Monday, September 15, 2014

The food allergy reaction

I mentioned in my last post that my father and stepmother came to visit me in August. The last night of their stay, we ate out for dinner as a family at the Mongolian BBQ. At the restaurant, I allowed our son to take something off the ingredient buffet that he ultimately had an allergic reaction to. It was a veggie patty and I mistakenly assumed that it was just vegetables. When Bry pointed out that sometimes those are held together with egg depending on the brand, I asked the waitress for the ingredients.
Contains: Soy, Egg, Wheat, and Milk ingredients
Now, as an allergy mom, I am very used to checking ingredients and reading labels. Why I didn't this time, why I wasn't more cautious, I can't say. This whole incident is something that I've beaten myself up for quite a bit in the last couple weeks. Our boy ate three bites of his dinner and and pushed it aside. His face got flushed and he started saying that he wanted to go home. He started vomiting right there at our table inside of 15 minutes of eating that third bite of dinner. The waitress and manager were understandably scared, but I assured them none of it was anyone's fault but mine. We all left the restaurant as quickly as possible to get him home so that we could give him some allergy medication; he threw up again twice more after we got him home. This reaction happened on a Friday. On Monday afternoon, we were in the allergist's office getting a prescription for an Epi-Pen and ordering some blood tests (to update his chart from two years ago). I've written about having a food allergic child in the past, and in that post I said, "Finding out what allergies your child has in a doctor's office is not nearly as distressing as finding out by accident." We learned about his egg allergy in the office so we had no idea just how violently he'd react until this incident.

Why an Epi-Pen? Our son did not go into anaphylaxis, which is what an epinephrin auto-injector is meant to help control. On the night of the incident, after we'd gotten home and gotten some Benadryl into our boy, I called my friend Taty; she's an allergy mom too and we support each other. When I told her what had happened, and described the reaction, the first thing she asked me was whether or not I was going to get him an Epi-Pen.
I had thought about it, but then again, he's never had airway issues before... She told me that just because he's never reacted with airway symptoms in the past, doesn't mean it may not someday happen. So when I talked to the allergist the following week, he agreed that an Epi-Pen would probably be a good idea. We were prescribed an Epi-Pen Jr. 2-Pack with each auto-injector containing 0.15mg of epinephrin (the adult version, with a yellow label, holds twice as much). One of the two-pack is at our son's school in the office and the other I keep at home or carry in my bag as needed. I debated pretty hard the issue of keeping the Epi-Pen in the school's office versus having our boy self-carry, but ultimately I decided that 1st grade might be a little young for self-carry. If he had a contact allergy, meaning that skin contact would cause a reaction, I might have reconsidered. His reactions are ingestion-only, meaning that he actually has to eat the offending food in order become symptomatic.

Epi-Pen's are not cheap, but frankly I think they are worth it. I would rather pay for them and never have to use them rather than need them and wish I had bought them. In the Mongolian BBQ restaurant, I had nothing. The waitress who had been serving us offered to see if there was any Benadryl and went into the staff area to check if anyone had anything we could use, but they didn't. We had to drive almost 20 minutes to get back home for some Benadryl. If I'd had my head on straight at the time, I'd have told Bry to drive to the nearest Rite Aid, CVS, or Walgreen's instead. The feeling of facing an emergency and being so unprepared is one of the worst.
Not a valid coupon
In addition to the Epi-Pen, I now carry children's Benadryl tabs that dissolve on the tongue. So, after telling my friend Taty the update on the getting the prescription for an Epi-Pen, she told me where to look for a coupon that will cover the co-pay, making the whole thing cost $0. Well, it will if you have prescription insurance that deals in co-pays. Ours unfortunately is not that kind. We have a health savings account from which we pay for everything medical, from doctor's bills to prescriptions to OTC medications. Which means in my case, the coupon was good for $100 off the total cost. Hey, $100 is nothing to scoff at, and I'd prefer having the discount to not having it...but another way of phrasing it might have been to say, "33% off your prescription". I know right? I wasn't kidding when I said they aren't cheap. I'll say again: I would rather pay for them and never have to use them rather than need them and wish I bought them. And I'll add: What price do you put on peace of mind?

I'd love to say that this was the only food allergy issue we had this summer, but it wasn't. Bry brought home fresh peaches from the local farmers' market one Saturday and later that night our son says to me, "Mommy, I can tell I ate too many peaches because my tongue feels soft." With that statement, he had my immediate and undivided attention.
Source: Food Allergy Research & Education (FARE)
I've done a lot of food allergy reading since he was originally diagnosed, and one of the things that's stuck in my mind all this time is a list of ways a child might describe an allergic reaction. From looking at the list on the left, you can see that our son described his reaction almost verbatim. The first thought in my mind was, "Oh no! Not another one!". A food allergy to peaches? Fruit allergies are actually more common than people realize, but the answer in our case was OAS - Oral Allergy Syndrome. I did some reading online about it, after talking to the allergist. It's like a food allergy, but not nearly as serious. An OAS reaction will only ever be to a fruit or vegetable, so nothing like eggs or milk. An OAS reaction will only occur in the mouth, so no hives, gastrointestinal discomfort, or airway issues. An OAS reaction is only to the raw version of the fruit or vegetable, but once the food is cooked, the reaction will not occur. Apparently, the OAS reaction is the body's own heat breaking down the proteins in the fruit or vegetable which is why eating them raw is the problem. Cooking the fruit or vegetable breaks down the proteins during the cooking process instead. If I were to take the peaches from the farm market and bake them into a cobbler, he could eat that. If I were to buy pasteurized peach juice, he could drink that. But I don't have time for cobblers and I don't buy juice, and as of this summer, I no longer buy peaches (or plums, or nectarines, or apricots just to be safe). I think what annoyed me the most about this OAS development, is that I had to update our son's med-alert bracelet...after having just bought a brand new one for him two months earlier.

After dealing with two separate food allergy issues for our oldest son this summer, I made an appointment with our allergist for our youngest son as a new patient. His appointment isn't until October. I had put off making him an appointment all this time, even knowing food allergies run in our family, just because he's so young; he's only just 2.5yrs old now. Skin testing is...uncomfortable at best, and little kids just don't understand why their back has been pricked 24 times over. I've wanted to spare him this as long as possible, but after this summer, I just don't want any more surprises. I feel like it's very important that we know what all our youngest is and isn't allergic to.

Best advice: If you deal with food allergies and don't already carry some kind of medication for it regularly, start. This Zumbamommy learned a hard lesson this summer.

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