Update

Just when I think I know it all (or most of it) and just when I feel like I've got the hang of it... this allergy life hands me another lemon, but we all learn and grow from it.  After B's anaphylactic ordeal last weekend, we've grown to understand how we can keep her even more safe. For that, I am thankful.

We have come to the conclusion that we may never know what caused B to react to her daily peanut dose, a dose she had been consuming for the last 4 months and doing fine with... but we realize that there were several very likely culprits and that all of them came together to create the perfect storm.  B's OIT doctor explained her situation as being like a "bucket."  When she reacted, it was because her bucket had reached it's capacity. We know that B's immune system was already being challenged when I gave her the dose that sent her into anaphylaxis.

B has a class 4 allergy to cat dander, which is pretty high.  Even though we do not have any pets, she was probably exposed to it because our in-laws who were visiting have an indoor cat (which we did not know prior to their arrival).  Cat dander may have been on their clothes and sleep-over belongings and tracked into our house.  This combined with the pre-dose high physical activity, lack of water and not enough food before her dose sent her over the top.

So, what we have learned from all of this and what we will be doing differently from now on is;

1. Zyrtec;  Anytime we have visitors who have pets or anytime we visit anyone else's home that has pets, we will be sure to dose B with Zyrtec before she comes into contact with them.
2. Water; I am pretty sure that from now on, both B and I will be sure that she has at least 4-6 oz of water to swish and wash down her dose with.  Neither of us will allow distractions to prevent her from drinking water after her dose.
3. Meals; we are going to re-train our brains concerning meal times.  B takes her maintenance dose right after school.  From now on, she will have a full meal before her dose (not a snack) and we will make dinner our lightest meal of the day.
4. Rest periods;  We are going to observe the "no physical activity for 30 minutes prior to the dose" rule.  We'd never been told that before, but some of the OIT docs have that included in their protocol, and so we will include it in ours as a precaution.

The day after she experienced anapylaxis (Sunday), B skipped her dose. On Monday, she had 1/3rd of her normal dose and did very well.  No complications.  On Tuesday, her OIT doc was back in town and we went to his office to dose her.  We all decided that her dose could be lowered from 4.5grams to 4grams.  She ate her 4 grams and had no complications at all.  She will remain on 4g of peanut for the next month or so and then will return to 4.5grams.

We thank all of you for your prayers and well wishes for B.  I am so happy that she will be able to continue on this journey to being free from her peanut allergy.  

Anaphylaxis

When we decided to seek OI therapy for B, we knew that there were risks involved.  We knew that there was a possibility of minor reactions as well as a risk for severe reactions, including anaphylaxis.  We have followed the protocols recommended by her allergists, as well as protocols recommended by other OIT moms, to minimize this risk... but sometimes there are accidents and sometimes there are unexplained reactions.  After all, these children in OI therapy are consuming their allergens, which are like poison to their body.

B had an anaphylactic reaction to her OIT maintenance dose on Saturday evening, 1/3/15.  We had to use the epi pen on her and admit her to the ER.  It was very scary and very unexpected.  I gave her the dose of peanut at her regular dosing time, 4pm.  About 1 hour after she took her dose, she began coughing like she was trying to clear her throat, scratching her chin and asking for water.  A minute later she was scratching at her entire body (at which point we did not see anything visible on her body).  Another 2 minutes later, she began having trouble breathing (wheezing) and started developing pinpoint hives on her trunk.

At this point, I knew that she needed her epinephrine.  I got it out of the emergency kit container that we keep it in, and told my husband that we needed to inject her.  My daughter freaked out, and my husband was in denial.  He said, "let's give her Benedryl.  She doesn't need the epi pen, her tongue isn't swelling."  My husband gave her a teaspoon of Benedryl and I continued to tearfully explain why she needed to be injected with epinephrine.  I pointed out her labored wheezing and explained to him that her airways were closing.  His response was to give her another teaspoon of Benedryl and wait for it to kick in.  I was basically pleading with him and trying to make him understand that she needed it.  I should have just given it to her.

While my husband and I were arguing about the necessity of using the epi pen, B was saying that her tummy hurt.  I explained to my husband that she now had 3 bodily symptoms that were affected and that she was experiencing anaphylaxis.

1. Pulmonary: Her breathing was labored and she was wheezing, I have never in my life heard her breathe like that, her nasal passages were also compromised (stuffy)
2. Integumentary: She had hives developing all over her skin on the trunk of her body
3. Gastrointestinal: She complained of tummy pain

I reminded him of Natalie Giorgi, the young girl who had no outward symptoms, who felt fine, and who passed away 20 minutes after spitting out her single bite of cross-contaminated rice crispy treat.  I explained that our daughter didn't need to have visible tongue swelling to be in anaphylaxis.  Her difficulty in breathing alone, warranted use of the epi pen... not to mention that she had more than 1 body system affected.  Meanwhile, a fourth body system was beginning to be affected;

      

      4.  Edema:  The last thing I noticed before I forced my child onto the floor and injected her was that she was just beginning to have minor swelling in her eyelids and lips.  
The epinephrine began working instantly and B stopped crying. She puckered up her sweet little lips and kissed me to let me know she was okay, as I called 911.

Everything that happened, from the first little throat clearing cough to the injection, all felt like it happened within 5 minutes, my husband thinks it was more like 20 minutes.  My sister-in-law who was there visiting thinks it was less than 20 minutes.  We don't know for sure how long it really was, but I do know that we took too long, and we hesitated.  Natalie's parents observed her for 20 minutes before they decided to inject her.  By then it was too late for sweet Natalie. 

I thank God now, and every minute since it happened, that we still have our precious child.  We made many mistakes that night, which I will list out, in hopes that it might help someone in the future should they experience the same events.

My mistakes;

1. I should have injected my child the very minute I knew she needed it.  Instead I pleaded with my husband and wasted precious minutes trying to explain the necessity of it.  Maybe subconsciously I was trying to convince myself that she needed it, or maybe I felt like I needed agreement from my husband.  I don't really know for sure.  I do know that I wasted time not giving it to her.  I hesitated.  
2. I haven't educated my husband enough.  He should be as well prepared as I think I am.  Ironically, my daughter and I practiced using the epi pen trainer just a few days before this all happened.  I'm not sure why, but we never included my husband in the practice.  I read and research all things food allergy related on a consistent basis, but I never relay the info to my husband.  I read about other people's mistakes and try to learn from them... but I have never bothered to make sure my husband knows what I know.
3. I watched my husband give Benedryl to B and never verified that he was giving her the correct dosage.  I give him credit for having enough fortitude to get it out and try to find the correct dosage, but I didn't verify that it was the dose she needed.  He gave her 1 tsp, then gave her 1 tsp more about 5 minutes later.  According to the dosage chart, she needed to have 2 tsp to begin with and could have consumed another 2 tsp as an emergency dose... although epi pen should have been given immediately upon hearing her labored breathing. 

My husbands mistakes;

1. He waited to long to listen to me.  At the time we injected her, he was on board with giving it to her. He could see visible symptoms (hives and minor swelling in her eyelids and lips) and that was what he needed to see, to affirm to himself, that she needed her epi pen.
2. He mistakenly believed that Benedryl was all she needed.  I made sure that he now knows that any time her breathing is compromised, that she needs to be injected.
3. He didn't know that epi is indicated if more than 1 body system is affected.  I explained it to him over and over again as it was happening, but until he could see the swelling... he was hesitant.
4. He was scared to inject her.  He was worried about what side effects the epinephrine would have on her, because prior to this event, we have never had to use it before.  He was scared that we would have to start OIT therapy all over again, from the beginning, if she were to have anaphylaxis and therefor he would not let his mind accept that she was indeed experiencing anaphylaxis.  None of that should have been considered.  It doesn't matter if she has to start over.  It doesn't matter that she had never used it before.  It didn't even matter if there were to be negative side effects from the medication. The fact is that it is a life saving emergency medication, and she needed it.  
5. He hasn't educated himself enough.  I wrote that my #2 mistake is that that I haven't educated him as much as I have educated myself, and I do take some responsibility for helping him learn... but ultimately  he is responsible for himself and his own learning. He has a child with a life threatening disability and if I died today, he would need to know everything that I think I know and be as prepared as I think I am.

After our first time ever using the epinephrine injector (we used the Auvi-Q), I can now say with 100% certainty that B (an 8 year old) would not be able to inject herself with her auvi Q epinephrine injector if she were ever to need it.  I can also say with 100% certainty that it is better if 2 people are there when she is injected.  I had to hold her legs still and inject her, while my husband had to hold the upper half of her body.  She was flailing around because she was terrified of the shot, and she had incredible strength.  It would have been incredibly difficult for me to inject her on my own, but I have a plan for if that day ever comes.  I would have to pin her arms and trunk with my legs while simultaneously handling her legs and injecting her.  Squatting on top of her if it were. 

I can't say enough for the Auvi Q injector.  The automated voice telling me what to do and counting down for me was a blessing to our efforts.  I can't imagine using the epi pen device that requires the user to hold the needle in the patients leg for an entire 10 seconds.  Holding the device on her legs for the required 5 seconds would have been impossible without first immobilizing her.  It was very scary.  Holding a needle in her leg for 10 seconds, without damaging her skin, would have been nearly impossible.  That is how needle gash injuries like this occur.

As for her therapy, we are taking it day by day. The anaphylaxis happened on Saturday.  B's doctor was out of town, but thankfully answered his phone when I called him from the ER.  We still have to determine the best course to follow for her OIT.  I'm still unclear if this will be detrimental to her therapy.  Her doctor instructed us to skip her dose on Sunday and give her 1/3rd of her normal dose on Monday.  Today is Monday, so we shall see how it goes.  Her doctor will be back in town and will see her tomorrow.  He will be deciding how much peanut to give and will administer it in his office in the hospital.   B has made 18 months of progress during this therapy  But, we aren't really sure just yet, what effect the anaphylaxis will have going forward with OIT.

As for WHY it happened, we have been racking our brains and trying to figure out why she reacted to her dose after all this time.  She has been consuming the same amount every day for the last 4 months.  There are 7 possibilities that we can think of, that may have contributed to sending B into anaphylaxis.

1. After she consumes her dose, she is supposed to be inactive for a period of 2 hours.  B was following that protocol when she reacted.  She was sitting on the couch watching a movie with her cousin.  Neither of the doctors we have had as providers has ever said anything about the period of time before we give her the dose.  Just before her dose, she was running around and playing very hard.  She did have a period of about 10 minutes before she ate her peanut to calm down... but maybe it wasn't enough. While on her dose she is not allowed to elevate her heart rate or her body temperature, as this increases the risk for anaphylaxis.  But, just before her dose I'm sure her heart rate was up and she was probably hot from running around.  My friend, Anna, who's son has already completed OIT for peanut has told me that her doctor in MI has her keep her son still for 30 minutes prior to dosing.  We will be following that protocol going forward.
2. She may not have had enough carbs in her belly.  Neither of her doctors has ever instructed us on feeding her before her dose, but it is well known and circulated among the other moms who have children in OIT, that they do better when they have a belly full of carbs before they consume their dose.  I had given B a small bowl full of pretzels and cream cheese dip.  My hubby thinks maybe the pretzels were not hearty enough.
3. Normally, B will drink a glass of water to wash her dose down.  This day, she said she had forgotten to drink any of her water.  I should have monitored that, but I got distracted.  She normally does good remembering to drink her water on her own... but she was distracted too.
4. B is class 4 allergic to cat dander. Class 4 is pretty high. We learned, after the fact, that the family members that were visiting us that day, have an indoor cat.  If they had cat dander on their clothes and sleep-over belongings, then B would have been exposed to it.  That means her immune system was already being challenged when I gave her the peanut dose.
5. Anna brought up the fact that maybe her immune system is compromised by a virus right now.  She is not displaying any signs of illness, but if she has a virus that her body is trying to fight off, it would compromise her immune system and increase the risk of anaphylaxis.  As each day goes by, the likelihood of this thought goes down.  She still isn't displaying any signs of an illness, so this scenario is unlikely.
6. She normally takes probiotics on a daily basis.  We ran out of them a few days ago, and she hasn't had them since.  The probiotics help her maintain a good level of healthy bacteria in her gut.
7. My husband wonders if her chronic battle against constipation has anything to do with her reaction.  He is wondering if the peanut protein is staying in her gut for a prolonged time, because she isn't efficiently evacuating.

In the end, we may never know why she reacted on this day, out of all the days she has been on the therapy.  We are better prepared now, for an emergency (having actually experienced it).  I just wanted to share the sequence of events with all of you, God forbid you are ever in this situation.  It all began with a persistent little throat clearing cough. 

Maintenance

B is now in what is considered the "maintenance" part of her two year long journey.  This entire second year, she will be consuming 4.5 grams of peanut on a daily basis.  During this time it is expected that her IgE will lower to a desensitized level.  At the end of B's second year of therapy, she will have a food challenge, which will consist of eating a large amount of peanut.  If she does not react, she will be free to consume as much peanut as she wants... but will be required to eat peanut on an almost daily basis to maintain her desensitization.

Last June, we found out that there was a local pediatric allergist who was planning on starting his own private practice and was planning to offer OIT!  Imagine how thrilled I was to learn that this doctor's office would be 20 minutes from our home.  The thought of no longer travelling 7+ hours to obtain treatment was so appealing.  We would no longer have to spend money on travel expenses or hotels.  No more subsequent trips to NC each time my child became ill.  The kids wouldn't have to miss anymore school, my hubby wouldn't have to take any more sick days!  This change would cut our out of pocket expenses in half.  No more $1,000.00/ month bills!  I couldn't believe our luck!

When I say "luck," I truly mean "LUCK!"

You see, there are only 24 doctors across the United States who are offering this therapy in private practice.  This life saving treatment is definitely not well known or even completely accepted.  We just happened to have the 24th doctor opening up an OIT clinic, do so 20 minutes from our home!  The only hesitation we had was that this doctor was new to OIT and had no previous experience with OIT.  But, after talking to him, meeting with him and learning that he was going to follow the exact same protocol as our current North Carolina doctor, we decided to take a leap of faith and trust that this was all in God's plan for B... maybe it wasn't "luck" after all!

In October, we officially made the switch to B's new allergist.  With the switch in location, also came a switch in the form of peanut.  Our NC doctor had been giving B 2400 milligrams of peanut flour which our new allergist calculated to be the equivalent of 4.5 grams of actual peanut.  Depending on the size of the peanut, it equals 4 or 5 peanuts that B is consuming daily.  We had previously been told that 2400 mgms of peanut flour was equal to 8 peanuts... but found out through several sources that this simply wasn't true.  So, 4 to 5 peanuts daily it is!

Now that we have a doctor that is closer, we are considering desensitizing B to all of her allergens.  There are some tree nuts that are just as deadly to B as peanuts are.  We chose to desensitize to peanut first because of how ubiquitous it is.  It truly is everywhere (as are clueless people that don't believe accommodations for children with life threatening allergies are necessary).

I cannot stress enough, how life changing this therapy has been for our family and for B. She is not even done with the therapy yet, but we have already seen a tremendous difference in her confidence.  While she still has to be extremely careful about coming into contact with certain tree nuts, we are not as worried about peanut.  She still has to be careful about what she eats because she cannot have even a single milligram more than 4.5 grams of peanut.  She still follows all the same precautions and only eats foods we provide her.  She still brings her own safe cupcake to friends birthday parties.  We still examine food labels like we are the FBI.  However we know that she is much more protected from peanut now, than she was a year ago... and that (to us) is priceless!

Finally! An update!

Wow, the last time I posted it was April!  I promise I am not a slacker... I have had a lot on my plate during the last 4 months.  My husband was deployed at the end of March, for training in his new career field with the Air National Guard. He was temporarily assigned to Keesler Air Force Base in Biloxi, MS.  Anyone who knows me well, knows that I will go to great lengths to prevent any type of family separation. So, we have spent the majority of the summer in Biloxi, MS with my husband.  Meanwhile, B is still doing her peanut OI therapy, but instead of biweekly visits, we have been stretching them out to monthly visits.  In order to keep the family together (and keep B on her therapy) I made 4 trips from GA to NC, 4 trips from NC to GA, 3 trips from GA to MS, 3 trips from MS to GA, 1 trip from GA to TN, 1 trip from TN to NC and one trip back home from NC to GA... 17 road trips in a 4 month time span.  Yes, I am tired.

During that same time period, I was also doing battle with B's school for her protective 504 accommodations. This year B is back in public school and repeating 2nd grade.  Although I home schooled her for 2nd grade last year, there are several reasons why we decided it would be best to have her repeat. Reason number one is her size... she is my teeny tiny girl.  When she was in public school for 1st grade she was the smallest in her class and we figured having her repeat second would put her in a class with kids more her size.  She was also the youngest in her 1st grade class, which brings me to reason number two.  Her late summer birthday meant she turned another year older long after her classmates had already reached that same age.  Now, she is in a class where she is the oldest, but a lot of the kids are about to turn 8 too... so she will be more in line with their maturity.  Reason number three was made from hearing about how hard 3rd grade is.  I didn't want B to have to go back to public school entering into 3rd grade.  She is going to have to get used to public school after a very lax year of homeschooling, so we thought it better to repeat information than have to learn new material while getting used to public school again. The 4th reason, which may seem silly, was made after consideration that her little brother, who started kindergarten this year, will be in the same hallway as 2nd graders and will be able to walk with his big sis to class.  And, lastly, we wanted her to repeat 2nd just in case I missed any material that she was supposed to learn.

Anyway, back to the protective accommodations... I asked the school for several things this year, and spent the majority of the summer digging up facts about how other schools have successfully implemented similar policies.  I presented the superintendent with a list of schools from around the nation who have created inclusive and protective wellness plans, all of which I called and verified the info.  I wrote letter after letter in support of our requests. I presented legal case precedence to support our requests.  I never backed down and, I won!  I'm not bragging or anything... but thanks to my hard work and determination for B to be safe AND included, she now has full access to everything her non-allergic peers have.  Without my determination, the school might not have changed a thing... but I think credit should also be given to a change in principals (getting a new principal was a HUGE blessing to my efforts.  I can honestly say I LOVE the new principal) and also to the many, many women from team anaphylaxis who helped me with everything and anything I needed help with. They gave me unyielding support, answered all of my questions, gave me ideas and encouragement when I needed it. They pushed me not to give up. They pointed me in the right direction to find laws and disability rights. This group of women is more valuable than gold.  I could not have accomplished any of what I accomplished without their help.  For these women, I am eternally grateful!

Due to all the wonderful accommodations this year, I can finally relax. My stress levels are lower than they have been since 2011, when B started school.  It is really difficult to put your child's life in someone else's hands and have to worry about her safety all day long.  This year, when I drop her off at school... I feel like I can go on about my day knowing that she is perfectly safe at school.  That is HUGE!  Part of this new found stress relief is due to the wonderful accommodations that she has at school, but the other part of it is the Oral Immunotherapy that B has been doing for the past year.

In these last 4 months, B has progressed steadily and without any complications.  She is now consuming 2100 mgms of peanut on a daily basis.  According to her doc, that is the equivalent of 7 peanuts! Next week she will up-dose to 8 peanuts (2400 mgms) and will be in maintenance, which is the 2nd part of her two-year-long journey.  For the entire second year, she will consume 8 peanuts a day.  Next August (2015) she will graduate peanut OIT and is expected to be able to consume any amount of peanut without having a reaction of any sort.  Amazing!  I still shake my head in disbelief to think of where B started and where she is headed.  To anyone out there reading my blog, who is also considering this therapy.  I encourage you to try it.  The therapy is a life changer, a life saver, a blessing.  I feel so fortunate that my girl was able to get the therapy and that she has done so well with it.  So many new doors are open for her.  Her life is finally starting to have some sort of normalcy.

About the blog... This will probably be my last post.  It takes a great deal of time for me to sit and write all of my thoughts out, and I don't think anyone is really reading.  If you are reading and you can think of a good reason why I should continue to keep writing, please leave a comment and let me know.  If what I am writing is helping even one person, it would be worth it for me to keep the blog.  However, if no one is reading... I have a million other great things to spend time on.  Ü

600 mgms, next is 900 mgms

Tonight I overheard a conversation that B was having with my husband.  She said "dad, when I am done with my peanut thearpy, I want to get a dog... but before I get a dog I want to go eat at chik-fil-A, and then I want to go to dunkin donuts and get a doughnut for dessert... then we can go to petsmart and get a dog."  I couldn't help but smile.  This is the life she has wanted but has never complained about not having.  She has handled her allergies with the grace of an adult, never complaining about the things she has had to avoid.  Now, a whole new world will be open for her to explore.  I am so excited about that, and more importantly... so is she!

B has completed her time on her 400 and 500mgms doses and is now on 600mgms of peanut flour and will increase to 900 mgms next week.  It seems as if the days are starting to speed up the closer we get to her goal of 2400 mgms.  If she stays on track, doesn't get sick or have to down dose, she should be in maintenance by the middle of June!  B is still a year and some months away from graduating the program, but she is well on her way!

B hasn't had any issues with her up-dosing appointments, nor has she had any issues taking her doses at home.  Everything is going extremely well, and we never take for granted how very blessed we are to have her enrolled in this therapy!

What it's like to be an "allergy mom" -by Carissa K. (with a few of my own edits)

"What it's Like to Be an Allergy-Mom"

1. As the parent of a child with food allergies, it makes us crazy when people make any sort of assumption about food allergies other than this one assumption -- a food allergy is a life-threatening condition that causes children to stop. breathing. immediately. It's very real... and it's very scary.

2. As the parent of a child with food allergies we want you to know that this is not a lifestyle choice. While it's admirable that some people choose to eat healthy and be aware of the ingredients in their food, we aren't standing in the grocery store aisle reading the label on everything that goes into our cart as a hobby. We're studying those ingredients to make sure there's not an obscure ingredient that could kill our children. (Did you know that caramel coloring is made out of dairy? Are you familiar with the difference between sodium lactate and potassium lactate?  Did you know that gummy worms can contain peanuts?)

3. As the parent of a child with food allergies there is not a play-date or school activity that our child will attend without us having a discussion with the hosting parent, event chaperon or teacher first. Every event my child has ever participated in (ever!) from t-ball to school to summer camps has always been preempted with a medical conversation first. We know we're perceived as high-maintenance parents. And we feel badly about that because the level of diligence we're forced to have about the subject of food allergies may not be consistent with the level of diligence our personalities would normally reflect.

4. As the parent of a child with food allergies we have laid awake at night, wondering if we'll be able to spot the signs of our child's throat closing. We've been told that anaphylaxis can happen in less than two minutes, so not only do we wonder if we'll be able to identify this emergency, we wonder if our child's teacher, babysitter, grandparent, recess monitor, friend or coach will know when our child can't breathe.

5. As a parent of a child with food allergies we have laid awake at night, wondering if our child will ever be able to attend a party in college or share a random kiss. And if she does, who will carry her epi-pen?

6. Speaking of which, as the parent of a child with food allergies we leave the house remembering the basics like phone, wallets, keys -- Benedryl and epi-pens. We know not to leave them in a car that is too hot or too cold and we always carry at least two, if not seven. Even with insurance, they are $100 a pop, so we treat them with the utmost respect for the year that we have them before they expire. But that's all ok, because those little devices carrying a shot of adrenaline could save our child, or at least sustain them, until the ambulance arrives.

7. As the parent of a child with food allergies, we sit outside every birthday party or sports practice while other parents leave. 

8. As the parent of a child with food allergies, we balance the emotional impact of being a helicopter parent against the medical threat of having our child go into anaphylaxis when we're not around. We feel guilty and scared of both.

9. As the parent of a child with food allergies, we have never relaxed, sat back and actually enjoyed or tasted a meal in a restaurant. Never. You see, we spend those meals playing and replaying the emergency plan in our head while quietly observing our child's breathing as she enjoys her meal.

10. As the parent of a child with food allergies, we regularly attend medical appointments in big time children's hospitals where we can't help but see other patients and deeply suffering families. And upon this realization, we are humbled and grateful and reminded of just how fortunate we are that we are the parents of a child with only food allergies. While our child has a life-threatening medical condition, it is manageable. And as long as we have help from you and others in managing it, our child is alive -- and that's really something!

250 mgms, 300 mgms

B successfully up-dosed to 250 mgms 2 weeks ago, and has up-dosed to 300 mgms as of yesterday. The doc says 300mgms is equivalent to ONE peanut!  Usually, when we arrive in Raleigh, we have about 2 hours to kill before B's appointment time.  We normally use that time to get lunch and stop at Pet-Co or PetsMart. B loves all animals and she especially enjoys visiting the kittens.  However, yesterday when we arrived I asked B if she wanted to go to the pet store and she said that she didn't.  That answer really surprised me, and when I inquired as to why not, she said that she wanted to hurry up and get to the doctor's office.  She said that she was so excited and that she couldn't wait to eat one peanut!  Needless to say, my heart soared.  My fearful, anxious little girl was so excited because she knew that she had reached an incredible milestone.

B ate her one peanut dose with a smile on her face and joy in her heart, then proceeded to wait out her 2 hour watch period without any problems.  She will be on this dose for the next two weeks, and then she will up dose to 400mgms.  The journey that B is on is an amazing one.  Seeing her confidence renewed and her anxiety slowly subsiding, brings joy to my own heart.  Our decision to start our daughter in OIT has been validated in so many different ways, B's excitement and joy is just one of them.