Melts in your mouth…

Huge day today! The updose was very successful, with both boys transitioning smoothly to 2350mg and eating real, looks-like-a-nut-feels-like-a-nut nuts today. The boys were excited all day in anticipation of starting ‘real nuts’, probably fueled by the promise of peanut M&M’s, the most visible and easily recognizable candy of all the taboo candies out there for them. Aviv was so excited about the prospect of having his first M&M, that he did a little dance in his seat the whole way down in the car, and even announced at school today that he was going to have his first nuts. While Ari has been happy to talk about this process with anyone, Aviv has been reticent; today was the first day he seemed to feel comfortable (or safe? Or excited? I’m not sure…) enough to bring up the topic on his own and share this milestone with his teachers. I’ve been concerned about how this has been affecting him emotionally, and it was a relief to see his excitement and hear him sharing proudly.

While the boys got settled in for their vitals check and began their movie du jour, Orr & I got a lesson from the SAFAR nutritionist in protein contents of different nuts, which types to use for dosing (glazed, chocolate covered, etc.), how to make the nuts palatable and measurable (raw jammed into a brownie, cooked into little muffins, etc.), and other tips for the next two weeks of dosing. We’re in a transition dose, between all powder (last time’s dose) and all nuts (next time’s updose), where they’ll have some of their nuts in a powder (that we’ll continue to mix into pudding or apple sauce), and some as actual nuts. Ari will have one and a quarter actual walnuts (plus his powder mix of hazelnut and pecan), and Aviv will have three quarters of a walnut and 2 peanuts (plus his powder mix of hazelnut, pecan and cashew). Peanuts are easy (uniform size and covered in sweet chocolate and a candy shell? Thank you, Mars Co.), but finding properly sized walnut pieces (to make sure the weight is accurate for the dose) is actually challenging, so we’ll have to figure that out quickly.

Then it was time for their dose: large quantities of pudding and apple sauce, respectively, with their powders before we turned to their cups of actual nuts. It’s funny – even though we all knew that the powder they’ve been eating for the past 2 weeks was ground nuts, it didn’t have the same visual/emotional impact as actual, whole nuts. There was a quiet moment when the four of us looked at their cups of nuts, and each other, as we absorbed the moment. Aviv turned to me and quietly told me he was scared. Me too, honey; me too! We reminded them that their bodies were getting stronger and that they could do it, and then we spooned glazed walnut pieces in to their mouths, watching nervously, curiously and excitedly as they experienced them. Neither kid loved the taste (walnuts can be a bit bitter), but ate them without issue. Then as the big finale, Aviv got to have his first peanut M&M’s. He peered into the cup to look at them, and Ari insisted on getting a close look too – this is the closest they’ve ever been to them, after all – before Aviv gobbled them up, beaming and proud.

We sighed with relief and listened with pride as the boys announced their success today to grandparents and friends on the way home. Aviv even asked that we tell his teachers tomorrow. I can hardly believe it. I remember sitting in a meeting for the SAFAR Advisory Counsel a month ago and hearing another mom tell of her daughter’s first peanut M&M that week, and getting teary, knowing how big that moment must have been for her, and also feeling that I couldn’t really imagine that/when that would occur for us.  I knew intellectually that this day would come; I’m just so stunned that it came so soon. I’ve been in contact with a few parents of kids who are in the non-Xolair trial, and they’ve had slow and steady updosing for 9ish months to get to the level we reached today in our first updose. I wonder if the wonderment of reaching each step feels as surreal, as there is more time to prepare for it and build toward it in the non-Xolair trial… sort of like having a baby, where the 40 weeks helps the baby fully form, and the parents more fully grasp how their life is about to change. It doesn’t make the wonder of having a baby enter your life any less amazing; you just have a little longer to feel the kicks, see the ultrasounds and absorb the reality. Here, we’re still trying to absorb the reality of this accelerated process; big smiles and happy shrieks of “We ate our first nuts!”, certainly helps.