OIT & Me

VALENTINE’S DAY ❤️

We arrived in clinic and Dr A asked how I’d been since yesterday. I said that I was still feeling a little sicky and anxious so he said he wouldn’t tell me what my dose increase would be as he didn’t want me to panic! Great idea for me as I am an anxious person and the brain is so powerful…

The nurse came back with my dose. After weighing out 125mg and 175mg yesterday, I knew this looked considerably more but I tried not to think about it… took the dose and symptoms were mild tingling as normal. Luke thought maybe it was 250mg based on the size so we spent some time making predictions…we were both wrong!

They then observed me. I coughed once (I tend to do this nervous cough!) so the nurse came straight in and asked if I had a cough. I explained that I felt OK and she checked my vitals and all was OK! I do tend to clear my throat normally but obviously they’re listening out for symptoms!

After 30 mins, she then came in with another dose. This one looked considerably smaller and they called it a ‘top up’ dose as it is classed as the ‘same dose’ if taken within 1 hour of eachother. 2 little hives appeared on my lip but nothing else.

Dr A then returned after 30 mins and broke the news….he told me he had given me 400mg of peanut and then topped it up with another 200mg !!! 600MG of PEANUT, WHAT!?!?! 🥜 🥜 🥜 🥜 🥜 🥜

I was soooo shocked and couldn’t believe it! They then observed me for another 30 minutes and then dismissed us for lunch. I was so worried I was going to react so felt a little sick but was OK.

They also cleared me today for ‘may contain peanut’ products which is HUGE for me!

In the afternoon, I returned for my almond and macadamia challenge! They did this over the following doses:

• 50mg of each nut
• 150mg of each nut
• 300mg of each nut
• 750mg of each nut
• 1.5g of each nut
• 3g of each nut

I am pleased to report that I passed the challenge and can now eat almonds and macadamia nuts.

We then went for a lovely walk in Trillith before heading to Carrabbas Italian Grill for a yummy valentine’s meal 💓

Today, we headed to clinic and on arrival, the doctor said we’d be moving onto actual peanut pieces instead of the solution!! Ummm….WHAT!!!!!

I was really scared to give this a go but he didn’t give me much time to worry and before I knew it…I’d eaten 125mg of actual peanut pieces!

The nurse advised me to eat something crunchy beforehand to fill my teeth, then eat the pieces before washing it down with water. This worked well. Tingling in the mouth was the main symptom. They then observed me before starting my egg challenge! I also like to eat after taking the dose so I had some more crackers (dry!!)

So, the egg allergy is a weird one. I’d always eaten egg until I was around 21. I then had a mild reaction to an egg in Luke’s University kitchen where he’d cooked me a fried egg. It resolved with antihistamine but follow up testing showed positive skin prick test but negative blood. The doctor’s advice was to avoid. Since then I’ve avoided all egg (even in baked products) and opted to have the egg-free flu vaccine which is always a nightmare to get!

But we’ve always had our doubts whether it was a true allergy or whether there was cross contamination with peanuts!

Anyway, my skin and blood work here both came up negative so Dr A was happy to challenge it. He asked us to bring in scrambled egg which was made this morning by my very own Chef Luke.

We then started the challenge:

• 200mg
• 1000mg
• 3000mg
• 7000mg
• 15,000mg
• 30,000mg

No symptoms throughout and happy to say that I PASSED WAHOOO!!!

Amanda then showed us how to weigh the peanut pieces. She provided us with a jewelry scale, a calibration weight and a packet of…PEANUTS!!!

Amanda said that when we weigh the peanuts they can be 10mg under or over my specific dose but no more or less. This is very strict!

The doctor then wanted me to dose 175mg before I left for the day so off I went to weigh my own nuts. I’ve never ever ever touched a peanut before and the skin is the last thing to desensitise so I was given gloves to wear. I was even scared to inhale the smell of them after so many years of avoiding anyone who opens peanuts!

I was then observed and vitals checked before being dismissed for the day! Symptoms with the 175mg dose were tingling and a hive on my lip.

We then went for an evening walk and watched the sunset which was just stunning! 🌇

Back to clinic in the morning!

The bed in this apartment is so cosy that it makes getting up early a challenge! We were quite tired from our late night at the aquarium so woke a little later.

I then ate my porridge and dosed the 70mg – I managed to take it as a full dose today instead of splitting and with minimal side effects – small amount of tingling and some burping after the dose.

We then headed out to Line Creek Nature Reserve for a short walk. It was quite cold today but we had a lovely walk through the forestry and it was fab to get some fresh air. The scenery in peachtree is lovely even with grey skies!

I then had lunched and did a half dose (35mg) around 5pm. I decided to just do the half because I’ve been getting the reflux symptoms this weekend and didn’t want to push myself too much. Thankfully, the earlier dosing seemed to work better. I felt a little nauseous but nowhere near the level of heartburn that I’d had preciously (but I hadn’t taken the full dose so who knows!).

I’m back at clinic bright and early tomorrow and we are doing my egg challenge. 🥚 We’ve been asked to take in scrambled egg so Luke is going to cook them up in the morning. I’m really hoping I pass this challenge as it will certainly open up lots more options for me 🤞! Then Dr A will hopefully go through the plan for the next two weeks for the peanut dosing and whether I need to slow down or stick at my current pace.

Now we’re currently watching the Superbowl! Luke is sad though because the 49ers didn’t make it. Anyway, I’m looking forward to the half time show. 😀

We had a quiet morning and then I took my 70mg dose. Symptoms were as normal (tingling, itchy mouth). Heartburn wasn’t as bad as last night but have been feeling a bit of acid reflux today so decided to just do the one dose as didn’t want to push my body too much. I’ve connected with some OIT friends and it seems that burping, heartburn etc is quite common when your body is adjusting. Hopefully it isn’t too much of a barrier!

We then spent the afternoon at the aquarium as the weather has been crazy today – very wet and windy! So we decided to get out of the hotel and do something inside. The traffic into Atlanta was insane but the Hawks were playing so that was to be expected.

We saw some beautiful sea creatures at the aquarium but did feel it was quite overpriced – $48 per person and $12 for parking. Nevertheless, we had a lovely few hours and I tried to ignore the annoying acid reflux symptoms.

I’ll be back at clinic on Monday so will see what they suggest with these new symptoms. 🤞

This morning, I dosed 70mg split into two 35mg doses 10 minutes apart. This is because we only have the small syringe (I forgot to get a bigger one from the clinic!). Minor tingling and itchy throat which felt fine.

I was nervous today as I had to do two of the 70mg doses which seemed a lot! I thought about it too much over the course of the day and got myself into a bit of a frenzy!

This evening, I decided to just dose the 35mg because I had quite an itchy throat after the first dose along with some heartburn so it freaked me out! Decided not to dose the last 35mg to err on the side of caution.

I spoke to Nurse Amanda and she said that cortisol levels are lower in an evening which could be why I’m experiencing more symptoms when dosing at night. I said in a previous blog that I much prefer dosing in a morning so this could be the reason. She recommended that I try dosing earlier which I think is a good shout!

I feel like a bit of a failure for not taking the 2 x 70mg today but I think I got myself too worked up about it and then when it came to it, my body was like hey, no thank you!!

The mental battle is just as hard as overcoming the physical barrier of eating your allergen so I’m being kind to myself 🩷

We go again tomorrow 💪

Today, was another updose day at the clinic!

They administered the 35mg dose and then waited 15 minutes and administer the next 35mg. Again, usual symptoms – tingling, itchy mouth and a small hive on my lip.

I was then sent for more labs. This is to check how my body is responding to the peanut solution and whether antibodies are being created. Dr A will examine my new levels when they come in and then set a plan for the next two weeks.

After clinic and bloods, before heading home, we popped into the Commemorative Airforce Museum. We had the most incredible ex-pilot showing us around. Definitely recommend a short stop by!

Tomorrow’s dosing is 70mg morning and evening. 🤞

Slept sooo much better last night which was well-needed. Had a big breakfast to line my stomach then dosed the 25mg – it’s so yellow and you can actually see the peanut flour really visibly now! Again, same symptoms of tongue tingling and itchy throat.

We then headed for a short walk in between dosing and found a beautiful waterfall which was just gorgeous. It was really warm today. It reached about 23/24 degrees celsius which is apparently quite unusual for Atlanta in February.

My new supplements also arrived: the digestive enzyme and the multivitamin. It is recommended that you take these to support your body through the process. I will need to buy a few more packs before we leave so I have plenty when we come home! The multivitamin and the digestive enzymes need to be taken with food so must remember this!

Also, I am pleased to report that the eczema cream Amanda prescribed yesterday has worked an absolute treat! Again, another product that isn’t available back in the UK so may need to stock up!

Evening dose of 25mg taken after a tummy full of homemade marinara pasta. It was delicious! Again same symptoms as this morning and a little hive on my lip. I’ve attached a picture 📸. They do disappear eventually though.

I woke up feeling a little sick this morning. The heating had been on in the night which made me feel really stuffy and I hadn’t slept well! Anyway, I had breakfast and dosed 18mg. We then had some quiet time post dose before heading to the clinic. Same symptoms as usual – tingling, itchy mouth.

When we got to clinic, Nurse Amanda said that we’d be doing the pecan and walnut challenge this morning. Again, these nuts are challenged together due to similar proteins.

This builds up from 50mg all the way to 3g with 15 minute observation periods between each dose. You have to eat every single piece of nut on the plate to consider the challenge passed (obviously with no symptoms).

Thankfully I had no symptoms throughout the challenge except the disgusting taste. Walnut tasted like dirt!

We then had an hour’s break from clinic and returned to start SLIT and updose the peanut solution.

SLIT stands for sublingual immunotherapy and Luke and I are both doing it for our environmental allergies.

With SLIT, there is a low risk of anaphylaxis and it is basically a solution which you spray under your tongue 2-3 times a day. Each person’s SLIT is made especially for their allergens so mine contains cat, dog, grass, trees, weeds, mold, alder, bermuda, dust mite etc.

Here’s us taking our first SLIT spray. We both really suffer with environmental allergies day-to-day (dust, pets etc) but also badly during pollen season. It is hoped that SLIT will effectively reduce symptoms when we come into contact with these allergens.

I then received my peanut updose – 25mg. The 7.5ml syringe was quite a lot so Amanda mixed me a new bottle which had a higher concentration of peanut – 50mg per 5ml. So I am currently taking 2.5ml.

When she walked in with the new solution, my first impression was ewww. It was soooo much more concentrated and is now a yellow colour!

I dosed 25mg in clinic and then was observed for an hour. Instructions to dose 25mg twice or three times tomorrow. It felt like the 25mg was a big increase but thankfully similar symptoms including a little lump on my lip. Also, have a little nausea but trying to distinguish between whether it is anxiety nausea or peanut nausea!

Amanda also gave me some cream for my eczema as the water here in Atlanta is making my skin super dry!

Saw some beautiful scenery and a little family of deers on our way home. 🏡 🦌

Monday morning quickly came around so back to clinic we go. No dosing this morning as they said they’d dose me in clinic!

When we arrived, the medical assistant went over my vitals and checked my weight again. She also discussed my symptoms over the weekend and make sure everything was recorded.

Amanda then came in and said that we’d be going up to 7.5ml today which equates to 18mg of peanut. 7.5ml means a bigger syringe! This felt like a lot of peanut solution. Thankfully, minor symptoms – tingling.

She then observed me before starting my tree nut challenge. We decided to start with Pistachio and Cashew. These were done as 1 challenge because they share similar allergenic proteins and if you’re allergic to one, you’re typically allergic to the other

We started at 75mg until we reached 3g and I am so pleased to report that…. I PASSED!!!!! Cleared to eat pistachios and cashews 🩷😄 taste – wasn’t fussed but they are plain, raw nuts with no roasting/salt etc!

The challenge took about an hour and half from start to finish and then Amanda gave me my second dose of peanut solution (18mg again). Again, itchy throat and a small hive on my lip. Then another observation period and vitals checked. I was getting tired by this point – the adrenaline of eating nuts sure makes you feel sleepy!

We were then sent home with instructions to dose another 7.5ml in the evening after dinner.

I was a little nervous for this one as I’d already eaten pistachios, cashews and had two doses today but thankfully, minor symptoms – tingling and itchy throat, small hive inside mouth. I definitely drank too much water with this dose though as felt bloated.

It’s been such a bright, sunny day today so I spent a lot of time admiring the views from the clinic window. 🌞

Need to try and find some breadsticks though, my UK supply is running out and these get me through dosing. Breadsticks in the US, anybody? My nurse hadn’t really seen them before but she did try one and enjoyed it. 😀

I messaged the nurse this morning to tell her about the corner of my eye swelling last night. I felt bad messaging her during her time off on a weekend but she was so responsive and kind!

Amanda was pleased that it had mostly gone down and thinks that I may have rubbed my eye after touching the peanut solution. Fun fact – your skin is the last thing to desensitise so you have to be really careful with touching any of the peanut solution! I haven’t been washing my hands after handling the syringe but will do so in future.

The lovely nurse Amanda also suggested that I take the peanut solution (12mg) in one dose today instead of splitting it. 5ml seemed a lot to take in one go but I said I’d give it a shot! The splitting of doses is great for making sure you’re ok after the first dose before the second dose 15-30 minute later but I do feel that it extends the anxiety window and it also means that you have to wait longer until your rest period is over!

It is important that you are calm 30 mins before the dose and for two hours after. This means that you can go about your daily routine but you should avoid hot baths, hot tubs, exercising etc. An increase in your heart rate and temperature can cause a reaction.

I had my lovely porridge oats again and then dosed soon after (always making sure my stomach is lined). I also tend to eat a cracker or a few breadsticks just to ensure I have enough carbs inside me!

Again, mild tingling and itchy throat but resolved with water – about 750ml!

We then got ready to explore the area for the afternoon. We’ve been quite sedimentary so fancied a long walk. We went back to the lake in Peachtree and had a great walk and enjoyed our packed lunch – it was only a salad 🥗 !

It seemed to be a typical Sunday at the lakes. Lots of families out in the park, people running, cycling and exploring using the golf carts! I love seeing the array of people using golf carts – from teens to sweet couples wearing blankets. Yes, people wrap up warm and it’s 18 degrees!

After our walk, we headed to somewhere called ‘The Avenue’ which has shops and restaurants. We did some window shopping and Luke grabbed a coffee and a cookie 🍪. We want to return here when we have a little more time.

I then made us a roast pork dinner when we got back to the apartment before taking my evening dose. It took me quite a while to dose after dinner because our apartment was sooo hot and my cheeks were really flushed from the cooking. Luke loves the aircon system so turned it on and this helped to cool me down!

Second dose of the day taken – again mild symptoms but throat more itchy than this morning.

There seems to be a trend. I think I prefer morning dosing to evening dosing. Whether that will continue, who knows but for now, the morning seems to suit my body more.

Monday tomorrow and returning to clinic. I’m actually looking forward to seeing the staff…they weirdly feel like our Atlanta family now 👪