One year ago, after a whole lot of pushing, we were given a referral to the SickKids Allergy Clinic. Three months ago, our son had a successful oral food challenge to almonds, and I cried happy tears in the clinic waiting room. Could this mean he's outgrowing all his tree nut allergies? Could this mean the end of the food worry, the constant fears, the ongoing education of every single person who cares for our son when we're not around? The idea of living food-allergy-free seems like a dream at this point, but that one little test at SickKids gave us hope.
Without that clinic, our son wouldn't have had the chance to be cleared of his almond allergy. Since having positive skin tests, we were told to avoid almonds, period. I slipped up once and gave him a glass of almond milk, with no reaction, but still, his allergist declared him allergic and emphasized the need to be more diligent. Since our son had a multitude of reactions as an infant, and confirmed food allergies, we were instructed to avoid introducing tree nuts and peanuts, under the assumption he was allergic.
But was he? Was he ever actually allergic?
Skin tests are only about 50% accurate when they are positive, so how could we rely solely on those? Our allergist said that the size of his reactions were a good indicator of the severity of a potential reaction if he ever ate the foods, so naturally, we avoided them for the last 6.5 years. And that brings us to today. After being cleared of his almond allergy, the SickKids allergy clinic sent us home with instructions to continue to introduce tree nuts to him. It's terrifying. Despite having no real reason to suspect he's allergic, I'm terrified every time we introduce something new. We've done walnuts and cashews so far without incident, but I am still so nervous to move forward without a team of doctors at my side.
This is why the work being done at SickKids is so important. They're learning so much about allergies, and trying to disseminate that to the allergy community as best they can, so allergists know when to refer for oral food challenges, and how to instruct parents on introduction of potentially allergic foods. Guidelines have changed so much since my son was a baby!
I had another opportunity to speak with Dr. Adelle Atkinson of SickKids, and got the low-down on a number of studies being done there. Their goal is simple: To cure allergies once and for all. Sure, it's a lofty one, but they've already made huge advancements in understanding allergies and clearing kids of them! Constant clinical, educational, and research work is being done in an effort to tailor allergy management plans for each patient and identify with accuracy, just how severe reactions could be. Wouldn't that alleviate so much stress? I mean, would a reaction be hives or anaphylaxis? It would be so nice to be able to predict that with accuracy instead of assuming death is looming at every meal.
Dr. Atkinson excitedly speaks of the studies being done, as she knows firsthand how amazing it is to "de-label" these kids. She's an allergy parent, too, so she understands the stress involved. She told me about the baked milk and egg studies challenges being done, to help kids get have access to more food choices as well as potentially outgrow their allergy more quickly! Imagine the impact this can have on a child's life?
"It's a great time to be in this field," Dr. Atkinson said. So many advancements and positive studies means a reduction in allergy diagnoses, and that's good for everyone. The challenge now is to disseminate the information to allergists other physicians and patients.
There are desensitization studies, and studies looking at the connection between immunosuppressant use and allergies. There's even a study looking into some cases where solid organ liver transplant recipients suddenly have allergies they never had before. The advancements are coming, and real answers are in the very near future thanks to the work being done there.
Wait times are long, that's true, but thanks to streamlining their system, the team at the SickKids Allergy Clinic has already reduced waits by over 4 months (it speaks volumes that after our son's almond challenge, we got an appointment for a peanut challenge a mere 4 months later!). They have dedicated oral food challenge days, and expedite infant appointments to reduce the chance of kids being labelled incorrectly from the start. That alone could have changed our son's path. What if he was never allergic to almonds, cashews and walnuts at all? We'll never really know, I guess.
Our son's peanut challenge was bumped up to August 23 because of a patient cancellation, so the wait was even shorter. (Stay tuned for the results of that, coming soon!)
I can't tell you how happy I am to live within a reasonable distance to the clinic, but everyone in the allergy community worldwide will benefit from the work being done there, of that I have no doubt."