No Peanuts Please

Blog Interrupted

2008-05-12T08:10:00.000-07:00

Not long after our daughter was diagnosed with anaphylaxis, I began talking to Anaphylaxis Canada (AC) about joining the team. This week I was happy to receive news that I have been appointed as a Director on the Anaphylaxis Canada board.

I have tried to adopt AC’s pragmatic and balanced approach when managing our daughter’s severe food allergy, both at home and in our community. After spending the past nine years on charitable boards, (most recently six years with Covenant House Vancouver), I am excited to offer my skills, energy and passion for the cause of food allergy and anaphylaxis, to Laurie Harada and her so-called ‘A-Team’.

As an Anaphylaxis Canada Director from British Columbia, I will focus on the development of a local presence in this province. In 2007 the BC Ministry of Education passed the “British Columbia Anaphylactic and Child Safety Framework” and the next step is to support those who will implement this important ministerial order.

My involvement with Anaphylaxis Canada will also include writing a column about our experiences as parents (details forthcoming). Unfortunately I will not have the bandwidth to author a column, become involved in British Columbia and author this blog, so NoPeanutsPlease will be offline for the forseeable future.

During the past 18 months you have visited the blog almost 12,000 times and enjoyed almost 200 posts. I thank you for your support and encouragement! It’s been a fabulous experience and has truly helped me in our journey as parents managing anaphylaxis.

Though I am disappointed to interrupt NoPeanutsPlease just as it was gaining significant momentum, I am very excited to be in a position to make an even greater contribution to the food allergy and anaphylaxis community.

Rhode Island Relaxes Peanut Ban

2008-05-06T20:40:00.000-07:00

The state of Rhode Island has voted to relax a ban on peanut butter in schools. The good news is that the peanut ban is being replaced by a law whereby "affected schools would be required to develop policies that provide a safe environment for students with peanut/tree nut allergies."

As the parent of a child who is allergic to eggs and dogs, (in addition to peanuts), I wonder why Rhode Island's legislators did not expand the bill to provide protection for all students with severe food allergy or anaphylaxis. They could have followed the lead of several other states.

NoPeanuts Poll: Bullying

2008-05-06T20:06:00.000-07:00

The most recent NoPeanuts poll asked "Has your child ever been bullied at school due to his/her food allergy?". Interestingly, 56% of the 41 respondents have children who are pre-school age, so of course this poll does not apply. For the 44% of readers who have school-age children, there is a 50-50 split between those who have and have not experienced bullying.

A new poll is now up: "Do you belong to a food allergy support group?"

Peanut Allergy 'Gone' In 5 Years? ... not likely

2008-05-05T10:34:00.000-07:00

Last week Dr. Wesley Burks was quoted as saying that immunotherapy could help peanut allergic patients by increasing their tolerance to peanuts.

In 2007, Dr. Burks' team at Duke University reported that "five of seven children with severe peanut allergy were able, after two years of immunotherapy, to tolerate a dose of 7.8 grams of peanut flour, equivalent to eating more than 13 peanuts ". Last week Dr. Burks noted that "these studies offer the possibility of at least raising the threshold of the amount of peanut that it would take to cause a life-threatening allergic reaction; whether these types of treatments are likely to cause eventual clinical tolerance to develop remains to be seen."

The media has run with this story under headlines such as "Peanut Allergy Gone in Five Years?" or "Allergy Expert Says Expect Cure For Peanut Allergy In Five Years".

While tolerance to 10+ peanuts would absolutely make peanut allergic children safer, and likely prevent fatalities, these headlines are misleading and will raise false expectations with parents of allergic children. When I first saw the headlines I couldn't click through to the story fast enough!

These studies are important and we are actually exploring peanut immunotherapy for our daughter, as it reduces the risk of exposure to a small amount of the allergen. The difference between a fraction of a peanut and 13 peanuts is significant when a child has severe peanut allergy and anaphylaxis.

That being said, while immunotherapy holds great promise as a treatment, it is not a complete 'cure' for peanut allergy and I cannot imagine that peanut allergy will 'gone' in five years.

NoPeanuts On Charles Adler

2008-05-02T17:46:00.001-07:00

Today I was interviewed on the Charles Adler show which is syndicated across Canada. Here is the link to the recording. (It will be on the site for 30 days and you will need to select 2pm on May 2, 2008.)

The interview went well. Charles asked several good questions and he was well prepared on topics ranging from Wesley Burks comments this week, to the Kentucky student being charged with wanton endangerment, to Trace Adkins comments on the Apprentice.

I actually took calls from listeners this time around which was new for me.

I am very glad that this issue is being well received. Charles noted today that he definitely learned something new from our conversation. I hope that his listeners found the interview insightful as well.

NoPeanuts On The Air

2008-05-01T19:53:00.001-07:00

This week NoPeanutsPlease was quoted in a Globe & Mail article covering bullying and food allergy. As a result of the quote, we have been interviewed several times on the radio. My wife was interviewed on CBC radio in BC on Tuesday evening and I was on Corus in Alberta yesterday. Laura Bantock of Kamloops, also quoted by the Globe & Mail, was interview by CBC radio in the interior of BC.

I am also scheduled to be on the nationally-syndicated Charles Adler show tomorrow at 12pm PDT on Corus.

If you would like to listen to my interview on Corus Alberta the recording will be online for the next 30 days. To hear it, select the specific hour on the site: April 30, 2008 at 11am. (I am on the air about 10 minutes into the hour.)

I appreciate the media's interest in this story! It is important that people are aware of this issue.

NoPeanuts In The Globe & Mail

2008-04-29T07:54:00.000-07:00

NoPeanuts was quoted in a Globe & Mail story about bullying. The story ran today and my comment was in relation to the case in Kentucky: "This is a pretty groundbreaking case," said Vancouver father Jeff Smith, who runs a blog called No Peanuts Please, through which parents have been swapping bullying tales after hearing of the case. "In some ways it's harsh. But it is an issue and it's becoming more well-known."

Bullying And Food Allergy ... cont'd

2008-04-26T09:18:00.000-07:00

Here is some additional perspective from the mother of the child that was featured in the recent ABC news story about food allergy bullying.

The more I think about bullying and food allergy, the more convinced I become that these young bullies simply do not appreciate the risk associated with their actions. I suspect that the majority of these kids would be out of the spelling bee if they were given the word 'anaphylaxis'! Huh?

Bullying is about intimidation and gaining power over another person. It would appear to me that bullies do not intend to cause a fatal reaction in a food allergic child. Instead it appears that bullies frequently prefer to inflict their tactics "repeatedly and over time".

As a parent I know that in many cases a blended approach of 'carrot' and 'stick' are needed to mold proper behaviours. An example of the carrot approach would be telling your child that if she behaves herself then she will get a sticker. The (metaphorical) stick approach would be demonstrated by telling the child that bad behaviour will result in a timeout in the corner.

This same approach could apply to bullying.

Improved education and awareness as to the severity of anaphylaxis will help most kids understand the risks associated with food allergy bullying. Most children feel good about knowing that they can help make allergic kids safer (ie: the carrot approach).

Unfortunately, there will also be a group of bullies that need a deterrent. For these kids the police charges in Kentucky last week would serve as the metaphorical 'stick'.

NoPeanuts Poll: Changes To The Food Supply

2008-04-22T02:09:00.000-07:00

In my last poll I asked you what you thought was the major factor in the increase in peanut allergy incidence. 41% of you think that it is changes in the food supply, not improved diagnosis and not the hygiene hypothesis.

A new poll is up.

Bullying And Food Allergy

2008-04-20T22:14:00.000-07:00

It is interesting that the criminal charges laid this week in Kentucky comes just after an article on bullying by ABC. The article featured a case of bullying where a girl had an apparent reaction to the smell of a peanut butter cup that was opened in her vicinity. (The prevailing wisdom is that it takes an airborne particle to cause an 'odor reaction', though the odor of a peanut has been shown to cause a psychosomatic response.)

The article noted that the incidence of bullying is rising, though bullying is nothing new. In my school days I do not recall ever encountering food allergy, though bullying and intimidation were just something you dealt with. When most people think of bullying they conjure up images of physical conflict, though (as noted in the article) verbal abuse can be more serious.

Allergic Living recently wrote an article about children with food allergy developing anxiety. I surmise that bullying can help foster that anxiety.

Here are two cases in point. The VanEssendelft children in the ABC report, both of whom have peanut allergy, have been subjected to stressful situations:

Sarah, 14, grew up with a group of girls that "attended birthday parties and play dates and had always kept a careful eye out for peanuts. Yet, still, the girls tried to test her allergy." Recently, however, these girls did not believe that her reaction to the odor of the peanut butter cup was real, so they decided to make a statement in the lunchroom by organizing a 'peanut party'. Thankfully a friend tipped Sarah off about the plan, telling her that the girls were bringing "everything peanut they can find, to watch your face blow up".

David, 13, recently had a "kid in the locker room say, 'I'm going to put peanut butter on the ball and I'm going to serve it to you so you have to set it,'". Apparently peanut jokes are common from this kid and he has said he wants to see David use his auto-injector.

Kids can be harsh. Clearly they do not appreciate the risks associated with severe food allergy and anaphylaxis.

The article also quoted Anne Munoz Furlong, founder and CEO of FAAN. "Whenever we talk about kids with food allergies in schools, their friends are a huge influence and can keep them safe. We have very often had teenagers tell us that their friends are their body guards, their friends are their eyes and ears."

The teen years are hard enough. A food allergy adds another level of complexity. Though it would be difficult to go through school facing these issues, I would also suspect that a certain resiliency, responsibility and strength of character could develop as a result.

While others can certainly provide support and assistance, the allergic individual is ultimately the one responsible for managing their own allergy. Best wishes to all of the Sarahs and Davids out there.

Criminal Charges in Kentucky

2008-04-19T08:19:00.000-07:00

Just this week I blogged about progress in anaphylaxis and food allergy legislation. These policies and guidelines endeavour to protect allergic children in the school environment, by implementing allergen avoidance measures and emergency protocols, should an exposure occur.

What we forget is that these guidelines serve to augment criminal laws that are already in place. This week a 13 year old boy in Kentucky was charged with felony wanton endangerment, after she sprinkled crumbled peanut butter cookies in the lunch box of another student with a severe allergy to peanuts. Thankfully the other child did not suffer a reaction.

What was this kid thinking? I know she is only 13, but as the parent of the allergic child this would be terrifying. Actually, as the parent of this 13 year old you might be even more terrified.

There were no prior issues between the two kids, so we have to assume that the 13 year old did not want to kill the other student. Based on that assumption, we only have one plausible scenario: that the girl simply did not take the allergy seriously. I am hoping that this was a prank or an experiment, as the kid in question did not truly believe he would cause serious harm. Perhaps it was on a dare?

(Note: subsequent to writing this post initially, one report indicated that the girl sprinkled the cookie in the allergic child's lunch 'to see what would happen'.)

The bottom line is that this is an extreme example of food allergy or anaphylaxis not being taken seriously. I actually empathize with people struggling to comprehend the severity of the disorder. Anaphylaxis is truly bizarre in that 99.9% of the time allergic children are perfectly healthy, notwithstanding unrelated health issues. I've had people say to me, "surely it is not possible for a peanut to kill a child within 15 minutes ... that's ridiculous!" I might not believe it myself, had I not witnessed our daughter's near fatal reaction on Boxing Day 2006.

Clearly there is work to be done in order to help the community understand that anaphylaxis and food allergy are a very real concern. The only benefit of this one student getting into trouble is that she can be made into an example for others.

If you are the parent of an allergic child, don't be angry at this kid. Instead, try to understand that anaphylaxis awareness is still not ubiquitous. Your own child would benefit if you leveraged this example in your community, so that others may learn from it.

A death in this situation would have been devastating to the entire school population, not just the family of the allergic child. One positive outcome is that the school district and the police recognized the gravity of the situation and took strong action. There are actually two classes of wanton endangerment, one a misdemeanour and one a felony.

The fact that the police charged the girl with the felony charge speaks volumes about just how serious they perceived this act to be. The misdemeanour charge applies if the accused places another person in danger of physical injury. The felony charge requires "extreme indifference to the value of human life" and a "substantial danger of death or serious physical injury".

Whether or not the child is found guilty, there is a silver lining to this unfortunate situation. The decision of the police to press this greater charge shows that they truly get it. This should also send a strong message to schoolyard bullies who tease children by chasing them with peanuts. This case sets a precedent and sends a clear message that similar actions will not be tolerated - not by schools, and not by the police.

I actually hope that the girl in question is shown leniency. A clear message has already been sent and I suspect she has learned her lesson. Perhaps a suitable punishment would be to have her perform community service. If she was to speak to schools, teachers and other students via a short educational video, they too would learn from this situation.

(Note: my initial source indicated that the accused was a boy. Subsequent reports have indicated that the accused is actually a girl. I have edited the text.)

Do You Think This Is Funny?

2008-04-16T07:51:00.001-07:00

Lorraine Sommerfeld, of the Toronto Star, was at a charity fundraiser this past week. There was a comedian performing at the event and during a rant about how today's children live a relatively sheltered existence, he decided to start in on peanut allergic children.

"He wanted to know what the deal was with kids today and something as harmless as a peanut. He held his thumb and forefinger an inch apart and said, 'If something this big is gonna take a kid out, guess what? He's not gonna make it.'"

It's disturbing, though perhaps not surprising, that anybody would find this funny ... though people did laugh. Others in the audience shared my dismay at the failed attempt to derive petty humour from the deepest, darkest fear for parents of an allergic child.

I concur with Lorraine's comment that joking about "a kid's affliction with a life-threatening allergy isn't even close to being fair." There is little I find funny about anaphylaxis.

Kudos to Lorraine for calling this guy out in the Toronto Star without giving him the satisfaction of having his name in the paper. Well played.

To Eat, Or Not To Eat (Peanuts)

2008-04-13T21:14:00.001-07:00

When we first learned of our daughter's severe peanut allergy and anaphylaxis, I remember wondering if we caused it. My wife ate peanuts during pregnancy and the theory of the day was that eating peanuts during pregnancy increased the risk that the child would have food allergy.

I was reminded of this when I read an article today about the rising prevalence of food allergy. In the article a parent noted that parents of allergic children "carry a lot of guilt around". She added that as the parent of an allergic child "you look at your sweet little child and wonder what did I do and what didn't I do?"

My wife did not avoid peanuts during either pregnancy, as we still did not know the severity of our daughter's food allergy before our second child was born.

We often wondered if we 'caused' the allergy.

The prevailing wisdom is that peanuts should be avoided if you have a history of allergy in your family. However, recent research in the UK seems to indicate otherwise. "Mothers of 77 per cent of children sensitized to peanuts had avoided peanuts during pregnancy. In this cohort study, maternal consumption of peanuts during pregnancy was not associated with peanut sensitization in the infant."

On the heels of this and related research, the UK government has gone so far as to suggest that expectant mothers who do not eat peanuts during pregnancy may increase the risk that their child will develop food allergies. "Lord May of Oxford said: 'It is quite striking that the increase in peanut allergies is rather in step with the increasing Government advice not to expose tiny children to them.'" The UK government is now formally reviewing its recommendation to avoid peanuts during pregnancy.

As is the case with most other things related to allergy, there is no clear answer to key questions, such as 'What causes food allergy?' or 'Should the major allergens be avoided during pregnancy?'. There is no definitive answer at this point.

The bottom line is that you need to make the decision that you feel most comfortable with, after consultation with your allergist.

Show 'Em You're A Tiger

2008-04-11T21:30:00.000-07:00

This is very cool, though I'm sure that isn't something that the Tigers can do for all fans. They sure made one family's day!

"I have have three big Detroit Tiger fans ... and have lamented the fact that we could not all go to a game since (my son was diagnosed) with (peanut allergy). ... (My husband) wanted to go to a game ... so I called the Tigers organization and asked if they had any plan or accommodations for kids with food allergies. ... About an hour later (they) ... offered me an 18 person party suite for NO CHARGE! I can't believe it! We are very excited and now they whole extended family will be able to join us in our own suite."

Play ball!

Not So Simplesse After All

2008-04-11T19:27:00.000-07:00

I learn something new every day with respect to our daughter's allergies and this week I learned enough for a month! Tonight I was reviewing What's To Eat, a food allergy cookbook, and was reminded that Simplesse is made from dairy and egg white. The good news, at least for us, is that the egg white is cooked during processing, and our daughter only seems to react to raw egg white. There are many names for egg and it is hard to remember them all. At least in Canada a label must read "egg and milk protein" when it contains Simplesse.

How A Bill Becomes A Law

2008-04-11T11:31:00.000-07:00

In the past two years there has been incredible momentum and success in legislative advocacy. Across North America there have been laws, recommendations and ministerial orders passed.

In BC we had a Ministerial Order passed in 2007 which requires school districts to develop anaphylaxis policies in order to protect allergic children. At the end of March 2008 Washington became the most recent state to pass actual law for the same.

FAAN's website indicates that there are now 17 states that have some form of government legislation, guidelines or policy requiring school districts to develop strategies that help reduce the risk for students with food allergy and anaphylaxis. In addition the vast majority of states now have policy governing students carrying prescribed epinephrine at school.

In Canada 90% of public schools have either standard policy, a policy advisory or a ministerial order (per Anaphylaxis Canada).

These achievements are a direct result of the effort and dedication of a large number of people in our community. Of course it also has required the support of key advocates and government sponsors. Thanks to everybody that has helped make such a tremendous difference.

NoPeanuts Poll: 75% To Have Lifelong Allergy?

2008-04-10T11:01:00.000-07:00

I ran a poll on the site asking whether you thought your child would outgrow his or her allergies. 75% of you expect your child to live with lifelong food allergy. For peanut allergic kids this is perhaps the reality. For children who are allergic to milk or egg the prognosis is better with 70-80% outgrowing their allergy by age 16, though it is possibly taking up to 13 years longer for that to happen.

Anaphylaxis Canada Comes To Vancouver!

2008-04-10T00:36:00.000-07:00

This past week I had the pleasure of attending Anaphylaxis Canada’s inaugural BC Conference held in Vancouver. The event covered two days, with a training session for spokespeople on Saturday and the formal conference agenda on Sunday.

This was my first Anaphylaxis Canada event and I was immediately struck by the sense of camaraderie and common purpose that the participants shared.

For those unable to attend, there were the NoPeanuts event highlights:

Marilyn Allen’s Saturday training session was excellent. She has the utmost credibility in the allergy community and I learned a great deal from her. Marilyn has mastered the art of walking the fine line between firm advocacy and empathy for other stakeholders.

Laurie Harada and her Anaphylaxis Canada ‘A-Team’ put on a fabulous event. You are welcome in BC any time!

It was very cool to meet several regular readers of this blog. Our conversations will keep me going when I post into the faceless blogosphere at 1am! Thanks for your support.

The breadth and depth of the Sunday speakers was excellent. We covered everything from Dr. Janice Jonega’s novel allergy eating plan to BJ Chute’s advice for rural folks to ‘leave the light on’ for the paramedics; and from Dr. Donald Stark’s reminder that ‘accidents are never planned’ to Laurie Harada & Gwen Smith’s advice to generate ‘the right amount of anxiety’ in our kids without instilling fear.

Meeting Kyle Dine, of Analphylaxis Canada was refreshing. Kyle is a recent college graduate and has dealt with anaphylaxis his entire life. As a parent of a toddler with anaphylaxis, it is reassuring to see a confident young man who has clearly taken over responsibility for his own allergy.

The biggest highlight had to be finally meeting Sara and Mike Shannon in person. At the end of the conference, Sara gave the participants a print featuring angels who deem themselves ‘Beacons of Hope’. We are going to frame the drawing for our daughter, as it was made by Sabrina Shannon in the year leading up to her untimely death in September 2003. Sabrina is indeed our beacon of hope.

Thanks again to the team at Anaphylaxis Canada, the event's sponsors and all of the volunteers. Of course, a big thank you as well to all of those who attended.

The NoPeanuts Playdate

2008-04-08T19:04:00.000-07:00

NoPeanutsPlease is about to reach a significant milestone ... 10,000 visitors! To celebrate I have decided to host an event in Vancouver during Food Allergy Awareness Week (May 11-17).

The first-ever NoPeanuts Playdate will be held at 11am on Saturday, May 17 at a local Vancouver park (TBD).

If you are in the Vancouver area and interested in attending the first NoPeanuts Playdate, please email me. Of course allergy friendly snacks will be provided ... please let me know in advance what allergies you are managing and I will endeavour to provide treats that are safe for everybody. (I'm up for the challenge!)

'Free' At Last

2008-04-08T00:07:00.000-07:00

Regular readers will know that I have an issue with unshelled peanuts at sporting events. It's very dangerous for those with peanut allergies as the dust and shell debris are generously distributed within a six foot radius of the person actually enjoying the peanuts.

The last time I brought our daughter to a Canucks game, a fan threw an unshelled peanut out of the upper section (after a bad call by the referee) ... as luck would have it, the peanut landed right on my daughters seat! My heart skipped a beat but I do not think she even noticed.

Just this week I posted about the Nashua Pride baseball team offering a peanut free section for its games. The AAA Rochester Red Wings have gone one step further, offering an allergy-free concession stand called 'Free'. In addition the team has designated an entire area of seating in left field a 'peanut and tree-nut free zone'.

The allergy free concession stand is very progressive thinking! I actually prefer it to the peanut free zone in the outfield.

So why did they take action with the food they are serving fans? Naomi Silver, chief operating officer of the Red Wings, said the idea came about as a result of "several fan inquiries." Of course it probably didn't hurt that Ms. Silver's son has a peanut allergy.

The irony is that the Wings are the "oldest and longest running minor league franchise in the history of professional sports", yet they are showing some of the most progressive thinking in terms of addressing the issue of food allergy at sporting events.

Let's hope that 'Free' excels as a AAA baseball prospect and gets promoted to the big leagues in the near future. 'Free' could possibly become a multi-sport phenom with Dave Nonis, Canucks GM, looking to make several moves in the offseason.

Perhaps one day I'll be able to go to a Canucks game without having peanut shells on my shoes and pant legs when I return home.

Air Peanuts Now Boarding

2008-04-07T16:07:00.000-07:00

I read an article today from CTV Winnipeg, in which a mother was contending that "her daughter's spring break was ruined because of an airline policy that can't guarantee safety for passengers with severe food allergies."

I have two issues with this contention.

First of all, like it or not, airlines cannot guarantee the safety of ANY passenger. Though the incidence of medical emergency from any and all causes has doubled in recent years from 19 to 35 per 1M passengers, the increase is primarily due to the "rising number of older passengers". There are multiple safety concerns facing airlines and they cannot be expected to provide a 100% safety guarantee, short of not allowing passengers with anaphylaxis to fly.

My second issue is with the sensationalism of the statement that West Jet ruined spring break. That type of rhetoric serves only to illicit a forceful, and opposite, response from the non-allergic public. Those dealing with food allergies are best-served to remain calm and stick with facts and logic when raising their concerns.

Notwithstanding the fact that airlines cannot guarantee safety, there are precautions that travelers and airlines can take.

What can airlines do to (easily) accommodate allergic passengers?
In multiple posts I have proposed that a very simple procedure that would significantly minimize risk, without unreasonably inconveniencing other passengers.

My simple proposal:
The airline crew should announce, as a courtesy, that there is a peanut allergic passenger on board and that it would be best for people to not eat peanuts, especially in the rows in close proximity to the passenger.

I have to believe that most reasonable people, upon hearing such an announcement, would forgo their peanuts to ensure the safety of an unsuspecting allergic child.

Air Canada recently followed this procedure for us and it worked perfectly. Other passengers were more than happy to help. It was a simple, practical announcement that made sure passengers were aware without alarming them. This is relatively easy for peanuts as airlines no longer serve them, and only those passengers who brought peanuts on board would be negatively affected. This could be somewhat more difficult for a cashew allergy since Air Canada sells those in-flight.

This relatively minor concession is worth the risk. In the above-noted post I told the story of another flight (when I was traveling without my daughter) and a passenger directly behind me opened a bag of peanuts at 7am. During that flight two peanuts rolled down under my seat ... that is a significant risk factor for my daughter and if we have to make an emergency landing everybody is inconvenienced.

an-uh-fuh-lak-sis

2008-04-07T00:55:00.000-07:00

I am often struck by life's little ironies. One such irony is that despite the volume of Blogger content covering severe food allergy, Google spell check does not recognize the word anaphylaxis.

Proud of the Nashua Pride

2008-04-06T20:18:00.000-07:00

As regular readers will know, I have a strong opinion that unshelled peanuts should be removed from larger sporting venues. This week the Nashua Pride, a minor pro baseball team, announced a peanut free section for their home games. I am fine with people eating peanuts at these events, but the unshelled variety of peanuts poses an unacceptable risk to people in the vicinity, should they have a peanut allergy.

Many times we have come home from Canucks games to find peanut debris on our shoes, pants and jackets. I would certainly be uncomfortable watching the game with my peanut allergic daughter if somebody nearby was spreading peanut shells all over the floor.

I am happy to see organizations taking a first step toward what will hopefully be removal of unshelled peanuts entirely.

Global TV News Feature

2008-04-03T13:15:00.000-07:00

For those of you in the Vancouver area, please note that tonight our family will be featured on Global TV as part of a news hour series on anaphylaxis and severe food allergy. The series is a run-up to Anaphylaxis Canada's BC Conference, being held in Vancouver on Sunday, April 6.

We will be featured somewhere between 6-7pm during Global TV's 6 o'clock News Hour. The local channel is 11 (Shaw).

This series is great for local exposure of severe food allergy and anaphylaxis.

Allergic Barbie

2008-03-31T18:43:00.000-07:00

Our 3 year old daughter is severely allergic to peanuts and, to a lesser extent is allergic to egg. One of the challenges of managing an allergy in a young child is to ensure that she knows that peanuts can 'make her sick' while not causing her to have overly heightened anxiety.

Recently I tried to get the point across by telling her that her Barbie was allergic to peanuts and eggs. I wanted her to understand that her 'allergic Barbie' could do all the things her other Barbies could do as long as she did not eat peanuts or eggs. Not surprisingly our daughter has latched onto the 'allergic Barbie' and become somewhat protective.

Tonight she took the game to a whole new level.

Apparently at 6:25 PM this evening 'Allergic Barbie' ate a peanut. Our daughter surprised me by playing out an entire emergency situation. She did not panic and dealt with emergency swiftly. First she took down Barbie's pants and used a needle in her doctor's kit to give Barbie an 'EpiPen'. She then used her Elmo phone to call the 'ambuhlance' and had Mommy open the front door to let the paramedics in. The paramedics helped make Barbie safe and everybody went to the 'hostibal' together.

I was very impressed. Since our daughter is three, she would not likely have full comprehension of the seriousness of an emergency. She simply knows that Barbie is 'sick' after eating a peanut, and she wants to help make her better. That being said, the emergency game clearly demonstrates that she knows to act fast, use an auto-injector and call an ambulance. Understanding the basics of an allergy emergency will make her safer.

In this month's issue of Allergic Living there is an article about children developing heightened anxiety as a result of managing their severe food allergy. The Barbie games we are playing in our home seem to be a healthy way to deal with a serious health issue without shocking our daughter.

It will be interesting to see how this develops over time.

Villager of Distinction: Trace Adkins

2008-03-27T23:03:00.000-07:00

The Villager of Distinction accolade goes to a person or group that has done something remarkable or special for those with severe allergies. The latest recipient of this accolade is Trace Adkins, the renowned country music star. Let me explain ...

Tonight my wife and I watched the finale of Donald Trump's Celebrity Apprentice. We have watched the Apprentice occasionally during its run. At first I have to admit that the celebrity version of the show seemed to be ill-conceived, yet for some reason I was drawn in.

The basic premise was that celebrities would play the game in the normal fashion, but instead of getting 'hired' by Mr. Trump, they would win $250,000 for the charity of their choice.

Over the course of the game I was struck by the way Trace Adkins carried himself. The man of few words seldom spoke but when he did it was often very insightful and noteworthy.

It was only in the last few episodes that I realized that Trace was supporting FAAN!

Trace has a six year old daughter with severe food allergies. In the finale Trace told Mr. Trump that he was playing for the "3 million fathers" who send their children to school living in the fear that they may not come home. He spoke with a passion that was seldom seen from him during the game. Being one of those fathers I was deeply moved by the emotion behind his words.

Trace is receiving this accolade for two reasons. As you can see from the enclosed Google Trends chart, there was a significant spike in Google searches for 'food allergy' after the March 6 episode of the Apprentice. It was in that episode where Trace was project manager and was able to talk about about FAAN.

I am also acknowledging Trace for the way in which he carried himself as an ambassador for the allergy community. He played hard but always with integrity, and he never lost sight of his motivation for playing in the first place ... his six year old daughter who suffers from severe food allergies. Very touching.

Well done Trace!

Please note: You can support Trace and FAAN by purchasing "You're Gonna Miss This - Single" at iTunes ... all proceeds go to FAAN and the charity single is only on sale for two weeks!

Eggs Still Here!

2008-03-18T00:14:00.000-07:00

What a scare we had on Friday night.

For the second time in only three birthdays Daddy again triggered an egg reaction. As many of you know, we recently received word that our daughter's egg allergy disappeared. What we have since realized is that it is gone as long as the eggs are even moderately cooked, e.g. boiled, fried or in baked goods.

On Friday Daddy was baking Madeleine a cake. (Yes, that's right ... Daddy was baking!) As a kid I always enjoyed relieving the mixer's beaters of their cake batter. Madeleine was helping me make the cakes and she asked to lick the beaters. Now that we were free of the egg allergy I thought it would be great fun.

It was fun until she developed at least a dozen large wheals and hives on her face and hands. She then became short of breath and her voice turned raspy and faint. We were very scared but remained calm. This exact scenario plays out in our minds multiple times each day.

We started with Benadryl ... 1 tsp, 2 tsp ... okay, 3 tsp ... finally the reaction stopped advancing.

The scary thing was not the hives but the fact that Madeleine's voice faded and became very raspy. She could not yell, though she could talk quietly. Once we saw the laboured breathing we reached for the autoinjector but the third tsp of Benadryl halted the reaction and over the next hour the wheals and red patches subsided.

The good news is that once the cake was baked, Madeleine was able to eat it without incident.

It seems that the threshold for an egg reaction has increased. In the past, anything short of commercially baked pasta resulted in a reaction. Now it seems that even the smallest amount of heat, such as boiling an egg, is sufficient to prevent reaction.

The batter that she ate contained 8 eggs. Turns out that raw egg is still an issue for our daughter but at least now we know!

An Anaphylaxis Mystery

2008-03-04T13:43:00.000-08:00

In December I wrote about the six cases of anaphylaxis that were apparently related to a Merck Frosst vaccine for measles, mumps and rubella.

This story has taken a strange twist.

Merck's vaccine has been cleared of having caused the allergic reactions. Health care providers will continue to investigate what exactly did cause the reactions.

Book Review: Allie the Allergic Elephant

2008-02-20T22:39:00.000-08:00

One of the things our daughter most enjoys is reading. She just loves books.

Allie the Allergic Elephant is an engaging kids book, and it is a great addition to the bookshelf for any child, but especially those young children who have food allergies.

Our daughter was engaged from start to finish and was amazed that Allie wears a 'special bracelet' to tell people she's allergic'. She also enjoys finding the bracelet on Allie's leg as it repeats throughout the book. This has been particularly helpful in getting our daughter to wear her Medic Alert bracelet. Whenever we encounter resistance we simply remind our daughter that Allie wears her bracelet whenever she goes outside, and she should do the same.

The book is written well for kids, moves at the right pace and is quite educational. It provides examples of what happens to an elephant who is having an anaphylactic reaction. Allie also shows children how to say 'no thank you' when offered a peanut and gives examples of foods that are safe or unsafe. Though other books incorporate similar allergy concepts, Nicole Smith and Maggie Nichols have successfully translated these concepts into terms that a three year old can understand.

It is very hard for parents to comprehend food allergy and even harder for young children. Allie the Elephant is a staple in our regular reading rotation and I would encourage you to pick up a copy if you have a child with food allergies. Our daughter has latched onto Allie as a soul mate and I have already put in my order for a stuffed Allie (complete with Medic Alert bracelet) should one ever come onto the market.

We're Eggstatic!

2008-02-18T19:02:00.000-08:00

I blogged earlier this week about our recent Eggsellent News and that we were expecting an upcoming egg challenge for our daughter. Well today was the big day. This morning I made French toast for Madeleine for the first time. We put the French toast in a container and headed to see the allergist.

The thought of sitting with a three year old for over three hours while she ate French toast in tiny increments was something less than optimal, but given the circumstances I was excited.

Our allergist started her with one small bite of French toast. We waited fifteen minutes with bated breath ... no hives, no redness ... we were in the clear! Or so we thought ... the second bite was double the first. After 5 minutes my heart sank. There on Madeleine's cheek was a single, large wheal. I was very disappointed.

I was afraid that the challenge would be stopped at that point, but after fifteen minutes where no additional hives appeared our allergist decided to keep the challenge going.

The portion of French toast was doubled again ... up to a quarter slice. We were ecstatic to see the first hive disappear and no additional hives surfaced, save one small dot on her hand.

Things had really turned and it was now safe to be very optimistic!

After waiting another hour after Madeleine ate one more half slice of French toast, we were given the all clear and in her honour Saturdays will officially be "French Toast Day" in our home!

The next steps are to ensure that she eats egg at least three times a week and to monitor any reactions. The addition of egg to her regular breakfast routine will help her develop tolerance.

This is huge news. Though I knew I would be happy, I have to admit that I was surprised by the wave of relief I felt once we were fairly certain that her anaphylaxis to egg had finally dissipated. I think that after two years you just learn to live with the allergy. In some strange sort of way I actually miss it a little because it was part of the fabric of who our daughter was. That being said, we will happily kiss the egg allergy goodbye!

Let's hope to have a similar result in two years when we revisit the peanut allergy.

Education Crisis (Averted?)

2008-02-17T23:28:00.000-08:00

I read an article tonight about an apparent 'crisis' situation in one Australian school region. It seems that in New South Wales "nearly every classroom" has a child with a serious allergy. I have blogged before about the fear that teachers have in dealing with serious allergy. It can be very traumatic even to imagine that you would have to give a child an injection from an epinephrine auto-injector during an emergency.

That being said, I was surprised to read the following passage. "'From a legal point of view, we would advise teachers not to medicate because they do not have qualifications,' Ms O'Halloran said. 'Obviously, if there's an emergency, the teachers need to act but ... it's very problematic.'"

It is no wonder that there is a (perceived) 'crisis' given that the teachers' federation leadership is implying that teachers need formal medical training to administer an EpiPen. That just adds to the anxiety teachers already feel. The teachers' federation is likely taking this position to bolster its efforts to secure a dedicated nurse for every school.

While it would be helpful (for a variety of health and safety reasons) to have a nurse in every school, teachers need not fear an EpiPen or Twinject. They do require training of course but the device is easy to use, and it is generally pretty clear when an emergency situation requires its application. Furthermore, there is minimal risk associated with administering an 'unnecessary' EpiPen dose in a less-serious situation that did not actually require epinephrine, but was 'mistaken' for anaphylaxis.

Though I am not a lawyer I would also question the validity of the legal advice the federation offers to its members. Teachers likely have 'duty to rescue' exposure should they be equipped to aid a child in an emergency situation and take no action. I think they would have no choice but to help.

In addition they would likely (hopefully?) fall under some degree of 'Good Samaritan' protection, codified or not, should something untoward happen during the attempted 'rescue'. I did a quick search for the presence of said legislation in Australia and though it appears that some form of law has been passed, it was not clear whether it extends to teachers.

There is also non sequitur in the federations legal advice to abstain from giving medical treatment. Why would a teacher administer emergency treatment in a situation other than an emergency?

Eggsellent News

2008-02-16T08:38:00.000-08:00

It seems that our daughter's egg allergy is gone. We made a switch to a new allergist in November and not only do we prefer our pediatric allergist, we have good news to report on the egg front.

First of all, find a pediatric allergist!
Back in November we took our daughter in to see a new allergist. We did not hit it off with our first allergist and I left the office very concerned about the level of care our daughter received. I discussed my concerns with a pediatrician that I know, and he confirmed that given the rapid rate of change in allergy research a pediatric allergist was the way to go. He also knew an allergist in our area that was very current with respect to her knowledge and helped us get an appointment.

In our first visit with our new allergist we did a new skin prick test (SPT). The first allergist did a SPT when Madeleine's arm was covered in so much eczema that there was barely enough room on her arm to do the testing. Many people (including us) have questioned whether we should not have been sent home to return another day.

Our first allergist also did not break the skin when he did the skin prick test (SPT) for peanut. Apparently current research indicates that the chances of a SPT triggering anaphylaxis are sufficiently low to allow the skin to be broken, especially since the test is administered in the care of an allergist.

Our new allergist is great with our daughter and very current in her research (at least from our vantage point). I am very glad that we made the switch.

Eggsellent News!
Of course it helps that in our first visit with our pediatric allergist that Madeleine did not react to egg in her skin prick test, though dogs and peanuts are still a concern. The negative SPT for egg was followed up with a blood test that confirmed that the egg allergy does appear to be gone. Let's hope that's true!

On Monday we have our egg challenge ... stay tuned for the results!

Mixed results on peanut
Though we were excited about the results on the egg front, it was interesting to learn the results of the peanut allergy. Though the SPT produced a 14mm wheal, which is very large, it has been shown (1) that an 8mm wheal is a reliable indicator of a peanut allergy incidence, but has a weaker correlation with the allergy's severity. "The positive predictive accuracy of the (SPT) is only in the range of 50-60%, meaning that a positive reaction will only predict a positive food challenge in 50-60% of patients." (2)

"No Peanuts, Please"
So it appears that we are in the clear on egg and given the mixed results for peanut, we may have good news there in a couple of years. In the interim, it's "No Peanuts, Please" for Madeleine.

References
1 - Hill DJ, Heine RG, Hosking CS, Pediatr Allergy Immunol, Oct 2004
2 - A. Ives, J. O'B. Hourihane, Current Paediatrics, Oct 2002

Bisphenol, Say What?

2008-02-13T07:56:00.001-08:00

Over the past year and a half I have read countless articles on the possible risks of early exposure to the severe food allergens. You ask yourself questions ... is there a risk due to soy being in formula? when should we introduce cow's milk? etc, etc, etc. All parents ask questions like these but as parents who manage a severe food allergy, we have certainly seen this self-questioning intensify.

The irony is that we spent all of this energy on optimizing the contents of our baby bottles, while it might actually be the bottles themselves that are a greater concern.

The news media and blogosphere have been heavily engaged in the debate on bisphenol A (BPA). The concern is that BPA mimics the hormone estrogen and even in minute quantities might lead to several health concerns. The only good news in the article referenced above is that once our Gerber and Avent bottles cool it appears that the BPA no longer leaches in to the liquid. In other words, though BPA would possibly leach in the dishwasher, the fact that we steam our bottle milk using an espresso machine, versus 'nuking' the bottles in the microwave, might possibly limit the exposure.

It strikes me that the BPA scare has a parallel with the concerns over the apparent increase in the incidence of childhood food allergy. We do not know whether early introduction of peanuts causes peanut allergy, nor do we know whether the use of bottles containing BPA really causes early onset of puberty or cancer over the long term.

The chemical industry contends that BPA in baby bottles "is not a risk to human health at the extremely low levels to which consumers might be exposed."

Forgive me if I do not take your word for it.

We will be replacing our bottles today.

Rounding To Zero

2008-02-11T23:21:00.000-08:00

There has been recent press about the fact that the rise in the incidence of food allergy may not be based on sound data. Authors have referred to anaphylaxis fatality estimates as a 'wild guess' or cited research that indicates that "the incidence of food allergy is not on the rise".

Does this matter? Yes and no.

It matters insofar as increasing food allergy incidence makes for good press and has generated significant awareness. It matters insofar that as food allergy becomes more common children with severe food allergy would be be afforded protection for their life threatening disability.

On the flip side the statistics do not really that much in our home. Though food allergy incidence in children is in the 5-6% range, it is 100% in our children. (Our second daughter has had a mild allergic reaction to mushrooms). Which number do you think is more important in our home?

The math is also less relevant since even a single child should be afforded protection in a school setting. It is critical that food allergic children participate equally with their peers at school and in social gatherings.

Overall I do hope that the incidence of allergy is lower. Though we have become comfortable with the management of out daughters' allergies, it would be great if fewer parents have to manage a severe food allergy. Though the allergy is a key part of what makes our daughter who she is, living with a constant fear of an anaphyalctic reaction is very difficult for parents.

Martha Stewart Living (With Allergies)?

2008-02-04T09:28:00.000-08:00

The staff at Martha Stewart are considering ideas for new publications.

One of the ideas being considered is a magazine dedicated to people who are living with food allergies or sensitivities. Here is the summary from Alexis, the Deputy Home Editor: "a special magazine that offers delicious allergy-friendly recipes, making life for people with food allergies and sensitivities easier and more delicious ... I’d like to empower people to make great recipes even if they can't use all the standard ingredients."

To vote head to the Martha Stewart blog.

Right now the allergy publication leads the way with 58% of 543,000 votes. A pet lovers magazine is in second place with 26%.

Surely awareness of food allergies would continue to grow, should there be a publication on the shelves with the Martha Stewart marketing machine behind it.

Next Stop Please

2008-01-31T23:04:00.000-08:00

I read an article tonight about a family that is suing Subway because their daughter had a fatal reaction to peanut in one of their restaurants. This case is very interesting. The key question will likely be whether or not Subway exercised sufficient care in the way it handled food.

I have received emails and read message board posts about Subway's careless food handling practices, at least with respect to severe food allergy. Based on first-hand observation I have often seen Subway employees go straight from handling cookies to handling sandwich ingredients. The risk of cross-contamination is obvious and I would never let my daughter eat Subway due to her severe peanut allergy.

Whether or not this lawsuit is successful, look for the case to have a major impact on how restaurants operate. What do you think corporate lawyers will say about the heightened risk associated with food allergy after this incident?

Though the knee jerk reaction will likely be for peanut cookies to be removed from Subway stores, there are other allergies to consider and what is really needed is comprehensive food allergy training and awareness for employees. Staff in these restaurants are often young and do not seem to appreciate the seriousness of severe food allergy.

My deepest condolences to this young girl's family.

Longer Expiry Date on Milk Allergy?

2007-12-14T20:04:00.000-08:00

It seems that this was the week of the question mark, as just about every post title this week ended with said punctuation. I posted regarding human rights in Ontario, the possible role of RGS13 protein in the suppression of anaphylaxis and the mystery of vaccine-related anaphylaxis.

In each case the news provided as many questions as it did answers. This is nothing new to those dealing with severe food allergy and anaphylaxis. There are many questions yet to be answered, and likely many questions that we have not even thought to ask.

That theme continues tonight.

I read an article about a recent study that seems to refute the old adage that 75% of children with milk allergy outgrow their allergy by the time they turn 3. In this study, only 20% of children outgrew their milk allergy by age 4 and it took until the age of 16 for 75% of children to outgrow the allergy.

Could it really be that it is now taking 13 years longer to outgrow milk allergy?

There were concerns about the integrity of the results in that the population studied was highly atopic, however the study's co-author Dr. Robert A. Wood noted that "it may also be that the character of milk allergy has changed over time".

It was already difficult to study food allergy given limited budgets and a demanding time frame. If the 'target' now begins to move that research only becomes more difficult.

A Protein That Suppresses Anaphylaxis?

2007-12-13T23:10:00.000-08:00

In late November research was published suggesting that a protein called RGS13 may play a role in suppressing allergic reactions and anaphylaxis. The research showed that mice deficient in RGS13 had higher mast cell activity and a higher incidence of anaphylaxis.

This study has the potential to help scientists understand why some people develop severe food allergy and anaphylaxis, and could possibly lead to a treatment down the road.

"Because RGS13 is also a protein found in humans and is expressed in only a limited number of cells--including the immune system's mast cells that are central to allergic reactions--scientists believe the protein may be an attractive target for developing new drugs to treat and prevent certain allergic reactions, including anaphylaxis."

"We still do not know what triggers the allergic or anaphylactic reaction in some people," says NIAID Director Anthony S. Fauci, M.D. "These findings open up important research avenues, such as examining the role of RGS13 protein in humans to determine if its deficiency or abnormal function triggers the mast cells to release chemicals that cause allergic diseases."

Though it will be several years before this research is complete and any resulting treatment is commercialized, this is certainly encouraging news.

Measles, Mumps, Rubella ... And Anaphylaxis?

2007-12-13T06:55:00.000-08:00

Health officials across Canada have stopped using a vaccine for measles, mumps and rubella after several patients experienced anaphylaxis. Merck Frosst Canada shipped almost 300,000 units of the vaccine, with over 200,000 of those landing in Alberta. In all, six people experienced anaphylaxis. All six were treated and have fully recovered.

Though the response was swift, the disconcerting part is that the exact allergen has not yet been identified. I am sure that the first step will be to consult the six patients who had a reaction in an effort to identify common allergens and then to identify where in the process a new allergen was introduced.

"At this point, we haven't seen any problem," Merck spokeswoman Sheila Murphy said. "We've come up empty-handed so far."

Another interesting factor is that "at least five of the six patients who fell ill in Alberta had a history of allergic reactions." Though it is unconfirmed, that implies that one of the people might have had their first incident of anaphylaxis as a result of this vaccine.

Let Them Eat Candy Canes!

2007-12-12T18:56:00.000-08:00

Our friend Gina at AllergyMoms posted a list of allergy safe candy canes today. Our daughter will be thrilled!

Is This A Human Rights Violation? - Part 2

2007-12-11T20:31:00.000-08:00

Yesterday I blogged about the human rights action that has been taken on behalf of six children at St. Stephen School in Ontario. Today I interviewed the key spokespeople on both sides of the issue. Maurice Brenner is the human rights expert who is supporting the children and Chris Cable is the Communications Manager for the York District Catholic School Board. (I want to first acknowledge my appreciation for their time today.)

Student safety is the priority
Both sides agree that the ultimate goal is to provide children who have anaphylaxis with a safe environment at school. Mr. Brenner noted that there is a "need to minimize risk with a safeguard" though he did acknowledge that "no safeguard will be 100% effective and since accidents will happen an emergency plan must also be in place".

Ms. Cable concurs and noted that "human rights call for accommodations for disability and though anaphylaxis is not actually listed as a disability, the onus is on schools to minimize risk" for those students with food allergy and anaphylaxis.

So why have things escalated to the human rights tribunal you ask? Good question.

Brenner's goal: Reinstate the prior process of parents checking ingredients
Mr. Brenner noted that the sole objective of the human rights action is to reinstate the prior two- step process where parents noted that lunches were safe and teachers confirmed that each lunch had a parent's note attached.

Brenner said that the former process involved "a simple note, not a detailed ingredients listing. It was just a simple note that said the lunch was checked and it was allergy free." He continued to say, "teachers are fine with the existing practice and are just following the direction of the school board. The (ingredients list) practice had been in place for five years without incident and the recent change in administration resulted in a change in attitude."

Why was the ingredient list process canceled?
According to Cable, the school board canceled the ingredients list process for two reasons. The first is to mitigate risk and the second is that she questions whether the process adds value from a safety standpoint. "(School) staff is not qualified to determine if a lunch is allergen free and neither are parents," said Cable. "You would have to be a dietitian to do this and parents would have to send in packaging so (staff) could read the ingredient list. (The process) gives a false sense security".

Where do we go from here?
Both sides are determined to see this through to the human rights tribunal. While Brenner noted that he is open to mediation, it was clear from speaking with Ms. Cable that the school board is going to stand firm in its position to go without the ingredients list process. This does appear to be headed for a formal tribunal hearing and you can bet that every school board across Canada will be paying attention.

Ms. Cable is fine with whatever ruling the tribunal makes and feels that "if York is a test case for the betterment of all schools (the school board) is okay with that. If there are specific things that the tribunal wants they should be put in place and resources will be required. This is a bigger issue than York. It impacts school boards across Ontario and beyond."

Shrove Tuesday 2007
I was struck by the Brenner's comment that the change in administration resulted in a change in attitude. This perceived change appears to be one of the biggest reasons that there is a human rights action today.

The turning point in school board / parent relations just might have been the cancellation of a 'Shrove Tuesday' celebration earlier this year. Brenner noted that in preparing for the celebration the school departed from prior practice, where a community allergy committee was consulted, and instead went ahead and ordered a new pancake batter that contained an allergen. Cable countered that the school purchased the same batter it always purchased, and a parent raised a concern that the batter "might have been made in a facility that might also have made products containing nuts".

Not only do the two sides have their own version of what exactly happened, they also differ on what transpired thereafter. Brenner noted that the school board sent a letter to parents noting that the celebration was canceled and "made it sound like the allergic kids had it canceled". Cable does not agree that the letter blamed the children with allergies.

Though it is not surprising that the two sides have different versions of events, it does appear that the biggest issue with Shrove Tuesday might have been miscommunication.

NoPeanuts' take ...
I have to admit that I am surprised at the extent to which the children, and more importantly their parents, have held steadfast on this issue. Though Mr. Brenner noted that the prior practice was easy to implement and consistent with recommended guidelines for special events, I tend to agree with Ms. Cable's contention that the process provides limited additional security for allergic children while possibly exposing the school board to significant risk.

Think about it. How diligent do you think most parents would be when they are making lunches at 10:30pm? They would do a quick surface check for peanut butter or eggs, but do you really expect them to know that hydrolyzed vegetable protein might contain peanut or that
casein might trigger an allergic response in those who have anaphylaxis to dairy?

School staff would face similar challenges when doing a quick surface check of lunches. As I noted yesterday, it is not likely that a teacher would would catch the sandwich that accidentally contained egg mayo instead of the eggless variety.

It does not make sense to have added risk without a reasonable expectation of an incremental 'reward'. While Brenner noted an increase in the number of serious allergic incidents at St. Stephen since the ingredients list process was canceled, Cable is only able to recall a single incident requiring Benadryl but not an epinephrine auto injector.

I concur with Ms. Cable's contention that the ingredients list process might actually create a "false sense of security" for parents. As I noted yesterday, I would certainly not rely on it to keep my daughter safe. I would instead take comfort from St. Stephen's comprehensive allergy policy which extends beyond the requirements of Sabrina's Law. It seems to me that the allergic children at St. Stephen are indeed being afforded accommodation for their disability.

While I fully appreciate the right of the children to refer this matter to the human rights tribunal, my original conclusion remains intact. The specific issue to be decided is whether the ingredients list process is an accommodation covered by human rights for the disability of anaphylaxis.

As this process seems to provide limited additional benefit beyond the extensive policies and safeguards already in place, I would be surprised if their action was successful.

Is This A Human Rights Violation?

2007-12-10T10:25:00.000-08:00

A very interesting story is emerging in Toronto. Human rights expert Maurice Brenner is supporting six children, aged 6-11, in bringing a human rights complaint against their school and its school board as a result of food allergy policy.

For the past six years St. Stephen Catholic Elementary School, in Woodbridge ON, has had a program aimed at making schools safer for children with severe food allergies. To augment the provisions of Sabrina's Law, which enacted formal policy to protect school children with anaphylaxis, St. Stephen required parents to list the ingredients of school lunches and required teachers perform a quick daily inspection of lunches.

The policy was appreciated by parents of children with severe food allergy, but has been canceled due to a need to conform with other provincial schools who do not have similar policies.

Chris Cable, spokesperson for the York Catholic District School Board, said that while the "Ontario Human Rights Code requires schools to accommodate children with disabilities, 'it makes no mention of daily inspections of children's lunches by school staff, nor does Human Rights require parents to send in notes with each lunch and snack to describe the ingredients.'" Cable added that schools in the district already comply with Sabrina's law and school board staff are trained twice a year to recognize anaphylactic shock and use an EpiPen.

Sabrina's Law sets reasonable minimum standards for anaphylaxis preparedness and the York schools appear to be in compliance. Though the heightened ingredient monitoring was well-intended, it did not align with other schools in the district and would certainly not have provided 100% safety for allergic children.

As I have written many times before, even the most well intended attempts to prevent food allergen exposure will not succeed 100% of the time. A quick surface inspection of lunches by a teacher would catch an obvious offender such as a peanut butter sandwich, but it would not likely catch something that contains a more obscure allergen, for example a sandwich that mistakenly contains real mayo (Daddy used the wrong jar) but the student honestly thinks thinks it is egg-free mayo.

The bottom line is that awareness and emergency preparedness are just as important as pure prevention.

While I share the fear that St. Stephen's parents have in sending their food allergic children to school, I am not convinced that there is a human rights violation in Woodbridge.

(Note: there is a follow-up to this post.)

From Soup To Nuts

2007-12-08T07:57:00.000-08:00

Amanda (aka Mrs NoPeanuts) was in Toronto this past week. She had lunch in a church basement and the cooks had made a lovely Moroccan soup. She was surprised to find out that the soup had peanut butter in it! She was even more surprised that the staff demonstrated strong food allergy awareness by noting the inclusion of peanut butter directly on the soup placard. Very cool.
I was intrigued by the inclusion of peanuts in soup. I had no idea that it was so common.

I did a search at Epicurious.com and found 19 soup recipes that contained peanut. Most of them had peanut in the name so you'd clearly notice but several others, Szechwan Carrot Soup (1.5 tbsp peanut butter) and Long Leaf Noodle Soup with Hoisin Marinated Shrimp Soup (1/2 cup peanuts), are more obscure from a peanut perspective. Many other soups, including Chinese Hot And Sour Soup, contain peanut oil.

Obviously if we were making these soups we'd modify the recipe to leave out the peanut. That being said, if we were at a restaurant and saw carrot soup we would not have immediately thought 'watch out for peanuts'.

Of course we always ask about peanuts when ordering but I did not realize that so many soup recipes used peanut and I might have trusted the judgment of a seemingly astute waiter who told me their carrot soup was safe. I will ask a couple of follow-up questions in the future.

I am sure that people out there are saying, "I knew that soups often include peanut!" I guess this just highlights that allergy management is a perpetual learning process.

Thanks to the church staff in Toronto. Your simple sign noting that there was peanut butter in your soup has been more helpful than you know!

Over The Hills And Jar Away

2007-12-07T21:37:00.000-08:00

This week I was at a software event in Los Angeles. In typical fashion there were cookies and other sweets laid out to fuel the event's patrons, many of who would spend hours on their feet presenting their products to customers.

Though people with peanut allergy would always be wary of cookies of unknown origin , I was somewhat surprised to note that the chocolate chunk cookies were set out in large glass jars filled with peanuts. Peanuts filled about half of the ~10L jars and the cookies were then stacked on top.

Though it is unlikely that a peanut allergic person would eat those cookies anyway, there is a chance that somebody could ask about the cookie, be told that no peanut was in them and then eat a cookie cross-contaminated by the peanuts that they were stacked on.

I know that seems like a bit of a stretch, but I am never comfortable around 5L jars of peanuts!

NoPeanuts In The Globe

2007-12-04T18:40:00.000-08:00

Today we were quoted in the Globe & Mail, Canada's national newspaper. Globe reporter Tralee Pearce was intrigued by the rapid growth in the incidence of food allergy and we were interviewed as part of her research.

In reading the article I was interested to learn that "the median age of first peanut-allergy reactions has dropped to 14 months from 21 months over the past decade." Over the same period of time "the median age at which the allergic child was first exposed to peanuts has dropped to 12 months from 19 months."

As we all know, there is no definitive explanation as to why the incidence of peanut allergy is increasing. Pearce also pointed out that the drop in the age of the first reaction might be due to the fact that parents are now more acutely aware of the signs of a possible allergy.

In the course of our discussion I intimated that the most frightening aspect is the suddenness with which a reaction can appear. "It's all or nothing," Mr. Smith says. "She's either totally fine or it's an emergency."

Thank you Tralee for taking an interest in food allergy.

Fear, Frustration and Hope

2007-12-03T06:49:00.000-08:00

Today I came across a great article on CNN. The article is written by the mother of a young boy named Teddy who has anaphylaxis, to peanut, egg, dairy and wheat. Unless you have a experience managing severe food allergy, you would not appreciate how difficult it would be to manage the allergy and keep Teddy safe. Teddy's exclusion list would dwarf Madeleine's, which is just egg and peanut.

I was struck at how well Teddy's mother articulated the fears, concerns and frustrations that parents face when they have a child with severe food allergy.

In the midst of managing a tough dietary regimen, Teddy's mother also faces the ignorance and fears of others. It is important to understand that most people just do not understand food allergy. They cannot comprehend that the perfectly healthy child in front of them goes into a life threatening reaction within seconds upon contacting the allergen.

An example of this is when people say to Teddy's mother "Oh, a little bite of cake won't hurt him" and "Why do you need to read the label -- I'm sure this is OK." If you have a child with food allergy you have almost certainly encountered this. It is frustrating, but your role as a parent protecting a food allergic child is to treat that as an opportunity to educate vs a reason to become frustrated.

Another classic example from Teddy's mother involved air travel. "When we fly, we have to fill out paperwork for a peanut-free flight, since even airborne peanut particles can pose a risk. Once a flight attendant slipped up on a connecting flight and began passing out peanuts. I asked her to please keep them away from our rows. "Oh? Is the peanut allergy still on board?" she asked." Though it is frustrating to have your child reduced to a label or stigma, this is another opportunity to spread awareness. It might he helpful to talk calmly to the flight attendant after the flight about her choice of language. Getting angry during the flight would just make you look like a 'peanut parent' who is totally overreacting.

School of course is a fear for all of us and Teddy's mother shares our concern that Teddy will "most likely have a segregated seat at lunch, and while that potential exclusion saddens (his mother), the growing number of children with allergies would seem to indicate he'll have some company in the lunchroom."

I chose to highlight this article as it covers many of the major concerns and fears encountered by parents if children with severe food allergy. We face these psychological challenges in addition to managing complex 'dietary logistics'.

Another element of the psychology of childhood food allergy is hope.

Teddy's mother says, "we still have hopes that Teddy will outgrow some of his allergies. After all, he's only 3½. If he can outgrow only one allergy, I hope it is cow's milk. He'd be able to eat the lengthy list of foods whose only allergen is caramel coloring. And I'd like to be able to drink a glass of milk and kiss him on the cheek without him getting a hive."

I've had this sample mental conversation myself many times.

Though we all have become adept at managing severe food allergy, the truth is that everyday we hope that it will somehow vanish in the same mysterious way that it appeared.

That Cookie Tastes Like Peanut

2007-11-28T22:20:00.000-08:00

I read a story tonight about a child who showed great allergy awareness despite not being allergic himself. (Though it is a Halloween-related story it just came out.)

Adam Waldusky is a 7 year old from Chippewa Falls, WI. At a Halloween party with (supposedly) safe treats the kids were eating cookies. Soon after the kids ate cookies, Adam's friend raised an alarm by telling Adam's Mom that he tasted peanut.

Thought it is not clear why Adam did not notice this himself, within minutes he began to swell. Adam's Mom was prepared and after administering an EpiPen she brought Adam to the hospital for the 4-6 hour observation period.

Thought it is great that story had a happy ending. I was also impressed that Adam's friend was the first one to recognize the danger and report it. It is impressive that at a young age he was thoughtful enough to think of Adam's allergy after tasting peanut.

One of the contributing factors to his awareness was the fact that Adam's Mom talks to the kids in Adam’s grade once per year, to promote allergy awareness.

It takes a village ...

Hitch

2007-11-27T23:12:00.000-08:00

Has anybody seen the movie Hitch? I had never seen it and was struck by the seen where Will Smith's character, Alex Hitchens, has an allergic reaction to shellfish. Though the movie found humour in the swelling reaction and showed him drinking enough Benadryl to appear intoxicated, it was very bizarre to see an allergic reaction played out in a movie.

Part of the comedy came through the distortions that the swelling reaction caused in his ears and face. The scary part though was that our daughter's anaphylactic reaction also had grotesque swelling in her neck, face and hands ... she was not even recognizable.

I wasn't sure whether to laugh or cry while watching the movie ... it was both funny and terrifying. It was truly bizarre how the scene made me feel. While Will Smith's antics were truly comical, recalling the image of my daughter lying on the bathroom floor was the antidote to humour.

Ann Munoz Furlong of FAAN summed this up well with the following quote:

"We hope not only does Hitch "get the girl," but he also needs to go see an allergist. He shows many of signs a major food allergic reaction. The next one could be even worse." said Anne Munoz-Furlong, Founder & CEO of FAAN. "It can be funny to watch in a movie, but if you are ever with someone experiencing a food allergic reaction it can be quite frightening. For those with food allergies, it is important to seek medical treatment immediately and to carry their epinephrine at all times."

Sunbutter Returns

2007-11-25T08:37:00.000-08:00

I know many of you are sitting at the edge of your seats just waiting for the latest update on my quest for Sunbutter. I was disappointed when Stongs no longer carried Sunbutter and I took to the Internet to find a new source. With a peanut allergy in our house Sunbutter is the closest thing I will get to my beloved organic peanut butter.

The issue locally is that only specialty stores carry Sunbutter and they charge way too much. Online I could get it for about $5/jar, landed cost.

But this weekend I was pleasantly surprised to find Sunbutter on the shelves at Stongs again! I was way more excited than I should have been. Stongs carries it for $3.99 so not only is it easier, it's cheaper.

For now I am back in action. Stay tuned ...

Anaphylaxis (sp?)

2007-11-24T12:57:00.000-08:00

It always strikes me as funny that the word 'anaphylaxis' comes up as a spelling error in Blogger. It fits the current level of awareness for the disorder.

Villagers of Distinction: Sara & Mike Shannon

2007-11-24T00:35:00.000-08:00

The Villager of the Month accolade has gone to a person or group that has done something interesting or special for those with allergies. It has honoured several people but as I award this accolade this evening I am struggling with the title.

Let me explain ...

Today I posted about how I thought I almost received a peanut cookie at a café. Though I do not have any food allergies, I seem to be vicariously allergic to peanut through my daughter. I react to peanut with an urgency that would suggest I am allergic myself. It is downright scary to think that I could accidentally consume something that would cause a possibly fatal physiological response. It is scarier still to imagine my daughter have that same reaction.

Tonight Gina Clowes of Allergy Moms emailed me. She reminded me that my Villager of the Month accolade was again due and her nominees are an obvious recipient for any and all allergy-related accolades. My concern was that a 'Villager of the Month' accolade just didn't seem appropriate given all that they have been through, and all they have done for the allergy community.

Many of you will know the story of their daughter Sabrina. The best summary of the Shannons' dedication to their daughter is summed up by Allergic Living, "On that terrible last day of September 30, 2003, Sara had made this promise to her daughter: she would do everything possible to prevent another child from dying of anaphylaxis. That promise has become her mission."

Sara has followed through on that promise.

For those who have children with anaphylaxis, Sara and Mike should serve as your inspiration. Collectively, our worst fear is that we might someday lose our child to a fatal allergic reaction. The Shannon's have turned their tragic loss into triumph and proved that all you can do in life is make the most of any situation, no matter how dire.

Gina Clowes was one of the first people to ever comment on NoPeanutsPlease. She counseled me to think of those with allergy to things other than peanut, and highlighted the story of Sabrina and her parents. After Gina's post I lay awake at night for about a month and wondered if I would have the courage to follow in the Shannons' footsteps. In those initial days after our daughter's diagnosis the possibility of a fatal reaction were of course exaggerated in my mind.

Madeleine would cough at night and my immediate response was to rush in and make sure she was not having an allergic reaction. It sounds crazy ... and it was.

Over the ensuing year my thoughts have returned many times to the Shannons.

My pittance of an accolade cannot begin to demonstrate my respect and gratitude for what they have done. We live in Vancouver and when Madeleine goes to school in three years she will be safer than she would be if she entered school today. Because of the Shannons' support for bill M210 here in British Columbia there are new anaphylaxis policies in our schools. Though we did not secure a west coast version of Sabrina's law, the support of the Shannons gave credibility to the efforts of PACT.

Though I hope to never follow in their footsteps, I am deeply moved by their response to the tragic loss of their daughter. Though I cannot even fathom the loss of Madeleine, I would hope that I could have a fraction of the Shannons' courage.

In honour of Sara and Mike Shannon I have renamed my 'Village of the Month' award. Henceforth the accolade will be called 'Villagers of Distinction'. The word 'month' connotes a point in time. The Shannons have given so much to the allergy community that any accolade, no matter how small, requires an element of permanence. It is not melodramatic to say their through their efforts they have undoubtedly saved the lives of multiple children.

Their efforts in BC may even someday save Madeleine's life and that possibility alone makes me forever grateful for their courage and their contribution to the allergy community.

Thank you Sara and Mike. You are truly an inspiration.

No! No! Not The Peanut Cookie!

2007-11-23T16:36:00.000-08:00

On several occasions I have blogged about the fact that it is impossible to completely avoid an allergen. If you have a peanut allergy it is likely that at some point you will inadvertently encounter surprise peanut protein, perhaps just when you least expect it. It is critical to be prepared for an emergency response should that be required.

Today we experienced this first hand

We were at a Vancouver café and my wife ordered an oatmeal cookie to go with her latté. (... how Vancouver is that?). I was watching as the café owner reached for the cookie and I said, "No! No! Not that cookie. We can't have peanuts!" I was slightly amused at the 'peanut conditioning' I have undergone. though I am not even allergic to peanut, (our daughter has the peanut allergy), I often react with an urgency that should be reserved for those who are actually allergic! It is very interesting.

The scare today was that I thought that the café owner had reached for the peanut cookies, and not the oatmeal cookies. When I looked closer I realized that he did indeed pick up an oatmeal cookie but their cookie label signs were in front of the wrong cookies. The peanut cookies were labeled as oatmeal and vice versa.

Let this be a lesson that even when you carefully read ingredients, signs, etc. you could still pick up a mislabeled food item and unknowingly consume an allergen.

This is just a fact of life for those living with food allergy. Though it is important practice safety and avoidance, it is critical that you carry an epinephrine auto-injector, such as an EpiPen or TwinJect at all times.

You cannot be too prepared and you just never know when anaphylaxis might be triggered.

It's The Leash You Can Do

2007-11-11T23:56:00.000-08:00

This week we went to the allergist and our daughter's dog allergy was confirmed. Though it is not likely anaphylactic it is a serious allergy and does appear to have been the culprit in our daughter's scary swelling and skin reaction that resulted in my wife administering an EpiPen. The reaction appears to be in response to dog saliva. Hypo-allergenic dogs do trigger the allergy.

Given the severity of the reaction you can appreciate our concern when we are walking down our block and somebody is coming the other way with a dog that is off-leash. It also scares our daughter into our arms.

I urge dog owners to consider this the next time they are out for a walk. It is common for dogs to be up to 50 feet or more away from their owners when off-leash. We avoid designated off-leash areas as they are a concern. Outside of designated areas it is inconsiderate to have your dog off-leash.

Sunbutter Eclipse

2007-11-03T19:44:00.000-07:00

Back in June I was so excited to find Sunbutter at my local grocer. Unfortunately they just took it off the shelves! The same distributor that sells Sunbutter also sells PeaButter. Apparently they are only going to carry one and Sunbutter is the odd butter out. Based on my PeaButter review I think you know how I feel!

Alas I am now searching for sub-$8 Sunbutter again. I think I'll check the Internet as suggested by a reader.

Peanut Free Baseball

2007-11-03T19:40:00.000-07:00

In June I posted about how sports teams were beginning to take peanut allergy more seriously. I came across this article tonight which gives a first hand perspective of a father and son who attended a Washington Nationals game on a night where a peanut-free skybox was offered for allergic kids. Note that the young boy in question developed hives despite all of the cleaning and precautions. I suspect that peanuts are just 'in the walls' of a ballpark, just like eggs seem to be 'in the grill' at diners.

Trick Or Treat ... Give Me Something Safe to Eat

2007-10-21T12:33:00.000-07:00

Today my mother-in-law told us that she has a friend who is going to buy peanut safe treats to give out at Halloween. After hearing many times about our daughter's allergy, this friend decided that she did not want to be responsible for a possible allergic reaction in a child who came to her door.

Though other allergies such as dairy or wheat are also a concern at Halloween, I thought that this was a great gesture. It shows the power of allergy awareness!

We are going to hand out Nestle treats at our door. Nestle actually offers a package of assorted peanut free treats including mini Kit Kat, Aero, Coffee Crisp and Smarties products. Our daughter loves Smarties so this works just fine for her.

As with all products marketed as peanut free, one caution is to not blindly assume that things are safe. In 2006 Nestle actually had an issue with the Coffee Crisp bars in its assorted peanut free pack. An unfortunate reality for parents of allergic kids is that even with peanut free products it is important to be ready for a possible reaction.

We are going to bring Smarties and Dare's Wagon Wheels to all of our neighbours' homes prior to trick or treating. That way we know that our daughter will receive safe treats at each home and we can just relax and enjoy our evening. My wife and the girls are going to be the three little pigs and I the Big Bad Wolf.

Happy Halloween!

Villager of the Month - Jen

2007-10-20T18:18:00.001-07:00

The Villager of the Month accolade goes to a person or group that has done something interesting or special for those with allergies.

This month's winner is our neighbour, Jen. Our daughter was invited to her son's first birthday. A few weeks before the party Jen proactively reached out to ask for our Wacky Cake recipe. She then went a step further and told all of the other parents that there would be an allergic child at the birthday party and to avoid bringing peanut snacks.

How incredibly thoughtful!

Jen made four chocolate Wacky Cakes and as always, they were moist and flavourful. These cakes are hardly a sacrifice for anybody and are very helpful for those with severe food allergies. The cake was a hit with our daughter. I think she ate five pieces, though much of the cake seemed to be smeared on her face and her dress!

Just as the party was winding down, an incredible thing happened.

I was speaking with one of Jen's friends and I mentioned that the cake was nut and egg free. It turns out that she has anaphylaxis to peanut! She was very happy to learn that she could actually enjoy the cake with the rest of us.

This was a rare treat for Jen's friend and it was also a pleasant surprise for Jen as she was not aware of her friend's allergy. Consider it allergy karma! You just never know who is going to have an allergy in your circle of friends.

Other parents could really learn from Jen. She simply asked for a cake recipe, advised other parents to bring peanut-free snacks and ensured that whatever else she served was peanut free. She did not fear the allergy. She did not make us feel like she had to go out of her way. As a result we never felt like we were an inconvenience.

Though I did have to be careful of a few egg items on the buffet style party spread, our daughter was really just there to play with the other kids and to eat chocolate cake!

It Takes a Village to manage an allergy! Jen set a great example for parents looking to accommodate children with food allergies.

Do Eggs Make YOU Sick?

2007-09-25T23:15:00.000-07:00

I thought I would share an interesting conversation that our 2 1/2 year old daughter had with her 2 year old friend. They were playing with our daughters' kitchen set. We have about 100 plastic food items and as they played our daughter picked up a plastic fried egg. The first time she saw the egg she asked us what it was. I was struck by that because we used to eat eggs every day but once we learned of her allergy we began to phase eggs out. She had never seen an egg!

As they played, our daughter turned to her friend and said ... 'eggs make me sick. Do eggs make you sick'? Her little friend had no idea what she was talking about.

I found this interesting because the day before I had explained to our daughter that not everybody gets 'sick' when they eat peanuts or eggs. I told her that though she can drink milk, other kids get sick when they drink milk. The point was that not everybody was allergic to peanuts, but there were things that were safe for her that others could not enjoy.

The concept of food allergy is very confusing for a two year old. Our daughter is starting to understand and it is fascinating to observe her as she scrambles up the food allergy learning curve.

Book Review: Mommy, Is This Safe To Eat?

2007-09-23T09:14:00.000-07:00

I was recently contacted by Christina Black, author of two books for peanut allergic children and their parents. Entitled 'Mommy, Is This Safe To Eat' and 'Starting School With A Food Allergy', the books are intended to help young children understand how to stay safe while still having fun.

I decided that the best way to review these books was to read them to my 2 1/2 year old peanut allergic daughter. She has made great progress in understanding her allergy. Every time she sees peanuts, peanut butter or potentially unsafe cookies she says: 'No peanuts for me. Peanuts make me sick'.

That being said, it is very difficult for her to be aware of peanuts hidden in other foods. The photos in these books, such as those depicting potentially unsafe muffins or crackers, were very effective. She was confused at times, and the point was clearly made that Mommy and Daddy to help her determine if a food is safe.

The M&M's were particularly confusing since Smarties are safe, at least here in Canada. She pointed and shouted, "Smarties!" only to have Daddy tell her that they were not Smarties and that she should only eat things that look like Smarties if Daddy or Mommy say it's safe.

The books also capture food allergy safety from a child's perspective. The allergy learning process can be confusing and frustrating, and the books deal with some of the most challenging scenarios: grocery shopping , forgoing cookies or snacks in social situations and dealing with concerns that a peanut allergy is the antidote to fun.

In future titles I would suggest a more engaging narrative format to bring the child deeper into the book. Children love to follow a well formed story or theme. Another idea would be to have something, perhaps a peanut, that repeats on each page. Kids enjoy hunting for these items when they are hidden throughout the book.

Though there are many websites, such as Safe4Kids, with content related to food allergy in the classroom, sometimes it also helps to have a printed book with pictures. These books could serve as a useful teaching aid for all children, not just those with allergies, as they learn about food allergy safety.

Red Tag Lunches

2007-09-22T09:16:00.001-07:00

I thought this was a cool idea. Though I abhor the term 'Peanut Police' I do like the idea of adding colourful tags to lunches that contain allergens. In this case lunches containing peanut are red tagged though no other allergens are identified. You could do the same for high risk foods such as dairy or wheat.

While many parents will immediately have a vision of adding so many tags to their child's lunch bag that it looks like a rainbow, within reason this could be a very effective way to give fair warning to those with allergies. It could certainly be something employed by the school lunch counter and parents could do their best to follow suit. Perhaps the home version would simply be a single tag that identifies that lunch as containing any of the major allergens.

The tag method is certainly a more pragmatic approach than a peanut ban.

Do Veggies And Omega-3 Reduce Risk Of Allergy?

2007-09-22T08:58:00.000-07:00

(post by Mrs. NoPeanuts)

I recently came across a research study that claimed a diet rich in fish and fruity vegetables such as tomatoes or eggplant, can cut asthma and allergy incidence in children. As a biologist, I find the scientific side of my daughter’s allergy intriguing and the research (or lack thereof) always interesting to read.

Researchers from the Department of Social Medicine at the University of Crete, Greece, and writing in the journal Pediatric Allergy and Immunology, studied the diet of 460 Spanish children.

They discovered that children who consumed more than 40 grams of "fruity vegetables" a day - namely tomatoes, eggplant, cucumber, and green beans - were much less likely to suffer from childhood asthma. In addition they found that children who consumed more than 60 grams of fish with a high omega-3 content also suffered less childhood allergies.

The study adds to a body of evidence supporting the health benefits of omega-3 and a diet high in vegetables.

What is interesting to note is that my daughter and I ourselves participated in a research study for Omega-3 conducted at our Children’s Hospital. The purpose of our study of course was not to examine foods linked to allergies but to help determine whether a dietary supplement of docosahexaenoic acid (DHA) during pregnancy has any effect on pregnancy duration or early infant development.

At 17 weeks pregnant, I started to take a supplement (which could have been omega-3 or I may have been in the control group) and continued throughout my pregnancy. The supplement stopped when I delivered.

For the first 18 months of my daughter’s life, the researchers monitored weight, height, head circumference and we ‘played’ games that observed eyesight, speech perception, problem solving, behaviour, motor skills and cognitive understanding.

Interestingly enough, when I became pregnant with our second daughter, we enrolled once again in the study and by complete chance we were put in the same study group, meaning whatever supplement I received with my first daughter I also received with my second.

And low and behold…my first daughter suffered from extreme eczema during her infancy and now also lives with anaphylaxis to peanuts and eggs. My second daughter, who received similar Omega-3 exposure in the womb (as I didn’t change my diet – except for the removal of peanuts and eggs), has no eczema and to date, thank goodness, no allergies.

“This is not the first time a diet rich in "fruity vegetables" has been linked to having the potential to reduce the risk of respiratory conditions like asthma, chronic bronchitic symptoms, and wheeze. However, this study claims to be unique because it assessed maternal dietary habits during pregnancy as well as children's dietary habits.”

“Fruits and vegetables are rich sources of antioxidant vitamins such as vitamins C, E and carotenoids, and other antioxidants such as selenium and flavonoids, that are thought to reduce airway inflammation by protecting airway cells from endogenous and exogenous oxidative damage,” the researchers said.

However, they found that no other fruits or vegetables were significantly associated with wheeze or allergy prevalence. The lead researcher, Dr Chatzi commented: "The biological mechanisms that underlie the protective affect of these foods is not fully understood, but we believe that the fruity vegetables and fish reduce the inflammation associated with asthma and allergies."

Though I do not know for sure, there is reason to believe that I did indeed have the Omega-3 supplement during my pregnancy for our first daughter, vs the placebo. There were no actual numbers provided in the Spanish allergy study but it does sound like our daughter’s Omega-3 consumption would make her an exception to the rule.

Despite all of the current research efforts, we still do not clearly understand what causes food allergy. There is an apparent randomness as to allergy incidence and severity.

Villager of the Month - Summer 2007

2007-09-14T06:26:00.000-07:00

This spring I started a new series called Villager of the Month. The intent is to recognize people and organizations who do special or interesting things to help those with food allergies. This month I have been featured in Allergic Living. I wrote an article about the theory behind this very concept and the reception has been great.

The latest recipient of the Villager accolade dovetails nicely with my post about the work that PACT had done with Bill M210 in B.C. The Food Allergy Initiative is a non-profit agency that raises funds toward the effective treatment and cure of food allergies. It also works to raise awareness of the seriousness of food allergy.

In August the FAI was a major force behind New York Governor Elloit Spitzer's decision to sign into the law the Allergy & Anaphylaxis Management Act of 2007 (AAMA) . The FAI's contribution was significant. "During the past year, FAI led a coalition of food allergy support groups and parents across New York State to achieve the passage of the AAMA. In March 2007, as a result of FAI’s leadership of a coalition in New Jersey, a similar bill, PL. 2007, c.57, was signed into law."

“This vital legislation will save lives,” said Robert Pacenza, Executive Director, FAI. “If a food-allergic child accidentally ingests even a minuscule trace of the wrong food, it can trigger a reaction that can kill within minutes. The AAMA will provide New York parents and schools with sensible guidelines to help keep these kids safe. FAI is proud to have been the organizing force behind this effort.”

Congratulations Robert and team. Great work on this legislation!

M210 Lives On ... In Spirit

2007-09-12T22:39:00.001-07:00

This past spring bill M210 made its way through the legislative process here in British Columbia. As a result of a strong grassroots effort led by a group called PACT, the failed bill actually lives on, at least in spirit, via a new anaphylaxis directive handed down this week by Education Minister Shirley Bond.

“Children with life-threatening allergies need to be safe in B.C. schools, and our direction today is for all school districts to take immediate steps to ensure all students are protected,” said Bond. “Boards of education will now be required to have school-based anaphylaxis policies and practices that meet rigorous provincial standards.”

This is great news. PACT was my villager of the month for June and I am very pleased to see that in the absence of a true B.C. version of Sabrina's Law we do have protection for our allergic children in the province's skills.

Kudos to all of those involved in the lobby effort to make this happen.

Allergic Living Features NoPeanutsPlease!

2007-09-11T17:26:00.000-07:00

The Fall 2007 issue of Allergic Living magazine features NoPeanutsPlease. I wrote a column on the concept of 'It Takes A Village' and it was included on the last page of the magazine: "Parting Shots: A father needs help to keep his anaphylactic daughter safe.". The article is not available online but was highlighted as a feature of the current issue.

You Ant Be Serious!?

2007-08-18T13:11:00.000-07:00

I bought ant traps today after I found 20 little ants enjoying a slice of watermelon on our kitchen counter last night. I figured that the warning to keep them away from the kids was due to boric acid. Turns out that these traps 'may' contain peanuts so the boric acid is the least of our concerns. I learned today that many pest control traps use peanut butter as bait ... who knew that people with a peanut allergy needed to be wary of ant traps?

I am not super alarmed from the research I have done but I think it might be best to use boric acid in my beloved Sunbutter instead of the peanut butter ant traps.

My target is the ants ... not my daughter.

Don't Pass The Mustard

2007-08-18T08:42:00.000-07:00

I read a piece this morning on mustard allergy. Even after the countless hours of research I have done, I was surprised to learn that a 2003 study found mustard allergy to be the fourth most prevalent allergy in children behind egg, peanut, and milk.

The article also presented an example of how overwhelming food allergy can be for parents. Here is a quote from the mother of a young girl who has anaphylaxis to peanuts and mustard:

[Emily would typically start preschool in the fall, but she will be held back a year. "I'm really considering looking into possibly home schooling unless there's something that I can really be assured she can be safe -- maybe a special place where the school is free of peanuts," Evans said. "Free of mustard is a stretch, a little bit.]

I remember having the same initial reaction. Over time you realize that despite your best efforts it is just not possible to completely avoid an allergen. It is important to practice avoidance but it is also important to be prepared in the event of an emergency.

Home schooling is a matter of personal preference. Though our peanut allergic daughter will go through the school system, I do have to admit that I am already very nervous for her first day of preschool this fall. I also hold out hope that BC passes anaphylaxis legislation prior to her first day of kindergarten in 2010.

Peanut Poetry

2007-08-17T18:38:00.000-07:00

I received an email from Allergic Living magazine this week. They are having a poetry contest that is taking entries up until next Thursday. I find blogging to be a great outlet for me and I suspect that others might enjoy poetry. Feel free to post a verse or two as a comment on NoPeanutsPlease as well. Good luck!

Boston Baked Beans

2007-07-17T20:56:00.001-07:00

This one is ironic. I was at a gathering of my extended family in Boston this past weekend. It was interesting to meet another branch of the family. We won a door prize as the people who traveled the greatest distance to be there. The prize was Salt Water Taffy and Boston Baked Beans. The irony is that unbeknownst to me Boston Baked Beans are chocolate covered peanuts. Sometimes you just have to chuckle. I'm glad that my wife noticed or I would have brought them home.

Peanut Parfait

2007-07-17T01:55:00.000-07:00

This week we were out to dinner. While eating a delicious strawberry parfait I crunched into something that has become foreign to me … a peanut! Ironically, I had just finished saying how much our daughter would enjoy the parfait. I found it interesting to experience first-hand the shock that an allergic person would feel when finding a surprise peanut. My first reaction was one of fear. It was as if I was allergic myself. I felt very strange and I could no longer eat the parfait.

I have not had a peanut in about six months. The taste is now unsettling and for obvious reasons no longer welcome. While I can still enjoy an omelet while traveling on business (despite our daughter's egg allergy), I no longer have a desire to eat peanuts. I was surprised that I had such a strong reaction. It is funny how the mind works.

Villager of the Month - June 2007

2007-07-17T01:39:00.000-07:00

This spring I started a new series called Villager of the Month. The intent is to recognize people who do special or interesting things to help those with food allergies.

For June 2007 I wanted to recognize the efforts of a group of concerned parents in British Columbia. Under the name Protecting Allergic Children Today (PACT), Caroline Posynick and other members of her organization spearheaded a letter writing campaign to MLAs and government officials in support of David Cubberly’s proposed anaphylaxis legislation.

Though Bill M210 failed to advance after its second reading, the government is certainly aware of the issue of allergic children in schools and that is largely due to the efforts of PACT and its supporters.

You can learn more about PACT or Bill M210 on the organization's website.

Six Months In

2007-06-25T22:56:00.001-07:00

So here we are ... six months into our daughter's severe food allergy. I have been struck by how tight knit the anaphylaxis community is and just how much there is to learn. I think we've done a good job of managing the allergy without having to significantly alter the things we do, but it is certainly a challenge at times. It is difficult to be 100% compliant in reading labels, checking ingredients, quizzing servers, bringing the EpiPen, bringing safe snacks, etc. It is annoying to deal with people who think that you are overreacting. It makes me sad to hear my daughter It is also quite stressful to live with the intense fear that rises up whenever you see a red spot on your daughter's hand.

That being said, while it would be great for her to outgrow her allergy I would not change anything. She is an absolute treasure and the food allergy is part of who she is. I am certain that we appreciate every day with her even more after experiencing a near fatal allergic reaction to peanut six months ago.

Sunbutter On the Cheap

2007-06-21T21:27:00.001-07:00

For those of you sitting at the edge of your seats wondering when I would find less expensive Sunbutter, the wait is over! I did a review of Sunbutter recently and noted that the only negative was its high price. Several readers commented that $8.49 for a jar of Sunbutter was ridiculous. Turns out they were right.

My wife talked to the grocery manager at Stong's our (excellent) local grocery store here in Vancouver. They now stock Sunbutter and price it at a reasonable $3.99. I guess that leaves me with a clean review of Sunbutter afterall!

Sunbutter is perfect for those with anaphylaxis due to peanut allergy in their homes. We do not let our daughter eat Sunbutter to avoid confusion but it has been an excellent peanut butter replacement for us.

Please Don't Pass The Mayo

2007-06-21T21:04:00.000-07:00

Tonight we had an incident that reinforced our decision to remove all raw egg products from our home. We ate dinner on the deck tonight. My wife ran back into the kitchen but for an instant and in the time she was gone, our daughter grabbed her hamburger and took a big bite. In the past we always had mayo on our burgers. Given our daughter's egg allergy this would likely have been a bad situation.

But alas we are now using an eggless mayo so disaster was averted. There was no way I could have gotten to the burger before my daughter. Naturally my immediate thought was a mental image of the allergic reaction that might have ensued should the mayo have been of the egg variety.

Our decision to remove eggs from the home came after I ate an omelet. It was about a month ago. Up to that point we kept eggs but removed peanuts. The thinking was that we could be careful with eggs but despite all my precautions during the cooking process, I gave my daughter a kiss after eating the omelet and she had a large welt on her cheek. That was the final straw.

Ironically a week or so after we removed eggs from the house my parents were here. My Dad found four eggs in the back of the fridge and fried them up. My wife caught him just as he was bringing the eggs downstairs to my Mom, who incidentally was playing with our egg-allergic daughter. Understandably my Dad did not think about the allergy and it was only after my wife caught him at the top of the stairs with a plate of eggs that he remembered. I did not even realize we still had eggs in the back of the fridge.

Though (like me) you'll probably miss many of your favourite food items, I urge you to rid your home of any products that contain allergens harmful to your family members. Accidents happen and it is just not worth the risk.

Topic Of Conversation

2007-06-20T22:34:00.000-07:00

I always find it interesting how many times our daughter's anapylaxis comes up in conversation. People are genuinely interested in it. Surely our forced preoccupation with her allergies is a major factor but when the topic comes up people do not shy away from the discussion. They are typically inquisitive and sympathetic at the same time and seem interested in discussing it at length.

I was reminded of people's interest tonight after reading an article which discussed the fact that food allergy seems to be growing exponentially. That point resonates with people whenever we discuss food allergy - they are not generally aware of this increase. The other thing they are struck by is how little research funding is out there. Though total research seems to be growing, at least anecdotally, the fact remains that food allergy research lacks funding versus other health issues. The Food Allergy Project sums it up well:

"Food allergy research is woefully underfunded. The National Institutes of Health (NIH) spends less than $10 million a year on food allergy research, compared to $107 million on attention deficit disorder and $1.2 billion on diabetes. These are all important diseases that deserve attention."

Whenever we discuss food allergy over dinner or in a group setting, people are troubled by the fact that while many healthcare professionals and scientists concur that there is likely a cure for food allergy, research into a solution is underfunded. Hopefully this will change as awareness builds.

Peanut Free Zone

2007-06-14T19:46:00.000-07:00

The Padres have followed the lead of the 2006 Minnesota Twins, offering one home game with a peanut free section. Though this is a positive step, there is room for improvement. First of all, they are offering one game out of 80+. In addition, even with Padres attendance up 8% so far this year they draw only 33,000 per game versus the 42,500 seating capacity. There is an opportunity to have at least one peanut free section for every game.

The one difference here, as compared with the Twins, is that the allergic kids are at least sitting in a proper section of the ballpark instead of being quarantined in a skybox. To enhance safety, the Padres have assigned two additional ushers to the peanut free zone and have a paramedic in close proximity in the event of an allergic reaction.

Allergic fans should understand that there are no guarantees. There is always the risk of a remnant peanut from a prior game, but certainly this is much safer than sitting next to a guy who has a mound of shells at his feet and particles blowing all over those seated nearby.

Though the Padres are taking a step in the right direction, I am looking forward to the first stadium that steps up and ends the sale of unshelled peanuts. This would allow allergic kids to sit throughout the stadium. The Padres designated section 326 as the peanut free zone. From this seating chart you'll notice that section 326 is so deep in the recesses of the upper deck that you might as well be watching from home.

Note: Soon after I made this post I came across another article while visiting ABCPeanuts. It noted that the Edmonton Eskimos of the CFL played their entire 2006 home schedule peanut free. Kudos to this CFL team for being the first to step up!

Product Review: AllergyMama.com

2007-06-09T14:00:00.000-07:00

Today marks the debut of NoPeanutsPlease Product Reviews. These reviews will focus on products that make life safer or more comfortable for those with severe allergies. The reviews will have four categories: Impact, Quality, Price, Style.

The first product I am reviewing came to my attention as a result of the interconnections created in May by Ria Sharon, our inaugural Villager of the Month. Ria highlighted other bloggers on her site during food allergy week. One of the featured sites was the Food Allergy Queen, who pointed me in the direction of AllergyMama.com. You could say it took a village ...

Product being reviewed
AllergyMama.com purses and totes

Impact
The first thing I look for is whether this product contributes to comfort or safety. We've often rifled through the recesses of a diaper bag trying to locate allergy medication that we know to be inside. The stylish and colourful AllergyMama.com totes and purses easily carry parental accessories. More importantly, the bags neatly hide allergy medication in a lined, zippered section on the bottom of the bag, thereby improving both safety and comfort.

Quality
The bags are made of a lighter cloth and to a high level of quality. Though I do have concerns about the durability of the cloth over time, and whether it will hold up in Vancouver's winter rain, there have been no issues to date.

Price
Priced at $65 for the purse and $82 for the tote, the bags are reasonably priced. In addition you have the option of ordering a custom bag at no extra charge.

Style
In addition to improving comfort and safety, these bags score points for style. Each bag is unique and the peppy colours, funky beads and catchy names (such as 'Harriet Takes New York') are just downright fun. A diaper bag has never looked this good!

Overall
The smart design of these purses and totes have been a hit with my wife. The zippered compartment is very convenient and the bags are quite stylish. Though the bags will likely not prove as durable as the traditional diaper bag, they truly are a great accessory for the hip urban Mommy.

NoPeanuts TV

2007-06-08T21:33:00.001-07:00

YouTube (aka Google Video) has a cool blog widget that allows users to view videos. I have a video strip below that allows you to view videos that are pulled based on the following search terms: peanut allergy, food allergy, anaphylaxis. The risk is that some suspect videos show up but I think this will be an entertaining addition to the blog. Note that when you click on a video thumbnail the video plays at the top of the page.

Dare To Dream!

2007-06-07T20:55:00.000-07:00

I cannot even imagine how relieved I would feel if our daughter grew out of her allergies. I just read an article about a four year old, peanut allergic girl who successfully completed a peanut challenge. She ate 39 peanuts! After living with a severe food allergy for three years I suspect that it would take an adjustment for her family to get back to 'normal'.

I am resigning myself to the reality that this is an unlikely scenario for us, (ie: <20% chance) , but it sure would be nice ... dare to dream.

Peanut Gala

2007-06-06T23:13:00.000-07:00

Tonight I was at an awards dinner for the technology industry in BC. The first course was seafood spring rolls with peanuts sprinkled on the side. I passed my plate to a colleague. I was shocked that a shellfish and peanut dish was served to such a large group. Perhaps I have become so allergy aware that I am naive once more.

Don't Wait For The Big One

2007-06-05T06:58:00.000-07:00

This week a 9 year old peanut allergic boy died in the UK after putting a piece of candy into his mouth. The boy had prior peanut reactions but none this severe. Sadly it often takes a severe reaction for parents to realize how dangerous the allergy is. This was the case for us and this particular story reminds me of how lucky we were.

Although our daughter had two minor reactions before her major reaction on Boxing Day, we were not educated enough to truly understand the risk. If your child has a history of even the smallest reactions to peanut you are advised to have an epinephrine auto-injector, such as an EpiPen, with your child at all times. At the first signs of an allergic reaction you should immediately call 9-1-1 and summon up the strength to use the EpiPen should that be necessary. If the reaction becomes more severe it is advised to use the EpiPen versus bringing it to the hospital with you.

Our (first) ambulance driver said it best, "don't mess with a peanut allergy".

Restaurant Review: Avenue Grill

2007-06-04T20:12:00.000-07:00

NoPeanutsPlease Restaurant Reviews will assess a restaurant's level of allergy awareness based on three categories: Menu, Server Reaction, Attention To Detail. I will then provide an overall rating of Peanut (allergy risk) or NoPeanuts (allergy friendly). Where possible I will foward the URL of the post to the reviewee to give them the chance to reply.

For those with food allergies every restaurant poses a risk. The point of this series is to outline where restaurants can improve and highlight restaurateurs who are astute when it comes to serving food allergic patrons. Even if you do not live in Vancouver these reviews should be helpful in terms of showing you what we look for.

Reviewee
The Avenue Grill on 41st Avenue in Vancouver, BC.

Menu
The Avenue Grill has a fairly broad lunch menu but it stays true to its bistro-meets-diner ambiance by offering up a page of egg dishes and a variety of burgers and sandwiches that all seem to include mayo. For those with egg allergies this menu is an issue. Though you could order your sandwich without mayo, the large volume of eggs going through the kitchen heightens the risk of cross-contamination. We ended up choosing a fruit salad and cottage cheese for our daughter.

Server
In my opinion, when it comes to managing an allergy the most important person in the restaurant is the server. The cook plays a central role but the server is the one who walks a food allergic patron through the menu and makes the cook aware of the allergy. I prefer to see a server who is receptive, attentive and sincere while helping us select safe food items. In this case, when we told our server that our daughter had a severe peanut and egg allergy we were met with a blank stare. I suspect she was either indifferent or slightly overwhelmed. It is critical to watch for this first reaction as a parent.

Attention To Detail
We made it fairly easy for our server by ordering a fruit salad for our daughter. We did forget to ask for no mayo on my wife's sandwich and my burger. Though we should have caught this ourselves, it would have been impressive if she noticed that mayo would pose a risk to our egg allergic dining mate.

Peanut vs NoPeanuts?
Unfortunately my inaugural review presents a great example of why I decided to add this feature to the blog. The Avenue Grill would be a suitable place to eat for many but for the food allergic, (and especially those with egg allergy), it should probably be avoided. The lunch menu offers up only soup and salad as items that are egg free and though you could ask them to hold the mayo on sandwiches, with so many eggs going across the grill the risk of cross-contamination is high. In addition, our observations did nothing to convince us that the restaurant takes care to clean surfaces fully and avoid cross-contamination in the kitchen. Though our daughter did not come into direct contact with eggs, by the time we left she had well over two dozen hives on her arms and face. This was not a good experience.

Overall Rating: Peanut

General Comments:
Though this feature is focused on the allergy awareness of a restaurant, I figure that readers would also like to know what our overall impressions were. An institution for decades, the Avenue Grill was high on the list of neighbourhood restaurants that I wanted to try. Unfortunately the inattentive service and fairly bland meal did nothing to make me want to return. There are better options for lunch in Kerrisdale, egg allergy aside.

Peanuts! Getcher Peanuts Here!

2007-06-02T15:37:00.001-07:00

If you have been to a baseball game or other major sporting event you are well aware of how prevalent unshelled peanuts are. Interestingly there have been several press releases recently advertising 'peanut restrictions' at sporting events. The most recent was for a peanut free home date for a Michigan soccer team. Another prominent example from baseball is the Minnesota Twins, who offer a peanut free skybox for four of their home games.

While a peanut free game is encouraging, I find the Twins offering to be patronizing, more than helpful. Though the Twins' press coverage generates allergy awareness, offering up one section for 5% of your games when you are averaging 28,000 fans in a 48,000 seat field is a pittance. I challenge the Twins and other major league teams to do more. It is great that they recognize this to be an issue. Though it would require some planning and oversight, it would be ideal if every stadium had a reasonable percentage of its seats designated as peanut free, or at least as peanut-shell free.

The last five times I have gone to an NHL game, in three different arena, a person within 5 seats of me has been eating a bag of unshelled peanuts. The fun of eating nuts this way is that it is publicly acceptable to make a huge mess. The downside is that I have to brush the peanut debris from my clothing before I head home to give my daughter a goodnight kiss. I am not looking to ban peanuts, but I would certainly prefer that only shelled peanuts were sold.

I understand that sporting events and peanuts go hand in hand. I used to eat a bag of unshelled peanuts myself at every NHL or NFL game I attended, complete with the aforementioned pile of shells at my feet. Now that I am aware of the danger that this might pose for those with allergies I could not imagine doing this again. Though there is a debate as to how dangerous this really is, a quick Internet turns up multiple cases of severe allergic reactions.

The Twins are helping on the awareness front but I challenge them to take a leadership role in making the game even safer for their younger peanut-allergic allergic fans. As we develop additional insight into severe food allergy, I hope that one day unshelled peanuts will become an artifact of sporting legend.

Peanuts, Peanuts Everywhere

2007-06-02T14:59:00.000-07:00

Those managing peanut allergies received concerning news in late May. It seems that 'Peanuts Are Hot'. The number of top 200 restaurants serving menu items containing peanuts increased 84% since 2000, and the number of menu items with peanuts increased 142%. In grocery stores peanut butter is growing at a rate of 7.6% and peanut snacks at a rate of 56%. Consumer favour for peanuts is very high with 80% of consumers saying that peanut butter tastes great and 75% citing it as a good source of protein.

With several cities now banning trans fat from restaurants, peanut products will likely become even more prevalent. One item of particular concern is the positioning of refined peanut oil as allergen free. As noted in a prior post on NoPeanutsPlease, "there have been contradictory reports on the allergenicity of highly refined peanut oil" and those with peanut allergy should perhaps err on the side of caution and avoid peanut oil until the research is clear.

Headline News

2007-05-21T08:11:00.001-07:00

Here are the peanut news headlines on NoPeanutsPlease.com today. It seems that everywhere I turn, whether online or in the Saturday Vancouver Sun I am reading about the Australian study on peanut allergy testing.

I understand that this is really big news and will lead to significant relief for many parents. But in addition to the concerns I noted earlier this week, I am worried that the non-allergic public will use these findings as the basis for claims that parents are overreacting and their child is probably not even allergic.

My research shows that this is not a particularly new finding and that instead we have a case of the media taking a story and running with it. I understand that this happens in reverse as well when a child dies from anaphylaxis but I continue to have concerns about how this story has been broadcast.

Sunbutter

2007-05-20T08:51:00.000-07:00

After several readers suggested Sunbutter as a peanut butter replacement, I was finally successful in locating a jar. Incidentally we found it at a health food store just a few blocks away. Well, it was worth the wait. My last product review was for Peabutter and as you may recall, I was not a big fan. I was happy to finally get a chance to review Sunbutter.

In reviewing food products I review taste, texture, price, ingredients. It is a little unfair to review peanut butter replacements as I am not reviewing them in isolation. They are being put up against by beloved peanut butter, with which I had to part ways several months ago.

Taste: Sunbutter serves up a strong aroma of roasted nuts as soon as you open the jar. It tastes like a sweeter version of peanut butter. The biggest difference between this and Peabutter is that the taste also finishes nicely. I found Peabutter to have left a bit of a strong pea aftertaste (yes, I know that it is made from peas!) Sunbutter has a rich, nutty taste that lingers on the palate beautifully. I do think it is a touch sweet for my taste, but it is something I could eat daily.

Texture: The texture was more similar to a richer peanut butter and it is creamy enough for those who prefer highly processed peanut butters.

Price: Sunbutter is expensive. In fact price is the only real drawback I could find. We paid CDN $8.49 for a jar which is quite high. In fairness, grocery items can be very pricey at our local health foods store. We'll price it elsewhere as well. (Update: We have found a cheaper supply!)

Ingredients: The ingredients are acceptable. Like most peanut butters there is added sweetness, via cane juice in this case. That being said, the sugar only total 3 grams per 32 gram serving . In addition, Sunbutter is higher in protein, appears to be lower in sugar and higher in dietary fibre as compared to Peabutter. Iron deficiency can be an issue for many kids due to picky eating and Sunbutter helps there as well, providing 8% of the daily value for iron.

Overall: Overall Sunbutter passes the test for those who have to remove peanut butter from their home due to a peanut allergy. I would recommend this as a peanut butter replacement for any taste and I will certainly buy it in the future myself. Now I just need to find a less expensive place to buy it!

Villager Of The Month - May 2007

2007-05-18T20:42:00.000-07:00

This week was Food Allergy Awareness Week. In honour of this FAAN initiative, I have decided to add novel content to the the blogosphere. Earlier tonight I posted the announcement of my new "NoPeanuts Site Reviews" series.

The second addition to the site will be the Villager of the Month 'accolades'. You have seen the phrase "It Takes A Village" used on this site to refer to the fact that parents of allergic children cannot manage the allergy entirely on their own. Other people will at times relied upon in an emergency situation. Teachers, caregivers and friend alike could find themselves in this situation while the child is under their care.

Intended as a 'thank you' on behalf of the food allergy community, the 'Villager of the Month' will have done something interesting, special or courageous to help those with food allergies. I encourage my visitors to nominate people by posting comments or emailing me (address is in my profile).

In honour of FAANs initiative this week, I decided name my first Villager Of The Month (for May 2007) based on the contribution they made to Food Allergy Awareness Week.

One contributor was the Elliott family in Nevada who chose this week to launch their new line of products under the NoNuttin' brand.

I also thought it was pretty cool for a 13 year old in PA to write to her local editor and promote Food Allergy Awareness Week with a personal letter. In our own way we can all make a meaningful contribution.

Gina Clowes of AllergyMoms posted a list of great ideas of things you could do to make a difference this week.

Villager of the Month
The first recipient of the Villager of the Month accolade is Ria Sharon of CheckMyTag. I have seen Ria everywhere this week. I visit many sites in my 'rounds' and over the past two weeks I have noticed numerous cases of Ria posting comments promoting Food Allergy Awareness Week. She also posted a great collection of stories about food allergy on her blog, stories she collected from other bloggers and friends specifically for this occasion. Her efforts were creative and made a valuable contribution to food allergy awareness. Ria has a line of alert products for allergic kids. The business is about a year old and was started after her 13-month-old had an anaphylactic reaction.

Congratulations and thank you Ria!

NoPeanuts Site Reviews

2007-05-18T18:50:00.001-07:00

I am launching a new series on NoPeanutsPlease.com. The series will be called 'NoPeanuts Site Reviews' and it will review other allergy sites. I have several categories with which I shall endeavour to 'rate' the sites. I am then going to give them an overall rating of either 'Peanuts' (ie: not good) or 'NoPeanuts' (ie: allergy free!)

Here's how you can help ...
I would like to generate a list of sites that you either really, really like or else those that you believe should have no place in the cloud.

Please post your suggestions as a comment to this post or else email me (address is in my profile).

Allergic To Raw Poultry

2007-05-17T21:19:00.000-07:00

This week I had food poisoning. It is interesting how many small parallels there are between food poisoning and food allergy.

On Sunday I came down with a severe fever. It was out of nowhere and for almost 2 days I had a fever of 103 and could barely open my eyes due to the headaches. I recognized the symptoms as food poisoning based on prior experience.

It was surprisingly easy to locate the likely source of the food poisoning. Based on a review of a Canadian Food Inspection Agency site I isolated the likely culprit: campylobacter. This is a bacteria related illness that typically comes from raw poultry. The symptoms were exactly aligned with what I experienced.

The only thing I ate that my wife did not eat all weekend was a BBQ burger at an outdoor block party. I do recall that the young man working the grill had ground chicken burgers on one grill and burgers on the other. My guess is that he had two grills with one set of tongs.

Though this is not even close in severity to a lifelong food allergy, one interesting parallel will be the close attention I pay in future to how the block party burgers are being flipped. There will be an element of fear, even if small, and that is something that the food allergic are forced to deal with at every meal. In addition, similar to an allergy the serious reaction is attributed to a microscopic irritant whose source cannot be identified with 100% accuracy.

I am feeling much better on Day 5 of my ordeal but I am not out of the woods yet. It has been interesting to see the allergy parallels this time around.

'Overstated' Is An Overstatement

2007-05-17T18:55:00.000-07:00

I've read one to many articles this week touting that "Peanut Allergies Are Overstated". I posted about this already this week but I think another post is in order. In my Wheal Deal post I blogged about the fact that the Australian research does not appear to be novel in its findings, though it does reaffirm findings of prior studies which is useful.

Upon seeing this article over and over in the press, I have developed more of a concern with the press coverage than the actually study. My concern with the press coverage is on three levels.

1) The articles should be more explicit in explaining to parents that 70% of these kids ARE allergic to peanuts and that an oral challenge is a very serious matter. It needs to be done in a hospital. The risk is that skeptical parents do their own oral challenge at home.

2) Since 80% of kids outgrow a peanut allergy, it is possible that in the interval between the skin prick test and the peanut challenge the allergy may have resolved itself. I will follow up to ascertain the average duration for this interval.

3) This might be a stretch, but if a child has never eaten peanut would a skin prick test serve as the introduction of the antigen? ... or would it take oral consumption? If it is the latter then would it not be possible for the oral challenge to introduce the peanut allergy and actually sensitive the child to peanut? Again, I suspect this is a stretch but I am just trying to think it through logically.

I also took exception to Dr. Wainstein's comment that safe daily peanut consumption rendered allergy testing irrelevant. The statement may be true but the term 'irrelevant' just serves to make the article a touch more sensational. It contributes nothing of substance.

I have been very disappointed in the way this story has been communicated to the public. It is just the type of story that the Peanut Doubters want to see and it risks giving false hope to parents of allergic kids.

Kids' Allergy Video

2007-05-16T23:53:00.000-07:00

This is a great video that shows kids talking about their food allergies. It is powerful to watch these kids. Our daughter is just starting to grasp the concept of an allergy and it gives me hope to see kids just a couple of years older talking about managing their allergies.

Our daughter recently turned two and though she says 'No Peanuts Please!' and that peanuts, eggs and doggies 'make me sick' she is not yet able to fully grasp her allergy.

It did bother me to hear over and over how these kids wish they didn't have the allergy. We wish they didn't have these allergies either!

Allergy Donors NOT Wanted

2007-05-16T22:57:00.000-07:00

NoPeanutsPlease was recently quoted on another blog and it generated over 100 visits in just three days. I was impressed. The blog's author, Moreena, has a challenging parenting situation in that her six year old daughter has had multiple liver transplants and often has a suppressed immune system, which presents a significant risk for infection. Frankly, managing a severe peanut allergy seems to be somewhat less of a challenge, though being thorough and prepared is likely a consistent theme for both groups of parents.

In an off-blog exchange with Moreena, she noted that she became familiar with allergy discussion boards due to the number of transplant recipients that also inherit a food allergy from their donor. This reminded me of an article last week about a Scottish woman who picked up a severe peanut allergy via blood transfusion.

It never occurred to me that this would be a risk but it does make total sense given that the IgE antibody is found in blood serum. It seems that the antibody is able to make itself right at home in new surroundings! Here is an excerpt from the article:

"It is believed to be the first time a severe food allergy has passed from one person to another through donated blood. The 80-year-old patient was given blood ahead of minor surgery ... Two days later she ate a muffin with peanut butter and became ill within minutes with anaphylactic shock. Her throat closed, she was struggling for breath and she had difficulty swallowing. Doctors immediately injected her with adrenaline and steroids to halt the potentially fatal reaction.

"... When they checked the records, they found the blood had come from a 19-year-old female patient with a history of severe allergic reactions to nuts ... The National Blood Service said it does not test donated blood for allergies. Allergy sufferers are allowed to give blood as long as they are not suffering any symptoms on the day."

I find it incredible that this has not been recorded before, especially given that the Prausnitz-Küstner reaction was documented 85 years ago! I wonder how many adults who 'developed allergies later in life' actually received them via a blood transfusion or organ transplant? I suspect not all of them but it does beg the question.

Seems that screening would be a good idea. An amazing future scenario might see an organ recipient being forced to choose between waiting for a matching organ that is allergy free, but might never arrive, or accepting an available organ from a donor who has severe anaphylaxis to five or more major allergens. I suspect in just about every case the patient would still take the organ, but it does present an interesting medical quandary.

Sometimes I am struck by how little we know about severe food allergies. Our lack of information is simply unfathomable. Though I am not enamoured with the circumstances of my involvement in this issue, I have to admit that I find anaphylaxis to be absolutely fascinating.

The Wheal Deal

2007-05-15T21:58:00.000-07:00

Today researchers from Australia announced their discovery that up to a third of children who tested positive to peanut allergy on a skin prick test did not react to an oral challenge. This is somewhat encouraging to parents with children that have been diagnosed as peanut allergic via skin prick test but who have not had a known allergic reaction. There is a chance that their child is not actually allergic ... wouldn't that be great!

I would not recommend that skeptical parents do their own oral challenge as the reaction could be fatal! In this study, the oral challenges were done carefully and in the presence of trained medical professionals. When the challenge data was compared to the skin prick data the researchers noticed that the children who had a positive skin prick test and a negative challenge all had wheal diameters below 13MM.

This is not a new discovery. As seen on Dr. John Weisnagel's site, studies have indicated this correlation before, for example a June 2002 study noted that "the performance characteristics of the skin tests were superior using raw extracts because the negative predictive value was 100% (if the wheal diameter was less than 3mm, they could be quite certain the child was not allergic). On the other hand, if the wheal diameter was larger than 3mm, the predictive value was only 74%. If the skin test wheal was 16mm or larger in diameter, the predictive value was 100% that the child was allergic.

There is indeed a strong correlation between a positive skin prick diagnosis and the results of the oral challenge, albeit less than 100%. In the majority of cases, a positive skin prick test does correctly indicate that the child has an allergy. Parents should consult an allergist before making a decision to confirm or refute the skin prick diagnosis with an oral challenge. It's best to err on the side of assuming that your child does have the allergy unless proven otherwise.

Happy Mother's Day!

2007-05-13T20:44:00.000-07:00

Happy Mother's Day to all the moms out there who frequent NoPeanutsPlease.

Not even Mother's Day went by without an allergy incident in this house. I made dinner tonight. I had a beautiful Chianti that I wanted to pair with a nice pasta dish. By now we are programmed to research before feeding anything to our daughter, especially when nuts or legumes are involved.

I love pesto. I was thinking that a pesto pasta would be nice and though we believe that our daughter is okay with pine nut I double-checked online to make sure that there was no specific issue. This is what I found:

"Peanuts are sometimes used as a substitute for pine nuts in food products such as pesto, so people who are allergic to peanuts should be very careful about eating foods traditionally made with pine nuts."

Oops. I opted for a creamy herb sauce with chicken and roasted peppers.

Shell Game

2007-05-13T20:21:00.000-07:00

Another weekend, another allergy scare. We've been on a roll lately it seems.

I play in a touch football league here in Vancouver and my wife takes the kids to games whenever the field has nearby playground equipment. During the first half of this week's game our daughter was playing near the swings when she came over to my wife with something in her hand.

My wife casually looked down to see her holding, of all things ... a PEANUT SHELL!

Turns out that (I'm guessing) some kids might have been in the park the night before, eating peanuts while sitting in the swings. They left the shells on the ground. I try not to judge people's actions. I was a peanut eater before December and you just don't think twice about that pile of shells you leave at the football game, hockey game, etc. It is simply a lack of awareness.

This time around we were lucky. There was no reaction at all this but we did give her Benadryl and play the fearful waiting game. For the rest of the morning even the slightest little facial blemish looked like a 1cm wheal!

It's virtually certain that you'll see somebody eating a bag of in-shell peanuts someday soon. Consistent with cultural practice, they'll likely be throwing the shells on the ground. Please ask them politely to throw the shells into the trash. They'll likely be unaware of the potential danger to an allergic child.

It Takes A Village.

Thai-ing To Remember

2007-05-10T06:53:00.000-07:00

My wife and I have already agreed that our the next time we are away without the kids we are having Peanut Butter toast and a huge omelet. For at least ten years I ate peanut butter for breakfast every morning. Many of those mornings I also had eggs. I am struggling a little with my fruit smoothies and oatmeal, though both are certainly great. I still haven't found Sun Butter but apparently that might be a solution.

The irony is that the peanut butter was easy to cut out of the house since it was right in front of me every day. It has been harder to break old habits such as eating Thai food. We used to order Thai at least twice month but of course that stopped once we discovered our daughter's allergy.

Thai cuisine might be the earth's single biggest supporter of peanut on a per-staple-dish basis. They put peanuts in everything.

I have blogged before about how it is not reasonable to expect a Thai restaurant to be peanut free, and I have seen why first hand. I am currently on a training course and last night our team had work to do in the evening. Once tummies started to rumble we ordered out. It was natural instinct to suggest Thai ... it's easy, many people like it, etc. As I began to order I remembered why I had not eaten Thai since December 2006.

As I placed my order I remembered that the Chicken Skewers had peanut sauce and the Pad Thai contained peanuts. The team seemed intent on Thai and my daughter was not around so I figured I'd just go ahead and order and make sure I did not have any peanut. I requested that the peanut sauce be left out and did not order the Pad Thai with peanuts.

So naturally when the order arrived I had double peanut sauce and for some strange reason they included a cup of crushed peanuts for me to use as a topping. Clearly something was lost in translation. I threw out the peanut toppings and tried to remember to wash my hands and face when I arrived home later that night.

When I walked through the door my daughter stirred and I went in to give her a kiss. Oops! I did not wash my face before doing so. Even though I did not knowingly eat peanuts, my default to the worst case scenario left me very worried about cross contamination. I went into her room every five minutes for an hour to make sure I did not bring home a peanut treat.

Everything was fine but for an hour I sat in my chair waiting for the worst to transpire.

Pathfinder Leads The Way

2007-05-02T23:18:00.000-07:00

This is just the story I needed to read tonight. After our daughter's anaphylactic reaction this week and today's unfortunate incident I needed a feel-good story. I needed to read something that would remind me of the many, many people out there who are focused on helping our daughter. I found solace in the story of David Dockendorf, principal of Pathfinder K-8 school in Seattle.

Typically when parents of allergic children push for better anaphylactic policy or (God forbid!) a peanut ban, they are met with resistance. Not the case at Pathfinder! Machel Spence has a second grade daughter in the school and when she raised concerns about the schools level of preparedness for an anaphylactic emergency, this is the response she received:

"The principal, David Dockendorf, was very quick to respond and after their meeting was completed with the nurse and staff he sat down with me and shared his list of steps the school was going to take to make my daughter's school environment a safer one. The school nurse, Terri Helm-Remund, was also very responsive to my concerns and within days there were signs all over the school, a separate nut-free table in the lunch room for my daughter and her friends who bring nut free lunches and an article sent home to all Pathfinder parents to read asking them to avoid peanut products for snacks in the classroom as well as bake sales."

This is great. Though I do not see mention of the school purchasing EpiPens, providing teachers with emergency response training or educating students that there are several allergens that can create a fatal allergic reaction, I will take comfort in the fact that Dockendorf was so responsive and caring in his approach.

It Takes A Village and clearly Pathfinder is showing the way!

Peanut Butter Family

2007-05-02T14:57:00.000-07:00

Today my parents tagged along for our daughter's weekly gymnastics class. The instructors have been great with the allergy and we've not had any serious issues to date.

This morning a new set of classes began and, per standard practice, we made sure that the other children, parents and nannies knew of our daughter's allergy. The instructors made an announcement and as always, the class was without incident.

After class our daughter made her way out to the foyer to get her coat and the Peanut Butter Family decided it was snack time. Parents, kids and Grandma all had peanut butter sandwiches and when Grandma caught our nanny's eye she sort of smiled in a way that suggested, 'what's the big deal'?

I understand that others cannot be expected to think proactively about our daughter's allergy. It is our responsibility. That being said, upon seeing our daughter they should have shown us the courtesy of putting the sandwiches away given that they had just heard about her allergy. This type of passive aggressive behaviour in response to our daughter's allergy bothers me.

Fittingly, as the family left one of the kids polished off his sandwich and innocently slid his hand along the rail as he ran down the stairs. One of the toughest things about the allergy is its ability to replace the joy of watching a child happily playing with the invisible terror of microscopic peanut proteins that might not even be present.

It's amazing how different the world looks when you're managing an allergy.

Dear Grandma, "It takes a village".

Bill M210 Update

2007-05-01T21:25:00.000-07:00

As you recall, Bill M210 is making its way through the legislative process here in British Columbia. I recently posted about the bill and also how you could help. Titled the 'Anaphylactic Student Protection Act 2007', the proposed law would make schools a safer place for allergic children.

On May 7 Sara Shannon will be in attendance at the BC Legislature. David Cubberly, who has put forth Bill M210 will introduce Sara and tell the story of her daughter Sabrina, who left us several years ago as a result of an anaphylactic reaction in her school.

We are all hoping that Bill M210 does make it to its second reading on May 28. For that to happen we need the support of the Liberals who have a majority government. Through my network I have personally contacted 10 Liberal MLAs including 4 ministers.

Here is the text of the letter I sent:

Dear _________,

I am writing to you in an effort to build support for the "Anaphylactic Student Protection Act, 2007" as tabled by MLS David Cubberly in March 2007.

This past December our 21 month old daughter had an anaphylactic reaction to peanut. It was terrifying. She did not actually even eat a peanut - she ate a gingerbread cookie that came in contact with a peanut butter cookie from a friend's Christmas baking exchange. Within 60 seconds she was covered in hives and losing her ability to breathe. Without the quick response of the paramedics we may have lost our little girl.

Just this past weekend our daughter was rushed to the hospital again. Without my wife's quick response, including the administration of an EpiPen epinephrine auto-injector, there is no way to know how far this allergy would have progressed.

It has been said that one of the hardest things about anaphylaxis is convincing non-allergic people in our daughter's life that this is real. As we have all seen with the tragic death of Carley Kohnen in British Columbia recently, these allergies are very real and very dangerous.

In an effort to mitigate risk, we have educated ourselves on the allergy and rid our home of peanut products. That being said, there are others in the community that we will come to rely on heavily for our daughter's safety, especially the staff in our schools. In many cases emergency response is required in a matter of minutes and without without clear emergency preparedness policy and procedures out daughter is at risk of a fatal reaction.

In his first reading of the Anaphylactic Student Protection Act, 2007, MLA David Cubberly mentioned the case of Sabrina Shannon who died at school after an anaphylactic reaction. There are many other cases just like hers. These children face considerable risk in a school environment but through awareness, policies and emergency response preparedness this risk can be significantly reduced.

People often say that this only affects 2% of the population but that is simply not true. These children have parents, friends and relatives that would be devastated should they have a fatal reaction. I would like you to consider this math ... if the the death of an anaphylactic child directly affected even 20 friends and family members in the community, then it is reasonable to estimate that over 40% of your constituents are directly and positively impacted by this legislation. Anaphylaxis is not just the concern of a small, vocal minority. It is becoming pervasive in our community and this will only increase given that the incidence of food allergy growing at an alarming rate.

I ask that you to support the "Anaphylactic Student Protection Act, 2007". It is sensible, pragmatic policy that will save the lives of children. There is also considerable support for the implementation of this policy. Organizations such as Anaphylaxis Canada have deep experience in supporting schools with education and safety programs. They would be eager to help. Teachers, principals and staff will not be left alone.

It takes a village to support children with anaphylaxis - you would do these kids a kind service by voting in favour of this bill.

Thank you in advance for your support ... and for your vote!

Did This Blog Save A Life Today?

2007-04-28T20:46:00.000-07:00

Today our daughter had her second anaphylactic reaction. It was truly another formative experience. What was scary this time however is that we do not know for sure what caused the reaction. In December we isolated the cause to be peanut, her peanut allergy subsequently being confirmed by our allergist. This time we do not know what happened, which is more frightening than the emergency situation itself.

Anaphylaxis is an invisible condition. Your child goes from perfectly fine, to near death and then quickly back to being okay within minutes. It's crazy to watch and not being able to pinpoint the allergen makes it even more frightening.

We think it might have been a dog this time! Our daughter is allergic to dog saliva - wheals appear when a dog licks her face. This is tough as our daughter loves 'doggies'. A few of our friends have dogs and initially they did not really understand how serious the reaction was. Once our daughter had her peanut reaction in December our friends usually have the dog out of the home when we come over out of concern. They have been very accommodating!

Today our daughter ran her hand down a dog's coat before we could stop her. We think she then touched her eye. Within 10 minutes her eye had swollen shut, wheals appeared on her face and she started to get serious swelling down the side of her face and under her jaw bone. I was not with her at the time and my wife was amazing in this critical moment.

My wife did not hesitate to use the EpiPen. My mother happened to be in town and helped my wife prepare the EpiPen for the injection. In the interest of full disclosure, my mother was the Teacher in the It Takes A Village series. She spent her whole career fearing a scenario just like this. Instead of facing an anaphylactic episode with a student, she was forced into a potentially fatal emergency situation involving her granddaughter.

My mother and my wife were incredibly calm and effective in the heat of the moment. They quickly and calmly administered the EpiPen, became emotional only after the reaction started to subside. It is very difficult to check your emotions and deal with the situation objectively when so much is on the line.

Once I arrived home I made sure my daughter took a little more Benadryl as the swelling had returned. We then rushed her to the hospital. I called 911 on the way to let them know what was going on. Out of concern for my ability to drive safely under the circumstances, 911 asked me to pull over and they sent an ambulance. Though I knew I would be fine I thought it best to not second-guess 911 so I pulled over. For the second time in a row the paramedics were amazing, arriving within 5 minutes and creating an overwhelming sense of calm. Though the reaction was not nearly as bad as the peanut response, the standard three hour wait in the ER was prescribed to make sure that the reaction safely subsided.

The paramedics and doctors were very impressed with the use of the EpiPen. They noted that all-too-often parents bring in a child without the EpiPen being used, often toting an unused EpiPen. The Emergency Room doctors have these parents administer the EpiPen in the ER under supervision, all the while coaching them to do this right away next time. The doctors reinforced the fact that you have to act quickly and that many parents just cannot bring themselves to drive a needle into their child's leg.

Bottom line: you simply have to do this!

My wife said afterwards, "If I hadn't heard so many stories from other parents through the blog, I can easily see how difficult it could be to use the EpiPen. You don't want to believe that the reaction is as serious as it is. You don't want to believe the situation is truly life or death. It would be easy to convince yourself that a good dose of Benadryl and a hug would be enough to make her better and that using the EpiPen is only for the greatest of emergencies. Being exposed to the experiences of other parents gave me confidence to use the EpiPen without hesitation. There was no questioning the use. It was simply the next step.

I credit the blog for giving me the confidence to use the EpiPen. It was awful to inject the needle into her leg but I knew I needed to do it. Before today I really wanted to believe that the first reaction was an isolated incident. I would never have driven a needle into my daughter's leg if I did not know about cases where children were lost due to a delayed response. Though we'll never know for sure, it is possible that today I saved my daughter's life and I credit our blog for that."

I agree with my wife that writing and discussing the blog played a major role today. She was calm and knew exactly what to do. She was also reassured by my past blog posts about the fact that these reactions are (unfortunately) commonplace for children with multiple severe allergies. Avoidance is never going to be absolute so it is critical to be prepared for an allergic reaction.

Our daughter was again a brave little girl today. It was very interesting this time to explain to her why Mommy drove a needle into her leg. She now understands that doggies make her sick. Her ability to communicate is going to be a great ally in managing her allergy ... she already says 'No Peanuts Please' when she sees cookies or other food and 'Doggies Make Me Sick' is now added to her list of phrases.

Today was a very tough day but it is comforting to know that we were ready. We acted swiftly and with confidence. Though you never want to see your child in a life or death situation, today we learned a lot about ourselves. It is very satisfying to know that we are able to execute our anaphylaxis emergency response plan.

Let's hope these skills are not needed again any time soon.

Not Soy Good

2007-04-21T01:27:00.000-07:00

As I sifted through my gmail tonight I found a message from Robyn at AllergyKids. The article discussed recent research into the possible link between soy allergy and peanut allergy.

The researchers urge parents of peanut allergic children to eliminate soy from their childrens' diets as well. "Some sensitive children have "hidden" soy allergies that manifest for the first time with a severe -- even fatal -- reaction to even the low levels of "hidden" soy commonly found in processed food products."

This is concerning. We make smoothies all the time that include tofu and our daughter has eaten edamame on many occassions. Though the article does not give a percentage as to the proportion of peanut allergic children who are also allergic to soy, the new information on soy is a cause for concern.

As is the case with many aspects of managing our daughter's peanut allergy, we have little choice but to take this seriously and remove soy from the home. We'll also have to do additional research into soy.