What a Food Allergy can Look Like

[peggyfromwastate]

And moonlight-- just cuz it's not a BIGGIE-- like a well known allergen-- anaphylaxis is anaphylaxis. Better to get checked out. You just never know.

[scrub-jay]

I think the single mom of this kid in PG was not educated well enough in her daughters allergy. The Dr didn't push the epipen requirement, the school nurses only would do Benadryl. I can not fault the mom-- she's deferring to "expert" opinion on the management of her daughters allergy.

It was just sickening all around.

SJ I'm very glad to hear changes are coming... But really THIS should never have happened. Never.

The bill has to pass first, I think it's been introduced at this point. This was a preventable death. There is not enough education, on the part of parents or school districts. I have been very pleased to see that there are now PSAs about food allergies and EpiPens on TV. The more education, the better, but we are so far from where we should be.

[peggyfromwastate]

SJ-- do you think that the school would have used an epipen in this instance? From what I read about the story way back, it sounded like they were hesitant to give Benadryl let alone an epi.

Most teachers I can across we're a bit hesitant when I "trained" them. They didn't want the responsibility. I think having an epi on site is reasonable, but it's a lot to think the teachers and staff will be able to recognize anaphylaxis for a kid with no known allergies and so be able to administer the epi and follow those protocols.

I think all kids of known allergies with Anaphylactic reactions need to have the epi and go thru the pita process (it is a PITA---every year) of re educating the staff, filling out the forms, getting fresh epipens... Every single time.

For less educated parents-- such as the one from the PG county death-- it's so hard if the ped/allergist doesn't really lay it out clearly. The school nurse-- usually she floats between 3-5 schools-- and nurse aid --- the one there every day--- should be on top of this too--- to insist that the patent bring in the allergy action plan, the epipen and all paperwork, etc.

So many failures in that one case. I don't think had the school had an epi on hand for general use that it would've made a difference.

Also-- my ds has gotten a LOT of slack from peers for not eating peanuts. Seriously. "why do you sit at the peanut free table?" as the little punk tries to smear peanut butter on my sons face. Ugh. That one caused us to go berserk on the lunch monitor and my dh to sit at the lunch table with ds and I said some choice words to the little kid who thought that was funny...

Sigh.

Just keep swimming!!!

[weeniegeniewife]

I still think Benadryl is useful to have on hand under physician instruction, but it can’t touch anaphylaxis.

I lovingly and respectfully disagree with this. When I was a sophomore in college I had a severe anaphylactic reaction that occurred within seconds. I was alone at our apartment and within 2 seconds of ingestion my eyes and throat swelled shut. I ran to the phone and dialed 9-1-1 but my throat was so swollen I could barely speak. While waiting for the paramedics I was able to race to the bathroom and grab a Benadryl. The ambulance took 15 minutes to get to me (I went to a small college in the boonies). When the EMT's got there my throat swelling had gone down and I was able to talk. The paramedics told me the Benadryl save my life, and there is no doubt in my mind it did.

My daughter has also had anaphylaxis once and Benadryl also helped her. In the ER they also gave her epi but, again, I was told the Benadryl had stopped the severe reaction. I carry it, and an Epi-pen, with me everywhere.

Another thing to watch out for is allergies to food dye. My daughter kept getting these really weird patches on her skin. They were bright, fluorescent pink, and smooth. She had had hives before and they looked different, but we found out they are a type of hive that you can get from red food dye! We had no clue she was allergic to it, but after putting two and two together and confirming it with testing, there ya go.

This is a great thread, BTW.

[peggyfromwastate]

WGW you have given me a lot to think about with respect to benadryl. I'm still not going to have the nurse administer it-- straight to epi-- but I definitely think carrying it with me would be smart. Tiny hot pink pills. No biggie.

[scrub-jay]

Peggy, my internship involved working with a school district to develop new policies for food allergies. I baselined their knowledge with a survey and was floored at the results, dismal. Fortunately, the district remained willing to work with me and we're building new training programs and they are adopting many recommended policies. Most people just don't understand how fast anaphylaxis can happen and how prevalent allergies are becoming. Personally, I do not think just having an EpiPen on site would have made the difference unless the little girl was one of those kids who could've administered it herself. Most people also don't realize that you need to hold down the epipen for 10 whole seconds, that is a LONG time during an emergency. I also want to add that the district I'm working with is implementing "food bullying" training to it's bullying-prevention problems on my suggestion. That is a huge and dangerous issue in school-aged children.

WGW- That is terrifying! You bet if it happened to us, I'm grabbing for both EpiPen & Benadryl. The allergists I've talked to have all emphasized that in many anaphylactic cases, Benadryl can't adequately respond to the full reaction, especially in the case of peanut reactions. In practice, I'd use every tool I've got though, we carry single-dose packets of Benadryl and EpiPens everywhere. I should add that an EpiPen will only buy you a little more time (15-20 minutes) to get to the hospital in a very severe reaction which is also why EpiPens are starting to come in packs of 2. My take home message is still: don't trust Benadryl and self-diagnosis alone, if you or a child have food allergies, don't limit your options by not being seen and getting an EpiPen.

[scrub-jay]

WGW- The food dye allergy is interesting, there continues to be a lot of research on it as the prevalence is increasing. And to your point on hives, the appearance can differ dramatically dependent on the allergen & response. I didn't know that red dye had a recognizable (and consistent) one. I'm glad your doctor knew!!

[Thirteen]

DH is allergic to pretty much every environmental allergy out there.
I am celiac.

We keep EpiPens in our house, and DH carries one on his car. During residency, he knew 2 kids with previously NKA die from contact with peanuts, and a bee sting.

I have been properly trained how to use one.

I think it's so important that people know information like this.
Thank you, ladies!


Sent from my iPhone using Tapatalk

[peggyfromwastate]

Peggy, my internship involved working with a school district to develop new policies for food allergies. I baselined their knowledge with a survey and was floored at the results, dismal. Fortunately, the district remained willing to work with me and we're building new training programs and they are adopting many recommended policies. Most people just don't understand how fast anaphylaxis can happen and how prevalent allergies are becoming. Personally, I do not think just having an EpiPen on site would have made the difference unless the little girl was one of those kids who could've administered it herself. Most people also don't realize that you need to hold down the epipen for 10 whole seconds, that is a LONG time during an emergency. I also want to add that the district I'm working with is implementing "food bullying" training to it's bullying-prevention problems on my suggestion. That is a huge and dangerous issue in school-aged children.

WGW- That is terrifying! You bet if it happened to us, I'm grabbing for both EpiPen & Benadryl. The allergists I've talked to have all emphasized that in many anaphylactic cases, Benadryl can't adequately respond to the full reaction, especially in the case of peanut reactions. In practice, I'd use every tool I've got though, we carry single-dose packets of Benadryl and EpiPens everywhere. I should add that an EpiPen will only buy you a little more time (15-20 minutes) to get to the hospital in a very severe reaction which is also why EpiPens are starting to come in packs of 2. My take home message is still: don't trust Benadryl and self-diagnosis alone, if you or a child have food allergies, don't limit your options by not being seen and getting an EpiPen.

SJ, I want to send my kids to your school district!!! What great work!!

I did get a lot of push back when I wanted ds to be able to self-administer his epi. Working with the staff and the allergist we all came to be comfortable with the school playground aides being trained in recognizing anaphylaxis (vs a kid playing around at recess) and in how to inject. He never did self carry but now in middle school I don't know what to do. I have the meeting with the nurse on Monday. I'm thinking self-carry--- middle school is way too hectic and every other kid has a peanut-candy.

[peggyfromwastate]

DH is allergic to pretty much every environmental allergy out there.
I am celiac.

We keep EpiPens in our house, and DH carries one on his car. During residency, he knew 2 kids with previously NKA die from contact with peanuts, and a bee sting.

I have been properly trained how to use one.

I think it's so important that people know information like this.
Thank you, ladies!


Sent from my iPhone using Tapatalk

He might want to not keep it in his car. They are a bit temperature sensitive.

[peggyfromwastate]

Another great tip I heard from someone (can't remember who) was to take your old expired epipens and practice using them on a fruit (an orange perhaps). Then you can get the feeling of the injection. I went thru our supply and we had about 8 very expired Epipens on hand-- rather than throw away I'm saving them for "training". The epipens come with plastic trainers but they aren't quite the same.

[hanginginthere]

DD had tummy issues with regular formula so our pediatrician switched us to soy based- BIG mistake- head to toe rash and terrible constipation...took her back and was told she had a "sensitivity" to soy- um, ya think? ;p In the end we went to the hypoallergenic aka as the REALLY expensive type (nursing was not an option) and she thrived but we still watch her for reactions at age 2 and soy is in almost everything

[Thirteen]

He might want to not keep it in his car. They are a bit temperature sensitive.

Thanks, Peggy! I didn't make myself clear earlier - when in-transit, he has one in the car with him. You are absolutely correct that leaving one in a car is not a good idea.


Sent from my iPhone using Tapatalk

[TulipsAndSunscreen]

So, we've just started introducing solids and haven't had any reactions yet. This thread has been very informative though and given me a lot to think about. For babies, can you even give Benadryl? What is the right action (besides immediate ER visit) if you notice a reaction in a very young child?

And if you notice a reaction, is urgent care good enough (closest med facility) or would you recommend driving further to the ER?

[scrub-jay]

So, we've just started introducing solids and haven't had any reactions yet. This thread has been very informative though and given me a lot to think about. For babies, can you even give Benadryl? What is the right action (besides immediate ER visit) if you notice a reaction in a very young child?

And if you notice a reaction, is urgent care good enough (closest med facility) or would you recommend driving further to the ER?

Yes, babies can have children's Benadryl under the advice of a medical professional. The correct action for a reaction depends - either way, get in contact with a medical professional. If your child's airway is closing up, she's turning blue, etc - CALL 911. I have an excellent pediatrician that I can get a hold of within minutes, when my dd presented hives, he called us back within a few minutes and instructed us on Benadryl. Maybe I should've called 911, but DH was home and monitoring her for signs of anaphylaxis.

As for urgent care vs. ER, I'd probably rely on the physician/advice nurse/911 opinion on that one. There are really too many variables with initial reactions to make that call ahead of time. You could call the urgent care and ask if they are equipped to deal with possible anaphylactic reactions since urgent cares seem to differ dramatically and that would be your worst case scenario.