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OIT – Egg Cross Contamination Milestone

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Just a couple of weeks ago, the doctor told us that we were at the point with OIT that Riley could handle cross contamination with eggs. At first I didn’t think much about it but then I realized that we could have eggs at our house! My 10 year old daughter was elated. She loves to eat eggs and because we only allow her to eat eggs when she is away from home, the scarcity made them taste even better. She wanted to eat eggs as soon as she heard the news.

I was excited for her, but it doesn’t mean that all of the anxiety was gone. It was still stressful to cook the eggs. I made the eggs in a separate pan that could be put in the dishwasher and made sure I cleaned everything thoroughly when I was done. I kept telling myself it was okay and as I watched my daughter spill egg on the table, her lap and the floor, I took some deep breaths. My son watched her cautiously from the other end of the table. This was going to take some time to get used to.

Baked Egg Challenge?

The doctor also asked if we would like to do a baked egg challenge. At first I was super excited and said I absolutely would. I thought it would be wonderful to be able to see some of the fruits of our labors and have him start eating some baked goods. However, when we were waiting for our 45 minutes after his up-dose that day in the doctor’s office, I started thinking about what he would be able to eat if we did the baked egg challenge. I make treats at home and have recipes for lots of his favorite things that I have learned to make egg free. It doesn’t matter much to me whether or not I use eggs in my cooking (in fact I’d almost prefer not to use eggs) so the real benefit would be what others could buy or make things for him.

I started trying to think of what someone could buy at the store for him, and I was struggling to come up with things. Unfortunately, he still can’t do frosting, so that meant no cake or frosted cookies or donuts. He can’t do regular chocolate chips because they may have nuts or milk and he has reacted to chocolate chips before, so we still avoid those. I could only come up with brownies or muffins. After our appointment I went to Costco and looked in their baked goods section. My heart sunk. EVERYTHING said may contain tree nuts, including the muffins. I realized that if we did a baked egg challenge, I would be able to make baked goods with eggs in them and maybe someone I trusted could make muffins or brownies for him, but that was really the only benefit. I didn’t want to sit in the doctor’s office for multiple hours just so I could have the pleasure of buying eggs and cracking them open once or twice before the end of our egg therapy in a couple of months. I don’t even like to crack eggs. I told the doctor we would pass.

Even though I was a bit discouraged about this realization, it was a great mental exercise to go through. It made me realize some very helpful things.

Milk

I realized that most baked goods still have dairy in them or on them. It made me glad we are treating him for milk as well. It seems that in order to be able to eat baked goods, he will need to be able to eat dairy.

The allergist didn’t say anything about cross contamination for milk or baked milk yet, but I am less worried about cross contamination. Riley has had very few reactions from milk and we eat milk products at home all of the time. We did a baked milk challenge with the allergist years ago and he passed. All of the milk reactions he has had have come from accidentally eating something with dairy, and in a noticeable quantity, like mistakenly grabbing a glass of milk or eating a baked item that had milk in it and was under-cooked. He can’t eat milk or dairy, but being around it hasn’t seemed to be a problem.

Nuts are a problem

Nuts are a still a big problem when it comes to cross contamination, especially in baked goods. I realized that a lot of the things we thought he would be able to eat weren’t an option not because they contained milk, egg or even nuts, but because they might have TRACES of nuts in them. We once had a trip to the ER over a trace of pecan in some granola. Just because we finish this treatment with milk and eggs, doesn’t mean we don’t have to worry about anything anymore. Riley is still going to have to be very careful about nuts, and will still be limited on what store-bought items are available to him.

I realized that even though I really didn’t want to do OIT forever, it would be worth it to try to get to the point where Riley could handle cross contamination for his tree nut allergies. This would include walnut, pecan, cashew, pistachio, and hazelnuts. If we didn’t have to worry about “traces of tree nuts,” it could open up a world of possibilities.

Social Inclusion is a Goal

In thinking about whether to do a baked egg challenge, I also realized I really didn’t care whether Riley ate baked eggs at home, what I did care about was that Riley could eat eggs baked into food that other people offered him at school, church, family events, or restaurants. Other people do not know how to make things without eggs, and stores don’t sell baked goods without eggs in them. Every time there is a social gathering that involves food, Riley cannot participate, and that hurts. It hurts him, it hurts me, and it often makes those around him feel bad as well. I want so much for eating to be the fun and the social bonding experience it is meant to be.

Safety is Our First Priority

More than anything I want him to be safe. I am not sure Riley will like eggs or milk products. These are things that taste so strange to him that he may never have an affinity for them, and that’s okay. Ultimately, if he doesn’t want to eat eggs or milk and chooses to never eat them after we finish treatment, that is fine with me! What I do care about is that he can eat at a restaurant and not worry about whether what he orders could make him sick or kill him. I care about him not feeling anxiety every time someone gets out a package of trail mix or when he is invited to someone’s house and they are cooking or eating eggs, or cross-contaminating the utensils. I care about how he will be able to live with roommates when he goes off to college without being afraid of what they are eating. I care about him surviving being a teenager and a young adult without having to try extra hard to do it.

Passing Up the Baked Egg Challenge

Ultimately we decided to wait and pass on the baked egg challenge. We can hang in there for a couple of months until we finish egg completely. Maybe by then we will be pretty close to finishing milk too, which will at least open up a few more options. There are not a ton of new benefits from being able to eat baked egg that make it worth adding yet another doctor’s appointment to the schedule, but I was glad it made me stop and think about why we are doing this and what we hope the future will look like when we’re done.

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