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.  

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.}

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.

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.

Christmas Morning Reaction

Just a brief note to record the fact that Georgia had some kind of contact irritation or allergic reaction on Christmas morning. Not sure what it was from, but she broke out in a red rash with hives all over her face, mostly on one side, and had to have some Benadryl.

She had eaten Dum Dums and Tootsie Rolls from her stocking, both of which I think were safe.
Not sure if she got kisses from someone who had been eating something unsafe or what exactly happened? This one will remain a mystery.

Since I'm on the topic of holidays, I just want to add that in my opinion there are too many allergen-laden foods in our house right now. I know that some "allergy moms" are super strict with their families when it comes to holidays and food. We, however, are not a "strict prohibition" or "zero tolerance" household, which is to say that we generally allow in foods that Georgia is allergic to and just police them. That said, we try to remain nut free and sesame free as much as possible. We do not buy these things and bring them into our home. This helps to avoid pantry mix ups, problem crumbs, cross contamination, and that kind of thing. (We are not as strict with eggs - we still keep eggs in the house and some processed foods made with eggs.) With family in town, and neighbors and friends having dropped off a few food gifts, I suddenly feel like we've got about 10-12 off limits foods floating around. Not a huge big deal, but I will be more comfortable when we're back to our usual ways. I tend to view these ingredients as threats to my child's health and safety; I think that others just view them as "things she can't have." Anyway, Joe may have to take a few of these items to the office with him tomorrow.

Oops. Minor Bib Incident.

I wasn't there at the time, but Georgia had a very mild allergic reaction (some hives on her face) to skin contact with a bit of food residue on a bib that she borrowed during a playdate. The bib was the style that slips on over your head (kind of like a tea towel with a head hole cut out of it), so it probably just grazed her cheeks. We think the culprit was either sesame (from hummus) or some peanut butter. The bib's owner suspects hummus. Of course she keeps their bibs clean to normal standards, though, so she jokingly inquired when we discussed the incident later, "Is Georgia allergic to sesame vapors or something?"

I agree -- it is kind of astounding how sensitive Georgia's skin can be. Fortunately, the hives didn't even require any Benadryl and disappeared within 15 minutes. But this incident was a good reminder of how careful we have to be to prevent Georgia's ingestion of allergens.

The silver lining here is that two more adults have now witnessed Georgia having some kind of allergic reaction, thus proving that I'm not crazy. Well, you know what I mean -- it's not that I thought I was crazy, but sometimes I wonder if other people think that Joe and I are just making of all of this allergy stuff up!