Thursday, July 29, 2010

Systemic

When a child is diagnosed with food allergies your heart sinks a little. The challenges that comes with finding appropriate food are complex. How can you keep them safe? Teaching your child to take care of himself is another story. You want him to be cognisant of the problem, wary of unknown foods but not terrified of food. Its a delicate balance between cautious and down right terrified. Now, when you find out your child is allergic to peanuts you take those fears and concerns to a whole other level. You start to think about that urban legend of the girl who died after she ate chili b/c the *secret* ingredient was peanut butter. Even if your child only gets hives from peanuts you always think about their little throat closing up and being rushed to the ER. Their delicate body clinging to life. That's a little dramatic but its always in the back of your mind when you are prescribed an Epi Pen. And the crazy thing about allergies is that one exposure might cause a rash and the next anaphalaxis...you just don't know until you know.

Raph has successfully almost outgrown his milk and egg allergy. His doctor thinks for sure next year (I've heard that for the last couple years but I digress) he will be completely nonallergic to milk and egg. At any rate, those allergies have weakened significantly and if he rolled around in egg whites and drank milk he might not feel well but he wouldn't be too terribly sick. Its comforting because at least they are getting better.

Peanuts on the other hand are a whole other beast. Only 20-25% of people with peanut allergies every outgrow their allergies. Its a crap shoot and all you can do is wait and see. So far Raph's RAST scores have only gone up, not down, for peanut. This means that he is not outgrowing it any time soon and with little exposures here and there it may have gotten worse. Its the cumulative effect of repeated trace exposures that can sometimes dictate the outcome of consuming an allergen. Sometimes not...you just don't know until you know.

Last week the person who makes copies for Mike's office brought in some cookies. She regularly gives them cookies and they have always been chocolate chip, sugar or oatmeal raisin. You know, regular. Mike brought home 2 bags. One had oatmeal craisin and the other chocolate chip. Raph ate part of an oatmeal craisin and Colin ate part of a chocolate chip cookie. Colin left about a quarter of his cookie on the counter when he was finished. The boys went to bed and Mike and I cleaned up. I ate the rest of Colin's cookie...it was peanut butter chocolate chip. We threw out the other peanut butter cookie and said it was good Raph doesn't like chocolate and had the oatmeal cookie. By the way, Mike tasted Raph's cookie first just to make sure.

A little later Raph wakes up and is upset because he's suddenly so stuffed up. We bring him to the living room to calm him down and help him blow his nose. As he sits in the rocker with Mike I can see that his eyes are swelling and tearing. His nose is running and he's scratching his head. I immediately think of the cookie. I know he didn't eat that particular cookie but it came from the same source and he and Colin were wrestling around after dinner. We watch him and he starts to wheeze, his lips and mouth are swelling, he says his stomach hurts and the back of his mouth hurts. I gave him Benadryl and his inhaler. Nothing.

I called the allergist's exchange and talk to him. I describe the situation and he tells me to give Raph more Benadryl, Zyrtec and his inhaler again. He said he's having a systemic reaction to the peanuts but its mild. We don't need to give him the Epi Pen just yet. While I'm on the phone Raph is doubled over in pain because his belly hurts so much and is getting worse. My doctor said to give him the medicine and use the Epi Pen.

In 6 and a half years I've only thrown away an Epi Pen because it expired never because I actually had to use it. That was about to change. All those years of fear and anxiety came to a head at that moment. It was not dire, he was not turning blue and I was not in a panic. He was, however, having a "mild" systemic reaction. It didn't seem so mild to me but I know it could have been much much worse. I have Raph sit on my lap and Mike used the Epi Pen on his little leg. He didn't cry, just jumped a little when the autoinjector rammed the needle into his leg. That was it.

Within 2 minutes his eyes looked normal, his lips weren't swollen, his breathing was quiet and he perked right up. I suppose anyone injected with epinephrine would perk up but you know what I mean. His hands were a little shaky but he was calm and sat up watching cartoons with us for a while. He was no worse for the wear and he felt fine. Its amazing what medicine can do. Especially when the outcome is so drastic and so quick. When you can actually see the changes happen right before your very eyes.

Now, all of this happened without him eating a peanut. His exposure came from his cookie touching the other cookie or Colin touching him with crumby hands. I know there is some outrage on the part of parents of non-allergic kids when a school or a facility is peanut free. I think what people do not fully grasp is how little it takes to make a child very very ill. Your kid might be grumpy if he can't eat a PB&J sandwich at lunch but his choice could potentially kill my son. Raph has no choice. These are the cards he has been dealt and its not something he can change. Many people think the solution is to have the allergic child sit at a peanut free table. That works to an extent...assuming the peanut eaters clean their hands and face after eating lunch and don't contaminate anything in the interim.

Think of it from the allergic child's perspective. They often watch as other kids get a special treat because they can't have it. They are forced to sit away from their friends through no fault of their own. They did not make that choice but you did make a choice when you sent a peanut butter sandwich to school. Wouldn't it make more sense to have the children who choose to eat peanuts sit elsewhere? If they want to sit with the rest of the kids then they can choose to eat something different next time. My son does not get a choice yet he is ostracized on a daily basis because of biology. Just think about that before you are outraged at the mere suggestion of something being peanut free. Just think about it...

Tuesday, July 13, 2010

When it clicks


It just clicks. Raph has had one of those 'Ah- HA!' moments recently when it comes to swimming. At the beginning of the summer he started swim classes and was on the verge of being dropped down a level. They did a skills test on the first day and his teacher raised an eyebrow when he said, "Now, put your whole head under water." Raph's face went under water for a millisecond ::dip:: then he immediately hopped out of the pool, wiped his eyes on a towel and went back to sit on the step. Oy.

He has come a LOOOONG way since then. Today I watched him jump off the diving board at my mom's house and swim the length of the pool. Totally unassisted. My mom was in the middle of the pool waiting for him and he swam around her so that he could do the whole length. Amazing.
The process has been quite impressive. A few weeks ago, after swim lessons were over, I bought him a pair of goggles. I didn't want them to be used as a crutch during his lessons so we waited. He put the goggles on and swam under water. His little Dumbo's feather got him over that fear and he could swim. He couldn't continue to swim unless he stood up, wiped his eyes and took a breath. I knew once he figured out how to take a breath without standing he would be golden. Today that little light bulb went off and he knew how to swim, take a breath and continue swimming. His form could use some work because he does look like a half drowning dog but I think that's to be expected.

Too bad that little light bulb didn't go off last week...you know, before Mike had to jump in the pool to rescue him and drowning his Blackberry in the process. Details, details.

Oh and get this, he can totally do a front and back flip in the water. Did so on the first try, much to the chagrin of his older cousin :)