Second Double Blind Food Challenge

0.1 milligrams of mystery nut flour

mixing 

AP U.S History all day, every day... 

6 milligrams of mystery nut flour

(where I reacted during my first challenge)

Filling out a dose escalation sheet

Some questions they ask me after each dose about my eyes, nose, throat, stomach, etc 

On January 10th, I had my second double blind challenge. This time, it went a lot more smoothly and I had no reaction. The method for escalating my doses was as follows (the same dose escalation I experience at every double blind challenge): 

0.1 milligrams at 9:00 am - no reaction

1.6 milligrams at 9:15 am - no reaction

6 milligrams at 9:45 am - no reaction 

25 milligrams at 10:30 am - no reaction

50 milligrams at 11:30 am - no reaction

100 milligrams at 12:30 pm - no reaction 

12:30 pm - 2:30 pm - observation, no reaction 

By the end of the day I had ingested 100 milligrams of mystery nut flour or placebo. I'm guessing this was the placebo. I'll find out during my last challenge which is this Tuesday the 24th. 

First Double Blind Food Challenge

                                         

                          Scratch testing for walnut, peanut, almond, cashew,

                          pinenut, and a control.

                          Peanuts beginning to react... one of the most uncomfortable
                          things ever, and so itchy.

Trying to distract myself with Tumblr, as usual. 

                              Transferring the ink outlines (drawn around each reaction)
                              on my back to paper as proof of what I reacted to.

Blood draw! So fun. 

0.1 milligrams of mystery nut flour, mixed into applesauce

                                   
My first double blind challenge began after the staff compared which allergens I was most topically sensitive to previous blood work results. As we could predict from my life thus far, peanuts were the most reactive. Though I had never had a real problem with other tree nuts, because cashews are close in their genetic makeup to peanuts, Dr. Nadeau and her team decided to add cashews to my therapy as well.

The term "double blind" means that neither the doctors, nurses or the patients know exactly which nut flour I'll be eating on that particular day. The lab technician prepares a concoction consisting of rice flour and whichever nut flour I'll be tested for mixed into either chocolate pudding or apple sauce. Rumor had it the apple sauce masked the taste better, so I opted for that.

Before I can actually start the desensitization therapy, I have to go through three of these double blind challenges. One for peanuts, one for cashews, and one placebo (in which I'll just be ingesting rice flour). This is to eliminate any possible psychological reaction to knowing what I'm eating. The double blinds will help set my initial threshold level, or the minimum amount of nut flour I can eat before I have a reaction. Later when the desensitization therapy begins, this is the dose on which I will start to build my tolerance. Doctors started with 0.1 milligram, increased to 1.6 milligrams after 15 minutes when they were sure I was not reacting, and then moved to 6 milligrams after another 30 minutes.

Shortly after my third dose however, I started feeling not so great. It wasn't exactly sharp pains in my stomach, but I was just uncomfortable. The doctors noticed a change in my complexion as well, and that was when they halted the challenge. I was given Zyrtec and Pepcid, both antihistamines to make sure the reaction didn't escalate. After being kept for observation for another couple of hours, I finally went home after a 6 hour day at Stanford Hospital.

If I had to guess, I would say that this challenge was probably peanuts. Everybody will be "unblinded" after the third challenge, so we'll see if I'm right.

The Beginning

My name is Lauren, and I am currently a 16 year old junior in high school. As someone who has suffered from severe food allergies to peanuts and other legumes, I jumped at the chance to be a part of an experimental treatment that will be a life changing experience for me and others participating in the study. 

Living with food allergies is a lot like playing a game of Russian Roulette every time you eat. No matter how careful  I am, or how many precautions I take, there is always a chance of accidentally ingesting something that could kill me. Going to restaurants entails a series of interrogations: Does the waiter understand the severity of the problem? Will they accurately convey my concerns to the kitchen staff? Will they understand how to accurately read ingredient lists and allergen warnings? 

Sharing someone's drink is completely off limits. That Reese's Peanut Butter Cup they ate 3 hours ago? Peanut protein is still viable in their saliva. 

But in just 6 months, all the hassle, all the fear, all the anxiety won't be a part of my life anymore. In just 6 months,  all the things everyone gets to take for granted, like where or what they eat, I'll be able to take for granted too. Through the efforts of Stanford Alliance for Food Allergy Research (SAFAR) under the leadership of Kari Nadeau, MD, PHD at Stanford University, I will be able to tolerate 4000 or more milligrams of peanuts. The average peanut is about 240 milligrams, while I begin to react at 6, equivalent to only a few grains of sand. 

This blog will be dedicated to my experiences throughout this study.