“My daughter had one reaction to cashews when she was 4 1/2 years old. She is now 11. She has had no other reactions. We have stayed away from all tree nuts because that is what we were told. I did so much reading and listening to other people’s stories about their journeys, especially the OIT families. I looked back into my daughter’s allergy testing and realized that she was negative to a few of the tree nuts, but we avoided them because that is what we were told. At the time of my daughter’s reaction, that was the protocol.

Our Allergist retired, and I had not found one locally I liked yet. I decided to make an appointment with Dr. B and look more into if our daughter would be a candidate for OIT. Dr. B has a different philosophy and that was the turning point for us. She believed the same thing that I had wondered for so long. Why were we avoiding all tree nuts if my daughter is not allergic to them all? She did bloodwork. She listened to what we wanted for our daughter. She listened to how the allergies affect our family. She looked at the spreadsheets I made of all the test results she had ever had done. She analyzed them, and questioned the same things I had been questioning about them for months. I cannot explain how many nights I was up reading through research articles and statistics and on and on.

She listened to how I do not like my daughter on so many asthma medications. My daughter’s environmental allergies are so bad. We had great discussions during our visit, and I felt she had understood who we were and. I did really like our Allergist that retired, but I always felt that he didn’t truly understand the impact a food allergy has on a family. I have four kids, and it really does impact our whole family and the way we all live. We have found an Allergist near us (Dr. B was a 2 hour drive,) that has agreed to help us continue with this different philosophy of not avoiding all tree nuts.

Dr. B told us if you want her asthma medications to decrease, she needs allergy shots. We started those last summer, and my daughter has just reached maintenance in her allergy shots. The allergy shots have helped, although it is too soon to know how much they will continue to help her. She has been able to go down with her antihistamines and asthma medication all ready. In previous years, even with tons of antihistamines, she was still miserable. Her seasonal allergies were terrible from the first bloom of the year until the first frost of winter.

Dr. B believed that my daughter is truly only allergic to cashews and pistachios, and we have been avoiding all of them unnecessarily. We are strict avoidance. We do not go to restaurants at all, and are super strict with the food she eats. Unless we make it, or have seen all the labels of all the ingredients, she does not eat it. She said that we are more than welcome to do OIT for cashews/pistachios, but those are the easiest to avoid because they are the most expensive. Often, they are never used as a nut filler in foods because they are too expensive. She said that IF we did all the food challenges that she recommends, and IF she really is only allergic to cashews and pistachios, she felt we would have a greater increase in her quality of life after all of that, than we would have if we did OIT for cashews/pistachios. Clearly everyone knows the huge undertaking that OIT is for a family. She said that if it is only cashews/pistachios her diet could be way more open than we allow it to be now. We could go to restaurants and go to places that do not have those nuts there. She said the freedom that we might feel after that part of the journey, might be enough where we do not feel the need to do OIT for cashews/pistachios.

She explained how some of my daughter’s testing is really not positive for the food protein, but rather her super high tree pollen coming through. The protein in peanuts, almonds, and hazelnuts are super close to tree pollen. My daughter is through the roof allergic to trees, and her body was mistaking those tree nuts as tree pollen, possibly. We have spent the last 15 months testing that theory with our local Allergist, and we have great news. We have completed food challenges to sesame, almonds, walnuts, pecans, and macadamia nuts. She is safely eating all of these. We have one more food challenge ahead of us. We just met with our local allergist this week, and my daughter’s component test for hazelnut looks very promising that she will pass the challenge. Her highest number was the protein that is associated with tree pollen. We have that food challenge scheduled the end of summer. If she passes that, our local Allergist believes that we can really change the way we/she lives our/her lives. It is scary and exciting all at the same time. I am trying to not get too excited because we still have hazelnut to check off the list. If she passes that, then we have all the major tree nuts done. We have not food challenged brazil nuts, pine nuts, and chestnuts. We do not eat those. Our local Allergist said statistically if we do this hazelnut challenge, he would be comfortable with us not avoiding shared facilities. That would mean I wouldn’t have to be calling companies constantly, like I do now. He said that if we go to a bakery (which she has never been to a bakery,) and the item does not contain cashews/pistachios, he is fine with her having it. This blows my mind, and might take some time for me to get comfortable with that, but I am focusing one step at a time. Our next step is the hazelnut challenge, and then I will go on from there.

Dr. B was the person who first started this conversation with us. She was the one that expanded my thinking and caused me to start pushing the boundaries with our local Allergist, and not just accepting to “avoid all tree nuts.” I will always think highly of her, and have great respect for her and her practice. There is always more to a story, but this is it in a “nut” shell.”