Celebration, Tempered.

We've been doing a lot of celebrating around here since Brendan completed egg OIT.  I'm snapping pictures of him eating foods like he's an infant.  Everything is a first:

First pancakes in a restaurant,

 first donut from a store,

 first funnel cake,

 first churro!

Brendan has decided that he loves pretty much all baked goods.  Donuts are his favorite :).  He's not all that keen on straight eggs, although, if he had to choose, a ham and cheese omelette would be his favorite way to consume them!

 Our celebration has been tempered, though-- by the same problem we had while updosing: vomiting.

Brendan has been on egg OIT maintenance for just over three weeks, and he has had two episodes of vomiting during that time.  Both times, the vomiting has been within 45 minutes of taking his daily "dose" of one tablespoon of egg white powder.  He has never vomited from eating actual egg, just the "dose" of the powder.  There are some explanations as to why he may have vomited.  The first time, we gave him his dose in milk, which never seems to go well for us.  The second time, he was on an antibiotic that can make you nauseous, so he could have vomited from the antibiotic (which we gave about 30 minutes before his dose).

However, after the second episode, the doctor on call decided that we should order a CBC (complete blood count) and check Brendan's eosinophil levels compared to when he started OIT.  There is a rare complication that can develop during OIT, for between 2-5% of kids, called Eosinophilic Esophagitis (EoE for short).  Symptoms can include vomiting, but usually the vomiting from EoE happens well after the child ingests the allergen, not within 45 minutes of eating the offending food like Brendan's vomiting happens.  EoE is a different kind of allergic reaction in the esophagus and/or gut, caused by white blood cells called eosinophils.

The total eosinophil level found in the CBC, while not an actual test for the disease, can be an indicator of whether or not the disease may be present.  The only way to actually test for the disease is to do a scope of the esophagus and take a biopsy.  If the CBC shows a significant rise in total eosinophil levels when comparing them to before we started OIT, Brendan may have eosinophilic esophagitis, which makes it very difficult (but not entirely impossible) to continue with OIT.

We had the blood drawn on Tuesday afternoon, and I waited on pins and needles.  We continued with his daily doses, and kept baked goods in his diet, but we stopped giving him straight eggs until we got the results back.  We also stopped the antibiotic, since that may have caused his second episode of vomiting (the antibiotic was for a face rash, so not any life-threatening infection!).

On Friday afternoon, I got the results.  Brendan's eosinophils are a bit higher than when we began OIT, but the are not high enough to be an immediate concern for EoE. So, as long as Brendan continues not to have symptoms with his dosing, then we are free to eat eggs again, and we are free to continue our celebration.  On Friday afternoon, we celebrated with a reindeer brownie snack!

 We have switched Brendan's dosing to the morning, since he has never vomited from a morning dose, and we will figure out how to cure the face rash later.  We are hopeful that these changes will keep Brendan from vomiting his dose, and that in a few months, we can say with certainty that we've kicked this egg allergy in the behind!  For now, our egg celebration continues, tempered by Brendan's struggles, but a celebration none-the-less.