Preparing for Oral immunotherapy (OIT)

Late last year the opportunity presented itself for my son, 4 years old, to start Oral Immunotherapy (better known as "OIT") for peanuts in 2020. My husband and I jumped in line cautiously, had 5+ hours of conversations with our allergist and four other moms of children who went through OIT, read "The Food Allergy Fix" and spent significant time discussing the options together. 

And now, here we are, about to begin. Our OIT journey starts in just a few short days, ironically just before Valentine's Day. I started this site Valentine's day week a year ago and never made any headway. Look what "I'm about to give my child his life-threatening allergen, now what?" does to me! Starting a website was daunting and scary, but now it seems like top 8-allergen free CAKE compared to what we are about to experience on day one of OIT.

What is Oral Immunotherapy?
Oral Immunotherapy (OIT) is training your body so that it no longer thinks your allergen is the enemy. You are desensitizing the immune response by consuming the allergen in gradually increasing amounts. The desire is that the patient will eventually be able to consume the allergenic food without experiencing an allergic reaction.

Day One of OIT
This is the most difficult day I can foresee. This is a rapid desensitization day where the patient consumes extremely small amounts of the allergen over 6-7 hours. This all-day OIT boot camp I am calling it, (because it is sure to kick my butt and I won't want to sign up for it again) prepares the patient's body to then accept pre-measured daily doses of their allergen at home. 

Every two weeks after our son's rapid desensitization we will then return to the allergist for an increased dose to then give for the following two weeks.

When to stop is determined between the patient and the allergist based on how the patient is doing and what the patient's desires are. Do they want to free eat their allergen? Do they want to just be protected for cross contamination? 

The Dreaded Required "Rest Period"
There is a dreaded two-hour required rest period each day after consuming your daily dose. Say what?! I'm complaining about resting daily for two hours? Um, heck yeah. Parents know what it's like with a young child. If you want them do to it, they want the opposite. "Son, go get all the ice cream out of the fridge and make an amazing chocolate sundae with all the toppings you want!" What does your son say? "No Mom, I DO NOT WANT ICE CREAM! I WANT A POPSICLE!" It doesn't matter what you ask, if it's your idea they want no part of it. And whenever you desperately need them to do something it's NEVER going to happen. So I am preparing my poker face and will not show any weakness or desperation. I will also blame EVERY.SINGLE.THING  on the allergist. Not my rules! Doctor's orders!

What's with the rest period? The short answer is if you get your heart rate up you can cause a reaction. No exercising, hot baths/showers, no running, no jumping, nothing that will get your heart pumping or your cheeks flushed.

"Hey 4-year-old boy! No running!" That's just bat s#&* crazy.

We will be watching lots of movies before we get comfortable testing out the rest period waters. I'm worried about him getting hot, getting frustrated, getting sad, having a tantrum or sibling fight, jumping, running, climbing the stairs, you name it I am worried about what could elicit a reaction. Blah. Damn rest period. And not just that, some patient's need only 90 minutes and others need four hours, you just don't know; two hours is the average.

Day One of OIT is Approaching, Now What?!

• Ensure your epinephrine is current and not expired
• Train friends and family on the signs and symptoms of anaphylaxis or a mild reaction
• Train friends and family on how to administer epinephrine
• Talk to your child about what to expect on day one of OIT; I recommend this book
• Use the following packing list to help you prepare for the rapid desensitization day and don't forget a vomit bucket and some plastic garbage bags for the car ride home just in case. You can line the floor mats with the garbage bag. 
• Finally, say a prayer, deep breath, meditate, dance it out, whatever is your thing...do it to give yourself the emotional self care to be calm, present and focused on day one. 

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Do you or someone you love have experience with OIT? Share your stories below, I'd love to hear from you!