Wednesday, October 27, 2010

An Allergic Reaction, But From What?

Sunday morning was Londo's turn to sleep in. I had a great morning with the kids and fixed them a breakfast of eggs and toast. In fact, I thought I was doing awesome because I staved off a tantrum over the toast with some quick thinking.

The Pumpkin had requested regular toast with jelly, so I fixed it just the way she likes it and put some homemade strawberry jelly from my MIL on top. After a couple bites, all of a sudden the Pumpkin said she wanted toast with just butter. She was about to freak out about it (ah, Three-And-A-Half, you don't make things easy), when I offered to give her the cinnamon raisin toast with butter I was just fixing for myself. Well, that would do nicely! And tantrum averted!

At the end of breakfast, I saw a couple red spots on my daughter's face. The Pumpkin has sensitive skin, so she is always getting odd bumps and spots of eczema and the recent impetigo and whatever else. So I looked at it as I wiped her off and thought I'd keep my eye on them.

Within 10 or 15 minutes, the spots looked bigger, redder, worse. I called her over from playing and examined them again. That's when I noticed a more blister-like appearance. Like a lightbulb came on, I realized they were hives. It must have been an allergic reaction, and the only thing she is allergic to (that we know of) is peanuts.

I wasn't sure how to react. I kept my eye on it for another 5 or 10 minutes. During that time, I proceeded to go through everything she ate or touched that morning. She's had eggs for years, cooked the same way, with salt and pepper, and it's never been a problem. The regular bread is the same one I make her sandwiches on every day with no problems. The jelly? The one that she said she wanted and then pushed away after two bites? Hmmm. Was that the same jelly that we've had before finding out about her peanut allergy? Was that the same jelly I used to use for PBJs? I have no idea. While it didn't seem likely, I couldn't rule it out entirely. What else had she touched? Just the same toys she'd been playing with since yesterday.

What on earth could have caused the hives? Where were the peanuts hiding? How could she have come into contact and/or ingested peanuts?

The hives started to look like they were fading. I realized I needed to wake up Londo. I wanted to be sure he saw what I saw before they were gone (we debated for a year over our perceptions of what happened when the Pumpkin first tried a little bit of peanut butter). And I needed my co-parent to talk through what happened and what we should do.

Londo and I started talking through what it could have been and what we should do (and I should have done). He threw out the jelly, just in case it had been contaminated. But he also pointed out that we just brought a bunch of unsafe candy into the house from the the trunk-or-treat the kids did at the Pookie's daycare. Although we didn't have any candy with actual peanuts in it(aside from plain M&Ms), there were candies manufactured in places that also have peanuts and there were a couple from a bowl that also had packaged peanut butter cups.

But she had been playing with all that stuff the day before with no reaction. And that morning, she hadn't gone near any of it! In fact, I had put all the candy up in a cabinet so she wouldn't ask for candy for breakfast (like she had the day before). Could it really have been from touching something like a counter that had touched some candy that was made in a place that also had peanuts? And then when she ate breakfast, she got some little remnant in her mouth? Really?

She was fine, and the hives went away after an hour or so, definitely within two hours. She didn't need the epipen, but it occurred to me after the fact that I should have at the very least given her benedryl as soon as I realized they were hives. I don't know about giving her the epipen, and I think I need to talk to the allergist. If her reaction was just hives, I don't want to freak her out by stabbing her in the leg with a needle. She was breathing fine and didn't say her throat felt funny, even when I asked. But I should have given her the benedryl. And woken Londo sooner.

This experience has freaked us out a bit.

On the bright side, her reaction was minor. A couple of hives? That's not bad. If that's her reaction to being exposed to peanuts, maybe we don't have to worry as much as we have been.

However, what we've learned about peanut allergies is that it's basically russian roulette with reactions. With one additional exposure, she could have an anaphylactic reaction. It doesn't necessarily have to be progressively worse reactions over many exposures. So, we still need to be hyper-vigilant.

And on the really-freaking-me-out side, even though it was a minor reaction, her exposure to peanuts must have been a really really tiny exposure through some cross-contamination because nothing she ate or was around had actual peanuts in it. We haven't had any peanuts or peanut products in our house in over 6 months. There are very few things in the house that are even made in facilities that also have peanuts, and those aren't things that she eats or even goes near.

We've been careful. So careful! And still, she somehow was exposed to something that caused the hives. Some tiny, unseen bit of a peanut. Some unaccounted for cross-contamination in my own house! My house that is supposed to be a safe haven for her!

This is making Londo and me really worried about the upcoming trick-or-treating. I thought we had a good plan in place, but now I don't know what to think. All I know for sure is that we will be extra vigilant and carry her epipen with us where ever we go. There's no telling what her next reaction will be... or what will cause the reaction.

14 comments:

Cloud said...

I don't know if this will make it worse or better... but it could have been something other than peanuts. I once broke out in hives for almost a month before I finally figured out that it was the new dryer sheets I had used. Did you change brands of wipes, soap or anything like that? It is really frustrating because it is next to impossible to get ingredients lists for some of these products. We just don't use dryer sheets anymore.

You are doing a great job handling Pumpkin's allergy. Don't beat yourself up too much over this incident!

Jac said...

We've recently had an asthma diagnosis for my son. It's been a long process which came to a head a few weeks ago with a middle of the night blue lip episode. My husband was away and when this happened I sat DS up, calmed him down, and it got better quickly. I took him to the doctor first thing in the morning and we finally got some meds for him. After it happened, I started seriously beating myself up about it. Why didn't I call 911, especially since I was alone with him and really had no idea what to do? If any friend of mine told me their kids lips were turning blue I would immediately tell them to call 911. Anyway, my doctor made me feel much better about it - she said mums know, on a gut level, when things are emergencies or not and the fact that DS recovered really quickly once I intervened bears this out. So, while there may have been additional things you COULD have done, on some level your mommy radar was probably telling you that although this was an allergic reaction, it wasn't an emergency and the end result proved your instincts were correct. I don't think we can overestimate mommy instincts. Don't beat yourself up (easier said than done, I know!)

Anonymous said...

One thing that some allergy parents do is to "seed' the trick or treating houses with safe treats. You could go to your neighbors with safe treats in sealed baggies and ask that they put them aside for when you arrive. You can then open the baggie and dump it out in to her bag and discard the baggie before you get home.

Good luck! Allergies suck.

Melba said...

Yeah, there's other things that cause hives... but man, I'd be leaning towards trace amounts of peanuts in SOMETHING, you know? Even if that doesn't make sense or is really unlikely, if it were my daughter with a peanut allergy that would be my hunch. Can't say why. Maybe my glass is half empty?

Could it be the raisin bread you made for yourself that she doesn't normally eat? I don't know about the US, but in Canada very few things are labelled as being "made in a nut free facility". I've seen it on maybe one or two things like cookies or candy. Never on bread or anything else like that. Seems like a facility that makes cinammon raisin bread may also make a bread with nuts? Maybe?

Totally grasping at straws. Your jelly theory is more likely... but man, this must be stressful. I hope it gets easier!

limboland la la said...

I'm sorry you've got to deal with this girl (and "Londo"). Seems pretty darn scary. It would definitely freak me out.

Wish there was some magic "stop being allergic to peanuts" shot.

-goofydaddy said...

could it possibly be stress hives? Our daughter used to get hives on her behind around bath time, and so we thought it could be the soap or the tubmat, or the shampoo... but then it didn't always happen after bath. The hives sometimes appeared immediately before the bath.

After a number of times of this happening, we realized the only commonality with the occurrences was they were on days that she hadn't taken a nap, and had a meltdown before, during, or after the bath.

just a quick search for "stress hives" on google gets this site (ignore the plug at the end for the natural remedy). Back then, I researched a bit and that site is pretty much what I kept seeing on other sites.

caramama said...

Thanks, all. I'm a little calmer now. There's just no knowing for sure what it was, and I just have to be okay with that. Somehow.

@Cloud - I've been thinking about that, too. But there was nothing new. I keep wondering if maybe she's developing a new allergy? I just don't know.

@Jac - So sorry that your son's got asthma! That's a difficult one to deal with, especially him turning blue in the middle of the night! Yikes! But I like what your doctor said about the mommy instinct. It does make me feel better to think of it that way.

@Anonymous - That's a great idea. I'll bring that up to my husband as a backup plan in case we aren't comfortable with the plan of trading unsafe candy for safe candy. Thanks!

@Melba - My husband is always saying "Occam's Razor" this or that. The most likely culprit would be some trace of peanut somewhere. She actually eats that raisin bread almost every morning, so I'm pretty sure it wasn't that. It is stressful, and I keep grasping at straws, too.

@limboland la la - I wish there was some magic shot, too. There is a 20% chance she's outgrow it, but we can't count on that. It's frustrating.

@goofydaddy - That is something I haven't considered! I will definitely keep my eye out for other times when she might get stress hives. Very interesting.

paola said...

I wouldn't use the Epipen unless Pumpkin actually goes into anaphylactic shock. Signs will be clear. She will have difficulties breathing and this is the sure fire signal that she needs adrenaline fast. The Epipen won't be necessary or do anything in the case of hives. PLease talk to your doctor if you are uncertain as to how and when to use the Epipen though.

If she is reacting to peanuts that she came into contact with in the sweets yesterday, without actually having eaten any, I'd say peanuts must set off a pretty serious reaction in her, and you would have already had an inkling of it. For example I can tell when my MIL has eaten walnuts and particles have landed on her clothes ( and her clothes have actully been aired) as I develop an allergic cough and have difficulty breathign, but then again I am super allergic to even the smallest walnut particle. I tend to agree with @cloud though and wonder if there is someting else that brought the hives on. Just keep an eye on her in the next few days and see if it is a one off or there is something else setting her off.

Lots of luck. It's really hard living with allergies.

Cloud said...

I agree, it is so hard to figure these things out. I really struggled with it as an adult graduate student in biochemistry. I can only imagine how much harder it is when the person with the symptoms is 3 years old!

And if she doesn't grow out of it, maybe the magic shot will be worked out by the time she's a little older. There are some docs in the UK working on desensitizing allergy shots. Something similar worked wonders on my plain old environmental allergies back in grad school. I hope they get the regimen worked out for the more serious allergies soon.

Charisse said...

Caramama, just wanted to send you hugs about the hives! Mouse has been getting them for the past 6 months - we are pretty sure they're from pollen (SF has had the worst allergy season in years) and Zyrtec seems to control them. But along the way we were told there are many many reasons little kids get hives, even from viruses. Who knew! We've waited so far on the formal allergy testing - her pedi feels that the tests are way less accurate for these milder allergies and so we're going to try stopping the Zyrtec in November, which should give us a good idea of whether they're truly seasonal (they started right after Spring Break when the weather got warm). If they are, then we won't worry too much about which exact trees; if they're not then we need to look into whether it's dust or something more pervasive.

But man, a kid with hives can whine, poor things! And I was pretty freaked out about the unknown cause for the first few weeks, until it became fairly clear from journaling that is wasn't food related and the only correlation was the weather. Anyway, they never suggested we get an EpiPen for environmental hives, but they did strongly urge us to keep Children's Benadryl on hand in case.

Maybe Occam's Razor is right. Allergies are weird though - it sounds like you did the right thing, and I hope Pumpkin continues well!

Geeks in Rome said...

wow! this is so hard! So scary, but you did great. Better not to freak her out and aim for minimal intervention.

I, too, vote for investigating environmental triggers. But how impossible is that? Just 1 million more things to worry about ans suspect!

good luck and stay strong!

hush said...

Hugs to you & yours. How sucky! Same to you regarding the asthma diagnosis, @Jac. Suckiness all around!

Caryn said...

Is she definitely not allergic to strawberries? I know they're very common allergens. Good luck! That's scary.

ARC said...

Your allergist probably already did this, but are there other allergens that are similar to peanuts?

For example, BabyT is mildly allergic to cashews as per the test, and apparently cashews and mangos are similar wrt allergies.

Maybe peanuts have a similar thing?

Good luck. We have a dairy allergy in our house, which AFAIK is mild, but we're still vigilant about it because BabyT is too little to tell people about it and there's that small chance of the anaphylactic response. Ugh.

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