And Away We Go!

Sydney has been on the wait list with Dr. Nash since she decided to do OIT in September.  Part of me wants to hurry UP and get started, but another part is happy to have the extra time.  She is going to have a lot on her plate, and a lot to adjust to, for the next 2 years.  Taking a few months for “the call” seemed more blessing than curse.

Of course, excitement took over when Sandra (receptionist) called this week to schedule Sydney’s OIT initial escalation day.  IT’S FINALLY HERE!  Mid-February we are going to drive up for a 3 day stay to get this party started.  Tom is coming with us this time, which I am thankful for; though Sydney warned him that he will be bored out of his mind.  Remember – bored is GOOD!  I like the way she thinks!

The first day of OIT is going to be the longest.  Nothing this kid can’t handle though, as it’s going to closely resemble the SEVEN days of food challenges she already has under her belt.  The first day she will arrive by 9am and start off with .1mg of peanut flour.  Do you have any idea how small that is?  Well, you know I love Google!  .1mg is equivalent to about 0.000003527 ounces.  I can’t even fathom how small that is.  I think I’m pretty close when I tell people “the size of a speck of dust.”

After that is tolerated for about 20 minutes, she gets another dose.  This one is bigger.  Watch out!  It’s a whole .2mg!  The idea is to slowly increase this microscopic dose to make sure she can handle the whopper that comes at the end of the day, her 6^th dose….  3 whole mg.  For those playing along at home, that’s a massive 0.000035 oz.  If she can hit this amount (and Dr. Nash has never had a patient not meet it) she gets to go home for the day.  Actually, she gets to go back to the hotel for the day.  Because tomorrow we’re comin’ back!!

The 2^nd day of this initial escalation appointment will go a lot faster.  Basically, Dr. Nash will give her the 3mg dose again when she arrives.  She waits for 2 hours to make sure she has no reaction and then she gets to go home.  And YES we are driving home after that!

There are 22 dose increases that she will have over the first year.  I’ve listed them below for the insanely curious.  They will be spaced 2 weeks apart.  As long as she doesn’t get sick (where we would have to dose-down) or have bad reactions to a certain level, she could hit maintenance by December 1^st.  I assure you, that is being exceedingly optimistic.  But that’s my job.  Just call me Ms. Glass is Half Full.

Dosing Schedule

3mgs

6mgs

12mgs

25mgs

50 mgs

75mgs

100 mgs

125 mgs

150 mgs

175 mgs

200 mgs

250 mgs

300 mgs  (about one whole peanut!!!)

400 mgs

500 mgs

600 mgs

900 mgs   (three peanuts!)

1200 mgs

1500 mgs

1800 mgs

2100 mgs

2400 mgs  (I’m going to faint – 8 peanuts!)

The entire second year consists of daily doses of 2400mgs.  At the end of the second year, Dr. Nash will do a peanut food challenge (just like Sydney did for other nuts in December 2013).  If she can successfully eat 24 peanuts, she passes.  And her life will never be the same again.