You give me allergy!

A few years ago Tim had to go to Italy for work, and I joined him afterwards for a vacation. As we were on a tour bus full of Italians headed for the coast, I was idly listening to a rather hackneyed love song in English when the singer warbled, "You give me ecstasy! You give me fantasy! You give me allergy!!" Talk about trying a little too hard to rhyme!

I don't know if Esther has ever fantasized about lentils, but unfortunately, we confirmed today, she is allergic to them. We really like dahl (an Indian dish with lentils and yummy spices), and eat it often. We have been giving it to Esther since she was about 11 months, and she had liked it a lot until recently, when she started not eating very much of it when I served it to her. (Now I wonder if her sudden loss of interest was because her mouth was itching.) Then the last two times I served it to her, I noticed hives around her mouth shortly afterwards. They went away quickly, but I called her doctor, who referred us to an allergist.

So this morning I held Esther down on her tummy on an examining table while a nurse pricked her 17 times with various possible allergenic substances (eight nuts plus all the ingredients in dahl) and Esther bawled and arched her back and tried to get away. Two of the pricks were for control purposes: a histamine (which anyone should have an allergic reaction to) and saline solution (which shouldn't provoke a reaction in anybody). Interestingly, Esther's skin reaction to the histamine was smaller than average, to the point that the nurse commented on it and asked us if she had taken any antihistamine recently (she hadn't). Her reaction to the lentils was the same as her reaction to the histamine, and she also had a modest--but not quite definitively allergic--reaction to the cardamom. Everything else checked out negative, even the peanuts, which apparently can be cross-reactive with lentils. When the doctor came in to look at the results, she told us to keep Esther away from lentils and cardamom, gave us a prescription for epipen jr. and instructions on how to use it, and ordered a blood test (RAST) for the entire legume family so we can find out if Esther has any allergies related to her lentil allergy. She thinks that Esther may grow out of her allergy, but wants to re-test her next year, and if she has a smaller reaction then they will do a food challenge. Esther tolerated having her blood drawn pretty well--I pointed out the blood spurting into the collection tube in an enthusiastic, what-a-lucky-girl-you-are-to-get-to-see-THIS! tone of voice, and after that our main problem was not that she was traumatized by the needle but that she wanted to grab the tube. On the whole, I think Tim was more traumatized by the visit than Esther was. It's hard for daddies to watch their little girls being hurt!

So, now I have to go fill an epipen prescription. (For anyone who doesn't know, epipen is a syringe of epinephrin that can be easily injected by a layperson into someone having an anaphylactic reaction such as severe difficulty breathing or a dangerous drop in blood pressure.) On the one hand, I'll feel safer for having it. On the other hand, it brings me closer than I'd like to a world where my child's life could be threatened by something as benign as a bite of food. Then there are the practical problems: making sure we carry it with us every time we go out (because who knows when Esther will put something random in her mouth!), making sure the staff in the church nursery know where it is and how to use it...it feels like overkill for something she almost certainly won't need, but the circumstances under which it's the most nuisance to have it with her are also the ones under which she's most likely to have to use it, if she ever does. (Lest I'm scaring anyone, the vast majority of food allergies are NOT life-threatening, Esther's two reactions so far have been not only mild but remarkably short-lived, and from her reaction to the skin test today, as well as the fact that she never scratched her hives or seemed to be aware of them, I'm guessing that for some reason she doesn't react strongly to allergens in general--so she's not at great risk for an anaphylactic reaction; it's just a precaution on the part of her doctor.)

Now we are going to become label-readers as well. Lentils, at least, should be easy to avoid--they're not super common in Western food, and I think they're typically a main ingredient of whatever dish they are in. Cardamom isn't super common either--but it's amazing how many store-bought foods have "spices" as one of the ingredients on the list. So I will either be avoiding those foods entirely, taking a risk on exposing Esther to a substance she may be developing an allergy to, or calling the manufacturer to find out exactly what they mean by "spices." Sigh. I do hope she grows out of these allergies!

On the bright side, now we can give her peanuts and tree nuts! I had asked the allergist to test those since we were there anyway, because now that I'm learning more about allergies I'm paranoid about giving Esther any potential allergen until she can talk and tell me if she's having invisible symptoms of a reaction (like itchy mouth). But that may be a year or two yet, and in the meantime her pediatrician has recommended high-calorie snacks (at her 18-month check-up on Friday she had nearly reached the 50th percentile in height, but is still below the 5th percentile in weight), and nut butters are a very healthy high-calorie food. So now we won't have to feed her ice-cream for every snack! ;-)

And I think I just heard Esther murmuring to herself in her crib, so I'd better go check and see if she's awake!

Linette