Just a little follow up

Since my last post was kind of a rant, I felt like I should update this blog to reflect that I think we've got everything worked out with Georgia's preschool now. I had a phone conversation with the teacher in which she probably concluded that I'm a little paranoid (her quote: "Um, we ate tomatoes?"), but also managed to convince me that she "gets" it as far as the need to check all foods, the concern for cross contamination, and so on and so forth. We left it that Georgia will continue to bring her own lunch, but will be allowed to eat some of the school's food so long as on any given day the teachers tell her it's safe.

Surprises:
1) I'm surprised that this is where we've ended up, that is, that I even feel comfortable letting Georgia eat ANY of the school's food, given that my generally held belief is that the risk isn't worth the reward, and that classrooms should be a food-free safe haven.
2) I'm surprised that the school/teachers even want the onus to be on them as far as telling Georgia "yes, you can eat it" or "no, you can't." It seems most schools are so afraid of potential liability that they wouldn't touch this issue with a ten foot pole and would prefer to have the parent make the call in every case.

What's playing into this:
1) It's a Montessori preschool, so the serving of food is not just about nourishment, but also about having the children work on a practical skill and share a communal experience. (Or something like that.)
2) I'd be more willing to say "screw the skill/communal experience" except for the fact that Georgia's been so hesitant to get involved in ANY group activities with other children, but her teacher reports that Georgia really likes the meal-prep part of the day, so I am loathe to take that little shred of participation away from her. For the sake of her social development, as parents we're kind of trying to latch on to something she likes and go with it here.
3) The foods in question are very basic, like last week they peeled oranges or bananas, and the week before that I think they made a salad of lettuce and tomatoes. I'd feel more comfortable if someone could give me an actual menu ahead of time, but I guess the teacher has persuaded me to relax and trust her that the foods she's talking about incorporating aren't going to be a problem. The fact that so far they have not been processed foods makes it less worrisome to me from an allergy perspective; I hope it stays that way.

This is fixable. But GRRRRRR I am so mad!

If I had written this post six hours ago, it would've been filled with profanities, so let's all be happy that I didn't have time until now.

Here's the short, cut to the chase version of the story:
Georgia started a new (one day a week) drop-off preschool program today where lunch is served. (God forbid the children go more than an hour and a half without eating, but I digress.) We spoke to the teacher about her allergies beforehand and sent her off to school with her own brown bag lunch. She comes home reporting that "she ate some of the school's food" because they told her it was okay because "nothing they serve has peanuts in it."

Ugh. This is beyond aggravating. There was obviously some kind of miscommunication between us and the teacher. We'll fix it. And no one was hurt, and nothing went wrong, so yeah, I've calmed down (a little) now.

But I was majorly annoyed because:

1) Food allergies suck. Our daughter has had trouble transitioning to a school setting (or any group activity away from mommy and daddy for that matter), so I would really rather have everyone's focus at the school be on her social/emotional development, and how she's doing, and what we can all do to help her feel more comfortable and less anxious, but instead, nearly all of our conversations with the school thus far have been about freakin' FOOD. And I feel I have no choice in that matter, because her health and safety is paramount. But I hate it that it's Day 1 and we're probably already becoming "those food allergy parents" in the teacher's mind, plus I could hardly even focus on the positives of how Georgia's first day went, because it was all overshadowed by dealing with this food mess.

2) I'm p.o.'d that the teacher undercut our instructions to our own daughter, although I'm sure it was unintentional on their part, and thankfully, Georgia was pretty much unphased by the whole thing. Still, how confusing must it be for her when mommy and daddy send her off with a packed lunch and tell her not to eat the school's food, and then her teacher tells her the complete opposite? She's only 3, can't read, and has to rely on adults to protect her, so it's not helpful to send her mixed messages.

3) Grrr...peanuts, peanuts, peanuts. Yeah, yeah, it's so great that there's a lot of peanut allergy awareness out there now. But I've got two beefs about it. One, it gives people a false sense of security and confidence, so they say things like, "this food is peanut free!" and forget to read labels, or think about cross contamination or how the food was processed or cooked. Two, I think peanut allergy awareness is causing people to space out about OTHER allergies. Georgia's allergic to four kinds of food, so please don't give her the wrong idea by handing her something and saying, "You can eat it, because it doesn't have peanuts." In this particular instance, I'd be more forgiving of it as an innocent mistake if my husband hadn't already explicitly discussed Georgia's multiple food allergies with the teacher beforehand, and if we hadn't been required by the school to submit medication authorization forms and a food allergy action plan signed by her doctor.

So there you go. Just had to vent. I feel better now. We'll get it all worked out super tactfully and amicably with the school by next week I'm sure.

Friendly reminder/PSA

This PSA is for:
1) myself;
2) our relatives;
3) the friends and strangers who ask us if Georgia's allergies are "severe";
4) the parents I know who seem to take their children's allergies a little too casually in my opinion, assuming that [no bad reactions thus far] = [no bad reactions in the future].

I'm not trying to scare anybody, and God knows I hope my child's allergies are not severe. This is just a little reminder that unfortunately no one has any way of knowing.

(The following is an excerpt from a recent blog post I read on Food Allergy Mama):

Finally, I wanted to pass along an email a good friend of mine sent to her family members after a child in her daughter’s class suffered a severe reaction during a school field trip, and didn’t have their medication. I think it serves as a good reminder that you can never be vigilant enough….

I was in Springfield yesterday on a 5th grade field trip with Laney when one of her classmates had a allergic reaction to peanut butter. He is 11yrs. old and has never had a bad reaction before. His mom did not have her epipen with her. He was sitting next to a boy that had peanut butter and they think he somehow touched his hand or the table and was exposed. He started out with hives and then started coughing and his throat was closing up. We called 911 and they were there within minutes. I went in the ambulance to the hospital with the mom and child and they were able to get him the epipen, oxygen, etc… in time.

As you can imagine it was a very scary experience for everyone involved. I send this to you as a reminder that we need to carry Maddie’s epipen with us at all times, no exceptions. Yes, the chances of it happening to her are extremely rare but I would never want to be in that situation without it.

I asked him, after he was feeling better, what it felt like and he actually said he thought he was going to die or suffocate.. It was really sad and the fear in his eyes is not something easily forgotten.

Finally, everyone was hesitant to call 911, thinking that the benedryl he was given would kick in. Never wait, every second counts in these situation.

A Happy Moment

After church, walking back from the bathroom, our route took us through a post-baptism celebration spread of delicious foods.

Donuts, pastries, cookies, and cake galor. Amidst it all, a plate of bananas and orange slices.

I did not say a word and figured we'd just walk right through (I'm not the most outgoing of creatures when it comes to the church setting), but Georgia immediately asked, "Can I have one of those bananas? Because we don't know if the cookies are safe."

Me: beaming with pride!
Georgia: happily eating a banana.

I know there may come a day as she gets older when it will bother her that others can eat things that she can't, but for now, I just think it's awesome that she really is starting to understand her food allergies, and that it doesn't phase her one bit. So I'm going to live in the present and try to enjoy happy moments like this one. Now, if only I could always do as good a job as she did of picking the healthy option for myself!

Explaining my Absence

It's been a while since I updated this blog, so much so that I feel the need to explain my absence. Here's the answer: Don't take this the wrong way, but sometimes I just get bored of food allergies. (To the other food allergy sufferers or food allergy parents out there: do you?)

As a parent of a food allergic child, there's a certain amount of continuing education that must go on, or else you'll be totally out of touch with medical advances, legislative changes (that affect things like your child's school experience, or food labeling), etc. This is especially true because even the best allergists in my opinion do not equip patients and parents with all the information we need to get by; there is a lot of patient "self education" that we're left to take care of on our own. But on the other hand, my real goal is just to go about living my normal life, allowing my food-allergic child to go about living hers, not thinking about food allergies any more than we have to. So, while advocacy and education in the food allergy community is invaluable, it's also something I just have to step away from now and then. If I read (or write) too much about food allergies, it can have the effect of overwhelming me, or sometimes getting me down or just plain scared, rather than empowering me, which is supposed to be the intent.

Anyway, I also take my boredom with the subject of food allergies to be a good sign that our family has been very, very lucky in recent months. (knock on wood.) Only when you're not dealing with actual allergic reactions can you indulge in not focusing so much on food allergies. It seems almost paradoxical, but I think our vigilance has allowed us to be more relaxed. It's always a balancing act, though...I don't want the pendulum to swing from relaxed all the way over to lazy or careless. But I fully admit that a lack of reactions can have that effect; our family gets too comfortable and starts taking more chances, making more assumptions about food ingredients that we shouldn't.

(Oh, also, I'm pregnant, and that's such a good excuse for so many random things that I might as well put it forth here as another reason that updating this blog has not been top priority.) : )

So, had I had the urge to update this blog in the last few months, here are a few things I would've posted on: (skip this if you want....it's about to get really long as I brain-dump)

• Ugh. The comments. When will I ever learn to NOT READ THE COMMENTS to allergy articles in main stream media? They are filled with hatred. I made the mistake of reading the comments to the December news of a Chicago Public School student's allergy related death. The allergy community stepped up with heartfelt responses and offers of support. But many others were screaming that the family was to blame, because they should've just homeschooled their child. I hear this sentiment a lot, but there's no winning. If you go out of your way to protect your food allergic child, then you are considered a zealous freak who needs to just relax and not make such a big deal of your child's allergies, who just needs to realize that allergic children can't grow up living in a bubble or they won't be prepared for living in the real world when they grow up, yada yada yada. But if you put them in public school, well then you're subject to potential shouts of "don't make your problem my problem" from other parents, or "you should've homeschooled" if something goes wrong. That's frustrating. With all due respect to families that for whatever reason have decided that homeschooling is the best option for their child, I do think that access to a public education and a safe classroom for my child is not too much to ask. The types of things I would even consider asking my child's elementary school to do in light of her food allergies are all (in my opinion) very "reasonable accommodations" under the ADA. If you can build a wheelchair ramp, offer a special ed class, and bring in a speech therapist, surely you can also keep my child's Epipen accessible, train teachers to use it, and consider keeping food in the cafeteria rather than the classroom?


• There was this whole brouhaha about a district in Florida where parents protested food allergy accommodations that one family had requested. Honestly, I don't know enough about it to have a strong opinion, because I've been tuning out the news so I don't know what the family asked for exactly. But it was so bad that FAAN had to get involved to help educate the parent population and the school board, and suffice it to say that the sentiment coming from the protesters was not very compassionate (e.g., "My child is special too!"). Read all about it here if you want.


• Back in December, the Wall Street Journal (amongst other publications) ran an article about the National Institute for Allergy and Infectious Diseases having issued the first clinical guidelines for diagnosing and treating food allergies. (Hello? It's about time.) It explained why relying on blood and skin tests alone is not sufficient. This was not news to me, and should not be news to anyone dealing directly with food allergies, but unfortunately I think it is. Too many doctors (generally speaking, pediatricians, as opposed to allergists) have not been properly educated about how to correctly identify food allergies, and this results in misdiagnosis and over-diagnosis, with families avoiding foods for no good reason. As someone who once had to put my daughter on an extrememly restrictive diet based on a simple blood test while we waited for two months to get an appointment with the allergist, I can certainly relate. Even after Georgia was seen by the allergist, she was left avoiding foods for quite some time that we were later able to add back into her diet. (Poppy seeds and green beans (all beans, for that matter) were once on our list. And they shouldn't have been. What a pain for us, and what a burden to put on others interacting with or caring for my child. I also felt it distracted from the significance of her real allergies to have all of these other foods coming on and off the list. How is someone supposed to trust me that she's really allergic to sesame, if just last week I told that same person "no beans!", but then turned around and said, "never mind"?) So, the article made some valid points, and I think the accompanying graphic did a good job of visually explaining the difference between proper and improper diagnostic procedures. Certainly there is still room for improvement in allergy testing, and I hope the scientists are working hard on that! The downside of the article (and similar articles covering the same topic) was that there was disproportionate focus on the false positives/over-diagnosis issue. Which only leads to more of the general public thinking, "food allergies aren't real," or, "is your daughter really allergic to nuts?" That sentiment gets annoying. For every person that asks me, "Why are there so many food allergies now, when no one I knew in the 70's had allergies?" I feel like half of them are genuinely curious with no ulterior motive, and the other half are secretly thinking, "I think a lot of these so-called allergies that people are being told they have are just fake. Are Georgia's fake?"


• My in-laws successfully watched the girls at their house for 3 nights while Joe and I went on vacation, and the weekend passed without allergy incident! Woo-hoo! This was a big milestone for us as parents to cross. I hope we didn't annoy Joe's parents beforehand with too much information and instruction, but I warned them that we'll do it again every time. : ) I'm so glad it went well, because it helps us build trust (not just with them, but with ALL other caretakers), which is something that we have to be willing to do in order to give our daughter a normal life. But I'm not gonna lie - I was anxious about it beforehand. (Which, don't misunderstand - had absolutely nothing personally to do with my in-laws. I had complete confidence in them but was nervous nonetheless.)

I think that's enough for now! I hope I didn't bore you too much in the process, because I think I'll be writing here off and on more regularly for a while now that I've come off of this 3 month hiatus.

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.