Allergy Shmallergy

Simplifying life for families with food allergies.

Needle-Free Epinephrine May Soon Be a Reality October 15, 2019

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By now, we all know that epinephrine is the first – and best – line of defense against a severe food allergy reaction called anaphylaxis.  But when symptoms of anaphylaxis first appear, many patients and caregivers hesitate to give it.  Why?

 

Not only are patients unsure about the timing to deliver a dose of the life-saving medication, but they tend to pause at the idea of giving an injection.  Parents worry that it will be difficult to administer or that it will scare/hurt their children. And, patients are at risk for minor injuries associated with delivery such as lacerations and misfirings.  Doctors and clinicians say epinephrine auto-injectors are “underused” in an emergency.  Delays in administration of epinephrine during anaphylaxis put the patient at risk for a more severe reaction that could require more medication to stabilize.

 

To date, patients have had a single option for getting a dose of epinephrine: an injection given to the patient through the outer, muscular part of the thigh.  But the food allergy community has long wondered, is there another way?

 

Enter: intranasal epinephrine.  

Essentially: epinephrine delivered through a nasal spray.

 

Researchers have examined how well the body absorbs epinephrine when it is given intranasally as compared to intramuscular injection (the way epinephrine is currently administered through auto-injectors).  What they found surprised us all:  epinephrine can be absorbed and distributed throughout the body as a nasal spray just as well as it would an injection.

 

This is wonderful news for patients and caregivers that are afraid of needles.  But it’s also good news for those wanting to help in an emergency.  Because nasal sprays are a less invasive treatment, patients and caregivers may find themselves more likely to act quickly, administering much-needed epinephrine sooner and more frequently than they would otherwise.  Nasal sprays could make acting in those first critical minutes of anaphylaxis easier which could make follow-on emergency treatment less complicated and would ultimately save lives.

 

A few pharmaceutical companies have begun developing intranasal epinephrine products.  One such company is Bryn Pharma which developed a portable, easy-to-use spray (currently referred to as BRYN-NDS1C). BRYN-NDS1C was granted Fast Track Designation by the FDA and is currently undergoing human trials.  Bryn’s nasal delivery device has already been approved for use in other conditions by the FDA.

 

Another company, ARS Pharmaceuticals, whose product is called ARS-1, was also given Fast Track Designation to develop intranasal epinephrine.

 

Studies and trials continue, while questions remain about the efficacy of this delivery system when a patient experiences such factors as nasal/sinus swelling or moderate to severe congestion.

 

Although final approval by the FDA and ultimate delivery of this medication to customers is still unknown, we should all have high hopes for more and innovative epinephrine options to consider in the future.

 

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Managing Food Allergy Anxiety April 20, 2017

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According to a study out of the Children’s Mercy Hospital in Kansas City, Missouri, children with food allergies are more likely to experience anxiety and depression than their non-allergic peers.  And, the more foods they are allergic to, the more likely they are to internalize those feelings of helplessness and vulnerability.

 

How does anxiety present itself in children?  What are the signs parents should look for?

Because children often lack the ability to identify the source of their stress and articulate their feelings clearly, anxiety tends to present in a number of different ways.  Some of these include:

  • stomach aches
  • headaches
  • clinging
  • avoidance: not wanting to go to events or school
  • changes in sleep and eating
  • tearfulness
  • daily persistent worries

 

Periods in a child’s development also make them more susceptible to anxious feelings; such as ages 7-10 when kids are old enough to understand serious health risks but are still too young to manage their fears efficiently.  Similarly, pre-adolescents (tweens ages 10-14) typically develop an awareness of germs, disasters and things that could possibly go wrong, making this age range primed for feelings of nervousness and worry.

 

What can parents do to help their children manage their anxiety?

  1. First and foremost, parents need to model calm. (More on that below…)
  2. When speaking about their food allergies, frame risk in a positive way.  For example, “reading ingredient labels, asking questions and carrying your epinephrine will help keep you safe;” “eating peanuts may make you feel sick;” “having regular cheese can make it hard for you to swallow and breathe…”.  DO NOT talk to kids about death, dying or their mortality.
  3. Give them words for their emotions so that they can express themselves and relieve some of that private, pent-up worry.
  4. Validate their feelings.  Anxiety about food allergies can spill over into more generalized anxiety.  Their fears and perspectives are real to them.
  5. Tell your child a story about a time you had anxiety.  And, if possible, maybe something you did to overcome it!
  6. Explain to your child that everyone experiences some level of anxiety.  It’s a normal part of being human.  But when it becomes overwhelming we need to talk about it to help let it go.
  7. Encourage your daughter or son to socialize with friends and family.  Being with others is a great distraction and reminds them of the support that surrounds them.
  8. Teach them skills to relieve stress, such as breathing techniques, getting out to exercise, or compartmentalizing the discussion of food allergy worries to 10 minutes a day and then moving on.  These are important techniques for life!
  9. Reassure your child that they are in good hands, both at home AND away, like at school, at grandma’s, etc.  Kids need to know they are secure and that those in charge know what they’re doing.
  10. Empower them!  Practice what to say to their friends, family, teachers, and restaurant staff about their food allergies.  Teach them what to do in case they suspect they’re having an allergic reaction.  Work together to read ingredient labels and manufacturing warnings.  Allow them to ask questions at the doctor’s office. The more capable they feel, the more in control they will be!

 

What about us?  

As food allergy parents, we – too – are familiar with the stress and anxiety related to the management and realities of food allergies.  It is as, OR MORE, important that we manage our own anxious feelings as parents so that we can be a model of calm and security for our kids.

 

Anxiety – in all forms – clouds good decision-making (it’s science!).  Keeping worries in check allows us to be more effective parents by approaching decisions and assessing situations with cautiousness and calm.

 

When adults feel out of control, they tend to overcompensate.  This primal need to protect our children kicks into overdrive, leaving parents spinning their wheels in a world they cannot sanitize or make safe enough.

 

Kids tend to absorb the perspective of their parents and they can become frightened if adults around them are very stressed or scared.  Therefore, it’s critical for parents to adopt a healthy attitude towards food, food allergies and the greater world to help their children manage their own food allergies.

 

What can we do to keep ourselves calm?

  1. Find support.  Connect with other food allergy parents or spend time with understanding friends.  Socializing reminds us that we’re not alone with our concerns.  Feel free to use Allergy Shmallergy’s Facebook page to post questions or connect with like-minded parents.
  2. Arm yourself with information.  Familiarize yourself with food labeling laws, causes and symptoms of a reaction, and your emergency action plan.  If you can, learn to cook!  In short, empower yourself!
  3. Adopt simple solutions for your food allergy hurdles.  Resist the pressure to be the perfect baker, for example, and focus on surrounding your child with LOVE.
  4. Trust in others who’ve shown understanding towards food allergies.  A lot of food allergy parents only feel their child is safe when he or she in in their total control.  It’s important to let go a little and let others help.  If you’re at a friend’s house, let the host find a safe snack  – you can still approve the ingredient list, but it will give you a window into their decision-making abilities.  Let your child’s teacher become his or her food allergy-ally while they’re at school.  Every child needs a village.  More importantly, every parent needs one too.
  5. Prepare and approach food-related situations with CAUTION without assuming CATASTROPHE.
  6. Get out and exercise.  Talk a nature walk.  Have a date night.  Be sure to find outlets and activities that bring you joy.

 

 

 

 

 
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