Pokes of A Different Sort

After hearing that Betty was getting allergy shots so she would no longer have difficulty around cats, and after I talked to Kelly about their doctor’s insight on getting asthma under control young so the lungs can develop unhindered, both Monkey and I felt like further investigation into her wheezeys and allergies was a good step forward.

We headed to the Vandi ASAP (Vanderbilt Asthma, Sinus and Allergy Program) clinic last Friday, and we’ve got a plan! I love a good plan.

As always, Monkey was so self-possessed and calm. She was a little nervous, but composed.

After learning the doctor we were meant to see had been called away for a family emergency, then the second specialist did not take pediatric patients, we finally ended up with Christine MacLean, and she was wonderful. Listened to Monkey and asked questions of both of us, not just me.

Though we had blood-work allergy testing results with us, she recommended we have the skin test done, too. She said it was more accurate. I am not sure if that is true. I suspect that is just their general operating procedure, but we were certainly open to getting more information, so we headed downstairs for more tests.

First stop, pulmonary function.

This was a great example of how working with a group that often works with younger patients makes a big difference. I would go with my dad for pulmonary function tests, and they were never this fun.

Testing began with breathing.

Testing began with breathing.

Monkey was measured on air intake and exhalation. The “goal” was to burn down the cottage with her fiery breath while exhaling.

Blow enough fire to burn down the house.

Blow enough fire to burn down the house.

After the first round of breathing tests, she used a ventolin inhaler with a spacer, and after that had a few minutes to work, she did the tests again.

Then we headed down for skin testing.

The initial test.

The initial test.

Thirty highly-likely allergens, ranging from dust to grasses, cats, dogs, etc. Horses had to be added in as an extra. Then we sat for 15 minutes to see which of these would react.

Waiting for red welts.

Waiting for red welts.

You can see the “H” in the shot above, which is histamine, which everyone should react to to show the test is valid. Monkey is obviously red.

After the tech read those shots, she selected the 9 most reactive to test with a small injection under the skin. The goal was to get a measurement on these reactions so it can be compared down the road after allergy shots have been given for awhile to see if the reaction is lessening.

This part was painful for Monkey. The shots hurt, plus the fluid injection quickly gets itchy and uncomfortable. She got through it was grace, and we waited for 15 minutes for these to react.

Red and a little bloody.

Red and a little bloody.

The skin testing and the injections didn’t turn up any new information, which I guess is good. Disappointing that the blood testing we brought with us would have been sufficient, but we couldn’t have known that.

The child is delightfully unallergic to most common things. She’s truly only allergic to cats, dogs, and horses.

Christine met with us again after all the testing was complete to go over the plan.

Monkey will be on a couple different allergy medicines. She’ll be doing nasal lavage, as well as a nasal inhaler. Her sinuses are “a mess,” and if those aren’t better, they won’t start doing the shots, so Monkey has been a trooper about doing these things, which aren’t all that pleasant. Finally, she’s on a daily inhaler, with the hopes of healing the lungs, rather than using the rescue inhaler so frequently.

This all began on Saturday, and she hasn’t had a dose of benadryl, nor needed the rescue inhaler, so it seems to be working.

I’ll call today to set up the schedule for allergy shots, which all agreed she was a good candidate for. The doctor who came in to explain them to us was great about answering our questions.

In general, people get the shots “intensively” for the first 6 months or so. That means 1-3 times per week. Then they eventually taper to maintenance levels, which will be once/month, then every other month. This whole process takes 3-5 years! Approximately 75% of their patients show great results from the shots, and about 50% find life-long “immunity” with them. The general impression I got was that you could go in for “booster”shots, which prolong the impact. We need to learn if having pets actually provides some of that immunity, too. Still so much to learn.

Overall it was a valuable, worthwhile visit. Monkey was falling asleep in her chair by the time we left the office. It was a long morning with lots of information.

On to the shots.

Nutella Red Velvet Poke Cake

Yessa and I had a hankerin’ to do a little baking yesterday, and I suggested she look through Ms. Lindsay’s blog and choose something that looked delicious. Ms. Lindsay is one of Buds’ and my co-workers in the Atlanta office. We had two of her recipes at our New Year’s Eve Celebration, and I felt pretty sure Yessa could find something delicious she would enjoy creating. Plus, Ms. Lindsay’s pictures are scrumptious to look at.

Yessa chose Nutella Red Velvet Poke Cake, and it was a tremendous hit. We’d never baked with nutella before, in fact, I don’t think we’ve ever even had it in the house. (While we were at the grocery store getting nutella, we ran into our neighbor who dressed as Merida for Halloween, and now we know her real name, and I can stop thinking of her as “Merida.” She’s Bailey.)

Oh my holy buckets and stars, folks. This was the best cake we’ve ever eaten, and it isn’t even frosted yet! And I don’t even like cake! It was so warm and moist and gooey. I also believe there will be more nutella baking in our future. Keep those recipes coming, Lindsay!

You really do poke it full of holes. Buster helped with this part.

You really do poke it full of holes. Buster helped with this part.

The nutella-sweetened condensed milk mixture pours vvvveeeerrrrryyyy slowly.

The nutella-sweetened condensed milk mixture pours vvvveeeerrrrryyyy slowly.

Still pouring.

Still pouring.

Soaking in. We tested it to be sure it was okay.

Soaking in. We tested it to be sure it was okay.

Musical Inclinations

After many moved dates and changes in appointments (Never try to start a new class right before the holidays in December!), Yessa finally had her first violin lesson.

Being of an introverted sort, at least upon initial introduction, Yessa was nervous, but once she saw Ms. Malinda, she was enamored. A more sparkly, friendly, supportive, kind instructor you could not ask for. (Rest in peace, my tear-inducing childhood piano teacher from The Nether World.)

Yessa spent the first class getting a violin (1/2-size), learning about the musical notes, practicing holding the instrument and playing the notes, and just generally getting comfortable.

It was a lovely first lesson, and she’s excited to go back.

Holding the instrument the first time.

Holding the instrument the first time.

Where the bow should rest.

Where the bow should rest.

The bunny ears that hold the bow.

The bunny ears that hold the bow.

Ms. Malinda prepping the horse hairs.

Ms. Malinda prepping the horse hairs.

Placement

Placement

"Mary Had A Little Lepper." Nashville does things their own way.

“Mary Had A Little Lepper.” Nashville does things their own way.

Showing Dad.

Showing Dad.

Let the practice begin.

Let the practice begin.

Grandma Babs is also taking violin lessons, and I envision a day when a duet of “Mary Had A Little Lamb” is being played via skype.