Allergy Shmallergy

Simplifying life for families with food allergies.

Food Allergies: Overcoming Disagreements November 27, 2017

thanksgiving-table-satya-murthy

The holidays are a magical time – filled with hope and kindness.  But when you have food allergies, holiday gatherings are sometimes filled with the possibility of being excluded, disappointed, or the fear of having a food allergic reaction.

As parents and patients, we feel like we are constantly educating others about food allergies.  Our extended families and friends surely should know by now how real and severe a food allergy can be – shouldn’t they?!  Unfortunately, many times our family and friends don’t understand.  They underestimate the severity of a reaction and the amount of time and energy we put in to preparing for a regular day – never mind a holiday!  We often feel let down and angry when others don’t take food allergies into consideration or are set on upholding their traditions at the expense of someone else’s health and safety.

These disagreements around the holidays can set off a chain of unhealthy interactions that could cause relationships to strain.  Don’t end your relationship with family or friends.  Try the techniques outlined in the article below first and see if you can teach them about what your life with food allergies is really like.

Please read this article I wrote, published in the magazine Allergy & Asthma Today by the Allergy & Asthma Network, for more information.

http://bit.ly/2ncAJHY

Screenshot 2017-11-27 11.34.17

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Allergy-Friendly Thanksgiving Recipes November 20, 2017

It’s actually fairly easy to create a Thanksgiving dinner that everyone can enjoy easily.  With just a couple of ingredient swaps, there’s almost no part of this inclusive meal that you’ll need to omit!  Try some of the below, post a photo and let me know how it all turns out!

 

MASHED POTATOES

You’ll Never Miss It Dairy-Free Mashed Potatoes (via Allergy Shmallergy)

By using broth and dairy-free butter instead of buttermilk, these mashed potatoes turn out savory and delicious – right down to the last lick on your fork.  My guests have always loved this recipe!

mashed-potatoes-439976_1920 (1)

 

MUSHROOM GRAVY

Pacific Foods Organic Vegan Mushroom Gravy

Available at local supermarkets, this gravy is both dairy and egg-free.  Another thing it has going for it?  You don’t need to prepare it!  **This gravy DOES contain almonds (almond butter) – please avoid if you are allergic to tree nuts!**

Pacific Foods Organic Vegan Gravy

 

CREAM OF MUSHROOM SOUP/GREEN BEAN CASSEROLE

Did you know you can make your own dairy-free (and gluten-free) cream of mushroom soup?  Why is this important?  Because cream of mushroom soup is the base for delicious green bean casserole!

 

The Kitchen Girl blog posted an easy recipe for Can’t Believe It’s Vegan Cream of Mushroom Soup.  Her recipe uses unsweetened almond milk; but if you’re allergic to tree nuts (as we are) you could substitute that for unsweetened soy milk or rice milk.  And, as a bonus, her soup is also gluten-free.  Looks DELICIOUS!

 

The magazine Gluten-Free & More posted a recipe for Dairy-free, Gluten-free Green Bean Casserole.  It involves creating your own gluten-free breaded onions to top the dish – just like the original recipe.  Those onions are my favorite part – I’d double this part of the recipe for my table!

 

STUFFING

The big obstacle for allergy-friendly stuffing?  Gluten!  Those pesky bread cubes make it a tough sell for those with a wheat allergy or celiac disease.  Enter Williams-Sonoma: they carry Mariposa Baking Co. Gluten-Free Cornbread Stuffing.  This rosemary and sage version contains egg and soy (and is manufactured in shared equipment with milk), but is gluten-free and pre-packaged.  One less thing to stress about!

 

If you can’t make it to the market, you can also order Three Bakers Herb Gluten-Free Seasoned Whole Grain Cubed Stuffing (contains egg) from Amazon Prime!

 

DESSERT

Dessert is always tricky for those with food allergies.  Holiday desserts are typically filled with butter, egg, gluten and nuts.

 

But these Allergy-Free Pumpkin Chocolate Chip Cookies have (almost) none of those things!  They are easy to make, can feed a crowd, and offer an alternative to make them gluten-free.  They combine the delicious, comfort of a regular chocolate chip cookies with the flavor-du-jour pumpkin spice!

 

Another favorite holiday dessert in our house is Sorbet Pie.  It’s light and refreshing (something much needed after a big, savory dinner) and it’s dairy-free, egg-free, peanut and tree nut-free.  Be sure to give the pie times to refreeze before serving!

 

 

(Thank you in advance! A portion of the proceeds of the affiliate links go toward AllergyStrong.org – an organization aimed at helping at risk families with food allergies.)

 

The Dangers of a Dairy Allergy November 17, 2017

cereal and milk pixabay StockSnap

 

Three year old, Elijah Silvera, was attending a regular day of preschool in New York City recently, when preschool workers fed him a grilled cheese sandwich despite school papers which formally documented his severe dairy allergy.  Elijah had a severe allergic reaction and went into anaphylaxis.  Standard procedure for anaphylaxis is to administer epinephrine and call 911 immediately.  Instead, the school called Elijah’s mother, who picked up her child and drove him to the hospital herself.  Doctors in the emergency room tried but were unable to save him.

 

Dairy allergy is the most common food allergy among young children.  And, although the peanut can produce some of the most severe allergic reactions (as well as some of the most tragic headlines), an allergy to milk products can be life-threatening.  The myth that a dairy allergy is not serious and doesn’t require as much vigilance causes great frustration to many who are allergic to milk, as does the idea that a food is “allergy free” if it does not contain nuts. To those who live with it, a dairy allergy requires an enormous amount of preparation and education since milk is an ingredient in so many products.

 

Dairy is cow’s milk and found in all cow’s milk products, such as cream, butter, cheese, and yogurt.  Doctors sometimes advise patients with a dairy allergy to avoid other animals’ milk (such as goat) because the protein it contains may be similar to cow and could cause a reaction.  Reactions to dairy vary from hives and itching to swelling and vomiting, to more severe symptoms such as wheezing, difficulty breathing, and anaphylaxis.  Strictly avoiding products containing milk is the best way to prevent a reaction.  The only way to help stop a severe food allergy reaction is with epinephrine; patients should always carry two epinephrine auto-injectors with them at all times.

 

Just like other allergens, cross contamination is a concern for those with a dairy allergy. Even a small amount of milk protein could be enough to cause a reaction. For example, butter and powdered cheese (like the kind you might find on potato chips) are easily spreadable in a pan, within a classroom or on a playground.  And, as with other allergens, hand sanitizer does NOT remove the proteins that cause allergic reactions.  Doctors recommend hand washing with good old soap and water – but wipes work in a pinch.

 

Those allergic to dairy must not only avoid food; they often have to look out for health and beauty products too.  Dairy can be found in vitamins, shampoo, and lotions.  It is critical to read the ingredient labels of every product you buy each time you buy it as ingredients and manufacturing procedures may change.

 

In the United States, any food product containing milk or a milk derivative must be listed as DAIRY or MILK under the current labeling laws (see The Ins and Outs of Reading Food Labels, Aug. 2016).  If you are living or traveling elsewhere, this list of some alternative names for dairy may be useful:

 

milk (in all forms: goat, whole, skim, 1%, 2%, evaporated, dry, condensed, etc)
butter (including artificial butter and margarine)
cream
buttermilk
sour cream
half and half
yogurt
cheese
ice cream
custard
sherbet
pudding
chocolate
ghee
whey (all forms)
casein
caseinates (all forms)
casein hydrolysate
lactose
lactulose
lactoferrin
lactalbumin (all forms)
diacetyl
rennet casein

 

Let’s spread the facts about dairy allergy so that our schools and teachers better understand how to accommodate and care for students with food allergies.   Any allergen can produce severe, life-threatening allergic reactions and all food allergies should be taken seriously and managed with attention.  I sincerely  hope that by informing others we can prevent another tragedy like the one the Silvera family was forced to experience.

 

Important Story: FDA Warning to Mylan, Maker of the EpiPen, on Device Defects and Review November 6, 2017

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Earlier this fall, the FDA issued a warning to Mylan, the makers of EpiPens.  In a scathing letter, the FDA highlighted manufacturing defects as well as Mylan’s failure to conduct adequate internal reviews after receiving many complaints about the life-saving device, EpiPen’s malfunctions.  To date, there have been 7 deaths, 35 hospitalizations and 228 complaints about EpiPen and EpiPen Jr. devices this year.  [See F.D.A Accuses EpiPen Maker of Failing to Investigate Malfunctions, New York Times, Sept. 7, 2017]

 

Following an FDA inspection of the manufacturing plant, FDA’s letter to Mylan describes EpiPens that were leaking epinephrine and others that malfunctioned.  In March of this year, Mylan issued a recall of a small batch of EpiPen and EpiPen Jr devices.

 

While it is difficult to connect these defects to the deaths reported, as anaphylaxis itself can be deadly even with properly receiving epinephrine, these reports are not encouraging.

 

In February of this year, we had a frightening experience. [Please read the full story,  The Fire Drill- 5 Key Lessons from an Intensely Scary Night.]  Not long after eating at a restaurant, my 12 year old, food allergic son was rushed home, wheezing severely and coughing.  He was so weak and nauseous that he could barely stumble to the bathroom.  As I asked him questions, trying to evaluate the situation, it was becoming increasingly impossible for him to speak at all.  I wheeled around to grab my EpiPens just steps from where my son sat.  When I turned back around, he was blue.

 

This is every parent’s worst nightmare.  It was certainly mine.  Amidst the chaos of an increasingly critical and deteriorating situation, my only saving grace was that I held in my hand an EpiPen that would contain the correct amount of the life-saving drug, epinephrine and deliver it safely.

 

I can’t imagine being in that same moment now, knowing that the EpiPen in my hand may or may not save my son’s life.  That it may or may not have the right dose of medicine.  That the needle may or may not misfire.  Would the knowledge of EpiPen defects cause you to hesitate?  Would you instead call an ambulance that would take even more time to arrive?  When minutes matter, these short hesitations in action, improper delivery of medication, and any other complications that arise during anaphylaxis could be costly…. even deadly.

 

Bear in mind, Mylan has also increased the cost of EpiPen from $50 in 2008 to over $600 currently.  And, while the high cost of EpiPens are prohibitive, parents are still buying them, and they’re paying for one thing:  reassurance.  They pay for the firm knowledge that this product administers the correct amount of medicine properly every time.  If that can’t be demonstrated, there are plenty of other auto-injectors on the market with a proven track record of reliability to consider.

 

Despite these less-than-comforting reports, please continue to carry and use your EpiPens and other auto-injectors.  According to the FDA in a recent Bloomberg article, “We are not aware of defective EpiPens currently on the market and recommend that consumers use their prescribed epinephrine auto injector. We have seen circumstances in which adverse events reports increase once a safety issue is publicized, like a recall. We continue to monitor and investigate the adverse event reports we receive.”

 

I plan to keep you all informed as we continue to follow this story.

 

To read more on this story, please see EpiPen Failures Cited in Seven Deaths This Year, FDA Files Show posted on Bloomberg, Nov. 2, 2017.