Oliver’s Baked Egg Challenge

Oliver blogged about his visit to the allergist recently. He hadn’t been to the allergist for a couple of years so we weren’t sure what to expect. We had some surprises that visit and some new information. One change was that even though Oliver’s egg Skin Prick Test (SPT) was 28 mm (very high) research has shown that if you have a ovomucoid SPT of < 11 mm then there is a good chance that you might be able to tolerate baked egg. Oliver’s ovomucoid SPT was 6 mm… so we left that appoinment excited and with renewed enthusiasmn that there was something positive that we could work towards with Oliver and his severe food allergies. We were going to do a baked egg challenge…

But as the challenge date approached our anxiety levels rose and we were really questioning why we were doing this. There was more than just the baked egg challenge that challenged our thoughts… Was this worth putting Oliver through? How were we going to explain to Oliver what was going to happen?  How were we going to bake these muffins?

The day before the challenge we travelled to Melbourne. Oliver and I went to buy the eggs. Oliver didn’t want to come into the shop with me. I explained that it was fine. He didn’t have to be worried. I would buy the eggs, we would put them in a bag and it would be fine. I hadn’t bought eggs in 8 years. What was I looking for? I decided on organic, free range eggs, size 50 g. So many different choices…

I baked the muffins the night before the challenge when Oliver was asleep. I baked them in my parents house using the recipe given to us by our allergist and following the protocol. The smell was so foreign. So strange. Having a highly anaphylactic allergen in the house was strange… it was difficult as I was paranoid making sure that I didn’t get the raw egg anywhere. The muffins turned out. We were ready for what the next day brought us…

The next day we left early for the hospital full of mixed emotion. All the research I had looked into pointed to Oliver having a good chance of passing the baked egg challenge but really anything in Oliver’s case was not the average case scenario. We had learnt this many times over with Oliver already. Oliver was taking it all in his stride and at these times I tried to feed off Oliver’s emotions and not my own. I asked Oliver how he was feeling about having to eat something that he knows he could be allergic to? His answer amazed me… I trust you and if you think I should try it I will do it, Oliver said matter of factly. My heart filled with pride but I also felt an immense pressure that he was trusting me so much and this could all fail and he could have a reaction. I explained this to him but I also explained that he is in the safest place to do this and that if anything was to happen then all would be fine. All the nurses and doctors are here and all he would have to say is that he wasn’t feeling well. On the flip side I explained… if it worked out and all went smoothly that would be great… but the only way we could definately know is by trying.

We arrived… the baked egg challenge protocol was eplained to us. We would feed Oliver a small amount of muffin containing the baked egg… we would wait 20 mins… the nurse would monitor any changes or allergic signs that Oliver might mention or that the nurse observes… breathing difficulty, listening to Oliver’s lungs, any wheezing or shallowness of breathing, hives on the skin, rashes, blotching, any changes… if nothing changed we would double the dose and go through the same process again and again until 1 whole muffin was eaten. This was the magic number… 2 eggs were used in the muffin recipe, with the recipe making 12 muffins, so each muffin would contain 1/6 of an egg… we needed to get through consuming 1/6 of a baked egg… didn’t seem so hard…

Before we started the challenge the allergist came by to answer any questions… I had many… why are we doing this? What are the chances for Oliver to pass this challenge? What are the reasons you think that he will get through this challenge? etc etc. Apparently recent Australian research has shown that if a child can tolerate baked egg and can have it in their diet at least 3 times per week (in the form of a muffin or one 12th of a cake and building up from there) then the child is 3 times more likely to grow out of their egg allergy. Well this was a good enough reason for me to get over my anxiety and give it a go! We wanted to do everything in our power to help Oliver maybe grow out of one or more of his severe food allergies… The doctor did explain that this research was carried out on children around 1 years old. I still thought positively about our situation and off we went…

Oliver food challenge getting ready

Here we go… what a bizarre and stressful feeling, feeding your child a piece of muffin knowing that it contained egg that he is severely allergic to…

The first dose of muffin was given… we thought that if anything was going to happen it was going to happen now at this first stage… why would it happen after that? Any time Oliver had a major anaphylactic reaction it was with the smallest of amounts… Nothing… wow… this could actually work… do we lend ourselves to hope?? Yes of course we do… Then after a couple of minutes Oliver complained about an itchiness in his throat area… the nurse said that this is common and not to worry… my worry levels were at 100… have a drink, sometimes it’s the different texture… Oliver had a drink and the itchiness subsided… 20 minutes passed, all the checks were done… nothing presented itself that was untoward… we were good to go the next round…

Oliver food challenge 3rd sample

Second dose… at this stage we are thinking that this could actually be possible… How are you feeling Oliver? Do you feel any different? Any itchiness? Any breathing problems? I couldn’t help it. I was trying to stay calm… Oliver then said he felt a tightness, strange feeling in his neck/throat… ok, have a drink… relax… it’s ok… just relax… have some water… sore tummy? Anything else changing? No, no, Oliver said. How’s the tightness in the throat going? Same, maybe a little bit better… we waited and the tightness eventually subsided. We waited a bit longer than the 20 mins as we all know Oliver’s sensitivity and how different he is… so much so that Oliver’s nurse that was looking after him today had happened to be one of his paramedics that treated him after an anaphylactic reaction to an unknown source and took him to the ER when he first started 4 year old kindergarten… how coincidental is that!

So we waited… spoke to the doctor and once he was symptom free gave him his third dose… straight away Oliver’s demeanor changed, he was not himself… Oliver has a very outgoing personality and the only way I can explain this change is that he becomes extremely quiet and inward… pale, ghostly quiet… I have seen this before… before a couple of his anaphylactic reactions… I didn’t like this… I asked if he was ok over and over. Even though he was looking right at me, he wasn’t really answering. The nurse checked his breathing, all fine, no wheezing, no change… Strange… Oliver do you feel ok? No… my throat feels like it’s closing. I can’t swallow. He is dribbling and I asked if it hurt when he swallowed. Shaking his head, he says no. Do you feel sick? No… I don’t know… I feel strange… Clasping his throat. He says it’s strange, it’s closing. I hate this… I have been here before… I feel so bad for him… The nurse gets the doctor, they give his a dose of Zyrtec (anti-histamine) and we wait and monitor. As there are no hives, no breathing difficulties associated, no visible swelling, we wait and monoitor for any changes or worsening of his symptoms to see if it might develop into anyphylaxis. We are not testing to see if Oliver is anaphylactic to baked egg the nurse explains… we are only testing to see that he can tolerate baked egg… This is already enough to see that he cannot tolerate baked egg… the challenge will be stopped…

Oliver food challenge not feeling so good

On one side we are releaved that this is over, on the other very dissappointed… Oliver’s symptoms eventually subside after what seems like a long time but probably not… and his personality slowly comes back. I feel we escaped the anaphylactic bullet… we spend an hour just sitting waiting for Oliver to feel better… We need to then go for a bit of a walk around to see if Oliver can tolerate movement before we can leave… Oliver walks for not very long and he complains of a very bad stomach ache. I look at his stomach and it’s extremely distended and bloated. Do you need to go to the toilet, I ask? No, but it’s really sore. We go back to the nurse and explain. She asks us to sit and take it easy again. Oliver gets worse and has a big vomit. Poor thing, he is feeling rotten. I feel rotten. But the doctor and nurse are happy that the egg is probably now out of his system. We take it easy for a while longer to make sure that Oliver is recovering and then we are allowed to go home…

What a day!!! A day full of many challenges and not just a baked egg challenge… a day full of challenges for all of us… the doctor explains that this can sometimes happen… we are in the best place to challenge this… we should have another SPT in 1 year – 18 months and they would use the results from his current egg SPT and his ovomucoid SPT in comparison to those then taken at the time and work out if he would be a candidate for a rechallenge… at this stage it is the furtherest thing from our minds but on the other hand we are happy that this is not the end… that we might have another chance… we can only hope… as humans we live in hope… on the positive side for all of you reading this… the research is indicating that this can be done and that this can help in the growing out of a severe egg allergy. Also we were across from a young girl that was 6 years old that had passed her baked egg challenge the year before and was back having a raw egg challenge and she was passing that with flying colours!! So even though our day didn’t end the way we had hoped for… we hope that yours does…

As I’ve said before… I often try and calm my emotions to Oliver’s as he is sometimes more in control of his than am I… the day after the challenge was no different… With a very bad headache I asked Oliver how he was feeling? I feel fine mum, no different to any other day. Ok, that’s great… so you don’t have a stomach ache, a tickling throat, a sore throat? No mum, like I never did the challenge… Great! I said… Ok so… how do you feel that the challenge didn’t work? Well mum… I feel that we tried… it didn’t work… and now things are back to the way they always were… Oliver said matter of factly… I actually am kind of glad that it didn’t work… as I really didn’t like the taste of the muffin, he said…. LOL!! You have to laugh!! What a special boy and everyday I am learning so much from him xx

 

One Reply to “Oliver’s Baked Egg Challenge”

  1. Hi Simone, Hi Oliver
    Grosse Achtung dass ihr das Eier – Experiment versucht habt.
    Ich habe Deinen Bericht das erste Mal gelesen bevor ich zu Bett gegeangen bin. Er hat mich ziemlich aufgewühlt. Und meine Gedanken waren noch lange bei euch bevor ich einschlafen konnte. Liebe Simone ich glaube ich kann Dein Wechselbad der Gefühle nachvollziehen. Es braucht eine grosse Überwindung seinem Kind etwas zum Essen zu geben wovon man weiss dass es bei ihm eine negative Reaktion auslösen kann. Ihr wahrt ja wenigsten in guten Händen und wusstet dass Oliver jederzeit professionell geholfen werden konnte.Trotzdem liegen die Nerven blank. Tapferer Oliver, dass Du diese Herausforderung angenommen hast. Zweimal ging es ja gut mit der Dosierung des Muffinsstückes. Beim dritten leider nicht mehr. Schade dass es dir. danach schlecht ging. Hauptsache ist, dass jetzt wieder alles in Ordnung ist. Und Du hast den Mut gehabt das Experiment auszuprobieren. Ich bewundere Dich und Deine Mami wie ihr mit der schwierigen Situation umgeht. In ein bis eineinhalb Jahren könnt ihr ja vielleicht nochmals einen Versuch wagen. Aber bis dahin wünsche ich Dir wenig, am liebsten natürlich keine Reaktionen auf irgendwelche Esswaren oder andere Reizstoffe. Ich schliesse Dich vom anderen Ende der Welt, sinnbildlich herzlichst in meine Arme.
    Wir schicken euch und Lukas und Papi unsere herzlichsten Grüsse. Ich habe gehört, dass ihr bald zum Skiurlaub in die Berge fährt. Da könnt ihr euch hoffentlich entspannen und allen Stresshinter euch lassen. Ich wünsche euch alles Gute und Liebe. Omi,Opi, Erika, Max, Mami und Papi

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