Baked Egg Challenge

Luke visits an allergist every year before school starts.  At that visit we get prescriptions for his Epi-pens and Albuterol.  We bring forms for the doctor to fill out so these medications can be given at school, if needed.  The doctor also gives us an "Action Plan" (required by the school), which is a detailed description of what an allergic reaction looks like and what medications (and how much) to be given in the event of an exposure.  At this visit, Luke will also typically have blood drawn to see where his allergen levels are at.  His peanut allergy levels are through the roof and there is little to no hope that he will ever outgrow that allergy.  But, we always look closely at his egg allergy, as that is an allergy that can sometimes be outgrown.  Luke's egg levels have dropped slightly with each blood draw, but have still remained in the "high range".  This past August we got a big surprise when his egg allergy level came back at a whopping low of 6!  His allergist was just as excited as we were and he wanted to do a baked egg challenge.  A baked egg challenge is where Luke would be given a baked good with eggs in it at the doctor's office and then we would wait to see if he has a reaction or not.  It is potentially a 4-hour visit.  We would be using "baked egg" because that is less likely to cause a reaction than eating straight eggs.  While I was excited about his number dropping so much, I was a little wary of giving Luke eggs, just yet.

We have been told so many different things over the years by our allergists.  They keep changing the protocols for when to give kids potentially allergy causing food.  When Luke was 16 months old and had an anaphylactic reaction to peanuts we were told not to give our next child peanuts until they were at least 2.  A couple of years later that protocol changed and we were told not to give peanuts until age 3.  The most recent protocol is to give peanuts as early as you can...meaning as soon as your child can eat solid food.  You see, allergists fear they have created more allergies by withholding the food and now believe that there will be less allergies by giving the food early.  We were also told that the way to outgrow an egg allergy is by NOT exposing the body to the food.  It is so confusing.  It is hard to know what to believe.

So, I hesitated when Luke's doctor wanted to do the challenge.  Luke's previous allergist wasn't going to do a challenge for any number over 2.  This doctor believed that 6 was low enough.  Luke sure wanted to do it.  This boy wants so badly to eat what the rest of us can eat.  David and I sat on it for a couple of months before deciding to go ahead and do it.  If he passed the test, it could open up a huge array of food for this boy.

In October, Luke and I headed to the allergist.  Thankfully, David worked from home so I didn't have to bring the whole crew with me that day.  When we got to the doctor, the allergist told me about an allergy conference he had just attended and that he spoke directly with one of the top allergists in the country about when to do egg challenge tests.  He told me that this "top" doctor does a challenge if the number is 10 or below and Luke's doctor was feeling good about testing Luke at his level of 6.

The challenge works like this...Luke is given a fourth of a muffin I bring (recipe provided by the doctor) and we wait fifteen minutes to see if he has a reaction.  If there is no reaction, he eats another fourth and we wait 15 more minutes, and so on until the muffin is gone.

  When we first got to the office, the allergist had Luke take off his shirt and he looked over his body and face and marked, with a pen, any red marks that he currently had, so he could have a good baseline of what his skin looked like when he showed up.  Baseline vitals were also taken.  Then Luke was given his fourth of a muffin.  And we waited.  Within 2 minutes his throat started to tingle.  Two minutes.  I couldn't believe he only made it two minutes.

Thankfully, Luke has never had an anaphylactic reaction to eggs.  When he was little, he would develop hives around his lips if he was given anything with eggs.  It happened every single time.  Even if it was just one bite of a cookie.  When I asked his pediatrician about it, he thought I was crazy and told me that Luke did not have an allergy to eggs.  I had that gut feeling, though, and stopped giving him anything with eggs.  A friend watched Luke for me one afternoon when I was pregnant and miserable and when she brought him home, she told me she had given him scrambled eggs to eat.  I didn't even think to tell her of my suspicion about an egg allergy.  Well, Luke's face swelled up big time.  So much so, that I could hardly recognize him as my child.  I took him to the doctor and again was told that this was not an egg allergy.  He said it was just a virus.  I didn't believe him.  I gave him Benadryl at home and the swelling disappeared.  Later, after his anaphylactic reaction to peanuts (which also included so much swelling in his face that he could hardly open his eyes), I had him tested for an egg allergy too (along with a bunch of other things) and his results came back highly allergic to eggs.  I was really looking forward to telling his pediatrician about it, but we moved before I got the chance!

Anyway, to continue, after the tingling in the throat began after ingesting the muffin, the doctor and I went back and forth on if we should give Zyrtec (or Benadryl) right away or wait and see.  It was not an easy few minutes for any of us.  While Luke has never had an anaphylactic reaction to eggs, the possibility is always there, especially with repeated exposure.  While we were debating, the first hive developed around Luke's mouth.  We called it quits at that point and he was given Zyrtec.  We had to hang out at the doctor's office for another hour to make sure the Zyrtec was going to be enough (an anaphylactic reaction typically occurs within an hour of exposure).  He was doing great after that first hour (tingling throat and hives were gone) and we were able to head home.  I gave him Benadryl before bed, which probably was not necessary, but the mom in me felt better by doing it.  I also checked on him a couple of times during the night, which probably wasn't necessary either, but it also made me feel better.

While this was a sad day, Luke took it like a champ.  My heart was heavy as my hope for him was dashed, but this boy quickly moved on.  I actually think the doctor took it the worst of all of us.  I found myself feeling sorry for him.

So, nothing changes.  We will keep avoiding those pesky eggs.  There is the possibility that this exposure to eggs could set him back.  At this point, I don't even want to know.  We will find out next year when he has labs drawn if his egg allergy has skyrocketed.  If so, at least I know that Luke is strong and can handle the verdict, whatever it is.