What is a trial?

In many of my posts I mention Gabriel 'trying' a food.  Most parents ask their kids "just try it" to see if you can get them to eat the asparagus.  For us 'trying' or 'trialing' a food has a whole new meaning.

Gabriel has Eosinophillic Esophagitis, and also suffers from severe life threatening food allergies.  When we try a food, it's a risky process that is done with the supervision of a doctor.  Each kid with EoE has a different process for trialing a food, depending on the kind of reactions they have, they're doctors advice, their age, risk factors, etc.

Over the last 18 months we have trialed:
strawberries
pork
lentils
pineapple
broccoli
squash
sunflower seeds
string beans
artichoke
turkey
beef
chicken
apple

This trying, scary, emotional process starts with blood work.  The doctor runs a test- that does not require putting food proteins anywhere near Gabriel, to make sure that it would not cause a life threatening reaction.  IN rare cases, children can actually suffer dangerous reactions to skin tests, so blood work is the safest way to start.

This is Gabriels scratch test after just a few seconds.
I did not get a picture at the end because I spent
the next 10 minutes fanning and consoling Gabriel until it was
 finally taken off at about 5 minutes.  

Once we've passed blood work we move on to scratch tests.  This is where the doctor takes a sharp plastic device, and scratches the surface of the skin and applies a liquid version of the food proteins to the scratched skin.  The skin is checked at 10 and 20 minutes.  IN the most severe reactions, a welt grows in the first 30 seconds. To make these tests a little more complicated-  Gabriel must be off steroids and antihistamines for 5 days before the test.  yikes.

Patch testing in progress

Gabriels reaction to patch testing tape

Patch tests.  Patch tests never work out too well for us....  Because many eosinophillic reactions are delayed response, it is important to test for a delayed response.  To do this, the doctor applies a special patch to the back with foods on it.  It stays on the skin for 3 days, and then is removed, and checked the 4th day for a reaction.  Gabriel is so allergic to the adhesive, that this is typically a traumatic week of screaming, crying, and flailing around- trying to reliving the burning stabbing itching covering his whole back.  Our last patch test was so welted from the adhesive alone, that the food results were not readable.







After all 3 tests, the allergist and I sit down and compile a list of foods that didn't show a reaction on any of the 3 tests.  While the tests and not incredibly accurate, and there is still a high likely hood that Gabriel can not tolerate the foods, the foods that did not cause a reaction during the tests are the least likely to to cause a reaction when eaten.
We choose which food to try first either by the highest nutritional value, or by Gabriel's choice.  This is always a balance over 'quality of life.'    When we have finally chosen a food to try- it's an even bigger ordeal!  I go to the store and debate for a whole hour 'do I buy a lot cause we're just so excited? or do I just buy one package incase its a fail?'  We have to wait until Gabriel is completely symptom free from any other seasonal, food, airborne, or illness reactions.  Once he's feeling great, we prepare the food together and cross our fingers.  We start slow.  Just one serving the first day.  If we are trialing a meat, I make a broth first, to make sure his body can handle it.  In a journal, we record and describe every bowel movement, every itch, every feeling, emotion, and complaint.  Some food reactions are very obvious-- rash around the moth, swollen lips, hives on his bottom, etc.  Other foods hide.  The send an army of white blood cells to attack his esophagus.  His esophagus begins to narrow in size, grow scar tissue and ridges down it, and affect his esophagus irreversibly, and eventually his ability to swallow.  These reactions we don't always know about until the doctor scopes and biopsies his esophagus.  While we cant see these reactions from the outside, they are just as dangerous.  If reactions are present, the food is removed immediately.  So, some trials last only one week, and others can last as long as a month.  Then comes recovery-  A new food can not be tried until he completely recovers from the previous reaction.  ...

Phew.  Welcome to the world of food trials.  Next time you go to an exotic cafe, and you get to try a new food---- Just imagine, for a second, if this is what trying a new food meant for you.

Oh and by the way, we failed everything on the list.