PITTSBURGH (KDKA) — When Aubriana Kane was just 1½-years-old, she reacted to a piece of cake with a little bit of peanut butter icing.
“Where it touched her skin, she broke out in a rash,” says her mother, Emily Kane.
Testing confirmed her peanut allergy.
Since then, her family has managed by simply avoiding peanuts. But that isn’t always possible. The tipping point was Halloween.
“If she got something that she knew she couldn’t have, just the tears started coming,” says Emily. “You go through it, the best you can, but you never know, and there was a Mr. Goodbar in there, and she got hold of it.”
That’s when peanut desensitization seemed like a good idea.
“A quarter to a half to a full peanut,” says Emily, “definitely under the supervision of a doctor is necessary. I would not want to do that on my own, just in case something were to happen.”
“We’re taking the thing we know you’re allergic to,” explains AGH allergy specialist Dr. Allison Freeman, “and we’re gradually exposing you to it that keeps you as safe as we possibly can.”
The idea is to get the immune system to respond in ways other than an allergy.
It starts with a very low dose of the allergy-causing food, powdered and put into solution. If the child tolerates it in the office, that dose is continued daily at home for two weeks. But you need some low key time.
“Two hours of quiet time,” says Dr. Freeman, “so you don’t exercise and cause that dose to get to your bloodstream too fast, or cause a problem.”
Then, the child comes back to the doctor, and if everything has gone well, every two weeks the dose is increased.
Eventually, the actual food is given and increased, sometimes up to 12 nuts a day. The whole process takes eight months, and is covered by insurance.
“When they reach that eight month mark, they’ve reached a maintenance dose, but they have to eat it every day for several years,” says Dr. Freeman.
It works 80 percent of the time. Some drop out because of stomach ache, rash, wheezing, or a bad reaction.
Surprisingly, no cases of anaphyllaxis have happened at a doctor’s office. It’s more likely to happen at home, with fever, too much exercise too soon, or just randomly.
For that reason everyone goes home with an Epipen.
“We do peanut, tree nuts, but we also do egg, milk, sesame seeds, sunflower seed,” Dr. Freeman says. “You have to have a center where somebody wants to do this. This is very time intensive for my staff and me.”
The program at AGH has been in place for one year, with five graduates.
Aubriana is one of them.
One challenge — getting her to like a food she’s unfamiliar with.
“We avoided peanuts all this time, and she does not like peanuts,” says her mom.
Turns out, three peanuts is the same as one Reese’s mini — so she takes three daily.
“She’ll tell everyone her medicine is her Reese’s minis,” Emily adds.
With no reactions throughout the process, her family feels confident visiting candy stores, ice cream shops, and other places where there might be cross-contamination.
“She can eat things manufactured in a peanut facility,” her mother explains.
Her mother wants her to have as normal a life as possible.
“Being able for her to go out into the world not have to, myself not to worry, and her not have to worry about ever being in a situation where her life is in danger because of the peanuts,” Emily said.