Introducing Peanut at the Food Allergy Institute as an Adult with a Peanut Allergy
My mom worried I might be allergic to peanuts months before I had a reaction at two years old that would prove her right. But before that, I suppose there was a time in my lifetime that my name and face existed without the association of food allergy. As the purple mountains and orange and teal stars were painted on the walls of my soon to be bedroom, there was a version of me yet to come that didn’t include food allergies. When I took my first breath, peanut allergy did not cross other people’s minds the way it does today.
But I’ve never known myself in that way. All I remember and all I’ve ever known is being a girl with a peanut allergy. And while I would go on to develop more allergies later on, the peanut allergy has always been there. It's always been a part of me.
That’s why, when I went into my last appointment at the Food Allergy Institute on Monday, May 22, 2023, I felt all kinds of mixed emotions as I ate peanut.
All the Feels
I have been a Food Allergy Institute (FAI) patient for almost three and a half years now. Through the Tolerance Induction Program (TIP), I am working towards a life unlike I have ever known. One where I can eventually eat whatever I want safely - even previously anaphylactic allergens.
In some ways, the program gets easier the longer you do it. I have a rough idea of what each clinic appointment looks like. I sign the medical acknowledgement papers, I challenge the food I dosed at home, I exercise, and then I introduce or escalate the food I will be working on through the next cycle. There’s less unknown from what to expect from the FAI than when I first started, and there’s some comfort in that. I’ve had so much success in these past years, and so I do trust the process.
However, as an adult in the program, I have a history. A history that’s been shaped by avoidance, structure, and reactions associated with peanuts. I still remember the summer evenings I sat on my parent’s kitchen countertops, with newspaper sprawled at my feet, searching for the word “peanut.” I was trained at such a young age that avoiding peanuts at all costs was a mission of my life. When I did experience reactions - big and small - I learned that I couldn’t always trust my body. There was a disconnect that I my young mind struggled to understand, but still existed nonetheless. That shaped me.
So when I sat there during my appointment, with an orange gummy with 1mg of peanut in it, I felt uncomfortable to say the least. Everything in my brain told me this was wrong. It was a battle, as it often is, to get myself to eat the darn thing. But even though every food challenge and food introduction has been a sort of mental gymnastics, peanut was just a little more challenging. My brain literally developed knowing that peanuts were harmful to me, and yet there I was about to go against every instinct I had.
This particular appointment was my first introduction to peanut, so in line with the usual structure, I challenged a food first. I had been dosing hazelnut at home, so I dosed hazelnut in the office first thing. Honestly, my focus was so much on peanut that I barely had room to worry about hazelnuts. The nurse put a ton of hazelnut (4g) in some rice for me. It took forever to eat, but once I had, I was checked out by the nurse and cleared for exercise. I ran in place for 5 minutes non-stop to ensure that if I was going to react, I would do it in the office. When I didn’t react, and I looked okay, it was time for the peanut introduction.
I was given a small, orange gummy for this introduction. It was only 1mg of peanut, "barely the dust of a peanut," according to my nurse. She advised that I eat it with a bite of rice, so that the carbs could hide the protein a little bit. Everything about being handed something with peanuts and making an effort to eat it felt wrong. I felt like my world was being spun in all kinds of ways. I went to eat it, and I just couldn’t. It was like something stopped my hand from moving. So I took deep breaths. I told myself it was going to be worth it one day. In the background, my mom and my nurse reminded me how so many of the things I have been dosing for the past three years - lentils, chickpeas, soy, pea - were all preparing me for this moment.
So, I ate the peanut gummy.
After Eating Peanut
As I chewed the gummy and rice - kinda a gross combo but I’m getting used to gross combos with all this dosing - I felt okay. I started out chewing SO. Slowly. I gained a little bit of confidence for just a second.
Then it hit me.
What did I just do??
Omg you just AtE PeAnUt. Whattt……..the…….heck.
My mind started racing with so many thoughts all at once. Watching the video back, it’s so clear in my face and my actions when this switch happened in my mind. All I wanted to do was freak out. And cry. Or possibly both.
But I didn’t because I knew if anything was going to cause a reaction, that might be it. The goal with introductions is not to push me to react. I took deep breaths. I tried to get it under control and listen to my mom and nurse talking to me, telling me I was doing great while my mind wanted to pull me into panic.
It took a few minutes for me to feel like I was genuinely going to be okay. I trust this program and trust the plan. I just don’t always trust my body. I could tell my body knew what was up. It’s hard to describe the feeling to someone who doesn’t have a reactive body. My body knew I had peanut. There was a shift somewhere, but it didn’t react. My body just let me know it knew. It wasn't happy, but it was going to tolerate it today. I was thrilled when I realized that everything was going as it should and eventually that uncomfortable feeling went away.
I waited for 15 minutes after I ate peanuts. Typically, the nurses will leave if they think you seem okay and tend to other patients in between. When she came back, she cleared me to leave. There wasn't itching, or any signs of a true allergic reaction. I was good to go.
And boy was I glad to go back to my hotel and rest for the remainder of the day after that.
What’s Next for Me
Hopefully, Vietnamese cuisine with peanut sauce? Peanut butter cookies? Reece’s cups? But not for a while still. In the near future, I will be dosing peanuts at home for nine weeks. Unfortunately, I’ve got a long way to go until I am safely eating all things peanut. But I’m also closer than I have ever been in my life to eating those things. I really believe it’s going to happen one day. I have tree nut allergies, yet now I’m eating most tree nuts freely and safely. Peanuts may be a bit harder for my body to get through, but I know I will at some point.
As of writing this, I am dosing 0.4mg of peanuts at home. We always start at home at an amount a little bit smaller than what we introduced in the clinic, but I will reach a higher amount before I go back to the clinic in July. It’s hard to predict the timing, as it’s so dependent on my body’s response. But I will be working through peanut for the rest of the year, with various in clinic challenges so that I can safely increase the amount in between. It’s possible that by this time next year, I might be working through my biggest allergen - walnut (fingers crossed but also ahhhh scary).
Each day, I will eat my maintenance and dose. Each day, I will get a little bit closer to remission. Closer to freedom. Closer to a reality where I am aware of what it’s like to exist without food allergies concerns.
Be sure to follow my instagram @nutfreementality for real time updates on my treatment, appointment recap videos, encouragement, and little bits of my allergy life.