Showing posts with label walnut allergy. Show all posts
Showing posts with label walnut allergy. Show all posts

Tuesday, May 19, 2015

Freedom!!!

May 19, 2015

We are almost at exactly the 2 year mark and a LOT has happened in the last few weeks so this is going to take a while, sorry! :)
Here's the topic list if you want to skip around or look for what interests you...

-Issues at school / resolutions
-OIT graduation - OIT challenge for Walnut
-Kid anxiety
-Food challenge for pecan, food challenge for hazelnut
-On the other side
-Faith and sharing hope
-Thanks

-Issues at school / resolutions
We were notified at the end of April that our Auvi-Qs (epinephrine auto-injectors - lifesaving allergy medication) were expiring so we got a new prescription ($$$$!) and Daniel took them to school. While he was there he dropped two in the office and went to the classroom to put the other two in the "red bag" that should travel from class to class with the kids.  The K teacher told him that they haven't been in the red bag all year.  ALL YEAR.  This was stunning and infuriating and terribly dangerous for a kid with severe allergies, asthma, and in the middle of OIT (although admittedly we did that after school hours in part to keep most of the risks in times where he would be with us).  If you have need of epinephrine - to quote my friend from Rock Food Allergies - Trish Gavankar - "Think of epi as your next breath.  It can't be farther from you than you can hold your breath".  Think about that for a minute.   It could be the thing that gives you your next breath if your airway starts to close.  Past reactions are not indicators of severity of future reactions.  They hadn't had his meds within reach for the entire school year (only two months to go).  He does self-carry one (and now we know should have been two) in his spi-belt, but he's five, and he forgets it.  We've had many mornings we discovered it after the bus had gone and had to drive it to school or realized in the evening that he hadn't had it all day.   It happens and we've worked at it, but that means there were days there was nothing within reach.  It's inexcusable and terrifying.   The risks are too high and it was clearly documented in his plan signed by the school that those life saving meds were to be with him at all times in the red bag.  We know they went on the field trips (the school checked the logs), but so did we!  We were his chaperones for every field trip this year.
The other issue is the social aspect - exclusion.  He's had a tough time being "different" and not allowed to do certain things: drink out of the water fountain, wash the lunch tables, or sweep the lunchroom floor.  He can't eat snack with any kid he wants or eat lunch anywhere he wants.  When parents bring in surprise birthday treats, he can't have what everyone else is eating.  He has to have something from his "safe snack" box.  The teachers aren't allowed to decide what is and is not safe.  So he either has to be able to decide on his own or he can't have any food provided by others at school, even if obviously safe for him.  This is really hard on him.  He has come home crying about other kids having cupcakes and it's heartbreaking.   If we had known, we could have sent one (we keep them in the freezer for emergency birthday parties).
So what did we learn from this?  The healthplan is a wake county document that is supposed to be comprehensive, but it's not - it doesn't cover missed schoolwork for appointments, exclusions/inclusions or keeping food out of the classroom.  Things in hindsight I wish had been in there.  It's a best intentions document, signed or not.  There is no recourse that our plan was not followed.  They have good intent - but the nurse at our school covers five schools.  Kids slip through the cracks and it's not safe.  Ours was one of them.  Thank heaven nothing happened that would have needed an epi injection because the office feels forever far away from the playground and many other places in a big school.  We should have continued the pressure for a 504 (a federal agreement) last spring and gotten more things in writing that were enforceable.
What have we done now to fix it?  The school admitted in our meeting with the teacher, nurse, and principal that they blew it and his meds are now in the red bag.  They reviewed all of their allergy plans to make sure that there wasn't another kid in the same boat.  We documented why he was high risk to help show them how dangerous that situation was.  We also asked for a 504 meeting at that meeting.  (This was prior to all of the food challenges being completed).
What now?  Patrick wants to change some of the items in his plan now based on the food challenge and we're trying to sort that out with the nurse.  Of course she's covering 5 schools and this is low priority on the list, but it matters to a 5 year old little boy who wants to be like everybody else.
Why the long writeup on the school stuff?  Other parents need to know how we fell through the cracks to keep their own kids safe, and to understand why some of us push so vehemently that they NEED a 504 plan when the nurses and staff at the schools will continue to tell you that you don't.  Everyone has to decide for themselves what the risk looks like and what they can handle - but it's hard to go into a school for the first time and have a CLUE what to ask for.  A 504 plan gives you federal weight, and the office of civil rights (OCR) will intervene on your behalf if the plan is not followed.
Here is a link to the 8 page 2014-2015 "blank" K-2 Wake County Health plan, and the 1 page asthma plan.  Please excuse our scribbles, this document isn't posted ANYWHERE, which is really frustrating, so we will be the annoying parents that link it.  #notreallysorryatall  You can see the options we had to choose from (subject to change but it's better than no idea what to expect).  Maybe this will help others to better prepare.
https://drive.google.com/folderview?id=0B4rsfLOOF00XLXotYXp0R0lOb2M&usp=sharing

-OIT graduation - OIT challenge for Walnut
May 6th after almost exactly 2 years of walnut OIT we took Patrick to the allergist to eat the thing we've spent his whole life telling him not to eat.  :)  It sounds funny, but it really did feel like handing our kiddo rat poison and watching him eat it.  He was nervous too!  I'll clip some items out of facebook so people can get a feel for what that day looked like.


Dose 1 - his "normal" maintenance dose of walnut powder in applesauce 2400mg.  Old hat! We've got this!




Dose 2 - 20 grams.  That's not a typo.  GRAMS.  Are you serious? #helikedit #oit #oitlife #mamahasheartburn


Dose 3 - at least 20 grams.  What's the big deal mom and dad? Can I have some more pudding to dip them in?


Dipping mini-poisons in pudding.  So crazy! Dose 4 was BIG!


We have more nuts to test - but it will be REALLY weird if he can eat walnut freely. This one has put him in the ER multiple times in a bad way.  #scienceisamazing
We got cleared for walnut! Holy cow. Needs to eat 2 a day from now on (need to find them in the shell until/if we get cleared for the other nuts). I'm not sure people realize what a life change this will be. TWO YEARS of life revolving in large part around condiment cups of walnut powder and 2 hour rest periods and never being able to miss a dose. THIS. THIS. IS. AMAZING.

So we couldn't go home due to house showings so we wandered around town looking for walnuts in the shell since we couldn't use shelled prior to challenging hazelnut and pecan.  Funny how suddenly we spent all afternoon looking for the thing we've spent years avoiding!

-Kid anxiety
It took us a little while to pin it down for what it was, but a few days prior to the walnut challenge, mr chill was having trouble getting to sleep and wouldn't go anywhere without his giraffe.  It's not just the parents that struggle sometimes with the anxiety.  The morning of the food challenge he kept asking what would happen if he had an "llergic rea-shun".  We reassured him that they would give him medicine and keep him safe and he was pretty easy going about it, but if you know him you could tell he was concerned.  Big sister was anxious too.   She's still pretty young to have had to learn how to inject her brother, what foods to avoid, and when to step in (she's had to tell other adults not to give him food).  She's a bit nervous anyway, and this has been hard on her too.  She had me in tears one night when he wanted "company" this week and she took her blanket and went and curled up in his twin bed with him.  I went in to see what was going on and she told me she'd cuddle him until he fell asleep or for the next 30 minutes.   Even at 7, she sees it too.  She gets his fear (and ours, which I hate), but I love seeing her show him that she loves him.   Brings me to tears every time.  It will fade I hope with time, but it's hard to see the shadows of anxiety and real fear in your kids.  It's not gone yet, but there is such hope and excitement.  Just hate that they learned to have real fear so young.

-Food challenge for pecan, food challenge for hazelnut
May 7th Patrick challenged pecan - it's genetically related to walnut - and after two years of OIT his numbers for pecan IGE had decreased by more than half - we were hoping for a two for one, but knew we had no guarantees.  Here are some snippets from that day.

Dose 1- first bite - pondering the taste of pecan for the first time.  ‪#‎oit‬ ‪#‎oitlife‬
 — with Daniel Walton.

Day 2 - Pecan- Slower today since he's never had this one before - tiny!


Dose 3. This one made me sweat.




Dose 4 - HUGE! He didn't eat all of this one.
Pass!!!!!!!!!!!!!!!!!! Woohoo!!!!  Two down and one to go!!  Science! I want to do a talk or something on OIT. I cannot believe the progress we've made! 


This is about the time that offers started coming in on the house - it's a bit of a blur as we were clearly focused on other things :)  He got his first ice cream in a normal ice cream shop on Thursday afternoon.  :)  (The only other time was at Disneyworld where they have exceptional allergy handling programs).  He was thrilled for the first 5 minutes and then was too busy playing to eat most of it.  He only had to avoid a Nutella topping and could choose from every flavor they had!  It took more time to choose a flavor than to eat it!  We also made a walnut apple dapple cake for him this week, he had it for breakfast a few times.  Erin spent 30 minutes with me one night shelling walnuts so we could fix it.  We're all going to get fat if he keeps passing these challenges and trying new desserts!


Patrick approved this cake!
Dose 1 - First time with a hazelnut - here we go again!  ‪#‎helikedit‬ ‪#‎oit‬ food challenge 3 ‪#‎gopatrickgo‬
 — with Daniel Walton.

Dose 2 is done (2 hazelnuts)! (no picture)

Dose 3 - good but too much chewing!  ‪#‎oit‬
 — with Daniel Walton.


Dose four! Nutella baby! He still likes it smile emoticon
 (and he's high on sugar now!)

He passed!!!!!
Thank you thank you thank you to all of you that worried, prayed, read labels and helped keep him safe and us sane! I want to yell Freedom like in Braveheart but with a happier ending!  smile emoticon

From Dad:
Patrick passed his hazelnut challenge smile emoticon A big thank you from Alli Renner Walton and I to all of the friends and family that read labels and avoided tee nuts for Patrick for the last 4 1/2 years!!
From Mom: 
I can't echo this enough. thank you all for helping keep him safe and helping keep us sane. This two year journey of OIT was so worth it!!

I cried in the car before I could go home from the allergist that day.  That evening we took the kids to La Farm Bakery for the first time, and then to mellow mushroom for pizza.  And we didn't ask what was in anything or give out cards or talk about cross contamination.  It was very very strange.


Freedom with tree nuts tastes like Nutella and macaroons and honey walnut cream cheese!
 — with Daniel Walton at La Farm Bakery.

My post into an allergy parent forum on facebook with other OIT parents.  We truly thought we were going to be in this (OIT) for another four years and suddenly we have found unexpected freedom. There have been a lot of tears (the good kind) as we've realized that he's already got the protection we have been praying for and thought was years ahead of us. So those of you thinking about OIT... here's your happy ending. We're still a little scared and have a lot of adjusting to do, (still carrying epi and still have asthma), but we took that trip to the bakery and let them pick anything they wanted. The request was of course that it have one of those three nuts in it - and we found a hazlenut chocolate cake for them to try. It was amazing. And the joy on his face (and his protective big sister's!) was worth every drive, worry, updose, and fear we've had. I feel like someone lifted the world off our shoulders yesterday. He threw away his extra maintenance doses this morning with the biggest smile. We will maintain eating our OIT nut to make sure we keep our desensitization, but it looks like our allergy journey is ending! Thank you all for the support you've given - we will still hang out and pray we don't find a new allergen, but right now we are in the giddy shocked stages of trying a "new" restricted food every day!

I still kind of want to get him that shirt that says "because science b*&^#@!", but some of those while hysterically funny are terribly kid inappropriate. :)  Alas, they can read!  



-On the other side
I have to say I'm truly not sure I have ever had so many joyful tears.  People keep telling us congratulations, and of course we say thank you it's truly amazing and our own modern day little miracle, and half the time realize a few minutes later they were talking about the house!  LOL.  It's ok, the rest of the world doesn't have to understand.  We get it and that's enough, and we are boundlessly grateful.  So many small things every day have been reasons to smile instead of stress.  The trip to the grocery store where Erin insisted we needed raisin, date and walnut oatmeal because he'd never had it before (and fixed it for him the next morning for breakfast as a surprise!)  Walking around the grocery store is shocking, instead of seeing everything that we can't buy, I see a zillion things we CAN buy - all of which he's never had before.  Some of them are admittedly junk, but it's  fun to walk around the grocery store in this giddy state that you can have whatever you want!  I remember swearing as a kid that I'd eat an entire pound of my mom's fudge when I was old enough to choose for myself.   Now that sounds like a terrible idea!  But the grocery store is just a tiny example of the million stresses we've had for years that are now reasons to smile.  And seeing the joy that the kids feel and the elated grins from tasty new creations or small freedoms are so worth all that stress.  OIT was not an easy journey, and we are extraordinarily lucky to be done in two years, lucky to have a doc in our hometown that will do OIT, lucky that we could do private practice because we'd never have been accepted into a trial or would have been kicked out due to asthma concerns, lucky to already have the protection of desensitization while he's still only 5 years old.  Blessed.  We have a long ways to go to figure out what life looks like on the other side, you don't undo all your precautions overnight!  We are still carrying the epinephrine and probably will continue to do so (it's also a great emergency treatment for asthma in a pinch!)  I keep thinking the euphoria will lessen, and it has, but it comes back with just as much zeal as that first day.  One day at a time.  Patrick is ecstatic about potentially having new freedoms at school, but process has to catch up with progress, and so far no real changes have happened.  We wrote a note to allow him some of his most requested changes - drinking from the water fountain, freedom to sit with anyone at snack and freedom to sit anywhere at lunch.  Now we wait for the nurse to approve or change his health plan (which must be maddening for a 5 year old!), but he knows he's safe, and his teacher knows, and for me that's enough.   There isn't that much time left in this year, but he wants so much to be like everyone else and to do those silly things that they all get to do (like wipe the tables in the cafe!)  That might not sound exciting to us, but when you've always been the only one who couldn't do it, those little freedoms are important.  That's the part the school system seems to be missing in large part - there are social implications to being different / and times he was mindlessly excluded to follow a rule that didn't fit a situation.  Don't get me wrong - I love his teacher and she clearly loves him, and that matters MOST.  She was not going to put him in a risky situation.   But it's brutal to see your child come home crying again and again over the little things, but they aren't little to him.  This is his whole world.


-Faith and sharing hope
So why are you shouting from the mountain-tops?
I feel like we've been given a gift.  A gift of a life with freedom in it instead of constant stress and labels and health plans, a gift of protection, of science.  I know a lot of folks don't have this faith, but I feel like God gives us choices and lets us choose to do work to make our lives better.  We were given opportunities to try new and scary treatment options, and we put in that work and took those risks.  Don't we owe it to him and to those who might also benefit to tell whomever will listen that they could protect their child, friend,  spouse, neighbor too?  We don't yet understand why the incidence of allergy has exploded.  But we have more options than ever before to attempt to protect the people that we love.  It takes a lot of prayer and love from the people around us to get through this stuff.  We need our community - our community of faith and our community of family, and our community of extended family (friends), and our allergy community.  So often we share only our sorrows and bad moments, this is a chance to say there is hope in the world, hope to protect people that you love, hope in new science.  It is not perfect, but it's created by humans.   We'll never have it 100% right.  But we will continue to try, and to take risks, to give ourselves and others that hope.  We were not expecting this now, I'm not sure we really believed we'd ever have this kind of freedom.  So this mom is going to do something un-natural for me - I'm going to tell everyone that will listen.  Two people contacted me today about interviews, for a blog and for a national parents forum on kids with allergies.  I plan to say yes.  Maybe this is why we were given this gift.  To give others hope.  So forgive us for yelling our joy until we're blue in the face, but this is the real job.  If we give someone else faith and hope, then it's worth every second of my personal discomfort at being the center of attention.  The science is improving.  There is hope, even for the severely allergic, the kids that would never make it through a trial (in hindsight that's us too!).  So thank you for the gift, we plan to use it well!

-Thanks
There is not enough paper to name all the people that have kept our family safe over these years.   The friends and family that sacrificed traditions and easy things to make things from scratch, try new things, read a million labels, texted photos of recipes and labels, cleaned counters, grilled servers and chefs, delivered allergy lectures, put up signs, warned other friends, followed the kids around at parties, left home tasty items that weren't safe for us, learned how to inject epinephine, and generally avoided lots of otherwise yummy things when we would be around.   Thank you for helping us through our anxiety, for listening to our fears, for the many hugs, for "weading da wabels", and for loving us enough to learn about a very scary problem that we couldn't manage alone.  It takes a huge village to do this - especially if things are outside of "normal".  (Who is normal really anyway!?)

I'll leave it at that.  Thank you could never be enough, but it's all we have to offer.  THANK YOU.
Mom/Alli, Dad/Daniel, Patrick, and Erin

Wednesday, May 14, 2014

Topping out on walnut for a while...

May 14, 2014
Day 355 (Almost a year!)

Well we hit the top dose today!  Woohoo!  2400mg of walnut flour.  We'll stay at this dose for a year.  I asked the allergist why it wasn't higher, and apparently this is the walnut protein equivalent of several nuts.  That was a shock, I had no idea it wasn't a one for one weight calculation.  (I thought we were still at less than one nut).  Everything seemed fine, we saw the somewhat normal redness right under his eyes, but no symptoms.  That didn't last long (also normal for him).  So we'll go in once a month now for a dose in office/monitoring/catch up.  After that year we will have his IgE levels retested and see if they've dropped enough to move on to the next nut.

That was a bit unexpected, but we've been so busy talking about school readiness that we missed that we were so close to this milestone :)

On that note - we've met with the elementary school nurse and assistant principal to discuss how we keep our little guy safe starting in two months (yikes!)  WCPSS (Wake County) has an allergy plan and an asthma plan that looks a bit like a choose your own adventure book (where you choose how you want them to handle certain situations like the lunch table and outside food).  Some of the choices were really non choices, and feel a little exclusive, but I get how a standard is much easier to implement.  (For instance he has to be able to either make his own food choices exclusive of an adult's input, or he can only eat food brought from home with no exceptions).  That's not a choice - he can't read labels, doesn't know all the places nuts can hide, and he's really too young to say no to all the tempting possibilities that will come up at school.  So only home food - always.  The bad part about that is the social exclusion from every party, event, candy handout, etc… for the whole year.  We're going to try to be the room parents so that we can offer to buy safe food/snacks for parties, but things will come up. We can have ice cream or things like frozen cupcakes stored at school and a snack box for the teacher to use in case of those surprise events, but he'll be different every time unless we bring in the food for the class.  So far he hasn't quite realized that he's going to be that kid.  It's time to start talking about it though, he has to get that he can't cheat the odds and take a bite of something.  We'd really prefer never to have to visit the ER again with him struggling to breathe.  At least all of the permanent staff and bus drivers are trained to use epinephrine. (yay!)  It also sounds like he can have an epi in room with him that will follow him around the school (they call this the red bag and in lower grades it follows the class everywhere - diabetes meds, epis, inhalers only).

The biggest points of contention so far (and they didn't really feel like an argument just things we have to sort out) are the school bus (does he self-carry on the bus and where is it kept), and what happens if there is a substitute (they are not epi-trained, anaphylaxis trained).  The bus I think we can sort out with them (and with the after care at the preschool).  They are willing for him to have it on him and that's a big deal.   Everyone likes to say the kids aren't allowed to eat on the bus.  Well, that's irrelevant since we are all well aware that they DO eat on the bus.  Some of them are on the bus for over an hour, we get it.  But we need for there to be an epi available.  Who knows what might be smeared on a seat where he puts his hands, or if he might give in and take a bite of something tempting?  The school wants it in his backpack front pocket, but that's too accessible to everyone IMHO.  We want it on his body (in a spi-belt).  That's what he's been wearing for months (with a trainer epinephrine injector with no needle).  It's under his shirt, small, and harder for another kid to get their hands on it.  The substitute issue is interesting.  For his Kindy year it's probably moot (there is an aide assigned to the class full time too, and the chance of them both being out is very low).  This is something the schools need to figure out.  Subs are not "normal" school employees, there are over 1000 in this county, and they are not epi trained (at least not unless you get lucky).  Leaving him in a class with a sub who doesn't know how to recognize or treat anaphylaxis at this age is not an option we're ok with.  The school didn't really have a good answer but said they'd look into it.   If they can't figure out something we may be picking him up if we find out they have a sub (and we may be asking for it in writing that they call us if his teacher and aide are both out).  We're willing to train a sub, but they aren't sure it will be allowed.  Ah the frustrations of HIPPA/FERPA, government policies, and ill thought out scenarios.

Other big news - for the time being we got denied for the trial at Stanford we were hoping to get into - but we're in their system and are watching (ok maybe stalking a little) as they continue to grow that research into Xolair and mass desensitizations.  Very very interesting stuff!

We did an allergy friendly easter egg hunt this year (no food) and the eldest kiddo at first was not happy until she realized that she was going to get a bunch of little toys instead of candy.  :)  That went well - and it was good to meet some other parents who know what it's like to have to stalk your kiddo at an egg hunt where there might be suspect candy.  We also met another little fellow at the allergist today doing peanut desensitization that I'm sure we'll be seeing every month since we're on the same schedule.

Any friends / fellow parents out there who are looking into this stuff, check out NC FACES on facebook or ping me and I'll get you on the group.  It is awesome to have a place to talk about this part of our world (when Enjoy Life Foods go on sale on zulily or amazon, what baseball games are nut free, how to navigate the local school system, 504 plans, etc…)

Thanks for listening - this one is getting long so I'll stop here and do another update soon!  We are so lucky to have friends and family that help us on this road.  Thank you all, you are blessings to all of us!
Alli

Thursday, March 20, 2014

Warning… science incoming!

March 20, 2014
Day 300
Dose 1500mg/day

300.  Sounds like it should be a milestone doesn't it?  It is!  We increased the dose yesterday to 1500mg and got some puffy eyes to show for it, but it faded a little at a time and no other symptoms cropped up.  The nurse and I kept a serious watch on him in the hours following the dose, but he's ok.  Nothing like a little mom anxiety to put your workday in perspective!   We also discovered this week that Chipotle uses no nuts in ANYTHING.  Boy that was kind of fun - told the kids to order anything they want on the menu with no reservations!  Very allergy friendly menu for most folks (not for soy, wheat).

So there's your minor update on our oral immunotherapy… now for the science geek out and hopeful research updates:

I've referred several times to the Stanford trials of OIT with multiple food allergens and specifically to the shortened OIT in combination with Xolair.  This supposedly is opening up to 4 other places in the US (although I can't officially find out where, I would imagine Arkansas Childrens, Hopkins, and UNC to be three of them… )   If we could desensitize more folks in far less time (and to up to 5 allergens at once), well wow.  It's frustrating as the news articles hint at things that you can't find on the Stanford or any other university websites, but I know it's all in progress research.  We would be thrilled if the trials were expanded into NC.  Heck we'd consider temporary relocation if we thought we could get into them even in California.  

Stanford blog post about allergy research (talks about the phase 2 Blinded study potential openings and potential future DNA tests that might show if OIT maintenance can be discontinued safely.  (It appears that for peanut allergy that is "cured" there are DNA changes - wow a safety screen test?!)

Presentation by Dr. Burks (formerly Duke, now UNC) on the state of food allergy research 12/18/2013.  This covers lots of the ongoing research for OIT, SLIT (sublingual immunotherapy), the Chinese herbal treatments (FAHF-2), Xolair (omalizumab) combined with OIT for milk allergy and for peanut, baked egg and baked milk trials, 

Blog post about FAHF-2 in combination with OIT (instead of Xolair) - this a great update about not only FAHF-2, but Stanford and Mt. Sinai research collaboration.

Perhaps I should consider a new career - I'm turning into a different kind of geek.  If anyone is as excited as I am about such things, send me a message and I'll show you lots of places to watch for updates.  Or maybe order a shirt from thinkgeek:




Until we meet again...
Alli

Wednesday, February 19, 2014

Adventures in snow and allergies

Feb 19, 2014
Day 271

Adventures in allergies....

We've had a good run the last few weeks - no issues to speak of and we've gone up to 900 and today 1200mg of Walnut powder.  One of our buddies (thanks LK!) took a walnut half into their work lab to weigh it so we'd have a better idea of what we are "eating" vs a whole...  The one she weighed was 2.85 grams for a half. (But that's what most folks would call 1 walnut).  So he's up to over 1/3. :)  That's pretty amazing.  Now I still have no idea what would happen with a pecan or hazelnut, and don't intend to find out anytime soon!  But that's great progress...  "Life" insurance - right? We figured this is a 6 year adventure we're on, and we're not even at a year yet.



Our snow adventures were interesting.  The allergist ran low on the walnut powder again two weeks ago.  So the monday before the snowstorm (last week), they didn't have it yet.  Tuesday they had it but closed early b/c of the bad weather coming in (which didn't hit but I don't blame them for closing).  They've changed suppliers for their walnut powder, so maybe this will stop happening now?  I hope so, it causes a LOT of parental stress!  Wed morning they had planned to be closed but we called and caught them there and Daniel zipped over there to get the doses.  Then the 2" in 2 hours hit.  While everybody was trying to get home.  Daniel got stuck in the crazy traffic but thankfully was almost home when all the streets turned into parking lots.  He stopped at the local bank and walked the last bit home with the meds.  You do what you have to do, but on some level you have to laugh.  He came in covered in snow (much to my amusement).  Then thursday the preventative asthma inhaler ran dry and I had to venture to the drugstore (but could easily have walked it).  Why there is no counter on the QVAR inhaler I have no idea, but I'm going to email them.  We also set up an automatic refill on it and they will notify us when it's ready so that won't happen again.

The new walnut powder is coarser than the old, but we kept a very close eye on him for the first dose, and nothing seemed amiss.  He's been on that for the last week or so and it's going fine.

Cool stuff - Epinephrine and school stocking info - this is a pretty darn good article about epinephrine in general, why it's important, and legislation across the US to make it available for the 25% of emergencies that are unknown/new reactions in schools.  Right now depends on where you live if a school nurse or staffer could give your kid an epi shot without a prescribed dose for your child.  Kids have died because these laws weren't clear and epi was available (another child's Rx) and wasn't used.  Stock epi solves that problem.  (unprescribed epinephrine available in schools).  With the increase in allergies, this stuff should be in public places, just like heart defibrillators.  It is the ONLY thing that can stop an anaphylactic allergic reaction.  Now that we're about to enter public schools I'm seeing just how scary the lack of clear policies can be.  NC needs to catch up to the rest of the US and get some clear laws in place to allow stock epinephrine and to protect those that have to administer it.

Fun snow stuff - we finally got the kids skiing this weekend (in NC) - shockingly the conditions were awesome.  We've created two little ski monsters though!  We had no troubles with allergy stuff with ski school, but we had to be creative on how to keep epis in the temp range while skiing.  (inside backpacks under jackets for instance).  It all worked out.

Stay safe friends!


Tuesday, February 4, 2014

big kid school, free epi training, and allergy cards

Feb 4, 2014
Day 256

Allergies have been high in our minds the last few weeks - we've moved up to 600mg of walnut powder for the daily dose. Tomorrow we go to 700mg at the allergist. It takes a lot of time, but he's thankfully a very agreeable kiddo.  He gets a bag to take whatever toys he wants... and sometimes he entertains everyone with his costumes and antics. This was 2 weeks ago - my little protector!  I hope he stays this agreeable for the years we have of this in our futures!


The superbowl (and of course party with lots of food) - was a great success, and in no small part to the friends (our local family!) that helped make sure he was safe and that everyone knew not to give him food without a parent okaying it.  Our host/hostess sent us this photo of the "baked goods" end of the table before we even GOT to the party.  :)  We also had him wearing allergy alert stickers so that those folks that don't know him would know not to feed him.


In other news, we just signed him to start kindergarden in July where he will join his big sister at the local Elementary school.  EEK.  We are barely starting those conversations with the school, eventually the school nurse, the teacher (we don't know who yet), and the allergist.   It's a LOT of paperwork, planning, and thinking through what makes sense, how to approach people, and how to most importantly keep him safe.  We don't want to induce some crazy burden on the school, but we don't want them to ever need to inject him with an epi.  Heck, I don't want to ever have to inject him!  (again)
This is amazingly stressful to think about leaving the "nut-free" preschool world and having to depend on others (some of whom we will never know), to keep him safe, at an age where he can't quite protect himself (or read the labels).  We have been researching on the parents of kids with food allergy forums (you need to register), went to a 504 plan webinar (you can watch the video), and talking to teachers, other parents, and anyone with any experience in this area.  The allergist was surprisingly negative about a 504 plan (he said a health plan is fine).  Given what we've researched, we don't agree, but we will talk it out with patience and come in with humility to talk to the school.  It's not a demand list, it's supposed to be a discussion to decide how we can all keep him safe, and a document that details what we agree upon.  We have a health plan in place for our eldest, but her life is not in immediate danger if it's not followed.  We will plod slowly down this path and take lots of notes...  And I will try not to shake every time I talk to anyone at the school about leaving him there without his army of protectors.  Gotta let go sometime...

Other cool stuff...
-FREE (used to be a paid training!) Epinephrine/anaphylaxis training online.  This is pretty awesome.  If you have friends with food allergies, take the 20-30 min and do this.  You may have to save them one day, you need to understand what to do and when to do it.  And THANK YOU epi-kit for making it free!
1. Go to http://www.EpiPenTraining.com and click Sign Up.
2. Fill in the Registration Form and agree to the Terms & Conditions.
3. Click Sign Me Up. 

4. A box will appear confirming that your account was created and that you're logged in.
5. Click Continue.
6. Click Begin or Continue Your Training Course.
7. Click Start.


-Allergy cards for restaurants - we dug all over the place and these things are EXPENSIVE and you get two or three laminated cards that you need to remember to get back from the server each time.  We used vistaprint (just picked a business card template), and printed 200 for about $20.  We put his picture on it, and wrote it as a request from him to help keep him safe (people are more careful when they know it's a child that can't protect themselves).  Don't spend your $ on the fancy "allergy" cards.  You can print EXACTLY what you want and get far more of them online from anyplace that makes create your own business cards.  We put emergency info on the back including please don't hesitate to Epi if you see symptoms.  So far it's been VERY well received.  We decided to do this after reading the restaurant blog (see last post).
Much love to you all - it's sometimes a very carefully planned out world we have to live in, but we do it with the support of all of you!
Alli, Daniel, E and P

Thursday, November 7, 2013

In the news and eating out

Day 167 (dose is 200mg)
Nov 7, 2013

So the good news is that allergies have been in the news a lot the last few weeks. The CDC finally posted voluntary guidelines for schools (with some GREAT resources linked).  That will definitely be in our toolkit when we go to talk to the elementary school this year for P.  Some interesting commentary about kids being allowed to self carry, and clear definitions that an allergy constitutes a disability in the language of the ADA (because anaphylaxis) puts breathing, eating, life at risk.  That language is necessary if you decide to ask for a 504 plan (accommodation based on a disability).

Also cool - the Federal bill for encouraging stock epinephrine in schools passed!  This is awesome.  It encourages schools to have better plans in place, to stock unprescribed epis (25% of school allergy emergencies are for unknown (undiagnosed previously!) allergies.  This might save my non-food allergic kid one day (or yours!) when they discover they do indeed have an allergy.  It doesn't mandate anything, but it helps encourage schools to change (and to get federal funding for doing so).  It needs Obama's signature and then it will become law.  It passed the senate on Oct 31st.

Fun stuff - Halloween went off without a hitch, the kids were spiderman/batman and Doc McStuffins (a vet disney character).  We trick or treated with friends and neighbors, and had a ball.  Everybody was very careful about checking candy, and anything labeled as tree nut unsafe or not labeled went right back in the bucket to hand out (get it out of the house!)  It's just one more time of year where a little more caution is in order, but it went really smoothly.



Eating out - still having good luck (although every now and then waitstaff needs a little extra grilling).  West Park Tavern and JD's are forever on my love list for their extra care.  Not too happy to find out that Papa Murphy's pizza dough is listed as not nut safe, and papa Johns is now selling a cookie pizza that is not nut safe.  The word on the allergy blogosphere is that cross contamination is an issue (dough handling, pizza cutters, etc...)  So looks like both of those pizza options are no longer options.  We don't eat it very often but that stinks.  We're not sure that he'd react with the minute amounts of cross contamination but is it worth the risk?  :(  Panera has also pretty much turned into a CYA restaurant.  They have a great allergen list / book, but plastered on every page is the warning that everything might touch everything so run for your life.  (this is me being snarky and rolling my eyes).  This country is so litigious.  If this keeps up he's never going to be able to eat anywhere without a CYA warning.  Which means he might not take those warnings seriously as he gets older.  That bugs me.  All the store bakeries are out for the same reason.  Those CYA warnings on the labels of everything they sell.  They might run a really clean shop and the risk might be zero.  But when the labels say may contain... you lose customers that can't take that risk.  So maybe long term all the chain restaurants are going to be out (not sure that's a bad thing).  The local eateries tend to have better (less processed) food, and actually care and take extra precautions.

All is well - just have to remember to read the labels, every time.  Ask the waitstaff, every time.  Don't eat without the epis with us.  That used to be hard, which is almost amusing now.  We adjust.

Thanks for traveling this road with us!
Alli, D and the mini waltons