Thursday, April 11, 2013

A Little Chef's Card Victory

First, a confession:  We don't go out to eat with the kids very often for a variety of reasons, one of which happens to be avoiding food allergy hassles.  And by "hassles" I mean both cross-contamination risk and the hassle of having to talk to restaurant staff about allergies.  There, I said it.  I am not very practiced at it, and so I still feel...shy?  Embarrassed?  Like I am bothering them?  

I know it's important for us to go out, and to model proper food allergy behavior for Georgia so that she can grow up to one day handle all of this on her own without a second thought about it.  I get that.  I'm just admitting here that I do not love it, and it is something I am having to force myself to practice. 

So anyway, that's a little bit of background, but tonight I have a success story to report.  Georgia and Joe went out for their first ever daddy/daughter dinner date, something we've been trying to incorporate in order to give each of our kids a little more one on one time with us, their awesome parents. 

Joe called ahead to the restaurant, Dunlay's on the Square, to ask what kind of oil they use for their french fries and to confirm that the same oil was not used for frying fish, since Georgia has both nut and fish allergies.  Whoever he spoke to on the phone assured him no fish were fried in the french fry oil.  

Fast forward to the restaurant.  Joe brought our little laminated chef's card along and handed it to the server while mentioning Georgia's allergies and placing her order.  The server returned momentarily to the table, apologetically explaining that it turns out fish had been fried in the french fry oil earlier.  What a great catch!  Ah, the power of communication. 

So, I guess the lesson here is: yea for chef's cards!  And also: suck up any feelings of embarrassment over being a high-maintenance customer, and always communicate!  (To his credit, Joe is really better about this stuff than I am.) 

Thursday, February 7, 2013

Sesame Reaction

Please ignore the fact that I titled a post "2012 Allergist Appointment" (or something like that) and then never got around to describing that appointment.  I'll get back to that eventually (maybe).

In the meantime, I thought I'd mention that several weeks back, Georgia had an allergic reaction to sesame.  Thankfully, it was minor and subsided after a dose of Benadryl, but it was a little disheartening nonetheless.  You see, as important as it is to be vigilant about avoiding Georgia's allergens, when we do it successfully I think it sometimes lulls me into a false sense of security.  I start thinking no reactions = no allergy, as opposed to no reactions = no exposure.  I had begun to think that maybe, just maybe, Georgia had outgrown her sesame allergy, and at our 2012 allergist appointment I was asking the allergist about doing a sesame food challenge.  (We were told, "maybe next year, depending on her test numbers.")  So, having convinced myself that maybe she wasn't even really allergic to sesame anymore, it was a bit of a bummer to find out that nope, she still is.  (Funny, this happened with egg a few years back, too.  Although I guess that experience should give me hope since she has since outgrown her egg allergy.)

The story of what happened just illustrates once again the importance of always reading labels.  We were at home, and Georgia asked for a sandwich so I made her one using some store bought bread we had on hand.  It was a brand we typically buy but turned out to be a different variety than what we normally buy.  I didn't even notice that the packaging was slightly different until Georgia took one bite of her sandwich and started complaining that her throat and face itched.  At that point I grabbed the bag, realized it was something new, and scoured the ingredients to find, sure enough, sesame.  Oops.

Now, I don't want to play the blame game, because there is no point to that.  We're all doing our best to keep our house allergen free to keep Georgia safe, no question.  But I couldn't help but be curious to understand how this happened.  It turns out that while at the grocery store, my husband Joe asked Georgia to grab the loaf of bread off of the shelf and put it in the cart.  She was happy to oblige, and he did not stop to read the ingredients (seeing that she had picked up the right type - or so he thought), and no one noticed that it was a different type of bread than our usual stuff.  So, lessons learned: (1) probably can't trust the 5 year old quite yet on food selection without double checking her work, and (2) we all need to pay more attention to slight differences in packaging.  [All experts and smart people agree that even if the packaging looks the same and it is something you've eaten 1,000 times before, you should still re-read the ingredients every time before purchasing, because you never know when the recipe of a processed food, or its manufacturing practices, have changed.  And that is 100% good advice, but I'm just being honest here and admitting that we do not always follow it.  I have not, for example, been re-reading the mac 'n cheese ingredients every time I buy a box of our "regular" brand.]

Another lesson:  maybe I should get back to making homemade sandwich bread more often.  I did that regularly for a year, to the point that we rarely bought bread.  The recipe contains only 6 ingredients (including water), and the whole family likes the taste even better than the store bought stuff.  It's not that time consuming to bake, but let's face it - does take more time than pulling a loaf off the shelf at the grocery store!  So I just need a figure out a way to work it into the schedule more frequently.  

Sunday, September 2, 2012

Allergist Appointment 2012

I can't believe that I never really got around to discussing Georgia's October 2011 allergist appointment, and now here we are having completed her 2012 allergist appointment.  Mostly that just means I've been busy (raising children, taking care of a baby, etc.), but I think it's also a positive sign that allergies don't mentally plague me on a daily basis as much as they used to.  At the beginning, when you get a food allergy diagnosis, your mind is swirling and there is a steep learning curve with many unanswered (and in some cases, unanswerable) questions to confront.  But as time passes, allergies just become a part of life like anything else.  So, I guess that is a good thing. 

Before we get into how this year's allergist appointment went, let me share a few bullets about other stuff.
  • My father passed away in May.  Obviously, that's a whole other story (and one of the reasons I've had a busy year), but the reason I'm mentioning it here is that I believe it to be noteworthy that we survived a week of non-stop grieving food generosity without incident.  We traveled for the funeral and were staying at my parents' house. My parents' friends were unbelievably kind to put on a veritable buffet of homemade comfort food for days on end after my dad died.  It truly was amazing - and delicious.  Obviously, my first feeling about this was thankfulness.  However, I was quite nervous about the prospect of Georgia eating so many things prepared in others' homes.  Many people were nice enough to even ask about her allergies, but good intentions and loving care do not always translate to safety.  For example, when sesame seed buns were offered, someone thought that Georgia simply eating bottom buns only would work.  But with vigilance, and passing on pretty much all of the baked goods, everything was just fine.  I will admit that my safety standards were not as high as normal, but high enough I guess?  Or did we just get lucky?

  • We made it through an entire school year without Georgia suffering any allergic reactions at school.  Woo-hoo!  Props to her teachers for so carefully reading all snack labels.  I'm thrilled that she'll be in the same classroom again this year with the same teachers.  (It's Montessori, so even though she's moving on to kindergarten, it is a mixed-ages environment.)  It's such a comfort to know that her teachers already know the drill.  Nevertheless, we still met with them a few weeks ago, because it never hurts to review emergency procedures and that kind of thing. 
  • Minor gripe:  if the school in practice is storing her Epipens and Benadryl in a conveniently located cabinet in the classroom, why must they continue to have me sign an "official policy" that states all medication will be kept in a locked cabinet in the main office, accessible only by the principal and her designees?  I'm satisfied because I've seen with my own two eyes where Georgia's meds are stored.  But I know our allergist would not be happy with the thought of medication being locked up and not in immediate reach.  I've been led to believe that in some cases of anaphylaxis, an extra 15 seconds or 1 minute can be the difference between life and death.  Anyway, I'm biting my tongue on this one since at base I've already gotten what I want, but it always bothers me when policies don't match reality.  

  • Earlier this month we went to the American Girl store in Chicago for the first time.  Overall, I was quite impressed with their allergy awareness.  (Of course you should use your own judgment, but I felt comfortable letting Georgia eat their food.)  When we booked the reservation online, there were boxes to check to indicate certain common food allergies.  I later called to speak to one of their customer service reps about Georgia's allergies and their allergen practices generally.  The only part I'd give them low marks on was communicating all of this to the server, because when I made sure to mention Georgia's allergies to the server, she handled it very politely, but clearly it was the first she'd heard of it.  I suppose from a practical standpoint that may have made absolutely no difference, but somehow it didn't instill a feeling of confidence in me about everything else they'd already told me on the phone.  I guess I assumed if you checked an allergy box on your reservation form that when you showed up there would be an allergy indicator next to your name or something.  Also, American Girl serves soy nut butter rather than peanut butter finger sandwiches, which is great.  However, I think they (or at least our server, perhaps I should say) are in the habit of nevertheless describing these in person as peanut butter sandwiches when setting them on the table.  I imagine this is to help the parents of picky eaters avoid any difficulties; call it peanut butter, and nobody asks questions (at least I assume that's the idea).  It caused our table to do a double-take, though, at which point the server corrected herself and we all chuckled mildly in relief.  Interestingly, Georgia still declined to eat any of them.  She really is unbelievably cautious at this age, at least when it comes to food, which is fine by me.  One more American Girl anecdote:  did you know that amongst their doll accessories, they sell an allergy-free lunch, including a faux allergy shot and medical bracelet?  We didn't buy one, but how cool is that?
I think it's a sign of the times that enough children have food allergies that a doll store would even have something like this available.  My first thought was, "Who needs this expensive set? We could fashion our own from stuff we already have at home."  I could see myself eventually deciding to treat Georgia to this, though, because in my view it's no different than the dolls with glasses, braces, or the ones in wheelchairs; every child just wants to feel normal and accepted for who they are. 

Wow.  Those were some seriously long bullet points!  Sorry for rambling on, but now I think I've got to go.  The allergist appointment summary will have to wait for a different post.  (And because I am too lazy to change it, this post will now have the most poorly selected title ever!)
Until next time...take care!  

Monday, February 27, 2012

Oh, hello there!

Hi there, poor, neglected little allergy blog o' mine. I'm not sure where the time has gone, except, wait, actually, yes I am. I had a baby boy in August, and as such critters are wont to do, he's been keeping me quite busy. Three kids under 5 is officially a handful in my book. With a scarcity of spare minutes for blogging, I've been devoting those minutes to capturing Waylon's babyhood and our girls' antics elsewhere rather than Georgia's allergies on this blog.

All of that said, I have made connections on this blog with other families dealing with food allergies (sidenote: my apologies to those of you to whom I owe emails; it's nothing personal but I've been terrible about correspondence lately), plus I like having some record of Georgia's progress, so I'm not yet interested in totally foregoing this blog or shutting it down.

They say when you get behind in school, sometimes it's best to just let go of what you haven't done and instead start reading for the next class. With that sentiment in mind, I'm jumping back into this blog without rehashing every detail of the past 6+ months.

But there were a few events worth mentioning...

In September, our family participated in a FAAN Walk for Food Allergy. I am not sure whether Georgia really got a kick out of being in a community of supportive people and others with food allergies, or if I was just projecting that sentiment on to her because I sort of felt that way? Anyway, it was a gorgeous fall day. We tried to explain to Georgia beforehand that the purpose of the walk was to raise money for scientists and doctors to learn more about food allergies, and she really latched on to that apparently. My favorite part of the walk was that she kept asking where the scientists and doctors were. "Is he one of the scientists, mommy?"

FAAN Walk for Food Allergy 2011

FAAN Walk for Food Allergy 2011
It was a 2 stroller kind of day for our crew.

FAAN Walk for Food Allergy 2011
Waylon, always the supportive little brother at 5 weeks old, wore his green ribbon in honor of his big sister. (Blue ribbons were for those with food allergies, green for friends and family.)

FAAN Walk for Food Allergy 2011
Good thing this wasn't a race; I think we would've come in dead last. Actually, we didn't really complete the whole walk, but I think it's the thought that counts, don't you? At this point in our life as a freshly minted family of five, I was impressed with us just for showing up.

FAAN Walk for Food Allergy 2011
June enjoying some fancy top 8 allergen-free jelly beans. (They had all sorts of free goodies there.)

FAAN Walk for Food Allergy 2011

FAAN Walk for Food Allergy 2011

FAAN Walk for Food Allergy 2011
I think I look pretty terrible here, but with good reason, right? And now you can see part of the reason our troupe was moving so slowly.

FAAN Walk for Food Allergy 2011
Georgia proudly showing off her free t-shirt.

FAAN Walk for Food Allergy 2011
Normally, people with food allergies just want to fit in with the crowd and be "normal." But when you're 4, you think it's pretty darn cool to get your very own special blue ribbon just for having allergies.

FAAN Walk for Food Allergy 2011
June kept running way ahead of us on this path along Lakeshore Drive. I love her wobbly toddler jogging. : )

Oh, shoot. Look at the time! Well, I had intended to write about Georgia's October allergist appointment, too, but if I wait to complete that, this will probably never get posted. So I'm just going to hit "Publish Post", run to get in the preschool pickup line now, and save the rest for a different day. Ta ta!

Monday, July 25, 2011

Peas? Really?

This should be short because I'm not sure what to make of it yet. Georgia has started occasionally complaining that eating peas makes her mouth itch.

What? Please, no. Peas, like peanuts, are a legume, so it's not totally unheard of for people with a peanut allergy to also be allergic to other legumes like peas and beans. But Georgia did a food challenge for green peas at her allergist's office nearly 3 years ago and passed. She's been happily eating peas with no problem ever since. (Yes, I know from experience that food allergies can crop up at any time, but still, it's harder for me to accept that that is what's happening here.)

Oddly, she likes to eat her frozen veggies straight out of the freezer sometimes (hey, it's easier for me as the chef, so I'm not gonna deny her that request), and she has told me that her mouth doesn't itch when she eats the peas frozen.

For now, I haven't cut them out of her diet, because I'm still trying to figure out if this is all real or not. Of course we take potential allergies seriously around here, but at age 3, she's not always the most reliable reporter and has been known to put on academy award worthy performances sometimes. So, we're keeping an eye on her pea intake and will ask the allergist about it at her next appointment.

Monday, July 11, 2011

Allergy Dad Confession: Cookie

Okay, that post title is a misnomer, because it's not really a confession when someone else is doing it for you. I think it's more like tattling. Whatever.

Georgia's preschool teacher sent her home with a homemade star-shaped cookie to celebrate the 4th of July. (Aside: people often do not get it why allergic folks are so wary of others' home baked goods. I know they mean well. I'm sure the teacher, who of course knows of Georgia's allergies, gave it to her thinking that it was safe. I'm guessing she'd be surprised and not totally get it if she heard that we still wouldn't let Georgia eat that thing. I'm just glad and amazed that in this instance Georgia didn't immediately gobble it up.)

Anyway, the point of the story is that not knowing more about the ingredients or the cross contamination risk from this woman's kitchen, we did not allow Georgia to eat the cookie and instead threw it out, or so I thought, but then I later found my husband standing at his dresser munching on it. You little devil, you! I guess he just can't let a good cookie go to waste!

Tuesday, May 24, 2011

Are Food Allergies Funny?

I know that post title makes it sound like I'm about to go off on a diatribe about how food allergies are not funny, but I honestly mean the question sincerely and would be very curious to hear your thoughts, especially if you (or your child) do not have food allergies. I am always interested to hear the viewpoint of people not so immersed in the allergy world as I am.

I've noticed that it's apparently okay in popular culture to poke a little fun at food allergies. This recent post over at Dooce, (which largely has nothing to do with food allergies), just reminded me of the topic. Clearly, she wasn't trying to offend people with food allergies, she was just trying to make her point in a humorous way by poking a little fun at herself.

I can also think off the top of my head of episodes of The Office, 30 Rock, and Modern Family that have all incorporated food allergies as part of the plot within the last two years. Being sitcoms, the situations shown are meant to be funny of course, but I find myself clenching up and having trouble appreciating the humor. I literally sit there having an internal dialogue with myself going, "Kate. Do not be so uptight. It is just a joke, for crying out loud." And in the category of "any press is good press," one could argue that even poorly portrayed images of food allergies raise food allergy awareness amongst the general public. (I'm not so sure I agree with that theory in this case, but I'm just throwing it out there. In my opinion, a truly inaccurate portrayal of food allergies can do a real disservice to people dealing with them. For example, a portrayal of a buffoon with a fake food allergy might fuel doubts about whether other people's properly diagnosed food allergies are real.)

Anyway, I'm mostly not offended by sitcom portrayals of food allergies, or people using food allergies in jokes, I guess, because I have to admit, it does just go to show that with food allergies on the rise, they are much more a part of the viewing public's consciousness than they would have been 5, 10 or 15 years ago. And that apparently makes food allergies acceptable fodder for comedy.

The more uptight part of me has to wonder, though: would it be okay to poke fun at someone with cancer, diabetes, autism, or some other affliction in the same way? Would the viewing audience find it as funny? Why are food allergies so funny? Sadly, I think it's because a lot of people secretly find it sort of annoying to have to be bothered by the food allergies of those around them, so jokes are a way to let off steam about that.

I don't know. Those are just some ideas I've been pondering. What do you think?

I do believe that in life it's critically important (regardless of the situation) to retain some ability to laugh at ourselves. So I'm really striving to foster the part of me that is not offended by attempts to humorously portray food allergies, and to tone down the part of me that is admittedly still a little uptight about it. It's all about finding the right balance, I guess.

Tuesday, May 10, 2011

I have no idea what just happened there

Well, that's not completely true. In retrospect, we're pretty sure that this was "merely" a contact reaction.

Wait, let me back up and start over from the beginning. We went to Florida on vacation. We stayed in a condo and ate most of our meals in. We didn't want to be total party poopers, so we tried venturing to a restaurant with the kids. And as luck would have it, Georgia somehow broke out into a pretty bad case of hives at the table....BEFORE OUR FOOD WAS EVEN SERVED.

Grrrr. What the hell? I mean, seriously, is this a joke? Can we now not even safely set foot in a restaurant?

I guess we will never know for sure what happened, but our best guess is that she brushed up against something on the table and then touched her face, or that some kind of food residue was left on one of the communal crayons in the crayon bucket that Georgia had started using while we were waiting to be served. For a while there, Joe and I had some fears that this incident might indicate that Georgia is now so allergic to fish that the mere presence of fish "fumes" in the restaurant was enough to set off this reaction. However, we've thankfully since proven that theory invalid, by getting back on the horse so to speak and venturing to a restaurant as a family again four days later -- a heavily seafood oriented one at that. (They're a bit hard to avoid when you're staying on an island.) So, it's probably more likely that it was peanut butter or nut residue of some sort on the table, chair or crayons, I'm guessing.

Anyway, a few more details on what happened:

-Georgia went from totally fine, to "Gee, honey, does her face look a bit splotchy to you?", to "Um, she's clawing at her face now..." in a matter of about 2 minutes.

-We gave her some Benadryl but then realized it was boiling hot from having accidentally been left in the car all day. Not being certain whether the active ingredient would still be effective, we didn't want to take any chances. We bolted from the restaurant, (my parents stayed behind to pay and take the food to go), and then our little family sped around the island stopping at four different convenience/grocery/pharmacy stores before finding a fresh bottle of liquid Benadryl for sale. (Just picture 6 months pregnant me, sprinting in and out of each establishment in pursuit of relief for Georgia.)

-I don't know if these were "bad" hives comparatively speaking, but they were certainly the worst case Georgia has ever had. Her face was the worst and continued to blow up a bit as we drove around, and the hives spread to her neck, shoulders and arms - but not nearly as bad as on her face. Her eyes were extremely puffy, especially underneath. I'm not sure the photos I took show any of it very well.

-Joe maintains a "fake calm" front for Georgia when this stuff happens, but man oh man, does he get tense!

-I was anxious and worried watching the hives spread, but not too panicked because I could see that she was breathing fine, and had no swelling of her lips or tongue. Also, we had the Epipens at the ready if things had taken a turn for the worse. (Thank God that did not happen!)

In the end, the Benadryl kicked in, the hives subsided, and all was well. Georgia took a shower back at the condo just to be safe, ate a makeshift dinner, and went to bed. (We later woke her for 1 more dose of Benadryl, just in case. Oddly, we found her out of bed, sleeping face down on the plush carpeted floor! I wonder if that was total coincidence, or if the Benadryl made her a bit loopy?)

So, that's it, but I think this little incident illustrates two things very well:

1) When dealing with a three year old, food allergies are often harder on the parents than the kid. Sorry if that sounds rude or self-centered, but in our experience, Georgia (at this age) doesn't get too upset about foods she can't have. Also, almost all responsibility for what she eats or doesn't eat falls on our shoulders and not hers. She's not even as mentally affected by her reactions as we are while she is having them. She's complaining of the itch, while we're worried that something life threatening is going on. (In the midst of this reaction, she looked down at her arms and said, "Well, the good news is that at least I don't have hives on my face!" I just laughed and said, "Oh, sweetie. If only you could see a mirror.")

2) Sometimes the eventual outcome doesn't paint a full picture (to friends/relatives/third parties) of what it feels like to witness your child having a reaction, or how it can continue to affect you afterwards as a parent. I'm sure that could be said for any type of accident, disease or medical situation involving one's own children, but what I'm getting at is the idea that this reaction can be boiled down to: she touched something, she had some Benadryl, she was fine! And I realize that the "she was fine" part is the most important. But while it's happening? Your blood pressure skyrockets. Your brain wonders "what if?" You blame yourself for having not wiped the table, or for having left the Benadryl in the car, or for whatever else you might come up with. And then afterwards, you're relieved that she's fine but find yourself wondering, "Is it even worth it to go to restaurants?" followed by, "But geez, she can't live her life in a bubble." Then you find yourself on the plane trip home 5 days later thinking, "Oh holy crap, what would I do, and how would I feel, if she had that same kind of "minor" contact reaction right here, in this confined space flying through the air?" (I really tried to put that thought out of my mind, but it did creep in there from time to time as I reprimanded Georgia for senseless (but totally normal for a three year old) behaviors, like putting part of the seatbelt in her mouth.

So, I guess that's it. None of Georgia's reactions (or our responses to the reactions) ever seem to go down "by the book", and we always learn something new. This time it was don't leave the Benadryl in the 90+ degree heat all day, and maybe wipe down your surroundings and don't use communal crayons. On that note, I think we've officially become "one of those" wiping families. Great. Which makes me feel a bit ridiculous, because it's not like you're going to wipe down every bathroom doorknob, or salt shaker, etc., wherever you go -- it's impossible to clean the whole world around you, so wiping any of it seems slightly pointless. On the other hand, once you've witnessed stuff like this happening to your child, suddenly it seems like a really good idea to not use those crayons, to wipe off her chair, and to clean her tray table and arm rests on the plane. (Side note about airplanes: you might recall our interesting encounter with Peanuts on a Plane from last year. This time I made sure to dress Georgia in long sleeves, pants, socks and tennis shoes just to minimize the chances of contact.)

Here are some pictures that I don't feel too bad about posting, though they break my heart a little. (One day I'll ask her permission, but she's still young enough right now that I think she'll look back on these and laugh, and not get mad at her mom for posting unflattering pictures. Besides, she's still cute as a button to me, even with hives.)

(Clear picture of her face from earlier in the day.)

Gratuitous "before" shots from the restaurant, while we waited outside for a table:
(That's her Pop Pop's pink lemonade, the only thing she consumed. An unlikely culprit. And we did confirm that Pop Pop hadn't been eating anything that day that would have caused a cross-contamination problem on the shared straw.)

(Doesn't everyone look so relaxed?)

Okay, and now for the "during" shots. These were not taken at the height of the episode, but after things started to subside a bit. The lighting conditions were bad, (or my photography skills were), so I'm not sure these photos do justice to the puffiness under her eyes.




And finally, a couple of photographs taken about 24 hours later. You can see lingering after effects of the hives. (Is that typical? Her forehead had tiny bumps that looked almost like itty bitty acne for the next several days.)

(It's hard to tell, but can you see the swath of redness running underneath her eye?)

One more gratuitous photo for good measure, my sweet girl sucking fingers as she always does to relax or go to sleep. As you can see, she's no worse for wear:
Love her.

Friday, April 15, 2011

Clear as mud

As much as I tried to put the most positive spin on our E.R. trip in the last post, Joe and I realized after having a few days to let it soak in that the experience left us with a lot of unanswered questions. I've since had another conversation with the allergist to clear up some of our confusion, so I thought I'd share the additional insight. (And here's where I again have to remind you that you shouldn't take any of this as more than a fun anecdote. You really can't apply our doctor's medical advice to your own situation, because it might not be apples to apples.) Okay, lawyerly disclaimer over.

And now for a side story. Part of our confusion came from the fact that, completely unrelated to food allergies or this weekend's incident, about 48 hours after our E.R. trip, Georgia ended up seeing a pediatrician regarding an ear infection that she had last month. When the E.R. trip came up in conversation, this pediatrician seemed shocked that the hospital had not followed "protocol" for response to an allergic reaction, and had not directed us to continue giving Benadryl after we went home. During the course of this conversation she exclaimed, "That was a life threatening situation!" Though I was not present at the appointment, Joe assures me he gave the doc a strong stink-eye implying, "Hey, lady, could we please not discuss all things 'life threatening' in front of my impressionable young daughter!" Still, though, it got us to re-evaluating Georgia's reaction.

So, what really happened Sunday night? Was it anaphylaxis? Should we have given the Epipen? Should the hospital have done anything differently? Should we have continued giving Benadryl? When are we out of the woods with respect to any reaction? These are the types of questions we had swirling in our heads.

Here are some (paraphrased) answers:

1) The allergist made us feel better by assuring us that we were understandably confused in the heat of the moment (and afterwards), because this was not a "typical" reaction.

2) She was not surprised by how the hospital treated us and thinks we likely would've gotten the same treatment at most area hospitals. As she put it, in her experience, if you do not have hives, they simply have a hard time believing that you are having an allergic reaction. (Never mind the fact that all literature on the subject indicates that hives need not be present; I think it's just a case of lack of familiarity and E.R. docs having to rely on knowledge of the most typical cases, not to mention juggling all manner of various maladies on any given night.)

3) After Georgia initially recovered from the reaction, we should have continued giving her Benadryl every 4-6 hours for the next 24 hours to make sure that everything stayed under control and that a biphasic reaction did not occur. So, we blew that one! (As did the hospital.) Joe did, however, end up sleeping in the same bed with Georgia that night, just to put our minds at ease, so I don't feel too bad about our flub.

4) Had we spoken to the allergist about 20 minutes earlier, while Georgia was still vomiting in rapid succession, the allergist likely would've advised that we inject the Epipen. She said that is what she usually recommends when internal symptoms (like vomiting, or swelling of the tongue) are occurring. She prefers to err on the side of caution and says it would never be "wrong" to use the Epipen, because it will not hurt Georgia. In this particular case, she said it would have stopped the vomiting and made her feel better. However, by the time we spoke to the allergist in the midst of dealing with this reaction, Georgia had at least temporarily stopped vomiting and had fallen asleep in the car, plus we were not far from a hospital, which is why the allergist did not advise us to inject the Epipen.

It's all so weird, isn't it? I mean, once you have the benefit of hindsight and knowing that everything turned out JUST FINE, it sounds ridiculous to have considered injecting the Epipen, because that's just a much more dramatic thing to do. For starters, it would mean immediately calling 9-1-1, arriving in an ambulance, and likely staying overnight in the hospital. Not to mention the fact that it would probably totally freak Georgia out (which I'm all for if it means saving her life, but generally against if it's not necessary).

But the problem is, you don't know until afterwards that, yeah, things will turn out just fine without the Epipen, and if you need it and wait, it can be too late! Which is why the allergist says when in doubt, use it.

I just feel funny knowing that there have now been two reactions where maybe we should've used the Epipen but didn't. (And then at the same time, with the benefit of hindsight and knowing that she recovered fully without the Epipen, there's a part of me that's glad we didn't inject the Epipen. Is that bad?) I am certainly not trying to take chances with her health in these situations, I'm just saying we've gotten very lucky in the past, but this is all a good reminder that one cannot count on "luck" during future allergic reactions. In short, better safe than sorry.

5) Does it even matter if it was anaphylaxis? What is the point of labeling the type of reaction? I don't know. To us it was just a point of curiosity, wanting to understand Georgia's allergies better, wanting to know if we should've used the Epipen, and wanting to know how "serious" her reaction was. (Also, we were confused by the list of "types of reactions" on FAAN's website, trying to fit Georgia's experience into one of their categories.) The response from the allergist was that, again, this was a confusing, atypical reaction, and we may have hit on a gray area where even she can't fully describe the reaction. It was not "just hives" because it included internal symptoms and no hives. She said certainly it had "anaphylactic potential" if it was not actual anaphylaxis. If her blood pressure had dropped, then it would be deemed anaphylaxis without question. But Georgia's blood pressure measured just fine by the time we were at the hospital. Could a BP drop be what caused her to so easily fall asleep on the couch or to pass out asleep in the car on the way to the hospital? I hope not but guess we'll never know. So if I understand it right, hives alone would not be anaphylactic, hives + vomiting would be anaphylactic, vomiting + blood pressure drop (or just about any symptom + blood pressure drop) would be anaphylacitc, but vomiting without the blood pressure drop = not anaphylactcic probabaly, but "anaphylactic potential." (Whew! What a mess! And maybe it doesn't even matter from a practical standpoint, but I thought I'd share, for what it's worth.)

So, there you go. We've learned a lot, but I'm also amazed at how unclear all this allergy stuff is to me. I mean, I don't consider myself to be on the uneducated end of the spectrum. I write a blog about food allergies (albeit mostly about personal experiences, not research) and read about them frequently. And yet navigating food choices everyday, and handling a reaction when it happens still feels much more like an art than a science to me. It's all just a collection of individual choices guided by medical advice, but not clearly black and white.

Monday, April 11, 2011

A Little Scare

Well, I guess it was bound to happen someday. We had our first allergy-related trip to the E.R. But don't worry - everyone's fine!

Georgia had a very delayed reaction (think: 4-5 hours after ingestion), consisting primarily of vomiting, after eating about a slice and a half of sandwich bread containing tree nuts. She took Benadryl and was later given an anti-nausea pill at the hospital, but at no point did we have to inject the Epipen. Our allergist recommended over the phone that we go straight to the closest E.R., so we did.

This particular E.R. probably deals with more trauma injuries than pediatric allergy cases, so I'm not sure anyone there ever 100% believed that Georgia's symptoms were due to food allergy and not the flu, since she was not presenting the "classic" profile of allergic reaction symptoms including hives and airway restriction. (But I saw my little girl playing hard all afternoon, and I saw her waking up as happy as a clam again this morning, so I don't think she just spontaneously came down with the flu yesterday at 5 p.m. and then fully recovered by 11 p.m.)

Regardless, she is fine now, which we are all thankful for. That is what matters most. The silver lining here is that it was a great learning experience. So I thought I'd just focus on the positives and discuss some of the lessons we gleaned:

  • Now we know to give Benadryl once an allergen has been accidentally consumed, even if there are no symptoms yet, because it might help prevent a reaction from starting. (I feel like an idiot for not realizing that we should've done that until well after the fact.)

  • Now we'll have the allergist's phone number stored on our cell phones. We had no trouble looking it up online from where we were, but it dawned on us that that won't always be the case.

  • Now I will feel less weird about going to the hospital if we ever have to do this again. I'll be less hesitant to seek medical help.

  • This is a "data point" for Georgia. I know from talking to adult friends with food allergies that they have developed over the years an ability to know what's going on with their bodies. They probably wouldn't mistake a food allergy reaction for the flu, because they know the sensations of having an allergic reaction. So, for Georgia, this is just another data point to help her better understand her own body.

  • We weren't on vacation, but the next time we are, I'll look up where the closest hospital is and how to get there. (I've heard that tip 1,000 times but never thought much about it. I guess I figured we either wouldn't need a hospital or would be calling 9-1-1, but last night I realized that there is a middle ground type of reaction, during which it's helpful to know how to get to the hospital.)

  • The pendulum that swings from lax to vigilant in our house just swung back to vigilant. As much as we are all trying to avoid reactions, and accidents are kind of inevitable, there's nothing like a reaction to remind you that allergies are real.

  • Having been through the E.R. experience now, I think next time we'll just head to the closest hospital and let the chips fall where they may, instead of thinking ahead to the rest of the evening, or what hospital we'd like to get to (banking on the fact that Georgia is probably fine), or that kind of thing.

  • Joe would add that one lesson he learned was to pack a hospital "entertainment bag" for your one year old who will be up way past her bedtime. Yeah, that sounds nice, sweetie, but seriously, what are the chances we'll ever have such a thing at the ready when we really need it?

  • Seems that cell phones don't work in most medical buildings. Next time I'll know to tell concerned family members not to worry if they don't hear an update for a couple hours. Also, I have rid myself of the delusional belief that an E.R. visit can be accomplished in thirty minutes or less. : )

  • Last valuable lesson: if you walk into triage and promptly throw-up into their trash can, you will be admitted faster. (True, but I'm just kidding about that being a "lesson".)

So, given the probability that an E.R. trip was going to be on our agenda someday anyway (sorry, just being a realist), how great is it that we were able to figure out all of these things in the midst of this reaction instead of a more severe one?

Other positives/funny stories:

  • June of course sprung a diaper leak while we were there, so Joe was covered in multiple bodily fluids. We did have a back-up diaper on hand, but no extra clothes, so June spent the rest of the evening charming the hospital staff mostly naked.

  • During a fussy toddler moment, some guy followed by two cops walked by, and Joe urgently said to me, "Video! Something that takes video! A camera phone, I don't know - something, anything!" I immediately started scrambling through our bags looking for a recording device, not understanding what he so urgently needed to record, thinking that it related to the guy or the cops. Turns out he was just hoping we had some sort of on-screen entertainment available for June. I get it.

  • I let the girls play with surgical gloves, but Georgia quickly and furtively shoved them back at me the moment the physician opened the curtain, because she thought she'd be in trouble for using them. (Maybe you had to be there, but it was really hysterical.)

  • We let June eat half of the Pedialyte popsicle that Georgia was given. (Georgia had to keep it down before they'd let us leave.) What can I say? By that point, we were convinced Georgia was fine, desperate to leave faster, and out of ways to keep June pacified.

  • We love our allergist! She responded quickly to the after-hours call, gave us clear advice, called ahead to the hospital to let them know that we were on our way in (not that that made any difference, but still, a nice touch!), and then called me this morning to see how Georgia was doing. Love her.

Yeah, I took some pictures. Why not? What else you gonna do when stuck in cramped quarters with your family doing a whole lot of hurry up and wait? Poor baby : ( Upside down reading Gloves Stolen popsicle