Life has been so hectic!

I started a new job, so I am now a full-time working mom a.k.a a woman that always tired and has no free time. I'm working on adjusting and getting more organized. I miss blogging, among other things, and I'm trying to figure out how everyone else does it all.

In the world of food allergies there is a lot of news.

First - I did a training at the PHELC Conference entitled Food Allergies in the Day Care Setting. It was well received by everyone. To be honest, I was a little surprised by how misinformed so many of the day care providers were (are?) about food allergies. Almost all of them had at least one food allergic child in their care, but only one (out of 70+) had a food allergy action plan on file. ONE! Thankfully, they took our class, and now they are more informed. Hopefully they will implement the techniques and strategies we gave them in the class, and make their centers safer for all of the children.

Second - The holidays are here. So please be kind and patient with us PLFA's- people living with food allergies. The holidays can be quite a challenge for obvious reasons, and a lot of people just.don't.get.it.

Third - I'm thinking about starting a local group for parents of kids with food allergies. I'll keep you all updated.

Happy Holidays!

My sister-in-law put me on to this show. Here's a clip...

Accidents Happen

Two mornings ago, I got up and gave my son a bowl of cereal. With cow's milk.

Usually, I don't even have cow's milk in my fridge, but my niece is here for the summer and so we have milk for her. I'm not even sure how I made that mistake, but I did. I poured the milk in bowl, gave it to him, and he ate every drop. And when he asked for more, I opened the fridge and realized that the soy milk was too far back for me to have moved it that morning. It was then that I realized I had given my son the wrong milk. I got him another bowl of cereal, with the correct milk, and gave it to him. And he ate it all, despite the fact that by this time his eyes were red and swollen, his face was red and he had already started breaking out in hives. He was scratching and eating cereal, and I felt like the worst parent on the planet. I got the dye free children's allergy medication, and gave him the "mommy doesn't want to use the Epi-Pen or go the ER so this better work" dose. It did. Thankfully.

He was still red and itching for a while, but that is manageable. We went to the doctor that afternoon, and I told her about my mistake. She asked me how it happened, and then called in a script for a stronger medicine, just in case. She totally understood my desire not to use the Epi-Pen unless he really needed it (like he can't breath) but she also reminded me not to be afraid to use it if he does need it.

Crisis averted. Baby safe. And a big thank you to all of my friends and family members that reminded me that mothers make mistakes, ALL of us.

Yay! We made it through a week at day care without any reactions.

In the end, I decided to send all of his food. I was, obviously, concerned about cross-contamination, forgetfulness and accidents, but after reading their menu I was less than impressed. Here's what the students ate one day this week:

Breakfast: Cheese grits, toast with jelly, pears, milk
AM Snack: Cinnamon buns, grape juice
Lunch: Hamburger on bun, roundabouts (tater tots), pineapple, milk
PM Snack: Chex Mix, Orange Juice

Here's another day:

Breakfast: Rice krispies, sliced bananas, milk
AM Snack: Cheese toast, grape juice
Lunch: Ground beef & cheese pizza, corn, Fruit Toss, milk
PM Snack: Chocolate Chip cookies, orange juice

On those two days, my son could have eaten pears, grape juice, roundabouts (if they made his separately), the hamburger without the bun, sliced bananas, and corn. Yeah.

Aside from that, I was less than impressed with the nutritional balance of those meals. Where are the veggies? The juice is not even fruit juice, it's a powder mix similar to Kool-Aid. Cinnamon buns and chocolate chips cookies as regular snacks? Don't get me wrong, my son eats cake and cookies and other junk food, but not multiple times a week. Those are treats, and they would be even if I didn't have to find dairy-free ways to prepare them. But he also eats, and loves, things like carrot sticks, peaches, bananas, and spinach. After looking at that menu, I completely understood why some of you send your children to day care/school with their lunch. Most people wouldn't even see anything wrong with this menu, as evidenced by the fact that this center is full of children eating this food every day.

What do you think? Is this standard fare at day care centers? Would you be satisfied with this menu? Do your children eat like this anyway?

Day Care

For the past two years, I have basically been a SAHM (Stay at Home Mother). I work as a tutor, but that takes place in the afternoon and on weekends between October and March, and during those times my son always stayed with a family member. Next week, my son will be going to day care. As of right now, it is only for a week, but it might become a long-term thing, depending on my work situation. And I am a little nervous.

Thankfully, my mother teaches Pre-K in this center. Actually, that's the reason he's going there, because my mother will be in the building, and she knows his teacher and the type of environment he will be in all day. I personally prefer home/family day care for young children, but in this case the center is the better choice. This center has a kitchen, so as part of the cost the children are fed two meals and two snacks a day. Obviously, my son can not eat all of the meals they prepare, but he can eat most of the fruit, and things like potatoes and juice. Initially, I was going to supply ALL of his food (including snacks and drinks). But the woman that runs the kitchen is really willing to work with me, and has begun the process of looking up ingredients so we know what is safe for my son. And, it would save me some money not to have to provide everything, especially considering that day care is quite an expense.

So now I have a decision to make. Do I pack all of his food or just some of it? Should I let him eat food from the center, keeping in mind that the likelihood for cross-contamination or accidental exposure goes up, even if he is only eating "safe" foods? Or should I err on the side of caution, and not take the risk? Does it make a difference that my mother is in the building (not the room)? Or that my younger sister babysits for the woman that runs the kitchen, so she has a slightly personally relationship with family? Do those things affect how cautious and careful she will be when making his food?

I know that I might sound a little paranoid. But this is my child. I know adults that think milk allergy=lactose intolerant. People have told me that food allergies aren't "real". (You think so? Tell that to families of the 150 people in the US that die of food allergic reactions every year.) I've had people earnestly offer yogurt or cheese, knowing that he has a milk allergy. Or cookies and cake. Oftentimes, they just don't know...or think things through. And so I have my reservations about trusting other people to feed my son. But, I also recognize that I am in a position to educate, which I am willing to do. Having my mother in the building and knowing the cook might make it easier for me, safer for him and maybe I can educate more people about the realities of food allergies.

Ah, decisions, decisions.

E-training

The ASCIA offers a free anaphylaxis e-training. If has been specifically developed for school and childcare staff, but parents, friends and patients are also encouraged to take it brush up on their skills and knowledge. I haven't taken it yet, but I will post an update after I take it, which will hopefully be this weekend. Click on the title or the link below to check it out.

Anaphylaxis E-Course Link

WebMD and food allergy prevention

I read an article on WebMD the other day about preventing food allergies in subsequent children when one child has already been diagnosed with food allergies. This is a topic that concerns me for obvious reasons, as my son has multiple severe food allergies. So far, most of the information I've read has been conflicting and inconclusive. The basic debate is whether or not pregnant women should utilize avoidance measures to prevent food allergies in their children. According to the study referenced in this article, women that took avoidance measures were less likely to have children with food allergies. However, at the end of the article is the following disclaimer:

Robert Wood, MD, director of the division of pediatric allergy and immunology at Johns Hopkins University School of Medicine in Baltimore, tells WebMD that pregnant women should not feel guilty if they do not want to follow avoidance measures.

"I explain to my patients that exposure [to food allergens] in pregnancy seems to be a risk factor in some studies, but the results are not consistent. We don't have the answer," he says.

I think that for the mother of a child with one, or maybe even two, food allergies, taking avoidance measures would be fairly straightforward. But for someone like me that would have to avoid multiple foods it is considerably more complicated. Although I work hard to ensure that my son has adequate nutrition despite his food allergies, it would be more difficult for me to do the same for myself and a growing fetus. Not impossible, but difficult. And eliminating multiple foods has its own risks, which have to be weighed against the risks of the baby developing food allergies.

Unfortunately, past experience has shown me that the numbers might not be on my side. For example, the majority of women experience their water breaking with their first child while they are home in bed. Only a small percentage of women experience their water breaking while they are standing, because the baby's head acts as a cork. Very few women are in public when this does happen. I was walking around Wal-mart when my water broke, I was one of the few. Children who are breastfed develop food allergies at a lower rate and of those who do develop food allergies, they are less likely to have multiple food allergies. I breastfed my son well past his first birthday, and yet he is allergic to four of the big eight. He is one of the few. To be honest, I would be quite upset if I avoided all of those foods, breastfed, and my child still developed multiple food allergies. There's a lot to consider when making this decision.

Binky's Big Day

It was Arthur's birthday and the whole class sang Happy Birthday. He brought special treats for everyone at snack time.

Mr. Ratuburn asked Arthur to pick a friend to help pass out the birthday cookies. "Pick me!" they all shouted. Everyone wanted to help except Binky. He knew he couldn't eat birthday treats or even help pass them out because of his food allergies.

"I want Binky to help me," said Arthur. "Binky has food allergies," said Francine. "He can't help you."

Arthur smiled. "We checked with Binky's mom, and my dad made chocolate chip cookies from Cherrybrook Kitchen that everyone can eat!"

Binky jumped up to help Arthur. "The first one is for you Binky," said Arthur. Binky took a huge bite. "WOW these are awesome?" said Binky.

The class cheered as Binky passed around the cookies. When he finished, he whispered to Arthur, "Thanks. This is the best day ever!"

This is the story that was on the back of the Cherrybrook Kitchen chocolate chip cookie mix. I hope you enjoyed it, I know we did.

Yay for Cherrybrook Kitchen!

After being informed by another food allergy mama that our local Target had some peanut, egg and dairy free cake mixes, I finally got to check it out. Initially, I went to the wrong Target and was frustrated by the blank stares and dumbfounded looks of the employees when I asked if they had them. Then I went to the bigger Target (I think the employee said it was a "Target Fresh") and found them. They had a few varieties, mostly from Cherrybrook Kitchen. I chose the chocolate chips cookies because I've successfully made amazing cakes and cupcakes that he can eat (a modified vegan recipe) but I haven't found a cookie recipe that I like yet. So, we came home and whipped up a batch of chocolate chip cookies. Most of us ate one, my son ate two, and I put away the rest for another day. So, what's the verdict?

Drum-roll please...

They were good! The taste and sweetness were just right, they were quick and easy to make, and everyone liked them. They were a little "cakey", but I took them out a little earlier than recommended because I wanted them to be soft and chewy, which they were. Overall, these were a hit and something I would buy again.

Travel and Food Allergies

I read an article the other day about travel and food allergies. According to a study conducted by the Mount Sinai School of Medicine, 90% of food allergic families have not traveled outside of the US due to issues surrounding medical care and unfamiliar foods. I think this is so unfortunate.

There are a number of resources available to food allergic persons that make international travel more manageable and safe. Yes, there is going to be more work and preparation for the food allergic family. More research and perhaps luggage. But there are so many viable options for international travel.

For the newbie to international travel with food allergies, Europe is a great place to start. Good command of the English language, excellent health care (that you will not have to pay for) and an understanding of food allergies abound in many countries. I doubt that a vacation to England will be fraught with potential minefields, at least not any more than a trip to visit grandma or your buddy from college. There won't be language issues, the society is familiar with food allergies, packaged food is labeled with potential allergens, and the medical care is excellent. If the long airplane ride or the thought of being an ocean away from the US scares you, start out with Canada, then you can take comfort in the fact that you can be airlifted back to the US in no time.

Although I would not recommend a trip to a less developed country (in terms of infrastructure and medical care) for the novice traveler, especially one with a history of anaphylaxis, you would be surprised how easy it can be. The primary reason for this is that foods are generally prepared fresh daily. It is easy to eliminate potential allergens when you know what goes into everything. Go to the market. Purchase the fresh food. Cook it. Enjoy.

Of course, there are a few things that will make a trip for the food allergic family less stressful. Here are my suggestions:

1) Stay in a hotel where the rooms/suites have kitchens, or rent an apartment or guesthouse for the duration of your trip. This way you can prepare most of your meals, and you don't have to deal with the hassle of asking questions and fretting about cross-contamination at every meal. And renting an apartment of guesthouse often works out cheaper than a hotel for a family or a group of friends.

2) Get a card printed that lists your food allergies in the language of the country you will be visiting. For some examples check out SelectWisely. Be sure to give the card to waiters, restaurant managers, friends, and others that will prepare or come into contact with your food. In restaurants, insist that the card is shown to the chef. If it's feasible, learn how to say a few phrases, like "I have a life-threatening allergy to peanuts" in the language(s) of the place(s) you will be visiting. If you have multiple allergies, talior your phrase to meet your needs. I have learned how to say "My son can not eat that, he has food allergies" in many languages.

3) Do your research! Depending on your allergy, some countries will be more difficult than others for you. If you are just venturing into the world of travel with food allergies, avoid going to countries where your allergen is a diet staple. You can always go on your next trip. For example, if you are allergic to soy, China might not be your best choice for a first trip. Also, try to find out in advance if there are local restaurants and grocery stores that are food allergy friendly, or will make your life easier (i.e. Vegan if you have a dairy allergy). A little more research before you go makes for a better trip once you arrive. Find out where the local hospital is, and if it is equipped to handle a life threatening reaction. If it isn't find out how far you would have to go, or stay in a different area. The internet has a lot of resources, so look for information that is specific to your allergy and destination. Or simply type in "food allergy" and "travel" and go from there.

4) Prepare. Order a special meal or bring your own food for the journey, pack extra allergy medication, make sure your epinephrine auto-injectors and inhalers are in good working order, get doctors notes for medication and food (especially liquids) to make going through security checks and customs easier. Put a few things in your carry on and checked bags to "hold you over", just in case. Something that you enjoy eating, but does not require refrigeration or cooking. For example, I always have one or two extra containers of shelf-stable soy milk, instant oatmeal and some fruit bars for my son. If we are unable to get to the store as soon as we arrive, or something unexpected happens, like a flight delay or cancellation, he will not be hungry and I don't have the added stress of finding something safe for him to eat. We have only had to my "emergency stash" once so far, but every slightly heavier carry-on was worth that one time of being able to sit in an airport, pour milk into oatmeal, stir and feed my son, stress-free. If you are adult with food allergies, you might want to bring along a medical release form. It authorizes others to administer life saving medication in case of a severe reaction. And don't forget your medical ID.

5) Don't be embarrassed! You know how to handle your food allergies, and you are responsible for keeping yourself safe. The same things that you do at home usually apply wherever you go. Don't be afraid to talk to airline staff about special meals, snacks and accomidations. For example, if you have a severe allergy, you might want to board early so that you can wipe down your seat area without delaying the boarding process. Call the airline and hotel beforehand to find out if they can accommodate you. Talk to your travel companions, your waitstaff, and anyone else that needs to know about your allergies. If people are ignorant and rude, adjust your plans accordingly. Dealing with ignorance is better than dealing with a hospital trip.

6) After all of the trips to the pharmacy, phone calls, organizing medical information, packing, watching your bank balance diminish and triple checking your plans, RELAX. Enjoy your vacation! People with food allergies travel every day without having any reactions, and you can too.

9 days, 6 airports, 5 airplanes, 2 airlines and 1 toddler

It has been a busy holiday season for us, as you can can tell from the title of this entry. We have spent a lot of time in airports and on airplanes, and some time with family and friends all over the US. I've discovered a few things about traveling with a toddler that will make future journeys easier, and also some things about traveling (and eating on the go) with food allergies.

One of the things that has truly been wonderful for us are restaurant cards. You can make your own, or print them from various websites, personally I print mine from Food Allergy Buddy. When we go to a restaurant, I give the card to the server with an explanation of the ways in which I would like to modify the chosen entree. So far, I have not encountered any problems. Most of the time either a manager or the chef comes to the table and discusses my son's allergies with me and ensures that the chosen meal is safe. This is excellent, because they are aware of "hidden" allergens that might not be apparent from the menu description, and are able to advise me of alternative options, some of which might not be on the menu.

During the holiday season, my extended family decided to have a dinner out. They chose a Tex-Mex place, and I was understandably a little concerned, as my son is allergic to all dairy. A Tex-Mex restaurant sounded like a trial by fire, but I decided not to object to their choice, while coming up with a backup plan in my mind. Much to my delight, after explaining my son's food allergies to the server and giving her the card, the chef came out and informed me that he has TWO children with food allergies and would make sure that whatever I wanted my son to eat would be prepared in a safe manner. I was ecstatic! Sure enough, his food was dairy (and other allergen) free and everyone was able to enjoy their meal.

I always have two or three cards in my wallet, just in case. They have proven invaluable to me during those times when we eat away from the safe confines of home. I've had managers comment that they love the card, as having the list of allergens written down makes their job much easier. Especially when people have multiple food allergies, it can be difficult for the manager/chef/wait staff to remember and keep track of what an individual diner can not eat. Being able to double and triple check without having to come and ask saves times and lessen the likelihood of errors and decreases frustration and anxiety for everyone. Yippee for stress-free dining!