A Sobering Reminder...

...that kids sometimes die from their food allergies. Ugh.

Full story here: Seventh-grader dies of food allergy at Chicago school

So tragically sad. I'd say I'm speechless, except there are countless thoughts swirling in my head, such as:

--it is stupid that all schools are equipped with defibrilators but not Epipens. At this point shouldn't Epipens be standard issue at all places hosting children, like camps, schools, airplanes, etc.? (I mean, I wouldn't personally want to solely rely on my child's school having an Epipen around rather than sending her own Epipen to school to be stored there, but still -- it seems there should be one there as a backup. What is the great harm we are trying to prevent here by NOT having extra Epipens around? Accidental injection? Overdose? Give me a break. The risk of potential death trumps that.)

--why does food have to be a part of SO, SO many school events in the first place? We wouldn't even have to get into the question of nut bans so much if food were just kept in the cafeteria at lunchtime. Kids deserve to have their classroom be a safe place for learning.

--Georgia has never had Chinese food. I view it as extremely high risk. I'd flip a lid if someone served her Chinese food at school. [EDITED TO ADD: I should clarify that I'm not blaming the teacher involved in this particular incident. I presume permission to eat the Chinese food was given by this girl's parents, but I have no idea. I just meant that as of right now I can't imagine ever feeling comfortable allowing Georgia to eat Chinese food at school, outside of my immediate supervision. But who knows, maybe I will feel differently about that when she's 13.]

--Georgia's preschool kept her Epipens at school, but this story reminds us all of how quickly a reaction can grow out of control. As they say, seconds count. (People TOTALLY forget that and look at you like you are crazy when you act annoyed about your daughter going to gym class in a separate building where her Epipen will be a block and a half away. No, they don't eat in gym. But do you want to be the one sprinting on a mad dash looking for an Epipen in case of some freak emergency? I don't think so.) I wonder if Georgia's teachers would've remembered where the Epi was in a time of crisis? I wonder if they'd have remembered how to use it? For my own sanity, I generally like to assume the answer is yes and put these terrible thoughts out of my head, but stories like this one are a painful reminder that things can go horribly wrong.

--it's not clear to me what all the facts were here. It appears there was no Epipen in the classroom or at the school to give the girl. But we have no idea how long it took the EMTs to arrive. Presumably they had epinepherine on board the ambulance, but I don't know. Also, as much as Epipens are thought of as a life-saving device (which they can be), I think people need to realize that sometimes they are not enough.

I don't mean to make this all about ME, and Georgia, and our family. My heart goes out to this family. I can't even imagine the pain and grief they are dealing with.

Now go hug your little ones, be they babies or all grown up. Squeeze them tight.

I just visited Kourtney Kardashian's blog. Really???

I'm not a follower of the Kardashians or their reality TV show, but I heard via FAAN's Facebook feed that Kourtney Kardashian recently had to rush her 11 month old son to the hospital after he had an allergic reaction (vomiting and hives) to eating his first taste of peanut butter.

Here's a link to the People.com blurb about it:
http://www.people.com/people/article/0,,20444171,00.html

Oh! I feel for her! I have never had to rush Georgia to the hospital and can only imagine how scary this must have been.

The reason I was compelled to visit her blog and comment was to leave an encouraging word. Apparently a lot of people have been criticizing Kourtney and calling her a bad mom for giving her son peanut butter in the first place, and then also for taking him to the hospital, saying things like, "I can't believe you'd go to the hospital for an allergic reaction."

Others in the food allergy community seem instantly ready for her to become a spokesperson, never mind that she's probably still adjusting to the news herself and isn't up to speed on all the facts about food allergies.

It is hard enough to deal with the overwhelming feelings that come with discovering your child has a food allergy. I can't imagine adding to that the stress of being in the public eye and having your every move judged. She may have chosen a life of celebrity and everything that comes with that, but she sure didn't choose for her son to have a food allergy. Good luck to you, Kourtney. I'm glad your son is okay.

RAST results

The results of Georgia's blood work came in and are as follows: (I'll explain the "Class" numbers to the best of my ability at the bottom of this post.)

Peanut went up but remains at a Class III.
Sesame went up and rose from a Class II to a Class III.

For some of the fish, we were able to get more specific results than in the past. They were able to separately test for cod fish, tuna, salmon, halibut and tilapia, and I'm not sure they did that before because I don't have 2008 and 2009 numbers for all those fish. She's testing positive for all of those. Her cod fish and tilapia scores went down, although they both remain in the Class III range.

Similarly, we got a more specific breakdown of the tree nut scores this year. The good news is that for some of the nuts (i.e., almonds, pine nuts and hazel nuts) her scores are so low that they are considered a Class 0 (i.e., negative test result) or Class I. Our allergist explained this to mean that if Georgia's scores remain low, then when Georgia gets a little bigger the allergist will recommend that she do a food challenge for those nuts. Now, even if she were to pass such a food challenge, she might have to continue avoiding those nuts for fear of cross contamination. However, manufacturing practices are improving, as is allergy awareness, so I know there are already certain products out there (e.g., particular brands of almond butter) that you can safely consume even if you're allergic to other nuts. So, no change on our nut avoidance practices for now, but maybe in a year or two? Fingers crossed.

Her highest tree nut scores were for pecans and walnuts.

Now the grand finale: Georgia's not allergic to shellfish! (Or "sellfish" as she likes to pronounce it.) Woo hoo! As the results have been explained to me, Georgia may never have been allergic to shellfish, but we were previously told to avoid all shellfish due to (1) her allergic history/profile; (2) the fact that testing is not 100% reliable; and (3) the fact that she has a fish allergy, thus making the risk of cross contamination high (due to the handling/processing of seafood). Anyway, we are thrilled. I don't know any 3 year olds who eat tons of shrimp and crab, but I don't care - this still opens up a whole new category of protein for us and moves a few foods back out of the "threat" column for our family. Even if Georgia hates the taste of shellfish, or refuses to eat it, at least Joe and I can now eat crab and shrimp at home without worrying - yea!

Practically speaking, we will be reading labels carefully, and probably buying exclusively frozen shellfish to eat at home. The risk of cross contamination from other fish in restaurants or from the fresh seafood counter at the grocery store is too high to risk eating that stuff.

While I had the allergist on the phone I also picked her brain about DHA fortified foods. You may have noticed your milk or other foods being marketed as, "Now with DHA!" They want you to believe it will make you smarter or make you live longer - I don't know. Hey, I'm not knocking it - I take a fish oil pill everyday hoping there's at least some value to it. What I was worried about was that these DHA fortified products may contain a fish oil that Georgia's allergic to. The allergist's answer was that many DHA products are actually made from seaweed and should be okay, but that we should always read labels. If something's made with fish, it is required by law to state that it includes fish. So, I'll be doing some label perusing at the grocery store soon. Last thing I need is for Georgia to be served supposedly safe milk and cookies, only to find out that the food scientists of the world have figured out a way to get fish into them.

Oh - so a word about the "Class" levels referred to above. In my own words: the Class just corresponds to the level of probability that a positive result is in fact accurate. It is not a measure of the "severity" of one's allergy, though you will see many confused parents discussing these things online as if that is the case. (In looking into the meaning of the Classes, I was amazed at the misinformation swirling around on online message boards. People saying things like, "My son scored a 6 on a scale from 1 to 4." What? That doesn't even make sense. Made me think of Spinal Tap, though - turn it to ELEVEN.) : )

Here's a slightly more scientific explanation from a website called Food Allergy Support, though I have to add that I'm not really familiar with the site or that organization and therefore can't vouch for the veracity of the following:

"The severity of a person's allergic response is not related to RAST level. Class 3 individuals can have severe responses and Class 6 can have mild. RAST tests are only useful to determine whether an individual is allergy, not how allergic they are. However, different antigens have different threshold levels above which an allergic response is likely. For example, people with a peanut RAST result of >14kU/l are likely to have an allergic response to peanut. Soybean typically required >30kU/l; egg as little as 7kU/l. Class 1 and Class 2 often fall below the threshold where most individuals would experience a food reaction, so doctors often consider results in this range equivocal. If results fall in this range and the patient has not experienced an actual reaction to a food, the allergy may be confirmed via a food challenge."

So, there you have it! This was supposed to be a quickie post. Oops.

Allergist Visit (and answers to some questions)

Our first visit to Georgia's new allergist was great! We all really liked her, including Georgia.

I can't believe how positive I felt after this appointment, considering that at the end of the day, nothing has really changed for us so far. We'll have to wait 7-10 days to get the RAST score results from Georgia's blood work, and even then I'll be surprised if she's eligible for any food challenges. Still, though, this doctor just spoke so positively about all of the research that's being done in the field of food allergies that it was the first time I've felt like there's real hope for a cure, not in the esoteric "someday" sense, but truly in the "Georgia won't always have to deal with this" sense. (Maybe even by high school!) For any food allergy sufferer, I'm sure that would be happy news. For a mother, the thought is enough to make one burst into tears of joy. (I didn't. I'm just sayin.)

Anyway, we asked some questions (some of which are frequently posed to me by friends or family), so I thought I'd share the answers. (The nerdy lawyer in me is now compelled to remind you that I'm just relaying what I heard, and that no one should follow this advice but should instead talk to a doctor about your individual circumstances.) Also, all of the answers below have been paraphrased and elaborated on to my heart's content.

1) The EpiPen temperature and light control issue. Official guidelines recommend keeping the EpiPen between 76-78 degrees and out of direct sunlight. This is tricky when you live in a place with temps ranging from -10 to 110. I know some people who keep their Epi in a cooler all summer when they go out. Others have been told to keep the Epi in its original cardboard box so as not to expose it to too much light. What are we supposed to do?

Our allergist's answers:
Temperature: She tells people to take it with them, and that if they're comfortable, the Epi is comfortable, and not to worry about it too much. So basically, I took this to mean don't leave it in your car's glove box (duh), but you don't need to stress if it's 90 degrees out and you're heading to lunch. Based on her answer, I won't be worrying with a special case for the Epi unless we'll be somewhere very hot or very cold for an extended period of time. Beach day? Yes. Quick trip to the park on a hot day? No.

Light: No, you do not need to keep it in a cardboard box, or a bag, or otherwise strive for darkness. The idea is to not leave it lying in direct sunlight, but carrying it around in the plastic green carrier it comes with should be fine. In other words, it's not going to go bad in light the way that exposed film would.

2) Labeling. We were looking for greater clarity about whether to avoid all foods made on shared equipment, or "made in the same facility as," and that kind of thing. We asked this question knowing that there's no "right" answer, but I just wanted someone to tell me what to do! Plus I wanted to know that the answer is based on facts and reasoning. (To elaborate: I feel like we have been living a double standard, because we never bring foods labeled this way into our home from the grocery store, and yet when we do occasionally eat out it's not like I'm asking to see the packaging of the bread that Georgia's sandwich is made on. So while I know, for example, that that bread doesn't contain nuts or sesame (because I asked the wait staff), I can't tell you that it wasn't "produced in the same facility" as another food containing her allergens.)

Allergist's answer: We can serve products that do not contain Georgia's allergens (peanuts, tree nuts, sesame, fish and shellfish) in the ingredients list but are labeled as having been produced in the same facility as those allergens. We should not serve products that are labeled as having been produced on the same equipment as those allergens. (Also, we should not serve products labeled as "may contain" or "may contain traces of" with respect to Georgia's allergens, but we were already clear on that.) The doctor did not know of any good statistical studies about the number of allergic reactions stemming from foods that supposedly did not contain the offending ingredient but were labeled this way (as "same facility" or "same equipment"). However, she did say that she has had patients who have had serious reactions to "shared equipment" foods.

3) What about June? June has eaten eggs, but she has not had any nuts, sesame, fish or shellfish, simply because we don't typically have those foods in our home. So far she has displayed no signs of food allergies. We were wondering whether she is supposed to continue avoiding those foods because we now have a family history of allergies? Or when are we supposed to introduce them?

Allergist's answer: The long and short of it is that before sending June to an environment like preschool (2 years from now), we'll need to know for sure if she has any food allergies. However, we shouldn't really introduce June to Georgia's allergens until we're prepared to make those foods a regular part of her diet, because there have been cases of people eating a food so infrequently that they essentially develop an allergy to it. (I don't think researchers are 100% clear on the science behind this causation concept, or where allergies come from generally, so don't ask me to explain it, but apparently insofar as it relates to how we are to treat June, this is the prevailing wisdom for the time being.) The allergist told us about families where 1 parent has to go on a weekly peanut butter date with the non-allergic sibling just to make sure that the non-allergic sibling continues to be able to eat peanuts.

It's a big sacrifice, I know, but I will go out on a limb now and say that when the time comes, I'll go on a weekly date to eat Reese's cups with June. : ) It would be a needless hassle in our daily lives right now to incorporate nuts, fish, shellfish and sesame into June's diet when the rest of us aren't eating those things at home, so we'll be tabling the introduction of those foods for at least another year or so.

4) EpiPen Use. Should we have injected Georgia with the EpiPen during reactions that were (a) handled adequately by Benadryl, but (b) caused her to cough? (We asked this question because of stuff I have been reading on the topic. My confusion was, if it's a seemingly "mild" reaction that appears to be adequately handled by Benadryl, is it really necessary to inject the EpiPen just because there's a little coughing involved?)

Allergist's answer: Yes. If the reaction is affecting skin only (hives, some facial swelling), then Benadryl is okay. If it is affecting breathing in any way or involves the swelling of the tongue, then inject Georgia's thigh with the EpiPen and call 911. Ugh. I could write a whole post about this topic. It's a bit frustrating and disheartening.

5) Peanut oil. Must we avoid it? Prior to this appointment, we hadn't been worrying about avoiding peanut oil in most settings, because studies show that most allergic individuals can safely consume peanut oil if it's not cold pressed, expelled or extruded -- types of peanut oil that are all associated with "gourmet" oils, not the stuff they dump in the fryer at your average restaurant.

Allergist's answer: Yes, you should avoid peanut oil. It may be true that most types are okay, but you'll never know for sure what you're getting, and it's too risky. Again, to this I say: ugh. It's not like avoiding peanut oil is hard when you're buying things at the store - you just read the label. The problem is in settings where things like fries or chips are served, and now we can no longer assume that they're fine. As an aside, I would say to anyone reading this who is uninitiated into the world of food allergies, this is part of the problem: you end up having to avoid a lot of foods that in actuality are probably fine for you to eat, not just the ones that you know are dangerous. It's more limiting, and it also causes people to look at you like you are crazy overprotective when you tell them your daughter can't eat the french fries because she's allergic to peanuts.


So, that was it! All in all, a great appointment and wonderful chance to get some questions answered. Our allergist thinks that immunotherapy treatments now being conducted in clinical trials may be available to the public in 2 to 3 years. Wouldn't that be fantastic?

Allergy Mom Confessions: Pad Thai

Last night after the girls went to bed, Joe and I ordered pad thai take-out. You know, the kind with the little mound of tiny bits of chopped up peanuts on top?

We took it outside and ate it on the back porch just to be safe. And it was delicious.

I felt like I should destroy the evidence and take a shower afterwards. Never in a million years did I think I'd be snarfing down pad thai on my porch like it was contraband. The things we do now... Too funny.

New Allergist

First let me say: if you are in med school, or thinking about enrolling, I highly recommend you pursue the field of allergy and immunology. Granted, I am not a doctor and know nothing about the training involved or what the job pays relative to other specialties, but I can tell you there must be a shortage of pediatric allergists based on how long it takes to get an appointment.

Georgia's allergist, who we liked very much, moved out of state, thus forcing us to figure out an alternative. Switch to a different doctor within the same practice? Or switch to a new doctor in an entirely different practice? Pros and cons were weighed. Complicating the decision-making process was my firmly held opinion (based entirely on anecdotal evidence) that there's a wide range in the quality of available allergists. Some allergists take the time to educate the patient (or the patient's parents, as the case may be), and others only run a simple blood or skin test and send you on your merry way into a total morass of misinformation, which is scary when you consider that confusion about allergies can lead to life threatening situations.

We ended up deciding to stay with the same practice since they know Georgia's history, and we have come to expect a certain level of quality service from them. Well, we decided to stay, that is, until I called looking for an appointment 8 weeks out and was told that NONE of the physicians in the group had a single available appointment for the remainder of the YEAR! Our name was added to a several-months-long waiting list, even though Georgia is considered an existing patient of this practice.

So, that pretty much ended it for me. We'll be trying out a new allergist, at a new practice, where we were able to get in with about one month's notice. We got a recommendation for this allergist from a doctor friend of ours, and I've now begun the process of building this new allergist's abilities up in my head to the level of "magical wizard who will solve all of our problems". That's realistic, right?

Seriously, though, I get kind of keyed up for these appointments. They only happen once a year. On the plus side, the limited frequency of visits is a nice reminder that Georgia's condition is a very livable one. Think of all the children with diseases that require them to be in and out of doctor's offices and hospitals all year, constantly being tested, poked and prodded. I am so grateful for our health and the fact that no one in our family is facing that situation at the moment. On the down side, the once a year nature of these allergist appointments makes it feel like you've only got one shot to get more information and ask questions in person. One opportunity to change the course of how you live your daily life for the next year.

I guess I'm exaggerating a bit; it's not like you can't contact them at other times of year, but the annual appointment is the big show in my book. So tell me now - are there questions you have thought of that I should be asking? I don't want to forget to ask anything while I've got the allergist's ear!

Dude, you need to relax.

So you think you're all cool and not at all worried about allergies. You're sure you're not harboring low-level anxiety at all times.

And then your cell phone rings in your office while you're at work, and it's someone calling from the preschool, and your heart is racing as they're saying, "This is so and so from such and such school, and I'm just calling because..." And you're thinking to yourself, "How fast can I get there?"

Except that all they are calling about is the fact that school pictures are happening on a Monday, but your daughter doesn't attend on Mondays, so you'll need to make a special trip to drop by if you want to have her included in the class photo.

Oh.

Okay.

So, um? No one's dying?

Fantastic.

We'll be there at 8:00.

Oh, and p.s. did you know that you just gave me a heart attack?

(No, I did not say any of that. Was just thinking it.)

Anyway, apparently I need to take a chill pill.

Chef's Card: Before and After

I had been meaning to create a decent chef's card for a long time but had never gotten around to it. Part of the delay was admittedly due to the fact that we just don't take Georgia out to eat much, but I know that's no excuse - I mean, it's not like we never go out to eat. And then every time we'd get ready to leave for a vacation, where we'd obviously be eating out several times in a week, the idea of a chef's card would come to mind again. I guess that in the hustle of wrapping up work, getting ready to leave town, buying necessities (and usually packing for 3 of the 4 of us), the chef's card always fell by the wayside.

Well, after this little incident, I finally got off of my duff and created a better one. If you aren't familiar with chef's cards, I think the pictures will explain it.

Before:

{Yes, that's a scrap of pink construction paper. Nuts/Fish/Sesame is my way of shortening peanuts, tree nuts, fish, shellfish and sesame. I know it's important to convey ALL of Georgia's allergies, but I'm also of the mind that too many words can lead to people tuning out the whole thing. Maybe others disagree?}

After:

{Free template available on FAAN's website. I highlighted the words at the top to draw attention to them. This one is printed on bright paper so that it's less likely to get overlooked by a waiter or cook, and it's laminated. I only have the one but figure I should print some more since they're likely to not return from the kitchen.}

What do you think? Looking at it now, I'm wishing I had specified pine nuts, but at least I remembered to put pesto, which is the usual sneaky pine nut culprit.

Georgia and June's Crayon Party

We celebrated Georgia's 3rd birthday and June's 1st with a crayon themed party. (Allergy-friendly, of course, which I feel compelled to mention since I've parked this post here on Dining With Goldilocks.)

This first picture is just for fun, lest you get the idea from the rest of these pics that everything always looks so put together in our house.

{Here's Georgia "helping" me with the decorations the day before. She's in pajamas, eating dry Cheerios, it's about 5:00 p.m., and she has strewn cupcake wrappers everywhere, amidst a pillow that she dragged into the kitchen and a toy stroller she knocked over.}

We covered all tables and parts of the wall in butcher paper for drawing. Crayons were on sale for back to school at Target, so I was able to get several hundred for just $4.00.


The cupcakes were maybe my favorite use of the theme. I bought a nice set of food coloring (which I'll be able to continue using for a long time), and made a veritable rainbow of frosting colors, in various shades of each hue. I purchased the edible crayon cupcake toppers.


Originally I thought I would go on Flickr to find cool pictures of crayons to use in our decorations, but I couldn't figure out how to print them. Then I thought, why don't I just photograph some crayons myself? Here is a no-sew Happy Birthday banner that I made out of 4x6 prints of my crayon snapshots.


Here's a better look at one of my crayon shots. They're all available under my Flickr handle (baumgak) if anyone wants to use them.


My niece, Alice, drawing on our walls. I figured drawing on the walls would be a treat seeing as how it's usually a big no-no.


I discovered this after the party. I believe it's supposed to say "Juney and Georgia".


We had a ton of fun making the favors, and they were a great tie-in to the theme. Here's a picture of the favors before they were bagged. Georgia helped me to upcycle crayon bits from the bottom of her box into star and circle shapes by melting them in the oven. Instructions found here. (Tips: Do not use washable crayons. If using silicone pans, put oven at 200.) Also, I adapted an idea I think I originally saw on Design Mom of taking a photo of an outstretched fist and inserting a lollipop stick, but instead we did it with crayons. Such a cool effect! I must say I'm impressed with us that we were able to get a usable shot of June for this purpose, since she can't make a fist on demand. She is pictured handing someone a tiny leaf that she found on the ground. Hey, whatever works!


We played "Drop the Crayon", a variation on the more familiar "Drop the Clothespin", wherein the goal is to drop a small object into vessels decreasing in size with each round. We started with a large metal mixing bowl and worked down to a drinking glass.


Sam checking out whether Harry made it.

He did!

Here I am casting a spell on the presents. Just kidding. Actually, in lieu of other gifts, we did a book exchange. Every child came with a wrapped book, and every child got to go home with a book new to him or her. I think it worked great for a very small group of young children close in age like we had.


This doesn't have much to do with the crayon theme, other than the fact that it's colorful, but I got the idea for using a Pack n Play to make a ball pit from Rookie Moms. I thought it was hysterical and the kids got a real kick out of it, too.

See, Sam is why we need a sign like this. : )


Sam and Harry having a chat in the ball pit.

Well, that about does it for showing off our decorations. On to the party pics and gratuitous face-full-of-cake shots!


"We are making these nice fake smiles for your photograph. May we eat our cupcakes now, please?"


Max re-purposing a "Drop the Crayon" bowl.


Happy Birthday!


How many people does it take to blow out 1 candle?


My sister commented that June appeared to be approaching the cupcake like a blind person at first. You can see what she meant from this picture.


Ahhh, there we go!


Just wanted to show off their "1" and "3" t-shirts. Georgia wore the "1" on her first birthday, too. I've decided to make number shirts a birthday tradition in our house. (Well, for the kids anyway!)


Synchronized cupcake eating!


I think Georgia's face is saying, "Daddy, please shave." Joe's been keeping his vacation beard well past vacation just for fun. It's going away this weekend, but now it will be forever remembered in photographs thanks to the many momentous occasions we celebrated in August 2010.


My baby!




A genuine Juney smile.


Thanks for visiting!

Walnut pesto mayo. Are you kidding me?

I feel like I'm beginning to bore myself with so much recent allergy talk, so I'm going to make a long story short:

• Went out to lunch with the girls last Friday.
• Looked at the menu online ahead of time for safe options.
• Ordered her a ham and cheese sandwich.
• Told the waiter about Georgia's allergies (nuts, fish, sesame). (Aka, peanuts, tree nuts, fish, shellfish, and sesame.)
• Tried to hand the waiter a small piece of paper with Georgia's allergies written down clearly in all caps. (My shoddy version of a chef's card, I guess.)
• Reminded the waiter to be careful not just of her food but of cross contamination from other food (e.g., the person who just prepared a PB&J shouldn't handle Georgia's sandwich).
• Food arrives. Georgia eats one bite only. She's normally a big eater.
• I notice one hive and ask my sister to wipe Georgia's cheek, thinking it might just be a contact reaction to something.
• I notice the mayo on Georgia's sandwich looks a little funny and ask my sister to investigate.
• Turns out, they put walnut pesto mayo on Georgia's sandwich! Are you kidding me?
• Remain calm. Wait to see if medication is needed. Decide medication is needed, because Georgia is acting like a spaced out zombie.
• Give Benadryl. She immediately perks up.
• Total reaction amounted to about 2 hives, zombie-like state, loss of appetite, redness on her cheek, one or two coughs (which may or may not have been related to any of this), and whatever the hell else may have been going on inside of her that I will never know about. (See below for more on that.)

I was kind of mortified that this all happened in the company of my sister's friends and their children, because I felt like we were causing a bit of a scene, even though everyone couldn't have been nicer about it. Good news is that Georgia ended up fine. Bad news is that this was a very frustrating experience. I'm normally so embarrassed (I know I shouldn't be) to address Georgia's allergies head on in restaurants, but this time I think I really did everything I was supposed to do up front. There was just a breakdown in communication between the waiter and the kitchen, I guess. Because I am a huge nerd, I have since written the restaurant manager a letter to tell them what occurred and that I think they may need better allergy policies or staff education in place. Basically, I just want to keep this from happening to someone else.

Silver lining here is that Georgia and I had a nice chat about her reaction on the way home. Any reaction, though unfortunate, is a data point that we can learn from, an experience that will help Georgia to better identify and articulate in the future when she thinks she may be having a reaction.

I feel like an idiot, because during our chat, I asked her if it felt funny when she ate the bite of sandwich, and I totally misundertsood her anwer. She responded by saying that it felt like she had a pipe in her mouth. A pipe? I was picturing the type of pipe a person would smoke tobacco from, and I couldn't even think of where she had seen a pipe, other than Curious George books, or maybe pictures of Santa. So I figured there was no way she'd really know what having a pipe in your mouth would feel like and basically chalked her response up to toddler nonsense. But later that day, when Joe got home from work he asked her about what had happened at the restaurant, and Georgia again told him that her mouth had felt like it had a pipe in it. "A pipe? What kind of pipe?" he asked. "You know, a pipe. Like how water goes through pipes," she said. Ohhhhhhhh. Duh. So, I gather that she was feeling some constriction of her throat or swelling in her mouth or something, based on this description. Which makes the whole experience just a little scarier in retrospect, but I am not going to dwell unnecessarily on that, because the point is that she recovered quickly and is fine.

(Wish I could have said the same about my mental state that day. I was still replaying everything in my head and worrying unnecessarily about hypothetical situations by the time I went to bed.)

Friendly Confines Indeed

(Just wanted to follow up that last post with something a little more uplifting, and then I'll get off the topic of this baseball game...)

Everything I've seen online today indicates that the Cubs' first peanut-free section was a huge success. People on Facebook described the experience as great, unforgetable, special, and even surreal. I haven't heard a negative word about it. Sounds like the Cubs organization seriously went above and beyond, thinking of everything they could do to make the experience a wonderful one for everyone involved. (I'm not kidding - they even had a nurse from the allergy department of the local children's hospital on hand. They gave out favors to the kids that included a picture of the Wrigley marquee sign with their name in lights!) I read these people's stories and realized what a big deal this was for some of the kids involved. Truly heartwarming stuff, folks.

Note to Self: Do NOT read the comments

When will I ever heed this advice? I'm not talking about comments on blogs like this one. (On that note, I would love more input from any readers of this blog, even when you disagree with me.) I'm talking about readers' comments to online versions of articles in popular media.

I keep making the same stupid mistake over and over again, scrolling down to the comments to see what the average Joe is thinking about food allergies, only to discover that the average Joe is apparently not so nice! (And it kind of crushes me. I wish I were better at not letting it get to me.)

I think what I have to keep in mind is that the average Joe really probably is pretty nice, (or at least has enough open-mindedness to learn more about something before vilifying someone over it), but the problem is that the subset of "people who bother leaving comments on these articles" includes more off-the-deep-end angry people than the general population does. Oh, and quite a few off-the-deep-end ignorant people, too.

I'm bringing this all up in response to what some people are saying about tonight's Peanut-Free game at Wrigley Field. You can get a flavor for the idiocy (without having to actually immerse yourself in it) by reading Kelly Rudnicki's smart responses here. (If you are not the parent of a food allergic child, I highly recommend following that link, if only to better comprehend the inane flack that the food allergy community has to deal with.)

I should not take this all personally, espcially because stupid comments are not unique to the topic of food allergies. I was utterly shocked last week after reading about the massacre of 72 immigrants at the hands of a Mexican drug cartel. The only thing more appalling than the fact that almost no Americans even heard about this event (despite it having involved the death of a Marine), was the comments to the article, which were along the lines of, "thank you Mexican drug lords, that's 72 less for us to deal with." I feel gross just having typed that.

But I digress. The point is that I really have not had unpleasant interactions or conversations relating to food allergies in real life, with real people I actually know. Real people are always curious, considerate, and sympathetic. It's only these online, practically imaginary (to me) people who are so rude. So I really should stop reading the comments.

Take Me Out to the Ballgame

In case you haven't heard the news, peanut-free baseball is coming to Wrigley tomorrow night!
Here's a link to the Sun-Times article about it: http://www.suntimes.com/news/metro/2630402,CST-NWS-nopeanuts24.article

This is thanks in large part to some key organizers and a facebook fan page called "Chicago Cubs Fans for Peanut Free Baseball." (My only part in any of this was to become a "fan" of that Facebook page, which you can, too, with only one little mouse click.)

The Cubs organization listened and agreed to make one section peanut-free for one night game this year. I think people are hopeful that this event will be a success and will grow from there. Peanut free sections, or even peanut-free stadiums are things other major league baseball clubs have done, but this event is a first for the Cubs.

So, a few personal thoughts about all of this:
--I don't think Georgia's allergies are so bad that she would be sensitive to sitting in a regular section at the stadium (i.e., that she'd react to airborne peanut dust). That said, she's never been to a ballgame or any place with such an abundance of peanuts, so I don't really know.
--Even if she could handle a regular section, I'd love to take her to a peanut-free game/section like this someday. It's a great way to show support for families of children who definitely do have allergic reactions without peanut-free zones. Also, it would be a great way to meet other kids dealing with food allergies, which is such an important thing for children. Everyone just wants to feel normal, ya know?
--With a little more advance notice, and had this been a day game, I would've tried to get tickets. But being that Georgia just turned 3, this is a night game, and she's got preschool the next morning (which she just started), attending this game won't be possible for us. Hopefully there will be a "next time" so that we can try to go next year.
--On that note, I foolishly had this fear that many people would be in the same boat as us and that there wouldn't be a good enough turnout for the Cubs to want to do this again next year. Silly me. Turns out the 8/30 Peanut Free box is sold out, with over 75 families on a waiting list! The Facebook page says to email fanservicesassistant@cubs.com if you are interested in attending a future game.

I'll end this with a little anecdote. Somewhere along the way, singing "Take Me Out to the Ballgame" became part of Georgia's bedtime ritual. We've probably sung it every night for more than a year now. Of course there is the line, "buy me some peanuts and Cracker Jack." But in our house, this is always followed by a quickly interjected, "but don't eat 'em!" Georgia probably thinks that's part of the real song. Ha! (Sounds so dorky, I know, and if you are not accustomed to having to teach your child allergy awareness all the time, you're probably rolling your eyes. But when you're trying to teach a consistent message to a very young child just beginning to grasp her own allergies, this is the type of goofy thing you end up doing, I guess!)

Unbelievable Turn of Events

In January 2009, Joel Stein wrote a piece in the L.A. Times which included such offensive, insulting gems as the following:

"Your kid doesn’t have an allergy to nuts. Your kid has a parent who needs to feel special.”

"And genes certainly don't cause 25% of parents to believe that their kids have food allergies, when 4% do. Yuppiedom does."

I'd rather not link to that article, but I suppose you can find it on Google.

In August 2010, Joel Stein wrote a piece for TIME magazine in which he revealed that his 15 month old son was.......wait for it........recently diagnosed with nut allergies. !!!! Here's a quote:

"The column was not the first thing that came to mind after my 1-year-old son Laszlo started sneezing, then breaking out in hives, then rubbing his eyes, then crying through welded-shut eyes, then screaming and, finally, vomiting copiously at the entrance of the Childrens Hospital emergency room."

I really wish Joel Stein hadn't written that first article.
But I also really wish his son didn't have a food allergy. I wouldn't wish it on anyone. Georgia has thankfully never had a reaction landing us in the ER, and I can't imagine how terrifying that would be for any parent.

Why must hurtful words, misinformation, and food allergies go hand in hand?
I'm sure only a small fraction of the people who read the first article will pick up the second. Even the second is a bit too cheeky and not enough mea culpa for my taste.

For more on this topic, go here: The Food Allergy Mama
or here: The Nut-Free Mom Blog
or here: Allergy Moms (newsletter) [scroll down to "Peanut-Free Tables are Turned!"]

That Went Well!

Things have been busy around here, but I guess I should follow up on how the allergy summit (as we affectionately refer to it) went. In short, it went great!

We met with Georgia's two teachers, the head of the school, and the head of the early-childhood portion of the school on the day before preschool started. We all gathered around a preschooler height table, sitting in tiny preschooler sized chairs. Ha!

I don't want to bore anyone with all of the details, but we discussed such things as:
-The basics: We went over Georgia's allergens (tree nuts, peanuts, sesame, fish and shellfish).
-Snack time: We'll send Georgia with her own safe snack everyday. Plus, the teachers agreed to send a note home to all of the other parents asking them not to send in snacks with Georgia's allergens. Essentially, a belt and suspenders approach. Hopefully the other parents will cooperate, but Georgia will be eating our food anyway. Georgia is a half-day student, so we don't have to worry about lunchroom issues this year.
-Substitute teachers: they'll need to know this stuff, too, so we discussed communication. I'm actually not horribly worried about this since Georgia's pre-K class has two teachers. It's unlikely they'll both be out on the same day.
-Treats: We'll bring in a stash of safe treats to be stored at school for Georgia to consume on days when special occasions like birthdays or holidays are celebrated with food in the classroom.
-Medication: One of Georgia's EpiPens will be in the office across the hall from her classroom, the other will be in the school's main office. We also supplied Benadryl. We used the trainer EpiPen to teach everyone at this meeting how to use one in case of emergency. We handed out an Emergency Medical Plan to be stored with the medications. It describes different levels of possible reactions and that kind of thing.
-I feel like there was more to it, but that's all I'm remembering right now.

The Cons:
-One of the women present twice accidentally referred to Georgia as a boy. I hate to say it, but this woman is a bit older, and I think the slip ups might be related to that - like a little short term memory issue. Which is totally no big deal, except that in the context of conveying information that is critically important to our daughter's health and safety, it didn't make me feel great that everything would be remembered and carried out according to the discussed plan.
-I made reference to storing the Epi's in an unlocked place, but someone misunderstood and later in the conversation referred to locking up the Epi's. A simple miscommunication that we cleared up, but I just hope that everyone got the gist that these things need to be very accessible. Fortunately, we have never even had to use them. But should the need arise, from what I've been told, seconds really count. If I had my druthers, the medication would be stored in the classroom, but apparently it's against school policy.

The Pros:
-This was not all new to them. The school has had allergic children before. They do not have formal policies or procedures in place, but at least we weren't having to fully educate them from square one, which was fantastic.
-Both of Georgia's teachers have some experience dealing with children with food allergies.
-One of Georgia's teachers was taking notes, which made me feel wonderful. She is also the one who suggested (before I even could) that she write a note to all of the other parents letting them know that there is a student in the class with allergies.

I will admit - I was totally nervous about this meeting. But I survived. It was fine. It was quite pleasant, actually. Silver lining of having an allergy kid: we got a chance to meet the teachers a day early. And though we may now squarely be labeled as the High Maintenance Parents, at least they know who we are. (I hope they like us!! What? I can't help it.)

Georgia's made it through one week of preschool, and already I feel so much more relaxed. She's doing a great job eating only our snacks and wearing her bracelet. As for my mental health, I'm not worrying about allergies on a daily basis. So all is well.

Maybe the fact that she has cried about going to preschool every single day and has been suffering from some serious separation anxiety has a silver lining to it, too: all of this allergy business has been put on the back burner. This week I've had bigger fish to fry in the motherhood department, if you know what I mean.

Not that we can fry fish in our house. (Hardy har har.)

To School!

This is a week of many firsts for us.
June's 1st birthday.
Georgia's heading to school (not "back to school" since she's never been before).
And the big kicker....
We're meeting with the head of the school and Georgia's teacher tomorrow morning to discuss allergies. Our first ever allergy advocacy meeting, if you will.

I am really not looking forward to it. I'm sure these women will be quite nice, and I know I have nothing to fear. It's just that this "allergy-parent" role is one of those things that I feel like I have to grin and bear even though I'd gladly have avoided the role. Oh well, such is parenting, right? I'm sure this will be the first of many such meetings with schools, camps, etc., so I had better get used to it.

At first I was feeling rather delinquent, because our meeting is happening, oh, the day before school starts. I would like to have scheduled this sooner and have this behind us already, but at least this way the information will be fresh in their minds at the beginning of the school year and not forgotten from an earlier meeting, right? Also, I'm feeling more prepared now. I used this food allergy checklist for back to school from The Nut-Free Mom blog. It's quite handy if you find yourself in this situation.

I'll report back on how the meeting goes!

Allerbling!

Georgia has Allerbling now. Sweet!

No, I'm not joking. Could I make up a product name like that?

Allerbling is a type of medical alert bracelet made specifically for kids, both in size and appearance. My hope is that its bright color will mean that people actually see it and pay attention (as opposed to a regular, metal bracelt, which would be easier to miss). I also hope that its kid-friendly design will mean that Georgia will keep it on at preschool. We'll see about that.

Here's a picture. Sure beats pinning a big "DO NOT FEED ME" sign to her shirt everyday. (I have actually heard of allergy moms of yesteryear doing that, when food allergies in schools were not so commonplace. Sounds ridiculous, and yet highly effective at the same time...hmmm....something to consider if this Allerbling thing doesn't work out!)

I'm anxiously awaiting Allerbling's addition of a sesame charm to the mix. Too bad Georgia will then have too many allergy charms for them all to fit on 1 bracelet. *sigh*

See, I'm here to make all of you peanuts-only mamas feel lucky!

Glad to be home

Just got back from a wonderful week's vacation! But...

Vacation brings food allergies to the forefront of our minds in a way that they normally aren't present in our day to day lives. More restaurants, takeout, desserts, and caretakers are involved.

All went really well. I have no complaints about vacation. I'm just saying that there is a sense of relief to coming home to your own pantry and fridge after a week on the go.

While traveling with a child with food allergies, vacation for me now has this "character building" aspect to it that I'd rather it didn't. As in, it forces me to practice being brave enough to ask questions of servers, restaurants, and hotels that (for God knows what reason) I often feel embarrassed to ask. (Confession: I like to make my husband do it instead whenever possible.)

Anyway...vacation was great. But it's also really nice to be home and to not be thinking about food allergies so often! Maybe you can relate?

EDITED TO ADD: Okay, so I was going to be nice and wasn't going to mention it to protect the innocent, but since my sister brought it up in the comments... There was that 1 incident where a pizza slice with pesto (i.e., tree nuts) was offered to Georgia, and she was moments away from eating it. Thankfully, that was avoided, though we'll never know how she would've reacted if at all. While this incident highlights how easy it is to have a slip up even when everyone is trying their best to protect an allergic child, and how hard it is for those not in the everyday practice of thinking about allergies to pay attention to every single ingredient, it's also a good opportunity for me to thank my family for trying so hard. Learning about allergies has been an evolving process for all of us, myself included, and I really appreciate my family's efforts to go along with all of our requests. I am thankful that vacation gave everyone in my family a glimpse into what it's like to think about allergies at every meal.

And you wonder why we allergy moms get a little nervous about preschool...

A recent conversation with Georgia (age 2, almost 3), which was brought on by the topic of eating at preschool, and her new allergy alert bracelet:

Me: "So you can wear this bracelet to remind people of your allergies."

Georgia: "Yeah! It will be so great! And then the food will be safe."

Me: "Well....no, not necessarily. The food might still not be safe. You can just eat our food. We'll give you safe food. Because, well, you know...some other grown ups are not quite as good as mommy and daddy at reading the ingredients. So let's just eat our food, okay?"

Georgia: "Right."

Me (seeing a chance to practice): "Does Georgia eat peanuts?"
Georgia: "Nooooooo."

Me: "Or tree nuts?"
Georgia: "Noooooooo."

Me: "Or cucumbers?" (Just checking here, to see if she has any clue what she's saying.)
Georgia: "Nooooooo."

Me: "Actually, cucumbers are safe, sweetie. You can eat cucumbers."

Georgia: "Some people can't eat cucumbers. But we can eat them."
Me: "Um. Yeah. I guess so. But you can definitely eat cucumbers."
Me again: "So, anyway....no peanuts."
Georgia: "Right."

Me: "And no tree nuts."
Georgia: "Right."

Me: "And no fish."
Georgia: "Right. I can't eat fish. Well, I can't eat orange fish. I mean gold fish. I can't eat gold fish."

(Oh crap...this is really devolving. Is she talking about goldfish crackers now?)

Me: "Well, you can eat goldfish crackers, right? Yes. You can eat goldfish crackers, honey. But you just can't eat real fish."
Georgia: "Right."

I think what we can conclude here is that my oh-so-smart two year old may tell you at any given moment that she is allergic to cucumbers and goldfish.

Raising Your Child's Awareness vs. Freaking Them Out

I recently read an interview of a psychologist studying the social and emotional toll of coping with food allergies. Specifically, the "shocking" levels of stress in mothers of children with food allergies.

I guess there was nothing shocking to me in the interview, but I took note of the following quote from Dr. Rebecca Knibb:

If the parents cope well, this behavior is learned by the child. Children are very perceptive and learn vicariously, i.e. they learn by watching how parents react to situations. If a parent is very anxious, the child tends to be anxious also.

That sounds about right to me. So, how do you teach your child to better understand his or her food allergy in order to keep them safe, without scaring them in the process? How do you go about hiding your "shocking" levels of anxiety from your sponge-like children? : )

My daughter is not yet 3 years old, and we are trying to gradually increase her awareness of her own food allergies and what that means as far as what she can and can't eat. This is especially important since she'll be starting preschool in the fall, surrounded by well-meaning adults and children who may occasionally offer her food that she should not eat.

However, we have never once told her something like, "You could die." I don't think she even gets it that plants die, or that bugs die when you squish them, so the last thing we need is for her to live in fear for her own life. I don't think any toddler should be burdened with such a heavy thought, but dare I say, our Georgia is an especially sensitive one. (Understatement of the century.) We have an age appropriate allergy book that mentions hives, coughing, itching, and that sort of thing, but if you asked Georgia, I think she'd tell you that her allergies might give her hives. If you asked her the follow up question of, "What is a hive?" I think that she might or might not be able to answer that. But again, please keep in mind that she's only 2.

So, it's all very weird. Some days she'll say things that make me feel proud of our efforts, like maybe she's really "getting" it. She's pretty good at asking us, "Do you have the EpiPens?" when we leave the house. (Not because we normally need a reminder, but more so that if she is ever with a new babysitter or relative that she will hopefully ask them the same thing.) And then on other days, someone will ask her if she wants a peanut butter sandwich, and she'll answer yes without hesitation, which is disappointing. But it's not surprising that when you're two, and have relied on trusted adults to meet your every need, that you don't exactly stop to question, "Wait - is this safe for me?" at every turn. It takes practice to instill this behavior.

Once again, there is no particular conclusion to this post. Obviously, I do have a certain level of anxiety related to Georgia's food allergies, though I try to keep it in check. Maybe this blog is a good outlet for me to write things down and get them off my chest, rather than passing my worries on to my daughter? It all goes back to that whole Goldilocks Principle thing -- I hope we are teaching her enough to be careful, but not so much as to be scared.

Up in the Air

Remember how I was talking about flying with Georgia on a recent post about our trip to Florida? Well, as of then I was feeling pretty chill about the whole thing.

Now, the Department of Transportation is soliciting comments about what, if anything, to do about peanuts on commercial airlines. You can go here to read more or leave a comment if you have an opinion on the matter.

To put it bluntly, reading the comments of other people with opinions on this matter has left me feeling like I'm going to hyperventilate. Crap, can Georgia really DIE from airborne peanut dust in a plane? Should I not even be letting her fly? Someone please talk me down from the ledge now.

I didn't even leave a comment for the DOT yet because I don't know where I come out on the issue. Reading this formal response to the DOT from FAAN made me feel a lot better. I guess sometimes listening to experts and research results is better than letting yourself be inundated with personal anecdotes. I'd recommend reading FAAN's letter if you are looking for an educated, well written response from the "allergy community", especially if you would put yourself in the "I just don't get it" category or the "it should be your problem, not mine" category.

In other news, I had lunch with my friend Kim this Saturday and thoroughly enjoyed picking her brain about her practices living with a nut allergy for the past 30 years. Contrary to the whole DOT comments thing, talking with Kim had me feeling like if anything I could relax my standards a bit more. She always makes me feel better. I'll write more about all of that later.

As an aside...Kim flew into town for the weekend.
As a further aside...I'm guessing that Georgia is not so sensitive as to die from peanut dust on a plane, or she would've been screwed on our last flight. But with no tests for severity, and no real exposure history/ingestion reactions to rely on, I have no way of being 100% sure.

One more thing...I find it interesting that the DOT is soliciting comments on other issues like waiting on tarmacs and baggage policies, but this peanut issue is garnering about 6 times as many comments as any other issue. Obviously a hot button topic. You would think people would care more about waiting 8 hours on the tarmac than not being served their precious peanuts, but apparently not.

EDITED TO ADD: I think the DOT dropped the whole peanut ban proposal. Well, it wasn't even a proposal, really. They were just soliciting comments, and the peanut farmer lobbyists went nuts. (ha ha. pun intended.) It's a shame.

Rhubarb Crisp

This isn't going to become a recipe blog. There are tons of existing resources for allergy friendly recipes out there already. However, as I was throwing together this rhubarb crisp tonight, it occurred to me that it's free of most allergens, and well, delicious, so I thought I'd share. It's very seasonal and easy to make.

1) Wash rhubarb and cut into small chunks -- about 4 cups worth, more or less.
2) Mix chopped rhubarb with 1 c sugar and 1/4 c flour and toss it all in a baking dish.
3) Combine the following in a bowl: 2/3 c brown sugar, 1/3 c butter (cold and cut into pats or smaller), 1/2 c flour, 1/2 c oats, and 1 tsp cinnamon. I mixed this all together using a pastry cutter cuz I own one and I'm cool like that. You could also use your fingers or two forks. Get it to a kinda crumbly consistency.
4) Shake crumbly topping on top of the rhubarb mixture in the baking dish.
5) Bake at 350 degrees for 30-40 minutes. It should be bubbly around the edges, with the topping having come to a brownish crisp. (Mine took the full 40. Damn!)

Yum.

Question is: will we share with our allergic daughter? Hmmm....

Florida Vacation Report

I went into this vacation fully expecting that we'd have at least 1 allergy "incident", not because I was trying to be pessimistic, but because I was trying to be realistic and prepared. We were on a seafood-laden island with a child with a fish/shellfish allergy after all, plus Georgia did have a reaction while we were there last year. I figured the risk of cross-contamination in restaurants was pretty high.

Fortunately, we had no incidents! (Unless you count the mysterious hive that Georgia got on her wrist on the flight down, but more on that later.) Our lack of allergic reactions was admittedly due in large part to the fact that we only made it out to eat with the kids once the whole week. We were lucky to be staying in a condo with a full kitchen. Our reluctance to eat out was only partly driven by allergy concerns; it was much more related to juggling beach time with naps and bedtime, and the difficulty of getting everyone showered, dressed and out the door. At any rate, I'll take it!

As for the flights:

This is an area where I as a parent am probably more relaxed until I go about reading certain other allergy blogs and realize that other people are WAY more freaked out than I am about flying with a food allergic child. Who is to say whose approach is better? Some people won't fly with food allergic children because it plain scares them too much. Others bring wet wipes and make sure to wipe down all armrests, tray tables, etc. Then there's us. We're careful (as we always are) not to let Georgia eat anything containing her allergens, and we bring aboard plenty of Benadryl plus four Epipens just to be safe. But we don't otherwise take extra precautions when flying.

And now, a couple quick stories:

On the way down, Georgia got one tiny hive on her wrist. Didn't bother her. No idea what it was from. Could potentially have even been a bug bite. But it did make Joe and I exchange glances and think to ourselves, "What if?" I guess it made me wonder if I should actually be wiping things down more often? Seriously, though, you can't wipe down the whole world around you, right? So I am not sure that there's a rational point to doing so in limited instances. I would be happy to hear a counterargument from someone out there reading this.

On the flight back, we were cruising along and then heard the man in the row directly behind us say to his wife, "Honey, hand me my peanuts please." [CUE SOUND OF NEEDLE SCRATCHING ACROSS RECORD.] Okay, so this one resulted in even bigger exchanged glances and raised my anxiety level quite a bit. I can't fully explain why, I mean, it's not like he said, "Honey, hand me my peanuts please so that I can then touch the kid in front of me and make her eat them." Right? Besides, on our American Airlines flight they were selling mixed nuts for snacks, so it was just as likely that any other passenger could buy/eat/drop nuts, right? But still. There was just something unnerving about it, and it had me thinking that maybe those parents who board the plane and start wiping things down are not so crazy after all. I can almost guarantee you that had we been sitting in this man's seat after him (like on the next flight), Georgia would have gotten hives from contact with the nut residue. (Nut residue? Is that an actual thing? You know what I mean.)

Now, here's the part that I actually find hilarious. So amazing to me that you have no choice but to laugh. He was not just having a little snack pack of nuts, or a trail mix, or something like that. He was actually shelling his own peanuts on the plane. You know, like people normally do at a ballpark. In fact, ballparks are pretty much the only place that I have ever seen this (unless you count the reception desk at my father's office, but that's another story all together, and not a common business place snack offering, in my opinion).

I know he was just oblivious and not some kind of anti-allergy zealot, but I couldn't help thinking, are you kidding me? Have you been living under a rock to not know that some people are in favor of banning nuts all together on planes, and you think it's cool to SHELL whole peanuts about 12 inches away from my peanut-allergic child?

Now, don't misunderstand me. Although I found this all amazing, and it did cause me a certain degree of anxiety, I don't bear any ill will toward the man. In fact, later in the flight he entertained our 8 month-old by making funny faces, so I give him major nice guy points for that. I just kind of couldn't believe the nut thing.

So, there you have it. No real point or conclusion to all of this other than to say these things always get me thinking. Should I wipe surfaces more? Should I take more precautions when flying? Should I just try to relax?

And now, just for giggles (or shock value depending on how you view these things), here's a photo of me eating nuts on my very first flight with Georgia, when she was a baby and we did not yet know of her allergies.


{That's me with the fancy pinky, looking terrible but happy. Georgia would be the hidden baby under the blanket, just below the bowl of nuts.}

Help this study reach 1,000 participants!

I've written on this blog before about our family's participation in the Children's Memorial Food Allergy Study. I also feel a sense of obligation to encourage others to sign up, too, because they need 1,000 participants to make the whole thing worthwhile. (Well, that's not how they put it - I'm sure there's a more technical statistical term for it.) Anyway, I had been meaning to do something but finally today just got around to sending an email to certain friends attempting to drum up support. So I figured while I was at it that I would post some of the same information on this blog. (The info below is from the AllergyMoms.com website.)

According to a recent survey, 86% of all U.S. clinical trials fail to recruit
the required number of participants on time. Never have there been so many
studies of promising therapies for food allergies-but without qualified
participants, this life-saving research cannot move forward. By participating in
a clinical trial, your family will contribute directly to the search for better
treatments and a cure.

Of course, participating in a research study is
an important commitment. You're sure to have questions about the therapy being
tested, the medical exams you'll need to take, the demands on your time, safety
issues, and more.

To learn more, check out the following resources,
which provide information on current food allergy clinical trials, how these
studies work, questions to ask if you're thinking of participating, and more.

FAI
www.faiusa.org/clinicaltrials

FAAN
www.foodallergy.org/page/research-activities

To learn more about the specific study our family participates in, go to: http://www.childrensmrc.org/allergy/study/

I Heart Faces: "I Heart Desserts"

The theme this week at the i heart faces photography website is desserts.

No birthdays to speak of in our household, but these cupcakes do represent a special occasion: Georgia's first time ever helping to decorate (and eat!) homemade cupcakes since her egg challenge in January. (For those following along, her tolerance of baked eggs continues to go well, and today she even ate the first pancake of her life at the ripe old age of 2 years, 8 months, and 2 days. Well, she had a few bites, anyway. Despite her excitement about trying the pancake, she didn't really dig in.)

Anyway, the cupcakes above are what happens when you click on a parenting website searching for new ways to handle your two year old's behavior and instead come away with said website's "best of" cake and frosting recipes.

Recipes available here.

More dessert photos to be found here:

Eggs, and Preschools, and Birthday Parties, Oh My!

There's quite possibly nothing more boring to read than blogging about blogging, but please bear with me for a moment. The problem with this blog is that I don't get around to posting my occasional post-worthy allergy thoughts, so they accumulate. After time passes, none seem important enough to post, or maybe they do, but then it's too daunting to write them all up, or I worry that it will all come across like I'm allergy obsessed because suddenly I have 6 allergy posts in 6 days? I don't know - clearly I'm over thinking all of this and just making excuses for what boils down to procrastination, so with no further ado, here is a dumping of some of these accumulated thoughts, boiled down as best as I can get them:

FAQ: How is the introduction of baked egg going?
Short answer is that it's going great - Georgia's been tolerating homemade baked goods without any reactions. Longer answer is that, as exciting as it was to be able to get started on introducing eggs to her diet, we've fallen off course in terms of following the doctor's protocol for introducing more and more egg. We haven't yet jumped on to the pancake step, because how am I supposed to think of recipes for getting her up to 1/4 of an egg per serving in her tummy three times a day? No, really -- that was a serious question -- does anyone have any suggestions? A serving of cornbread really only has about 1/8th of an egg at most, so I'd have to double the portion size and serve it at breakfast lunch and dinner to get us there. With cupcakes, I'd have to give her even MORE, because each cupcake would have less egg. I'm about ready to say screw it, things have been going fine, let's move on and try the pancakes.

FAQ: What is the rationale behind the introduction of baked egg? Is the idea that she is building up a tolerance to eggs?
Good question, but no, it's not about building up a tolerance to eggs. My lay person's way of explaining this is that baking the eggs at a high temperature ever so slightly changes the shape of the protein that she's allergic to, just enough that when she eats it her body no longer recognizes it as an allergen (i.e., her immune system stops treating the food in question as a dangerous invader that it needs to fight). I'll post a link to the relevant study sometime.

Ugh. Preschool.
Georgia will be old enough to attend in the fall. Aside from anxiety I have about taking that next step of having to trust Georgia and a bunch of other people (teachers, kids, etc.) to keep her safe, I've also been dreading just having the allergy conversation with the folks at the preschools we've been touring. Well, she got accepted to one, and the way it works is you accept and say you're going to attend while you wait to hear back from the others -- apparently this is pretty standard around here. So, we had our first allergy conversation with the preschool that she is, as of today, supposedly attending. (Can you tell I still have my fingers crossed about coming off the wait list at another one? For geographic proximity reasons, that's all.) I'll be positive here and say that the conversation went about as well as one could hope for. The woman giving the tour assured us that it would be no problem, that other children at the school did have food allergies so they were accustomed to dealing with it, and that we could leave EpiPens in the school office or with the classroom teacher, etc.. On the other hand, I have to be honest and say that even when given a pretty good answer, I felt like there was no possible way this woman could understand the fear that an allergy parent has. Because even when EVERYONE (parents, teachers, etc.) all have the best intentions, people sometimes make mistakes. I couldn't help but see the bowls of snack mix in the kindergarten classroom that we walked by and just start to worry. Georgia will be barely 3 years old when she starts preschool. Can I really hope to drill it into her head that she cannot share snacks with other kids? I think they have "snack parents" at this school that trade off bringing food in for snacks. I am hoping that we can get Georgia on a regime of just eating her own personal food rather than the provided snacks, even though the snack parents will be told not to bring things with nuts. Partially because in my opinion I can't really ask them to look out for any ingredients including nuts, fish, and sesame. (Although, how many preschooler snacks have a fish ingredient, right? I wonder about all of the DHA (fish oil) that's getting added to more and more things these days, though. Not sure if Georgia would have a problem with that or not.) But if we have Georgia just eat her own food, then will all of the other parents question why they're even being made to have to deal with my kid's food allergy and therefore just stop reading ingredients? (If she were in 4th grade, that might make sense, but I think at the preschool level it's still important to keep all those sticky pb hands and nut-crumbs, etc. as far away as possible - there's too much risk of contamination and sharing.) Is it time for me to just start trusting a little more, even though that might mean exposing my child to greater risk? I want to protect her (as any parent would). I have to balance that against the idea that I can't protect her from everything forever. Ugh. You can see I'm already going around in circles about this mentally. Broken record here, but can I just say for the one millionth time that it sure would be nice if a test for the severity of my child's allergies existed, so that I might only have to worry that she'll get a mild case of hives at school rather than worrying about something potentially fatal.

Other allergy parents
I feel comfortable discussing food allergies in this forum, but generally speaking I'm uncomfortable with it as a conversation topic. I guess I'm insecure, because I always assume the other person I'm talking to is judging me in some way - either judging me for having a child with food allergies (i.e., they must be assuming it's my fault!) or judging me for how I'm dealing with it (i.e., they probably think I'm being overprotective!). At a recent birthday party, though, it occurred to me that I'm perhaps even more uncomfortable and insecure about discussing food allergies with other food allergy parents. Isn't that awful? Aren't these the very people that should understand where I'm coming from the most? Yes, that is true. And I'm always happy to find them, except that there's no handbook for how to deal with children's food allergies, so I'm always a little bit dumbfounded as to how to address the fact that we don't all deal with allergies the same way. Perhaps the issue is that no one's way is the one and only "right" way, and yet I just so want to be doing the "right" thing, whatever that is. So anyway, at this particular birthday party, the allergy mom was allowing her peanut and tree nut allergic child to dive right into a bakery-bought cupcake with crumbled chocolate cookie as a topping while I was making Georgia have some more fruit and promising her that we'd get her a special treat later in the day instead. (I know, I'm horrible - I really should start bringing my own stuff to these parties, but I keep forgetting and then it's time to head to the party and we're usually running late already. Fortunately she's just young enough to still not really care about missing the treats, so I've been getting away with this.) I just sat there watching this other kid with her cupcake wondering, "Am I doing this all wrong? Am I being too uptight?" The mom in question happens to be a work friend of mine, so I was able to ask her whether her child still had food allergies. Answer - "Yes, but her allergies aren't severe - it would just be like hives or something. " Hmmm...already a different response than what our allergist would ever say. So I said, "But doesn't it make you nervous that one reaction isn't really predictive of the next? You know, that it could be hives last time, but um, something far worse the next?" (Don't want to say anything too terrible around the kids!) Answer - "I didn't know that. Our allergist never told us that." Hmmmm....for various reasons, I already had the impression that their allergist isn't the best. (My friend had even told me as much before.) But this is all very frustrating to me! Why aren't the allergists telling everyone the same set of information? Let me just tell you the two conflicting thoughts going through my head at the time: (1) Ugh! Other allergy parents that are not as vigilant as us are not helping our cause (see preschool discussion above). If she's walking around acting like possible nut ingestion is no big deal (she actually wants to try to "build up a tolerance" for her daughter by exposing her to more and more nuts (at home), despite her allergist having told her that that's not a good idea right now and her husband disagreeing with her as well), then how am I supposed to get other parents and school officials that come into contact with folks like her to understand that when my kid shows up, I expect them to take the whole allergy thing much more seriously?, and (2) Maybe she is the smarter one here. Because maybe if we look at our lifetime happiness levels, and the lifetime happiness levels of our children, her approach of being WAY more relaxed about food allergies and less protective will result in so much less anxiety and mental stress for her and her family that any medical consequences of the increased number of allergic reactions potentially resulting from her approach will be outweighed by the fact that they just didn't worry so much! I mean, I can guarantee you that she's not off thinking about this birthday party right now, writing a blog entry about it! : ) Maybe this is a case where ignorance really is bliss.
Anyway, it's like I want to go with conclusion #2 and just relax, but I can't get my mind to stop slipping back to the, "Yeah, that's all fine and well, but what if she DIES?" thoughts. You know what I mean? Ugh. Again, have I mentioned lately my annoyance with the fact that they cannot yet test for the severity of one's allergies?

Another reaction
Last week I picked up a loaf of bread at our neighborhood food co-op. The ingredients passed inspection, but Georgia ended up having a minor (skin) reaction to it. We think it was sesame, because other available loaves did include sesame as an ingredient. I feel like I should've known better, like my gut was telling me at the time not to buy the loaf because of those other loaves. But what does this mean? That we can only buy from national producers that can give me a better allergen statement, and we can never buy the farmer's market type stuff? Maybe. I don't know. I'll be doing a separate post later on my frustration with labeling.

Okay, that's enough dumping for today.

Operation Pancake

For anyone who's interested, here's the protocol for phasing baked eggs into Georgia's diet that they sent us home with, verbatim. (I'm not sure why I'm posting this in so much detail, maybe so I'll remember it years from now? The lawyer in me also now feels compelled to add that I'm not posting this as a suggestion that anyone else try it. Talk to your doctor - duh.)

Home Introduction of Baked Egg

It has been determined that it should be safe to introduce egg in a baked form into your child's diet. If your child experiences any possible reaction or concerning symptoms, stop the food and contact us for further instructions. Once your child has clearly tolerated baked goods with 1/8 to 1/4 of egg per serving, you can add similar products up to three servings a day, as well as commercially prepared baked goods that are otherwise safe. The following is a genreal plan for the introduction of baked egg - you can do this as often as once a day to start, although you can also progress as slowly as you like and do this over weeks or months rather than days:

• Begin with any baked egg recipe - cookies, cakes, muffins, cupcakes, brownies - and use one egg for a recipe that makes 12-16 servings. Your child can have one full serving to start, therefore will get 1/12 to 1/16 of an egg to start. You can also use a recipe with 2 eggs and give one-half serving.

• If there is no reaction to these products, you can increase so that your child can get up to 1/4 egg per servings.

• If these products are tolerated with no signs of a reaction, you child may have them up to 3 servings a day.

• After two to three months, you may introduce pancakes or waffles.

• You can then contact us to discuss the possibility of introducing straight egg if you desire. Up until this point, you also need to continue to avoid mayonnaise, custards, ice creams, meringues, and other foods with concentrated, less cooked eggs.

More weirdness...

Just writing to say that in the past couple of weeks we've had a few more mild skin reactions around here that are apparently from kisses.
Like, Joe went to a business lunch and had crab cakes, later came home and gave Georgia a kiss hello, and voila, big red marks.
None of these incidents has been any big deal, but still it's disconcerting. I don't know if she's somehow getting more sensitive, if we've gotten too lax, or if we've just been unlucky.
The moral of the story is: we're now doing a better job of brushing our teeth after eating any of Georgia's allergens.

Hmmm...that was weird

Georgia had a mild reaction to something tonight. We're pretty sure it was from Joe kissing her (a lot) when he got home from work. This is not the first time that she's had problems from kisses. She did not seem at all phased (or even notice that she was having a reaction), but we gradually noticed the appearance of red blotches and tiny hives on her face knee caps.

Isn't that crazy? Someone eats something -- hours earlier -- then kisses her face, and she ends up with hives on her knee caps of all places.

So the great mystery is what food it was. Joe didn't think he had eaten any allergens, but he did have a pizza for lunch that included pine nuts. I'm off to google whether pine nuts are a tree nut. I thought they were considered a seed and are okay for Georgia to eat?

If anyone is reading this and knows the answer, please leave a comment or email me. Gracias.

UPDATE: Okay, I'm feeling like a lousy allergy mom, because apparently pine nuts are a tree nut, so I should have known that. I definitely would have looked into that before feeding her anything with pine nuts (like pesto), but I did not think that Joe eating a pizza 5 hours before kissing his daughter would cause any problems. Ugh.

Georgia's egg challenge (a.k.a., "worst playdate ever")

So, here's the rest of the story about yesterday's failed egg challenge at the allergist's office.

First of all, in a stroke of amazing coincidence, one of my best friends, Maggie, and her family were there at the same time that we were. I mean, what are the chances that she, who lives in the suburbs, would get an appointment to bring her son to the doctor in the city, at the same time and on the same day and in the same pediatric allergy practice as us? Do you have any idea how long it usually takes to even get an appointment there? Given the expected long length of these appointments (thus requiring backup help for child entertainment), and the importance of the information to be conveyed and the opportunity to ask questions, both of our husbands were also in attendance at these appointments, as was Maggie's daughter, Anna, a favorite playmate of Georgia's. Beforehand we joked about how hard it can be in our busy lives to find the time to get together and how maybe we should just meet up like this more often. Of course, that was before Georgia failed her egg challenge and Maggie's son Abe got sent home with a diagnosis of a peanut allergy! I'm joking about it being the worst playdate ever, though, because it was still nice to see familiar faces and for Georgia to have someone to play with for a while during the FIVE hours that we were there, most of it cooped up in a little exam room.

I don't want this to be the wordiest blog post ever, so I'm going to cut to the conclusion and then back up and give you the recap in bullet point form. Conclusion: Georgia had an allergic reaction during her egg challenge, so she's still considered allergic to eggs, but since the reaction was (a) relatively slow to develop, (b) not extremely severe, and (c) occurred after eating a pretty large amount of egg (about a full egg and a half), they think that she is "well on her way" to outgrowing egg allergy and that she may be able to tolerate eggs in baked goods. We were sent home with specific instructions about how to safely attempt to phase baked egg into her diet. (More on that in a later post.)

Now, the play by play:

• Arrive. They take Georgia's vitals. We hand over the 1 egg scrambled and 1 piece of french toast prepared with 1 egg that we had been instructed to bring along.
  
• Challenge consists of feeding Georgia ever-increasing quantities of this food at 15 minute timed intervals. After each interval, her skin, breathing and blood pressure are checked before more food is given.
  
• First "dose" = 10% = about 2 bites of a piece of french toast.
  
• Next "dose" = 20% = about 4 bites.
  
• She seemed to be doing great, showing no signs of a reaction to the egg. We thought she'd pass with flying colors and that we'd get out early.
  
• More "doses" of food. Eventually they added about a teaspoon of scrambled egg to the mix.
  
• Last "dose" = she was told to eat the remainder, so a few more bites of french toast and a couple of bites of scrambled egg. We were then put on a half hour wait period, so we went out to the waiting room with Georgia's friend Anna to give the girls some more space to run around and toys to play with. That's when things started to get weird.
  
• Anna was getting into the toys. Georgia was playing well at first, but then we noticed that she was coughing every few minutes - not like a coughing fit, more like a clear your throat a few times type of thing. Hmmm, we thought....probably nothing...just coincidental timing...maybe she was coming down with a cold? Her cheeks, which were a bit pink before the food challenge even started (due to the cold winter winds and uber-dry heat of our home), seemed to be growing redder, but we wondered if we were imagining that or if she was just getting flushed from playing around. She started rubbing her ears, which also grew red, but it took us a while to notice that. The truly odd part was that she kept saying, "Can I go to sleep on those chairs?" and then went over and laid herself across a few of the waiting room chairs and began sucking on her fingers, her normal self-soothing routine for going to sleep. It wasn't even close to her nap time.
  
• To show you just how convinced we were going into the egg challenge that she'd pass it, we somehow deluded ourselves into the belief that all of these symptoms meant an oncoming cold, not an allergic reaction. We took her back to the exam room to be checked out.
  
• They agreed that it was theoretically possible that this was a cold starting. They decided to wait a bit more before giving her any Benadryl to stop the reaction, to see if it would progress (like an allergic reaction) or not (like a cold, which would obviously take much longer to develop and worsen).
  
• By about 15 minutes later, she had broken out in an eczema flare over most of her body - her chest, back, stomach, legs, hands, wrists, etc. She had hives on her hips, knee caps, wrists, and maybe some tiny ones a few other places. She was occasionally sneezing. She was scratching herself but not complaining of being itchy. Actually, she seemed fairly oblivious to all of this and did not complain of being bothered by the reaction, even though she was acting kind of weird
• Benadryl was given to stop the reaction. A 1 hour wait period began, so that they could make sure that the reaction had subsided before letting us go. It took a while for the symptoms to subside, but they eventually did.
  
• We went home. Georgia ate lunch and went down for her nap. She slept so long we eventually had to wake her up to keep her on some semblance of a normal schedule. By the time she woke up from her nap, her skin looked much better. By her bedtime, her cheeks weren't even pink. You never would guess that any of this had happened. We gave her 1 tsp of Benadryl at bedtime as instructed by the allergist.
  

So, there you have it. In retrospect, it is kind of funny that we would even kid ourselves into thinking that she had spontaneously caught a cold in the middle of her allergist appointment, seeing as how we were there for a food challenge with the known possibility of an allergic reaction. Duh! Call it hopeful optimism or denial, whichever you prefer.

The egg challenge was a big bummer in a number of respects. We really had been hoping to cross at least one of Georgia's food allergies off of the list, just to make it more manageable. Also, it is never fun to witness your own child going through something uncomfortable (and potentially dangerous) like an allergic reaction, not just because of the presently occurring reaction, but also because of what it means for her future. Although I'm sure she'll learn to live with her allergies, we just so wish that she didn't have to grow up dealing with any of this stuff.

So, that was the bad part. However, as mentioned above, based on Georgia's reaction yesterday they think she may be able to tolerate baked eggs. From a lifestyle perspective, this is hugely positive news. As my sister pointed out, two year olds are a lot more likely to be running across cupcakes and cookies than scrambled eggs.

More on the "Baked Egg Study" and the doctor's protocol for introducing baked eggs into Georgia's diet in a later post. Bye for now!