Tag: Allergies

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Allergic Living has advice on how to respond to a severe allergic reaction, particularly when to administer epinephrine and seek emergency medical treatment.

At first she didn’t show any symptoms and her mother gave her a dose of antihistamine; but in 20 minutes the systemic reaction began. Her father, a physician, gave her three doses of epinephrine, but it wasn’t enough to stop the rapid-fire chain of events. She began vomiting, her throat swelled to the point where she could no longer breathe and she went into cardiac arrest. She died in his arms.

Natalie’s story has spiked fears among Allergic Living’s readers, in particular parents of children and teens with food allergies. It has also raised questions about just what to do in case of an accidental allergen ingestion, so we turned to two experts for answers.

The key takeaway: you can’t always be sure a mild reaction will stay mild, because it takes time for the body to absorb the food. I was fortunate enough to survive learning that lesson, exactly one week before Natalie Giorgi’s death. All I lost was an afternoon and the $200 co-pay for the emergency room. It could have been so much worse.

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I’ve been attending San Diego Comic-Con for more than 20 years, but this was the first time I left the con in an ambulance.

I’m OK now. Though I might not be when I see the bill.

It started at lunchtime. We went to New Break, an independent coffee shop near Ralphs, which we’d been to before. They were offering samples of a blended peanut butter banana coffee drink, and while I really wanted to try their blended mint mocha, it was safer to skip something made on the same equipment.

What I decided on was a Mexican Mocha. Generally, these add cinnamon, maybe nutmeg or chili powder. I’ve had drinks with that and similar names, and Mexican hot chocolate, plenty of times. I didn’t ask what was in it, but I had just told them I was allergic to peanuts when I decided to skip the blended drink.

I considered getting it iced, but there was some confusion as to what was included in the lunch deal, so I got it hot instead. That turned out to be a wise decision, since I probably would have started out chugging a few ounces of a cold drink.

Two sips in, the back of my throat and my lips started tingling — a bad sign. I stopped, flagged over one of the baristas, and asked whether there were any nuts in the drink. She didn’t think so, but said she’d check.

I pulled out my emergency kit, took my Benadryl and Pepcid, and set my Epi-Pen on the table in case it progressed. I probably should have just taken it right then, but who wants to spend the afternoon in the emergency room instead of Comic-Con?

Meanwhile, the coffee shop staff had been unable to find ingredients for the mix, and had to call the owner to confirm that yes, there were peanuts in it.

Great.

Over the next hour, it felt like the reaction was under control, so I figured we could return to the convention center. Unfortunately, anaphylaxis can take several hours to run its course, and medication can wear off before it does. Continue reading →

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Allergic Living reports on a peanut allergy treatment study that shows a great deal of promise. Called sublingual immunotherapy, or SLIT, it’s surprisingly simple: Introduce a small amount of peanut protein in drops beneath the tongue each day, slowly ramping it up over time.

After 44 weeks of the daily doses, 70 percent of those getting the peanut powder could tolerate at least 10 times more peanut in an oral food challenge before showing symptoms than they could have at the outset of the study. In a follow-up challenge at 68 weeks, they could tolerate about twice as much again.

It’s a similar premise to allergy shots, which work well for airborne allergens but not for food. And while I’m creeped out by the idea of deliberately ingesting something that I’m used to avoiding because it could kill me (this has to be done under medical supervision!), like so many other things it’s all about dosage. It makes sense that it could work.

The main drawback is that 30% of the participants didn’t show improvement, though the people running the study suspect that it’s a matter of finding the right dosage for each patient.

The article mentions another problem being that the amount tolerated is relatively small: they could eat the equivalent of two peanuts before experiencing allergy symptoms.

I say: Two peanuts? Are you kidding me? I would LOVE to be able to safely eat that much!

So it’s not enough to eat Thai food or PBJ. It would mean I can stop worrying so much about cross-contamination! I’d still carry my epi-pen around, but I’d feel a lot safer about, say, drinking a milkshake at a restaurant that also serves peanut butter shakes, or eating an eggroll at a place that also has kung pao, or eating a chocolate chip cookie that’s been stored on the same shelf as the peanut butter cookies.

One question I do have is how effective it is at reducing sensitivity to similar allergens. Would taking the peanut treatment help someone tolerate legumes better, or are they different enough to require a separate course of treatment?

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If you have food allergies, dining out is always a risk. We had a close call our first night in Chicago on a family vacation last month.

After a long day of travel, we got settled into our hotel room and went down to one of the hotel restaurants for a late dinner. It was a Sunday evening, around 9:30, and while the front desk had assured us that the restaurant was open until 11, that turned out to only be half true. The restaurant entrance was blocked off, but the kitchen was serving the full menu to a shared seating area that you entered through the bar.

We’d been concerned about finding food for our not-quite-two-year-old son. Kids’ menus are awfully limited these days, and very heavy on cheese, which he can’t eat. Chicken nuggets are fine once in a while, but only go so far on a ten-day trip. So we were pleasantly surprised to see a Sunbutter, jelly and banana sandwich on the kids’ menu. Because of my severe peanut allergy, we keep peanuts out of the house, so Katie goes to sunflower seed butter and almond butter for toast and sandwiches, and J loves it so much he’ll demand a taste if she’s eating it. Score!

After a very long wait, the waitress finally brought the sandwich, dropped it off saying, “Here’s your PBJ,” and left.

Wait, PBJ?

Katie tasted it, and it was in fact peanut butter.

Red alert mode engaged!

As I mentioned, I’m severely allergic to peanuts. We don’t know yet whether J is, but we didn’t want to risk finding out in a hotel in a strange city thousands of miles from home.

The waitress seemed a bit confused by the issue when we finally got her attention (all the while trying to find other things we could feed an increasingly-cranky toddler who thought he was finally going to eat), and we had to point out that yes, the menu specifically said Sunbutter.

They did take the sandwich off the bill, and replaced it with a plain jelly-and-banana sandwich. But it put us on alert for the rest of the week.

The really disturbing thing was that it wasn’t just any sunflower seed butter listed on the menu, but a specific brand, one whose purpose is to be a safe alternative for people who are allergic to peanuts. That’s like telling a diabetic that you have Clemmy’s sugar-free ice cream and handing them Ben and Jerry’s. Or giving someone Everclear to help with their dehydration.

We lucked out, because Katie caught it before J could eat any of it. Really, the restaurant dodged a bullet too: They could have served it to a family with a confirmed allergic child. Imagine how blindsided they’d be when someone silently replaced a peanut-free food with peanuts. Continue reading →