BCH Allergist

Today we had Layla's appointment up at Boston Children's Hospital with an allergist per Dr. Verhave's request.  (Her GI Dr.)  We met with Dr. Lee for the first time and he was wonderful.  We discussed all of Layla's history and he did some more skin testing on her.  If you remember previously Layla showes allergies to peanut, soy, milk and oats.  This time he also tested her for tree nuts and retested her for milk and soy.  The tree nut was positive and the milk and soy were fine.  However, he did say not to introduce milk or soy back into her diet because her reaction could be different than that of a skin test.  For example, when we give Layla ice cream, it's on those nights she is up all night with a belly ache.  Or when we have tried to re-introduce milk, she'll get a terrible bout of diarrhea and stomach cramps.  So for now we are staying away from these foods.  So pretty much the only new thing we have learned thus far is not only is Layla severely allergic to peanut, she is also allergic to tree nuts (walnut, almonds, etc..)

When speaking with Dr. Lee, I told him that our general rule of practice with Layla is that we will give her a product if the box says, "Manufactured in a facility that processes food with peanuts" and that we keep her away from food where the box will read, "May contain nuts, peanuts, etc.".  Much to my suprise, Dr. Lee said that although this was a reasonable assumption to make, that we were playing Russian Roulet with this assumption.  Apparently, through studies it is found that foods that say "Manufactured in a facility that processes food with peanuts"  have been known to have a higher concentration of peanut in them.  SCARY!  Some may have none at all and some may have a high concentration and you just dont and wont know which is which.  So from this point forward, we are to eliminate all foods that have anything or say anything at all about peanuts and tree nuts.  Tough part being that unless you have a child that has a nut allergy, you simply cannot imagine the number of foods that contain nuts!  Many times they are foods that you would never even think would contain nuts.  Jelly Beans for example!  She is only 2 and I am hoping that as she gets older this part will get easier for her and that we will find alternative foods for her so that she doesnt feel left out.  Especially since her big sister gets to eat everything!

Next on our agenda is to get her re-scoped as soon as possiblle to see if the esophogus irritation has improved.  If it has, then it will be a safe assumption that Layla's issues are due to reflux and keeping her on the prevacid will be the treatment.  If there is still irritation, then we are going to have to assume that the reflux is due to an allergy process and she will be diagnosed with EE (eosinophilic esophagitis).  If this is the case, then she will have to undergo an extensive amount of allergy testing to determine which food or foods are causing the allergic reaction in her esophogus.  I have heard that this can be a tedius task, but I have faith if this is the route we are headed in, then we will figure it out.

All of this being said, Layla is doing exceptionally well.  She has a few tough bouts with RSV and has had to be put on a nebulizer, but aside from that she is sleeping better and eating better and all in all just acting better.  At her last weight check, she had the biggest increase since she was a baby.  All of this wonderful news and we are so very grateful!  She ruled the roost today and got the attention of practically everyone in the hospital as she pranced around in her purple tu-tu.  This has come to be her daily attire as she will not leave home without it!  (She is 100% girly girl!)  She held up really well during the skin testing (much better than the previous time) and is currently napping peacefully on the couch! 

Thanks everyone for thinking of us!  All of our love and please continue to keep the Marsh family in your prayers!