Oral Immunotherapy or OIT

1. Oral immunotherapy is a method of inducing your immune system to tolerate a food that it is currently over-reacting to. It involves re-introducing the allergenic food to your system in gradually increasing amounts, with the goal of allowing you to eventually consume the food without experiencing a reaction.

I need to start by saying in no uncertain terms should you do this on your own, without the strict  supervision of a Board Certified Allergist. 

When our allergist first broached me with the idea of OIT as a solution for my daughters very severe, life threatening food allergy 5 years ago, I was totally on board.  Unfortunately for me, my then 4 year old and my Husband we're totally not on board, they were so far from on board they weren't even near the station.   I was frustrated and fearful as she was just about to start school and OIT seemed the obvious choice.  We had done a good job of avoidance since her first reaction at just over a year old.  She had, had only one other reaction.  A contact reaction that went into full anaphylaxis when another preschooler kissed her and had peanut butter on her face.   So convincing them that eating peanuts was the right choice, wasn't happening.

It wasn't until a very scary reaction and hospitalization, when she was seven, that both my Husband and daughter started to consider OIT as an option.  It took almost two more years, until they both were fully on board and we finally started desensitization with our allergist, Dr. J. Baker.   We started on July 1, 2013, full of nerves and anxiety we climbed the stairs to Dr. B's practice...I was terrified and fighting the urge to cry and run screaming from the building.  Was I really going to allow our very trusted allergist to feed my child the one thing that could kill her?! 

Turns out, I was willing to.  That day was bright and sunny; hot really.  We had bags of stuff; a laptop, ipad, books, coloring books, DSi (that I bought to bribe her to be on board), snacks, drinks, lunches, gifts (in case I needed to do more bribing) and lots of sets of epi pens (you don't need to do this, your allergist office is fully stocked with epinephrine).    Most allergist have cozy rooms, TV's and dvd players, video games and books.  You don't have to pack like your moving in, I promise.

They started the appointment by taking her vitals, that totally freaked me out.  Would this be the last time someone took her blood pressure?  Her temperature?  Your mind goes there, it's really a strange dichotomy of emotions and thoughts.  

Then they brought in the first tiny syringe, full of cran-grape juice and .025 micrograms of peanut flour.  An amount of dust so small you'd not be able to notice it on a table.   And with no real fan fare, it was stuck in her mouth and she was swallowing what was a poison to her body.   Then nothing.  Nothing happened.  No hives, no swelling, no vomiting, no dropping blood pressure.  Nothing.  

Fifteen minutes later, they brought her another dose, just a tiny bit more peanut flour this time...and still nothing.   By the third "up dose" her throat was tickly, but we pushed through as that was a natural reaction, expected when her allergen hits there first.   By the 5th up dose, she had a tummy ache and we stopped.  Our nurse mixed me a container of juice and peanut flour that I would give my daughter two times a day, every day until our next appointment.   

The fear naturally moved on to the first dose at home, which also happened with zero issues.  So boring! All that anxiety and fear, for nada!   We were on our way.

The appointments marched on, by August she was eating little pieces of peanut; the size of tiny baby teeth).  We had a rhythm and we continued on, even taking vacations to Seattle and camping (don't go camping while doing OIT.  Trust me.).   We had very mild symptoms occasionally.  On one dose she had one hive on her left cheek for 15 minutes after each dose.  Another two brought excess saliva/phlegm which required a little cup to spit in go everywhere with us.  Gross right.  Every dose caused horrible gas.  Oh the smells were awful!  I discovered daily probiotics helped enormously.  

In November Dr. Baker and Marianne said, "Your done.  You've reached the final dose.  Stay on it for three months and come back for the 24 peanut challenge."   What?! Done.  No.  We like the safety of here, the consistency in seeing the two of you weekly.  Were we really done? Just had the challenge to complete and that would be it?  Not possible.  We left with directions to eat 8 peanuts 2 times a day, for three months. 

But alas, in February, weighed down by anxiety far worse then the first appointment we went back to Dr. Baker's office so that Liberty could eat 24 peanuts at once.  This time I was so frightened because that's a lot of peanuts.  A lot of what could kill her all at once.  Funny, that worry hadn't gone away.  We'd been long cleared to eat items with cross contamination.  Cleared to have peanuts back in the house again...but 24 peanuts.  Oh, the fear.   

It took her 34 minutes to choke down all 24 peanuts.  She hates the taste of peanuts.  And then nothing.  Nothing but celebrating! 

We graduated from OIT in February.  Now we eat a daily maintenance dose of 8 peanuts a day, and that keeps Liberty safe from accidentally ingesting peanuts. 

OIT might not be for every family, but it was absolutely the most amazing thing for my family.  In just this weekend we went out to dinner and had a brownie ice cream sundae (IN A RESTAURANT) and we ate at a huge buffet and I didn't even pay attention to what Liberty was eating!  She just ate what she wanted.    We're hoping to go to Africa in a year, and we've flown and I didn't say a word to anyone about her peanut allergy.   We go safely everywhere, I never even think "what if" any longer.  My daughter says it best, "We're free!"

We still carry an epinephrine injector with us always.  OIT is a treatment not a cure.