Tuesday, August 5, 2014

Kiwi Allergies

I have talked about oral allergies in other posts and highlighted bananas, pineapples and apples.  One fruit I would never have expected to have allergic properties is the kiwi.  Introduced to the U.S. in 1962 it has become a very popular fruit.

Today over 4% of European children experience the allergy.  And it cross-reacts with many other foods and substances, including birch pollen, avocado, banana, rye grain and hazelnuts, meaning the allergens share similar properties and can react the same way in the body.  To read the full article click on Kiwi Allergy.  

Eczema can lead to Food Allergies

A recent blog on the FARE website (Food Allergy Research & Education) highlighted the story of a woman who would treat her eczema with a soothing cream made with goat's milk.  After eating goat cheese the woman experienced a severe allergic reaction.  This is the first time there was direct evidence of a food allergy occurring after exposure through the skin.  The full story can be read on the the FARE blog.

As someone who has experienced eczema I wonder if some of the creams I used to soothe it also contained substances that could cause food allergies.  For example, many creams contain almond oil which could lead to a nut allergy.

Bullying -- A Problem for Children with Food Allergies

Unlike physical disabilities food allergies are not readily apparent to those around you.  For a child with food allergies, exposure to the food one is allergic to can trigger a serious physical reaction.  The physical reaction is painful and the emotional toll is high as well. 

Unfortunately because many people do not understand food allergies they do not take them seriously.  Even worse, children with food allergies are often bullied causing emotional distress in addition to having a physical ailment.  Most schools have policies against bullying.  But, if the teacher and the student do not understand or or are unaware that a food allergy can be life threatening no action may be taken to alleviate the child with food allergies suffering.  Many publications have taken up the cause of preventing food bullying.  The New York Times wrote a particularly good article about food bullying and its consequences.
The EMPOWER program offers counseling for children with emotional distress from managing food allergies.  It is run by the Jaffe Food Allergy Institute at Mount Sinai Hospital.

Although I was never bullied in school over my allergies, I did feel out of place at times.  No one wants to be pointed out to the rest of the group as someone who has something wrong with them.  It was hard to be the person who had to limit what people could have at parties in the classroom.  It made me a much shyer and quieter person than I would have been.

Food Allergy Advocacy

As someone who has suffered from severe food allergies for most my life I am encouraged and inspired to see advocacy for food allergies is taking hold.  The most important areas to address are schools and their policies, the travel and restaurant industries recognition of food allergies and research for a cure.  There are some advocacy platforms that are making inroads and raising awareness.  

Many schools currently "accommodate" food allergies.  My grammar school experience was to sit with all the allergic kids at a separate table.  The kids who were allergic to milk brought nuts to get the protein they needed.  The kids who couldn't eat nuts drank milk.  We all felt ostracized and conspicuous.  In addition, the smell of the nuts made me feel ill.  The college I attended offered one of the most accommodating food allergy options available.  But it still felt weird going over to a special section to get my food and having to remember to order my meals in advance.   All of the accommodations helped to prevent disastrous consequences. Yet no-one has any requirement to make sure allergens are not in the school environment.  The following video highlights what happens when food allergies are not taken seriously.  It is titled Food Allergy Bullying.  It is a strong story but an example of what a lack of knowledge can do.



Airlines and restaurants are the least accommodating.  Nut allergies are life threatening.  If you are on a plane and go into anaphylactic shock there is no recourse unless you have your own Epi-pen with you.  It seems to me that if airlines can accommodate dogs, cats, oxygen, babies and the handicapped they would be more willing to work with such a life threatening allergy.  Restaurants are also not as serious about food allergies as they should be.  I once went to a Japanese steak house where they used peanut oil to fry the hibachi. The smoke from the peanut oil almost killed me.  There was no sign or indication they used peanut oil to fry the food.  Only upon entering the restaurant and smelling the smoke did I realize I was in a life threatening situation.  I find it interesting the government supports the listing of calories which are not life threatening in the short term but not potentially allergic ingredients. Today the sole responsibility for identifying what is in a product at a restaurant is the person with the allergy.

Finally, there does not seem to be a great deal of interest in finding a cure for food allergies.  Medicines to treat asthma and pollen allergies are billion dollar businesses. Xolair, a new treatment for peanut allergies seems to minimize the effects of peanuts on allergic people.  At a cost of $10,000 there must be a way for companies to make money.  The Food Allergy Research and Education Network provides funds for research and awareness. Advocacy costs money just as research does.  Food allergies are an important topic for the general public to understand.  The following video highlights some of the struggles of people who are allergic to food.

Stronger advocacy could result in stronger laws to help people with allergies.  An amendment to the Americans With Disabilities Act would greatly enhance food allergy sufferers lives.   Changes requiring schools to educate the rest of the school population about the dangers of food allergies, a requirement for restaurants to list key allergic ingredients similar to those found on food boxes and a requirement for airlines to not serve nuts if notified an allergic person is on board would not hurt business but would definitely help all allergy sufferers.

Monday, August 4, 2014

Xolair - A Solution for those with Peanut Allergies

A few months ago my allergist suggested I use Xolair to try to mitigate my peanut allergy.  I have pretty violent results when I smell, touch or eat peanuts.  Xolair is being tested to help reduce the reaction to peanut allergies.  I ended up opting out of taking Xolair because I had to work and go to school and it took three months to participate in the study.  The study results can be accessed by clicking on Xolair Study.  

The results of the study were impressive.  People with severe peanut allergies were able to tolerate much larger doses of peanuts than they had been able to in the past.  I am rethinking my decision to postpone trying Xolair.  

Protection During an Anaphylaxis

School will be beginning shortly and whether you are starting first grade, high school or college it is important to protect yourself if you have food allergies.  Two very important things to do to make sure you are protected during an anaphylactic reaction are to have a form on file at your school or place of work allowing someone to administer a dose of from your epi-pen.  Depending on how severe your reaction is you may not have the ability to do it yourself.  Allergic Living -- a magazine and website has a very helpful form to use to provide authorization for just such an event. The link to the form follows;
http://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/Anaphylaxis-Emergency-Action-Plan.pdf


A second very important thing to know is how to administer an epi-pen shot in the event you have anaphylaxis.  Epi-pen has put together a very good video teaching you how to administer it to yourself.

Being prepared and practicing can save your life but also others lives. Warning an employer or a school about your allergies protects you in the case of an emergency.  

Saturday, August 2, 2014

Make August Food Allergy Awareness Month



I think this campaign is a great idea!  It is right before the start of school and everyone who deals with children should be educated about food allergies.

The Food Allergy Research and Education Organization FARE


Did you know?
  • Fifteen million Americans have food allergies?
  • Every three minutes someone ends up in the Emergency Room with a reaction from a food allergy?
  • Food allergies in children have increased by 50% between 1997 and 2011.
  • Food allergies now affect one in thirteen children
  • There are eight foods that cause the most reactions
    • milk
    • peanuts
    • eggs
    • tree nuts
    • soy
    • wheat
    • fish
    • shellfish
With the explosion of food allergies in children and the fact there is no cure an awareness of what to do when a reaction happens is very important!  


Who Am I? And Why Do I Have These Food Allergies?

Imagine that everywhere you go you have to be careful about what you eat, what you touch and what you breathe.  To try to bring food allergies to life I thought it was time to open up about myself and what life has been like for me as a person with food allergies. Let me begin by saying I did not always have food allergies. I say that even though I was allergic to milk as a baby and had to have soy formula instead.  But I don't remember it and if you don't remember it, it doesn't count.   Prior to age of four my favorite snack was M&M Peanuts.  I am told I loved scrambled eggs too but I don't remember that either.  

My first recollection of my allergies was when I was visiting my grandparents in Sedona, Arizona with my family.  I was four years old and it was my dad's birthday.  We had an ice cream cake with either pecans or walnuts on it for decoration.  I popped one in my mouth and almost immediately I began to have trouble breathing.  No one in my family had every seen or experienced anaphylaxis before so they were not sure what to do.  My mom gave me a big dose of benedryl and sat with me through the night.  As the benedryl kicked in I had less trouble breathing and fell asleep.  

Once we arrived home my mom brought me to the doctor and explained what happened.  The doctor spoke to her tersely and told her I could have died and we should have gone right to the emergency room.  She listened and we went home.

About a year later, my dad who never had an allergy in his life, said try this pistachio.  I don't believe you are allergic.  Not knowing what a pistachio was I popped it in my mouth.  Almost immediately, my throat closed.  My mom raced to get the epi-pen.  She slammed it into my leg and we rushed to the emergency room.  There they loaded me up with benedryl and I had to take steroids for the next six days.  Needless to say, it was not worth the experiment.  

Since then I have been tested for food allergies and I am allergic to nuts, eggs, sesame, mustard and shellfish.  I avoid all them at all costs.  But as careful as I am the environment can cause me to have a reaction.  If I am sitting next to someone eating nuts I experience a severe shortness of breath.  Is it psychological or physical?  I really don't know.

The most recent and scariest episode I have experienced is last year on the day of my parents 35th wedding anniversary celebration.  I went to work out at the local gym.  While on the treadmill I experienced serious shortness of breath and began to get welts all over my body.  The gym is 5 minutes from home.  I called home and told my parents about the reaction as I was driving home.  By the time I reached the house my face was swollen, I was having trouble breathing and the welts now extended across my torso and up and down my arms.  We got in my dad's car and drove to the emergency room.  They injected me with benedryl and almost immediately the welts began to disappear and the swelling began to go down.  By that evening I was well enough to attend the party and have a good time.  We guessed that someone must have touched nuts before getting on the treadmill and I reacted either to the nut dust or the sweat from the person who just ate the nuts.

So I learned a few lessons from my experience I would like to share with you.

  1. Always wipe down gym equipment before use!  Do not assume someone else did it for you.
  2. Don't drive during an anaphylactic reaction.  Call 911 and wait for an ambulance.  I could have passed out while driving endangering myself and others.
  3. Always carry your epi-pen.  If I had brought it with me I could have prevented the severe reaction I had.
  4. Reactions can happen anywhere and at anytime.  Be prepared!
Even though I have lived with allergies all my life I still sometimes disregard my own good advice. I am hoping by exposing my own reactions if you see someone experiencing a reaction you will know to call 911 and hopefully save their life. 




Airline Policies regarding Food Allergies

My first post in June highlighted JetBlue as an accommodating airline for those with nut allergies. For those who haven't found it you can click on JetBlue Most Accommodating Airline and go directly to the blog post.

My personal experience propelled me to investigate airline policies surrounding nuts and what an airline would do to accommodate a life threatening nut allergy.   When I notified the JetBlue crew that I was allergic to nuts they accommodated me by making an announcement they would not be serving nuts on the plane and asked that passengers refrain from eating nuts.  I thought that meant that was their policy. Instead, when I began researching for this blog I found that JetBlue's policies were similar to other airlines.  Southwest seems to have accommodations similar to those of JetBlue.  In general, I found the following is what airlines are willing to do.
  1. You can notify the crew you are allergic to peanuts.
  2. In some cases they will create a three row buffer zone for you if they serve nuts
  3. But they will not ask passengers who brought nuts with them to refrain from eating them.
  4. Some airlines will allow you to board early and wipe down your own seating area to assure it is nut free.  
Allergic Living a magazine and website offers a chart in PDF form that lists individual airlines and their policies.
Here is the link to the actual site.  http://allergicliving.com/



You can access the  PDF by clicking on Airline Policies Regarding Peanut Allergies  


It is amazing to me that airlines are so cavalier about such a life threatening allergy.  It seems to me they probably do not understand the severity of the situation.  A recent film, "More than an Inconvenience" highlights the difficulties food allergy sufferers have when traveling.  I couldn't link you to it so I am providing you with a URL to watch the film.
<iframe src="//player.vimeo.com/video/65931486" width="500" height="281" webkitallowfullscreen mozallowfullscreen allowfullscreen></iframe>


Luckily, food allergy sufferers are becoming more vocal.  As airlines understand better the risks of food allergies they may be more amenable to offering accommodations for food allergy sufferers.