Allergy Shmallergy

Simplifying life for families with food allergies.

Can I Safely Get a Flu Vaccine with an Egg Allergy? October 15, 2021

Filed under: Health — malawer @ 11:40 am
Tags: , , , , , , , , ,

Flu season is upon us and it’s poised to spread like wildfire once again. Patients who are allergic to eggs want to be protected from the affects of the flu, but worry about the risk of anaphylaxis from the ingredients in the vaccine. Those of us with an egg allergy face the same challenge each fall: Can we safely get a flu vaccine?

Myth Busting

Concern about egg allergy and the flu vaccine is one of the many myths that surround vaccines that we can easily dispel. YES, you can get your flu shot even if you have an egg allergy. The amount of egg protein that might be in the shot is too little to trigger a severe reaction according to allergists and the CDC. If you also have asthma, it becomes even more important to get vaccinated as asthma can lead to more discomfort and serious complications.

Another myth worth dispelling: You cannot get the flu from the flu vaccine. The vaccine does not contain a live virus; the live virus used to produce the vaccine is killed, broken up, and purified to make the vaccine. This means, the flu shot does not have any ingredient in it that can make you sick or spread the virus as was previously thought. The components of the vaccine allow your immune system to form antibodies that will be ready to attack should you be exposed to the real thing.

A Little History

Vaccines have been produced using egg for more than 70 years.

When the flu vaccine was first introduced in the early 2000s, it contained a small amount of egg protein. At that time, doctors were concerned that those with an egg allergy might have a reaction. They were particularly worried that the nasal spray delivery method might overwhelm the immune system and trigger a response. For that reason, they used to recommend the injectable flu vaccine followed by a 15-30 minute observation period for anyone with an egg allergy.

…the scientific community has noted that only 1.31 people in 1 million will react [to the flu shot]. That’s 0.000131% for perspective. You have better odds of being hit by lightning.

Where We Are Today

Things are different today. Although the flu vaccine still contains a very small amount of egg protein (ovalbumin), studies have examined the use of both nasal and injectable flu vaccine in allergic and non-allergic patients and have recorded almost no reaction for those with an egg allergy. In fact, the scientific community has noted that only 1.31 people in 1 million will react. That’s 0.000131% for perspective. You have better odds of being hit by lightning. That’s great news!

There are some who react to vaccines. In the last 10 years, there have been several studies that have shown that most of these reactions are caused by another component in the shots, not the trace amount of egg.

As such, the CDC encourages those with an egg allergy to get the flu vaccine and no longer recommends an observation period. Now, you can get your flu shot and be on your merry way!

Severe Reaction to Eggs in the Past?

No worries! The CDC still recommends patients with a history of severe reaction get a flu shot, but they suggest doing so in a medically supervised environment. That could be at a clinic, doctor’s office, hospital, outpatient facility or anywhere else where healthcare professionals can respond to an allergic reaction in the unlikely event one should occur.

The CDC defines a severe reaction as any symptom other than hives, particularly cardiovascular (fainting, lightheadedness, etc), respiratory (wheezing, coughing, etc) as well as any reaction requiring epinephrine.

In Short/Recommendations

  • Doctors recommend that patients with an egg allergy get their flu shot.
  • If you have an egg allergy, the chances of having a reaction to the flu vaccine are incredibly low.
  • Both the flu shot and the nasal spray vaccine are safe for those with egg allergy.
  • Most patients with egg allergy no longer need to be monitored following their vaccine unless instructed by their doctor.
  • **If you have had a severe reaction to egg, be sure to get your flu shot in an inpatient or outpatient facility.**
  • The flu vaccine protects patients from serious illness.
  • If you have asthma, the flu shot is important to keep you from experiencing complications from the flu.
  • **If you have reacted to the flu vaccine in the past, talk to your healthcare provider before getting your next shot.**

Questions?

For more information, please see the CDC’s page Flu Vaccine and People with Egg Allergies.

Symptoms of the Flu

Should you experience any of the following symptoms, please stay home and call your doctor.

Symptoms of the flu – which range from uncomfortable to dangerous – can vary:

  • Fever/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Tiredness
  • Vomiting and diarrhea, *this is more common in children than adults

 

Free-From Manufacturers Who SHIP TO YOU! April 18, 2020

49662769878_cffd512851_c

Photo by Wonderland via Flickr, Attribution 2.0 Generic (CC BY 2.0)

 

It’s rough getting groceries these days!  You never know what you’ll see or miss at the supermarket.  One day it’s bread, the next it’s chicken!  And, those empty shelves can be a little disheartening.  It is even worse when you rely on a specific product to keep you safe and out of the hospital.

 

While most consumers can get by with a different brand here and there, families with food allergies can’t.  They depend heavily on specific brands and products to keep them fed and safe from experiencing a severe allergic reaction called, anaphylaxis.  “Free-from foods” are often in smaller supply than their  regular counterparts without a global pandemic. Because many consumers are buying in bulk (or sometimes panic buying) as they shelter-in-place, it often means food allergy-friendly essentials are unavailable to those whose health depends on them.

 

Let’s take a look at how to get the food you or your family needs as they STAY HOME and shelter-in-place:

Good tip:  Some companies are running a little behind on shipment (only a week) so order BEFORE you need something urgently.

 

We’ve noticed that some big box stores are selling certain free-from items online and are willing to ship things like gluten-free pastas (whereas boxes of regular pasta are often “in-store only” products). It’s worth taking a quick peek at these sites if you need a product more urgently since they tend to ship food fairly quickly.

 

Cold products (those that need to be refrigerated or frozen) are best purchased directly at the store or through a local delivery service (such as Instacart, PeaPod, etc).

 

Some items that are hard to find in person, are easy to find online.  Some free-from/allergy-friendly brands are shipping directly to their customers.  Look at all the manufacturers who are working overtime to ensure you get the products you need!

 

If you’re looking for a big or little treat, why not try a food allergy-friendly bakery?  Some are local (for pick up) and others you can order online.  Here’s Allergy Shmallergy’s list of Allergy Friendly Bakeries.

 

Allergic Living also compiled an excellent list of how manufacturers are handling the increased need for their products during the coronavirus – read here.

 

(Do you have a free-from product you’ve been purchasing directly?  Leave us a comment and we’ll add it to the list for other families!)

 

Schar  – offers gluten-free products including breads, snacks and pasta

Enjoy Life – offers products free from the Top 14 allergens!  Enjoy Life makes snack foods as well as baking supplies (chocolate chips, flour, pizza flour, etc).

Vermont Nut Free Chocolate – this feels critical to me!  I’ve already had enough chocolate to become a living, breathing chocolate Easter bunny.

Namaste – recommended by a baker, this is a great resource for gluten-free and allergy-friendly baking and waffle mixes, soups and pasta mixes.

Made Good – known for their granola bars and cookies, Made Good is currently offering 35% off plus free shipping!

Ener-G – Known widely for its egg-free egg replacer and gluten-free products.

WowButter – a tree nut and peanut-free sunflower butter now ships directly!

The Gluten and Grain-Free Gourmet – offers gluten, dairy and soy-free products.  Paleo friendly.

Safely Delicious – snacks that are free from gluten, peanuts, tree nuts, dairy, soy, and egg PLUS they are donating a portion of their proceeds to SpokinCares and Food Equality Initiative.

Eleni’s New York – the delicious, safe nut-free cookies can be delivered right to your door!!

The Gluten-Free Bar – selling gluten-free granola bars and bites!  On sale now…. stock up!

Cherrybrook Kitchen – their gluten, dairy, peanut, nut-free baking and breakfast mixes have been a staple of many pantries.

No Whey Chocolates – Chocaholics rejoice.  These are dairy, peanut, tree nut and soy-free.

ZEGO Foods – These healthy bars and mix-ins are full of the good stuff with none of the allergens.  For real – they are free of the Top 14 (check out their allergen statement!)

OWYN – selling plant-based protein drinks as well as dairy-free milk!

Kate’s Safe and Sweet – free from peanuts, tree nuts, soy, wheat, fish, shellfish, dairy and eggs (as well as pea, legume, sesame, chickpea and coconut-free!), Kate’s cake mixes, frosting, food coloring and accessories ship quickly straight to you!

Senza Gluten – This 100% gluten-free restaurant and bakery in NYC is closed through May 1st, but lucky for us they ship!

Kips – Who doesn’t love Top 8 free granola bark?!  Free from peanuts, tree nuts, dairy, eggs, wheat, soy, fish and shellfish.

Baked Cravings – Too many amazing tree nut and peanut free treats to name!  Ships nationally!

Simple Kneads – Small batch baked goods in a dedicated gluten-free facility.  I can smell the bread from here!

Partake Foods – Makers of delicious gluten-free, vegan (dairy and egg-free) cookies.

 

But wait, there’s more!

Should you need an epinephrine auto-injector refill and wish to avoid the pharmacy, remember that many pharmacies are delivering prescriptions free of charge.  And, Auvi-Q continues to serve patients through its excellent home delivery program that ships straight to your door!

(more…)

 

Effects of Heat and Cold on Epinephrine Auto-Injectors June 24, 2019

It’s that time of year again!  Camp, beach time, days at the pool…    Does weather change how you carry your epinephrine?  It should.

swimming-170608_1920

 

Available in auto-injectors, epinephrine is the only medicine available that will slow or stop the life-threatening symptoms of a severe allergic reaction, called anaphylaxis.  Because no one plans for an emergency and allergic reactions can be both variable and unpredictable, patients must carry two epinephrine auto-injectors  (EAIs) with them at all times.  Yes, even to the pool.

 

The Ideal Temperature

Epinephrine is temperature sensitive, making it a tricky accessory to carry in the summer and winter months.  To remain 100 percent effective, epinephrine must stay at room temperature (68-77 degrees Fahrenheit or 20-25 degrees Celsius). Short trips between 59 and 86 degrees Fahrenheit won’t harm the product, according to researchers.

 

sun-1651316_1920

Effects of Heat

Research has shown that prolonged exposure to heat can degrade the strength of epinephrine.  And, constant heat resulted in bigger change in epinephrine.

 

 

Confusion

Although short-term exposures outside room temperature conditions are safe – researchers and doctors don’t often define what “short-term” means.  A few studies looked at “real world” temperature fluctuations, mentioning that little or no significant change in epinephrine was observed under these circumstances.  But, what constitutes “real world” and how many degrees outside of the ideal window (68-77 degrees Fahrenheit) is too high?

 

It IS, however, worth noting that keeping an EAI in the car is not a good idea as it often puts the auto-injector FAR outside that ideal room temperature and affects the quality and effectiveness of the epinephrine.  Temperatures inside parked cars even on a mild can soar well beyond 100 degrees in just a few minutes (read more here).  

winter-1127201_1920

Effects of Cold

Recent studies have shown that epinephrine doesn’t appear to degrade if accidentally frozen.  However, if the medicine is kept below freezing, the epinephrine can freeze despite the fact that the auto-injector may still fire – making it useless in an emergency.

 

To Each Injector His Own

Each epinephrine auto-injector is constructed slightly differently.  Extreme heat or cold may not only affect the epinephrine – it might interfere with the mechanism that delivers this life-saving medicine.

 

Watch the effects of extreme heat and cold on EpiPens: please see Allergy Superheroes post, Epinephrine Abuse Experiments – it is very enlightening.

 

Discoloration

Many who carry EAIs point to the color of their epinephrine (shown in a little window on EpiPen brand EAIs) as a way to judge if it’s still potent or viable.  According to manufacturers and pharmaceutical companies, this method isn’t a sure bet.  If your epinephrine is discolored or cloudy, then it is no longer good.  However, if it appears clear, this does not necessarily mean it hasn’t degraded or otherwise expired.

Words to Carry By?

Don’t judge an auto-injector by it’s [lack of] color.  The best way to ensure your epinephrine auto-injector will work properly and at full strength is to keep it as close to room temperature as you can and within its expiration date if possible.

 

Do your best and get out there and enjoy the weather whatever it is!

 

 

 

Join the Food Allergy Fighters – Race for Every Child June 3, 2019

 

**Registration is FREE until Wednesday, June 5th!**

 

Come join us!  All are welcome to join the team, The Food Allergy Fighters, for this year’s Race for Every Child.  The Race for Every Child 5K will be held on October 19, 2019 beginning at Freedom Plaza in Washington, D.C.  You can participate in person or virtually, as a walker or a runner, individually or with the whole family.  Children ages 3 to 10 can also participate in the 100 yard Kids’ Dash.

 

When you support the Food Allergy Fighters, you are making a difference for all food allergy patients – here and around the world. Our team will specifically raise funds to advance food allergy research.

 

Children’s National Medical Center in Washington, D.C. is on the forefront of both clinical medical as well as psychological research as it pertains to food allergies.  They run an exemplary program that is always evolving for the better.

 

hospital-79605_1920

 

Every dollar raised through the Race for Every Child enables Children’s National to advance pediatric health and provide world-class care to every child, regardless of illness, injury or ability to pay.

 

Please join us – register here!

 

Once you register, please create a profile and share with friends and family – all are welcome!

 

Thank you for your participation and we look forward to seeing you at this meaningful, family-friendly event this fall!

 

 

 

 

 

 

Food Allergy or Food Intolerance? January 14, 2019

abdominal-pain-2821941_1920

 

Following an illuminating study conducted by Ruchi S. Gupta and her colleagues Christopher M. Warren, et al, it is clear that most Americans don’t understand the difference between a food allergy and a food intolerance.  The study found that in the U.S.  20% of adults claim to have a food allergy, but when evaluated by a medical doctor only 10% have symptoms consistent with a true allergy.

 

What is a food allergy? What makes it unique?

Food allergies are an immune system response to food.  When the body mistakes a food as harmful, it produces a defense system (in the form of antibodies) to fight against it.  These antibodies in the immune system – called immunoglobulin E (IgE), found in the lungs, skin and mucous membranes – release a chemical that sets off a chain reaction of the vascular, respiratory, and cardiac systems.

 

Food allergic reactions can vary from hives, swelling of the mouth, lips and face, and vomiting to respiratory issues (such as wheezing), drop in blood pressure, fainting, and cardiac arrest.  Anaphylaxis is a very serious and potentially fatal condition that is characterized by a sudden drop in blood pressure, loss of consciousness and body system failure.  Epinephrine (administered by an auto-injector) is the only medication that can slow or stop anaphylaxis.

img_3973

The most common foods that cause a food allergic reaction are:  peanuts, tree nuts (such as walnuts, pistachios, pecans, etc), dairy, eggs, wheat, soy, fin fish (salmon, tuna, etc), and shellfish.  But almost any food can cause an allergic reaction.

 

 

What is a food intolerance?  How does it differ from a food allergy?

Food intolerances also make people feel discomfort.  However, this discomfort is not life-threatening.  Food intolerances are a digestive response that occur when food irritates the digestive system or makes it difficult for a person to break down the food.

 

Symptoms of a food intolerance can include bloating, gas, nausea, stomach discomfort/pain, vomiting, diarrhea, heartburn, headaches, and irritability.  Dairy, or lactose intolerance, is the most common trigger.

glass milk pezibear-1379822_1920

 

What are some other differences?

 

Food allergic reactions can occur with even the smallest amount of food ingested.  In addition to the range of major symptoms when ingested, it can also cause a skin reaction just upon contact.  A food allergy is a reaction to the protein contained in a food (such as gluten with a wheat allergy).

 

With food intolerances, amount of food consumed matters.   The more food consumed, the worse the digestive reaction.  Food intolerances occur because the body cannot break down the sugar in a given food (like lactose in milk).

 

Food allergies are diagnosed in several ways.  The golden standard is an oral food challenge – where a patient eats their suspected allergen under medical supervision to note the reaction.  Patients may take an IgE blood test or be asked to take a skin prick test to diagnose and monitor food allergy.

 

When a food intolerance is suspected, patients are often asked to keep a food journal or diary in which they note the foods they ate as well as the symptoms they experience.  Patients may also be asked to eliminate a particular food from their diet and note symptoms for a period of time.

black-coffee-2847957_1920

 

In both cases, a doctor will help give an official diagnosis and guide the patient through any changes that need to be made to their lifestyle.   Those with food allergies will also discuss issues like cross-contamination, emergency action plans, and epinephrine.  Those with food intolerances may talk about medications that can help to ease symptoms. Avoidance of problem foods will be suggested for food allergies as well as food intolerances.

 

Knowing the difference between a life-threatening food allergy and an uncomfortable food intolerance will help keep you safe, make appropriate lifestyle changes and get you the relief you need sooner.  

 

 

 

FDA Approves First Generic EpiPen September 6, 2018

The U.S. Food and Drug Administration (FDA) has recently approved the first generic EpiPen to be made by Teva Pharmaceuticals.  There are currently several brands of epinephrine auto-injectors available to patients:  Mylan makes EpiPen, EpiPen Jr. and its own brand-sponsored generic; kaléo offers Auvi-Q; and Impax Laboratories markets Adrenaclick.  However, this generic EpiPen by Teva Pharmaceuticals will be the first time a non-brand alternative is available.

laboratory-2815641_1920

Obtaining approval from the FDA for a generic was complicated by the fact that both the medication (epinephrine) as well as the device itself had to be reviewed.  There is no firm estimate on when to expect this new generic on the market or the cost of the product once it gets there.

 

The competition generated by a generic should help the epinephrine auto-injector market. To date, Mylan’s EpiPen has nearly monopolized the market but its exorbitant cost has gained unwanted attention.  Mylan’s EpiPen price has risen over 400% in the last 10 years to over $600 a set.  To counter the negative press, Mylan created their own generic EpiPen which still average $300 per set.  Patients and families are hoping the introduction of a true generic device will drive down the cost of the absolutely necessary, life-saving devices as well as help to prevent epinephrine auto-injector shortages like the one we’re experiencing presently.  They’re also hopeful this generic will help expand options covered by their insurance plans.  Doctors, emergency workers and advocates are also optimistic that this may help get epinephrine in the hands of patients who may otherwise be unable to afford it.

 

 

 

Your Must-Read Allergy and Asthma Resource April 26, 2018

Screenshot 2018-04-26 10.22.49

Check out The Allergy & Asthma Network’s fantastic and informative publication Allergy & Asthma Today.  You can find it in your doctor’s office or online.  Not only does it contain information about food allergies, but it also covers asthma and other allergies as well.  I learn something new in every issue.

 

Screenshot 2018-04-26 10.16.32

The latest issue features two of my articles.  The first covers lupin allergies. (Have you heard of them?  You’ll want to learn more…).  And, the second article covers the backlash Sony Pictures faces following their decision to include an allergic reaction in the children’s movie “Peter Rabbit.”

 

Be sure to check these articles and all the others out today!

 

 

#MinutesMatter: Be Prepared for Severe Allergic Reactions March 2, 2018

hospital-1636334_1920

I hope that no one finds themselves in the situation of experiencing a severe allergic reaction.  But it pays to be prepared.  Studies have shown that delayed use of epinephrine is the leading cause of negative outcomes during anaphylaxis.  That’s why #MinutesMatter in the event of an emergency.

 

What can you do to prepare for an unexpected allergic reaction?

Screenshot 2018-03-01 23.04.43

1. Have a current Emergency Action Plan (EAP) and review it.  Emergency Action Plans are forms filled out by your doctor or allergist which outline actions to take in the event of an allergic reaction.  They are arranged into If/Then actions based on symptoms making it easy to determine what you should do. And, EAPs should always note the presence of asthma in a patient, as asthma can complicate a reaction.  To learn more, please read Allergy Shmallergy’s Emergency Action Plan or obtain a copy like the one created by the American Academy of Pediatrics.

2.  Lay patient down.  If the patient is vomiting, lay them on their side. Elevate the legs if possible.  This position helps with blood flow.

3.  Administer epinephrine.  The sooner, the better.  Should you need to administer epinephrine, do not wait.  Early administration of epinephrine is associated with the most positive results, including less medication needed at the hospital.

4.  In the case of severe allergic reaction (anaphylaxis) first administer epinephrine, then call 911.  You will need to go directly to a hospital after experiencing anaphylaxis even if symptoms subside.  This is because patients require additional monitoring and because secondary reactions can occur – even hours after contact with a suspected allergen.

img_3973

Other keys to success:

Always carry two epinephrine auto-injectors with you wherever you go. Most allergic reactions occur between seconds to 60 minutes after coming into contact with an allergen.  However, in rare cases, allergic reactions can be delayed.  Epinephrine is the only medication that will stop an anaphylactic reaction.  

 

Train your tween, teen and friends about the symptoms of anaphylaxis, how and when to use an epinephrine auto-injector.  Make sure they understand that there’s no major downside to using an epinephrine auto-injector.  Remind them to inject first, then call 911.

 

Carry an antihistamine for minor allergic reactions.  In the case of anaphylaxis or when two or more organ systems are involved (for example, vomiting AND hives – which is gastrointestinal and skin), patients will still need epinephrine to stop this type of severe allergic reaction.  However, if someone is experiencing minor reactions involving only one organ system (for example: hives, itchy mouth) antihistamines will help make things more comfortable.  **Continue to monitor patients after giving antihistamines to make sure a reaction hasn’t returned or isn’t progressing into anaphylaxis.**

 

 

Most importantly, follow this Emergency Room mantra:  If you THINK you need to use epinephrine, you DO need to use it.  

 

In a severe allergic reaction #MinutesMatter.

 

 

 

 

What is an Oral Food Challenge and How to Prepare February 5, 2018

Let’s start right from the beginning:

glass milk pezibear-1379822_1920

What is a food challenge?

Sometimes a skin prick test and/or a blood test does not give a doctor enough information to know if a patient is truly allergic to a particular food.  A food challenge, sometimes known as an Oral Food Challenge (OFC) or just oral challenge, is the best way for an allergist to evaluate a patient’s allergic response.

Food challenges are sometimes used to diagnose a food allergy.  While skin prick tests and blood tests are great indicators of a food allergy, they cannot help a doctor or patient understand their individual risk of a reaction.  Only the Oral Food Challenge can demonstrate a person’s true sensitivity to a given food.

Oral challenges are also helpful in determining whether a patient has outgrown a food allergy.  Doctors will suggest an oral food challenge when they believe an individual may successfully tolerate a food they previously tested allergic to.

How does it work?

For a variety of reasons, doctors may want to test a patient against his/her food allergy.  In a doctor’s office or hospital setting, food is given to that patient every 15 to 30 minutes – beginning with a very small amount and increasing with each “dose”.  The patient is observed and medically evaluated at each interval to check for symptoms of a reaction.  Feeding typically continues until a full portion of that food is consumed safely.

If the doctor sees symptoms of a reaction, he/she will stop the test.   If, on the other hand, there are NO symptoms, your doctor may rule out a food allergy and discuss ways to manage that food going forward.

stethoscope investigation semevent-2458537_1920

Where do you go for a food challenge?  Can I do it myself at home?

OFCs are ONLY conducted in a doctor’s office or hospital setting and should only be done under a doctor’s supervision.  It is critical that the patient be checked by a doctor or nurse at each stage in the process for a reaction.  And, should such a reaction occur, the medical staff are on-site ready to respond immediately.

You SHOULD NEVER conduct an oral food challenge at home.

How safe are OFCs?

Food challenges have an excellent safety record because allergists and trained professionals follow medical standards and procedures for the test and they are prepared to handle any emergency that arises.  Thousands of OFCs have been performed worldwide safely.

Be aware, there is a risk for an allergic reaction with this test which is why it MUST be performed by a doctor in a medical setting.  The most common reactions in an oral challenge are mild skin and stomach reactions which are typically treated with antihistamines.  Allergists are prepared to use epinephrine and other medications in the unlikely event that a more severe reaction occurs.

That said, most doctors recommend an oral challenge when they believe the patient will tolerate an allergen.  They try to set their patients up for success.

How do I prepare for a food challenge?

1.  Remind yourself and/or your child that there is no “passing” or “failing” an oral challenge – there are only results.  In this way, you can keep anticipation and disappointment in check.  [But feel free to go crazy celebrating if you’re able to add another food to your diet later!]. Use words like “tolerate” and “didn’t tolerate” rather than pass/fail to reduce the pressure for you and/or your patient.

2. Have a conversation with your allergist’s office about what to bring and how to prepare it.  Allergists typically recommend how to prepare the food you are testing for.  For example, when my son tested for soy, we brought soy milk; for wheat, we brought toast; for milk and egg, we were instructed to make muffins and French Toast using a particular recipe.  Depending on your child’s age and particular tastes, the allergist may be able to alter the recommended food to make it more palatable.

3. You will need to stop taking antihistamines as well as some other medications for at least one week prior to your appointment.  Discuss this with your doctor’s office for further instructions.  ALWAYS take emergency medication (such as a rescue inhaler or epinephrine) should you need it leading up to the oral challenge. Oral challenges can be postponed if need be.

4. Prepare for the day.  Oral Food Challenges often take several hours.  Think about what will amuse you and/or your child for that period of time.  Consider coloring books, small lego sets, matchbox cars, books, a portable DVD player or iPad for kids.  And bring something engaging and calming for you: books, laptops, portable crafts (like knitting, colored pencils, etc) can help ease any anxiety as you begin.  And, yes, that means you might arrive with a giant “tote bag of fun,” looking like you’re ready to move into the doctor’s office like I did.

5. Write down questions about the possible results of the test as you go along,  You should have a chance to discuss the results after the challenge has finished.  Some questions you may wish to ask if you can add a new food:

  • What do the results tell us about my allergy?
  • Are there any limits to the quantity/variations of this new food we can add?
  • Can we add this food in its baked AND unbaked forms?
  • Does this change the way I read food labels for safety?
  • What symptoms should I look for over the next few hours and days?
  • Does this alter my Emergency Action Plan?  Can you fill out a new plan so that I can copy this information for the school nurse, after care, babysitter, etc?

6.  Know that it’s very common to be nervous about these appointments.  If you experience a little anxiety, you’re probably in the majority.  Remind yourself that your doctor would only recommend an oral food challenge if they felt it was possible to tolerate that food.  And, keep in mind healthcare professional are monitoring you and will intervene at the first symptoms.

 

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

 

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.

 

Parenting Positively in the Face of Food Allergies September 29, 2017

microphone-2170045_1920

 

 

Last year, I had the pleasure of speaking with Lyndsay Edwards of Allergy Blog Awards UK.  In her podcast, she asked a lot of thought-provoking questions on the topic of parenting a child with food allergies.

 

Because of the challenges and risks associated with food allergic reactions, it is critical to raise food allergic children to be confident, resourceful, and self-advocating.  And all of that begins with a good attitude towards food.

 

Here is the transcript of Lyndsay’s well-crafted podcast [or listen here: Allergy Blog Awards UK – Allergy Shmallergy Living Positively with Food Allergies].

 


 

So, I know your son was diagnosed with a dairy allergy at 6 months old and other allergies by the time he was just 15 months old, can you just take us back to that time and what it was like for you getting the diagnosis?

 

Despite his eczema, acid reflux and asthma (conditions that I now understand to be related to food allergies), I was in denial.  Even though I followed her instructions to the letter, I scoffed at our pediatrician’s recommendation to avoid feeding my son a whole host of allergens as we introduced first foods.  “He’s probably not allergic to any of these!” I remember saying.

 

When she called us to discuss the results of my son’s blood test, revealing that he was allergic to eight different foods in addition to environmental allergens, I was completely overwhelmed.  I couldn’t stop wondering:

 

What does this mean Not only the test results, but also in a bigger sense:  what does this mean for his life?  Will he have a normal life?  And more importantly, what can I feed him for dinner tonight?!!

 

I found myself grieving for the hopes and dreams I had imagined for my child (like baking cookies and spontaneous trips to get ice cream), but then my husband snapped me out of it.  He reminded me that we would find work arounds.  And, if they didn’t exist, we’d create them!  Very quickly, THAT became my focus.

 

 

How do you cater for your son at home?  Do you all eat the same?

 

Because my son was allergic to so many foods, I had to learn how to cook (and fast!).  Unbelievably, he’s my most adventurous eater.  He loves everything seafood (no matter how crazy the dish), sushi…  and he’s consistently adding requests to his list.

 

These requests inspire me to learn how to cook all kinds of intimidating international cuisine.  No one who knows me would have EVER guessed that I regularly cook Chinese food or Persian or make all kinds of sushi.  In high school, I once burnt soup!  SOUP!

 

When he was a toddler (and an only child), I was making separate meals for my son.  But being a short order cook isn’t my strong suit and I didn’t want my son to feel like I was treating him differently because of his allergies.  In his own home, he should feel safe and included.  As I got better at reading recipes, swapping out his allergens for substitutes, I started serving only one meal (what a relief!).  I also began finding meals with optional parts (like tacos that you could stuff with cheese or not and make-your-own pizza night).  I now have quite a collection of tried and true recipes that are free of peanuts, tree nuts, sesame seeds, dairy and in many cases egg (an allergy my son has since outgrown).

 

 

When did you start your blog and what inspired you to do so?

 

It was very important to us to raise a confident child who felt capable in the world.  Food allergies are very stressful.  I wanted to share simple solutions with other parents and put out useful information so that families can remain calm and make informed decisions.

 

 

One of the things that really stood out for me on your blog is how you focus on teaching your son about his food allergies in such a positive way so that he doesn’t feel left out or sad, can you just explain how you do that and what has worked for you and your son?

 

We have repeated the message that everybody deals with something – sometimes that “something” is invisible to the eye, like food allergies.

 

We try to downplay the importance and emphasis on food.  For example, we try to reward achievements with activities rather than treats.

 

And, we remind all of my kids that the best party of any party is always the company, hardly ever the cake.

 

Involve your kids in problem solving.  We can’t control the fact that my son has food allergies, but I can give some control OVER them by getting his input on overcoming obstacles.

 

Prepare, prepare, prepare to provide special treats in anticipation of special events.  Bring a gluten-free cupcake to the party; pack a sesame-free hamburger bun for the barbeque; carry a little dairy-free butter out to dinner.  Create positive experiences around food and demonstrate how easy it is to overcome challenges.

 

Let him vent!  We’ve taught my son the names for his feelings and encouraged him to talk about them.  First, children need to know the language to use to express their emotions.  Then they can engage in an open dialogue to release stress and give parents an insight into how they are experiencing the world.

 

 

Ok, before I get to my last question, can you tell everyone where they can find you on social media, your website, etc?

 

Yes, of course!

[You all know where Allergy Shmallergy is! shmallergy.wordpress.com]

Twitter: @shmallergy

Facebook:  Allergy Shmallergy

Instagram: shmallergy

 

 

And my final question is if you could give allergy parents one tip, what would it be and why?

 

Help prepare your child to negotiate the real world: practice asking questions, allow them to speak to a waiter, in short: EMPOWER them!  Give them the tools to tackle the world!

 

And, provide a safe place for them to come home to. A safe home environment (free of allergens) as well as a safe space psychologically where they can relay their triumphs and articulate their frustrations without judgment or anxiety and find support.

 

That’s two tips (sorry!), but I hope they’re both helpful!

 

 
%d bloggers like this: