Oh, it finally happened! She's done! She graduated Peanut Oral Immunotherapy!
And now some explanation, of what exactly happened today, and what that means for us now.
WHAT HAPPENED FOR THE GRADUATION:
Well, clinically, nothing too out of the ordinary. We've been coming to the clinic each week on Wednesdays to escalate her dose. This was pretty much just like those, except for the notable fact that this was the last one of the weekly visits. That, and the fact that she's never eaten so many peanuts in her life at one time before, and she did just fine. The "graduation" dose was 24 peanuts. Being a four-year-old, she takes her time eating, and it's a lot faster when it's in the form of something other than a plain ol' peanut, so she actually had the equivalent of 24 peanuts in peanut M&M's (all yellow as that's her favorite), two plain peanuts, and peanut butter.
She ate it. We waited. No reaction as usual. Graduation.
That's it.
The postscript and gee-whiz on that story is that Dr. Jones told us that our girl was probably the youngest patient he's had graduate from peanut OIT (He's had younger patients graduate from other allergy treatments -- Milk, egg, etc., but not peanut). She just recently turned four years old, for future reference.
And as niceties, at graduation, she was awarded with a graduation certificate and some free kids meals at Texas Roadhouse (which notably is probably the one restaurant that is the farthest from peanut-free you can get as you may have noticed).
WHAT DOES THIS MEAN FOR US NOW?
Well, the biggest and best change is that she's now free to eat peanuts! We don't have to check food labels for peanut contamination or peanut ingredients. We don't have to worry that some kind sharing 4-year-old is going to share something with her that will be fatal. Heck, if someone is having a snickers bar, she can have some too.
And best of all, we don't have to worry about her safety from hour-to-hour and we don't have to always be anxious about if she's safe or not.
THAT is a good feeling, my friends.
Now... a couple of caveats. :) Yeah, yeah, it's not all fluffy clouds, daisies and marshmallows... (but it's pretty darn close...). Here's how it goes for us from this point. She will need to take a maintenance dose of 8 peanuts (or equivalent) morning and night for 6 months. After that, I believe she switches to a final maintenance dose of 8 peanuts per day just once per day. In a while, we will be taking her to get some labs drawn, and I'll post the "before and after" numbers for those of you who are interested. I'm not sure what to expect from the lab numbers. If I remember right, I think Dr. Jones says the IgE levels raise with this, but I really don't know if that's just an initial raise when the treatment is started and then they drop again? I just don't know. And frankly, I don't really care. Whatever the lab work says, it doesn't change the fact that she can eat them by the handful now and handle it just fine. I do remember Dr. Jones talking to us at the beginning of this treatment telling us that he had seen a bunch of times when a patient's peanut IgE level were sky-high, off-the-charts, and the person was eating peanuts by the handful no problem. That's what matters, after all.
Further caveats: I don't know how long this lasts, but yes, we've been told to still keep her epi-pen with her just in case. Frankly, even if he didn't tell us to do that, I'd probably still want to do it. It can't hurt, and it might help. So yes, she'll still have that little accessory tagging along with her.
But ladies and gents -- she's safe. That's why we started this thing. That's why we researched this thing up and down to see what we could find in the medical literature about it, and made the resolute decision that we were going to pursue this.
A big thank you to the many friends/neighbors/family members who have helped us do this. Thank you to my sister Christa for alerting us to the existence of this clinic in the first place. Thanks to you who made an extra effort to have only peanut-free foods at social/family events before we started. Thank you SO MUCH to the friends/neighbors/family who watched our baby while Katie took our 3-4 year old to do these treatments every week. And of course, a huge thank you do Dr. Jones and his staff at Rocky Mountain Allergy for making this still very rare chance available to his patients. It's a risk for them to be breaking the common allergy/immunology clinic inertia, going very much directly against the mainstream medical train of thought with these patients who have severe allergies. They are daring to actually *treat* the condition and not just collect patient fees, tell patients to avoid peanuts, and then blame noncompliance with the treatment when "strict avoidance" doesn't turn out to work in a world filled with peanut products.
It should also be noted that the shirt she wore today -- her choice. Not ours. :)
