5.13.2008

Seven minutes TO heaven? Are you aware?

Seven minutes in heaven conjures images of teens exchanging kisses in dark closets. Maybe the phrase niggles at your memory pulling bits of an '80s teen flick that you can't quite remember who was in it or what it was about.

For many, however, the phrase is ominous and sounds a lot more like "seven minutes TO heaven." For individuals with food allergies, seven minutes after the onset of an anaphylactic reaction can be the difference of life and death. Anaphylaxis is an allergic reaction involving two or more bodily systems. Severe cases involve a sudden and precipitous drop of blood pressure and/or breathing complications. People that survive a severe case received as shot of epiphedrine within 5 minutes of the onset of symptoms. People that did not recieve that shot end up a statistic of people killed by food.

Tossing out a bunch of numbers and statistics doesn't really do much to drive home the point, however. Knowing that ninety four percent of school nurses reported having at least one child with food allergies in their school is unlikely to sway you. Nor is reading that more than one third of the nurses indicated that they had 10 or more students in the school with food allergies, and 87 percent stated that, compared with other health-related issues, food allergies among school-age children is somewhat or very serious. (as reported in a 2004 study published in the Journal of School Nursing)

Instead let's break this down and make it personal - what do those numbers mean? As a parent reading you and/or your child(ren) already know or will know someone juggling food allergies. Now let me make it a little more personal.

A year and a half-ago, my daugher attempted her first peanut butter sandwich. She was a month shy of her second birthday and more than a littel intrigued by her big brother's favorite lunch. She took one bite and spit it out. She hated it. She pawed at her tongue pleading with us to get it off. It was her only response and we assumed she simply disliked the thick. stick to your mouth texture. Hours later she vomited. Somewhere deep in my gut the little word "allergic" nagged at me. I pushed it aside with the cushion of hours that her sick stomach and her exposure had between them.

A week later we were baking cookies. We had chocolate chips and peanut butter chips to toss into the dough. The kids plunged their hands into the chip bags. Megan ate one peanut butter chip. She popped a second one in her mouth and her face quickly turned from that giggling, happy smiling face she'd been wearing to one full of dread. She began to paw at her mouth again as the tears came down her cheeks. In seconds she was off the chair she had been standing on and vomiting profusely all over my kitchen floor. We cleaned her up. We calmed her down. So we thought. She began to vomit again and this time bright red hives started to emerge on her stomach and back. Her cheeks were red and her eyes were filled with tears and fear. I called the pediatrician to confirm what I knew for certain.

Megan is allergic to peanuts.

Since then, we've seen her allergist three times for general visits. She's now twice endured a skin prick test to confirm her peanut allergy and, after breaking out in a rash from body lotion that contained nut oils, to confirm an allergy to almonds and walnuts as well. She's had blood tests to confirm the skin test and to set a baseline for where she falls on the severity scale of her allergy. (On a scale of 0-6, she's a 5.) Megan goes no where without two EpiPens at arms reach and a bottle of antihistamine close by. We are pros at reading food labels and navigating eateries.

Overall, Megan is a bright, vivacious three year old. She understands her allergy better than many adults in her world. She knows that her reactions have gotten more severe and faster with each exposure - including a recent vomiting episode on the heels of eating a pretzel that came from a batch "processed in a facility that also processes peanuts." That cross contaminated pretzel confirmed a truth she already knew, it doesn't take much to trigger a reaction and while we've not yet had to confront it, the next one could be one to compromise her breathing. She understands, in a way so many grown-ups don't, that previous reactions and the severity level of one's blood test do NOT indicate the way a body will react to future exposure. That's part of what makes food allergies so scary - you can't anticipate. You always need to be prepared for the worse case scenario.

Megan won't eat anything handed to her without asking "does this have nuts?" as she points to the label on the package. And this is the part that makes me nervous. Our family, my parents, her preschool teachers, her dance teacher, even her 5 year old brother, are aware that the dreaded "may contain" or "processed in a plant that also process..." labels are as off limits for a food allergic person as the label that reads "This product contains: [allergen list]." This isn't something, however, that is top of mind for everyone else.

A recent study indicates that up to 1 in 10 products with a "may contain" or processed in" label contains enough peanut protein to trigger a reaction in an allergic person. Or, in real life terms, when the mom in our dance class, remembering the two nut allergic girls in class, put the small Snickers bars back on the shelf in exchange for the Milky Ways she still had selected goody bag candy that neither allergic girl could safely eat.

As parents you have, or you will, bring in cupcakes, cookies, and any other array of snack items to class functions at some point. If you're in Meg's class, please don't take it personally when she's sitting with her own homemade cupcake instead of the pretty bakery cupcakes you sent in. It's not a snub. It's a cross contamination concern. When we're standing off in a corner with her trying to calm her down for feeling 'left-out' please understand, for a three-year old it's hard to have a graham cracker when the rest of class is having Munchkins.

This blog post is the sort that rankles some parents. Listen, I also have a picky eater who would exist on nothing but potato chip laden peanut butter sandwiches if we let him. Although my picky eater HAS given up his staple food at home for his sister's sake, I'm not asking yours to give up his/hers. This isn't a campaign to ban peanuts from schools. Frankly that'd be awfully near-sighted of me. Food allergies are much more extensive than one little legume - there are children with deadly allergies to eggs, wheat, milk, soy, shellfish, corn, and many other less publicized foods in addition to the kids like my Megan with her peanut and tree nut allergies.

I'm not campaigning for an end to Reese's. I *AM* trying to share a personal glimpse at a growing trend. And ok, I am asking that you take the extra moment to look carefully at labels when you're providing a snack for a group of children. Sometimes the "not safe" product is seemingly innocent. It's the plain M&Ms. It's an overwhelming list of jelly bean brands. It's the bakery cookie or cupcake. It's a particular brand of pretzels. I am asking that you do your research because even if it's not YOUR kid, it's your friend's kid or your kid's friend. I'm asking that you ask questions - ask the teacher "I want to send in something for Logan's birthday next week. Are there any allergy concerns in the class?"

I am also asking that eating products with the top 8 allergens (milk, eggs, soy, peanuts, tree nuts, fish, shell fish, wheat) begins to equate to "washing hands and face." Think of it this way, you're at the park eating your PB&J. You run off and leap back into the action - touching various surfaces as you go along. There is likely trace amounts of peanut butter left on your hands if you've not washed thoroughly - and THAT little bit CAN trigger a reaction in some allergic individuals. A ring of milk proteins left around your lips can transfer to an allergic person with a kiss. It may not send them into anaphylatic shock, but any reaction, for an allergic person that knows anaphylaxis is a possibility, is a terrifying reaction.

Maybe you've not made the personal connection yet to food allergies. If not, allow me to introduce myself again. My name is Sandy. This is my daughter Megan. A peanut can kill her. A walnut or almond can send her to the ER.

This week is Food Allergy Awareness Week. If you made it this far through this long post, I thank you. Now pass a link to this along to help spread the awareness to one more person.

5.09.2008

Symbolic

When I'm not juggling the array of things the family likes to toss at me, I sometimes don my PR maven hat and write a release for my daughter's preschool. The last week we've been working on something to give the interested local TV station about the school's annual butterfly release project. Each year the 400-ish students watch roughly 70 caterpillars morph into butterflies. Then, on a day dedicated to spring and flying things, the classes take turns letting their multi-colored captives take flight with a release organized in one of the property's flower gardens.

Two years ago I rooted the symbolic celebration in the school's renovated building and new addition. This year the butterflies symbolize growth and milestones - the school's newly minted (or soon to be minted) 5 year olds leaving preschool behind as they begin their kindergarten journey. Not just them! Wait! This year's crop of 3 year olds have completed that milestone of "first year of school!" and now pick up the mantel of "big kids in the building." Symbolic joy all around.

This morning I polished the release one more time, got the big smiling nod of approval from the director and considered the project complete. The boy and I dropped Meg off in her classroom, of course, taking time check on the caterpillars in her classroom and admire how quickly very hungry caterpillars can grow. (And imagine! They've done it all without eating through one piece of chocolate cake, one ice cream cone, one pickle, one slice of Swiss cheese, one slice of salami, one lollipop, one piece of cherry pie, one sausage, one cupcake, AND one slice of watermelon!! I wonder if Eric Carle knows?)

It wasn't until later this afternoon that the words I had written really struck home - and it came in the very same symbol.

Megan was piecing together puzzles on one of her favorite web sites. I had been called over to admire her latest completion. Just to our right, on the same table the monitor and keyboard sat on, was our very own butterfly habitat. It had been a Christmas gift to me from Logan. It was something he knew we'd enjoy together based on our summers of hunting for little 'capperpillars' (as the kids have each called them at one time or another) to keep in our little bug box until they emerged with wings. Earlier in the day we'd noticed something different about our 10 little chrysalises. Three of them were empty and brown mottled winged butterflies clung to the netting drying their new wings.

My three year old was ignoring her new pets - the puzzle was demanding her attention. I heard rustling. It was either one of the flying things fluttering around (which we hadn't really yet witnessed) or it was another hatchling. The movement caught my eye. A butterfly emerging. Pulling itself out of the cocoon that had held it captive for 10 days.



It's wings were folded up and damp. It took steps away from it's former home and shuddered. Each pulse seemed to add more volume to it's wings until it appeared much like it's friends currently hanging around the netted tower.

I had been able to catch my breath long enough to get Megan's attention. She sat next to me, face pressed to the netting watching the process (and wings) unfold. "He's so beautiful," she whispered, already deciding every "painted lady" in the place was a boy.

An hour later I was standing outside and silently thanking the clouds for holding their rain in during "bus stop" time. Meg stood at the front door as I waited at the base of the driveway for the bus to pull to a stop. As soon as I returned with her brother, she gave him the most recent butterfly report. He ran to the porch to see for himself. He spent the next several hours, nose to netting, looking for clues that another one was about to emerge. So far they haven't.

Just before we got the bedtime routine rolling, they checked in with the butterflies one more time. It was then, watching my almost-done-with Kindergartner and my soon-to-finish-her-first-year preschooler, that the words of the release I had written came flooding back to me.

We're going to release our new friends on Sunday. Somehow it seems only fitting that these symbols of new milestones spread their wings and leave their habitat on Mother's Day. Although my own little caterpillars aren't about to make that leap, quite yet, they're growing fast and in the grand scheme...it won't be long.