I write this, lying on the couch, absolutely exhausted. I swore to myself that I would simply do nothing tonight after the mammoth day I've had at the hospital, but I really need to offload.
So, today was the big Allergy Challenge Day at Pau hospital. It's been months in the making. Actually, when I think back to going to Dr. Assali's practice in January with Jess driving me because I was still on morphine, I realise that it's now been six months in the making. And for me, that actually equates to six months of something just sitting at the back of my brain, coming forward now and again, saying, "remember you have me to deal with". It's safe to say I've been very anxious about today. Not specifically the measured poisoning itself(!), just the whole day: have I got the details correct; do I have the right paperwork; did I get the correct patches and have I put them on the correct parts of his arm; am I going to understand what's happening; will anyone speak english and will they support us; how is he going to cope with the challenge? I was absolutely exhausted last night going to bed, my head reeling with all these questions.
So we were up at 6.30am this morning, patches on the arms at 7.10am and in the car by 7.20am. We had some admin to do at reception and made our way round to the paediatric department at 8.00am on the nose. We had a room to ourselves and the nurse couldn't really speak english. No matter, she was lovely and we all persevered. I signed a form, she took his height and weight and checked his body for any pre-test blemishes (to mark them off as pre-existing). Then is was time to get the cannula in. He point blank refused to have any gas so after 10mins of the two nurses trying to find a vein in his inner elbow, puncturing the skin and still not getting a vein, he was howling and shouting that he wanted to go home. We tried to talk him round with the gas but he wouldn't have a bar of it so it so they just had to go old school, sing songs and find a spot on the back of his hand. Finally.
The test started almost immediately afterwards. It was essentially 10 steps of walnut exposure of increasing quantities starting with some crumbs rubbed inside his bottom lips, followed by a minuscule portion of crumbs fed to him on a spoon with apple compote. The portion sizes gradually increased and we watched Charlie and the Chocolate Factory while they administered the test portions and took his vitals. More walnuts were administered every 30mins and he got through seven stages with no reaction whatsoever. Then the protocols changed and he was fed some pieces which he was able to pick up and put straight in his mouth. This was the game changer. I reckon that within about 5mins, he was starting to rub his right eye and I immediately recognised the same closing and swelling that had happened before. I rang the alarm and the nurse came through, showing those French eyes that quite clearly mean, "Ooh la la".
The nurse got straight on the phone for the paediatric doctors to come round and various people were in and out, checking on him and discussing his reaction. William started to get really scared as he could tell things were going wrong, and he just kept asking for Iain. I think he was scared that they were going to prolong his day and he wouldn't get home at all. After about 10mins, they administered some IV antihistamines and not too long after that he started to get really snuggly. I got BunnyElephant and while we were on FaceTime to Iain, he fell asleep. It was around this time that Dr. Assali came round and started telling me what the situation was. I knew this was important information and that I hadn't quite got all of it so asked if one of the english speaking doctors that had already been in could come and explain everything better. I let William sleep and managed to get some food.
At about 3.30pm two doctors came back around and gave me a good rundown and it was surprisingly good news. He'd completed seven stages which showed he was actually able to tolerate quite a high amount, and the fact his reaction was not symmetrical suggested that it was a localised rather than a systemic (anaphylactic) reaction. The doctors felt that it was possible that William had put the walnut in his mouth then touched his eye which has much more sensitive skin than anywhere else on the body, so it had just flared up. She assured me that despite how he looked, this was all really good news and the Dr. Assali wants us to make a follow up appointment at his surgery in a month to begin a reintroduction programme. I was actually astounded. I was sure that we were done and I wouldn't be back for two years, but here we are, still moving forward! Amazing.
Finally, William woke at about 4pm, had some food and I got him home. He was actually in great form by the time we were leaving. Back to his usual chatty self and asking lots of questions. He's exhausted though (much like me) and despite having a two hour kip this afternoon, went straight to sleep tonight at 8.30pm. I'm about to head up too. I am shattered. Thank God today is over though and that we can move on. I'd loved for it to have been a complete green light for walnuts and to have been able to get rid of the epipen but although we're not there yet, it's certainly a step in the right direction.
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