Mystery Reaction

Trying new (to Charlie) processed foods is always tricky, but usually ends well. Recently, though he popped. That’s the way it goes.

Here’s how we introduce Charlie to a new processed food: By the time it gets to our house, we’ve already scoured the ingredients list (we don’t keep food he’s allergic to in the house). But we don’t trust the ingredients list alone. We start feeding it to him by giving him a single, tiny bite. He waits 10 minutes and, if he’s not displaying symptoms of a reaction, he gets a slightly larger bite. We continue until we’re comfortable that he’s OK with the food and can eat large bites. This is similar to the food challenges we do at our allergist’s office. It’s a good way to catch a problem food early, but it’s rough on Charlie’s patience. He’s three.

This time, we found some veggie popsicles that looked fine, ingredients-wise. He loves the fruit version of these, so we started our home challenge with one after dinner one night. Bam. He popped.

We’re always read for this – we were at the hospital nine minutes later. When we walked up to triage, I said “I have a three-year old with-” and the nurse immediately waived her hand in front of her face and said “an allergic reaction, I see. Come on in.” I really love the staff at our hospital.

Charlie Reaction

Charlie sporting hives. He’s feeling chipper, though.

Luckily, steroids did the trick, and no epi was needed. He was lucid and even happy the whole ride to the hospital, which made the ride much easier for all of us. When you’re trying to determine if your kid is headed into anaphylaxis, a boatload of hives on his face will make you more than a little tense.

What triggered it? We don’t know, and that’s always frustrating. But that’s just the way it goes with food allergies: you’re always worrying, and you’re always watching, you always know how far you are from the hospital and you’re always bristling with epinephrine injectors.

Food Allergy Challenge: Peanuts

This kid tolerates peanut butter.

This kid tolerates peanut butter.

Charlie tolerated peanut butter at his food challenge today. No, he shouldn’t eat it again. But, it’s not lethal to him. MK and I are so happy, we could pop.

After being off his allergy meds for several days, Charlie walked into the doctor’s office, hopped onto the little bench, and downed 10 consecutively larger portions of peanut butter, starting with a portion so small he couldn’t even taste it, and ending with a sizable bite. We waited 10 minutes between each portion, and I (and the nurses and doctor) monitored him closely. The whole thing lasted an hour and a half, but it felt like 20 minutes to me.

Charlie’s face didn’t display any hives during the test, but his arm got a bit red at the inside elbow and a tiny hive appeared on the other arm. The doctor also skin- tested him for environmental stuff (he’s allergic to mold) and tree nuts. He’s allergic to everything except hazelnut. (We initially thought that opened the door to Nutella, but it contains whey.)

At this point, the doc says, the peanut butter appears to exacerbate Charlie’s eczema. The doctor thinks Charlie will outgrow peanut by his next food challenge, which is in the Spring. But, for now, we’re happy just knowing that he’s not likely to experience anaphylaxis from accidentally eating something that has peanuts in it.

Still on the anaphylaxis list are egg (confirmed), dairy (confirmed), and tree nut (possibly). Knocking peanuts off the list is a huge win, and gives us hope that the others will be outgrown, too.

Scared Eggless

A couple nights ago, Charlie sat down at the table for dinner, looked at his plate, and pushed it away, saying, “Dis make me sick. I go to da hospital.” We told him that it wouldn’t make him sick, using that high-and-soft tone you use when you’re trying to reassure someone, but freaking out on the inside. I don’t want my kid to be afraid that the food he’s about to put in his mouth might turn out to be poison. But that’s the risk he’s taking every time. MK and I are vigilant and we cook meals that are as safe as mere mortals can verify, but allergens have gotten through our defenses a couple times, thanks to the cross-contamination crapshoot.

I’ve also had two nightmares this week about Charlie eating foods he’s allergic to. In one, he was well into an oversized bowl of vanilla ice cream. In another, he was just finishing off an entire glass of milk. In both, I realized that epinephrine probably wouldn’t save him now, and then I woke up.

October 4th is his next food challenge. If that is successful, it would go a long way towards making me worry less. Actually, probably not.

For Crying Out Loud

Charlie had a severe reaction at dinner last night. His face started looking like ground beef, distinct hives popped up all over his body simultaneously, and he started to cough. We used the EpiPen and then drove him to the ER, where they kept him for a long time before sending us off with the usual steroid.

Like last time, we don’t know what caused the reaction. We don’t keep any foods in the house that he’s allergic too, and all of the things he ate for dinner were seemingly safe. The peaches and veggies he eats all the time. The chicken nuggets are processed, but he’s eaten nuggets from that bag before. I know that doesn’t rule out cross-contamination, but still, geez.

As usual, the day after an anaphylaxis incident is tough on the whole family. Charlie is wild and disobedient. MK and I are exhausted from both the emotional drain and the lack of sleep that comes with getting up all night to check on him – not to mention the time spent analyzing what went wrong, and worrying.

The last reaction needing the EpiPen was in late April. We almost made it 4 months. Sigh.

Allergic Living Spreads Awareness with Six Steps Poster

This week is Food Allergy Awareness Week (FAAW) and Allergic Living magazine is one of the organizations leading the awareness charge. Today I spotted a neat new poster from the magazine that gives some easy-to-remember advice for spotting a reaction, treating it with epinephrine, and getting the patient safely to a hospital.

Six Steps That Save Lives Poster

Allergic Living’s new Six Steps That Save Lives Poster. Image Credit: Allergic Living

One of the things that struck me about the poster is that it notes that feeling faint and having a drop in blood pressure could be the only symptom of anaphylaxis. Charlie had a reaction like that once: he had some minor redness on his face and watery eyes, but because he gets redness anyway (and I’d never seen him get watery eyes), I wasn’t sure it was anaphylaxis until he started to look like he was feeling faint.

Anyway, this is great information. I’ve seen people posting online with the same question that I’ve grappled with: what is a black-and-white rule for identifying anaphylaxis? The answer is that there is no black and white rule, but knowing the symptoms will help you make the judgement call. I like that the poster reminds you to use the epinephrine injector (EpiPen or Auvi-Q, these days) even if you’re not 100% sure it’s a reaction. The word I’ve heard from multiple doctors is that getting an epi injection won’t kill (or even injure) most people, even if they’re not having an allergic reaction after all.

Food Allergy Challenge: Strawberries

Charlie is not allergic to strawberries anymore

Fruit salads are about to get even better.

Charlie is no longer allergic to strawberries! His allergy doc suggested we test him at home for strawberries, so we went to a park and the kids played between small bites of some fresh strawberries. Charlie LOVED them, and didn’t have any symptoms.

So, we’re down to four: dairy, egg, peanut, and tree nut. And possibly something we don’t know about – remember that reaction he had in the back yard a couple weeks ago? We sure do. And the ensuing tree pollen test turned up nothing. That’s good news for our birch tree. I was ready to yank that thing out myself if it was the problem.

It’s tempting to think, “If he’s outgrown bananas, strawberries, and legumes, maybe he’s outgrown the rest, too.” But the bloodwork numbers are still high on dairy and egg for Charlie. The only one that the doctor has suggested putting to a food challenge is peanut. We’ll have that challenge this summer, when it’s safe for Charlie to go off antihistamines.

The EpiPen Saves The Day

epipen

The orange tip is extended to prevent anyone from getting an unexpected poke from the used EpiPen.

Charlie had an anaphylactic reaction on Sunday afternoon. He was playing in the back yard for more than an hour (with no food), when he suddenly developed a super-runny nose and hives on his face. By the time we reached the house to give him Benadryl, his face looked much worse, so we all piled in the car.

And then he started to cough.

Charlie coughing when he’s having a reaction is a miserable thing to hear. It’s the most futile, thick cough ever. Add that to the massive hives that popped up on his arms and wrists, and we knew the 10-minute drive to the hospital was going to be too long. We stopped the car, MK administered the EpiPen to Charlie, and we got going again. And then, as he always does after getting epi, Charlie started to look better. Within minutes, the cough disappeared entirely. His face started to look like his face again. And although the hives remained for quite a while, they were dramatically reduced in size just minutes after the shot. The ER kept us for  a couple hours, and then we were back to our house.

And now Charlie wakes up crying multiple times every night.

And Max is acting out and clearly stressed.

And we’re trying to figure what the hell caused Charlie to go ana in the middle of the yard. No food. So pollen? It was a very high pollen day, and it was windy. The doctor drew Charlie’s blood and is testing for pollen now. He also recommended that Charlie avoid the birch we planted in our yard a couple years ago. The beautiful river birch that Charlie, more than the rest of us, really loves. It will go to a new home.

So, now we’re trying to figure out this new, major wrinkle. Charlie’s upcoming peanut challenge for May has been pushed until after the summer.

* Interesting note: We had nine injectors (eight EpiPens and one Auvi-Q) on hand. Some in MK’s purse, three in a pack I carry on my belt, and some in a fanny pack we refer to as the “epi kit.” It’s always with us.