with the basis of your decision: there was just too much going on at the time to add that on as well.
I am a grown-up with a tree nut allergy – she can make it happily and successfully to adulthood :) I am allergic to walnuts, almonds, pecans, hazelnuts, pistachios, etc. I am NOT allergic to coconut (is this actually a nut?) or chestnuts. I can also eat peanuts. Peanut allergies are a whole different ballgame with all of the GMO food nowadays. I can eat any foods that don’t specifically have nuts, but have the label “produced in a facility with nuts” with no problems. I do have to watch out for: pesto, chapstick and other beauty products with almond oil in them, shaving gel and hair conditioner, crusts on otherwise non-nut pies/cheesecakes, almond extract (I know, duh, I just didn’t put it together), various Middle Eastern dishes (these are all lessons learning the hard way). My reaction to nuts has changed as I have grown up – I used to get itchy skin, then swollen lips and a little trouble breathing (not anaphylaxis) and now as an adult I seem to get migraines instead. I can have nuts in the house (I make my kids sandwiches with Nutella on them occasionally), but I usually do have a reaction when I am around goods with nuts while they are baking (i.e. banana bread) (in fact, side note, I also have an allergic reaction to baked bananas – smelling or eating – even though I am NOT allergic to bananas. I think it is just a psychological reaction from the banana bread my mom made while I was growing up). When I was growing up, Epipens were not as prevalent as they are today. I learned to avoid any sweets that pretty much weren’t pure chocolate and other people’s home baked goods. I carried Benedryl in my back or in the car. Teenagers and college friends did try to “test” me and sneak me nuts – I’m really hoping with allergies becoming more prevalent that kids today wouldn’t do that – it is annoying and scary. Also, I used to take a big dose of Benedryl a couple of times a year and eat nuts because I enjoyed them, but at some point a doc told me to stop doing that, I was going to accidentally cause a major reaction and intensify my physical reaction to the point I couldn’t even be around nuts.
I ended up in the hospital one time as a result of the allergy, BUT it wasn’t the nuts per se. I ate some cheesecake at a restaurant with friends while I was in a high school. I started to have a reaction and freaked a little because I wasn’t with my parents/at home. I took a pill version of Benedryl that I had in my purse and went home. I was still having trouble breathing so I used my inhaler and took some liquid Benedryl an hour later. All of the antihistamines in those drugs swelled my blood vessels open in my brain and it started pushing against my skull and I couldn’t see for a bit. Scary, but I totally did that to myself. Lesson, don’t overdo it on the drugs :)
Sorry, I know this isn’t about me, you seem to be the type who finds comfort in anecdotal evidence. Echoing above, its nice that Ebeth isn’t a toddler, my allergy didn’t present itself until I was 6 or 7 and I was able to learn about it and manage it just fine, almost all the time. I…still don’t even know if my dad understands I’m allergic to nuts. When he comes to visit he brings me Almond Joys as treats. I don’t remember him or my mom having to do much with it. I know, different times we grew up in. She will be fine.
Two of my friend’s three kids have food allergies, and she said the skin test isn’t so bad. Hope it all goes well for Elizabeth.
In completely random news, I think “Potential Peanut Allergy” and “Restricted Airways” are both excellent band names.
Tre had the extended scratch test for allergies (covered his entire back and one arm) six years ago, and he reacted to every single allergen except one. So yeah. Allergic to the physical world, is what that is. But he didn’t really mind the test all that much. It was boring and no fun to have to lie on his stomach that long, but he got to watch a movie in the doctor’s office, and that pretty much offset the down sides.
Allergies are super weird, yo. Tre’s been getting shots for the last six years, and he still has a year ahead of him, and he’s still all kinds of allergic. Part of me keeps thinking “SCAM” but eh. We do what we think is best, right?
Ohmigosh, my husband had similar results–plus it turned out that he was highly allergic to the bandages they’d used to cover the testing area on his back. His experience was so bad that I think it was very, very smart to separate the testing from the surgery.
Okay, I know you don’t want to freak yourself out Googling, but maybe have a look at this one non-freakout-inducing Wikipedia page: http://en.wikipedia.org/wiki/Oral_allergy_syndrome My DH has this, Oral Allergy Syndrome, and it sounds as if E’s symptoms might lean that way. DH is sensitive to certain allergens only when the corresponding plant pollen is also around. So most of the year he can eat most foods with no problem, and when he *does* have a problem, the main sign is tingling in his mouth and throat, and he knows to stop eating the food right away, and it never gets any worse than that. He is in his late 40s and has never needed an Epipen for a food reaction (though he has needed ER care for a totally unrelated medication allergy, so we do know how serious anaphylaxis can be). OAS can be kind of a pain but overall it’s a very livable thing.
BTW this is one of the things that makes me go “Hmmmm” about genetically modified food crops. It sure seems possible that science could introduce new varieties that cross-react with other foods in ways we won’t even suspect until people start turning up with weird allergies.
Oh. My. Goodness. This is me! Wow, I have had this since I was 8 or so, but never knew that there was an actual NAME for it. I am seriously so excited to learn this. I had allergy shots for years for various pollens, and have had this oral itchy stuff to fresh fruits and veggies for forever also, but never knew the connection. And truth be told, it never bothered me enough to actually ask much. We mentioned in high school (20 years ago) that I was getting itchy mouth with say, apples, and so I had an eli-pen to carry around just in case. My oral itchiness never did more than annoy me, but I did use the epi-pen when my nurse at summer camp accidentally gave me a huge overdose of my allergy shot and anaphylaxis happened. Anyway, everything makes so much more sense not. Wow. Thank you so much!
My middle DD is allergic to nuts and soy. Because her reaction is mild (though she tests very strong) and she’s great at avoiding eating the foods, I give the school a note that she doesn’t have to be at the allergy table. Honestly, the biggest pain is keeping the epi-pens up to date at home and school.
I have been scratch tested 6 times since I was a child, and I can honestly say it wasn’t too terribly bad. I remember when I was a kid it wasn’t any fun at all, but not a horrible thing. The worst thing for me is that every time, the doctor would stand over me and discuss the reactions as if I was not a real person but rather a lump of evidence, and that is a bad feeling. All this to say, Elizabeth isn’t likely to be scarred by the experience. If the allergist does not give her Benadryl afterward, it would be a good idea to.
During the skin prick test is a great time to produce an ipad with a newly downloaded game you know they’ll love…
Nut allergies are not all gloom and doom. Our 9 year old son is allergic to peanuts and all tree nuts. We discovered the allergy when he was about 18 months old and had a nibble on a peanut butter cracker. His got red and splotchy. We avoided nuts for a long time and sent him for tests when he was about 3.
Because we had avoided nuts, but not things processed on shared equipment, and had had no problems, the allergist told us that we did not need to be more restrictive — thank goodness, because there are a lot of things processed on shared equipment. Yes, you have to be aware of the ingredient labels, but I would suspect that pecans and walnuts are far easier to avoid than peanuts are.