When I was three years old, I went shopping at Costco on a Saturday with my family. The weekend shopping trips with my mom, dad, and sister were a ritual in my household, and they always went in the same order: Costco, Target, Trader Joes’. Costco is famous for its samples, and as a food-loving, non-picky kid, I was excited to try everything. That Saturday, “everything” had included a small sample of trail mix. I had always eaten nuts without issue, including peanut M&M’s and basically every nut-filled snack imaginable, so my parents had no reservations about me eating them that day. After Costco, we stopped at Target where I started to feel sick and ended up going to sit in the car with my dad. As we pulled out of the parking lot to leave I vomited all over the car, and my sister. Ever since then she’s had a fear of vomit, and my family still jokes that incident is what started it. My parents immediately called my pediatrician, who suspected I had an allergic reaction, and after taking Benadryl and getting in the tub at home to wash the vomit off, my life began to change in ways none of us expected.
I started going to the hospital to get blood tests, and that’s when I found out that I was not only allergic to peanuts, but also walnuts and pecans. The peanut allergy was by far the most severe, life-threatening one, but the other two were serious as well. Overnight the peanut butter and M&M’s disappeared from our cabinets, and I got an EpiPen. My parents had to talk to the school nurse, and all of my teachers, and I started sitting at the “Peanut-Free” table in the lunchroom. I still remember one day sitting alone at lunch because all of my friends' parents had packed their food with nuts. Little by little, though, I learned how to live with my newfound allergy.
The day everything changed was Wednesday, July 6, 2016. I remember the date because it was Eid-Al-Fitr, and since then my parents have said the following events were some kind of Eid miracle. My allergist had been encouraging my parents to enroll me in an Oral Immunotherapy (OIT) study to try to build my tolerance to peanuts by exposure over time. On July 6th we got the call to go interview for the study, and we drove to Lurie Children’s Hospital in the city where I became the last kid to get admitted into the PALISADE trial.
I was pretty young, only 6 years old, but I remember that OIT was scary, and really gross. The trial worked by having two groups, one that was receiving placebo peanut protein, and the other that was receiving the real thing. I somehow miraculously ended up in the group that was actually getting the peanut, and I slowly began building up my tolerance. It started with tiny pills filled with peanut powder mixed into applesauce, then packets, and finally whole, real peanuts. I was at the hospital all the time, and I was young enough to not fully understand how the OIT could change my life, but old enough to remember my friends asking me why I kept missing school.
Throughout the trial, everything was extremely controlled, but every once in a while we had a “test day”. The best way for me to explain it is to compare it to a “push day” at the gym when you try to PR in all your lifts. A “test day” in OIT meant pushing the limits of how much peanut protein my body could tolerate. Unfortunately for me, though, a test day almost always ended in an allergic reaction. While the throat closing up and breaking out in hives definitely wasn’t fun, the fun part for me was how much food the nurses let me order from the cafeteria afterwards. Lurie’s Children's Hospital had the best lime jello, mac & cheese, cookies, and pasta that I had ever had. After an allergic reaction, I had to be closely monitored for a while, and I think I watched more movies and TV shows in the allergy research ward there than I ever have in the rest of my life combined.
Now, ten years after starting my OIT at Lurie’s, I can proudly say that I’m able to eat 20 peanuts every night. Eventually the drug for the PALISADE trial got approved for use, and the study closed, but the effects the trial had on my life have been immeasurable. As an unexpected bonus, I managed to test out of my pecan and walnut allergy as a side effect of the treatment. More than anything, though, I’m grateful for the peace of mind the trial gave my parents. They no longer have to constantly worry about what could happen if I accidentally eat something containing peanuts while I’m out with my friends or away from home. Knowing that fear no longer controls their lives is one of the greatest gifts the OIT gave our family.
Ironically, even though I can have peanuts now, I still hate them. I used to think there would be some overnight switch where peanuts no longer disgusted me and I was excited to have Snickers, but I honestly find them gross. I think because I used to associate them with so much fear, I can never see them as something positive. I can also still recognize the scent instantly, even on the bus to track meets when someone pulls out a PB&J in the back, or when I can smell the Reese’s Cup on my friend even though she had it two hours ago at lunch. I often dread having my peanuts at night, and it’s a hassle to remember to bring them with me whenever I go on vacation, but despite those minor annoyances, I don’t think I would ever trade this life for the constant uncertainty and fear that used to surround each meal not cooked in my own home.
If I could give one piece of advice to anyone who’s considering OIT, it would be that fear can’t be the reason to avoid it. You have to accept that you might have some allergic reactions, and you might hate the taste of whatever it is that you’re eating, but the result may be a lifetime at peace without the stress around food. The process can be uncomfortable and exhausting, but the freedom from constant anxiety surrounding food is worth it. OIT didn’t just change what I could eat, but it completely changed the way my family and I live our lives.