College with Food Allergies, Emotional Aspects of Food Allergies, Food Allergies & Asthma

Alcohol and Food Allergies

Disclaimer: This post is not medical advice. This article is written from Morgan’s perspective of managing his food allergies to peanuts, tree nuts, sesame, fish and shellfish.

I returned from a trip to Seattle in early September, having educated a bartend at a fairly high-end cocktail bar on how many gins can contain tree nuts, and realized that it might be worthwhile to write a post on navigating alcohol with food allergies. If some bartends don’t even know… I can only imagine where everyone else is! 

This is an incredibly expansive topic. It’s made much more complicated by the growth of the “craft” industry (craft beer, craft cocktails, craft cider, etc.) that yields infinite variations in products. I’m going to address a few background items first and then share some notes on specific types of alcohol. 

Background Notes

Allergy Labeling 

At the end of Prohibition in the U.S., the responsibility for labeling alcohol did not fall to the FDA but a different federal agency, the Alcohol and Tobacco Tax and Trade Bureau (TTB). So as a quirk of history, when the FDA started to regulate nutrition labels in the 1990s on all packaged foods, alcohol was not affected. 

This creates an obvious problem – you don’t always know what is inside the bottle or can you’ve purchased. That means you could buy a bottle of Southern Comfort and have no idea it contains tree nuts as a flavoring product. Or, order a cocktail that uses Frangelico (a liqueur) and the bartend couldn’t check the bottle to see it contains hazelnuts. 

This makes drinking alcohol a minefield for someone who has one or more allergens. At a different high-end bar we went to, my boyfriend ordered a drink that contained a specialty Vietnamese liqueur. It turns out it contained cashew, but it was only through sheer luck that the producer voluntarily mentioned that ingredient on the label. (For the record, I don’t have drinks with mystery liqueurs so I wouldn’t have been drinking it anyway) 

This is something that needs to change. 

Production Labeling

On the other hand, the TTB is notoriously strict about what a producer can put on their label. This is because before (and after) Prohibition, many liquor producers were adding poisonous substances like gunpowder and trying to pass it off as a legit product. In order to restore confidence in products being sold, we forced producers to only use certain terms that indicated a certain quality of production.

Southern Comfort is labeled as “spirit whiskey with natural flavors and caramel color.” Those “natural flavors” include tree nuts derivatives. 

Whereas Four Roses, a popular bourbon, is labeled as “kentucky straight bourbon whiskey.” By law, Kentucky straight bourbon cannot contain any added colors or flavors – it must be 40% ABV or higher, aged in new oak barrels for two years, and must be made from at least 51% corn. In this case, it could be a handy rule to avoid anything that says “natural flavors” on the label.

Not all categories are useful. A “London Dry Gin” is a type of gin made with a low amount of sugar (hence, dry) but can encompass gins that are made with almonds (Bombay Sapphire) and those that aren’t (Tanqueray). 

Craft Production

Due to the federal deregulation of alcohol under Jimmy Carter’s presidency, there has been a boom of small producers across the country – usually called “craft producers.” Some of these craft producers have grown to be mega-brands in their own right, such as Left Hand Brewing and High West Distillery. 

Craft producers are usually more transparent than the big producers. They are also more accessible – since they’re a local small business, you can call them up and ask a question about their production. They will know the answer to whether they use wheat in their craft whisky, for example. Calling up one of the mega-corps? Less likely to be successful. 

Notes on Alcohol Types

I didn’t start drinking until I had conducted thorough research on how alcohol is made. Over the years, I’ve tallied up more insight into each category. This is hardly an all-encompassing explainer, but here are some notes on the major styles of liquor and some things to watch out for. 

I’ve also done distillery tours in Scotland, brewery tours in the U.S. and Canada, and tours of craft producers in the U.S. This kind of information isn’t really something that is a Google search away (or, it would take you a lot of time to compile this – it’s taken me years!).

Visiting the Talisker Distillery on the Isle of Skye, Scotland

Wine

Wine is one of the most straightforward and well-regulated types of alcohol on the market. The primary allergen typically used in production are sulphites, which appear naturally in both red and white wines (although whites usually have far fewer). 

Whether you’re buying a French Bordeaux, an Australian Shiraz, or drinking bottom-shelf wine from a box… wine is always made from grapes or other fruit, but if it’s made from other fruit, it has to be labeled as “fruit wine.” 

Wine is harvested from grape plants and then dried out on large stands before adding yeast to ferment in order to produce alcohol. To make a sparkling wine like Champagne, they put the product in a bottle with more yeast to ferment further. 

Wine is typically aged in glass, ceramic, concrete, stainless steel, or oak casks. They are allowed to add grape juice (or fruit juice) at some point in the production process and still call it wine, as well as Yellow No. 3 coloring and carmine (an additive). 

There are a few odd wines I’ve seen in my time – an almond wine, for example (but they must label it as an almond wine since it’s not made from only grapes). But wine is typically a pretty straightforward alcohol for many people with allergens given the strict requirements on added flavors and production process. 

A small vineyard in Tuscany that I visited in April 2022

Beer

Beer is more complicated. 

The major brands like Bud Light have actually added a voluntary ingredients label (“Water, Barley, Rice, Hops.”) Traditional beer is made from malted barley. Barley, a grain crop, is harvested and then tricked into sprouting its sugary seeds using hot water. This is called malting. After the barley has been tricked, the brewer drains off the water filled with sugary barley, ferments it with yeast, and then makes it into beer. Most brewers also add hops, a bitter flower, for flavoring. 

In 2015, the TTB modified its guidance and allowed beer makers to sell beer with many added ingredients as long as they were labeled on the package. This is about as close as you can get to an ingredients list. You can see a list here. And, you can see their guidance on how those additions might appear on a label here. Basically, there needs to be at least some description besides “beer” that notifies the consumer that there’s been fruit or spices added to the beer. 

However! In recent decades, brewers have also used other grains to make beer – including wheat, rice, corn, oats, and rye grains. In this case, you might find beers that are called “wheat beers” or an “oatmeal stout” (which is a stout, a dark beer, brewed with oats). However, the beermaker is not required to list wheat or any alternative grain unless it comprises at least 25% of the grains used. That is particularly unfortunate if you have a particular allergy to a type of grain, instead of all grains. 

This yields an unexpected trade-off in beer. On one hand – finding out that a mass-produced beer like Heineken is safe for you is very helpful, because they are going to make it the same exact way everywhere in the world and it’s a very simple recipe without any additives. They are using barley, water, and hops (and yeast). On the other, you can call up your local craft brewer and see what kinds of grains and additives they use and get clarity on what they put into the beer. But local craft producers might sneak in unusual ingredients. 

I’ve seen plenty of craft beers brewed with peanut butter, hazelnuts, and other allergens. One particular ingredient for concern from craft brewers is lactose, which makes a particularly creamy kind of beer. It is not always labeled as a “lactose beer” or “beer brewed with lactose” so watch out for those! It is often mentioned in the description of the beer on the package, but sadly, they aren’t required to label it if they use lactose in production. 

Liquor: Vodka

Vodka is a spirit distilled from, well, just about anything as long as it doesn’t have a distinctive taste or color and is bottled at 40% ABV or higher. Most vodkas are grain vodkas, meaning they are distilled from wheat or rye or barley. However, vodkas can be made from other materials like potatoes or sugarcane. 

The good news is vodka must be labeled as flavored or have some other notice if they’ve added anything to it besides the base grain. So if you can have Grey Goose (made from wheat), it will always be the same Grey Goose if the bottle just says “vodka” and not “vodka flavored with X.” 

Tito’s is a famous gluten-free vodka, made exclusively from corn. That’s a great example of a craft brand that’s become super popular in the last 20 years – originally started in 1995, Tito’s has become a big brand in the U.S. for vodka. 

Craft vodkas have more variation than the megabrands in their spirit base. I can think of a local producer here who uses sugarcane, so it becomes slightly sweet, but most vodkas are a “neutral grain spirit” meaning they’re distilled from grain of some kind.

Liquor: Gin

Gin is tea made with vodka. You take an assortment of botanicals (such as juniper berries, eucalyptus leaves, flower petals, and so forth) and steep them in vodka to make a flavored vodka. After the steeping is complete, you re-distill the final product to produce a clear spirit that includes the flavors of your tea. 

While juniper is the dominant flavor, a naughty little botanical can make an appearance in some gins – tree nuts. Both Beefeater Gin and Bombay Sapphire Gin contain almonds. There are many, many craft gins like Monkey47 that also contain almonds. Newer gins on the market such as Four Pillars’ gins contain macadamia or cashew nuts, and walnut is also known to make an appearance. 

My saving grace has always been Tanqueray, a popular mass-market gin that doesn’t contain any nuts. I’ve also heard Aviation Gin, another popular mass-market brand, is safe.

Now, on the craft side, most producers take pride in the types of botanicals they put into the gin. Many times their website will actually list all of the botanicals used, so you might be able to actually identify all 22 botanicals used in The Botanist gin, a popular Scottish gin.

Generally though, to play it safe – this is one to avoid if you cannot do almonds. I’m grateful I can now eat these, but I’ve stumbled into many many gins that have almonds once I looked them up on their website. Let alone other niche craft gins that have other tree nuts! 

A gin & tonic served up at a craft gin bar in Barcelona, Spain

Liquor: Tequila & Mezcal

Tequila is a heavily regulated product from Mexico, made entirely from 100% agave plant. Tequila uses agave from a specific region of Mexico and produces a sweet and vegetal spirit, while mezcal uses agave from a much broader region and is typically smoky (due to a different production process).

The regulations are pretty strict to call it tequila – of a bottle, only 1% can be additives like sugar syrup, glycerin, coloring, or oak extract. Any other flavorings or additives are a no-go. “Añejo” tequila is simply tequila aged in an oak barrel without any extra additives. 

Mezcal has much looser rules and, given the explosion of craft mezcal, can be much dicier. I actually ran into a mezcal once at a bar that was made with peanuts (using a traditional mole sauce as a part of the production process). Cool idea, not great for me to be drinking. I discovered this because the bartend offered some for free, I politely declined, and then looked up the mezcal to learn more because “it tasted so good!” according to them. It’s uncommon, certainly, but a good reminder the craft producers are more likely to take risks in their production processes. The added benefit is the transparency they offer, but it’s always a risk to drink something you don’t know anything about. 

From a regulatory perspective, tequila is much much more controlled. You could not get away with adding a mole sauce into the production of a tequila. 

Liquor: Rum

Rum is broadly three types: clear/white/silver rum, aged rum, and spiced rum. All rum is distilled from sugar cane and molasses. Clear/white/silver rum are brand-new, unaged rums. Whereas aged rums, obviously, are aged (typically in oak casks). 

Spiced rum is the troublesome category. Rum is actually pretty tricky to navigate with a nut allergy because there are many marketing designations that have no basis in regulation: dark rum, black rum, gold rum, etc. don’t actually mean anything. 

Spiced rum is rum that uses spices, many times nuts. I believe Bacardi has five major rums and at least one of them contains nuts. The recipe for The Kraken (a popular spiced rum) is secret. Some rum brands are becoming more transparent, such as Captain Morgan, and disclosing what spices they use. 

Craft rum is a saving grace here as many local distilleries who want to make whisky actually start out by making rum and gin first –– it helps pay the bills while the whisky ages. They will be able to disclose to you all the spices used if they create a spiced rum.

I generally avoid rum. Too many pitfalls. In fact, I think I’ve never had a mass-produced spiced rum. I have had one aged rum before. But if I’m out at a bar or a party, I’m not reaching for the rum. God only knows what is actually in the bottle. 

Liquor: Whisky 

By far the most regulated of the major liquors, whisky is dominantly American, Canadian, or Scotch. There is a big rabbit hole here, but essentially – all whisky is made first like beer, then distilled in copper stills and aged in oak casks, with varying requirements on time. If there are added flavors, it must be labeled. (Even Fireball is labeled “whisky with natural cinnamon flavor”) 

Almost all major whiskies use a blend of grains, typically corn, rye, wheat, and barley. Bourbons must be made from mostly corn, rye whiskies from mostly rye, and single malt Scotch to be made from 100% barley. Blended scotches, such as Chivas Regal or Dewar’s, can be made from a blend of grains. However, different whiskies can use a different “mash bill” or combination of grains. The same producer might make one American whisky using corn/rye/oats and make another American whisky using corn/rye/wheat. And, they don’t have to tell you on the bottle.

Since whisky is always aged in oak casks, there are some variations. In America, the typical aging profile is “new American oak,” meaning it’s a brand new cask. Whereas in Scotland, they typically use “ex-bourbon casks” or “ex-sherry casks,” meaning the cask was previously used to age bourbon or sherry wine, and is now being used to impart flavors to the product. The casks types are heavily regulated – producers can’t simply throw it into anything.

There is a sub-genre of whisky that is aged in rum casks. I typically avoid these because I’m not 100% certain whether those casks were used for spiced rums (they never say, anyway). The only other whiskies I’ve ever been caught off-guard by are the flavored ones. Skrewball is a popular peanut butter-flavored whisky and Southern Comfort is flavored with tree nuts. There are all sorts of “flavored” whiskies and I drink absolutely none of them. Not even the Crown Royal apple-flavored one! The more standard whisky is better and safer as the production is heavily, heavily regulated.

A neat pour of whisky at canon, a bar in Seattle

Liqueurs

Typically a mad dash to see how fast you can have an allergic reaction. I’m only half-kidding. Liqueurs are generally a base spirit or liquor (wine and vodka are common bases) that have been infused with various additives, flavors, and other ingredients. Unlike gin, they are not re-distilled. They often retain the color of the infused ingredients. 

Liqueurs are a black hole of information. Whether it’s cheap ol’ Malibu, Campari, Cointreau, Luxardo Maraschino, Strega, red vermouths, or blanc de blanc vermouths, there is very little transparency in the industry. Closely guarded “family recipes” mean there isn’t much information on what is used in the production of the liqueur. The recipe for one famous liqueur, Green Chartreuse, is only known by three people in the world (yes, really). 

Liqueurs are also tricky due to their variations. Kahlua is a popular coffee liqueur. The original recipe does not contain nuts, but many seasonal variations they release contains nuts (like ‘The Mudslide,’ a riff with peanut butter). Many amaretto liqueurs use almonds, but not all. Disaronno, a popular amaretto, apparently uses cherry pits to achieve the same flavor without using any nuts (but who knows, really, and I haven’t had Disaronno before).

Most vermouths are wine that have been flavored with roots and herbs. I’ve never had a reaction to a vermouth, but I also don’t drink a lot of vermouths, so it’s possible some special vermouth has snuck in some nuts and nobody knows (yet).

Craft producers are absolutely your friend, as many are making “amaros” and “aperitifs” that achieve the flavors of these classic liqueurs like Campari or Aperol but have added transparency in the ingredients that they use. 

Depending on your allergies, you may be left with a real “trial and error” system when it comes to liqueurs. Many craft producers have good alternatives to the mass-produced versions and added transparency on the ingredients they use.

Cocktails & Cocktail Bars

It’s a minefield, but the most common suspects for additional problems in cocktail ingredients (besides a liqueur) would be:

  • Orgeat, an almond syrup, that is used in popular drinks like the Mai Tai 
  • Black Walnut Bitters and/or Coffee Bitters, a lightly alcoholic flavoring agent, that is used in some nicer bars for drinks 

Ironically orgeat is a favorite ingredient in rum-based drinks, so you’ve got a real potential for a double whammy on a nut allergy if they’re also using a spiced rum that contains nuts. 

A sensational craft cocktail at Stravinsky, a top 50 bar in the world in Barcelona, Spain

Craft cocktail bars can range in quality. But any bartend worth their salt will tell you that they cannot possibly know for sure whether the liquor and liqueurs used contain specific allergens. I haven’t had problems with many of the standard liqueurs like Campari or Aperol, but that doesn’t mean you won’t! Craft cocktail bars also use niche liqueurs that would be difficult to research on the internet. 

On top of that, many standard bars do not practice hygienic cleaning. They rinse out cocktail shakers with water but most bars are moving so quickly, they usually mix equipment to make different drinks. The shaken martini for one client using a gin containing almonds will be measured in a jigger and poured into a shaker set; then, after a quick rinse of the shaker (and sometimes the jigger, but not always) they will make your drink. Is that safe preparation for someone with a severe food allergy? No.

More upscale cocktail bars are much more cautious and mindful about preparation, typically because they have multiple bartends on-hand. These environments have been more hospitable for me but it’s always important to tell them your food allergies! 

Other Notes on Staying Safe

Ultimately the safest option is just not drinking. That’s probably the easiest! Here are some other notes. 

Distillation reduces a lot of the protein, but not all, from added allergens.

Hardly medical advice, but a panel of EU researchers in 2007 studied 32 gins and found almond protein (when almonds were used) was not detected above 0.1 mg/L. As they say, “the Panel notes that proteins and peptides are not carried over into the distillate during a properly controlled distillation process.” 

To me, this is small comfort for someone allergic to almonds. It may help avoid a very severe allergic reaction, but doesn’t guarantee someone will not react to protein inside. Also, this only really applies to gin? As noted previously, many of the products that actually “contain” nuts like spiced rums and liqueurs are not re-distilled after introducing the nuts. That means the presence of nut protein is way, way higher in those products! Gin is re-distilled, which helps reduce the amount of protein leftover.

Cocktail menus do not always list all the ingredients.

As someone who travels a lot and enjoys eating at new restaurants, do not take the menu’s word for it. Many cocktail bars add additional ingredients to the drink that are not listed on the menu. Make sure to always clarify your food allergies if you do order a craft cocktail, or stick with something safer. 

Tasting notes or flavor profiles are not ingredients. 

Often times you might run into a description of a whisky or a wine that mentions how “nutty” it tastes. This is almost always just a flavor descriptor. It is very, very rarely a description of what is actually used in the product. If it does actually contain nuts, it will be hinted at on the label (using “natural flavors” or a similar phrase).

Don’t drink if you don’t know it is safe.

Simply put, stick with what you know. I have never, ever accepted a mystery drink at a party. I do not order cocktails off menus with unknown ingredients. I stick with brands and types of alcohol that I know are safe. I always bring up my allergies when ordering drinks. If I’m at a less-hygienic environment like a dive bar, I’m not ordering cocktails period. I’m especially not going to take risks when alcohol is limiting my own cognitive ability to make good decisions or notice any symptoms to a reaction if they arise. 

This is hardly a complete post on everything alcohol related, but I hope it was a helpful starting point for people who are navigating food allergies and alcohol! These are my own notes and experiences. You may have different experiences with alcohol. Please be safe!

Eosinophils & Mast Cells, Food Allergies & Asthma

Managing the Fall Flare of Pollens

I love the Fall – the changing of the tree colors, the temperature cooling down from summer heat, and when my children were little, the excitement of a new school year. Along with that love is the challenge of managing numerous conditions that flare in the Fall, if you’re like me and my family. Pollen allergies, asthma, Mast Cell Activation Syndrome (MCAS) and/or Eosinophilic Esophagitis (EoE) can heighten during the Fall season and be a beast to manage.

Near Lake City, Colorado

I’ve written previously about Mast Cells and the Fall Flare on this blog, and I’ve learned some new ways to manage the Fall Flare, so I wanted to write about this topic again.

The main new item that I can share, is that waiting until the Fall to manage symptoms that arise doesn’t work for me. By the time I’m feeling nasal congestion or the tightness in my stomach (from EoE), it’s difficult to take enough medication to calm down the symptoms without making myself feel sick. I need to pre-medicate, beginning in July, with small amounts of Zyrtec, Ketotifen (a mast cell stabilizer that also helps keep eosinophils at bay), and Nasalcrom. I slowly increase the dosage of these medications as I move into Fall to manage pollen allergies and MCAS symptoms.

For me, EoE isn’t a year round issue. It is at its worst in the Fall. I begin to use swallowed Flovent or Budesonide slurry every few days in July, slowly increasing the dose to twice a day as necessary through October when we have our first freeze or snowfall. Then, like magic, once the freeze comes my EoE symptoms disappear!

For my son, managing his asthma is a year round focus. Upper respiratory infections in the winter exacerbate his asthma, and pollen in the spring through the fall also can set him off. And of course, COVID is still roaming around, and he wants to ensure that his asthma is well managed should he get another round of it.

Year round, I see a Network Care Chiropractor to keep my nervous system calm. During the winter months, I go every 2-3 weeks. In the Fall, I see him every week! The Fall Flare really triggers my mast cells to activate, which in turn activates my nervous system to be on high alert. This makes sleeping difficult, and it also creates anxiety. It’s a bad combination and for years, I was almost unable to function through the Fall. Now I’ve learned to take the extra time to take care of myself and visit my doctor so that I can feel as well as possible during the high pollen season.

I have also increased my daily practice of Zhineng Qigong to 2+ hours a day. This practice has helped my body to heal so much since I started it 5 years ago. I have had several teachers through the years, however I do the practice solo most of the time in order to do the specific practices that help my body to feel good. Practicing year round has helped me to not only feel better in my body, but also to have a higher threshold when Fall comes around. What that means for me is that if I am stressed for several days on end, and the pollen counts are high, I’m less likely to have a mast cell meltdown where I feel like I can’t get out of bed. Lowering that threshold for triggers to create havoc has made my life much more livable this year! I ensure that I’m taking care of myself year round to be at my best health when the Fall Flare starts.

I hope all of you are taking care of yourself at this time of year and enjoying the beauty of Fall!

Eczema & Rashes, Eosinophils & Mast Cells

EoE and Barrier Dysfunction from Detergents

I recently had a friend in the EoE (Eosinophilic Esophagitis) world forward me a recent research study about detergents such as Sodium Dodecyl Sulfate (also known as Sodium Lauryl Sulfate or SLS) and their impact on the esophageal barrier. She had heard about this study at a recent conference. The research found that detergents can induce esophageal inflammation.

The research conclusion was “Detergents may be a key environmental trigger in EoE pathogenesis.” (You can read the research here.) This shocked me into looking into my cabinets to see how many products I use that contain SLS. I thought that I might find one or two, but I discovered that my toothpaste, hand soap, shampoo, dish soap and other items all contained SLS! I decided that if using products that contain this detergent could have anything to do with my EoE, I’m willing to find new SLS-free products and do one more thing to help myself heal.

It has taken me the better part of a month to find items that are truly SLS free. Part of the reason why SLS is put into so many products is to make the liquid lather up nicely, and that includes toothpaste. I was most concerned about finding a new toothpaste, because I have had so many reactions to anything new put into my mouth. I haven’t been able to use mouthwash since I was diagnosed with EoE and MCAS (Mast Cell Activation Syndrome) without getting canker sores and/or having terrible itching. I was thrilled to find mint flavored toothpaste by the company, Hello, that I can tolerate! No reaction whatsoever. Also, I can get it at my local Whole Foods store, which is an added benefit. (There is also a fluoride free version of this toothpaste.)

Many products made by companies that you would think would be free of SLS aren’t as safe as I thought. Seventh Generation has SLS in some of their dish soaps, but not all. Tom’s of Maine is the same with some of their toothpastes. I searched “SLS free” products on Amazon, and found sodium lauryl sulfate listed in the ingredients of the product even though the search pulled it up as safe. I’ve learned to carefully read all the ingredients, and to not trust Amazon’s search algorithm!

If you’re like me where you’re very committed to certain products because your sensitive skin can tolerate them, finding products without SLS that you can tolerate can be quite a feat! I’ve had atopic dermatitis to coconut oil, so Dr Bronner’s pure castile liquid soap was a no go. I went through numerous SLS free hand soaps getting eczema and rashes before I decided to continue to use what I know works for me – Dove Sensitive Skin Beauty Bar (also known as a soap bar!) I now have a soap dish by every sink in my house for me to deposit my soap bar after use. To date, it’s the only SLS free hand soap that I can use.

Shampoo was also very difficult to find without SLS and without coconut oil. My hair stylist suggested this product, and it has worked great for me and even lathers up! I was able to find it on Amazon.

Lastly, I found dish soap from Better Life that I had used before and just got lazy by picking up products at Costco. Of course, all of those products have SLS in their ingredients. The Better Life dish soap also comes unscented, but surprisingly this scented dish soap doesn’t bother me!

I’m now actively engaged in protecting my skin barrier and my esophageal barrier with the use of these products! If you’ve found others that work well for you, tell me about them at [email protected]

PS – I have not been paid to endorse any of these products. They are suggested based upon my experience. PLEASE make your own decisions of changing products to SLS free based upon what works best for you, which may be different products depending upon your own sensitivities!

College with Food Allergies, Food Allergy, Travel/Eating Out & Food Allergy

Retrospective on 3+ Years of Traveling with Food Allergies

Over the past 3 years, I’ve traveled a lot for work – and for fun. I’ve traveled nationally to San Francisco (CA), Tampa (FL), Whitefish (MT), Seattle (WA) and Boston (MA) a lot – plus some recurring trips inside Colorado where I live. I’ve traveled internationally to Italy, Calgary (Canada), Scotland (UK), and Barcelona (Spain). And I’m currently planning more… Chicago, San Diego, Mexico City, New Zealand, and maybe even Portland (Maine)? My boyfriend has joined me on many of these trips and even has done some of his own to Japan.

Even though I’m allergic to peanuts, tree nuts, sesame, shellfish, and fish, I’ve never had an allergic reaction while traveling. I’ve had a few close calls and one extremely angry waiter, but I’ve traveled freely and enjoyed every second. I think it’s easy to look at this and say – oh wow! Morgan’s got it in the bag. That’s not true. I also travel with plenty of anxiety about food and eating out. I’ve learned some tried-and-true tips that have helped me to manage food safely while traveling and to avoid bad consequences. 

So I wanted to share these practices that have kept me safe and also share some stories that help illustrate how & why it works.

Cadaqués, Spain

#1. Don’t Take Dumb Risks. 

Never had curry before? Don’t try it for the first time on a flight. In a small Irish pub in downtown Boston and they serve fish & chips, but their kitchen looks smaller than yours? Don’t eat the fries. Tell your waitress that you’re allergic to seafood and she says that other visitors with that allergy haven’t had any issues with the food? Don’t take her word for it. Don’t speak the language and you don’t have an allergy card? Don’t eat! Don’t speak the language but you do have an allergy card but you don’t understand their response? Don’t eat! 

These are broadly what I call “dumb risks.” They’re dumb! Use your head. Of all the principles and practices, this is the one that has kept me alive. I read news stories – ranging from sad to tragic – about people having allergic reactions or experiencing severe anaphylaxis because (broadly) they took dumb risks. 

This could also be called the Jungle Juice rule. If you attend a college fraternity party, they’re probably going to serve jungle juice, a cocktail that usually looks like it’s made in a bathtub… and tastes also like it was made in a bathtub. If you’re allergic to almonds, there are a lot of gins that contain almonds. And chances are somebody bought a cheap gin to make their jungle juice. Did you need to know all of that in order to avoid the jungle juice? Did you need to know the specific gin they used in order to decide not to drink the jungle juice?? No! The jungle juice is a dumb risk, period, whether or not you’re allergic to almonds. 

So, a few dumb risks I don’t take: 

  • Eating anything without telling the waiter about your food allergies
  • Eating fried foods at places that serve fried fish dishes 
  • Eating the bread provided, whether or not it has sesame seeds on it 
  • Eating dessert at a restaurant 
  • Drinking something where I can’t identify the ingredients
  • Eating meals prepared on a plane 
  • Eating anything where I can’t identify the ingredients on a proper label
  • Eating a meal that is usually unsafe but is promised “it is safe”
  • Taking the waiter’s word for it, particularly when there is a language barrier 
  • Eating at a restaurant where most of the menu is shellfish and there’s one “safe” looking option

I was out for a work trip in Boston and went out to dinner with the clients. We ate at a nice Italian restaurant. After sitting down and looking over the menu, we each ordered our dishes and my colleagues asked for an appetizer to share that was made with bread and pesto. Traditionally, pesto contains pine nuts, which I’m allergic to. I always give my normal spiel (allergic to this and that, please tell the kitchen, etc etc) and the waiter promised it was fine, everything will be processed with the kitchen, but even the appetizer should be okay. Pesto, historically, is not safe! It is a dumb risk to eat pesto while eating out. So in this case, guess what? I didn’t eat the pesto! Five minutes after the pesto and bread is served, the waiter comes back with a concerned look and says – “oh actually, yes the pesto does contain nuts, you haven’t eaten any, have you?”

Bread is the common culprit while traveling with a sesame allergy, but while I was in Barcelona, I was surprised to learn at one restaurant that their bread may contain tree nuts due to the way it’s prepared in the kitchen. I only found this out after ordering and agreeing for bread to be served to the table as a part of the appetizer…. and then mentioning my allergies. It would’ve been a very dumb risk to not mention my allergies or only mention a couple of them! 

This is a principle I have learned time and again will save my life. It sucks. Of course I’d like the ease and simplicity of hopping on a plane and eating whatever looks good. Of course I’d like to just hop into any hole-in-the-wall and eat what they offer me when I walk in. Of course I’d like to live a carefree life when it comes to food, drink, and travel. 

But I’d also very much like to return home and do it again in a few months, and every dumb risk I might take is a little guarantee that might not happen. 

Isle of Skye, Scotland

#2. Don’t Travel Internationally to Countries Where You Wouldn’t Eat at the Local Restaurant.

My boyfriend traveled to Japan last year with a close college friend. I would’ve loved to go. But historically Japanese food and my allergies do not mix well. The fish & shellfish-heavy cuisine, the sesame used both as a garnish and inside sauces, the hidden fish used as a base for broth (dashi), and so on. I’ve been able to make my own Japanese cuisine at home thanks to a well-curated recipe list, the endless patience of my boyfriend to verify if things “taste alright,” and a keen curiosity to taste things I’ve never had before. 

But here’s the rub. If I’m not gonna eat at the local Chinese takeout place, I probably shouldn’t go to China. Is Chinese food all like the local Chinese takeout place? No! Actually famously, American Chinese takeout is very different than all of Chinese cuisine. But if you’re not gonna get the local version for fear of your own allergies – what are you gonna do when that’s the only kind of food around?

There are a few brave souls who go through the rigamarole of making it work. Maybe one day I’ll be one of those people carting around a hot plate, only eating rice and fresh veggies, and occasionally stopping into some American food joint that’s been exported into the city for a taste of home. But it also feels like a dumb risk going to a country where I can’t eat most of their food. 

My combo plate of allergies specifically rules out East and Southeast Asia… and also the Levant / the Middle East. Could I make India work? I don’t know, actually. I do know that there are some surprising uses of nuts in some Indian curries, but I don’t know enough to tell you the difference because I haven’t eaten at a lot of Indian restaurants in Denver! This principle hits the hardest because I love to travel and I’d love to see the shrines in Kyoto and the majestic mountains of Tibet and hop on a little motorcycle and careen through traffic in Bangkok. But it’s just not in the cards. I can’t even eat at my local Thai place. 

#3. Create a Shortlist of Options.

There are obviously many places to travel, nationally and internationally, that exist in a sort of “gray zone” when it comes to allergies and intolerances. This gray zone has been widened extensively in the last decade as travel and tourism has expanded as an industry. “Gluten-free” and “vegan” are not crazy concepts. Social media has vastly upgraded people’s awareness of these issues. Does that mean the owner of a small pasticceria in Venice is going to go through all the steps to make sure your food is safe for a dairy allergy? No, probably not. That’s a dumb risk. But it does mean that in some corners of the world, there is a surprising amount of awareness. 

I think of this like GPS. In order for your phone to work, it has to ping 3 satellites to find your exact location. So creating a shortlist of options is creating a GPS for a safe meal. I’m figuring out whether (1) the food looks good, (2) the restaurant can probably make a safe meal, and (3) it’s a dumb risk. While traveling in Barcelona, a lot of restaurants were ruled out in buckets 2 and 3. There were specific tapas menus that heavily featured seafood. There were nice, upscale restaurants that had a lot of nuts distributed throughout the menu. Is it possible to get a safe meal there? Maybe! I don’t know. But I’m pinging around my options, trying to create a shortlist of restaurants that I would actually like to eat at and seem relatively safe. 

Having this shortlist is so helpful when traveling in a group. I get pretty anxious when a group of friends just say “oh let’s check out this restaurant up the road!” Me? I’m Googling that, looking at their menu, assessing whether there might be a safe option, and whether it’s a dumb risk… all on the car ride over. I try and circumvent this and proactively offer an option from my shortlist. A response could sound like “oh! You know what, I’ve heard there’s this place not too far that serves incredible X, seems like a good stop, I was planning on trying it out.” In groups, there’s a lot of momentum toward someone who already has a plan. Proposing an option and saying “I was planning on trying it out” gets people to be enrolled in what you already wanted. 

When traveling Italy in a small town near Lake Como, I already had 4 restaurants on my shortlist. There were plenty more to eat at, but either the reviews looked bad, the food looked bad, or their ability to make a safe meal looked uncertain. We hit up those shortlist options to great success. 

When I was in Tampa for a work trip, I made a shortlist so I knew what food options I might have in the area of the event. It came in handy later that night when everyone was moving toward a restaurant I disqualified – and I quickly realized I would need an alternative. I was in a big group so I pulled aside a friend and said, “wanna skip the line? I’ve got another place.” We ended up having 5 or 6 join us. 

A quick aside – I actually developed this principle from trial-and-error (more error) while studying abroad in 2016. I was quick to realize that my friends were happy to wander around a city and just sit down somewhere to eat. That wasn’t going to work for me on a number of levels. They were wonderfully deferential about whether I felt safe at a restaurant, but I quickly learned that it was best to have a couple of options to suggest so we didn’t have to stop at multiple restaurants, only for me to say no. 

Ristorante Borgovino in Lake Como, Italy

#4. Get to Know Labelling Laws.

One excellent shortcut to eating out is buying your own food. It saves you money and saves you time (and probably anxiety) over eating out. The problem is, every country has their own labelling laws. 

Let’s start in the US. Liquor and booze is unlabeled. Manufacturers broadly get to decide whether they add the “may contain” or “manufactured in…” statements. We have our Top 9. And a label looks a certain way. 

That’s not always the case! While traveling in the UK, I noticed their labels look very different. Their nutritional values like calories and carbs look different. And the allergy notice, and which allergies are labeled, are different. Same was true in Italy, in Spain, and (from my boyfriend) in Japan. Japan is a curious example here – by law they’re required to label a Top 7 that includes crab, buckwheat, and egg. But it is optional to highlight or bold 27 (!) other allergens like banana, peach, salmon roe, and yam. You’re not gonna find “yam” highlighted in the US. 

I always look up labelling laws before traveling somewhere internationally. There is a lot of information out on the Internet about what they’re required to label, how it might look, and what their top allergens are. This is very useful when purchasing goods while on the go. I’m not an expert on these things. But it offers a degree of confidence that I wouldn’t otherwise have when I’m purchasing that bag of chips in the train station. 

#5. Get to Know the Culture Before Going.

I’m actually not just talking international here. What’s the famous regional dish? What do people like to eat? How do people like to eat? Are there a lot of a certain kind of restaurant in the city? 

You don’t need to be a cultural anthropologist to get a sense of these answers. Sure, in the US, you might get some similar patterns. But we all know there are regional differences! Austin (TX) is a taco city and famous for its restaurant scene with hip fusion restaurants. Boston (MA) has a lot of pubs and not a lot of breakfast spots. Whitefish (MT) is a big ski resort town so they have a lot of classic American food centered around burgers. Scotland loves its fish & chips. Barcelona cannot get enough tapas. 

In the US, chances are there is always a shot at a local safe fast-food or fast-casual spot that can satiate your food needs if you’re eating out. Traveling internationally, much less so. Watching a few YouTube videos and trying to piece together what people like to eat will help you navigate the culture while abroad. German food has a lot of safe options for me, surprisingly. Thai? Not so much. Knowing these differences helps you navigate common situations you might run into – and make better decisions, especially when creating a shortlist. 

I traveled for about 3 weeks in total in the UK (split between London and the wide open country in Scotland). I never once ate fries – “chips” in British parlance. It just wasn’t worth it. Could I have convinced some poor pub to fry me a separate batch? Yeah, sure. But fish & chips are so pervasive in the culture that it was unlikely I’d ever get a fresh, safe batch. The local Village Inn (an actual place I stayed at) in rural Scotland isn’t going to have an extra fryer on hand. Why go through the bother? I know that, in a principled manner, it’s supposed to be true that we are able to eat the things we want in a safe and reliable manner. In practice, knowing the culture is an easy way to find paths of least resistance and ask for the steak pie instead (after checking on allergies). 

Canmore, Alberta, Canada

#6. Don’t Drink Unfamiliar Drinks.

You may not drink alcohol at all! That’s probably the easiest solution. But if you are to imbibe while traveling – and this is especially true while traveling inside the US – don’t try things that are unfamiliar. This is a dumb risk. But I wanted to call it out specifically for a couple reasons. 

In the US, we have a growing culture of “craft cocktails.” These are a step beyond your classics. They use fancy liqueurs, custom syrups, bitters… all sorts of ingredients that are rife for allergy issues. Plus, the cross contact issue in bars can be exceptionally troublesome. Many normal restaurants are making every drink (using gins that contain almonds, whisky made from wheat, sesame syrups, nut-flavored rums) in the same containers and only rinsing them in between with water. Upscale establishments are much more hygienic, but also pricier and harder to get into. I’ve spent years deeply understanding liquor, wine, and beer to feel safe while drinking. I probably know more than a few sommeliers about the production process, the aging, and the final product of a lot of liquors – I wish I was kidding here. Some of that knowledge has been fueled by visits to producers while in Italy, Scotland, and Spain. But a lot of it is simply internet research and YouTube. It’s one of the reasons I know so many gins use almonds as a botanical. 

If I’m out at a bar and I have the option to choose between a fancy craft cocktail that uses an ingredient I’ve never heard of before (let’s say, Italicus) and a glass of wine – I’m gonna go wine. First of all, they usually pour the wine from a bottle into the glass, keeping it much safer from cross contact issues. Second of all, I’m not gonna sit at the bar and look up Italicus and try to see if there are ingredients for it! That’s a dumb risk to drink a cocktail in which I don’t understand the ingredients… let alone all the other cross contact issues. 

At more upscale establishments, you might have some leeway. In Denver, there is a world famous bar (Death & Co) and while traveling in Barcelona, we went to Stravinsky’s, another world famous bar. Stravinsky’s only serves cocktails and I noticed some items on the menu I didn’t recognize. At Death & Co, when I explain my allergies, they actually go through a whole separate process to ensure no cross contact issues, which is lovely. So I brought it up with my waiter at Stravinsky’s, explained my allergies, and he got it! Not only did he get it, he also understood the cross contact issues and noted that it would be handled properly. It was a great experience. 

#7. Be Sheepish if You Have To.

Don’t feel confident explaining your allergies? Or, just really really tired after a long day and not feeling like explaining it to somebody new for the third time that day? Act sheepish.

“I’m sorry to be a pain in the ass but it’s really important…”

“I’m sure you get a lot of folks like me…”

“Look I know this is kind of a pain…”

There is an undeniable toll on mental energy when you’re traveling with food allergies. Acting sheepish is a great way to shortcut my own inner resistance to bringing it up for the fifth time in the same day. Because I’ve had to live through all five experiences in the same day! The waiter in front of me hasn’t, and it’s just as important to mention it for this meal as the last one. Ultimately, your food allergies are not a pain in the ass to deal with! They are not an inconvenience! 

But at the end of a three week trip in Scotland and the UK, I really just wanted to curl up at home and not have to worry about these damn things for the hundrendth time. So this was my shortcut. I told the waitress “Look I’m sorry to be a pain in the ass but I’ve got severe food allergies and I really just want to have a safe meal” (I laid in all of my actual physical exhaustion into this statement). She listened closely as I explained my allergies, smiled, and told me that the kitchen would know and everything I ordered should be safe, but she’d let me know. I felt better – it was the fifteenth explanation that week – and I noticed how useful it was. 

I’m not saying you should run around using this line with everyone, but when you’re feeling it, use it. It’s helped me stay consistent in always telling the waitstaff my allergies! 

Barcelona, Spain

#8. Deal with the Unexpected.

There’s an old saying that’s goes “expect the unexpected.” Great advice when it comes to a delayed train in the UK, not great advice when the stewardess starts serving nuts on a nut-free flight. I’m much more proactive in my approach: deal with the unexpected. 

When we were in Barcelona, we went to a tapas restaurant that had indicated it was a safe option from their website. Turns out, their menu was seasonal. The menu we were presented once we sat down was very, very different than the one online. It had all sorts of fusion cuisine, there were nuts and fish all over the menu. I thought to myself… “Hm we might need to walk out, but let’s see.” Our waitress María approached the table and asked if we were ready to order. I replied (in Spanish) that I first had a question, and I went about explaining my allergies. As I went down the list, her eyebrows furrowed deeper and deeper. At the end she said, “Okay let’s take a look.” And then to my absolute delight and surprise, we went jointly through the menu and figured out which dishes would be safe to eat. She knew every hidden ingredient like oyster sauce in their eggplant dish or sesame oil in their pork gyoza. They even went so far to replace one sauce from one dish with another (safe) sauce from another dish. She even came back with bad news about one dish, saying the sauce had a “may contain” statement with one of their ingredients. 

Turns out María also works the kitchen in the mornings. That helped. She was also very fluent in English – that also helped. But I also proactively told her about my allergies before ordering, because I wanted to know: is there anything safe for me to eat here? If not, that’s okay, we can go elsewhere, this was unexpected. But she absolutely made it work. (Shoutout María at The Sopa Boba in Barcelona, you were incredible). 

By proactively dealing with the unexpected – speaking up, establishing clear boundaries, saying something is okay or not okay, and clearly explaining what’s going – I’m able to make sure the unexpected is more of a friend than an enemy. I’ve never had a perfect travel experience. I was surprised to have nuts served on a train trip while in Italy (for me, not a big deal since I’m not airborne allergic but still very unexpected). I was surprised to learn a pub in Boston fried their chicken in the same friers as their fish even though they barely served fish. I was surprised to learn a small burger joint in San Francisco used nuts in one of their sauces. I was surprised to learn Delta Airlines likes to serve pistachios to their business class clients. I was surprised to learn a dinner joint in Whitefish MT was completely safe for me to eat even though I had a lot of doubts. I was even surprised to learn a sandwich joint down the street from where I live was completely a nut- and sesame-free kitchen! 

Anyway. My point is that the “unexpected” is always going to crop up. You might expect it, sure, but the stakes on allergies are much higher than a missed train or a delayed flight. It’s best to stay proactive and let the journey take you where it may. For what it’s worth, that might include a stop at a 2nd restaurant that’s actually safe for you to eat at. 

#9. Don’t Fake the Language.

Ah, a tale where I totally messed up.

I learned pretty quickly traveling in Italy that it was easier to explain my allergies in Italian than in English. Something about the language barrier there just left me ill-at-ease explaining my allergies in English. So I figured out how to explain what I was allergic to in Italian.

Here’s the scene: we hit up a local joint while in Venice. After we order a small snack and a couple drinks, I explain to the waiter (in Italian) my allergies. He says something that sounds a lot like what I’ve heard previously – that they use sesame in the kitchen but it won’t be on the food. I said that was fine. When the food was served, the bread had sesame all over it! I realized my mistake immediately. I whipped out my translate app, I apologized for the misunderstanding, but queried again about the allergies. And he came back in mostly-broken English, but sounding plenty frustrated: “I told you the bread had sesame! You said it was fine!” Whoops. We sent back the food, finished our drinks, and moved on. 

Lesson learned. Moving forward, I told future waiters: “I don’t know how to respond to this in Italian,” then used my Italian phrase for my allergies, and then looked at them expectantly. That seemed to do the trick! I always got a response that intermingled the Italian words for the allergies with English explaining the dishes and they did a much better job handling everything. 

When I traveled to Barcelona, I did not make the same mistake. I was practicing Spanish for plenty of time before visiting and I felt comfortable carrying on a conversation. I knew the context clues while ordering and I understood what people would say (in their infinite variations) even if I wasn’t totally fluent. That served me very well again – I felt very safe ordering, every waiter or waitress immediately understood my order, and we could carry on a short conversation about what was safe/why/etc. 

So don’t fake the language. 

A supplemental idea here – learn how to talk about your allergies in the local language. The core concept here is I want clear communication. If their English isn’t fluent, I think it’s a dumb risk for them to understand the English words for my allergies. I want to explain to them, in their language, about my allergies. That’s clear communication. In Spain this was superbly important because every single waiter understood los frutos secos or frutos de cascara (tree nuts) – it’s a top allergen to be labeled on food. Soy alergíco a los fruto secos… is a great a way to get their attention. You’re saying: this is important! If I said “I have an allergy, to all tree nuts” it’s possible I wouldn’t achieve the same amount of clarity. They may hear “nuts” and think nueces which in Spanish is technically only walnuts (although there’s some regional variation about whether that translates to just walnuts). 

I want them to be able to go back to the kitchen and clearly communicate the same thing I told them, and if that requires a little bit of extra work on the front end to learn some context words, and practice it a few bajillion times, then I’m going to do it. Still – don’t fake the language! 

Iceland

#10. Use Your Tools.

Whip out that translator app. Hit up the local grocery store. Stay at hotels with a kitchen (or at Airbnbs that don’t have outrageous fees). Mark your allergy with the airlines. Bring a backpack and carry a snack. Ask questions. Invite friends over instead of going out. Eat at the local fast casual place you know has a safe option.

When I travel to Boston for work, I usually stay in an Airbnb instead of a hotel. It’s usually more cost appropriate and I get a kitchen. I can walk to a local grocery store, buy food for (at least) breakfasts for the week, and store them in the fridge. I travel by myself for those work trips, so this makes it really easy to always have a safe breakfast option without having to navigate a local cafe. There are some hotel chains that also offer a kitchen ensuite, which would suffice. 

I think of my planning decisions for a trip – the type of hotel, the airline, the location, the activities – as building a “menu of possibilities.” Depending on my choices, I get different menus. The hotel I stayed at in Whitefish? Had a mini-fridge and a small sink for dirty glasses. That meant all of my food was going to be at restaurants or takeaway. Meanwhile when I was traveling Scotland, I stayed at a beautiful little Airbnb with a full kitchenette. I stopped by the local co-op to pick up food for the days I was staying there and now I didn’t need to worry about food unless I was out hiking some munroe. 

Making sure you have everything you need beyond the basics of your medication is so crucial to ensure the trip goes well. I did not walk around Barcelona without having the Spanish and Catalan languages fully downloaded inside my Google Translate app. It’s a tool! I might need to use it.

When I was in Tampa, I found a local Chipotle to eat at for a pre-meeting meal. A classic, safe option for my food allergy set. I knew they’d have safe options. Could I have hit up a local joint? Yeah, maybe. But I wasn’t in the mood and I thought – why not use the tools in front of me? Let’s go to Chipotle. 

En Fin

None of these rules or principles have prevented me from running into trouble. 

I still have waiters reject orders at restaurants, saying they aren’t safe. I still have to explain my food allergies everywhere I go. I still need to read ingredient labels. I still have those couple minutes of anxiety, trying something new that I’ve never had before and wondering if somebody messed up. 

Those things never really go away. That’s life. That’s just how it is. Yes, colleagues who don’t have any prior knowledge of my allergies always ask about it once I bring it up with the waiters. Is it tiring to explain it for the 5,000th time in my life? To answer their questions about how severe it is, when I first learned about it, and whether I carry an auto injector? Actually yeah. It is, a bit. But I also know that it comes from a place of curiosity and care. So I share a bit more than I feel like and our bond grows a little bit deeper. 

I know I’m lucky that I don’t have such severe allergies that it might prevent me from hopping on a plane in the first place. I know a lot of this is possible because I like to spend an inordinate amount of time on research. But these things have kept me safe and I hope they help you on your next trip! 

Bon voyage 🙂 

PS – Here are a few other ideas that didn’t make the final cut for this article but I do feel are important to mention:

  • Be mindful of what your date is eating, it will become important later in the night (if the date goes well) 
  • Always carry a snack that you know is safe, even if it means bringing it through TSA 
  • Bring Rx paperwork just in case 

If you want to read more about international travel, eating out, and other previous experiences, check out:

  • Preparing for my studying abroad experience & navigating foreign universities, here
  • Backpacking Iceland for 2 weeks, here
  • Navigating hip upscale restaurants and fusion food, here
  • Traveling in Italy for 2 weeks, here
Food Allergy

Outgrowing Almond Allergy!

When my son, Morgan, was a little boy he continued to add more and more food allergies. He started with a peanut allergy reaction – breaking out in hives from touching a peanut butter sandwich at the age of 9 months. Thankfully, he didn’t eat it!

He added an egg allergy after a reaction to the MMR vaccine, and subsequent testing at 18 months old confirmed egg and also confirmed a severe peanut allergy. Our allergist suggested that he not eat tree nuts because of the likelihood of cross contact in the manufacturing process with peanuts.

Then, at the age of 3, he had full body hives and we went back for more testing to determine what food was causing the issue. To our dismay, he added another allergy – shellfish, but he hadn’t eaten shellfish the day of the hives, so we began to suspect sesame as the cause of the hives, but didn’t get that confirmed until a later allergy testing. We had further testing completed a few more times as he got older in the hopes that he would have outgrown a few of these allergies. While he did appear to outgrow egg allergy, it wasn’t until he was in high school that he was willing to go through a food challenge for eggs, which he passed. That was the only food allergy he had outgrown during his childhood.

He wasn’t supposed to be allergic to fish, as per one of the allergy testing results, yet had full blown anaphylaxis to one bite of trout on a camping trip a few years after this testing. That was a shock to say the least! So we added that food to his ever-growing list of food allergies.

He was managing peanut, tree nuts, shellfish, fish and sesame allergies from middle school through college and out into the work world. We basically had given up on him ever outgrowing any of these food allergies.

It has been 13 years since that last food challenge (he’s 28 years old now), and Morgan recently got brave enough to test for almonds, which had come back negative in two previous allergy testing results. A food challenge can be very anxiety producing, and we’ve found that Morgan has to REALLY want to eat the food to make the process worthwhile.

Here is Morgan’s summary of the food challenge as posted on his LinkedIn account:

You can probably imagine how excited we all were with this development! I suppose the moral of the story of food allergies is: never give up on outgrowing a food allergy!

Morgan has begun eating almonds in all kinds of foods (always ensuring that there is no cross contact with any other tree nuts since he still has those allergies), and also drinking almond milk. It has expanded his diet enormously and we are so thrilled!

Food Allergy, Food Allergy & Anaphylaxis

Eye Ointment made with Peanut Oil!

I have long been challenged with dry eyes. My optometrist and I continue to look for ways to mitigate my scratchy eyes and blepharitis (inflammation in the eyelids where the oil glands become blocked). I had another flare of my dry eyes recently, and my doctor suggested a new product: Optase HyloNight. I was excited that not only would the product help my dry eyes, but would also help the blepharitis. Too many times, a product that helps one issue causes the other issue to get exacerbated.

I carefully read the Amazon page about the product and ordered it. I’ve learned with all of my food allergies and other sensitivities to be thorough in vetting any new product I’m going to introduce, especially if I’m going to be putting it into my eye.

When I received the eye ointment, I read the box and the Instructions for Use that was inside the box. Imagine my surprise when I read the statement, “May Contain Peanut Oil” in both places!

The first thing I did was to go back to the Amazon product page to re-read the Inactive Ingredients that were listed there to make sure I hadn’t missed the information. Here’s what I found:

As you can see in the Inactive Ingredients, there is no mention of peanut oil! I was shocked.

For those of you not versed in the language of peanut oil, there is cold-pressed peanut oil which should be avoided by anyone who has peanut allergies, such as myself. There is also highly refined peanut oil, which shouldn’t contain the protein that creates the IgE reaction in those people with the allergy. However, your doctor can best inform you whether you should refrain from ingesting either form of peanut oil, depending upon your specific circumstances.

There is no indication on the box what kind of peanut oil was used. I reached out to the seller of the product to provide feedback, and never received a response. Therefore, I decided it best to not use the product at all.

I also informed Amazon that the product page is not complete, yet I did so weeks ago and there has been no change to the information on the page. I also provided a review of this product so that other potential buyers with peanut allergies would not purchase it.

It took several phone calls and messages to get a refund on the product since a refund is not generally given from Amazon on eye ointments. I had to explain that the product page is not accurate.

This situation is a good reminder to ALWAYS read the information of any product that you’re going to use on yourself or your child with food allergies. You can never be too cautious!

Eosinophils & Mast Cells

Medical Procedures with MCAS

Facing life with Mast Cell Activation Syndrome (MCAS) is a daily challenge for most patients. Adding some type of medical procedure to that daily challenge can feel truly daunting. Yet sometimes we have to have a cavity filled, have a preventative colonoscopy or have surgery. At these times, good preparation will help the procedure go more smoothly.

I’ve had an MCAS diagnosis for almost 2 decades, and I’ve faced all kinds of medical procedures, and I’ve learned what has worked well for me; however, I want to caution that each of us individually needs to determine what works best for us in these situations.

In my doctor’s attempt to figure out what was wrong with me when I first started exhibiting symptoms of no longer being able to eat certain foods, having acid reflux and stomach aches, my GI doctor sent me to have a CT scan. At that time, I had no idea I had MCAS, and had the CT scan done with contrast, meaning I swallowed a liquid with dye (the dye can also be injected via IV). I began feeling hot and nauseous and chalked it up to the nasty tasting formula. For the next several days, I felt like I was sick. Only after being diagnosed with MCAS was I told to never again get any type of test with dye injected or swallowed as this was a major trigger for most patients with MCAS. I was having an allergic reaction to the dye, and didn’t realize this was making my MCAS symptoms worse and not helpful to me at all. And it turned out the CT scan was normal!

The Mast Cell Disease Society has a document called Emergency Room Response Plan that is not only fillable for your particular details and gives details of medication an ER staff should use for a reaction, but it also delineates what medications you should stay away from. They also have a list of triggers here. I have learned to NOT rely on medical personnel, even in the ER, to know what MCAS is or what can trigger activation. I have to know what my triggers are, and how best to educate others as to what I can and cannot be given medically. This includes foods, medical procedures, and medications.

I have had cavities filled without a problem, and lidocaine works well for me. However I know of people with MCAS who cannot stand the vibration and the noise caused from the drill. And for some people, anxiety around going to a dentist can create enough stress that mast cells begin to activate.

Stress around a potential medical procedure needs to be well managed. Many of us have years of seeing doctors who tell us our symptoms are all in our heads, or we’ve been given an array of tests that make us sicker and we trial medications that we react to. It’s easy to see why we become stressed out with a potential medical procedure. We’ve had so many negative experiences, and we don’t want another bad situation to occur. I’ve found that explaining to my doctor my past experiences of what has worked well to be helpful. And I make sure the doctor knows exactly what I’m allergic to, and what drugs to stay away from. Most of the time I have to explain what MCAS is, and I’ve had doctors tell me there is no such thing. If they say that, then I know to go shop for a new doctor!

In the early years of trying to get a diagnosis, I had multiple endoscopies and colonoscopies. My GI doctor felt it was important to keep my body calmed down during these procedures and he would give me IV Benadryl before the procedure started. I didn’t have any issues with the endoscopies and colonoscopies other than I felt very exhausted after the procedure.

When I had a hysterectomy, this same GI doctor had me do a short course of Prednisone to calm down my system prior to going through a major surgery such as this. Again, the idea was to give my body the best chance of recovery without a reaction. I was able to get through the hysterectomy surgery fine, and my husband brought safe food to hospital for the 3 days I was there. However, the only pain medication that I can tolerate is Fentanyl, which I had through IV in the hospital and then through a patch when I went home, since having any medication go through my gut causes severe stomach upset, and yet I was still nauseated. I was put on a Scopolamine patch for this and ended up having hallucinations! Come to find out, many MCAS patients have difficulties tolerating Scopolamine, but once again I didn’t know this at the time, and neither did my doctor. It was a bumpy recovery for the first week, when I landed back in the ER for the hallucinations, but I demanded to have no medication patches and that I would just tolerate the pain. This worked for me.

I understand that not everyone would want to choose this course of action, however I can’t even take Tylenol without stomach upset. And it just isn’t worth it to me in most instances to take pain medications. I’ve had 5 breast biopsies – some stereotactic and some full surgeries to remove larger volumes of tissue – and I had to use a small patch of Fentanyl only once. I’ve found that if I just rest and take it easy, my body heals better than trying to take medication so that I can get moving back into my life quicker. And with the breast biopsies, a cold pack mitigated most of the pain for the first few hours after the procedure.

I recently had a preventative colonoscopy, and I was surprised how much easier it was this time than 10 and 15 years ago when I had my last ones. The GI doctor used Propofol, which was a much kinder drug to my system, and I chose to not have IV Benadryl because my MCAS is not as flared as it was years ago when I was first diagnosed. Also, the prep part of the procedure can be nasty since I can’t do anything but water during the prep day. Jello, popsicles, etc. all have dye in them which doesn’t work for me.

I was able to tolerate the Golytely prep just fine and only had to do 50% of it to be fully prepared for the procedure. That’s another thing I’ve learned – do what’s best for my body for the result that the doctor wants. My intestines aren’t those of a “normal” person, and therefore I don’t need to overdo the prep. The other thing that I’ve discovered that’s changed with a colonoscopy is the use of carbon dioxide rather than air for the doctor to get a better view of the colon. This allowed my intestines to absorb the carbon dioxide rather than having to pass air after the procedure, which can be quite loud and painful!

Medical procedures with MCAS require that we become our own advocate. Make sure to educate all medical personnel about your history of reactions, what works well and what is likely to be a trigger. Keep your stress level as low as possible by having a good friend or family member with you for every procedure. You don’t have to do this solo! And make sure they have all your medical history too. Then you can relax, as much as possible, and sail through your procedure!

Eosinophils & Mast Cells, Food Allergies & Asthma, Food Allergy, Food Allergy & Anaphylaxis, Food Allergy & EpiPen

New book on all things Allergic

There’s a brand new book out called Allergic: Our Irritated Bodies in a Changing World by Theresa MacPhail. Theresa is a medical anthropologist – who knew there was such a thing ?! – and has done an admirable job covering topics from the medical discovery of allergies, diagnoses, where allergies might source from, treatments, research and more. I’ve just finished reading the book, and I’ve enjoyed reading it, and thought that my AllergicChild readers might benefit from what I found helpful in the book.

I’ve been in the Allergy World all my adult life, and have had years of experience with my own allergies and those of each of my children. Yet, I still learned more about the immune system and how it operates by reading this book. I also learned more about Dupixent and how it came into being. That was a fascinating part of the book to me. I’ve been wondering if it would be a good drug for me to try to combat my Eosinophilic Esophagitis (EoE) diagnosis. This book gave me more details than I’ve been able to find elsewhere. And my conclusion is that the price of the drug is still prohibitive for me!

Ms. MacPhail has interviewed literally dozens of the most esteemed allergists, scientists and researchers for the various topics she covers in this book. If you’ve been part of the Allergy World, you will likely recognize almost all of these individuals. It felt comforting to me that she went to the experts who shared their experience and specific research.

And beyond just the experts, she also interviews parents and advocates who have created groups and non-profits that help individuals in the Allergy World. I liked reading about these individuals, especially since I know them and have met them at food allergy conferences through the years. I respect them tremendously, and reading about them in the book only made me have even more appreciation for them and everything they have done for our community.

If you’re looking to learn more about food allergies, pollen allergies, your immune system and treatments that are on the horizon, I’d definitely suggest you read this book!

(PS – I’m not receiving any remuneration to provide you this review, nor do I know the author. But I would love to have more conversations with her if I ever did get to speak with her!)

Coronavirus COVID-19

Long COVID & leaps in healing

I have been writing a series of posts about my grown daughter, Michaela, and her path back to health from COVID and then from Long COVID, which started with the first blog post here. It has now been 20 months since the initial acute COVID infection, and the last 6 months have been better than any Michaela has had since being diagnosed with COVID.

Since my last blog post on the topic in the beginning of January 2023, Michaela has tried only one new modality, Neurofeedback. Sadly, it turned out to be too much for her body and nervous system. While my experience with Neurotherapy was wonderful (which I wrote about here), we learned from the results of Michaela’s QEEG (Quantitative Electroencephalography) that she had experienced some type of brain injury in her early childhood. This injury could have occurred at birth, when the doctor used a “suction method” to guide her through the birth canal, or one of the several times that she fell down the stairs of a 100 year old home in which we lived when she was a toddler.

The QEEG isn’t capable of providing the date of the injury, but the results of the test were consistent with someone who had experienced a traumatic brain injury many decades previously. The reason why that was important to know is that Michaela’s brain isn’t communicating optimally from one side to the other, which creates energy discrepancies, and makes Neurotherapy more challenging, requiring the sessions to go much more slowly.

The previous brain injury was also likely to blame for her grand mal seizures after she experienced severe dehydration back in 2017, which I wrote about here. So the culmination of a childhood brain injury, plus two grand mal seizures created a weak link for COVID to attack. (I wrote about COVID and a body’s weak spot here.)

For Michaela, that weak spot was her brain, and her brain fog and vision issues were the symptoms from COVID inflammation in her brain. We were hopeful that Neurofeedback would be able to quell that inflammation and to help her heal. Instead, it activated her nervous system to the point that she couldn’t tolerate doing the therapy. She wasn’t able to sleep for a week, and even deep breathing put her body into a fight/flight feeling that was untenable. She stopped the Neurofeedback, for now, and decided to continue to practice Zhineng Qigong as her sole means of getting better from Long COVID.

She has been able to practice various routines up to 5 hours a day, and has continued to see improvement. She’s able to ride in a car now without vision issues and nausea. She’s also able to work about 5 hours a day on the computer, which is a very big deal from where she began. She no longer has the feeling of burning organs, and her hives have lessened dramatically. She has more energy than she has had for the last year, and is able to follow conversations and engage in them! In other words, big improvements.

Michaela (laughing despite all she has been through), Me and Morgan

Michaela was interviewed by the Denver Post about her Long COVID experience. The article can be accessed here. (If you hit a pay wall, you can load the Denver Post app and access the free article through that.)

We continue to hope for an article that can provide more treatments for patients than just a litany of research, but Michaela wanted to share what works for her to help others.

Eosinophils & Mast Cells

Neurofeedback, MCAS & Anxiety

I recently completed a series of Neurotherapy sessions at a local clinic called Neurotherapy of Colorado Springs. I was thrilled with the results that I experienced while still being in therapy, and I continue to see more positives now that I’m a graduate! I wanted to share with my readers how valuable Neurofeedback can be.

First, I’d like to share why I chose to pursue Neurotherapy. During my long progression of healing from Mast Cell Activation Syndrome (MCAS), I began to read about how our thoughts affect our body. I’ve written about New Thought elsewhere on my website here. I began reading books by Dr. Joe Dispenza and Ernest Holmes, and learned how powerful my mind really is, especially when it comes to illness. The education was very helpful, but reading about something and actually doing it to effect change are two different things.

I attended two of Dr. Joe Dispenza’s in person courses about 10 years ago along with participating in his monthly telephone presentations, which was a different progression of courses than what he currently has. Nevertheless, I was able to learn meditation techniques and was disciplined to meditate every day in addition to “blessing the energy centers” of my body for a couple of years. While I learned a lot of new lingo, for myself I never could see much progression in the healing of symptoms I was experiencing. I know some people really relate to Dr. Joe’s techniques, but for me I didn’t get results, and in fact some of the breathing techniques he suggested made my symptoms worse!

I looked into Dynamic Neural Retraining and the Gupta Program, both of which help to retrain the brain, and was concerned about my ability, once again, to get any results when I was basically left on my own to practice these programs. Some people are able to follow directions, and feel the energy, and make progress. For me, I’m not blessed with that. I need hand holding and someone to provide feedback to me to ensure I’m not off doing my own thing and wondering why I’m not getting any results.

I had begun to read about the relationship that mast cells have with the nervous system, and I knew from my experience with Rapid Resolution Therapy (RRT) that having my nervous system calm down around traumatic events was very helpful. However, my nervous system felt like it was at the level of fight or flight constantly, even when there wasn’t any trauma or upset occurring. That’s what landed me doing a Google search for Biofeedback and Neurofeedback.

I found that there are A LOT of practices that call what they are doing Neurofeedback. They wanted to rent me a machine to take home and plug myself in. Once again, I didn’t trust that I could do that correctly. And I really wanted to do Biofeedback AND Neurofeedback since I knew that I had a lot of body symptoms occurring from MCAS like itchy skin, stomach aches, occasional hives, general inflammation and hot flashes.

Other practices promised amazing results for anxiety in 6 sessions, yet performed the same services on every patient. This didn’t feel like the right route for me, especially knowing how sensitive my body is. I wanted something that was geared toward me, and I was willing to put in the time and effort to make it work.

It took a while of being on a wait list until I could get into Neurotherapy of Colorado Springs. My insurance didn’t cover the sessions, and I’m not sure if any does, but their practice is booming! They see people with brain injuries, children and adults with ADHD, older people with memory challenges, and many other brain related issues including anxiety. The best part was that when I mentioned that I wanted to calm down my mast cells and that I had a diagnosis of MCAS, the Director knew exactly what I was referencing. I can tell you that rarely occurs. Too many times, I’ve had to explain to doctors what MCAS is, and I was thrilled I didn’t have to do that this time.

I first completed a qEEG (Quantitative Electroencephalogram) which measures electrical activity in brain waves. I wouldn’t be able to read the results of this, but a Neurotherapist at the practice was able to look at my brain waves and tell me almost EXACTLY what my symptoms likely were (even emotional responses to stress and anxiety), where they sourced from, and what they would be able to do to create new neural pathways. I was quite impressed, especially since I hadn’t given any background information at that point. He was able to see all of this based upon my brain waves being too active or not active enough in certain areas of my brain.

The qEEG is such an important gathering of data, and many Neurofeedback practices that I had interviewed didn’t use this tool, mainly because it is an expensive test. I’ve had friends who have gone to those practices and ended up experiencing increased anxiety rather than diminishing anxiety with sessions of Neurofeedback. That’s the last thing I wanted to have occur.

I attended two one-hour sessions per week for a total of 50 sessions. Within the first two weeks, I was able to sleep more soundly. More than just the changes that I noticed, my husband noticed how much calmer I was. I was able to stick with difficult conversations without “freezing” or needing to take a break. In general, I was functioning much better with much less anxiety.

As I wrote in a previous blog post, I got COVID in the middle of Neurotherapy and was shocked at how much my brain turned to mush when I returned to continue with sessions. I was able to get brain function back quickly however, and graduated with what feels like a different brain!

Anxiety previously would awaken me in the middle of the night, and I’d have difficulty getting back to sleep. I now have a breathing practice which I can get centered into and fall back to sleep easily.

I’m able to continue to practice HeartMath which I wrote about previously here, which helps to keep my parasympathetic nervous system helping my body to rest and digest.

My skin is no longer a dot-to-dot rash of itchy bumps. And best of all, I no longer have symptoms of IBS (Irritable Bowel Syndrome)! I feel sure the IBS was related to all of the anxiety I was experiencing with MCAS.

I’ve tried adding new foods to my diet and no longer have the immediate MCAS response of flushing and anxiety. The interesting thing is that I do still have EoE (Eosinophilic Esophagitis) and that disease mechanism does not seem as responsive to the Neurotherapy. I’m in hot pursuit of a modality to cure it now.

In the meantime, I would encourage anyone wanting to retrain your brain to check out Neurotherapy!

Coronavirus COVID-19

COVID and a body’s weak spot

The COVID pandemic has been going for three years now, and it keeps on giving – this time to my husband and me in the form of our first COVID infection. Given that we’re both in our 60’s, I’m grateful that we got a milder variant that’s now making the rounds in Colorado and beyond. I’ve recently learned some new information about COVID and its impact on the body that readers of this blog may appreciate.

I have been doing Neurotherapy for the last 7 months to help calm down my mast cells (a detailed blog post is forthcoming on this once I have completed my sessions). I had been advancing with each session and seeing some great improvements in my sleep and ability to focus when I came down with COVID.

What was explained to me was that in their Neurotherapy clinic, they have seen that COVID attacks a person’s weak spot. What I mainly felt during the acute stage of the infection was stomach discomfort (a common refrain for me with any type of illness since my mast cells congregate in my gut), and a lot of nasal mucous (and thereby a cough). I guess I’m lucky – I have two weak spots!

For some people their weak spot may be their gut, for others their lungs. And people may not even realize that the body part most affected by COVID is or was a weak spot. Suddenly, they are having issues with their sinuses, which they seemingly never had an issue with before. Or an old back injury that was healed becomes flared after having COVID.

This was fascinating to me that COVID looks for a weak spot to move into and exploit. I haven’t yet seen research on this, but we are just beginning to get an understanding of what the COVID virus does to our bodies.

The other thing I learned at Neurotherapy was how much COVID affects the brain. I had been doing 2 sessions a week of Neurotherapy for 5 months when I got sick. Each session is recorded to show on a computer screen how my brain is creating new neural pathways and decreasing inflammation. Having specific data of where my brain was functioning pre-COVID gave me a view of how much COVID affects the brain once I went back for more therapy sessions.

I didn’t really realize how much my brain had gone into a fog during the illness, and was still slogging along at about half speed once the acute illness had moved on.

I stayed away from Neurotherapy for two weeks to recover and went back to therapy with a seemingly congested brain, unbeknownst to me at the time. The amount of inflammation in my brain was visible on the computer screen from the probes placed along my occipital lobe and temporal lobe. What was easy for me to perform previously in Neurotherapy sessions was suddenly impossible! My brain was completely unable to focus on the task at hand, and I felt like I had mud in my neural pathways. It was shocking for me, and fascinating for my Neurotherapist to compare my therapy results pre-COVID to post-COVID.

It took weeks for my brain to recharge and get back to focusing and being able to hit the markers that previously I had achieved during Neurofeedback.

As of this writing, I still have the lingering cough, but my brain is back functioning and even doing better than its pre-COVID state according to my Neurotherapy results. From all of the news articles about people feeling brain fog, even labeling themselves as having “COVID brain,” it may be that all of us have a brain weak spot that COVID exploits!

Coronavirus COVID-19

Long COVID and Mold Exposure

My grown daughter, Michaela, has been experiencing long haul COVID after being infected with the virus in November 2021. (You can read a series of blog posts about this journey starting with the first post here.)

I have heard from many readers, which is wonderful!  You have asked how Michaela is doing and have also shared that her journey with Long COVID has given you hope. She has learned more about what helps her feel better, and what is too much for her to tolerate. The items that she can tolerate continue to change as she continues to heal.

In the process of searching for healing of her symptoms, she tried many modalities, and found that Zhineng Qigong was gentle enough to not throw her nervous system into overload, and also powerful enough to really assist her healing. She continues to expand her daily 3-hour routine into new practices, slowly introducing new movements and watching how her body responds.

The Eden Energy practices that she tried didn’t provide consistent healing, and she decided to remove those from her daily protocol. The Medical Qigong was helpful to read about in books and to utilize sparingly. It was too strong for Michaela’s sensitive body systems to practice daily. She has learned a lot about Medical Qigong from a series of books about Chinese Energetic Medicine.

She had experienced more healing since my last blog post in July 2022 detailing her path to health, and we were very encouraged she was on the road to a full recovery. Sadly, everything took a turn for the worse in the fall.

In October 2022, the garbage disposal in her apartment backed up and a maintenance rep from the management company was sent to fix it. This began a series of issues of strange smells inside her apartment, the discovery of a sewer pipe that had an incorrect piece in the pipe, a water leak, and to top it all off, the entire apartment building lost heat for 1 week when the boiler went out during a hard freeze. All of these items were very stressful on her nervous system, but more than that, she began experiencing more and more brain fog, fatigue and general malaise.

So many Long COVID patients experience a recurrence of symptoms, that we chalked up her symptoms to another round of Long COVID exacerbated by the stress of trying to manage multiple maintenance people inside her apartment trying to fix problems.

Michaela looked under her kitchen sink in November and discovered mold building up on a cabinet board. She hadn’t looked under there previously, so didn’t know how long it had been present. She taped plastic around the cabinet area to attempt to keep the small area of mold that she could see from permeating her living area.

She has a diagnosed severe IgE allergy to mold, and has had reactions before ranging from repeated rounds of bronchitis (as a child, the school she attended had a water leak that ended up with a moldy classroom underneath the one she was in) to lung and breathing issues (when a previous rental she was in didn’t mitigate mold in a bathroom properly).

When the management company was ready to mitigate the mold, it was mid-December, and they sent Michaela to a hotel. Within a few hours, she realized how her lungs felt so much better. She was able to take big breaths for the first time in months. The management company was going to fix the pipe that had been improperly fixed previously and replace the cabinet that contained the mold spot, but wasn’t going to fix the floor that had rippled from the water that was caught underneath it. This meant that they weren’t even looking for mold that was possibly present in the floor boards.

After these fixes were complete, Michaela asked that an air sample be taken by a professional mold mitigation company to ensure that all the mold had been removed prior to her moving back in. The air sample came back with mold still being present, which wasn’t a surprise to any of us. By that time, she was realizing how many of her clothes and other personal effects that she had brought to the hotel were also covered in mold spores. She put on certain clothes and found that her eyes began to itch. The more information she got from the mold mitigation company, the more she realized that everything in her apartment was going to have to be mitigated to get rid of the mold, and many items like her mattress and couch would have to be tossed because there wasn’t any way to remove the mold.

The management company hired a mold mitigation company to come in to wipe down all the walls and surfaces. Sadly, the process began by spraying chemicals everywhere first! Thankfully, they continued to pay for Michaela to stay in the hotel, but it was becoming more and more clear that what they were doing was going to make her studio apartment unlivable for her sensitive body. Between the chemicals and the lack of removing the floor boards and flooring, her apartment was never going to be mold free.

In fact, we began to wonder how long mold had been present without her realizing it. The symptoms of mold exposure and those of long COVID are very similar. Brain fog and fatigue are vague symptoms that could be sourced from either or both. The key was to get her into a safe living situation to calm down her nervous system and get her back to at least where she was prior to the mold exposure!

The lease that Michaela signed when she moved into her apartment basically excludes remuneration for mold damaging items. They expect that the renter will have that in their renter insurance policy (Michaela didn’t purchase an addendum to include that, not knowing that such would be an issue, so she will receive no compensation for her personal items that have to be tossed – 50 plants, all her shoes, mattress, couch, cushions, pillows, etc).  She was allowed to break her lease without a fee, which she has done.

A few days before Christmas, we moved Michaela from Denver to Colorado Springs to live with my husband and me. It’s been 3 weeks since she was in her apartment, and we can see her spirit coming back. She no longer has the fatigue and brain fog, and is looking forward to finding a new safe place to live with no mold.

Just washing her clothes ended up not being enough to remove the mold from some of the fabrics, so we will be taking all her clothes to a commercial laundry facility that uses an ozonator to remove mold. We hope to be able to preserve at least some of her clothes so that she doesn’t have to start from scratch setting up a wardrobe.

The year 2022 was an extremely difficult one for Michaela and for our family. Long COVID is like nothing I’ve ever seen, and she still has improvements to make to be able to get back to working full time, being on screens and being able to drive. The financial setback from the mold exposure was not only in losing most of her personal property, but also her inability to work. We are all looking forward to a more prosperous 2023!

Read the next blog post in this series here.

Eosinophils & Mast Cells

Quick Help for MCAS

It took me about 5 years to get an official diagnosis of Mast Cell Activation Syndrome (MCAS) after getting stung by a wasp and having my body then experience allergic-like symptoms, an inability to eat many foods without a reaction, ongoing stomach aches, diarrhea and acid reflux. Sadly, many people today are still having difficulties getting an MCAS diagnosis. I know this because I hear from so many of them asking for assistance.

I’ve also had the question posed to me, “What helped you feel better quickly?” Depending upon how long you have been suffering with MCAS symptoms, your body may be able to tolerate different medications that can alleviate your symptoms. However, if you’re like me and have had a long list of issues for years, feeling better can be a slog that takes years to find the right combination of medications and other modalities to begin to help you heal.

I was prescribed Zyrtec and Zantac (it was still on the market in 2006 when I began to have symptoms) initially. For about 2 weeks, these medications were wonderful. Everything calmed down and I was able to eat any food I wanted, and I then went off both meds only to have my acid reflux and gut issues come roaring back. After that, I continued to feel worse and worse with each passing year. All of the gut issues I was having didn’t immediately respond to medications. And some of the prescription meds my doctor prescribed made me feel worse rather than better. Antacids like Zantac or Pepcid gave me more symptoms than what they were helping, which was very frustrating!

After 5 years, I was prescribed Ketotifen, a compounded prescription mast cell stabilizer and immediately felt better with the first pill. This was the first and only medication that provided relief to me without a horrible array of side effects. I eventually ended up taking the maximum dose of 4 mg per day, yet I was still having numerous other gut issues that weren’t helped by the medication.

That led me to a modality called Network Spinal Analysis, (which is now called Network Care), a type of chiropractic practice that focuses on energy in the body. I have written about this here. I was able to get my stomach churning and nausea to cease after each session, which was a wonderful relief! However, this calm body wouldn’t last but about 24 hours at first. I continue to see a practitioner twice a month to keep my body tuned up, and I’ve found other modalities to help the gut problems.

A real key for me was to switch to eating organic, and I ate food that had no spices or oils on them. I didn’t realize how important this was until I could feel the difference in the lessening of acid reflux that I had been experiencing daily.

I tried Traditional Chinese Medicine, which was helpful but VERY slow in progress. For someone looking for more information, you can read about that here. Some MCAS patients are able to tolerate ingested herbs and supplements easily. I was not. That is likely why it took years to build up any type of tolerance and get to a therapeutic dose. And Chinese herbs aren’t meant to be taken forever. I was certainly helped by them, but it wasn’t a quick, easy fix.

I was then introduced to Zhineng Qigong in my pursuit to heal my body. This type of Qigong was created by Dr. Pang Ming, a medical doctor, a Chinese Medicine Doctor and a Qigong Grandmaster. In 1979 he created Zhineng Qigong to help his patients heal at a medicine-less hospital in China, and the results were amazing. Patients were being healed of cancer and gastritis along with many other issues. I have been practicing Qigong daily for 3 years now and I continue to learn more of the nuances of the breath, posture, movement and energy. I could immediately feel a release of tension in my shoulders and hips, and my immune system got a boost during every practice where I would feel like I was catching a cold before practicing, and afterward I no longer had that feeling! It also put me much more in tune with my body which I needed to continue my healing journey. There are wonderful teachers of Zhineng Qigong which you can read about here and here.

Lastly, a modality that has calmed down my nervous system is Neurofeedback. I have found that my mast cells and nervous system have a communication going between them that has continued for years, and isn’t positive! If I get stressed, my nervous system calls in more mast cells. And if there’s pollens, my mast cells activate my nervous system and suddenly I feel anxious. And many times, I wasn’t able to stop this process, which meant the source was somewhere other than my body. In fact, I learned that my brain was creating a lot of the issues I was having. I began Neurofeedback in my city of Colorado Springs at this practice. I have been thrilled with the results. Within 2 weeks, I was sleeping again! I didn’t realize how much my sleep had been compromised with all the mast cell activation that was still occurring. If I had work stress during the day, my nervous system would be so activated that I would be itching through the night and unable to get a good night’s rest. Part of my Neurofeedback session is also HeartMath which I wrote about here. Now, I have a paced breathing practice that calms my nervous system down and I’m able to stop my mast cells from activating! I wish I would have discovered Neurofeedback years ago to help my brain not get into the patterns I’ve lived with where anxiety was so heightened. However, I’m very grateful to have found it now to be able to create new neuropathways in my brain which is calming down my body.

Coronavirus COVID-19, Eosinophils & Mast Cells

HeartMath, MCAS & Long COVID

There’s recently been recognition in the “forward thinking” Mast Cell Activation Syndrome (MCAS) doctors that mast cells have some type of communication with the nervous system. And this communication also seems to be occurring for long haul COVID patients. This communication appears to create the symptoms of anxiety, gastrointestinal issues and itchy skin, and may create other symptoms also.

As a patient with an MCAS diagnosis, and as a mother of a patient with a long haul COVID diagnosis, I can say that the nervous system is DEFINITELY affected by both of these conditions.

The autonomic nervous system is a complicated mechanism, and I’m certainly no expert. What I understand is that there is a sympathetic nervous system, which activates our bodies into fight or flight. This saved us from being eaten by a tiger many thousands of years ago, and is certainly necessary, but we don’t want it working all the time. Then there is the parasympathetic nervous system, which activates our bodies to rest and digest. We want a balance between these two systems.

My experience with MCAS is that the parasympathetic nervous system is no longer activated the way it should be, and my sympathetic nervous system is constantly overstimulated. Everything my nervous system comes in contact with is perceived to be a tiger – pollens, food, smells, etc. And my parasympathetic nervous system gets drowned out by all this overamping so that I have trouble digesting foods and getting a good night’s sleep.

In the short run, this isn’t a bad thing to have the sympathetic nervous system working hard. When we all lived with the danger of a tiger eating us, we wanted our nervous system to be highly responsive, to get us moving. Now, an argument with a family member shouldn’t stimulate the same response. Yet, when your nervous system can’t distinguish the immediate danger of a tiger from a kitten, the entire nervous system goes out of balance. And that is bad news for your body, especially when this imbalance lasts for days, months or years.

Mast cells are part of our body’s protection against viruses and bacteria, and are also stimulated during an allergic reaction to release many chemicals. From what I’ve been told, mast cells are in the layers of the gut and skin very close to the nerves, so it’s not surprising that there would be communication between mast cells and the nervous system. There’s been interesting research on the Significance of Conversation between Mast Cells and Nerves.

While there is very little research currently on long haul COVID, my daughter’s experience is that not only are her mast cells activating but she’s also having issues related to a dysregulated nervous system, such as dizziness upon standing, a fast heart rate and extreme anxiety.

So how does HeartMath figure into all of these nervous system issues? HeartMath is an app to allow you to view your inner emotional state based upon your heart rate and coherency. A Bluetooth device attaches to your earlobe to monitor your heart rate variability and guide you toward inner calm through real time feedback.

Heart rate as reflected on the HeartMath app. From the HeartMath Institute

If you are a follower of Dr. Joe Dispenza, he has been touting HeartMath for the better part of the last decade as a way to create the healthy vision you want in your life.

If you’d like to see a demonstration of HeartMath and the way to breathe to get the best results, watch this. (This video also includes information about how this type of breathing is helpful for treating long haul COVID).

I have found that there are times of the day when it’s really difficult for me to sit down and focus on my breathing. If I’d had a busy day at work, the transition into a calm breathing pattern is definitely needed, but sometimes quite difficult to maintain! However, I have been continuing to practice for 10 minutes a day, twice a day. I am certainly seeing results such as better sleep, more balance of my emotions and less anxiety overall. In other words, my parasympathetic nervous system is coming into balance!

For my daughter, she found that she has had to start small to not overwhelm her nervous system. Yes, even deep breathing can upset a very anxious body! If your nervous system is really overamped, you may need to start with just putting the Bluetooth device on your ear and breathing normally for several sessions before adding the deep abdominal breathing. The feedback from the app will communicate with you by sight with various colors and waves visible, but also by auditory dings. This helps your brain to know what it needs to do to “breathe better” and to create more calm.

I want to provide my body the best chance for healing, and if I can do so without medication and get good results, that’s amazing! There are HeartMath practitioners around the country that can assist you with getting all the information you need to get started on this. Or you can just purchase the Bluetooth device, load the app and proceed forth yourself. Either way, feeling calmer and less anxious will be your reward.

PS – I am not being compensated by HeartMath for this blog post. It is solely based upon my own and my daughter’s experience.

Coronavirus COVID-19

Long Haul COVID and Healing

The ongoing saga of long COVID for my daughter, Michaela, continued into April 2022. Two prior blog posts on this topic are here (first) and here (second). She tried Benadryl, Pepcid, Zyrtec and Ketotifen along with Chinese herbs and creams, and each of them created more issues for her: vertigo, shaking, nausea and temperature extremes in her body. She decided to give up even trying to incorporate them into her healing routine.

She was experiencing so many symptoms that we realized that one doctor wasn’t going to be able to diagnose everything, nor provide a solution. The thought of her having to go to a cardiologist for the heart palpitations, an endocrinologist for her menstrual cycle issues, a neurologist for the brain fog, an ENT doctor for the dizziness and vestibular system, an allergist for the hives and mast cell activation symptoms, and an ophthalmologist for her vision issues was overwhelming. She didn’t have the energy to withstand so many doctor visits, nor the brain function to be able to make the appointments and then get herself to the doctor’s office without being able to drive. Yet she needed to do something, or she was going to continue to experience an array of issues that she had never had before with Mast Cell Activation Syndrome (MCAS).

My husband and I were doing searches online to help her find long-haul COVID groups (so that she might be able to speak with someone else experiencing what she was), dysautonomia groups, and any research that might be helpful for her to heal. We found that Western medicine doctors were prescribing medications that they hoped would work, which she couldn’t tolerate taking anyway, or sending patients to physical therapy, or sending them for more testing. We didn’t find anyone who had “the answer,” despite the fact that a few snake oil salesmen/doctors were out there peddling their “research”. A word of caution about that – given that Michaela and I have managed chronic illnesses for decades, we’re very attuned to doctors who claim to have all the answers that no one else has ever found. In general, we run in the other direction!

Because of her tenacity, Michaela got on the phone with Bright Health, her health insurance provider, and asked for help after telling them what she had been through with all of her symptoms and doctor visits that hadn’t provided her any help. She thankfully got a woman who listened, and provided her with the name of a physical therapist who she heard had some success with helping people with long-COVID. Michaela immediately called this new PT.

Michaela in her apartment in May 2022

Dr. Dan Stoot of High Definition Physical Therapy was the first doctor to understand what Michaela was going through and willing to help her with specific exercises. He was working on research about long COVID with the University of Denver, and had been working with patients for almost 2 years at that point and having success. He spoke with her over the phone and provided her with his cell number to contact him with any questions before her first appointment. This was wonderful! When she went into his clinic to be evaluated, he turned off the lights and asked her to do simple tests so as not to activate her nervous system. This allowed her body to calm down enough for him to get an accurate assessment.

He said that several of the issues that Michaela was experiencing were centered within her brain stem, and told her that her symptoms were similar to a Traumatic Brain Injury. He also told her that he had seen all the symptoms she was experiencing in his long-haul COVID patients. This helped her to realize she wasn’t alone in this mess. She shared with him about her suicidal thoughts, which he had heard about from other patients. This helped her to feel calmer, and that there was hope for some healing.

He had her begin with eye exercises since her inability to look at computer screens and to drive were the two biggest issues she wanted to handle. That one hour appointment wiped her out for the rest of the day!

Her body was in such a state of overload that she was having trouble sleeping, or even getting her body to rest, and also having issues with having enough energy to make it through an evaluation appointment.

She began to listen to the audio book for Breath by James Nestor which helped her to learn new breathing techniques to calm down her nervous system. Since she wasn’t able to be on the computer to watch any videos or do any Google searches, audio books and paper books became her sole entertainment and means to educate herself.

She began reading voraciously about Traditional Chinese Medicine, Immunology, Massage, Acupressure, Shamanic Healing work, the Autonomic Nervous System, Dysautonomia, the Vestibular System, and Qigong – especially Zhineng Qigong which came out of a Medicine-less hospital in China that combines Buddhist principles, Daoist principles, Western Science, Kung Fu and Medical Qigong.

Michaela started to slowly practice some Wisdom Healing Qigong that I had been practicing for a few years, however this practice was too fast for her and she followed this instead. Wisdom Healing is a “branch” of Qigong that is similar to Zhineng Qigong. The slower practice I linked to is Zhineng Qigong. She found that when she practiced this, her body felt better. The energy started to integrate better and she was able to breathe easier. One of the practices is called “Lift Chi Up Pour Chi Down” which is a series of movements done very slowly and looks similar to Tai Chi. There is also a Sound Healing practice that Michaela incorporated from Wisdom Healing Qigong, however she was experiencing burning in her internal organs so badly that she only listened to this practice rather than doing the sounds herself. These two practices became her main focus for healing along with the eye exercises Dr Dan Stoot had given to her.

When she went back to see Dr. Dan for her second appointment, he couldn’t believe the amount of progress she had made. He told her none of his other patients made such progress in one week and asked what she was doing. She told him about her breathing exercises, Lift Chi Up Pour Chi Down and Sound Healing practices. She still had so many symptoms and issues occurring, but to know she had made progress gave her not only a boost of hope, but also a commitment to continue with Qigong.

We knew of a few local Qigong practitioners and asked them for suggestions of Zhineng Qigong teachers. Michaela began to pursue several Qigong practitioners across the world and began having conversations with them about what she was experiencing, and asking if they knew of anyone who had healed themselves from Dysautonomia. Each person she spoke with would give her little nuggets of wisdom, but the only person she found who had healed herself was Dr. Cynthia Li who wrote Brave New Medicine. Dr Li also incorporated Wisdom Healing Qigong into her own healing journey. Michaela had read her book, and reached out only to find that Dr Li wasn’t taking any new patients. That didn’t deter her. Instead, she continued her quest to find someone who could teach her more about healing herself.

By the end of April, Michaela began practicing Qigong and Sound Healing for a total of 3 hours per day, mainly because that’s the amount of time these practitioners said they practiced in order to achieve health after a serious medical issue. She was willing to do anything to get better.

Despite doing the eye exercises that Dr Stoot gave to her, Michaela’s eyes weren’t getting better enough for her to feel comfortable driving. Dr Stoot suggested that she go to a Neuro Ophthalmologist, however once again these doctors aren’t in any insurance network, and private pay was required. Instead, she saw a “regular” ophthalmologist about her vision issues. All of his testing showed there was nothing wrong with her eyes. While you certainly don’t want to wish for an ailment, it would have been nice to have some diagnosis for specifically what was going on!

She found a practitioner for Rapid Resolution Therapy (RRT) to begin to resolve her Medical PTSD and to decrease her overall anxiety. Michaela’s issues with the medical establishment needed to be overcome in order for her to be able to have blood draws where she didn’t end up in a panic attack. This therapy did help her anxiety to calm down, and it also provided the opportunity for her to be able to notice what she was thinking when her body and nervous system began to ramp up.

Michaela was continuing to have digestion issues, blood pressure issues, an inability to control her body temperature, and urinary problems. A Google search on various types of Dysautonomia came up with a diagnosis called Autonomic Neuropathy that included these issues and more. While she didn’t have a formal diagnosis for this condition, it was helpful to have a name to call the constellation of symptoms that she was experiencing. We noticed that many of her symptoms she was experiencing came back to the Autonomic Nervous System, and it was evident that her nervous system was not responding appropriately.

She read a book by Donna Eden called Energy Medicine: Balancing Your Body’s Energies for Optimal Health, Joy and Vitality which was very helpful with healing energy patterns in the body that promote healing.

She has begun to see a Medical Qigong Doctor candidate in Denver, Dina Rifkin, who even comes to her apartment! Dina began to teach her specific moves to help a specific organ. This type of Qigong is different from what Michaela was practicing, in that Medical Qigong can work with healing specific medical issues. Dina has healed herself from several chronic illnesses, which was the kind of experience that Michaela was looking for, in addition to Dina’s knowledge about Medical Qigong.

The process has been VERY slow because Michaela’s body overreacts to any type of stimulation, even when it’s good for her. She is given a few exercises to do each day, and has had to restrain herself from being an overachiever and doing too many. She tried that a few times and overwhelmed her body into a detoxing mess.

She has continued to visit the Network Chiropractor to integrate the energy in her body, and that has definitely helped her nervous system to calm down. It has been wonderful for her to get out of her apartment once per week and also to come back home feeling calm.

Michaela has also begun to work with a Zhineng Qigong teacher, Reyna Lerma, to perfect her form with Lift Chi Up Pour Chi Down in order to get even more energy healing from Qigong.

As of this writing, she has been practicing 3 hours of Qigong daily for 80 days, and she has seen enormous progress:

  • No more heart palpitations
  • She can sleep a full night from 9:30pm to 6:30am (and she keeps on this schedule!)
  • No more blood pooling
  • No more hot and cold extremities
  • No more fainting
  • No more paralysis of limbs
  • No more suicidal thoughts
  • No more brain fog
  • No more flushing or hot flashes
  • She can use computer and phone screens to work, watch movies, search Google and be on Zoom
  • She’s able to work at least 3 hours a day with ample energy
  • Her menstrual cycle lasts 7 days instead of the entire month
  • She can also now sit outside under her favorite tree and enjoy the sun and the Rocky Mountain fresh air.

She still wants to heal these next items, and feels sure that they will heal as she continues her pursuit of Qigong practices and energy healing:

  • End the idiopathic hives
  • Heal her gut so that she can eat a wide variety of foods again
  • Cease the eye issues so that she can drive
  • Be completely rid of organ burning/buzzing feelings
  • Have enough energy to work as much as she wants!

I will keep you updated with her progress. The amount of healing that she has experienced surpasses anyone that she has spoken to on social media in the various groups for long-haul COVID or Dysautonomia. Her goal in this quest to heal herself is to not just manage these many complex symptoms but truly heal the cause which created these symptoms in the first place. And then to share her experiences with anyone who is interested.

She has yet to meet anyone else who is using Qigong to heal themselves from these conditions or long-haul COVID, but this may become the only modality that can truly provide relief for the millions of people suffering and looking for a way to get back to their life!

To read the next installment in Michaela’s healing journey from Long COVID go here.

Coronavirus COVID-19, Eosinophils & Mast Cells

MCAS and post-COVID weirdness

My grown daughter, Michaela, was diagnosed with COVID in November 2021, which I wrote about here. COVID is a wily foe, and while we all hoped that she would recover as her brother, Morgan, did (which I wrote about here) – her path was much more harrowing.

After recovering from the acute stage of the illness, she returned to her remote work  – business and life coaching of several clients over Zoom – yet she noticed that her eyes had difficulty looking at a computer screen. She chalked it up to being tired, and moved forward.

She also got back to Salsa and Bachata dancing. However, a few hours of dancing wore her out for a week! This was not her usual level of fatigue. She was accustomed to dancing for hours several times a week, plus working, hiking, and numerous other activities without ever feeling tired.

Food was also still an issue. She kept noticing that her stomach was still not tolerating foods very well, and everything still had to be cooked. She limited her variety of foods, no longer ate any fruit or vegetable raw, but still had acid reflux frequently.  

After one family gathering for Morgan’s birthday, she got what she thought was food poisoning. Yet, no one else at the party got sick, and she realized that her stomach was worse off than she thought. She wondered if cooking a spaghetti squash in her brother’s oven ended up exposing her to juices of other foods. That small amount of cross-contact caused a firestorm in her gut, which meant that her stomach really hadn’t improved after the COVID virus.

Getting together with friends, she would feel fine before she left her place only to arrive at a designated location feeling exhausted. Once there, she realized that she kept asking the same question again and again. What was wrong with her brain? Why couldn’t she track conversations like she previously could? She loved being with people, yet now the noise and the interaction felt overwhelming.

Then came the hot/cold temperatures of various body parts. Her feet would be cold, and her hands hot. She’d never experienced this before. She was using Chinese herbs on various acupressure points trying to calm down her entire system, and the results weren’t what she wanted. It seemed like each day she was battling with weird symptoms that she’d never experienced before with MCAS. The herbs and creams previously calmed down any mast cell degranulation, but they couldn’t touch the symptoms she was now experiencing.

In mid-February 2022, she went outside for a walk. It was a cold evening, but nothing that she hadn’t experienced before, hiking in Colorado. She went on a walk near her apartment, and suddenly realized that her body needed to get home right away. She felt panicked at the thought of being outside. After arriving at home, she was feeling really anxious and felt like it was extremely difficult to breathe. She called me almost unable to get the words out. She told me her heart was racing, and she didn’t know what she was feeling. The main thing she did say was, “Don’t take me to the ER.” With her last experience of having 2 grand mal seizures in the ER after an IV push of Benadryl that was too quick, she now has what we have learned to call Medical PTSD (post traumatic stress disorder).

I chalked up her current situation to another MCAS storm. I suggested she take 2 Benadryl, and I stayed on the phone with her until Morgan got to her apartment. He took one look at her and said, “She’s having a panic attack. I’ll stay with her overnight.” He ended up staying that night and through the next day, and she still wasn’t doing well emotionally by early evening. The strange physical symptoms came and went, but she was so disoriented with what I’ll call brain fog, it was difficult to have a conversation with her.

Looking back now, I wish we would have taken her to the ER. She was so adamant about not having an IV put into her, that I didn’t want to create any more stress on her body. We didn’t realize until a few weeks later that she wasn’t having just an MCAS storm. Hours of Google searching helped us determine she was also having post-COVID syndrome, or long-haul COVID, or whatever term you want to call the myriad of symptoms that people have after having COVID.

Her body seemed to have gone over a threshold with the panic attack. She began to experience numerous symptoms that came and went daily: heart palpitations occurring dozens of time an hour, and especially when eating; blood pooling in one limb or one side of the body but especially in her torso; an inability to lie down without feeling she couldn’t breathe making sleep difficult if not impossible; hot and cold extremities; a buzzing sensation throughout her body and in her organs; brain fog so severe that it was impacting her ability to communicate with friends or family; nausea especially when looking at any type of computer or phone screen; vestibular issues such as dizziness which made it impossible for her to drive a car; burning organs; burning skin; an inability to take any medications because of side effects like extreme anxiety; panic attacks that lasted hours; depression to the point of producing suicidal thoughts; gastrointestinal issues where she could tolerate eating very few foods; hot flashes and flushing; hives that appeared out of nowhere; and her menstrual cycle lasted the entire month. Basically, she couldn’t eat, couldn’t work at the computer, and couldn’t drive.

Some of the scarier symptoms like fainting and a paralysis feeling also occurred. The paralysis would occur frequently in the middle of the night where she felt like she couldn’t move a limb and had to pick it up. This morphed into neuropathy where she would feel lightning bolts/electricity run through various parts of her body, and numbness at night.

Working became much more difficult. She got helped from the Colorado Center for the Blind to have Siri programmed on her phone and computer to take directions from her so she wouldn’t have to look at the screen. She did her coaching through the phone instead of Zoom, but it was very difficult to keep notes and keep her brain functioning.

She tried to get in to see her Primary Care Physician (PCP) with her new insurance. Since she was a new patient, he was unable to set an appointment with her for 6 weeks! In the meantime, she got in to see a new allergist with her new insurance network. He listened to her and said that all of her symptoms were caused by anxiety, and if she got that handled, she’d be fine! You can imagine how awful that made her feel.

She saw an acupuncturist who overamped her system, and ended up creating more issues than she was helping. After just a few treatments, she could no longer tolerate the Chinese herbs and creams that she had been using, and she lost one of the 3 foods she was eating. The acupuncturist didn’t understand how to help Michaela in a gentle or any meaningful way. It was so frustrating trying to find someone to help her manage all of these symptoms she was experiencing!

I looked up post-COVID clinics located in Colorado at a website called Survivorcorps.com. This is a group of long-haulers providing resources and supporting research about post-COVID issues. I found that UC Health had a clinic, however when Michaela called them, they said they only took patients who had been in intensive care in the hospital. National Jewish Health also has a clinic; however, they wouldn’t take her insurance, and said that the initial appointment would be $650 and then blood tests and any other test ordered would be paid out of pocket. That wasn’t doable! The post-COVID clinic in Boulder that was listed didn’t take any insurance. Everything was private pay.

Michaela went to the last clinic listed in the Denver area in Westminster. It was a 45-minute Lyft ride from her apartment. She had a one-hour intake appointment with a physical therapist, who pronounced her 98% disabled because of her inability to eat, work or drive. Michaela said she wasn’t there to be declared disabled. She was there to get help and wanted some exercises or something to help all of her symptoms! The PT said Michaela would have to come back the next week since it was time for her lunch break. Frustration was mounting at this point. There were a lot of tears at this point, on my part and for Michaela. These so-called post-COVID clinics weren’t there to really help patients!

It was so difficult for Michaela to garner the energy to go see these doctors, then pay for the transportation or have a friend drive her, only to be dismissed without any real help. She lives alone, and her friends had trouble understanding that she wasn’t well, especially because she wasn’t able to adequately communicate with them what she was experiencing. People had their own lives, and weren’t always available to drive her places, help her do laundry or get food.

My husband and I live an hour south of Denver. We were talking with Michaela several times a day, and sometimes having a call with her in virtual silence to just be a voice at the end of the line when she was having panic attacks that literally lasted all day. We were helping her get food delivered (you have to look at a computer screen to order food!) or bringing food to her. Morgan was also helping with food deliveries and other emotional support.

These were harrowing days, filled with trying to find some medical professional to help her, while also trying to keep up with our own schedules. One Sunday when my husband got back home from visiting Michaela in Denver, he asked me to take him to the ER since he was experiencing chest pains. He ended up in surgery the next day for cardiac catheterization and received 2 heart stents. Thankfully, he recovered fully, but the stress was getting to all of us!

My husband, Robert, and Michaela, who smiles despite all of her challenges!

Michaela was seeing a Network Chiropractor who was helping with her symptoms and then he overamped her system and she experienced back pain and anxiety. She stopped for a few weeks before going back to see him and to ask for very gentle entrainments. I picked her up weekly for this doctor appointment since it became the only modality that was helping her to feel connected with her body. And he was the only provider who was listening to her, and honoring what she was experiencing. He was honest about what he could help with because he didn’t understand long-COVID, but he did understand integrating energy in the body and he would work with her on that.

There are a few concierge doctors taking on long-COVID patients that we found across the US; however, new patient appointments were months or even a year or more out into the future. And everything was private pay, starting with $3000 for an initial appointment. That wasn’t going to help Michaela navigate her symptoms and her life today.

This is now the beginning of April – about 6 weeks since February’s major panic attack. She finally got in to see her PCP who diagnosed her with long-haul COVID, and ordered up numerous blood tests which all came back normal. This was not a surprising development, as we had been researching online for weeks at that point, and heard that normal blood tests were common. What was surprising was that the PCP told Michaela that she wasn’t his “kind of patient” since he was a family practice. She had chosen him because he was near her apartment which made it easier to get to him since she wasn’t driving.

I have never been so disappointed in the American healthcare system than I was at this point. It is absolutely appalling and one can feel so powerless with the never-ending rules, personalities, and unmet expectations one has to navigate, only to be let down in the end. What is a patient supposed to do when every avenue within western medicine closes them off?

Sadly, we have come to learn that Michaela’s story is very common in the long-haul COVID world. Many of the blood tests that western medicine doctors order aren’t the tests that will show what COVID has done to the immune system, vascular system or brain. And for anyone who has a chronic illness, western medicine is sadly lacking in physician appointment time to truly delve into a patient’s experience and history. Doctors are trained to look at the data from blood work or other tests and then prescribe a pill.

Long COVID doesn’t provide data in the western model, so doctors succumb to the easiest way to get the patient out of their office in the 15 minutes of allotted appointment time – tell them it’s all in their head: “Get your anxiety under control” or dismiss the patient outright: “You’re not my kind of patient.” In other words, the doctor is saying, “I don’t know what to do with you, so this must be your fault and not any lack of training or compassion on my part.”

This frustrating situation gets better because of Michaela’s tenacity and resolution to heal herself. Here is the next blog post about her extraordinary journey on the path to healing!

Travel/Eating Out & Food Allergy

Traveling in Italy with Food Allergies

I’ve just arrived back from a 16-day trip to Italy. It was amazing. It was also my 2nd time in Italy, having previously traveled in 2016 with friends while studying abroad. I wanted to break down some interesting observations from this go-around about navigating international travel, dealing with English fluency, and staying safe while traveling.

As someone with severe food allergies to peanuts, tree nuts, sesame, shellfish, and fish (plus mild asthma), international travel has plenty of minefields to navigate! You can read all about my experiences studying abroad in college by clicking here.

The Florence Duomo

Flights

We booked our tickets through United many moons ago and only later learned we’d actually be flying Lufthansa + AirDolomiti on the way there, while we’d be flying AirDolomiti + United on the way back.

I had never flown Lufthansa and given that the flights were booked with United, I couldn’t go into Lufthansa’s portal and mark that I had allergies. A rather dumb user experience, I have to say.

At check-in, I asked the agent to note that I had peanut/nut allergies on the flight readout (she added it successfully) and she recommended that I mention it to the stewardess upon boarding. The stewardess was…surprised and asked if I had requested a special meal. At that point, I realized this was a flight with meal service. (Ha!) I told her no and she wrote down my seat number on her hand.

What ensued was genuinely surprising: multiple different agents on the plane came over during the flight and asked a variety of questions — whether I was peanut dust allergic and would react if any nuts were served at all on the plane, what I’d feel comfortable eating, whether they could guarantee the meal didn’t have nuts (they couldn’t), and even one time they brought over a platter of food for me to inspect. Amazing service.

I ended up declining all of the meals but they still offered me salads and fresh fruit and yogurt with an ingredient label. Wonderfully accommodating. Also, lesson learned –– call ahead! I’m sure that I could’ve navigated this ahead of time had I thought through the likelihood of a meal service. But since my past many years flying internationally didn’t involve it, I didn’t even think about it!

The AirDolomiti flights were short pond-hoppers with only drinks service, so no worries there.

The flight back was a similar experience with United and I generally avoided the food + snacks served, except for one that did have ingredients labeled on them.

Navigating Eating Out

The last time I traveled Italy in 2016, I had a fairly straightforward experience. I spent around 2 weeks in the country in total, traveling between Genoa, Milan, Venice, Florence, and Rome. As a college student, I kept a fairly low budget and ended up eating pretty simple meals. Pasta, pizza, street pizza, and gelato. It was a straightforward and peaceful experience with very few problems.

A small, quaint restaurant in Varenna, Italy

Coming back, I had expected to have a similar experience. Sadly, not the case this time around.

I think this in part due to my partner and I having a bit of a bigger budget and eating at nicer places than just the pizzeria down the street. It meant navigating a sit-down restaurant environment and English fluency issues.

Italian restaurants are very different than American ones. Most only have a few waitstaff in total. One restaurant we dined at in the Lake Como region sat around 20-30 people and they had 3 total waitstaff who took orders, poured wine, served the plates, etc. I’d say they are not as strained as French waitstaff (who are truly busy all the time), but still quite busy. This is mostly because they’re paid a fair wage and don’t rely on tips to make a living, so the restaurant doesn’t hire as many servers.

A food allergy notice at the back of a menu

Some restaurants followed EU regulations and listed the Top 14 allergens on the menu using their number system. So, on the menu, it would look something like:

  • Quatro formaggi pizza (1, 8)
  • Margherita pizza (1, 8)
  • Anchovy pizza (1, 6, 8)

Where the (1, 8) corresponded to an allergen listing at the back of the menu — in this case, gluten and dairy.

I quickly learned that this numbering is not comprehensive. Many dishes had cross-contact issues or, upon asking, the kitchen would state that in fact a sauce on one of the dishes actually contained nuts even if it was not noted on the menu. This was a surprise (and also unsure if this is breaking the law).

Not all restaurants had this numbering, so I didn’t rely on it. I brought up any questions with the waitstaff directly.

At the beginning, I relied on just talking about my allergies in English. The staff understood, even if they couldn’t respond in full sentences back in English (which always makes me a bit nervous), and I received great care. When one restaurant in a small town in northern Italy served us food, our waiter even vocally confirmed with each dish that it didn’t contain any of my allergens. He also taught me what my allergies were in Italian.

This worked pretty well until one restaurant in Venice, where I was basically berated by a waiter for messing up an order. He didn’t speak great English, so when I asked whether the open-faced sandwiches (a local specialty in Venice) contained my allergens, he stated something which I understood as “no, but there is sesame in the kitchen,” – a common refrain from waitstaff when dealing with allergies – but which later turned out to be that there was sesame in the bread.

I discovered this upon serving. I quickly pulled up a translate app and translated an apology and saying I think we misunderstood each other. To which he now more clearly pronounced in English, “No! I told you there was sesame in it and you said, ‘it’s okay’!”

Clearly, it wasn’t working. So I learned how to say the full spiel in Italian. “Sono allergico a noci, sesamo, pesce, e crostacei.” That always got the attention of the waitstaff. The problem was that they quickly responded in Italian, which then I’d have to correct course and say “Okay I didn’t catch that, sorry, could you say that in English?” This dance continued at a couple restaurants until I started to preface my Italian by saying (yes I literally said this) “I know how to say this in Italian but I don’t know how to respond…”

It became a scot-free experience after that. Some of the waitstaff at nicer restaurants in Rome & Florence even had very fluent English speakers, which made the experience very seamless.

One unique moment was when we were having drinks at a local upscale bar in Florence. I ordered one of their cocktails, which when delivered contained a small something in the glass. This was not noted on the menu, by the way, and very unusual to serve a cocktail with something inside it. Turns out it was a small almond biscuit they dropped in the bottom of the glass. I had to patiently explain to the waiter about my allergies and they thankfully remade the drink without the almond biscuit.

So, I had some close run-ins this time around. It was unnerving, honestly. I think keeping to simpler fare has its benefits. Most of the nicer restaurants always took the extra step to make something “fancy”: sesame-encrusted breadsticks, anchovies in their cream sauces, nutty biscuits in their cocktails. The simpler places kept it, well, simple.

Lake Como, Italy

One extraordinary experience, however, was at a restaurant in a small town near Lake Como. It was one of the first nights we were in Italy. It was a tiny place, probably 10 seats total. The owner was the waiter. After he served us a basket of bread with sesame breadsticks (unusually common in the north of the country), I explained my allergies. Not only did he remove the breadsticks, he cut fresh bread just for us and remembered everything for the duration of the meal. It was a nice reminder that traveling with allergies can be safe with the right kind of service.

Another restaurant was a great example of this. When visiting a recommended restaurant from a friend in Florence, I ordered a simple pasta dish after explaining my allergies. The waiter said he’d go and check the kitchen. He comes back and tells me in somewhat broken English that it isn’t safe, but try one of these other three on the menu. I order the one that sounds good, and then he comes back again and informs me, oops! Those three aren’t safe either. But one of these other two dishes will be. Thankfully, it turns out that last dish was definitely safe. Lots of open communication kept me safe! Saying it in Italian always clearly communicated my needs.

Example food label in Italian

We didn’t only eat at restaurants and sometimes grabbed snacks ‘on the go,’ particularly when we were traveling. I quickly learned what the different allergens were (in the above image, latte or dairy is bolded in the ingredients list, and then a “may contain” puó contenere statement is listed below for celery, mustard, and soy). This was a nice reminder that European packaging laws are much more comprehensive than American ones and I avoided anything that mentioned my allergens in the ingredients list or the puó contenere statement.

Gelato

Gelato is definitely a draw of Italy. Often it uses fresh fruits and flavors to create a creamy, extremely flavorful product. Eating gelato runs the same risks as ice cream from an ice cream shop, although the process to make gelato is a little different. However, the final product is a lot creamier and thicker than ice cream.

Black Cherry Gelato from one of the best spots in Florence

Gelato can be served out of ice cream tins or separated out, covered tubs. From a cross-contact perspective, the tubs are the safest because it uses separate serving spoons and keeps the products separate from each other. However, most gelato shops serve it out of ice cream tins.

One interesting observation my partner had was that, in Venice, almost everyone had “shared” scoops. Like an ice cream shop, there was one scooper they used for all the gelato. This is a major problem for me because pistachio is a very common and popular flavor of gelato. And to navigate the English fluency + allergy conversation for a 2 euro scoop of gelato just… isn’t really worth it.

But most places in Italy outside of Venice actually have individual scoops for gelato. Due to the thick and creamy quality of the gelato, the scooper itself never touches anything except the gelato it’s serving. I don’t have a video to show this, but basically they’ll scoop up a big amount on this serving knife and then “push” it into the tub. So the scooper never touches other gelato or even the cones/cups.

I kept to safe flavors and ate plenty of yummy gelto. Black cherry is my favorite.

(P.S. Sometimes they add a little “biscotti” to the top of the gelato when serving – a plain, vanilla cracker. I never ate it, but I asked one gelateria if it contained nuts, and they showed me the ingredients. Totally safe for me.)

Trains

The last time I traveled Italy, I kept to regional trains. Most countries in Europe have two or three different “tiers” of trains. There are high-speed trains, regional trains, and local trains. The high-speed lines (TGV in France, AV in Italy) are the most expensive. They are also more modern, comfortable, and plush. Regional trains tend to be older, slower, and a lot cheaper. Local trains are usually just local versions of regional trains (like a local rail service that extends beyond the metro lines).

A ticket on a regional train line between two major cities ran ~20 euros and took a half-day or more to get between places. A ticket on a high-speed line between two major cities runs ~40 euros and takes only a few hours or less. We used Italo, a private train company, almost exclusively in our travels because they were a bit cheaper for our routes.

However, I had never taken Italo before and we got a good deal on some first-class tickets. It was very comfortable. Turns out, first-class on Italo also includes drink & snack service like on a plane. I have taken many, many trains across Spain, France, Italy, UK, Denmark – I had no idea this was a thing. I even did some nice first-class travel in the UK. The food service there was “optional” at a little catering stand near the end of the car.

Turns out, they do serve snacks with nuts in their little snack packs. I always declined the snacks and just settled for a drink. Given that the train is not like a highly-pressurized environment like an airplane, I wasn’t necessarily worried about it but I can imagine that this would pose an issue to travelers who are more sensitive to nuts. We just wiped down our seats & tables and kept a safe distance.

Other Thoughts

It was an amazing trip, filled with art, culture, museums, history, and wonderful people. I loved every second!

Venice, Italy

One note is that finding an American breakfast is very difficult in Italy. The common options were some kind of pastry (croissant, usually) or fresh fruit. While in more touristy areas there are restaurants that offer some sort of egg + toast combination, most cafés don’t. Interestingly, almond croissants are not popular in Italy. Pistachio ones make an appearance every once in a while. I kept to cream-filled croissants, fresh fruit, yogurt, and delicious cappuccinos.

Speaking of coffee, it was very unusual to find a café that served coffee with anything but normal milk. I don’t have a dairy allergy, but the “alternative” milk fad has not really reached Italy yet. I love a good oat milk latte, but I only went to one café that had any alternative milks on offer.

But overall, definitely a trip to remember! I’d highly recommend visiting the country. It’s gorgeous, filled with kind people, and so much history.

If you want to read more about international travel, eating out, and other previous experiences, check out:

  • Preparing for my studying abroad experience & navigating foreign universities, here
  • Backpacking Iceland for 2 weeks, here
  • Navigating hip upscale restaurants and fusion food, here
Coronavirus COVID-19, Eosinophils & Mast Cells

COVID Infection with Mast Cell Activation Syndrome (MCAS)

For those of you new to reading my blog, I wanted to provide a little history of MCAS in my grown daughter, Michaela, prior to getting to the topic of COVID.

Michaela got a diagnosis of MCAS shortly after I did about 10 years ago. We noticed how she was experiencing many of the same symptoms that I was with gastrointestinal issues, but she also had symptoms of interstitial cystitis, which her grandmother had been diagnosed with.

MCAS is a constant balancing act, and it can affect virtually any organ in the body. For Michaela, her thyroid, bladder, stomach and intestines are most frequently compromised when mast cells begin to degranulate.

She got placed on a variety of medications from a Gastrointestinal doctor including Zyrtec, Zantac (when it was still on the market), Ursodiol (alters bile for less histamine release), and Ketotifen. She never felt great on all of these medications, especially since her body continued to have ongoing inflammation evident in general swelling of her gut.

She took on her own healing, especially after a harrowing episode of two grand mal seizures in the ER, which occurred after getting dehydrated and having a mast cell flare. You can read about this scary episode here. After the seizures, and having aspiration pneumonia, she added lungs to her list of compromised organs. Her lungs would react to chemicals especially and she had to be very careful of what she was being exposed to.

Prior to COVID, Michaela had gotten her mast cells managed quite well through a completely organic diet of vegetables and fruits (cooked and raw), meditation, Network care (a type of Chiropractic practice), Traditional Chinese Medicine herbs, and plenty of Salsa and Bachata dancing! She no longer needed to take any “Western Medicine drugs”, and had been off of them for over a year when diagnosed with COVID.

She no longer had inflammation in her body, and had lost 30 pounds just through healthy eating, dancing and enjoying life with plenty of laughter and friendship. She is convinced that especially the Zyrtec and Ketotifen had created more inflammation in her body than it helped to decrease. She was feeling better than she had felt in years. And then came COVID.

It is important to state that Michaela decided to not get a COVID vaccination due to her extreme reactions to chemicals, and her sensitivity to anything being put into her body.

After 18 months of social distancing, mask wearing and very little dancing, she got to celebrate her 31st birthday in November 2021 with a test for COVID. The pre-birthdate party she celebrated with her friends became just one of the positives she experienced – the other being the results of the PCR test.

She awoke a few days after the party with a severe migraine, which is not a usual symptom of MCAS for her. Similar to the symptoms that she experiences with a MCAS flare, COVID began to create gastrointestinal issues. She was virtually unable to tolerate eating anything because of acid reflux and nausea for about 10 days. She kept hydrated with mineral water, and never had any lung involvement, which was a relief. She barely even had a cough for the entire illness, and the fever only lasted about 36 hours and wasn’t very high. She did have fatigue, but was prepared for that since we had heard that was a normal symptom of COVID.

She had some strange symptoms like very painful skin that almost felt like it was burning, and it was difficult to take a shower. Some of the TCM creams helped this. So the “usual” COVID symptoms weren’t at all what she was experiencing, but she definitely had COVID and her gut no longer would tolerate the variety of foods that she had previously been able to eat. She couldn’t eat raw foods, like apples, anymore. Everything had to be cooked, and food didn’t taste good once she lost her sense of taste and smell.

It was a rough illness but she didn’t require hospitalization, and didn’t even need to go to the doctor. She did reach out to Dr. Xiu-Min Li, our Traditional Chinese Medicine doctor, to inquire about what she could do for her immune system to help it fight the infection and get back to normal. Dr. Li suggested various herbs in patches placed on specific acupuncture points, and that helped a lot.

The acute infection lasted for 10 days, and yet she still had chronic acid reflux that wasn’t helped by Pepcid. A half dose of Pepcid created a mast cell storm that was very uncomfortable and included sweating, nausea, and a feeling of almost passing out. So, Pepcid was out of the question. Overall, though, she felt like the worst had passed and was ready to get back to her “normal” life.

Our family was able to celebrate Michaela’s birthday and Thanksgiving the first weekend in December. What we didn’t know then was that the end of the acute illness was the beginning of another path that became quite scary and weird, with new symptoms and ongoing fatigue, and a journey that Michaela continues to forge a path through. The continuation of her experience and her path back to health is shared in the next blog post here!

College with Food Allergies, Food Allergies & Asthma, Food Allergy & EpiPen, School & Food Allergies

Helping Your Child Manage Allergist Visits

This is a blog post that I’ve been intending to write for years. I wanted to share what we’ve experienced about helping our son, Morgan, learn how to manage visiting his allergist while he still lived at home. He could then make good choices about getting an allergist once he was out on his own, and Mom wasn’t around to give directions!

We’ve been blessed that Morgan was able to have the same allergist for 21 years, until he graduated from college. She watched him grow up and to learn to take responsibility for his health. However, it wasn’t until he was 19 years old, as a freshman in college, that he went to the allergist unaccompanied by Mom. Boy did it take work to get to that point!

Morgan visited with our allergist at least every 6 months throughout his life, beginning with his first appointment at 15 months old. He learned the routine of an office visit – fill out the paperwork listing all his medications, have a height and weight check, take a lung function test or two, and visit with the allergist to tell her how he’s feeling.

If Morgan had experienced any type of issue – a cold, virus or a pollen reaction – I wanted him to learn how to use his words to explain what happened. This was good practice for him to be able to explain to any adult what he was experiencing in his body and what he needed to feel better.

It took many years for Morgan to learn how to properly list all his medications that he took for pollen allergies and asthma, and to not forget any of them. He had to know the exact medication name, the milligrams, how often he took the medicine and whether he needed refills. I began having him complete this form when he was in grade school so that he could learn the details of his health needs. He would need to check with me about the answers, but he did all the writing.

Many times he would have school forms or camp forms that needed to be completed. He would complete parts of those forms, and I would fill in the rest until he was able to complete the forms by himself once he applied for accommodations in college.

It is vital that our children know all about their health condition(s), and are prepared to go to the doctor by themselves. Taking the initiative and the time when they are young to allow them to learn about the paperwork will help them later in life when they leave home.

It was at Morgan’s first allergist appointment that he had his first skin prick test. Holding down a wiggly, itchy toddler for 15 minutes was no easy feat!

From that test on, I kept an Excel spreadsheet where I input results from every skin prick, RAST and Immunocap blood test through the years. Every 3-4 years, we had repeat tests run. Because of the number of allergies that Morgan has, it has been helpful for him to refer back to this spreadsheet to see if he’s got an allergy to mold, or to some food that he wants to try. Then he can discuss the allergy test result with the doctor to see if a food challenge is warranted.

Once Morgan graduated from college, and moved to a suburb of Denver, Colorado, he needed to get a new allergist. He searched around and found a physician who knew our allergist. This doctor had been an allergist for over 30 years, and that made Morgan feel more comfortable. Morgan moved again two years later, and once again wanted to find an allergist near his home. This time, it wasn’t as easy to find a good fit. The first doctor he saw said that carrying just one autoinjector – Auvi-Q – was enough. That was enough for Morgan to decide this wasn’t the doctor for him. He knew he needed to always carry two Auvi-Q’s, and the fact that this doctor didn’t state that was concerning enough to leave the practice.

He decided to search for another doctor, and has now found a younger woman that he likes very much. She has redone all of his food allergy testing, and found that he is able to do an oral challenge for almonds. So far, he hasn’t found a desire for this. He continues to have food allergies to peanuts, tree nuts, sesame, fish and shellfish, and continues to see an allergist once a year and ALWAYS carries two Auvi-Qs with him everywhere.

I have full confidence that he knows how to manage his health, and he is fully capable of communicating with an allergist about all of his medical needs. And that was always the goal!

Eosinophils & Mast Cells

MCAS & Research on Chemical Exposure

For too many years, medical doctors have questioned patients with symptoms and reactions from chemicals. I’ve had a doctor tell me that it must be in my head! But I knew that I was having breathing difficulties, rashes, or headaches from being around chemicals.

These chemicals could be Volatile Organic Compounds (VOCs) such as paint, aerosol spray, off gassing from wood floors and even nail polish remover. Or other chemicals such as pesticides, cigarette smoke and perfumes can also elicit a reaction in sensitive patients like me.

New research, recently published in December 2021, from researchers at The University of Texas Health Science Center at San Antonio as well as the Massachusetts Institute of Technology and the AIM Center for Personalized Medicine, supports Mast Cell Activation Syndrome (MCAS) as an underlying mechanism for chemical intolerance. You can answer 3 questions as part of the Brief Environmental Exposure and Sensitivity Inventory (BREESI) to determine your level of intolerance.

If you’d like to read the full research report, you can do so here. You will notice a familiar name in the MCAS community on the research – Dr. Lawrence B. Afrin.

For those of us with chemical sensitivity, this research isn’t surprising at all! For too many medical doctors, it will take even more explanations as to what MCAS is and how chemicals can affect us. This isn’t an IgE allergy, but there are now questions that can be asked and answered to determine if you have a chemical intolerance. And this research is a starting point for a conversation to educate the medical community, and also our families, friends, schools and workplaces of the seriousness of reactions to chemicals.

This chemical sensitivity has kept me working out of my home since I got diagnosed with MCAS. My senses are assaulted in too many office places with the smell of cleaning solvents, perfumes and the pesticides sprayed to get rid of bugs. And the conversations that I’ve had with people have more commonly ended with them saying that I’m just too sensitive to my environment.

My husband lovingly says that I have the nose of dog – I can sniff out someone who has been smoking, or is wearing cologne from across the room! I have had to move away from someone wearing perfume if they sit next to me because my eyes start watering and I feel like my chest is tight making it difficult to breathe.

In our home, we no longer use any harsh cleaning chemicals. I found myself gagging too many times with the smell of 409 or Windex. The brand Better Life has been a great find for every type of cleaning product with natural ingredients. (They aren’t paying me to say that – I’ve just found that they are the best and they work!)

For a year or so, I colored my hair, but soon developed an allergy to the hair dye. My scalp began to burn when my hairdresser applied the color, and I decided to call it quits. After that, I also decided to no longer paint my fingernails or toe nails, wanting to keep anything chemically based away from my body to help it heal and not to be triggered.

A few years ago, I wrote about my daughter, Michaela, and the issues she was experiencing with chemical exposures in this blog post. She has had to continue to stay away from swimming because of the chlorine. I love to swim, but I too was disliking the chlorine exposure at the pools in our area, mainly because of skin rashes I was getting. I found an athletic club with a pool that uses an ozonator to filter the water, and a VERY minimal amount of chlorine. So little, in fact, that you can’t smell chlorine when you walk into the pool area. It has been so wonderful to be able to swim and to not get a rash from the chemicals!

I’ve also had to be very careful of the makeup, lotions, and anything else that I apply to my skin or hair to make sure that there are no fragrances and minimal chemicals in their ingredients. Once I find a product that works, I stick with it for years!

There is so much more research that needs to be done on MCAS and the range of triggers. We sensitive ones are like canaries in the coalmine, however all of this chemical exposure isn’t good for anyone. But for those of us with sensitive systems, it can literally be life threatening!

Eosinophils & Mast Cells

MCAS & EoE Coexistence

When I was first diagnosed with a Mast Cell Activation Syndrome (MCAS), my GI doctor told me that when he got my biopsy results back, he expected to see a high eosinophil count also. And he was correct! That was before research had been completed on these two cellular disorders, and today it’s more common to hear mast cell patients talk about also having high eosinophil counts.

I haven’t heard of a lot of EoE patients, however, talk about high mast cell counts. Yet from my anecdotal evidence, I have spoken with many adults and families managing EoE who tell me about symptoms of their EoE that sounds VERY familiar with mast cell patients.

I believe there is big opportunity for more research on how these two cells interact, and how a patient who receives a diagnosis for one of these illnesses needs to be monitored for the other.

Eosinophil
Mast Cells

To my unscientific eye, these cells do look similar, however from the research we have now, we know that they don’t respond similarly to stimuli. In a 2014 research study, the authors found “Eosinophils were more viable when mast cells were present, dependent on soluble mediators and on physical cell contact…Mast cells were not as clearly affected or made more viable by eosinophil coculture.”

Further, the research found, “Both mast cells and eosinophils are present in biopsy specimens of patients with EoE. There is a great mast cell signature in EoE, and the presence of mast cells has been found to be useful in distinguishing between EoE and gastroesophageal reflux disease in biopsy specimens….IL-9 produced by mostly eosinophils served as a potent mast cell growth factor.”

Since I have a diagnosis of both MCAS and EoE, I can tell you that I have learned the difference of what the symptoms feel like for each of the illnesses. With EoE, I will experience the following symptoms in a flare (which is most likely to occur in the fall season): coughing, choking, gagging, acid reflux that I feel in my breast bone, and high stomach/lower esophagus pain, nausea and diarrhea. With MCAS, there isn’t as much of a season where I feel the symptoms. In general, I have some of these symptoms every day, to a greater or less degree: “hot flashes” with anxiety feelings after that, itchy skin and rashes, stomach pain, nausea and diarrhea. I have found that EoE affects the mucosal barrier of my gut much more than does MCAS. In other words, the eosinophil cells feel meaner and more destructive than the mast cells.

It’s difficult sometimes to know which illness is affecting me. I have found that for me certain medications work better to minimize the symptoms of one condition. Your own experience may be different! For me, Zyrtec helps MCAS but doesn’t do much at all for EoE. The mast cell stabilizer medication, Ketotifen, helps both MCAS and EoE, but is really effective for MCAS. The swallowed steroid, Asmanex, helps the EoE but doesn’t do much for the MCAS. Chinese herbs help both because the herbs aren’t geared toward one kind of cell, but instead work on inflammation in the body as a whole. That’s one of the reasons I like Traditional Chinese Medicine so much!

There are more drugs being researched that have been shown to decrease IL-5 (Interleukin 5) which is a cytokine involved in both MCAS and EoE. Mepolizumab, sold under the brand name Nucala, is one of these monoclonal antibody drugs, and has been studied for eosinophilic asthma and idiopathic mast cell activation and shows promise. We need more options to manage these two conditions, that although rare, can completely debilitate the patient and are becoming less and less rare.

Eosinophils & Mast Cells

Mast Cells and the Fall Flare

Many Mast Cell Activation patients have similar experiences when it comes to this time of year, known affectionately by many as the “Fall Flare.”

What is the Fall Flare? It’s the time of year from around the middle of August to the first frost where the pollens, especially ragweed, are high. Other weeds and molds can also be high. This combination creates triggers for mast cells to activate, which can mean misery for MCAS patients.

Some MCAS patients are able to tolerate a wide variety of foods in their diet until the Fall Flare occurs, and then they’re back to only tolerating a few foods again. So frustrating! Stomach aches return and brain fog. Asthma can flare, and for those of us with EoE (Eosinophilic Esophagitis) coughing and choking can return with a vengeance. Nasal allergies will also become problematic as pollens hit the “high” or “very high” levels.

I’ve found that keeping track of pollen counts is a good way to prepare myself to increase my antihistamine medications (and Chinese herbs) to combat symptoms. The website Pollen.com doesn’t provide exact data for my area. Instead it is an “average” pollen count from past years, which can be wildly inaccurate especially if there is rain or wind. Better than this website, I like to follow a local allergist’s pollen count on their website because pollens will dip and surge depending upon the daily weather. Rain can calm down the pollen counts, while wind can make a “moderate” pollen count seem much higher.

Fall isn’t the only time that pollens can exacerbate MCAS symptoms. In the Spring, trees are usually the highest pollen producer. Grasses start in the early summer months, and can remain high throughout the summer depending upon your location. And for those with indoor allergies, it can be a year round adventure.

As a child, living in Colorado, I had allergies to grasses, trees, weeds and molds. My allergies would amp up in April when the trees would bud and remain until that wonderful first freeze that used to occur by the end of September. We always got our first snow by the first of October. Our weather has become so much warmer, and allergy season has now extended from March through October. This year, we had days in June that topped 90 degrees, and many days into the end of September with that same hot temperature. That is unprecedented, and my symptoms of gut aches were much worse this year than they have been in previous years.

Through the “magic” of Dr. Li’s Traditional Chinese Medicine, I rarely have nasal allergies anymore. However, with this year’s Fall Flare I began having stomach aches in mid-August with the start of ragweed pollen. These have continued until now on and off. We’ve had only a few rains over the last 2 months, which would really help to tamp down my symptoms.

Short of being able to change the weather, what can you do as a MCAS (Mast Cell Activation Syndrome) patient to calm your symptoms at this difficult time of year?

  1. Keep a diary of your symptoms to see if there is a pattern with the weather, or with your exposure to fragrances or food. Getting rid of triggers goes a long way toward feeling better and more stable.
  2. Pollens are a stressor to your body and mind, equal to the stress of working too long of hours or of not getting enough sleep. Give yourself a little extra care, and try to not take on too many activities outdoors when the pollens are high.
  3. You might want to consider wearing a mask if you need to be outside. I’ve found that to help keep my symptoms at bay.
  4. If you don’t have an air purifier, you might consider getting one. Additionally, air conditioning helps to not only cool the air (since many MCAS patients react to heat) but also to filter out pollens especially if you use HEPA filters. They’re more expensive, but I’ve found they are worth every penny!
  5. Keep your windows closed during high pollen season, and keep your pets out of your room if they also go outside frequently. They are bringing in pollens to your home.
  6. Make sure to speak with your doctor about your symptoms, especially if you are feeling unable to complete your regular tasks. There is likely something that can be done to mitigate your symptoms and get you back to life!
  7. Remember that the Fall Flare doesn’t last forever. Taking it one day at a time, and maybe even one minute at a time will make it more manageable.
Eosinophils & Mast Cells, Food Allergy, Food Allergy & Anaphylaxis, Food Allergy & Families

Food Without Fear

What a great name for a new book by Dr. Ruchi Gupta! And the book contents are also wonderful, and well worth reading. The subtitle to the book is “Identify, Prevent, and Treat Food Allergies, Intolerances, and Sensitivities,” and it is these extra topics that make the book so enjoyable to read.

In case you haven’t heard of Dr. Gupta, here is a snippet from the bio on her website for the book: “Ruchi Gupta, MD, MPH, is a Professor of Pediatrics and Medicine at Northwestern University Feinberg School of Medicine and a Clinical Attending at Ann & Robert H. Lurie Children’s Hospital of Chicago. Dr. Gupta has more than 17 years of experience as a board-certified pediatrician and health researcher and currently serves as the founding director of the Center for Food Allergy & Asthma Research (CFAAR). She is world-renowned for her groundbreaking research in the areas of food allergy and asthma epidemiology, most notably for her research on the prevalence of pediatric and adult food allergy in the United States.”

It was Dr. Gupta’s research in 2019 that found that over 10% of adults in the USA are estimated to have a food allergy. It was also Dr. Gupta whose research estimated that 8% of children in the USA have a food allergy, and to make things even more personal for her, she is a food allergy mom.

I have been in the food allergy community for over 20 years helping my son to manage his life threatening allergies. I can’t remember a book I’ve read on the topic of food allergies that also includes: FODMAPs, FPIES, EoE, OAS, GERD, Autoimmune disorders, Alpha-Gal, and Chemical Sensitivities. Some of these topics are taboo in the medical world, but Dr. Gupta tackles all of them, and she gives information that I haven’t read before anywhere.

She also goes into the Microbiome and its affect on the immune system – one of my favorite topics! She delves into the question of whether we Moms are to blame for our children having food allergies, and lets us all off the hook. Thank goodness!

There is great information about the Western diet and its impact on inflammation in our body and the gut-brain axis. Additionally, she discusses the nervous system and the vagus nerve, which is such a welcome subject when discussing the immune system, and is only recently being discussed by Western medicine doctors.

The only topic that I wish was discussed in the book was Mast Cell Activation Syndrome (MCAS). So many people mistake the symptoms of MCAS with food allergies, and there is a definite difference. You can read more about MCAS on my website here.

Even if you’ve been in the food allergy community for years, I think you’ll find this book educational, and you will likely learn something new!

Note: I was not paid in any way to write this review of the book. As with any book featured on my website, I personally read the book and decide whether it fits my AllergicChild.com audience and also meets the standards of truth necessary for any family managing food allergies.

Eosinophils & Mast Cells

Mast Cell Activation Head Trip

One of the most frustrating things with Mast Cell Activation Syndrome (MCAS) is getting an actual diagnosis. The condition mimics so many other illnesses and conditions that it fakes out the patient, and even more so, the doctor(s). Sadly, some doctors, without the ability to make a diagnosis of what is wrong with a patient, will say “maybe it’s all in your head.”

I heard those words from various doctors when I was attempting to get diagnosed with what was wrong with me. It took me 5 years of suffering before I finally got a diagnosis, and that was 10 years ago. Once I did get a diagnosis, I would still hear variations of it. And it was very disheartening.

I saw a Chiropractor for a few years, who said to me once, “I should have someone sneak a new food into your meal. I’ll bet you’d be fine eating it.” I was mad and shocked that she would insinuate that the severe gut issues I was experiencing was caused by something I was making up in my head or by anxiety. She knew that I was seriously ill, and eating only 4 different foods. At the time, I knew that I was having reactions to trace amounts of foods (and chemicals). I had to be careful of pots that weren’t thoroughly cleaned, or a knife put into my vegetable oil based “butter” that cross contaminated it. Right around that time, I had awakened in the middle of the night at least twice feeling as if I couldn’t breathe. I finally found the source – my mouth guard I wore overnight. I had not thoroughly cleaned my mouth guard of the cleaning chemicals I had used. It’s frightening to awaken in the middle of such a severe reaction, and it taught me to be much more careful. It also taught me that trace contact with items could be severely affecting me. My body was really amped up, and I needed to be much more careful. I knew that this chiropractor wasn’t the right one for me anymore, and chose to see a new practitioner who honored the experiences I was having, and who knew that my symptoms weren’t all in my head!

Then there was the allergist at a food allergy conference that I attended about 5 years ago. I asked a question about Mast Cell Activation, to which he replied that there is no such thing. It is made up! That was difficult to hear, but I realized that in his pediatric allergy practice he didn’t have the training to understand mast cell issues. I couldn’t imagine being one of his patients trying to find out what was wrong, and having to hear him negate their experience! I decided to unfollow him on Twitter as my final goodbye to his way of thinking.

When I would hear comments like these from a doctor, I felt he/she was suggesting that my physical symptoms weren’t real. And I knew they were very real, and were causing me a lot of pain.

Yet, I also knew that my mast cells activating had a mental/emotional component to them. And I’ve understood and tracked this better through the last few years. If I feel stressed because of pollens in the air, or feel overwhelmed with work, or not getting enough sleep, my gut hurts more. And why does my gut hurt? Because the twitchy mast cells in my body are most prevalent in my gut. The receptors on those cells are constantly looking for a reason to protect me. And there’s nothing like stress to activate those receptors.

I’ve gotten better at being able to identify when I’m stressed. I have a local allergist’s office that posts the local pollen counts daily, and this helps me to check their website when my gut feels especially cranky. Inevitably, the pollens have gotten higher, and I might need to increase my antihistamines.

I can clue into my body when I’ve been working a lot to see what is occurring in my energy levels. Am I overtired? How am I sleeping? Am I anxious with a new client? All of these help me to monitor whether my mast cells are likely to activate in an attempt to safeguard me. And a lot of those feelings are actually sourced by what’s going on in my brain. What am I telling myself?

This is where I’ve learned that there is communication between my brain and my body that is important to recognize. The desire to be perfect at work and to never make a mistake is sadly a familiar mantra in my brain. Yet, recognizing that I’m human, and mistakes are part of the human experience is something that I still struggle to accept. And when one of those mistakes occur, my brain is likely to chastise me with harsh language. And guess what? The mast cells activate!

Another way that my brain affects me is how I view my condition. I’ve learned with a chronic illness that if I awaken in the morning feeling less than optimal, and I then kick into telling myself, “Another day of feeling terrible,” I’m guaranteeing that I will have a joy-less day.

If, on the other hand, I tell myself, “Okay body, you’re not feeling as well as you would like, but let’s get going and see if this gets better,” it’s amazing how my body starts to shift. Inevitably, I find that I can still take a slow walk in the neighborhood, or even just have a loving conversation with my husband or a friend. And my mood begins to lift, and my body begins to feel better.

Spending time with the family!

I’ve learned that if I wait until I feel wonderful, or even normal (whatever that is/was!) to do things, then I will never go and do anything. Sometimes, going and doing things is what helps me to feel better. And if nothing else, just having a conversation with someone and connecting to them allows my brain and body to shift.

So, while MCAS isn’t all in my head…the thoughts surrounding the symptoms and conditions of MCAS are certainly affected by my thoughts. I’m continuing to learn more about the brain and its wiring with the body with an app called Curable. I will write more on this blog about what I’m learning as I continue to practice the exercises. So stay tuned!

Coronavirus COVID-19

The Journey to a COVID Vaccination

Now that my son, Morgan, is a 25 year old man he is making the informed decisions about all aspects of life, including choosing allergists, physicians and whether to receive a COVID vaccine.

I feel secure in the knowledge that he is fully capable of making these decisions, and it’s really wonderful that he and I can still talk through them meaning he still values my input, at least a little!

Morgan’s history with vaccinations is problematic. He received an MMR vaccine at 15 months old, in 1997. Because he had reacted to touching peanuts previously, and had never eaten eggs, we remained in the waiting room for 20 minutes. Nothing appeared there, however he later reacted by swelling to the point his eyes shut, and his entire body swelled into what I called an alien for 3 days. It was frightening. During the doctor visit, our pediatrician referred us to an allergist while saying, “Morgan is having more allergic reactions than I know how to treat!”

Several years later, it was time to get a Chicken Pox vaccine which we had delayed. With his eczema, our allergist suggested that the vaccine would be preferable to him having what would likely be a more serious case of chicken pox. We went to her office to have the vaccine administered gradually in increasing dosage amounts, and he appeared to do fine. However, 6 hours later he began to vomit every 15 minutes.

He became severely dehydrated, and we took him to the emergency room. They had to re-hydrate him through an I.V., and he remained in the ER overnight. For the next two days, he was horribly ill. Our allergist is convinced this was a reaction to the shot. He never exhibited hives, yet we learned that allergic reactions can take on many different symptoms.

Fast forward to heading off to college. The Meningococcal vaccine was required for those students living in the dorm. Both our pediatrician and our allergist said let’s wait on this vaccine, and our allergist provided a medical exemption. If the illness had shown up on campus, we would then get Morgan vaccinated. Thankfully, that never occurred.

For those of you who read this blog frequently, you will remember that Morgan had COVID-19 which I wrote about here. Since no one yet knows how long the immunity lasts, and because he would like to once again travel, Morgan began to look into getting the COVID vaccine.

He did his own research to find out that today’s Chicken Pox vaccine appears to use some of the same preservatives as the one used in the Pfizer COVID vaccine. He was also aware that a few individuals in Britain who had diagnosed food allergies were experiencing anaphylaxis to the Pfizer vaccine, generating a warning from the British medicine regulator stating anyone with a history of anaphylaxis to foods or medications to not receive that vaccination. However, the United States Center for Disease Control states that the “CDC recommends that people get vaccinated even if they have a history of severe allergic reactions not related to vaccines or injectable medications.”

The Johnson & Johnson vaccine looked like a better alternative, and it was only one shot. Morgan discussed this with his new allergist, who agreed that this was the best choice for him. She also liked this shot because he had had a case of COVID. She suggested that he obtain the vaccine in a hospital environment, and to remain there for at least 30 minutes after the vaccination.

This past week, Morgan received the vaccination! He was prepared to have some flu like symptoms, especially since his boyfriend, Quinn, had received the J&J shot and experienced some symptoms for about 24 hours. By the evening of the shot, Morgan began to feel body aches, and had a rough night sleeping. He felt a little nausea, but by 48 hours after the shot he was feeling back to normal.

Hooray for a positive outcome! He’s especially looking forward to traveling, and is already preparing for his first trip now.

Eczema & Rashes, Eosinophils & Mast Cells

Slowly Healing from Mast Cell Activation Syndrome

I was diagnosed with MCAS (Mast Cell Activation Syndrome) almost 10 years ago. It took a few years of trying every prescription medication my GI doctor could find to begin to get my symptoms stabilized, and even then I still was suffering from weight loss, fatigue, stomach pain, insomnia and an inability to increase my diet.

I have written at length about how I got diagnosed in a series of posts here. I have continued to work toward healing, and the question that has come into my mind a lot recently is, “Why is it taking so long for me to heal?”

I know that I am SO much better than I was 6 years ago when I first started with Dr. Xiu-Min Li and Traditional Chinese Medicine. (If you want more detailed information about Dr. Li and her protocol, read this.)

I was hoping to get back to New York City to see Dr. Li in person last year and to discuss my slow progress of healing, but the pandemic altered those plans. Thankfully, our almost monthly Zoom calls have kept her up to date and have kept me receiving all my digestion teas, creams and herbal foot patches. However, unlike other MCAS patients of hers, I am still unable to tolerate almost anything that goes through my digestive system, and that severely limits my progress. I have been able to sloooowwwwly increase the herbs in my digestion tea in milligram quantities, and the same is true for the herbal foot patches. I would so love to just be able to take herbal pills and begin to eat a wide variety of foods and feel great! For some reason, that isn’t the path of healing that has been laid out in front of me. And the only way to tolerate more herbs in my digestive system is to heal my digestive tract. Dr. Li reminds me to practice patience and to be grateful for small amounts of progress.

Acupuncture is helping to heal my stomach and gut, but it too is a balancing act of my doctor using enough needles to create healing without stimulating my system too much with too many needles. Thankfully, I don’t have to worry about how she does that, but I can tell you that she has learned my internal system quite well over the last 6 months. I explained to her at my first visit that my nervous system gets amped up and goes into fight or flight mode if my body gets overstimulated, which defeats the entire purpose of acupuncture! Dr. Debbie thinks that my body needs to detox the toxin that she believes remains from when I reacted severely to a wasp sting almost 15 years ago. She has begun a detox regimen where every 2 months she pokes my ears and encourages them to bleed. It sounds barbaric, but I can attest that my body is feeling less toxic, and according to her my pulse and tongue appear to be showing signs of the detoxification which is very encouraging. This detoxification is currently showing up in my skin which has flared with eczema and other rashes that itch furiously. So again, we are working slowly and methodically toward healing.

Both of these Traditional Chinese Medicine modalities have allowed me to decrease my medications, which is a real gift. I no longer need the swallowed corticosteroid that I was using for EoE, because the combination of acupuncture and digestion tea has healed my esophagus. (To read more about acupuncture and EoE, read this.) And I’ve decreased my Zyrtec dose to 1/2 of a pill daily because I no longer suffer from extreme pollen allergies in the spring and summer. Additionally, I haven’t had to take any Rhinocort AQ nasal spray so far this year. That is amazing!

I continue to see my Network Spinal Analysis (NSA) chiropractor, Dr. Munn, weekly and have learned that my spine is unwinding. In the years that I was so sick and unable to sit or walk for long periods of time, my spine was apparently twisting. I just knew I hurt, and didn’t realize everything that was going on with my body. My body is now healing, and the unwinding of my spine has created a tingling feeling on the left side of my back where it feels like it’s been asleep – probably because it has! This unwinding has been alternating between pain and relief as years of energy are releasing. Once again, Dr. Munn tells me that we can’t force my body to unwind because we don’t want to overload the nervous system, and the body is going to take its time…patience, patience. Read more about my experience with NSA here.

Wisdom Healing Qigong is assisting my body with releasing all of that energy, and I practice it daily. I have found the meditative practice not only helps my body, but it also calms my mind. MCAS created a lot of anxiety inside my mind, and I used to get jumpy with every sound and was constantly worrying about every symptom I was experiencing. Meditation and Qigong have quieted my mind so that I can now distinguish when I am jumpy, and can use detective work to determine what is creating that anxiety.

The only way out is through. The unwinding of my body is also the unwinding of my mind, and I continue to learn more about myself through this journey. I now experience more connection between my mind and my body, and the herbs and other healing modalities create even more opportunities to be with any painful or challenging areas along with the ability to be with the good stuff. My body is no longer asleep, and I’ve learned how to breathe through pain and not need to take a medication immediately to numb it. I would certainly love to not itch, but this too will pass!

Food Allergy, Food Allergy & Families

What the FASTER Act Means to Us!

You have likely heard of the Faster Act of 2021, but just in case you need a little more information about how it will affect those with sesame allergies, let me just say – it has been a long time coming.

First, a little history: When my son, Morgan, was diagnosed at 18 months old in 1997 with food allergies, there was no labeling law in affect. We went home from the doctor’s office with a diagnosis of peanut and egg allergies, and I decided to start making as much of his food from scratch, because I couldn’t trust that the label on any food accurately listed the correct ingredients. And any type of cross contact during the manufacturing process was an even further dream of getting that information!

The Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004 went into effect on January 1, 2006. According to the FDA website, “Congress passed this Act to make it easier for food allergic consumers and their caregivers to identify and avoid foods that contain major food allergens. In fact, in a review of the foods of randomly selected manufacturers of baked goods, ice cream, and candy in Minnesota and Wisconsin in 1999, FDA found that 25 percent of sampled foods failed to list peanuts or eggs as ingredients on the food labels although the foods contained these allergens.” Good thing I was being cautious about labels on food products!

The ‘major food allergens’ that were required to be listed in plain English with FALCPA were: peanuts, tree nuts, eggs, milk, wheat, soy, fish and shellfish. These are known as the Top 8 in the USA. Other countries required different foods to be labeled on products manufactured in their country, and some of those countries included sesame.

Morgan got diagnosed with a sesame allergy after he endured a severe hive reaction from eating chicken nuggets at McDonald’s. We had a skin prick and blood allergy test performed by our allergist, and she wanted to see if he was allergic to sesame, since those little sesame seeds can appear in food and be almost undetectable. Sure enough, he was severely allergic, and we have been monitoring labels and calling customer service telephone numbers for food manufacturers for the last 20+ years. And let me tell you, it is VERY difficult to find a bread that doesn’t have cross contact issues with sesame!

At one time, I tried to make my own gluten-free bagels since our daughter was diagnosed with Celiac disease. I figured that these bagels would also work for Morgan, and we would know that they didn’t have any sesame in them, nor any possible cross contact in our safe kitchen. After hours of work trying to make a masterpiece, the bagels turned out less than ideal – better for use as a hockey puck or a door stop than for eating!

Since then, we searched for a safe bread in the grocery store, hoping to find one that didn’t also have sesame seeds on a different bread in their manufacturing line. We would then call the company and ask if there was ANY chance that the bread would cross with sesame in their plant. Sometimes we would find out that there was another product that contained sesame that was also run on the same lines. Sometimes we’d be lucky and find a safe bread! For years, Morgan used Roman Meal bread for sandwiches and for a hamburger bun because we couldn’t find any safe hamburger buns in any of our local grocery stores.

The FASTER Act – Food Allergy Safety, Treatment, and Research Act – not only requires that food manufacturers list sesame on a label beginning January 1, 2023, but also provides for more research on the prevalence and economic costs of food allergies. The food label must list sesame in ‘plain language’ and will become the ninth food allergen to be labeled, allowing those of us in the USA to rename the Top 8 to the Top 9!

President Biden signed the Act into law on April 23, 2021.

Morgan and I cheered upon hearing that! And he so looks forward to being more confident of his food choices knowing that sesame will soon be labelled!

Emotional Aspects of Food Allergies, Food Allergy, Food Allergy & Families, Interviews

Not Today, Butterflies! A Book About Food Allergy Anxiety

A great new book by Nicole Ondatje was published this week. Read below for an interview with Nicole about this great new children’s book!

Nicole, you have a new book out called, “Not Today, Butterflies! A Book About Food Allergy Anxiety.” What gave you the idea to write this book?

My nine-year-old daughter has severe anaphylactic food allergies. At age four, she started experiencing anxiety about her annual allergy skin prick tests, attending birthday parties, visiting family, and eating at restaurants. Searching online, I could find children’s books regarding food allergies and a handful of children’s books regarding anxiety, but there weren’t books that specifically and directly addressed food allergy anxiety in children. So, I started researching techniques to help children manage their anxiety, and testing which approaches helped my daughter the most.

 When she turned five, my daughter enrolled in a clinical trial for the peanut patch, adding blood draws and food challenges to her long list of anxiety-provoking situations. My approach was to help her write and illustrate a story in which she overcame her fears of going to her peanut patch appointment by being brave (and getting a sweet treat afterwards). She felt that the story, called “Rosy Goes to the Doctor,” helped her prepare for future appointments. That is how I was inspired to write a children’s book to help my daughter and other children like her who struggle with the daily challenges of living with a food allergy.

The illustrations in the book are wonderful. Did you do the artwork also?

I love the illustrations! Bumblebee Books and Olympia Publishers provided me with an illustrator named M. Das. I felt that it was important that the illustrations were somewhat realistic and included imagery of a human child to whom children could truly relate, rather than a fictitious animal character. My daughter and I worked together to provide the illustrator with detailed descriptions of each character in the book and what we wanted to see on every page. It was really neat to see our words come to life in the drawings that came back to us.

As the parent of a child with food allergies, how much of the book was written from you or your daughter’s personal experiences?

All of it! Both my husband and I have an anxiety disorder that we have to manage, and we experience additional anxiety about our daughter’s food allergy. Our daughter has experienced terrible anxiety in anticipation of her allergy appointments, going to play dates and birthday parties, being different from her friends and schoolmates, and speaking up to friends as well as strangers about her allergy. It breaks my heart that she lives each day with this nagging fear about the lurking danger of her food allergy. Our approach has always been to educate and empower her to learn what she can do to keep herself safe. As a family, we have tried all of the “Ways to Help Your Child Manage Anxiety” included in the back of the book (except the proximity food challenge and happy visit), and we’ve practiced them for many years to learn what techniques help us the most.

 I love the birthday party situation in the book where Quinn has to speak up for herself. I felt butterflies for her! How did you teach your daughter about handling such a situation?

It started with reading a lot of children’s books about food allergies together and having an open dialogue with her. In fact, our first ever food allergy book was your book “Allie the Allergic Elephant: A Children’s Story of Peanut Allergies”. We read books that encourage speaking up about your food allergy, like “The Peanut Pickle” by Jessica Jacobs, and “Food Allergies and Me: A Children’s Book” by Juniper Skinner. We read books that help you prepare for a social event and learn how to stay safe, like “The No Biggie Bunch” series by Dr. Michael Pistiner, and “Joey Panda and His Food Allergies Save the Day” by Drs. Amishi Murthy and Vivian Chou. We read other books about calming anxiety in children, like “Don’t Panic, Annika” by Juliet Clare Bell and “Sea Otter Cove: A Relaxation Story” by Lori Lite. We also encouraged our daughter to practice speaking to strangers about her allergy by having her place her order at restaurants and ask about their food allergy practices, and by participating whenever we trained friends, family, school staff, and caregivers on managing her food allergies (in fact, these were practices we learned from you and Morgan!).

 It took several years and many birthday parties before any of us felt reasonably calm about the experience. We still follow the same process of checking with the party planner ahead of time on what food will be served, reading all of the ingredient labels, staying away from foods without a label, and making sure we have two epinephrine auto-injectors with us. As my daughter has gotten older, it upsets her more to bring her own safe treat and eat something different from the other kids at the party. Sometimes we are able to work with the other parent or bakery to ensure the shared party treats are safe for my daughter to eat. But we continue to work on helping her accept being “different” from her peers. Maybe that will be my next book topic!

In the Notes to Parents in the back of the book, you mention teaching a child mindfulness. What’s the best way that you’ve found to have a child be willing to try this skill?

Number one is finding the right tools, and number two is setting an example by practicing mindfulness yourself in front of your child. I’ve included a number of mindfulness tools for kids in the back of the book, but two additional tools that we love are “The ABCs of Yoga for Kids” learning cards and “50 Mindfulness Activities for Kindness, Focus, and Calm” cards. We practice these cards together, often before bed. A great book to help teach your kids about mindful belly breathing is “Sea Otter Cove: A Relaxation Story” by Lori Lite. We sit and practice different breathing techniques together, starting when we are already calm. As a parent, I absolutely loved Dr. Kristen Race’s “Mindful Parenting” book along with all of her amazing techniques for busy parents and the entire family. My child has witnessed firsthand how I can maintain more peace and levelheadedness when I am disciplined with my daily meditation practice. When I am feeling particularly frustrated or stressed in front of my child, she sees me stop, pause, and take a breath, or blow out an elongated breath, or remove myself from a heated situation and find ways like reading, listening to music, or taking a bath to calm myself. She also sees me push myself to do something in spite of my fear, and I help her recognize all of the instances in which she has been brave despite her food allergies.

Is there anything else you’d like to tell us?

I truly hope that this book helps children and families with food allergies. It’s based on my own personal experience, research that I’ve done through books, conferences, webinars, and meeting with a child psychotherapist whose own child has food allergies. Before publication, it was vetted by that same psychotherapist as well as my child’s board certified asthma and allergy doctor.

Thank you.

Thank you Nicole!

Eosinophils & Mast Cells

Acupuncture & Eosinophilic Esophagitis

I have been a patient of Dr. Xiu-Min Li’s for over 5 years now, utilizing her Traditional Chinese Medicine (TCM) herbs to assist with healing my gut, and minimizing the symptoms I have experienced from the dual diagnoses of Eosinophilic Esophagitis (EoE) and Mast Cell Activation Syndrome (MCAS).

I have also been slowly weaning myself of other medications that are standardly given for EoE and MCAS. I am currently on a very small dose (1/4 of a 10 mg tablet) of Zyrtec (antihistamine) and an even smaller dose (1/20 of a 1mg capsule) of Ketotifen (mast cell stabilizer) in addition to one puff of swallowed Asmanex daily. The reason why I am on such a low dose of these medications is that my gut has been healing, and taking higher doses of any of these medications makes me feel worse rather than better.

Additionally, while Flovent is generally given to be swallowed to mitigate the symptoms of EoE, I recently found out I’m reactive to it. I experienced hives and eczema on my upper chest after being on the drug for a few weeks, and even with lowering the drugs, the itching was severe. Therefore, I went onto Asmanex, also swallowed, and no longer have any itching!

There is no cure for EoE or MCAS currently. These traditional drugs are to assist with symptoms, and prevent further damage to the gut. I wanted to find a cure, which is why I became a patient of Dr. Li’s in 2015. (Find out more about my Healing Through Traditional Chinese Medicine here.) For patients who live in and around the New York City area, Dr. Li will provide acupuncture treatments to assist their body in healing during regularly scheduled appointments.

Since I live in Colorado, I have monthly or bi-monthly Zoom chats with Dr. Li to check in with her about my progress and to order more herbs. I needed to find a local practitioner who was willing to provide me acupuncture without over-stimulating my body. Dr. Li’s biggest concern was that my body could overreact to acupuncture, and I needed to ensure that any doctor I saw would understand the level of stimulation that I could withstand that would be helpful and not hurtful.

I’m happy to report that I have found a wonderful doctor here, Dr. Debbie Hsaio Ki Ting in Colorado Springs, who received her degree from Samra University of Oriental Medicine in Los Angeles, CA and the Beijing Academy of Traditional Chinese Medicine in China. Dr. Debbie was happy to communicate with Dr. Li if that was necessary, but Dr. Li said that she trusted her to understand what my body needed.

What we all want: A Healthy Esophagus

When I first met with Dr. Debbie, I went into a long explanation of my various diagnoses to ensure that she understood everything I thought she needed to know about me. I have to laugh now because her response to all of that information was similar to Dr. Li’s – Traditional Chinese Medicine isn’t concerned with “Western medicine” diagnoses. They view the body in an entirely different way: energy balance and restoring the flow of Qi (chi). Dr. Debbie’s conclusion was that I have a lot of inflammation in my body, and she would be able to mitigate that inflammation through acupuncture.

Dr. Debbie has found the perfect balance of stimulation without overdoing it. The first few sessions were a little too much for me, and I found myself with severe stomach aches a few days after the treatment. I shared this information with her, and she backed off by using fewer needles until I could tolerate more needles. And I began to feel MUCH better after having acupuncture. I noticed especially that my intestines calmed down tremendously. That was especially nice since the fall flare of pollen was beginning to ramp up, and I continued to feel better and better!

My gut is much calmer and not so reactive, and the only thing that has changed is that I’ve added acupuncture into my healing regimen. I continue to take all of the herbs and apply the creams that Dr. Li has prescribed for me in addition to having acupuncture every other week from Dr. Debbie. I continue on the road of healing, and not just symptom relief, but true healing! I’m very hopeful to soon be able to increase the number of foods that I eat from my paltry four. It has been a long road of recovery for my gut, but I was very sick when I began TCM.

If you’d like more information about Dr. Li’s research, she has published a study about Traditional Chinese Medicine and Acupuncture, Successful Management of Eosinophilic Esophagitis Using Traditional Chinese Medicine: A Case Report.

Coronavirus COVID-19, Eosinophils & Mast Cells

Mast Cell Activation Syndrome and Post COVID-19 Illness

A recently published article by Dr. Lawrence Afrin, the author of Never Bet Against Occum: Mast Cell Disease and the Modern Epidemics of Chronic Illness and Medical Complexity, and two other mast cell doctors, have found a consistency of symptoms of Mast Cell Activation Syndrome (MCAS) and those of “long-haul COVID-19”. They also postulate that those patients with severe COVID-19 symptoms of hyperinflammatory cytokine storms may in fact have undiagnosed MCAS, a chronic multisystem inflammatory disease.

If you are not familiar with the illness of Mast Cell Activation Syndrome, it is a beast of an illness to live with and to diagnose, mainly because the symptoms can look like so many other illnesses. (I have written a series of informational articles about MCAS here. )

For some people, the symptoms of MCAS aren’t enough to actually seek medical care. They may have an occasional stomach ache, or rash, and have never needed to become a detective to determine why they were able to eat blueberries, for example, last month and this month their stomach hurt horribly after eating them. Or the few hives that they get in the autumn season aren’t enough to bother them. Yet underlying these symptoms and others, the body’s mast cells are overreactive, while the person will declare themselves perfectly healthy. Then, when the body begins to fight off a virus such as COVID-19, the body overcompensates its response to the viral load and releases thousands of chemicals (cue the cytokine storm) that end up doing more damage to the body than the virus itself.


SARS-CoV-2-Reactive T Cells Found in Patients with Severe COVID-19

Recent statistics regarding COVID-19 suggest that only 15-20% of patients will experience a severe form of the illness. It is interesting to note that previous research on the prevalence of MCAS in the developed world is 17%, with the abundance of individuals unaware that the symptoms they are experiencing are in fact from mast cells acting abnormally.

Any virus would call forth a response by mast cells in order to heal the body. The problem with MCAS individuals who remain undiagnosed and therefore untreated, is that their mast cells are dysfunctional and react inappropriately to COVID-19 causing thousands of chemicals to be released into the body.

Fatal cases of COVID-19 are frequently caused by cardiovascular conditions, and heart damage has been one of the frequently cited long-term affects of the illness. Mast cells play a significant role in cardiovascular complications seen with COVID-19 such as pulmonary embolisms. Additionally, mast cells patients frequently cite “brain fog” as one of their symptoms, a common complaint of long-haulers with COVID-19.

Fatigue is a classic symptom of MCAS, frequently made worse by insomnia. Once again, these are common complaints of individuals who are still experiencing symptoms months after being diagnosed with COVID-19. In the research report, the doctors provide a table of symptoms by organ/system comparing MCAS with COVID-19 patients. The similarities are striking.

For individuals in the midst of the virus, doctors are finding that medications used to mitigate the symptoms of MCAS, inhibiting mast cell activation, are also helping COVID-19 patients: cromolyn; leukotriene inhibitors, dexamethasone, low-dose naltrexone, quercetin, and H1 and H2 blockers (antihistamines such as Zyrtec and Pepcid). These drugs might mitigate the severity of the illness, helping patients to not progress to the severest form of the disease.

An interesting note in the article concerned MCAS patients who had been previously diagnosed and were being treated for their mast cell activation. When these patients tested positive for a COVID-19 infection, all fared well enough that the doctors stated that “none have required mechanical ventilation, let alone died”. Their conclusion was that the patients had their mast cells at least partially controlled so that they did not suffer the most severe courses of the disease, but that they were still at increased risk for suffering from the post-COVID-19 illness.

For those of us with a diagnosis of MCAS, the volume of research that is currently occurring on COVID-19 will undoubtedly help us to have more understanding of our illness. And hopefully, a cure!

You can read the full article, Covid-19 hyperinflammation and post-Covid-19 illness may be rooted in mast cell activation syndrome in the International Journal of Infectious Diseases.

Coronavirus COVID-19

Food Lessons Learned (So Far) in the Pandemic

I don’t know about you, but some days I definitely am suffering from Covid-19 fatigue. When we were under “Safe at Home” orders in Colorado back in March, and for the subsequent 6 weeks, each day felt like an eternity! I couldn’t keep track of what day it was because every day felt like it lasted a week, and I just kept hoping for some good news and an ability to go back to “normal.” Normal was being able to find the foods I needed to purchase without having to visit five grocery stores! Normal was being able to go out to the movies, go to the gym, and get together with my Qigong practice group in person. I’ve come to the conclusion that whatever we get back to won’t be like the previous normal but maybe we can get to a new normal. The Covid-19 pandemic has become a dividing line of a life before and after.

This is similar to how I felt when our son, Morgan, was diagnosed with life threatening peanut allergies. There was life before peanut allergies, when we could eat anywhere and eat anything. And then there was life after, when every bite had to be monitored and every label read. It was a demarcating line in our lives. Adding each new food allergy diagnosis didn’t make as much of an impact on our daily lives as that first allergy.

This kind of understanding helped our family to roll along with the pandemic a little easier in some ways, and we had a little bit of rough roads in other ways. We aren’t yet to the after the pandemic. It’s the during stage that we’re currently experiencing. And who knows how long this stage is going to last. We’ve learned some lessons that I want to share with you, and maybe you’ll have a few lessons you can also share with me!

Lesson #1: Have safe foods on hand always!

My husband, Robert, and I tried to get N95 masks in local stores and on the internet in February 2020 to no avail. Everywhere we checked was sold out. We finally found a few masks through Ebay, but this sparked my husband to suggest that I’d better get a stockpile of my safe foods, since it was clear to him that people were fearful and that makes for interesting buying choices!

With my diagnoses for Mast Cell Activation Syndrome (MCAS) and Eosinophilic Esophagitis (EoE), I am currently eating just four foods (all organic) – chicken breast, turkey breast, broccoli, and frozen Cascadian Farms hash browns (for some reason I can tolerate these but not fresh russet potatoes). I’m so grateful that Robert suggested that I get more of my foods on hand before others began to hoard food products. I was able to purchase a month’s worth of these groceries for myself, which allowed me to continue to eat when limits on the numbers of chicken packages, for example, were placed in most grocery stores in our area. Since February, I have kept a constant supply of one month’s worth of groceries in the freezer. I rotate the foods each week as I purchase new items. I will continue to keep this stockpile of safe foods for as long as the pandemic continues, just in case there is more hoarding or limitations on purchases in the future.

Lesson #2: Befriend your grocery clerks when you have special food needs!

For the last several years, I have been purchasing the frozen hash browns at my local Natural Grocers. I became good friends with the purchasing manager and the receiving manager since I had a standing special order of 2 cases that they ordered for me weekly. By late March, their corporate headquarters was no longer allowing special orders, which was very disappointing.

Despite my explanation to the store manager, and my years of purchases, he was unable to guarantee that I’d be able to purchase 2 cases at a time and unable to even know if they would be receiving hash browns on a weekly basis anymore. However, the receiving manager was willing to put aside every and any case of hash browns that were received and hold them for me, unbeknownst to his manager. Having a good relationship with him, and explaining my medical condition, allowed him to better understand what I was managing.

At one point, I called in to the store to see if the receiving manager had any potatoes set aside, and when he said yes, I told him I was so thrilled that I’d ask him to marry me if I wasn’t already married! He said, “I’m married too, but you can still ask me!” And I did! We laughed and laughed at the absurdity of the situation, and it took months for him to regularly received these potatoes again, forcing me to scour stores from Colorado Springs to Denver to try to purchase as many frozen hash browns as the store clerks would allow me to purchase.

Lesson #3: In a pandemic, don’t expect special treatment!

Many times I would head to a grocery store register only to have a checkout clerk tell me that I wasn’t allowed to purchase so many packages of the same product. Despite having a letter from my allergist explaining the few items that I can eat, and his request to please allow me to purchase what I needed for one week, the clerks and even store managers , would say no.

One time, I received a special order for the turkey breast that I had purchased for years at a local King Soopers, again on special order. I would generally pick up 12 packages at a time every two weeks. Again, I had two meat department employees who were so good to me, and we had become friends. They knew what I was experiencing trying to get my safe food, and would continue to make special order requests for me. Yet, when I got to the front of the store to pay, the self-checkout clerk began screaming, “You can’t buy that much meat. Don’t you know there’s a pandemic going on?” Again, no amount of explanation or doctor’s letter was going to cease her yelling. So, I purchased the two small packages that she would allow me to purchase, and went home.

When I told my husband what happened, he was incensed and went back to the store. He spoke with the meat department manager who said to take the other 10 packages to the front of the store to purchase them, and tell the clerk that if they had a problem to contact him. Wouldn’t you know that he had no trouble purchasing all the meat without any issues!

Lesson #4: Be willing to break some rules!

I can’t count the number of times that I left the grocery store to go to the parking lot with my allotted amount of chicken or frozen hash browns and put them in the car, only to change my jacket and mask and head back inside the store to purchase more of the same items up to the limit allowed.

Many times I’d go to my regular stores and find no supply. I’d end up driving to numerous stores around the city just to get enough food to refill my stash for the week, if I could even find the items. I wasn’t willing to eat down all of the food I had in the freezer for fear that the distribution issues could continue long after my supply ran out. Those “safe at home” orders suggesting that we only grocery shop once a week weren’t going to work for me.

I generally am a rule follower, and I understand not purchasing massive quantities of toilet paper, for example, so that everyone can have their fair share. However, when you’re talking about being able to eat at all, there were some rules that were going to be broken in order for me to stay alive!

Lesson #5: Be willing to ask for help finding your special foods

There were a few weeks where I couldn’t find my potatoes anywhere in Colorado Springs. I asked my daughter, Michaela, who at the time lived in Lakewood, a suburb of Denver, to check around for me. She graciously searched and found a case worth, but then had to take the packages to our son, Morgan’s apartment since her freezer wasn’t large enough to accommodate this grand prize!

Michaela also has a diagnosis of MCAS and eats only organic fruits and vegetables. She was having difficulty finding foods at one time in Lakewood, so we found some safe foods in Colorado Springs and made a rendezvous midway to exchange foods.

I also had wonderful neighbors who were willing to pick up 2 packages of organic chicken for me when they went to the grocery store if they found any. People who don’t have such strict diets are free to eat a variety of items, and were so helpful in offering to make purchases to keep me fed.

At this point, I’m flush with all of my foods and haven’t had any difficulty recently being able to purchase everything that I need.

I continue to express gratitude every time I’m able to easily find the foods that I eat, and I’m especially appreciative to no longer have to be sneaky in order to keep myself fed!

Coronavirus COVID-19, Food Allergies & Asthma

Having COVID-19 With and Without Asthma

My son, Morgan, and his boyfriend, Quinn, returned from their vacation in London on Monday, March 16. If you haven’t read about that challenging return to the US, you can read about it here.

Both young men went home to self-quarantine after their return. During the trip, for a few days Quinn had been experiencing symptoms of fatigue, muscle aches, and a very low-grade fever, then he’d feel better. Since there was no way to get a COVID-19 test in England or Scotland during their trip, he just continued to enjoy the trip.

Morgan lives alone in an apartment in Westminster, a suburb of Denver, CO, while Quinn lives alone in Arvada, another suburb. Morgan felt sure that they had been exposed to the COVID-19 virus during their travels since they had been in planes, trains, automobiles and the Tube in London! They did their best to wash their hands and use the hand sanitizers available in many locations, however the nature of travel ends up with frequently being in crowds.

Morgan’s boss at the Longmont Economic Development Partnership had a baby while he was in London, and he returned to work early Tuesday morning handling not only his workload but hers also. His days were very long that first week back at work with numerous online meetings on the impact of the coronavirus on the local economy.

On Tuesday, March 24, he awoke with body aches, especially in his legs. At first he thought it could be from the yoga he did the previous day. Then, when he spoke with Quinn, he discovered that Quinn had been experiencing not only a stuffy nose but also a sensation of not being able to taste his food, which come to find out is apparently a strange symptom that many people with COVID-19 are experiencing. At that point, they were both convinced that they had the virus.

Day 2 of the virus, Wednesday, brought more of a tight chest for Morgan. He had been taking his inhaled steroid, Qvar, once per day but decided that he needed to check in with his primary care doctor to see what his next step should be and how to obtain COVID-19 testing. UC (University of Colorado) Health is a large network of hospitals and doctors in Colorado. They are providing telemedicine information and appointments for anyone with symptoms of the virus, in order to keep patients at home. Morgan called in to see where he could be tested for the virus and what he should do about the tight chest since he is diagnosed with mild asthma. He was told that there was no testing available in Denver unless he was hospitalized. As for the tight chest, the nurse with whom he spoke suggested that he increase his Qvar to twice a day. She also discussed what he should do if his breathing got more labored or he experienced wheezing, which was for him to call in for a telemedicine appointment with a doctor, who would likely prescribe Albuterol for his nebulizer. He was still working from home during all of this, trying to balance his need to rest with the workload.

As for Quinn, he didn’t have any new symptoms. He has no underlying health conditions, having outgrown asthma during puberty. He never has any issues with breathing troubles with a cold or illness. His strangest symptom was not being able to really taste his food. He was able to continue working from home all week without any fatigue or other symptoms.

Day 3 brought on a fever for Morgan who awoke with a general malaise, and a cough. When we spoke with him that evening, he sounded thoroughly exhausted. He had called back in to UC Health, in the middle of managing meetings for work, to request another telemedicine appointment for the next day, Friday. My husband and I hung up the phone quite concerned that the virus was really affecting him, and still clinging to the hope that he’d be able to stay in the “moderate” area of the illness. I posted on Facebook about both Morgan and Quinn having the illness and was pleasantly overwhelmed by the loving response of so many friends and family members concerned and sending prayers.

Day 4, March 27, was a lovely surprise to find Morgan feeling better. (My husband and I have a routine going where we talk with him every morning and evening!) He had decided to take the entire day off from work to rest, which in Mama Bear’s mind was a very good decision! He refrained from taking Tylenol the previous night, which he says upsets his stomach, and allowed his fever to spike through the night. He was up at 3 am taking a shower from sweating so much. But all that sweating helped him to feel much better on Friday morning. His cough was more productive sounding, and his energy was certainly better. I’m convinced all the positive energy coming from everyone also helped! His conversation with the doctor later in the day via telemedicine did not yield a prescription for Albuterol for the nebulizer. Instead, she suggested using a spacer and upping the Albuterol to 2 puffs, every 4 hours as a first step. It appears that doctors are trying to take small steps in fighting this illness to still have more available actions to tackle a worsening condition. We breathed a sigh of relief that his body was fighting off the virus, and by the evening he was feeling about the same, which we took as a good sign.

Day 5 is today, and his condition appears to have stabilized. He continues to say that he feels about the same. He is planning on resting all day today and tomorrow since it’s the weekend. Morgan hasn’t had to use the Albuterol inhaler at maximum dose because he has gotten relief from using it just a few times daily. The chest tightness has dissipated, and his cough didn’t even keep him up at night. He still has a slight fever that comes and goes. By the evening, however his cough was to the point where Morgan was having trouble talking without being interrupted with a coughing fit. We could hear him wheezing, which was really scary. He had been sitting in the bathroom of his apartment creating a steam bath for himself with hot water from the shower. He was also taking the Albuterol more frequently that day. We got off the phone that evening really concerned. In the middle of the night, I found myself awake wondering how EMTs would be able to get into Morgan’s apartment building since it is locked with no door person in attendance. I was in a very fearful place emotionally, and barely slept all night.

When we spoke to Morgan the next morning, Day 6, we decided to do so on FaceTime so we could see what he looked like. The telephone doesn’t provide as much information, we discovered, as being able to look into his eyes and to see how he was feeling. And thankfully he seemed to have turned a corner for the better. It was frightening how quickly the illness could turn from being stable to being really sick. And from what I read online, people who end up hospitalized for the illness, have on average been at Day 7. With that in mind, we continued to call him every morning and evening on FaceTime to check in over the next several days.

Morgan had several friends offer to get him food, however he only felt comfortable asking his sister, Michaela, to do so because she understands how to read a label for his food allergies (which are peanuts, tree nuts, sesame, fish and shellfish). She was able to get him groceries, dropped them off at the front door of the building while he gloved and masked up and picked them up.

Each day has brought him a little bit more energy, as he started back to work for a few hours building up to working all day by Thursday, April 2, Day 10. As of today, Day 11, he still has a cough, but the fatigue is finally gone. He’s also staying inside his apartment until he is completely free of all symptoms. One of the doctors he spoke to said that he should be free of symptoms for 72 hours before going out in public, and that he should be isolated for 14 days after the symptoms start. At this point, he still has several days to go to reach that milestone.

This weekend, we plan on having a virtual family dinner since we can’t get together in person! My husband’s birthday occurred while Morgan was in London, so we’d like to celebrate that. And we are certainly celebrating Morgan and Quinn both recovering from this illness!

As of now, I would say that Morgan experienced the “moderate” symptoms of the illness, while Quinn has enjoyed a “mild” illness. From what I’ve read, the mild or moderate illness will likely last 2-3 weeks, which doesn’t sound mild to me! And honestly, without either of them having access to a COVID-19 test, we are just assuming that they have that virus and not another influenza or cold-type virus. This is a very small sample size, but there does appear to be a difference in Morgan’s symptoms of chest tightness and coughing than what Quinn has experienced. Maybe that’s the difference in having asthma, since Morgan is prone to having asthma exacerbations with any type of upper respiratory illness.

I am so appreciative for all your wonderful energy in the form of thoughts and prayers for Morgan and Quinn! Stay home and stay healthy!!

Coronavirus COVID-19, Emotional Aspects of Food Allergies, Travel/Eating Out & Food Allergy

Traveling with Food Allergies When Coronavirus is In the News

If you read this blog frequently, you know that my son has had a planned trip to London since last year. I wrote about this in my last blog post here.

After many discussions, research and the existing environment on March 7th, Morgan and Quinn decided to go ahead with their trip carrying hand wipes and masks along with two backpacks of clothes and traveling “stuff”, and flew to London on Icelandair.

Morgan has flown on this airline several times overseas, and very much appreciates that they do not serve peanuts. This time, he and Quinn had no seatmates because of so many people altering their travel plans. They flew through Reykjavik and got on another flight into London without any problems, and started sight seeing immediately.

Quinn and Morgan In front of Westminster Abbey

They continued sightseeing around London and enjoyed each day, visiting a Botanical garden, a cheese factory and walking the city. Then, on Wednesday evening in the USA, President Trump instituted a travel ban from European countries to be effective 48 hours later, on Friday, March 13 at midnight.

My husband and I almost fell off the couch when we read this notification! We knew that Morgan’s flight home from London went back through Reykjavik, and wondered what that was going to mean for him. We quickly messaged Morgan, knowing that he was likely asleep, and asked for a quick chat in about 6 hours when he would be awake Thursday morning. We got up at 3am to discuss options with him.

By then, it had been announced that US citizens weren’t included in the travel ban, which helped our anxiety calm down a little. Both Quinn and Morgan had been receiving multiple text messages from friends and other family members warning them about this travel ban. Quinn had been trying to get through to Icelandair since they had awakened, however all the phone lines were busy. At this point in England, there weren’t any travel bans; nothing had been closed; and there were less than 500 cases of the virus in the UK as a whole. So, Morgan and Quinn couldn’t quite understand why we were so nervous.

Meanwhile in the US, grocery stores were experiencing people purchasing food and toilet paper as if Armageddon was forthcoming. K-12 schools and school districts and colleges were shutting down, and/or going to online classes. Workforces were being told to telecommute. Every hour there was some new information to digest and to adjust to. We tried to explain all of this to them, and that we’ve never been at this place before with a pandemic affecting not just the US but the world. Given that they are grown men, and paid for the trip themselves, we didn’t feel it was appropriate to pull a “parent directive” to get home now! We believe in supporting our now grown children, and loving them through their choices and decisions. We agreed to talk later in the day before they went to bed Thursday evening.

About 12 hours went by and we spoke again. They still hadn’t been able to reach Icelandair. We began to talk about what other airlines could get them home to Denver if they never were able to reach the airline. What was a safe airline for peanut allergies? Who flies the route directly from London to Denver? We knew we didn’t want them going through a European country if they were traveling after Saturday at midnight ET because of the port of entry issues. Denver’s International Airport was not one of the airports receiving passengers from Europe, and ending up in another US city where they would need to find another flight home to Denver was just too much to contemplate with additional fees, food allergies to manage and potential overnight accommodations needed. They had looked into other airlines’ flight schedules, but many of the seats had been booked at exorbitant prices, and they really wanted to reach Icelandair before paying for another flight. We agreed that they would go to Heathrow airport Friday morning to see if they could get information directly from the Icelandair ticketing agents.

On our Friday morning, which was already after lunch London time, we texted with them. Morgan said the ticket agents were of no help. They had been given no information to pass on to customers, and had no idea if their original return flight going through Reykjavik would be able to land in Denver on Tuesday, March 17. Then as we were texting, Quinn was finally able to get through on the phone to Icelandair. Their flight had not been cancelled even though most other flights flying on March 14-16 had been. This sounded suspicious to my husband and me. How would they have a flight of all Americans and be able to fly directly to Denver? We were ready for them to give up on Icelandair, book a flight with another airline, and get out of London that day! We decided to continue to ask more questions. What happens if the UK is included in the travel ban in the near future? Do you have a backup plan? What happens if you end up in New York or Chicago? We knew that was going to cost money for them to then find a way home to Denver, and to find a safe, food allergy accommodating airline to do so. In the end, they decided to leave Heathrow and keep their reservation on Icelandair to fly home on March 17.

We were really concerned at this point, especially when they said that they were going to continue their trip schedule and travel to Scotland via train, a 4 hour ride, on Saturday morning, March 14 and spend the weekend there. They planned on returning to London on Monday to spend one night in the city before boarding the plane to come home. My husband and I were taking this one day at a time, and that day sure felt like about 48 hours in length. There was so much going on in the news, and our reality was so different from our son’s and Quinn’s.

Then, on Saturday, March 14, President Trump extended the travel ban to the UK and Ireland. My husband has a way of seeing some things that are coming, and he had a feeling this was going to occur. We just didn’t expect it so soon. The travel ban would go into effect on Monday, March 16 at midnight.

We texted with Morgan, who had already seen this information on the BBC. He said, “We will be continuing as planned but know potential changes are in store. Icelandair is posting a full flight list at least a day in advance so we will know, and they will keep us updated. More excitement to come! But we are having a blast in Scotland.” My husband and I are really worried. Their Tuesday flight is after the UK ban goes into effect, and we know they will be landing in a city other than Denver. And likely their flight is going to be cancelled altogether, because you can’t just change the destination city on a whim when flying an airplane.

There have been numerous times in our children’s lives when we have had to let go, and let them “do their life” even when we don’t agree with their decisions. This was one of those times. We were really concerned how Morgan was going to manage his food allergies, how the coronavirus screening was going to be managed, what airport he was going to be sent to, and what the cost was going to be for him to get himself home to Denver.

And then we awoke Sunday morning, March 15, to this message:

My husband and I were jumping up and down in tears, we were so happy! After seeing this message, we saw the pictures online of the enormous lines at the various US airports who were receiving the European flights after the European travel ban had gone into effect. Hundreds of people all crowded together in these long, snaking lines to have their temperature checked. We knew it would be a hassle to be sent to one of these 13 airports upon arrival in the US, but we had no idea it would also put all of these passengers at risk for the virus with a complete lack of social distancing. We were so glad that Morgan and Quinn wouldn’t be subject to that.

The British Airways flight was full when it took off from London 45 minutes late. Mama bear checked the online status to know when to expect his arrival in Denver. We were not going to meet him at the airport since we live 90 minutes away, and with the social distancing requirements that had been decreed in Colorado, we decided to follow the rules and await his text message.

As you can see, my husband and I were more than a little excited to have him back in Denver! In Colorado on Monday, March 16th, all restaurants were closed except for takeout and delivery. Most employers had gone to telecommuting workforces, and the Governor has asked for no meetings of people in excess of 10 persons in addition to shutting down all gyms and movie theaters. Morgan is working from home, and will be self-quarantining for the next week or two since he has been traveling abroad, but currently has no symptoms of the virus.

It was quite an experience to watch our world change so drastically within a week, and to have our son across the world in the middle of a pandemic. I’m very grateful to have him back in Denver!

I’m sure that Morgan will be providing a blog post about his travels and all that he has learned from this BIG adventure. Stay tuned for that in the near future!

Coronavirus COVID-19, Food Allergies & Asthma, Travel/Eating Out & Food Allergy

Here’s the Conversation I just had with my son about Coronavirus

The news of the Coronavirus (COVID-19) has begun to get my attention these past few days.

In general, I am not overly worried about the virus and its impact on my son with his well-managed asthma; however, he has been planning to go to London on vacation in less than two weeks. It’s a wonderful opportunity for him to share the city that he loves with his boyfriend, Quinn.

My son, Morgan, is now 24 years old, has mild asthma and multiple food allergies to peanuts, tree nuts, sesame, fish and shellfish. With the US Centers for Disease Control and Prevention official today stating that “It’s not so much a question of if this (coronavirus) will happen any more, but rather more a question of when this will happen and how many people in this country will become infected and how many of those will develop severe or more complicated disease,” I realized that it’s time to have a conversation with Morgan.

Morgan and Quinn have plans to go to Britain for 10 days in March, and everything is planned, paid for and reserved. Waiting for the day to leave was the only thing left do do until this Coronavirus outbreak occurred. Now there are a few more things to prepare for just in case there is an outbreak of the virus in Britain while he is in the country.

Since Morgan is a young man now, Mama Bear here can no longer dictate his life…and truthfully, I never really had that power even when he was young! I thought it would be beneficial for the two of us to have a conversation about the virus, and so I asked him “What have you thought about the Coronavirus and your plans for going to London?”

I must say that I was impressed that he said that he and Quinn have been having conversations about how to stay healthy with hand washing, bringing wipes, and probably wearing a mask especially in the Tube in London where they will be near so many people. Morgan said, “I am nervous to travel. I don’t want to be stupid.” The two are closely monitoring any travel bans, and keeping up with the WHO recommendations and with the BBC for news on the virus in Britain. He recognizes that just like with influenza, his asthma is a health condition that can be exacerbated with the virus and is a cause for concern.

But, it’s now his decision as to whether or not he wants to reschedule his vacation. There are no travel warnings as of this writing for Americans going to Britain, and both of our countries have individuals who have been diagnosed with the virus. Thankfully both countries also have very good medical systems, which from what I have read, has helped those patients who do have a more severe form of the virus requiring hospitalization. And good medical care also keeps the virus from spreading to other individuals.

I have two N95 respirator masks to give to him for their trip. Two days ago, I tried to purchase more of these types of masks, which are rated the best for keeping out small particles including virus germs, and there aren’t any available in my local stores. Every Home Depot, Ace Hardware and Lowe’s is sold out already! I managed to find the masks online only through an individual seller on Ebay and purchased several more for the entire family at a reasonable price. Sadly, many sellers on Amazon.com have increased their prices to double or triple the regular price of a mask, if you can find any in stock.

Morgan has been taking Qvar daily, and has a prescription also to Albuterol. I suggested that he contact his allergist to find out if the doctor has any other suggestions for him especially if he ends up getting the virus here or abroad.

Another item we talked about was what he should do if he were to be quarantined in Britain. These quarantines have begun to hit various cities in numerous countries when an individual gets sick with the virus. People have been quarantined in China, but also in various other countries, and have lasted anywhere from 14 days to a month. With food allergies, not having access to safe foods is a serious issue, and one that requires some forethought as to how that situation would be negotiated in a hotel, for example. Morgan is putting together an action plan on how to manage such a plight. He and Quinn will be staying in an Airbnb for part of their stay and in a hotel for the remainder. It would be a real mess if they spent their vacation locked in a hotel room!

Morgan is going to check into the National Health Service (NHS) to see how an American can access these services should he need to. From his recollection with studying abroad at the University of Lancaster in Britain three years ago, it was fairly easy and inexpensive, unlike the US healthcare system!

There are a few pieces of good news in all of this. First, thankfully the mortality rate is fairly low for this virus versus previous coronaviruses like SARS or MERS. No one enjoys getting sick, but most people are surviving this virus. And secondly, Morgan has another 10 days to gather more information and to watch the spread of the virus to determine whether he will be heading to London or rescheduling his trip!

Eosinophils & Mast Cells, Food Allergy & Families

Happy 20th Birthday to AllergicChild!

Twenty years ago this month, I started AllergicChild.com. The Internet was still barely beyond the idea stage, and there were VERY few websites pertaining to food allergies.

I had just written my book, “Allie the Allergic Elephant: A Children’s Story of Peanut Allergies,” which my husband and I had self-published. It was the first edition of the book, and several newspapers across the US and Canada had run an article about the book giving out our office telephone number as a way to buy it. I was getting phone calls from numerous families managing their child’s peanut allergies wanting to make a purchase. Hence the need for a website to reach across the world, and to help with lowering the number of phone calls!

The website opened up a lot of communication with families trying to figure out how to send their child to school safely; how to go to worship services and how to explain food allergies to extended family members. I literally received hundreds of emails every week asking me every question you can imagine about how to manage their child’s food allergies.

I answered every email I received. I knew that I had one of the few websites on the Internet that had information about food allergies, and people were always so thrilled to be able to reach a real person who would answer their questions. And many times, I had questions for them as to how they were managing issues that we had yet solved. It was a healthy exchange of ideas.

The website soon included pages detailing our experience of sending our son to preschool. He turned 4 years old the end of January in the year 2000, and we had several months worth of preschool stories to share. I continued to add pages to the website with other experiences as we tried to navigate life safely.

In December of 2005 I began to send out a monthly newsletter. Blogs had yet come into being, and this was the best way to share food allergy news with our followers. My son was almost 10 years old by that time, and he had his own column in the newsletter called “Morgan’s Corner” where he answered questions. Readers would send in inquiries about how Morgan dealt with the emotional aspects of food allergies, such as bullying or being left out of activities. The American with Disabilities Act had yet to be amended to include eating as a major life activity, and sadly schools were not as aware of accommodations to keep children with food allergies involved in all of a classroom’s curriculum.

We had a lot of information on our website about how to read a label to ensure your child was safely avoiding their allergen since labels had no laws governing what had to be listed. In January of 2006, the Food Allergen Labeling and Consumer Protection Act (FALCPA) became effective. This changed our family’s ability to be able to read an ingredient label and know what was in the food. Labels still had a long way to go to become as reliable as they are today, but it was a great starting point!

The ADA Amendments Act of 2008 became effective January 1, 2009. Morgan had been attending a school that was very aware of 504 Plans and had already placed him on one at the start of kindergarten in the fall of 2001. This Act helped many other students across the US have access to accommodations where school districts weren’t as educated about food allergies.

Facebook seemed like a good place for us to extend our reach, and in 2009 we started our AllergicChild group on the platform. It has grown organically up to over 13,000 followers today.

In 2011, we started the blog that I continue to this day. Morgan has added many of his own experiences to the blog including middle and high school trips, preparing and going to college, studying abroad in college, and being in the work world. Raising a good self-advocate was my primary purpose as Mom, and that took all of his 18 years of living at home!

We added a category of Eosinophils & Mast Cells to the blog in 2013 after both my daughter and I got diagnoses. We found there is a big overlap in families who have food allergies, to manage these issues and even celiac disease too. And we continue to share our experience and our hope for a cure.

Thank you for coming along for the ride these past 20 years! We couldn’t have done it without your support, emails and readership. Hopefully we’ll have a cure for food allergies so we won’t need to be here in another 20!!

Travel/Eating Out & Food Allergy

Hip Restaurants, Fusion Food, and Dating

I’ve been in my current relationship for over two years now. He’s so great. We’ve done multiple trips together and have begun to settle into whatever this “adult life” means. He even helped during this holiday season to navigate not one, but two, Thanksgiving meals (one with friends, one with family) to make sure the food being served was safe.

Quinn-and-Morgan
Quinn and Me in Seattle earlier this year

During this time, our dates have shifted from the one-off nice dinner to celebrate a birthday or anniversary or the occasional night out with the other spending time watching a show or hanging around inside to consistent outings. It helps to have a salary instead of piecing together scholarship money in college! One consistent feature of these outings has been trying new hip restaurants around town. As Denver has come into its own as a city, new restaurants have popped up all around the city. They’ve overtaken old warehouse buildings, commercial space in new apartment buildings, and even an old ice building.

It’s not a given, but many of these are some kind of fusion food. With the exception of one amazing Italian restaurant we enjoyed that’s sadly now closed down, every “hip” restaurant we’ve visited fuses together flavors from different cultures or countries. Some of it is more tame –– like a now-defunct Hispanic kitchen that fused Cuban and Meso-American flavors –– while others are a lot more bold in its attempts. Just last night, we visited The Wolf’s Tailor, one of Bon Appetit’s Best 10 New Restaurants of 2019. It’s delicious food and a fusion between Japanese and Italian flavors.

The Wolfs-Tailor
The inside of The Wolf’s Tailor

As some of you may know, I’m risk averse to any Asian cuisine. It’s just… hard for me to manage. Being allergic to all nuts, sesame, shellfish and fish tends to knock off every dish at an Asian restaurant –– and if not, it certainly seems impossible to avoid cross contact. The sneakiest tends to be soups, as some Korean and Japanese soups will use a fish base and not mention it. I just don’t do it. I have plenty of other delicious food options that are easily accessible, delicious, and safe. So, no Thai curries or Chinese noodles for me! (My favorite is when I mention this to someone in a group wanting to eat a sushi restaurant, and in an attempt to be generous, they say something along the lines of “well you could have the steak, right?” (I can only laugh, since it’s out of good intention.)

Fusion food then presents a problem: what elements of the cuisine are they using to impart flavor? I’ve run into this problem before at another fusion place in Denver called SuperMegaBien. They throw a party of fusion in all their dishes –– and sometimes, the fused cuisine used nuts or sesame to achieve that effect. In a deep twist of irony, the mole sauce was safe. Mole is a traditional sauce used in some Mexican cooking and often uses nuts to thicken the chili sauce. I was surprised that the mole was safe, but their twist on a marinara wasn’t! So, fusion food represents a minefield: sometimes the most unsuspecting dishes can be safe while the usual suspects may have an unsafe element.

To me, the best way to prepare is just to become more educated about food. Over the past couple of years, I’ve read up more and cooked more to understand different cuisines. I must admit, I had lumped miso paste/sauce into the off-limits Asian bucket before even understanding what it was (fermented soybeans with salt and koji). A favorite stand-by of mine is Salt Fat Acid Heat, a cookbook by the wonderful Samin Nosrat. It’s both a reference book and a recipe book, and I’ve learned so much about food from that book. There’s also a Netflix show she produced under the same name.

To be able to walk into The Wolf’s Tailor with that knowledge helped me read the menu better. Usually, at these new “hip” restaurants, dishes are both seasonal and intensely flavored. A quick trick I usually use at more standard restaurants is to find a dish with seemingly safe ingredients (as they usually list out what the dish has in it). Anxiety sets in if there’s a restaurant where they just have the names of the dishes without any information. In either scenario, of course, I still tell the staff about my food allergies and make sure the chosen dish is safe. Since fusion food often has hidden elements to impart flavor, there’s no guarantee that the food chosen –– even if it lists out dish elements –– is safe. Often those dish elements are incomplete and they use additional food behind the scenes to create flavor. Still, I understood what a miso-honey glaze would be like on a pork rib, whether a chicory salad would be safe, and whether taleggio is a cheese or a vegetable (it’s a cheese).

I’m super emphatic at these restaurants about my food allergies, and gratefully the staff have been understanding and accommodating. The Wolf’s Tailor had to prepare their take on a vadouvan sauce differently (something new I learned about last night!) since there could be some issues with nuts. Amazing accommodation and understanding. Same with the numerous other restaurants I’ve visited. Unless my allergy is embedded within a sauce or stock they’re preparing ahead of time, it seems that many of these restaurants can safely accommodate my allergies.

I also believe fusion food is the future. With globalization and this increasing mish-mash of culture, especially in the United States, there’s more and more experimental restaurants popping up. Sometimes, it’s even fusion food trucks who are trying new combinations of flavor. I love it all! Still, fusion food can be hard to navigate if you don’t understand some of the building blocks they’re using to create food. (Highly recommend some of Bon Appetit’s YouTube series like It’s Alive with Brad. I’ve learned a lot and they’re fun to watch!)

Of course, it helps to have an understanding partner in all of this. Quinn is amazing and accommodating — he searched the menu with me for safe dishes and was happy to enjoy the same exact things I was. Quinn will usually go far enough to not order a cocktail that has gin in it (famous for sometimes containing tree nuts) to make sure that everything is safe. I hope you find someone as accommodating as he is, and I hope you have fun on your food adventures! Try something new and safe: you’ll never know what you’ll find.

Holidays & Food Allergies

Multiple SAFE Meals on Thanksgiving!

As this year’s Thanksgiving day approaches, our family will once again be planning multiple safe meals for the day, cooking all of them at the same time so we can eat together!

We’ve spent Thanksgiving Days in the past trying to get extended family to bring or prepare safe foods, and sometimes that worked and other times it didn’t. It ended up being a very stressful day for me ensuring that our son didn’t touch anything or eat anything that he is allergic to.

Many times, we found what worked best was to host the meal at our house, where at least we knew that there would be no smoking and no pets, both of which he also reacted to. Yet, I felt like a police officer at the door asking what was in the food that everyone had prepared. Not exactly a way to endear oneself to the extended family!

My son, Morgan, has five life threatening food allergies to manage: peanuts, tree nuts, sesame, fish and shellfish. And while those aren’t generally on a Thanksgiving Day menu, we still had to read through ingredient labels, be concerned about spatulas and cross contact in the kitchen and try to manage the menu to stay away from pecan pie!

Now, Morgan’s limited diet is nothing compared to the rest of the family! The perspective has changed with new diagnoses for myself and for my daughter. His boyfriend, Quinn, luckily doesn’t have any food allergies, and is very aware of not eating anything that Morgan is allergic to. The two of them are going to be bringing a dessert that both of them can eat, since no one else in the family eats dessert currently!

With an EoE (Eosinophilic Esophagitis) and an MCAS (Mast Cell Activation Syndrome) diagnosis, my food options are currently limited to four foods. Turkey breast is one of those, however it has been suggested to me by Dr. Li, my Traditional Chinese Medicine doctor, to cook all of my meat in an Instant Pot. So, I will be purchasing an organic turkey breast to cook just for myself! In addition, I will be having my usual organic russet potato and organic broccoli. It’s difficult when it’s the holidays to stay with eating the foods that I know are safe for me. I’d love to be able to eat just a bite of something new and different, however I have paid the price for doing so many times, creating mast cell activation and a stomach ache that continues for days. This year, I will be enjoying my meal with the people I love, and that makes up for a lack of variety!

My daughter, Michaela, also has an MCAS diagnosis. She currently eats only organic fruits and vegetables. She and the men of the family will be having organic sweet potato and mashed organic cauliflower. Along with me she will also be eating organic broccoli. Then, she may also be adding colorful organic carrots.

My husband has begun eating only organic foods, and he rarely eats anything other than meats, fruits or vegetables. He will roast the whole organic turkey in the oven without any stuffing since no one will be eating it!

We’ve gotten really good at utilizing all 4 burners on the stove to make all of this food, serving it up all at once. That’s no easy feat for a regular meal. For a Thanksgiving meal, it’s the one time of year that we make sure to all eat together even if we are eating many different things!

Have a wonderful Thanksgiving with family and friends! And remember that it’s not just about the food.

Eosinophils & Mast Cells

Mast Cell Activation Syndrome and Chemical Exposure

Many MCAS patients have difficulties with scents and odors. The Mastocytosis Society lists these items along with many other triggers on their website.

My daughter, Michaela, has been experiencing mast cell degranulation upon exposure to certain chemicals, and not just the scent or odor. Most recently it has been to chlorine in a swimming pool. It’s also been to an exposure of carbon monoxide, and to the off gassing from new floors and paint in a house.

The result of all of these exposures has been the sensation of a reaction followed by gut pain. She has taken Benadryl to mitigate the symptoms, and has never had to use an epinephrine autoinjector since the reaction hasn’t been that severe. Within a day of the exposure, she gets a terrible cold virus. Each time she has used her detective skills to determine what caused her symptoms, and came back to these chemicals.

Her recent reaction to chlorine is disappointing because she loves to swim. She swam every day during the summer when she was a child, and never had any issues. However, in the last year, both times when she went swimming, she has ended up with swollen nasal passages and a sore throat within hours after swimming, along with a painful stomach. She takes Benadryl, which helps the inflammation and then the next day she comes down with a cold virus. She is hoping to find a pool in the Denver area, where she currently lives, that uses minimal or no chlorine, but has yet to find one!

The carbon monoxide exposure was the weirdest because there is no smell. After touring a newly constructed hotel in Denver, she was feeling nauseated and having trouble breathing without coughing. She couldn’t figure out what was going on, and the symptoms quickly ceased. Two days later, she awoke and felt the familiar symptoms of a mast cell reaction along with the breathing difficulty and dizziness. She immediately went to the emergency room where the doctors said she exhibited all the signs of carbon monoxide poisoning and that the hotel that she toured was in the news after having a carbon monoxide leak. They put her on oxygen for several hours and then released her. Because her lungs had been compromised two years previously during aspiration pneumonia, she has to be very careful about exposures to breathing in chemicals.

Michaela also experienced a strange reaction two summers ago. She began experiencing what she thought was a mast cell reaction at a house she was staying at taking care of the owner’s dogs. She felt dizzy, nauseous and began having the shakes – classic signs for her of a mast cell reaction. She took Benadryl and an extra Ketotifen, and felt only slightly better. The next day she began getting a terrible cold virus, and chalked up the entire situation to getting sick. After three days, at the end of the job, she returned home and then went to our Network Spinal Analysis chiropractor. He immediately asked her how she came into contact with chemicals. He stated that the cold she had was from an overload of chemicals running through her body. He could feel her body’s negative response the minute he began working on her. She called the home owner and found out that they had just had their floors redone and new paint applied to the interior walls! The off gassing from the renovation had created organic compounds to be trapped in the house, and she reacted violently. The good news is that she has learned to ask more questions about her environment when she is staying somewhere other than home.

Mast Cell Activation can be a serious issue, and one that she has learned to manage on a daily basis by asking questions and being very aware of her environment to mitigate exposure as much as possible.

Travel/Eating Out & Food Allergy

A Trip of a Lifetime – Backpacking in Iceland

For those of you who regularly read this blog, you know that I’ve been looking forward to going back to Iceland, having stopped in Reykjavik for 36 hours on a layover to my study abroad program in the fall of 2016. Three years ago, I didn’t have near enough time to travel to all of the areas of Iceland that I’d heard so much about. I promised myself that I’d come back, and when I mentioned this to my Dad, we decided to make this a Father/Son trip.

The last blog post, Preparing for a Backpacking Trip to Iceland, outlined what it took for my Dad and me to prepare for the trip. Now, I’d like to tell you about our epic trip in August!

West Fjords

Icelandair

We flew Icelandair just like I flew back in 2016. I confirmed their policy of not serving peanuts on board the airplane. I didn’t ask for any announcement to be made, and pre-boarding wasn’t necessary for me since I had plenty of time to wipe down my seat and tray table. They do sell food on board, but I really wasn’t worried about it since we took an overnight direct flight from Denver to Reykjavik. I figured that not many people were going to eat. And if I had a seatmate who pulled out peanuts or my other allergens (tree nuts, sesame, fish or shellfish), I wouldn’t have had any problem asking him/her to please put them away.

On our flight home, an announcement was made asking passengers to not eat nuts during the flight, so there was someone else on board with an allergy. It was nice to know that they would make that announcement!

Eating Out at Restaurants

Once we arrived in Reykjavik, we got our rental car, our backpacks that we had checked as baggage, and we went out to eat brunch. We ate out a few times in our two weeks in Iceland, and in general I can say that restaurant food is very expensive. After all, most foods have to be imported into the country. Their specialty is lamb, which was a staple on almost every restaurant menu. There are sheep everywhere on the island. One restaurant even had the sign, “Free Range since 876!” – the year that Iceland became a country. We did have lamb one night in a ‘gastropub’ which is kind of a mix between a bar and a restaurant. It was delicious!

Having been in a Scandinavian country in 2016 – I did a research project in Copenhagen, Denmark for a month prior to studying abroad – I knew that breads were going to be difficult for me to eat because of my sesame allergy. Iceland was no different. The bread provided in restaurants, and those that we found in grocery stores all contained or stated “made in a factory” with sesame. Their bread is kind of bland, so sesame and other seeds are used to add flavor. So, no bread for me!

Iceland also has a great fishing industry. My Dad had decided prior to our trip that he wasn’t going to eat any fish while we were camping or in a restaurant, since I have such a severe allergy to fish having had anaphylaxis in the past to one bite of trout. Every restaurant we ate at also had fish on the menu, but the ones we chose (and believe me, we only ate out about five meals the entire vacation), didn’t have fish as the main item on the menu. I was able to find waffles for our first brunch in the country, which were delicious.

Father and Son

All of the wait staff in the restaurants spoke English very well, so I didn’t have any difficulty communicating about my food allergies and how to keep me safe from cross contact. Many of the wait staff were from different countries, and were temporary summer workers. It was great to find out where they hailed from – Czechoslovakia and Denmark were the home countries of two of our waiters.

One night we went out for hamburgers, which were great. When the bill came for $50 US dollars, we realized that cows weren’t habitants in the country, so the meat had to be imported causing the price to be so extremely high!

Most restaurants had a local favorite, Smørrebrød, on their menu. This is an open-faced sandwich cuisine popular across most Scandinavian countries, and many have fish on top. Of course, with the bread also being unsafe, the combination of two of my allergens meant it was definitely not the meal for me!

Food for Camping

We brought Mountain House freeze dried foods for all of our dinners at the campsites which could be prepared in about 10 minutes using a JetBoil and boiling water. These meals saved us money on food, and also made it easy at our campsites to prepare dinner when it was windy or rainy. By the end of the trip, we realized we bought too many Chicken & Rice meals and were begging for some variety… but at least it made dinners easy throughout our trip! 

Morning view from my tent at our campsite

For breakfast, lunches and snacks, we went to a grocery store every day or two and purchased fruit, vegetables, Skyr (an Icelandic yogurt that was wonderful), wraps that were safe, ham, bacon, cheese, Ritz crackers, etc. Mainly we were purchasing foods that didn’t have many ingredients and/or weren’t processed. Iceland is in the European Union, and the labeling was very good. Some labels were in English, and when they were in Icelandic, I had my Google translate app that allowed me to take a picture of the label and get the ingredients translated. I did look up the Icelandic names for all of my food allergens prior to the trip so that I could be prepared to read those on any label. Once we found a safe brand of wrap, for example, then we’d always look to purchase it in the next grocery store as we traveled around the country.

We rented two gas stoves, two coolers, and a table from a camping store in Iceland, but we brought many other items with us like our sleeping bags, tents, pans, plates and utensils in our backpacks. A few mornings when the weather was being difficult to be able to cook an omelet, we opted for fruit and Skyr instead and hit the road to see the sights.

Sleeping in Hotels and Airbnb’s

We stayed in a Hotel the first night we arrived in Iceland. It was kind of a funny situation in that I booked the room and neglected to notice that there was only one queen sized bed, and not two twins as I had assumed from the picture. So, my Dad and I got to be really cozy the first night in Iceland!

I have filters in my searches for hotels and Airbnbs to ensure that the places I stay have no pets, but that really wasn’t an issue in Iceland. We didn’t see any tourists with their own pets, however there were some dogs owned by store owners, but we didn’t see any in the Airbnb’s and hotels we stayed at.

One night, about halfway through the trip, we got rained on all night. Then the next day, we got soaked visiting a waterfall. All of our camping gear was wet, and all of our clothes too! In the moment, we were entirely miserable and ready for a night to dry off, so at the last minute we decided to get a hotel room. The cheapest room we could find was $260 US dollars, and we were grateful to find it! We needed it for our physical comfort, but also for emotional comfort after being wet and freezing.

Yep we looked and felt cold …. freezing!

The only other time we stayed at an Airbnb was the last two nights before we left to come back home. So most of our nights were spent camping, sleeping on air mattresses and enjoying the quiet solitude.

WiFi in Iceland

We purchased a mobile hot spot through our rental car company, which was great. Even when we only had 2G, we could at least communicate by calling using cellular over Wifi if we needed to make a call. Most of the time we had 4G. Cell service was available throughout the country. There are also many Wifi hotspots in Reykjavik, the capital city, but we rarely found one while in smaller towns around the country. 

Seeing Iceland

We spent our days in our rental Toyota RAV4 driving from one beautiful location to another. We would drive hundreds of miles every day, starting from Reykjavik and traveling counter-clockwise around the island. We camped out on the beach one night, and since the daylight lasted until 10 at night, we got to enjoy the scenery even more. We drove through numerous fingers on either side of fjords around the island and got to see waterfalls everywhere.

Skogafoss Waterfall

We’d get out of the car to hike into locations to see more scenery, and then choose where we wanted to camp at night as long as it was a designated camping site. Many times we were the only campers, which was great.

It was just the best trip ever. My Dad and I laughed, talked and walked throughout the two weeks.

Trip Suggestions for You

If you’re thinking about a trip to Iceland, I’d say DO IT! Here are some suggestions I have:

  • Expect to spend a lot of money. Reykjavik is at least $100 US dollars a day. Around the country, you will likely be spending at least this much as you experience the country! Hotels or Airbnb’s will likely cost $300 US dollars a night.
  • Learn the Icelandic words for your allergens
  • Get the Google translate app on your smartphone
  • Get to know some of the staple dishes (like Smørrebrød) so that you can manage your allergens
  • Ask for help if you need it. Icelandic people are incredibly nice!
  • Have a great time!
Travel/Eating Out & Food Allergy

Preparing for A Backpacking Trip to Iceland!

The streets of the city of Reykjavik, Iceland

In the fall of 2016, our son, Morgan, flew through Reykjavik, Iceland, on his way to study abroad. He was in the country for only 36 hours, so didn’t get a chance to see much of anything beyond the city. He promised himself that he would get back to Iceland to see all of its natural beauty sometime in the future.

The future is now! For two weeks in August, he and my husband, Robert, are going to share a trip of a lifetime backpacking in Iceland! The preparation for this trip has taken almost 9 months to put together, and the food is almost the least of it.

Iceland is part of the European Union, so it wasn’t necessary to fly to an embassy here in the USA to obtain a Visa. Both already have passports, so that box was checked easily.

Both also carry medications, and Iceland has strict requirements of medications being in the original prescription box and the medication must not expired. This has required some work on Morgan’s part.

Morgan is now in the work world, and has his own medical insurance. He needed to find an allergist in the Denver area, where he now lives, to obtain current prescriptions for Albuterol, a steroid inhaler and his Auvi-Q’s. This was a big step because he has only seen one allergist his entire life, and she retired just as he was graduating from college. He wanted to find the same wonderful care he had received from her, and as luck would have it, he found an allergist that had trained with her many years ago! His enormous history in three medical files was copied and sent to this new allergist. Morgan forewarned the doctor that there was 20+ years of appointments, skin prick tests and reactions to pore over. All went well with the new patient appointment, and as a Mom, I’m thrilled Morgan has found a very capable allergist to continue his care!

Since Morgan flew Icelandair previously, and had no difficulties at all, they decided to fly the same airline. Morgan always brings his own food on airplanes, and doesn’t expect to be served a safe meal. They don’t serve peanuts on flights, which is great!

The next step was to figure out what the father/son duo were going to pack to bring with them on the airplane. Robert and Morgan have an annual week long camping trip each summer in the Lake City area of the Colorado Rocky Mountains. It is a trip they both look forward to every year. They have all the gear (and then some!) that they would need to camp in the Rockies. However, Iceland is a little different in that they don’t allow campfires. So, they will be renting a camping stove in Iceland, along with tables and chairs. And they will bring jet boils for water heating.

Everything in Iceland is expensive – food, camping equipment and sleeping bags. They will be bringing as many supplies as they can fit in their suitcases while ensuring the bags are under the weight limit. Even frying pans from Walmart will be packed in their luggage!

They plan on purchasing an abundance of their food in Iceland as they travel from location to location; however, as a backup they are also bringing Mountain House brand freeze dried food that just need hot water added. This too will be packed in their luggage. They don’t want to risk trying to find freeze dried food in Iceland, since this brand may not be available. Mountain House is the only brand that we have found that doesn’t have Morgan’s allergens – peanuts, tree nuts, sesame, fish and shellfish.

In Iceland, camping is allowed only in designated camping sites. The good news is that there are no bugs, spiders, mosquitos or snakes. And the only animals are arctic fox, mice, rabbit and reindeer – so nothing warranting concern for an animal getting aggressive like bears will in the Rockies.

Since Iceland is known for its fishing and a fish-oriented diet, they will be taking extra caution with Morgan’s anaphylactic fish allergy. Morgan can’t even stand the smell of fish, so shopping in stores or markets may get interesting!

This is a trip of a lifetime, and the two are SO excited for this adventure! I will be reporting back with a blog post after they return, and I’m sure the two of them will be providing many pictures and commentary too.

Eosinophils & Mast Cells

Stress and Mast Cell Activation

white blood cell. mast cell or a mastocyte, labrocyte. mast cells are the cells responsible for causing allergic reactions or anaphylaxis, also aide in the healing of wounds and defense against invading pathogens.

There are many stresses in our world that can cause a mast cell to degranulate: pollens, chemicals, foods, illness, injury and even good old emotional “stress.” If you have a mast cell activation syndrome (MCAS) diagnosis, being mindful of stress is key to keeping your condition from negatively affecting your life.

I have found that there are some stresses that are more easily managed, such as the foods that I eat or the chemicals that are in my home. I make sure that I never “cheat” with foods. I know which foods I can tolerate, and I always maintain my diet with only those organic foods. Is it hard to be that vigilant? Yes, it is! However, I know my body well enough now to understand that adding any extra stress doesn’t make me feel good, and certainly puts my physical and mental health at risk if a stressor comes along that I can’t foresee.

My husband and I have recently begun using only non-toxic products in our house for cleaning. We’ve found that the Better Life brand is great, and they have every kind of product you can think of for glass cleaning, dusting, dishwasher soap, etc. (By the way, I’m not receiving any funding for this endorsement. It’s based purely on my experience.)

Other stresses are more difficult to learn how to manage. I’ve gotten better through the years to be able to recognize when my work is creating too much of a burden on my time, thereby creating stress. I am blessed to be able to work out of my home, which assists not only with the environment in which I work, but also that I can make my own foods in my own kitchen, and I can take a 20 minute afternoon nap if I feel so inclined.

I can’t stop the spring or fall pollen flares, but I can be mindful of increasing my use of antihistamines, taking a shower before bed, and keeping the windows of my home closed and the air conditioning on. All of these actions help to lower the stress load of pollens on my body.

Having an allergic reaction to a bee sting last summer created a storm of mast cells that necessitated a round of Prednisone to calm down the reaction. Any type of allergic reaction creates tremendous stress on the body, and especially for those of us with MCAS. I am always aware of bees in my environment since I’ve had a bad reaction previous to this one, and I carry an Auvi-Q in case the reaction is severe. Sometimes, though, a bee comes out of nowhere which is what occurred with this sting.

Late last year, I got a case of bronchitis that lasted 6 weeks, and left only after taking an antibiotic, which I haven’t had to take in over 12 years. The stress of the illness plus the medication was difficult for my body to recover from, and my mast cells were trying to be helpful by degranulating. Instead, I felt sick to my stomach in addition to coughing! Bodies do heal, and slowly I got better.

Also, over this past year, I have twice had injuries. I fell on a gravel path last year, spraining my ankle. It took months to get back to “normal” of being able to walk. My mast cells reacted for about two weeks with a storm of activity while my nervous system responded to the bruising and swelling of my ankle. I increased my Ketotifen to calm down my system, and took care of myself. Because of my sensitive stomach, I’m unable to take any type of pain medications – even Tylenol or Advil – without having more mast cell degranulation. Therefore, I get the opportunity to rest, breathe into the pain and to heal instead of taking pain medication and moving back into life right away.

Last week, I was in a car accident when a 1/2 ton truck ran into my car going 40+ mph. I thankfully was able to walk/limp away from the accident, however my car was totaled. The impact on my muscles, and the bruises that continued to show up for days, showed me what a stress the accident had put on my body. Sometimes, there’s nothing we can do when a big stressor shows up. I’m very grateful that my body had been doing really well with no illnesses or issues for a good 5 months before the accident occurred. And it’s been a difficult recovery where once again I’m unable to take any pain medications.

My goal is balance – balancing the stress in my life which plays out on my mast cells. It requires for me to be constantly aware of my body and my environment. I have to be a good advocate for myself, especially if I’m in a location that is filled with perfumes or smoke, and get out immediately! I worry less and less about what others think about me, and whether they think I’m weird. I’m sensitive, and that’s a good thing!

College with Food Allergies, Travel/Eating Out & Food Allergy

Food Allergies and Shared Kitchens

Maintaining control of kitchen supplies and surfaces is a must for those with food allergies. Yet, there are many times when a shared kitchen is all that is available. When is it safe to cook there? And how do you do it? When do you need to find an alternative method to prepare food? What are your limits when it comes to safety?

College

When we were searching for a safe college living experience for our son, Morgan, who has allergies to peanuts, tree nuts, sesame, fish and shellfish, many colleges promoted their dorm floor “community kitchen” as an option for preparing safe foods.

These kitchens allowed ALL students to cook brownies, pizza or whatever else might be hitting their palate at midnight when the cafeteria was closed. Most of the kitchens we saw were supplied with utensils, baking trays and various other kitchen gadgets to be able to cook and/or bake.

Preparing meals for someone with food allergies, using the same utensils and pans that had previously been used to make brownies with walnuts for example, was not a cooking situation that would prove safe for Morgan without a large amount of cleaning surfaces and supplies first. And the potential for cross contact was very high in the cleaning up process, so we did not see this as a good solution.

Also, these college community kitchens relied upon the students to clean up after themselves, or to clean up after the previous student’s cooking attempts. Custodians and maids are frequently hired by colleges to clean the community bathrooms, but rarely are they cleaning the community kitchens.

We decided it was safer for Morgan, and it was his preference, to eat in the dorm cafeteria where cross contact could be monitored by the chef and employees. During his two years of living on campus at college he never prepared any food in a community kitchen.

University of Denver where Morgan attended college

Sharing a Kitchen with Roommates and/or Housemates

Once Morgan moved out of the dorms, he lived in an apartment with three other roommates. They had shared a very small kitchen. Morgan asked that none of his allergens be brought into the kitchen. Each of the four roommates had separate bedrooms, so he didn’t try to monitor what food they brought into their rooms. He just wanted to ensure that nothing was brought into the kitchen area.

There was only one “oops” in the 9 months they lived together, and the roommate who brought in nuts cleaned up everything – pans, countertops, utensils, plates, and even threw out the sponge – to ensure that Morgan didn’t have any contact issues.

During his senior year of college, Morgan moved into a house with two other roommates and kept this same request that none of his allergens be cooked in the kitchen. It worked well, and his roommates always honored his request.

Studying Abroad

While studying abroad in England, Morgan had to request special accommodations for his living and dining situation. Students who came from other countries to the University of Lancaster were provided a dorm room with a shared community kitchen to ensure that they met more students at the school while preparing their meals.

While that would have been nice, it wasn’t a situation that Morgan felt comfortable with. Students came from numerous countries, many of whom were accustomed to regularly eating the foods that Morgan was allergic to – especially nuts and sesame.

Morgan had to provide arrangements with the Disability Services Office to have an “ensuite kitchen.” That resulted in him being the only person using the kitchen in his dorm room. The room was tiny and the stove only had two burners, plus there was no oven! But he made it work for the 10 weeks of the school quarter while he was there, grateful that he didn’t have to try to monitor all the variety of foods in a community kitchen. And he still met many students in his classes and in the dorm.

Airbnb and vacation properties

Morgan traveled overseas before studying abroad during his junior year of college and stayed in a variety of Airbnb properties. He also travels a lot for work now staying in these properties. He has found that cleaning all of the cutting boards, utensils, and pans before using them to cook is a necessity.

He has also stayed in Airbnb properties where the host will provide breakfast or some other meal. This gives him the opportunity to explain his food allergies, and he has never accepted food from someone else.

He has stayed in a property where there were other “roommates” who used the kitchen. He was only in this situation for a week, and decided to not ask that all of the roommates refrain from bringing in his allergens. Instead, he cleaned the kitchen utensils that he was going to use for making oatmeal for breakfast, and ended up eating out for most other meals at safe restaurants.

A final word

What we’ve found is that it’s most important to listen to your intuition about a situation AND always be honest about your food allergies. It’s never worth accepting a food from someone because you’re concerned you’re going to hurt the feelings of your Airbnb host.

Bring plastic gloves to be able to do the cleanup in a kitchen without having any cross contact issues, or ask a friend to help.

You might have to pay more money in order to get a safe living situation or a safe traveling situation – but your safety is worth it!

Eosinophils & Mast Cells

How to Obtain a Mast Cell Activation Diagnosis

I have recently been hearing from numerous people asking me how to obtain a mast cell activation diagnosis. What kind of doctor should I see? What kind of tests should I have done? Is there a blood test for it?

I share what I had to go through for 5 years before getting a diagnosis. I saw numerous different doctors – a primary care medical doctor, a D.O. primary care doctor, a private practice allergist, a private practice gastrointestinal doctor, an allergist and a GI doctor in a medical research facility…the list goes on and on. While I had numerous blood, urine, skin prick and food allergy tests, endoscopy and colonoscopy tests, no one could figure out why my stomach hurt 24 hours a day and I was continually losing foods in my diet. Everything came out “normal” in these tests; however, no doctor was actually biopsy testing for mast cells.

The food allergy and skin prick tests showed that I had some food allergies, but I wasn’t able to eat the foods that I wasn’t allergic to without severe gut distress. In other words, I was still reacting to foods that I wasn’t allergic to, and this was baffling for my allergist. This is a common refrain of those with mast cell issues. When I read online about someone who says that they are down to only tolerating a few foods, I ask the question, “Has anyone mentioned a mast cell activation disorder to you?”

Sadly, at this point, there is no blood test to determine a mast cell activation disorder. I got a diagnosis of a mast cell activation disorder when I saw a GI doctor who sent out my endoscopy lab biopsies to be stained for mast cells and tryptase. He also stained for eosinophils, and there were plenty of those in my esophagus and intestines also. By the time I finally saw a doctor who knew what to look for and how to accurately test me, my mast cell count was 30-40 per high powered field, and my eosinophils were 80-90. Most doctors agree that you want these counts below 15 per high powered field. Finally, I knew why I was feeling so terribly!

Mast Cell granules which contain mediators

What I found is that medical doctors know a protocol to test for systemic mastocytosis, and they are more than willing to do that. I had one doctor who wanted to do a bone marrow biopsy on me. Thankfully I knew that I didn’t want that type of an invasive test. I had read enough about the systemic form to know that I didn’t have those symptoms.

There’s a great write up on diagnosing all types of mastocytosis and mast cell activation syndromes on The Mastocytosis Society website here. The interesting item to point out when it comes to mast cell activation disorders is that one of the criteria for diagnosing it is to put the patient on H1 and H2 inhibitor medications (generally Zyrtec and Zantac) to see if they feel better. If the patient feels better, then it must be a mast cell disorder! Backwards logic.

Most people seeking a diagnosis have been dealing with all kinds of odd manifestations of mast cells for years before they get to a breaking point and decide they need to get a diagnosis. Most mast cell activation issues manifest with gut involvement. A person’s bladder may be affected (a diagnosis of Interstitial Cystitis involves mast cells), but they also have gut issues. The good news about the gut involvement is that an endoscopy can be completed and biopsies can be stained to determine if mast cells are proliferating.

So, first thing I suggest to people is to have a food allergy testing to see if there are foods to which they have a true allergy. The second testing I suggest is to get an endoscopy and have the biopsies stained for mast cells.

If you do receive a mast cell activation diagnosis, you want to get on some type of antihistamine (and maybe even a mast cell stabilizing medication) as soon as possible. The longer that a person delays, the longer that mast cells will be activating, and the worse you will feel. This activation can create havoc on organs, and the cycle only gets worse. Soon it’s not only your gut that is affected, but the mast cells are proliferating at such a high rate that they can even move into your brain. You then begin to experience “brain fog.” This is a neurological issue where it’s difficult to concentrate, to remember things and to follow conversations. This cognitive dysfunction can affect people of all ages when there is mast cell involvement. I’ve experienced it myself when I was the sickest. Thankfully, by getting on a cocktail of antihistamines, a steroid, and a mast cell stabilizer for a few years, I was able to come back to my body. From there, I’ve done many other non-Western modalities to help my body heal.

I don’t know of one person who was suddenly able to get better without any type of medical intervention when it comes to a mast cell activation disorder. But you can get better! I am living proof of that.

Mast cell issues are increasing at a phenomenal rate currently. Ask any allergist if they have mast cell patients, and virtually every one will say yes. They will also probably say that they are some of the sickest patients they have, with so many symptoms it’s difficult to know where to begin to help them!

As a patient, we need to advocate for ourselves. Listen to your intuition. If a test doesn’t seem appropriate for you because of the cost or because it’s too invasive, speak up.

Read up on mast cell issues. The Mastocytosis Society website in the US and the Mastocytosis Society Canada have great resources to help patients get treatment.

I’m always willing to chat and to assist you by sharing my experience of what has worked for me! Feel free to contact me at [email protected]

 

 

 

 

 

 

School & Food Allergies

Managing Food Allergies During Elementary School Field Trips

Our son, Morgan, was 10 years old when he originally wrote the answers to these questions in April of 2006. This article appeared in a newsletter that we published, long before there were blogs

He was anaphylactic to peanuts, tree nuts, sesame and shellfish, and severely allergic to dogs, cats and other furry animals. He got eczema from food dyes, had mild asthma and was allergic to grasses, weeds and trees. At 22 years old now, he still has all of these allergies, plus he added fish to his anaphylactic food allergies.

Now that you’re getting older, do you ever go on school field trips without a parent joining in?
Only once so far. It was to a mining museum. I brought along my Epi Pens and Benadryl just in case if something happens. I have chosen on my next field trip, to Bent’s Old Fort in Eastern Colorado, to go with neither of my parents joining.

What do you have to bring in order to be safe? 

I have to bring safe snacks, my own lunch, and of course my Epi Pen. I also bring Benadryl just if I get itchy eyes or something that is mild. I also make sure to have a friend nearby so that he knows what is happening and can tell my teacher to give me my Epi Pen if that would ever be necessary.

What did you experience on a recent field trip that could have been unsafe?

At the mining museum, we panned for gold. I did not participate because from an experience at the Denver Museum of Nature & Science. They had a little exploration box where you could dig for dinosaur bones. I could have done it, but on the sign, it said: Sand is made from Walnut Dust. I never did go do that again! At the Mining Museum, there was dirt and things at the bottom, along with gold flakes. I did not want to take risks just in case if the water was some type of oil, or whatever.

Did you feel left out not being able to participate in that?

Actually not. I have to be able to cooperate with my allergies and my life.

What do you plan on doing on your next field trip that goes all day and is 2 ½ hours away by bus to Bent’s Old Fort?

I plan to bring the same things as the Mining Museum trip – snacks, lunch, and my Epi kit which includes all my medicine. I also planned with my teacher that everyone will bring a safe snack and lunch, plus safe things to do, like not trade food things.

Are there any field trips that you wouldn’t want to participate in?

Yes, quite a few. The petting zoo, the cookie factory (if we ever went there), and a lot of other things that wouldn’t be safe for me if they were one of my allergens.

School & Food Allergies

Managing Exposures to Your Allergens at School

Our son, Morgan, was 10 years old when he originally wrote the answers to these questions in March of 2006. This article appeared in a newsletter that we published, long before there were blogs

He was anaphylactic to peanuts, tree nuts, sesame and shellfish, and severely allergic to dogs, cats and other furry animals. He got eczema from food dyes, had mild asthma and was allergic to grasses, weeds and trees. At 22 years old now, he still has all of these allergies, plus he added fish to his anaphylactic food allergies.

What would you do if someone brought peanuts or nuts into your nut-free classroom at school?
I would just say, ‘I’m severely allergic to nuts. You can’t bring these into the classroom. Maybe could you bring in something else that is safe?’

Has this ever happened?
Once. One of my friends brought in cooked nuts with sesame seed on top for Chinese New Year. He said all right, but I don’t think necessarily he understood. He was from China.

What precautions are required for you to go on a field trip? Who carries your medications?
You need to make sure that you are going somewhere that is safe for you. K-3 should have a parent/guardian that understands your food allergies and that can administer your Epi-Pen or other medications that are necessary. 4th and 5th graders should be responsible by now to carry their own medication and travel by their selves unless your parents do not feel comfortable with it.

Do you have a full time nurse at your school?
No, I don’t. She usually at most comes in once a week because she works at 4 different schools. She helps write up my Health Care Plan.

Do you participate in meetings to plan your 504 Plan and your Health Care Plan? Why do you think it’s important for you to be there?
Yes, I do. Why? Well, so that I know my future teacher knows what I’m allergic to, and can also handle it. I think it’s important for me to be there because so that they get to know me, and actually understand what can happen if I go into anaphylactic shock. Also, I think I should be there so that I get know them and how it will work out with the classroom rules.

Food Allergies & Asthma, School & Food Allergies

Food Allergies, Trusting and Training Others

Morgan was 10 years old the end of January 2006 when this article was written originally for our February newsletter. He was then anaphylactic to peanuts, tree nuts, sesame and shellfish. He is severely allergic to dogs, cats and other furry animals. He gets eczema from food dyes, has mild asthma and is allergic to grasses, weeds and trees.

Where are your EpiPens® kept at school?

Just in case if I have an allergic reaction at school, I can use them. They are not by my side in the school. Two are in the office – one to stay there and one to go out to the playground with the monitor. I don’t think that is the greatest place to put them though because they are locked away. I also have one in each of my classrooms. (Mom’s note: in 2006, it was not legal for Morgan to self-carry his EpiPens, therefore other arrangements had to be made. It wasn’t until 2007 that he began to self-carry).

Do you trust that your teacher would know what to do if you were to have an allergic reaction?
Yes I do.

Do you trust the office staff to know what to do?
Not really. We had a boy a little older than me that had an allergic reaction and they did not use his epinephrine. They thought he had the flu. He did not die thankfully.

When you get older, do you plan on teaching your friends how to administer an EpiPen®?
YES I do! So they know what is happening when I’m in shock and what to do. Usually one of my friends is close by at all times.

What did you teach your Cub Scout Den about emergencies and food allergies?
I taught them how to use the EpiPen® and when to use it. I taught them the process which is put the EpiPen® in my thigh, call 911.

With the recent death of a girl dying after kissing a boy who had eaten peanut butter, what different behavior will you practice when you get older?
I’m never going to date a girl who eats peanut butter all the time. It is just too dangerous.

Will it be difficult to tell a girl what she can eat?
No. Not necessarily. It won’t be that hard just because it is a situation between life and death. I don’t want to risk my life.

Pet Allergies, Travel/Eating Out & Food Allergy

A Lesson of “Pet Free”

When our son, Morgan, was young we were always SO careful to protect him from dogs and cats because of his severe allergies, diagnosed from a skin prick test, and confirmed with a few disastrous exposures. Prior to him receiving allergy shots, if he was in a house where a dog or cat had ever lived, his eyes would swell shut within 10 minutes. After receiving allergy shots, he wouldn’t have such a severe reaction, but was still subject to some asthma issues.

I have also been skin prick tested for allergies to dogs and cats, and have a severe cat allergy, and supposedly no dog allergy. However, I have been in homes with a dog and experienced a runny nose and cough, so there must be some dogs that bother me. (I’ve yet to figure out which breeds bother me, and which don’t.)

A few weeks ago, my husband and I went to Winter Park, Colorado, to stay in a condo owned by his brother. We were told that the property is “pet free,” and that they don’t allow anyone to bring in pets, which was a welcome relief. We packed up for a 4 day/3 night stay looking forward to rest and relaxation in the beauty of the Colorado Rockies.

When we got there, we noticed that there were dog hairs on the couch. We knew that his brother’s family owned a dog, and figured that the dog must have come to the condo with them at some point. I wasn’t too concerned since I have only ever had issues when the dog is in the room with me, and then only with a few dogs.

We bought a lint roller at a local hardware store and gathered up all the dog hairs we could. I wasn’t having any of my traditional runny nose or cough, so I thought I was doing fine with the dog hairs. And the condo was basically clean, with no dog hairs on the carpet, so we proceeded to stay the entire weekend having a great time.

I did notice while we were there, that during the night, around 3am, I kept waking up with an acid feeling and stomach ache. This isn’t unusual for me since I have a diagnosis of Eosinophilic Esophagitis (EoE), and I chalked it up to not taking enough acid medication.

By the time we got home, I realized that more acid medication wasn’t helping to mitigate my symptoms, and that my EoE had really flared. In Winter Park, it was snowing the entire time we were there, so there were no pollens in the air, which is my usual trigger. The only thing that could have triggered an EoE flare was the dog hair! That was a new experience for me.

I haven’t been in a house with dogs in several years, and it has been decades since I stayed overnight in a room where a dog has been. I now know that “pet free” to some people means that they don’t allow OTHER people to bring pets to their rental property. It doesn’t mean that they don’t bring their own pets!

When we have booked a condo through AirBnB, I always inquire with the owner whether pets have EVER been in a property, yet with my own brother-in-law I neglected to do this.

Another lesson learned!

 

 

College with Food Allergies, Food Allergies & Asthma

Searching for a College when you have Food Allergies and/or Asthma

Recently, my son, Morgan, and I spoke at a FARE Community Engagement Council event in Denver on “Preparing for and Going to College with Food Allergies.” It was a wonderful event with dozens of attendees – both parents and teens – managing food allergies.

We shared first about what parents can do to prepare their child for college during grades K-12. You can read that blog post here.

Then, we spoke about how to go to college with food allergies, and the necessary steps to find out the information about food allergy awareness at a school.

I am frequently asked how to begin searching for a safe college when you/your child has food allergies and/or asthma. What questions do you ask when you visit a college? When should you ask these questions?

It was very important for me to remember that my son was the one going to college, so he and I had several conversations prior to visiting any college about what he wanted to learn during a college visit. I asked him to develop a list of questions that he had for college officials about living arrangements, eating in the cafeteria and academic interests. We then compared our lists and came up with the following questions pertaining to the food allergies and asthma. Your list may also include specific academic interests.

Here’s a list of questions on food allergies and asthma that are useful when visiting a college:

  • Are ingredients listed on all foods served in the cafeteria? If not, is there an app or a website that will have the ingredients?
  • Is there a chef on site to take special orders?
  • Are the cafeteria workers trained on food cross-contact?
  • How many of your child’s allergens are regularly served?
  • Can my child and I speak with a dining manager about my child’s needs?
  • How old are the dorm buildings and cafeteria facilities?
  • Has there been any water damage or flooding in the past?
  • Are the dorms air-conditioned? (If not, what documentation will be necessary to submit for a medical necessity to live in air-conditioning?)
  • Are pets (such as dogs and cats or other emotional support animals) allowed in the dorms?
  • Can the resident adviser be trained on the administration of an epinephrine auto-injector?
  • Is stock epinephrine carried by security personnel on campus?
  • Can roommates be selected to ensure no food allergens are in the dorm room?
  • How is a 911 call handled on campus?
  • Is food allowed in classrooms and lecture halls?
  • Is smoking allowed on campus?
  • What paperwork is necessary to complete for the Disability Services Office to provide accommodations?

Yes, this is a long list of questions, yet you may have more depending upon your child’s allergies and needs.

When do you ask these questions?

I’d suggest first starting with the college website. If you go to the Dining Services page on the college’s website and find NOTHING about food allergies, that is your first clue that you may have an uphill battle. Schools that are aware of food allergies put that information on their website along with who to contact to ask questions.

The Housing page on a college website will generally not have any information about food allergies, but will likely have a contact person for questions.

We found that Disability Services website pages are usually geared more toward those with learning disabilities; however a few schools are starting to incorporate information about food allergies and what paperwork will be necessary. We waited until our son was accepted into his school of choice to begin specific conversations with Disability Services about our son’s situation. While a school should not deny admittance because of a disability, there’s no reason to give too much information prior to acceptance.

We found it best to have specific appointments set up with the Housing Office and with Chefs in the Dining Hall when we visited a campus to learn more about how they managed students with food allergies. Prior to him being accepted, we only asked general questions about what accommodations could be expected for a student with food allergies and/or asthma.

As for the Disability Services Office, we visited with a representative after my son was accepted to the school. We asked very specific questions about paperwork necessary for our son to receive accommodations. We found out that many schools will require that your child have recent testing confirming food allergies and asthma if specific accommodations are being requested. In other words, a skin prick test from 10 years ago was not going to suffice. A letter from our allergist delineated the specifics of what Morgan was going to need to safely attend college. The Disability Services office paperwork is best completed in the summer prior to the school year starting so that everything will be established once school starts. And remember that everything is completed and driven by your child once they are 18 years old. Schools expect your child to advocate for themselves.

Most colleges in today’s environment have managed students with food allergies. That can be a good thing if your child expects to eat in the cafeteria. It can be a negative thing if the college expects your child to have allergies similar to other students they’ve encountered, and you want a different accommodation.

There are several other lists of colleges and their accommodations for students with celiac and/or food allergies that might be helpful. Of course, it’s always preferable to use these lists as a guide and to visit the college yourself to ask questions specific to your child’s needs.

Allergic Living’s college list is here.

FARE’s college list is here.

 

College with Food Allergies

Preparing your child with food allergies in K-12 for college

Recently, my son, Morgan, and I spoke at a FARE Community Engagement Council event in Denver on “Preparing for and Going to College with Food Allergies.” It was a wonderful event with dozens of attendees – both parents and teens – managing food allergies.

During the presentation, the first thing we discussed was what parents can do to prepare their children in grades K-12 for college. After all, going to college is something that requires planning! And for children with food allergies, more planning is required. Also, more skills are required to be able to safely attend college.

Nicole and Morgan Smith at his high school graduation in 2014

Here was the list we shared that outlines what your child SHOULD be doing, or is able to do, before leaving for college.

  • Always carries epinephrine autoinjector – If your 18 year old is heading off to college and Mom or Dad  is still reminding them to carry their autoinjector, there’s the potential for a very hazardous situation to occur. Parents aren’t going to be able to ensure that an EpiPen or Auvi-Q is being carried every time a child leaves their dorm room. Carrying epinephrine in a fanny pack or other bag can begin as early as four or five years old so that a child begins to understand that anywhere he/she goes the epi comes too!
  • Able to order food at a restaurant – This is a learned skill and one that took our family years to perfect. We had a chef card we created that explained Morgan’s allergies, but we also allowed him to begin to practice ordering his food at about age 10. If he forgot to mention something, we were there to assist. As he moved into high school and attended meals without us, we felt confident he knew how to explain his food allergies and cross contact to the wait staff and/or chef.
  • Can effectively read product ingredient labels – For Morgan, he does not eat any food that is labeled “may contain,”so he needs to be especially careful to accurately read every piece of text on a label. Learning how to read can become fun in looking for food allergens listed on a label, and we began that in kindergarten. It’s also important to know when to call the customer service telephone number for a product to determine whether the product is safe or not. Morgan continues to pick up the phone to call a company now that he’s an adult to provide for an extra layer of comfort.
  • Can identify an allergic reaction and/or anaphylaxis – This is more difficult if your child hasn’t had anaphylaxis since they were a baby, where they may not remember the symptoms. A discussion with your allergist can assist with your child being able to list symptoms and know when it’s time to administer an autoinjector or an antihistamine.
  • Can train friends and others about allergic reactions and epinephrine administration – This is especially important in the college setting, because there is no school nurse who is going to be training friends, Resident Assistants or professors. Practicing at home with expired autoinjectors, injecting them into oranges, helps your child know how to explain administration to friends. The Auvi-Q device was great fun for Morgan’s college friends to learn since it talked them through how to administer!
  • Is comfortable making appointments and speaking with a doctor – We had Morgan begin to complete all the pre-appointment paperwork for an allergist’s appointment beginning in late middle school. He needed to know what the names of his medications were and what dose he took. Then we transitioned to him discussing his concerns with the allergist at appointments, with Mom also in the room. Finally, he began to make his own appointments with the allergist and to go by himself. This was necessary before he went to college, because Mom or Dad wouldn’t be able to be with him at every doctor’s appointment.
  • Remembers to take medications for pollen allergies and/or asthma – This is a difficult skill, and will probably need plenty of parental supervision. There are also apps, alarms and other technological advances that can help with this. This skill comes in late high school or even later depending upon your child.
  • Can advocate with teachers, the Disability Services Office, chefs and employers – A college is going to view your child at 18 years old as an adult, capable of completing their own paperwork. Practicing this skill beforehand is vital for good outcomes in college. Advocating with teachers can begin in elementary school. If Mom/Dad resolve every issue, children don’t learn how to advocate for themselves. Talking through a situation, at home, with your child can help them to gain the courage to handle the situation at school. Of course, there are some situations that still need Mom/Dad to guide, but learning how to speak up early in life helps strengthen the advocacy muscle. Talking with an employer about food allergies is a life skill that your child needs to learn, unless they plan on being independently wealthy!
  • Able to shop for groceries and cook for oneself – Learning how to cook is great fun and can be a family activity starting in the toddler years. Label reading at the grocery store can start once your child can read. Both of these skills are so helpful for college students to keep themselves safe and well fed.

I imagine that no child with food allergies is perfect at all of these activities; however, knowing that your child can manage the most important skills will allow you, as the parent, to support your child heading off to college!

School & Food Allergies

The Challenges of Food Allergies in Elementary School – Part 2

This newsletter interview of my son, Morgan, occurred in January of 2006. I will be continuing to add these “old” interviews to this blog.

Morgan became 10 years old the end of that January. At the time, he was anaphylactic to peanuts, tree nuts, sesame and shellfish. He was severely allergic to dogs, cats and other furry animals. He got eczema from food dyes, had mild asthma and was allergic to grasses, weeds and trees.

If you were suddenly not allergic to peanuts, would you want to eat them? 
No actually. I would not. I don’t really know why, but it just seems that I don’t like them, even if some day I’m not allergic to them.

If someone comes up to you in the lunchroom with peanut butter and jelly and wants to sit next to you, what do you tell them?
I tell them, “Can you please move away, I’m severely allergic to peanut butter.” Usually, that doesn’t happen very often because my friends literally swarm upon me protecting me. If that doesn’t work, I go tell the lunchroom monitor, or my Vice Principal, who usually walks around the tables.

When you go to birthday parties, what do you do to keep yourself safe?
I bring my own snacks to birthday parties, actually. Just to be safe, I check the ingredients on everything they serve, but if really nothing’s safe, I just eat what I brought.

Do you ever go on sleepovers? What has to be done for you to be able to attend?
If I ever go to a sleepover, I only go to a dog and cat free house, and I make sure they’re not having peanut butter and jelly sandwiches for dinner with sesame buns! I bring my own food for a sleep over, so really, I bring everything from home that is safe for me.

What do you fear most around your allergies?
I fear most that I will have an allergic reaction eating something that the label did not say something that I was allergic to was in it, and end up in the hospital.

Have you ever had to use your epinephrine kit?
No. I have not. I have had to go on Prednisone steroid a few times after a bad allergic reaction to something we never figured out. And I’ve taken Benedryl lots of times after a dog licked me and after eating eggs, which I used to be allergic to.

Do you think you could give yourself the epinephrine shot if you had to?
Yes. Only if it was right in the beginning of the shock, so I could still use my hands and not feel paralyzed.

What can you tell other children who have food allergies to give them help and hope?

I always tell them to stick up for them selves and always read labels. Those are what I mainly say, although I also give other advice. Also, besides reading labels and sticking up for your food allergies, just bring your own stuff everywhere if it’s out of your house just to be safe. If you go into anaphylaxis, have people know what to do if it ever happens. Have them know where your Epi Pen is and other medicine is. Don’t have them not know what is happening if you do go into anaphylaxis.

To read “Part 1”, please click here.

Eosinophils & Mast Cells

Progress and Setbacks with Mast Cell Activation Issues

For those of you who manage mast cell activation issues, you know how things can go great and then reverse direction within a day! Mast cells can be triggered by foods, chemicals or scents, and by environmental triggers and seemingly by 100 other items where we’re constantly playing detective. I work hard to keep my diet completely organic and to stay away from foods I’m allergic to; to not be exposed to any chemicals (such as hair dye or cleaning solvents) and to mitigate dust, pet and other pollen exposure. That has helped me to progress tremendously since my activation issues began 12 years ago. I’ve also found a few new areas that create setbacks, which I’ll share below.

Progress

My daughter, Michaela, and I have both been on Dr. Xiu-Min Li’s protocol of Traditional Chinese Medicine herbs to assist with calming down the inflammation in our bodies from mast cell activation. We both use the herbs topically only, as neither of us is able to tolerate swallowing the herbs for consecutive days or periods of time. Dr. Li has been especially helpful in assisting each of us to feel better with an herb paste that we put on the bottom of our feet overnight. These specific herbs help with acid reflux and calming the gut. I also use a special cream on my entire body that helps to calm down the mast cells throughout my body – skin, gut, nasal passages, etc.

Dr. Xiu-Min Li of Mount Sinai Medical Center

I’ve been on this protocol for 3 years; Michaela for 1 year. Each of us would love to be able to increase the foods that we are able to eat AND to have no stomach issues. We’re moving in the right direction, which is really wonderful.

Me and Michaela June 2018

Both Michaela and I also see a chiropractor in Denver who specializes in Network Spinal Analysis (NSA). This has helped our energy levels to increase and to balance out energy in our bodies. Mast cell activation can affect sleep patterns and also can affect how energy flows through the nervous system creating pain in the back especially. It’s not unusual for me to have hot flashes and awaken in an anxious state scratching an itch that isn’t prevalent during the day! NSA helps me to get better sleep, and has also helped me to be able to exercise again without extreme pain.

Setbacks

In May of this year I fell on gravel after tripping over a 3 inch lip in a trail. Not only did I cut up my hands and knees, but I also sprained my ankle and pulled muscles in my chest. My entire body went into a nervous overdrive. Within a few hours of the fall, my mast cells began going crazy causing me to feel nauseous and dizzy. I knew a mast cell degranulation was occurring because I’ve experienced it frequently enough in the past. I choked a few bites of food down and took an antihistamine along with extra Ketotifen (a mast cell stabilizer) to begin to calm my body. While it took a good month for me to be able to walk on my ankle, it took only a few days for my mast cells to calm back down. However, for those few days, I was so tired and nauseous it was reminiscent of years ago when I felt like that every day! Now, it was a minor setback. I learned that stress to the body (or to the mind) can have big ramifications for mast cells.

I also wrote about my bee sting that occurred in the summer here, which was also a minor setback. Thankfully, I know to respond quickly to bee stings and to get on Prednisone as soon as possible!

Michaela also experienced a strange reaction during this past summer. She began experiencing what she thought was a mast cell reaction at a house she was staying at taking care of the owner’s dogs. She felt dizzy, nauseous and began having the shakes – classic signs for her of a mast cell reaction. She took Benadryl and an extra Ketotifen, and felt only slightly better. The next day she began getting a terrible cold virus, and chalked up the entire situation to getting sick. After three days, at the end of the job, she returned home and then went to our NSA chiropractor. He immediately asked her how she came into contact with chemicals. He stated that the cold she had was from an overload of chemicals running through her body. He could feel her body’s negative response the minute he began working on her. She called the home owner and found out that they had just had their floors redone! The off gassing from the renovation had created organic compounds to be trapped in the house, and she reacted violently. She has now learned to ask home owners where she will be staying overnight if they’ve had any recent renovations! The good news is that she has learned to ask more questions about her environment when she is staying somewhere other than home.

Mast cells activation issues require constant vigilance and awareness of one’s environment. Injury and chemicals stress the body. Mast cells are only trying to protect, but with an activation disorder they end up hurting the body!

 

School & Food Allergies

The Challenges of Food Allergy in Elementary School

Back in December of 2005, I began sending out a monthly newsletter from me/AllergicChild. This was long before blogs came into being!

I created a Morgan’s Corner in the newsletter for our then 9-year- old son to answer questions about living with food allergies. Morgan is now 22 years old and a college graduate! Yet, many of these memories from these interviews are worth saving on the blog and sharing with you.

You will notice in the interview below that Morgan doesn’t list Fish as an allergy. He had yet to experience anaphylaxis on a camping trip to trout that illuminated the allergy!

I’m sure many of you will relate to his successes and challenges as I continue to add these to the blog and share them.

How old are you Morgan?
I’m 9 years old and in the 4th grade.

What are you allergic to?
Peanuts, Tree Nuts, Shellfish, and Sesame. I’m also allergic to Dogs and Cats, although it’s mostly anything that’s alive with fur on it. Although those are but a few what I am really allergic to, those are my main.

Do you ever remember not having allergies?
No, I do not remember not having food allergies. I was really young when we found out, so I don’t remember.

What’s the worst part of your allergies? In other words, what do you wish you could change?
I don’t know really what the worst part is. It’s either not going over to a friend’s house or I can’t eat something. I also wish that I did not have dog allergies just because a lot of my friends have dogs, so they have to come over to my house instead of me going over to theirs.

Have you ever been teased because of your allergies?
Well, twice actually. Once, a friend of mine went running around the playground, of course chasing me, holding a peanut butter cracker and yelling “Eat it Morgan! Eat it!” Another time is when another one of my friends actually went around chasing me pretending to be a peanut butter sandwich. All these times, I went and told the teacher and they did get in to trouble. We’re friends now, and I don’t think about it much anymore.

Have you ever been left out of activities because of your allergies? If so, what? How did that feel?
Food Fights, Food Fights, and more Food Fights. Seriously, I have to either not participate, or check the labels on all foods at a party at school. That usually takes a long time though. It sometimes felt great that I’m safe, but I also want to participate. I have also been left out when my 1st grade classroom went next door and I couldn’t go in. The classroom wasn’t peanut free. I told my teacher how it felt to be left out. She cried, and it didn’t happen again.

Eosinophils & Mast Cells

Bee Stings and Mast Cell Disorders

There are many people who suffer from a bee sting allergy, and most don’t have any food allergies. Thankfully, so far, neither of my grown children – Morgan and Michaela – have experienced any reaction to the bee stings that they have received.

It’s a different story for me. As a child and into my early 20’s, I received several bee and wasp stings without any issues other than a little discomfort. That all changed in 2006 when I was stung by a wasp on the back of my thigh. That was the beginning of my entire immune system going on “tilt”. I was later diagnosed with a mast cell disorder, which honestly could have been active for years prior to this bee sting. And the reaction to the sting brought my system over a threshold from which it hasn’t yet recovered.

The wasp sting reaction lasted for 3 weeks with hives on my thigh and itching. I didn’t realize then that I should have gone to the doctor and gotten steroids or some other treatment. Foolishly, I toughed it out.

I did tell my allergist at our next visit, and she gave me a prescription for an epinephrine autoinjector because of the severity and length of my reaction. I never experienced any breathing issues, which I’m grateful for. However, as with any type of allergic reaction, you never know what the next one could bring.

This past week, I was stung by a bee while out walking in my neighborhood. I sustained the sting on my left pointer finger right below the knuckle. I pulled out the stinger immediately and headed home to put on ice. I truly didn’t think I’d have a reaction this time since my mast cell disorder is better maintained with antihistamines and mast cell stabilizers, and I’ve never reacted to previous bee stings. Yet, the swelling began the next day.

18 hours after the sting

 

24 hours after the sting

 

36 hours after the sting

By a day and a half after having the sting, my hand looked more like the Incredible Hulk’s than my own! It was itchy, and the swelling was so bad that I had to hold my hand above my head to keep it from throbbing. Again, I had no breathing issues thankfully, but the swelling was getting to the point that I was concerned that the skin on my pointer finger was going to burst.

I set out for my allergist’s office, ended up seeing a Nurse Practitioner since my allergist wasn’t in the office that day. She sadly had no knowledge of mast cell disorders, and thought a few extra antihistamines would do the trick. I had to beg her for a prescription of Prednisone. She acquiesced and said I should take 20mg of Prednisone each day for 5 days and then stop. I’ve never heard of this, with no titrating off of the drug. I asked her about that, and she said it wasn’t a problem. Again, not what should be done for someone with a mast cell disorder!

When I got to the pharmacy, the pharmacist had thankfully noticed that the 20mg tablets of Prednisone contain dye, which I react to, and asked if I’d prefer the 10mg tablets. I was so thankful that he noticed this! He then told me that she had prescribed two 20mg tablets a day for 5 days. So that’s 40mg of Prednisone a day with no titrating off!

I called the Nurse Practitioner and asked about this mixup and what should I be taking? She said the 40mg was fine. At this point, I knew I’d better get in to see a doctor, and went to my family practice doctor to get everything straightened out.

The doctor put me on a short course of Prednisone, starting at 20mg and titrating off over the next 4 days. The drug quickly began to lessen the itching, pain and swelling.

A few reminder lessens learned:

  1. Past reactions to bee stings/wasp stings don’t indicate current reactions.
  2. With any type of serious reaction, see a doctor! And if you have a mast cell disorder, it’s always better to see one who understands the nuances of reactions with mast cell patients.
  3. Make sure to have any type of dye allergies listed at your pharmacy.
  4. Never go off of a steroid suddenly. Always titrate down!

 

 

 

 

College with Food Allergies

Graduating from College and Managing Food Allergies

The first week of June 2018 was a whirlwind of graduation week (from college) for our son, Morgan, and our family. Graduations are an exciting time filled with activities and emotions for every family. And for us, it was a major milestone for Morgan to make it through four years of school with no serious allergic reaction with his allergies to peanuts, tree nuts, sesame, fish and shellfish!

Because Morgan was the Student Body President his senior year, he was the University of Denver student graduation speaker. And yes, that is a Winnie the Pooh bear on the podium with him! He quoted Pooh several times in his speech. Here’s one snippet: “I hope that we all have at least one something that makes saying goodbye hard. It will be something or someone that we cherish deeply. And it doesn’t have to be big either. As Pooh says, ‘sometimes the smallest things take up the most room in your heart.’ Let’s all take the time to express and celebrate that something or someone today.”

Morgan participated in and experienced so many wonderful adventures  in 4 years of college: clubs, student government, study abroad, internships, jobs, friendships, roommates, and intimate relationships. Every one of these were affected by his food allergies, and he learned how to become an even better advocate!

The graduation has brought back memories of how far Morgan has come since he began college almost 4 years ago. And Mom has had to do a lot of growing too!

Living with a Roommate in College

When Morgan graduated from high school, (which I wrote about in a blog post here four years ago),  we knew he was heading to the University of Denver. He really wanted to live in the dorm with a roommate in the Living and Learning community called the Pioneer Leadership Program.

Over that summer in 2014, Morgan and I had one meeting with the chefs at the school, and he determined that with their training from AllerTrain, and their willingness to continue to learn, it would be safe for him to live in the dorm and eat cafeteria food.  We had a single room with a kitchen as a backup, but that would mean he couldn’t live with the Leadership program, which was a major barrier to participation.

He and I had many conversations that summer as I passed the baton, so to speak, to him to determine how he was going to tell his assigned roommate, Thomas, about his food allergies. Truth be told – he did so in a text message after having coffee for 3 hours chatting about how they each wanted their living situation to play out!! That was my first lesson in letting go. I really wanted for him to explain EVERYTHING about food allergies and his asthma to Thomas. And that was the first in a long list of Morgan learning how to take care of himself, in the way HE wanted to create his relationships and his life in college.

Thomas and Morgan on move-in day in September 2014

Through the years, Thomas was a roommate with Morgan during their first, third and last school years, and he was a travel companion through Europe prior to studying abroad. He now understands everything there is to know about Morgan’s food allergies, recognizing allergic reactions and how to operate Morgan’s Auvi-Q.

Morgan and Thomas the day before graduation in June 2018

When I thanked Thomas for being such a wonderful roommate through all the years, he responded, “If I had to give up peanut butter to get a best friend, it’s a small price to pay!” Truth be known – he gave up a lot more than that, but this is why my son was so adamant to figure out a way to have roommates in college!

Learning How to Advocate Even More

Morgan’s activities in high school included playing piano for the Choir and participating in Speech & Debate, which allowed him to experience overnight trips and roommates. This helped him so much with the college experience, and having to manage food allergies.

I’d really encourage all parents to allow and encourage your children  with food allergies to be involved with activities in high school that require them to go on overnight trips; to manage roommates in hotel rooms; to be responsible for carrying their medication(s); to train chaperones and teachers about food allergies; and to be faced with situations that don’t go as planned.

Morgan wrote about a last minute invitation to a business lunch here which offered an opportunity to advocate on the spot while working in college.

He also wrote extensively on his study abroad experience in his junior year at the University of Denver here:

Studying Abroad with Food Allergies

Preparing for Study Abroad

Travel, Travel, Travel Abroad

Medication and Safety While Abroad

The difference between high school and college really is that we parents have to trust that we’ve done as much as we can do to train our children how to make good choices. While they are still at home, we hear more about what’s going on. Once they go to college, a healthy relationship for my husband and I did not include having our son check in to tell us what he was eating, or to share about every one of his activities.

We did want to keep track of his trips and where he was located, but when he was in Denver, we would frequently hear from him via text every few days or so. And we spoke with him only every few weeks on the telephone. We live an hour away by car from Denver, so he was able to come home to visit (or we would go to DU) every 3-4 weeks.

For me, I was so accustomed to being VERY involved with all of Morgan’s medical issues, it was really difficult to loosen the grip I had on him, and to trust that he knew what to do with his pollen allergies, for example. When to take a Zyrtec for his nasal symptoms, or when his ocular allergies were causing his eyes to swell – he no longer needed me to ask “do you need…..?”

We are still working on me learning how to “zipper my lippers” on his medical needs!

Mom Learning How to Let Go

It truly has been a one day at a time process for me to learn how to let go of my obsession around Morgan’s health, which I wrote about in a blog post here.

Thankfully he never had a serious allergic reaction in college warranting a trip to the ER. He did land there once with a mystery stomach issue, which was enough excitement for us. I credit Morgan’s ability to manage and remain vigilant about his food allergies every where he went.

When he left to travel through Europe before his study abroad in England, I counted the days that he would be gone. It was 140 days. I counted them down every night. It was the longest 140 days of my life! We kept in contact with him more than we ever did when he was just one hour away from us. He managed everything beautifully. I knew then that we had trained him well.

Shortly after he returned he was telling me about how he was going out to dinner with some friends and that he would ensure he ordered a safe meal. I realized that the thought hadn’t even crossed my mind to be concerned. I told him that he’d made it through 9 countries and 33 cities during almost 5 months, and if he could do that without an allergic reaction, I knew he could take care of himself going to a restaurant in Denver!

Morgan grew from a boy into a man during college, which is what we all hope our children will do. He’s ready to step into the work world with his first “real” job as an Economic Development Specialist for the Longmont, Colorado Economic Development Partnership.

I will continue to have to work on letting go of him and his food allergies, asthma and various other medical conditions. I’ll always be a Mom!

 

 

College with Food Allergies, Travel/Eating Out & Food Allergy

Traveling to Mexico City for a Youth Conference

Unlike traveling to San Francisco, which I wrote about here, Mexico City had its challenges. I was attending a conference in Mexico City called the Youth Congress for Sustainable Americas, which is organized by a non-profit organization based in Denver. I attended with some other students from the University of Denver, including Darylann who was the Vice President of the Student Body with me as President.

We booked flights on United: it was either United or American Airlines and United’s policy for food allergies is much friendlier. They don’t serve any packaged nuts and I’ve flown United before. I can say I was apprehensive since United isn’t like Southwest, but I actually had zero problems on the flights to and from Mexico City. I had to fly through Houston, so it was a long period of travel each way, but I didn’t have much problem.

This was also my first international trip since going abroad in Fall of 2016, so I was very excited! I brushed up on some key words in Spanish and tried to be as best prepared as possible. We arrived late on Thursday, April 5th  and immediately took a taxi to our hotel near the airport. We immediately went to bed. The conference didn’t start until the evening on the Friday the 6th, so we spent the day around the city, mainly in Coyoacán (a borough of the city). We saw the Frida Kahlo Museum and some parts of the city. It was great!

We then went to the conference, beginning with a dinner at a venue in the city (Hotel Carlota)! It was pretty hip venue. I must write and give huge thanks to the conference organizer, Robin. She made sure absolutely everything was safe. She’s also fluent in Spanish, so she could make sure with the service staff that all of it was safe. She was also managing other food restrictions like vegetarian, so she was super cognizant of it all. We had a delicious and safe dinner (I overheard the waiters talking about the “especial” meal for me, so I knew Robin had taken care of everything).

The next day, the conference was in El Club de Banqueros, an event venue in the middle of the city. It was gorgeous! The conference had participants from across the Americas, so we had live translation between English, Spanish, and Portuguese. Mostly, the translation was for us Americans and Canadians who didn’t know Spanish – although most of the folks from Spanish-speaking countries had to use the earpieces for our Portuguese speakers! Robin was coordinating all of the food at the venue. She worked with the staff (in Spanish) to make sure I had safe meals. Truly, she was just tremendous.

Some other conference attendees and myself! Folks from the US, Venezuela, Mexico, and more!

The day was long, but we had an exhilarating dinner that night at a private art venue in the city with a local food crew. They were making tacos that changed my life. They were using all fresh, local ingredients and hand-pressing and heating the tortillas on-site. They made a variety of fillings. Robin helped check which of the fillings were safe with the food crew (again, Robin to the rescue!). I was able to enjoy some incredibly delicious tacos with fresh ingredients.

These were insanely good.

We had one last day of the conference on Sunday, for the morning. After that, five of us from Denver (two staff from the non-profit and three of us from DU) went and adventured around Mexico City for the rest of the day. Darylann and I flew back together on Monday and resumed school!

Now with the sequence of events established, let’s talk health challenges! First, the water. I was careful during the first 36 hours or so. Mexico City does not have great water and I knew that walking in to the weekend. I had bottled water and I knew not to just fill my refillable water bottle at any old water fountain. Then: the hotel we were staying at served (drip) coffee in the morning and while they said that the water they used was filtered, my stomach definitely disagreed. I threw up, recovered quickly, and continued on with the rest of my day. However, it wasn’t a pleasant experience.

The venue we were at for the conference (El Club de Banqueros) actually filtered their water enough: they provided coffee throughout the day and my stomach agreed with that coffee. Lesson learned! I refused to get water or coffee from our hotel for the rest of our time in Mexico City. I exclusively bought bottled water and was much more conscientious about drinking water through the whole weekend.

The second real issue was the smog and pollution. Denver is a pretty clean city so my mild asthma is rarely triggered, even during the springtime season. I’m not consistent with an inhaled steroid (Pulmicort) to help moderate the asthma, especially during the winter, because my lungs are just fine during that time of the year. This was an agreement reached with my doctor, so please talk with your doctor about the best practices to help control asthma if you have it. Anyway, with the spring season only just starting in Denver, I hadn’t really been on Pulmicort, but I brought it anyway, along with all of my other medications, just to have in case anything happened. I’m glad I did! The smog really activated some minor breathing problems the first day I was in Mexico City: essentially, it was just some tightness in the chest. I took Pulmicort regularly through the whole weekend and I didn’t have any further issues (the problems dissipated).

Now, for the weirdest story of the trip! It was our last day and we were adventuring around the city. We went to the Palacio de Bellas Artes, a beautiful cultural center in the center of the city.

Palacio de Bellas Artes

There are gorgeous murals from artists and has some beautiful rotating galleries of contemporary art. Diego Rivera has a very famous mural installed at the Palacio – and after seeing the Frida Kahlo house, I definitely wanted to see some of his art! Everything was going fine for the first fifteen minutes: we dropped off our bags and began wandering around the gallery.

Slowly, my skin became red. It wasn’t blotchy or full of hives either: it just gradually became redder in color. My eyes swelled up and my face turned a nice hue of red as well. My skin was not itchy at all, but my eyes definitely hurt. I had no idea what was going on!! My companions were all very concerned and pointed out my very red skin. I looked like a very sunburned American walking around with very red eyes. However, I had absolutely zero breathing problems and nothing else was happening besides my skin and eyes being very red. Nothing even itched! Such a weird, weird thing.

Anyway, I was wondering if it was something I had eaten for lunch (a delayed reaction, nonetheless, because I had eaten over an hour prior). However, once we grabbed our things and stepped out of the building, I took a Benadryl and my symptoms disappeared within the next fifteen minutes. I still have absolutely no clue what happened, but I’m glad I don’t look like a red alien! If any of those symptoms became progressively worse, or if I had breathing problems, I would’ve immediately asked one of my friends to call emergency services and administer an autoinjector. That would not have been an ideal situation, but it would have been medically necessary.

Other than those three things, the trip was great! Robin was such a huge help in making sure my food was safe for the duration of my trip (she even helped order a dinner at a restaurant our final night there).

The 2018 Youth Congress for Sustainable Americas

The whole experience was amazing, and I loved the city so much! I also loved all of the people I got to meet at the conference and had such a blast. I wish I could’ve stayed even longer, but I had to get back to school.

If you’re looking for more information about traveling with food allergies in general, you should click here. If you’re looking for more information about traveling internationally, you should click here. I’ve had a blast traveling over the past two months and I can’t wait to graduate from college! Happy travels, all!

College with Food Allergies, Travel/Eating Out & Food Allergy

Traveling with Food Allergies and Friends to San Francisco!

Over the past two months, I’ve made two incredible trips: one to San Francisco for over a week and one to Mexico City, Mexico (read about that trip here)  for four days. It’s rather a busy time for me at the moment (I’m graduating from college in literally two weeks!) so I’ve been meaning to write this post for a while. I figured I’d finally get around to it!

San Francisco (Spring Break 2018)

I went to San Francisco with my two best friends, Thomas and DK. We traveled Europe together and currently live together, so we know each other’s travel rhythms and they are both well acquainted with my food allergies (peanuts, tree nuts, sesame, fish and shellfish), allergic reactions and how to administer my Auvi-Q.

We planned on staying in San Francisco during Spring Break from Friday to the following Sunday (a little over a week). Thomas’ aunt and uncle live in San Francisco and they offered that we stay with them! They didn’t have any dogs or cats, which would have been a deal-breaker for over a week’s stay: I don’t have problems with most dogs or cats for a short period of time due to allergy shots, but over a longer stay I wanted to minimize problems. We affectionately called this trip “Dadcation 2k18” because we joke we’re all a bit like dads.

When initially planning, DK believed he was going to be out in San Francisco before we were for a spiritual retreat (he’s planning to be a Catholic diocesan priest). In the end, the retreat was moved so DK merely booked separate flights. Thomas and I, however, decided to fly Virgin America! It was incredibly cheap ($200 roundtrip versus at least $350 on other airlines) when we were booking flights a couple months out. I double checked their food allergy policy and everything was going to work out just fine! They didn’t serve any peanuts and while I couldn’t get a pre-board, I knew I’d just carry along some sanitary wipes and clean off the seat I was going to sit at.

Note: As of late April 2018, after I flew Virgin America, the airline has been fully integrated into Alaska Airlines. Alaska does have a pre-board option, unlike Virgin.

I try to stick with safe airlines (Southwest being the gold standard), but we were very price conscious since we knew San Francisco was going to be expensive. I felt comfortable with my choice and I had absolutely zero issues with the flight!

We took a short Lyft into the city and met Thomas’ aunt and uncle, Mike and Bette. They were absolutely extraordinary hosts and truly loving, wonderful people. We arrived around 8pm and decided to go for a late dinner at a local pizzeria. I immediately fell into the casual rhythm of travel: go with the flow, deal with any issues as they arise, and make sure I always have a safe option. Pizza felt like a good choice, too, since it’s usually not too crazy. It was more of a craft Italian restaurant, so the meal was delicious and I merely asked the waitress to make sure that the pizza was made safely to keep me safe! Worked great.

Since Thomas and I literally had just finished finals (we’re on the quarter system at the University of Denver), we decided to take the first couple of days pretty easy. We slept in, hung around Mike & Bette’s place, and just enjoyed the area. Mike and Bette had asked if we wanted any food around the place and Thomas had merely requested breakfast food so we could go out and experience the city in during the day and eat as we pleased. They provided so much food.

In all honesty, I have no idea whether Thomas informed them of my food allergies. He’s very cognizant of my food allergies after living together for 3 of 4 years in college. Nonetheless, all of the food Mike and Bette purchased was safe. Of course, breakfast food for us was eggs, sausage, fruit, and vegetables so it was pretty hard to find something unsafe.

Over the course of the next week, we walked around most major parts of the city. We also purchased a week pass for the transit system (the Muni). We walked along the entire Embarcadero and the whole pier, saw Chinatown, went to Alcatraz on a night tour, saw two incredible cathedrals, participated in a civic protest, and enjoyed nights on the pier and in Noe Valley. We ate wondrous food, saw incredible parts of the city, and stayed in on some rainy days. It was a truly fabulous week. I want to highlight a couple of events that I did not anticipate.

Dads take San Francisco (Thomas, DK, Me)

On one day, when we were walking down the Embarcadero, we ended up on the far north side in Ghirardelli Square. Technically, that’s up in Fisherman’s Wharf (an area of the city). My general rule with any chocolate is not to eat it unless I have called and made sure the production process is safe since so much chocolate nowadays includes nuts of some kind. Ghirardelli is not safe for me: some explicitly contain nuts and everything else has a “may contain” or “made in a factory” warning. Nonetheless, we entered into their shop and I mildly perused their offerings, just seeing what was around. Thomas and DK were superbly excited because they love chocolate and Ghirardelli. I waited around while they got a milkshake and purchased a couple gifts.

Obviously, I couldn’t purchase or eat anything. I can’t say I was disappointed about this adventure, because travel is a push & pull between what different people want to see or not. Thomas was all about Ghirardelli. I had a similar experience down on Fisherman’s Wharf walking past Boudin Bakery and some of the local seafood shops. Boudin produces world-famous sourdough bread but it wasn’t particularly safe (due to cross contact) and obviously the local seafood wasn’t safe for me. I wasn’t going to get a bowl of clam chowder with the boys, so we went elsewhere that night (we ventured back to a safe burger place in Noe Valley). I had to make sure I had safe food and DK & Thomas were very accommodating.

However, I wasn’t going to let DK and Thomas leave San Francisco without letting them try their seafood. I knew they wanted to eat some of it. So, we made a night where I would see a friend who was in the city (her name is Melissa) and they would go with Mike & Bette to a delicious seafood place. This worked great! I met Melissa in the Mission and ate some wondrous Cancun-style tacos and they ate seafood. This was essentially how we accommodated each other during our Europe trip: I would make sure I could find safe food and then the boys would be able to eat whatever they pleased.

Mike also took us to his club (it’s at the Presidio Golf Course). Very, very nice! We met up with two University of Denver alumni who live in the city with whom Mike & Bette are friends. We ate a late lunch as a group and I double-checked with the servers that the food would be safe (it was). I ate some short-ribs and had a lovely discussion. However, that afternoon was pretty unplanned: we had absolutely no idea where we were going that evening.

Me, Bette, Mike, Thomas, and DK on our last morning in San Francisco!

As it turns out, we wandered around the Presidio and the area: there is an old military base and some beautiful green lands in the area. We took our time and savored the day. We then walked along the beach all the way back down to Fisherman’s Wharf. By this time, I was getting pretty hungry for dinner: the good news being I remembered there was an In-n-Out at the Wharf that I spied when we were at Ghirardelli earlier in the week. I suggested In-n-Out to the boys and they are 100% on board. It worked out fabulously! In-n-Out is a great safe burger place for me, but I definitely double checked that everything was still safe before paying.

San Francisco was an incredible city and it was so much fun! I am so grateful to Bette and Mike for their hospitality and generosity. It was an amazing week and I will forever cherish that time. I had zero issues during the whole trip and I just can’t speak highly enough of the city and our time.

 

Eczema & Rashes, Eosinophils & Mast Cells

Healing Eye & Skin Allergy Issues

Both my son and I had a childhood filled with eczema. For me, it was long before anyone knew that eczema was related to the atopic march of allergies and asthma. For my son, Morgan, we learned various ways to combat his eczema and make him more comfortable, which I have written about here.

Through the years, we’ve learned of many more skin issues that can occur related to mast cell issues and environmental allergies, and have found various products that have really helped both of us.

Morgan frequently had itchy skin, and not always from eczema. When he would play outside in the summertime, when the pollens were high, he would frequently itch afterward. We didn’t want to have to give him Benadryl or cover him with steroid cream each time. We found a product called Sarna which really worked. It was steroid-free and you can purchase the “original” or “sensitive” which is fragrance-free. My daughter says the original “smells like my childhood!” because we applied it to Morgan so frequently.

Morgan also has ocular allergies. Sometimes his eyes got so red and puffy we had to resort prescription eye drops and steroids. We tried to not allow it to get to that extreme by using Zaditor eye drops. These drops have Ketotifen as the active ingredient, which is a mast cell stabilizer. With my daughter and I having a mast cell activation diagnosis, we use these drops frequently during tree pollen season and enjoy great relief.

Colorado winters are extremely dry, and everyone in our family has been in need of more skin moisture this past season. We’ve found Vanicream to be an answer to our alligator skin issues, and to ensure that eczema doesn’t flare. It is naturally fragrance free, and can even be applied to facial skin without clogging pores.

My mast cell issues have created another issue on my facial skin – Rosacea. I will react to most makeups by just getting redder skin. I found the company Rosaceacare years ago, and love it! I use the ZincO cream that includes a sun block on my face. I also love the cleanser and moisturizer.

Kiss Freely has great lip balm that my daughter loves, and their body butter is amazing! It really helps dry skin and is free of all allergens and gluten that have caused us to react previously.

Lastly, I have eyelid issues. Specifically, it’s called blepharitis, and is frequently seen in people with mast cell issues and rosacea. My eyelids get red and swollen and need to be cleaned daily. This is important to keep me from having to ingest oral antibiotics or to be putting antibiotic drops in my eyes frequently. I’ve found a product called HypoChlor can be used on gauze to scrub my eyelids and keep them from becoming inflamed.

One last note – I am not being paid to suggest any of these products. They are what works for us, and I hope that if you have similar skin and eye issues, you might find the suggestions helpful!

 

College with Food Allergies, Food Allergies & Study Abroad

Selecting Your Study Abroad Program

This is a selection from my new e-book “Studying Abroad with Food Allergies,” available exclusively on Amazon Kindle. I detail all the important things you should think about when planning, traveling, and studying abroad! Buy it here. 

Study abroad is centered upon a program in a certain country. Some programs are run by universities, others run by research institutes, and even others run by American organizations in other countries. There are many different configurations for study abroad programs. Here are some typical categories:

  • University Programs. These programs are like year-long exchange programs where you are considered a normal student at the foreign university. You typically live on (or near) campus in university-provided housing, but homestays might be an option. Depending upon the country or university, classes may be taught in the native language.
  • Research / Experience Programs. These programs typically integrate a research or internship. Students may take classes and then complete an internship or complete both concurrently. These may be affiliated with universities, but are not always. Housing may be a homestay.
  • Language Immersion Programs. These programs are usually not affiliated with universities and are instead independent institutes. Housing is typically a homestay and academic curriculum is taught in another language.
  • Exchange Programs. These are year-long programs where, like university programs, you are considered a normal student at the foreign university. Exchange programs “switch” students from the respective universities: a university in Japan will send two students and receive two students for the whole year.

I have friends that were in each of those different programs. I was on a university program (more on that soon). One of my close friends, Kieran, was in an experience program in Brussels where he lived in a homestay with a local Belgian family, took classes for 5 weeks, and then worked for 5 weeks at a local international security think tank. I have two other friends who were on a university program in southern France, but in a homestay. I have a friend who was on a Mandarin immersion program in Beijing. I also have a friend who was on an exchange program to Japan, and another on an American research program in Chile. There is such a wide variety!

DU partners with programs around the world. One of the reasons we have such a high participation rate is because of these partner programs. DU students pay the university normal tuition, fees, and housing costs and DU helps cover all of the associated costs of registering, applying, and housing costs at partner programs. More importantly, if a student has a 3.0 GPA or higher and studies abroad in their junior or senior year, they qualify for a scholarship program that covers visa fees and flight costs! This scholarship is called the Cherrington Global Scholars Program.

Most universities have an office for study abroad: at DU, ours is the Office of International Education (OIE). OIE has an easily navigable site that lists out all of the available programs and their requirements. Some programs might have a language requirement or minimum GPAs or even certain majors! For example, there is a program in Milan that is specifically for opera majors at DU.

Criteria for Programs

These were some of the criteria I considered when I was selecting my program for study abroad. They at least help narrow down from a wide variety of programs that exist in the world and that DU partners with.

  • Are you comfortable studying in a country where English an official or primary language? Do you speak a second language?
  • Are classes taught in English?
  • Does the program offer credits toward my major or minor?
  • What kind of housing does the program offer? What kind of housing are you genuinely comfortable living in for at least four months?
  • Is the local cuisine (relatively) safe?
  • Is this actually where you want to go?

For me, I immediately knew that I would not be comfortable in a country where English isn’t a primary language. I can butcher some Spanish, but I wasn’t comfortable living in a Spanish-speaking country or communicating in Spanish. Study abroad is supposed to be uncomfortable and it is supposed to stretch your boundaries, but it isn’t supposed to be dangerous. I didn’t feel safe constantly communicating in Spanish or in a Spanish-speaking country since I wasn’t sure if I could constantly maintain food safety for the many months I would be there.

This also relates to another criterion mentioned above: is the local cuisine (relatively) safe? It’s impossible to find any cuisine that won’t contain at least one of my allergens, so I was looking for cultural cuisine that I could, on average, feel comfortable in finding a safe option. This criterion eliminated some English-speaking programs in English-speaking countries like The Gambia because I wasn’t entirely sure if I could consistently have safe food. Even though I wasn’t considering China, Japan, or Thailand by this point, this would also have eliminated those countries from my consideration.

I eventually narrowed down to mostly a few host nations: New Zealand, Australia, the United Kingdom, and Ireland. I also kept the Netherlands, Denmark, and Sweden on my radar because of their high-rate of English proficiency and relatively accessible cuisine.

This narrowing process may be different for you depending upon your food allergies. It might be stricter and you might focus exclusively on European countries (or only one country); it also might be less strict depending upon what you need to manage. Conduct some Google searches to explore different country’s cuisines and their languages. This was immensely useful to me before I started to explore programs in-depth. That way, I didn’t go chasing an impossible program down a rabbit hole.

Lancaster Castle – at the University of Lancaster where I went!

Most of the programs were university programs and I double checked that they at least offered some classes I could count toward my academic degree. Sometimes, students forget that it is study abroad and not travel abroad. This is still an academic experience and it makes sense to take classes that still count for academic credit since you’re paying the money! OIE made accessing these lists at the various programs very easy, so if your university does not offer such a nice website, you might have to do some digging to figure out their academic offerings!

Want to learn more about housing at study abroad programs, coordinating accommodations, planning international travel, and more? Get my new e-book “Studying Abroad with Food Allergies” now, available exclusively on Amazon Kindle. Buy it here.

Holidays & Food Allergies, School & Food Allergies

Managing Valentine’s Day While Keeping Your Sanity!

I remember the fear I felt when my son was in elementary school around Valentine’s Day school parties. I knew, from my childhood, that candy and food surrounded every party in the classroom. I also knew that it would take preparation and education to ensure that my son’s classroom remained safe during and after any party his class had.

Vermont Nut Free Chocolates Valentine’s Day Pack

 

My son started kindergarten in 2001, when food allergy awareness was definitely lacking. My initial thought was to remove all food from the classroom and have a food-free party! I thought it was a brilliant idea – crafts, games and fun. When I shared that with the teachers and the other room parents, you would have thought I suggested we starve the children for the month of February! So, food was very much a part of every year’s school celebration in addition to the kids bringing in Valentine’s Day cards, many of which included candy treats.

For my son’s entire elementary school years (all six of them from K-5), I was a room Mom in charge of planning every party. What a job that was, but I felt it so important to do this for his safety. This certainly helped for me to know what was planned for fun and for food. It also helped to steer the menu away from my son’s allergens – peanuts, tree nuts, sesame, fish and shellfish.

The classroom teacher sent out a reminder the week before Valentine’s Day reminding every family to NOT bring in foods that contained the allergens of any child in the classroom as a candy attached to the Valentine’s card or as food for the party.

Despite this, there were several years where we had issues. One year, a Mom brought in beautifully homemade cupcakes that had peanuts sprinkled on the top. The teacher looked at me when they entered the classroom on party day, and I gave her the evil eye threatening to make a scene if she didn’t handle it right there and then. The cupcakes were removed from the classroom immediately.

Another year, one family who didn’t understand English very well, brought in sesame candy to celebrate the Chinese New Year along with Valentine’s Day and put it into every child’s Valentine’s bag to take home. Many children got into the candy during the school day, and sesame seeds went everywhere. Since this occurred in 3rd grade, the students were much more aware of the issues this posed for my son. The Principal had to get involved with this issue and brought the parents in to explain food allergies and why sesame covered candies can’t be sent in to school. I’m not sure they ever understood the issue!

By 4th grade, my son’s classroom had a dance party with fruit and punch as food and that was it! That was such a wonderful step in the right direction – I was thrilled.

Once my son went to middle school in 6th grade, there were no longer any Valentine’s Day celebrations or parties. I didn’t miss the party at all, and honestly, I don’t think that my son did either.

If you’re still battling an elementary school with parties, I’m feeling for you! We learned that even with reminders to families about not bringing in food allergens, mistakes can still happen. If at all possible, be in attendance at your child’s school to watch the food. And practice with your child before the day how to respond to food that doesn’t appear safe – tell the teacher, don’t eat it, and make sure to tell Mom/Dad! If you’re school is open to having parties without food, there are so many activities that can be enjoyed.

Here are more links for safe Valentine’s Day Candies, Kissing with Food Allergies and food free treats:

Allergy-Friendly Valentine’s Day Candy Guide by Spokin

Valentine’s 2018: Top Allergy-Friendly Chocolates, Candies and Food-Free Treats  by Allergic Living

Food Allergies: Hot Tips For Kissing Safely by Allergic Living

4 Ways to Pledge Your #TealLove for a Child With Food Allergies This Valentine’s Day by Kids With Food Allergies

 

Food Allergies & Study Abroad, Travel/Eating Out & Food Allergy

Medication & Safety While Abroad

This is a selection from my new e-book “Studying Abroad with Food Allergies,” available exclusively on Amazon Kindle. I detail all the important things you should think about when planning, traveling, and studying abroad! Buy it here. (It’s free with Kindle Unlimited!)

As a part of its study abroad program, The University of Denver (DU), where I attend, offers membership to a service called International SOS. International SOS offers consultation on health and security for individuals traveling abroad. This service was incredibly helpful to me while planning out for study abroad. All DU students are required to have at least one consultation with International SOS (over the phone) before they leave.

I called up International SOS and spoke with two individuals. The first individual was a security and travel expert and she briefed me on the ongoing security situation in all of the countries I was planning on visiting. She gave me a debrief on ongoing developments regarding terrorism and personal safety, as well as general practices as a US citizen abroad. This was great and very useful.

The second individual was a medical doctor. He was incredibly helpful. He had the medical knowledge required to understand my food allergies and the international experience to understand how they could be best managed while I traveled. He made sure I knew how to manage cross contact and how to be careful while purchasing food at restaurants while traveling (a skill I was well versed in!).

He noted that I would be unable to fill a prescription from an American doctor while traveling in other countries; instead, he recommended that I travel with my medicine in their original boxes that have the prescription on them. As such, I planned on carrying all of my medicine, including an extra set of EpiPens, in their original box.

If I needed to get a refill of a certain medicine, I could at least present the doctor in the foreign country my original prescription box to obtain a prescription that would be filled at the local pharmacy. Since different countries set-up their health care systems differently, an American prescription wouldn’t be able to be filled at a foreign pharmacy.

He did not believe there was any required paperwork to carry my medicine (EpiPens, antihistamines, asthma control, etc.) in the countries I was visiting. He recommended that, if it made me feel more comfortable traveling with a doctor’s letter that allowed me to carry my medicine, then I should obtain one. I did.

The US Department of State also offers a service called STEP (Smart Traveler Enrollment Program) that pushes updates to your email on ongoing security alerts in the regions you are traveling in. This also allows the US government to identify that you are in a country in case something happens and get you help. I also enrolled in STEP for my entire time abroad.

Not every school offers a service like International SOS. I think that finding a good resource online is possible. You should conduct thorough research on the countries you are visiting and the rules for bringing in medication. Countries usually have websites that detail these rules. Moreover, you should talk with your doctor about what is necessary to manage your medical conditions.

Want to learn more about other important planning items you need to think about before studying abroad like housing, accommodations, travel, and more? Get my new e-book “Studying Abroad with Food Allergies” now, available exclusively on Amazon Kindle. Buy it here. (It’s free with Kindle Unlimited!)

Eosinophils & Mast Cells, Travel/Eating Out & Food Allergy

Traveling to Orlando FL with Mast Cell Issues and Food Allergies

For the first time in 14 years, our family took a week long vacation with just the 4 of us: my husband, me and our two grown children – Morgan (almost 22 years old) and Michaela (27 years old). We headed to Orlando, Florida for a week’s worth of fun and sun in December. With Morgan on the quarter system for college, and Michaela already working, this was an ideal time to vacation during “low season”.

Denver International Airport

We flew Southwest Airlines on a non-stop flight from Denver to Orlando. Southwest has worked great for all of us in the past, and has allowed Morgan to preboard and wipe down his area. Traveling to Florida, we were on a brand new plane which was on its first day of flight, which was wonderful! That flight and the flight home worked perfectly – both were mid-morning flights, so not the first flight of the day, but we’ve never required that as part of our travel plans. When we boarded the flight home, the flight attendant told us that the previous flight also had no peanuts served, which made for a nice, clean plane. But we still wiped down the area where Morgan sat.

Traveling and managing Morgan’s food allergies – peanuts, tree nuts, sesame, fish and shellfish – along with his pet and environmental allergies pales in comparison to managing Michaela’s and my mast cell symptoms. She  and I both eat only organic foods; however, her diet is vegetables and fruits, while I tolerate only a few foods – chicken breast, turkey breast, frozen Cascadian Farms hash browns and broccoli. My husband, Robert, is on the Whole 30 food plan – so cooking for all of us requires a short order chef!

Actually, we don’t ever eat out because of the organic food requirement, and the mast cell issues require much more vigilance than even food allergies. The type of water that I drink can affect my stomach! Unbelievable, but true. And for those of you with mast cell issues, I’m sure you know what I mean. So, braving a family vacation is a big deal. It also requires a lot of patience on each person’s part since each of us has different needs depending upon the situation. We’ve learned to also have activity days and rest days to keep positive attitudes!

We rented an AirBnB house that guaranteed it was pet and smoke free, and had a full kitchen since we would be cooking every meal. We planned ahead by finding out where the local grocery store (Publix) was, and I special ordered from them a week’s worth of the frozen potatoes that I eat. We also found a  Whole Foods for Michaela’s foods, although it was 30 minutes from where we were staying. Morgan and Robert purchased their foods from each of these stores also.

The pool area in the community center where our AirBnB was located.

I didn’t bring the organic ground turkey that I usually eat because I had called ahead to Publix and Whole Foods to ensure that they would carry it – plain with no spices added. However, when we arrived neither actually carried it, despite their reassurances that they did. This created a search across Orlando to find such a product. We finally did find a different brand, but I learned to bring it in the future since it’s so difficult to find elsewhere!

In regard to bringing food, we got a letter from our allergist to allow us to bring food onboard the plane through TSA. This letter was never requested, but we had it just in case it was. Also, the allergist’s letter delineated that we would be bringing frozen food in a cooler and checking it through as baggage. This too worked just fine with Southwest Airlines, and they never requested the doctor’s letter.

We found that the home we stayed in wasn’t well equipped with kitchen supplies, so thankfully I had brought a few frying pans and lids in my luggage. I always bring my own yellow colored spatula so that even my family knows which spatula is mine! I also brought my Instant Pot in my luggage. Since Michaela and I are part of Dr. Li’s private practice of Chinese Herbs for Allergies, Dr. Li has asked that I only eat meat cooked in the Instant Pot to help my stomach heal, and purchasing another one in Orlando didn’t make sense. So we brought a second suitcase with all these kitchen supplies!

All the grocery shopping and driving took us half of the first day in Orlando to set ourselves up. Then the fun began!

We went to the Kennedy Space Center and Cape Canaveral for our first outing. We packed our lunches and left them in a cooler in the car while we visited the Cape. We neglected to call ahead to see if a microwave would be available, and later we were told it wasn’t. In fact, they wouldn’t even allow any outside food in the space center, even with a medical condition from what we were told. So we ate our lunch cold (cold potatoes, broccoli and chicken will fill up the stomach, but doesn’t make a tasty meal!)  in the car. Not the ideal situation, but we enjoyed each other’s company. And with my husband being a space enthusiast, we had a great time seeing all the exhibits.

We headed down to Cocoa Beach that same day. Being from Colorado, getting to see the ocean is a big deal. We enjoyed it thoroughly, especially since it is “low season” and there was hardly anyone else there, despite what we would call hot weather in December – mid-70’s!

Cocoa Beach

The next day, we went to Disney Animal Kingdom. We wanted to especially see the new Pandora – World of Avatar, and to visit the Tree of Life. Michaela and I had to pre-make our meals the night before so that we would just have to heat them in the park. Morgan and Robert were able to bring salads and sandwiches – no heating required!

The Tree of Life in the Center of Disney Animal Kingdom

We searched online and found that they have lockers near the opening gate, which is where we put all of our lunchboxes plus snacks. Thanks to an inquiry on my AllergicChild Facebook page, I found out that the park does have one microwave for the public in the Baby Center area.

The park doesn’t have a lot of air conditioned locations, and with the temperature in the lower 80’s plus the humidity, our daughter began to have heat issues. You may remember me blogging about this issue here when she ended up hospitalized after having two grand mal seizures.

Thankfully, right next to the Baby Center, there was a First Aid office. She was able to get a bag of ice and sit in air conditioning for a little while to cool off. Twice more during the day, she went to First Aid to get more ice. I can’t say enough nice things about the Disney employees in First Aid – they were just magnificent. Each time she would come in, they provided a large plastic baggie of ice, and remembered her name from the first time. They treated her with such kindness, and we were so grateful for that.

Since the lockers we chose were at the park entrance, and the baby center was in the center, Michaela would walk with her plate of food piled high with cauliflower, carrots and squash nibbling until she got to the microwave. Several times, we had people stop us asking where she got her food! Dozens of people in the locker area brought their own food. Disney asked no questions about the coolers or even the water I brought in, which was wonderful.

The day was really long since we stayed for the River of Lights nighttime show, but it was well worth it.

River of Lights Show at Disney Animal Kingdom

We had all walked miles, and with feet hurting, we headed back to our AirBnB ready for bed!

We took a rest day the next day, and Michaela and I headed out to visit a Network Spinal Analysis chiropractor in the Orlando area. These doctors are specifically trained in a type of chiropractic work that involves gentle, precise touch to the spine cuing the brain to create new wellness promoting strategies.

We’ve found that part of the mast cell symptoms is extreme back pain, and all the walking we did the previous day was wreaking havoc on our spines. We found a lovely young woman who had recently opened her practice, and got us aligned and ready to walk the next day at Universal Studios Wizarding World of Harry Potter!

This was the big event that we were most looking forward to.  Universal  also had no issue with us bringing food into the park. And I brought my own water without anyone asking anything about it.

The lockers were once again near the opening gate of the park, however this time the microwave was very close in a “nursing room” in the family center.

We decided to purchase the 2-park pass since Hogsmeade is in one park, and Diagon Alley in another. My husband owns a marketing consulting firm, and he declared that as good marketing! And, of course, much more costly, but well worth it.

The Knight’s Bus in “London”

The weather was much cooler on this day (mid-60’s), and foggy which made for a great day to visit the magical world of London,  feeling it was somewhat realistic to their actual weather.

We next went to Diagon Alley where Morgan got to taste his first Butter Beer.

Tasting Butter Beer for the first time!

Morgan had previously emailed Universal to inquire about whether Butter Beer would be safe for him. He listed his food allergens, and got this response:

Burdick, Bob (NBCUniversal, Orlando) ([email protected]) wrote:

Hi, in Universal Studios, we have fruit stands in the parks with apples, oranges, grapes, watermelon on them. Also have lemon and strawberry slush carts which will be ok, also have turkey legs on carts that are just smoke plain. We have a full service unit it is Lombard’s landing and Finnegan’s, we have a chef in each unit have the server bring the chef to the table and he can go over all the things he can do for you In Islands of Adventure we have 2 full service units one called Confisco’s and one is Mytho’s, we have Chefs in both of those units, have server bring Chef to table and he can go over the things he can do for you, we have another walk up unit it is Thunder Falls, we have smoke chicken, smoke pork ribs, and roasted corn on cob and roasted potatoes with fresh herbs and salt and pepper, also have French fries all natural cooked in soy blend oil that is the only thing cooked in those fryers too.  I will also say no desserts at all from any of the restaurants too. 

We also have three broomsticks which have smoked chicken and smoked pork ribs, roasted corn on cob, baked potatoes, roasted potatoes with onions, garlic, salt and pepper, and fresh herbs and some salads too.  

The butterbeer is nut free, is made in a separate room. Pretzels and popcorn are ok too. The soft serve is ok at florean ice cream shop, not the hard pack ice cream. The restaurants in citywalk will be able to help you with your allergy all units have 4 chefs in them   

If you need any more information or help feel free to give me a call at 321-388-2123, Chef Bob.

We never purchased any food product in the park, but it was lovely to have all this information if we did. There was a lot of fish and chips on the menus in both Diagon Alley and Hogsmeade, but obviously there would have been safe food items if Morgan had wanted to eat.

There were several shops with candies and sweets in them. This is the ingredient label on the back of Chocolate Frogs which states, “Contains Milk and Soy. Allergen information: Shares Equipment With and Produced in a Facility Containing Milk, Egg, Peanuts, Tree Nuts, Wheat and Soy.” We didn’t find one candy that didn’t have this labeling. The candies were great for gifts, but not safe for Morgan to eat.

The Wizarding World overall was superb. If you go, you have to purchase a wand! There is a map of all the locations where the wand will work it’s magic…I’ll leave it at that because that’s part of the fun figuring out how to create the magic!

There were rides and shops throughout both parks, and once again we walked until our feet swelled! We road the train, the Hogwarts Express, in between the two parks.

Mischief Managed!

The next day was a rest day to pack up and get ready to fly home. We realized that we had cooked 21 meals on the 4-burner stove in the Air BnB kitchen, and no one went hungry!

If your family is like ours, and doesn’t or can’t eat out, it’s still possible to have a wonderful vacation and cook every meal yourself. With a lot of pre-planning and preparation, we had the most wonderful, magical vacation!

 

 

 

College with Food Allergies, Travel/Eating Out & Food Allergy

A Private Chef and a Broadway Show

The Broadway Show Rent!

I had a really unique opportunity last week. As the Student Body President at the University of Denver (DU), I get invited to events and special functions all the time – but this time was particularly special. The Broadway musical Rent was visiting Denver and our Vice Chancellor of Advancement at DU (his name is Armin) invited myself, the Student Body Vice President, and two of our student government representatives to go out to dinner with him and his husband and then see the play! Armin is essentially in charge of fundraising for our university, so this was quite an honor.

We began coordinating a dinner place over email. While the Vice President (Darylann) and I had previously had lunch with Armin, I had no expectation that he would remember my food allergies. He first offered a spicy Chinese restaurant in the area. I counter-offered with two local restaurants I knew would be safe (and not incredibly expensive either). Armin tried to reserve a table at either of those restaurants, but they were all booked up.

Instead, he hired a private chef.

I can say with absolute certainty, I’ve never had an experience quite like this. A private chef? At Armin’s fancy place in downtown Denver? And then a Broadway show?? I was completely blown away. Armin asked us to all send along our food allergies or other requirements so the chef could adequately prepare food.

One of the student government representatives, Jake, has Celiac Disease. Darylann has gastrointestinal issues that prevent her from consuming dairy. And I have my own food allergies to peanuts, tree nuts, sesame, shellfish, and fish. (The other rep, Scott, doesn’t have any intolerances or allergies). Darylann, Jake, and I all were joking the chef was just going to serve us a bowl of rice and call it quits!! We underestimated the chef’s ability severely.

The chef, Megan, was incredible. She prepared a four-part meal: a salad with vinaigrette and watermelon beets, a sautéed butternut squash with spicy vinaigrette and yogurt, baked chicken breast with mushrooms and a delicious creamy sauce, and cherry meringue kisses for dessert. It was all 100% safe. She double checked all of the ingredients, prepared Darylann’s dinner without the yogurt and cream sauce, and accommodated all of my allergies perfectly. It was incredible. She was completely at ease accommodating all of our food allergies and intolerances and double checked with all of us.

The show afterward was fun too!! I was still shaking in my boots by how awesome (and delicious) the dinner was and how successful the chef was in accommodating all of our allergies and intolerances. This just goes to show that multiple different food allergies can and will be accommodated in a professional setting with a caveat – make sure to speak up about your needs! This was an exquisite experience!

Emotional Aspects of Food Allergies

Food Allergy Anxiety

At the recent Food Allergy Bloggers Conference, there was an excellent session lead by Dr. Abby Herzig of WeBelay .

Dr. Herzig is a Child and Adult Clinical Psychologist who led one of the best discussions I’ve ever participated in about food allergy anxiety. The best part was the audience participation. So many Moms and Dads shared about their own anxiety, and that of their child. Some shared that their child was way too brazen creating more anxiety for them as the parent, while others were concerned that their child’s recent allergic reactions were affecting their ability to enjoy food and eat.

I had so much anxiety when my son, Morgan, was diagnosed with peanut and egg allergies in 1997 at the age of 18 months old.  My anxiety was high because Morgan reacted not only foods, but also to pollens in the environment – dandelions were one of his worst reactions – and to dogs and cats. He also had weeping wounds of eczema all over his body. All of this created a fight or flight response in me every time I took him out of the house. I used to joke that Benadryl was a food group for him.

When children are too young to speak for themselves, it’s the responsibility of the parent to educate others about food allergies – and any other allergies too. And that’s a heavy load at times. How to stand up to extended family  was a topic in the conference session, and many different ideas were brought forth.

Having everyone in the family over to our house was how we managed it. We cooked all the food that our son was going to eat, and we asked that none of his allergens – which grew to a list of peanuts, tree nuts, sesame, fish and shellfish – be brought into the house. (He outgrew his egg allergy by middle school.)

For some parents in the session, spending a holiday cooking for other family members wasn’t what they wanted to do. Some had made arrangements to go to other family’s homes with the caveat that none of their child’s food allergens would be served. For us, the biggest issue was the dog and cat allergies, and all of our extended family had one or the other in their homes.

At the conference, we discussed that managing extended family helps our children to learn boundaries as we set those boundaries about what is safe and what isn’t safe for our child. It isn’t easy to stand up to one’s mother-in-law, but showing a child how to do that gives lessons that no amount of talking can provide.

Another great part of the session was the support that everyone gave and received. Too many times on social media, I’ve found that parenting styles can be criticized. Food allergy accommodations are questioned by others as too lenient or too strict. When you’re looking someone in the eye during a conversation, it’s much easier to support them where they’re at, and to see their concern.

For those with children brimming over with anxiety, we spoke about the need for counseling to get underneath where the anxiety is coming from. Some children have stories in their mind about a recent anaphylaxis episode that might not actually be factual. Yet it’s important to discover what the story is, and to mitigate the anxiety.

My son has never shown much anxiety over his food allergies, even when he experienced anaphylaxis during a camping trip. When my husband called me from the ER, he put my son on the phone to let me know he was fine. My son’s first words were, “I’m not coming home.” Of course, I was an anxious mess hearing the harrowing tale of eating his first bite of fish, and I wanted to see him in person to ensure everything was okay. However, I yielded to his sense of himself, and agreed that he could stay with his Dad watching over him cautiously. Not every kid would feel that way after experiencing anaphylaxis, and that’s okay too.

If you or your child are experiencing debilitating food allergy anxiety, where depression is setting in and/or eating is becoming a difficulty for your child, I’d like to suggest: Share your feelings with a professional! You don’t need to suffer, nor does your child. Some of the strongest people I know ask for help.

If you or your child are experiencing food allergy anxiety on a situational basis, there are many articles and research online that might be helpful:

Food allergies linked to childhood anxiety

Allergy’s High Anxiety: How to Tame Kids’ Fears of Food Reactions

The link between food allergies and childhood anxiety

and Dr. Scott Sicherer’s newly updated book, Food Allergies: A Complete Guide for Eating When Your Life Depends on It also has information about how to manage food allergy anxiety.

The online food allergy community can be a great resource too. There are Facebook pages for all age ranges, and various combinations of specific food allergies that are managed. Some local communities have in-person support group meetings on a monthly or quarterly basis, where you can meet people face-to-face managing a lifestyle similar to yours.

I’ve found the best anxiety reliever is to talk with an understanding friend…preferably someone who has been there!

 

 

 

Food Allergy Bloggers Conference

Blogger & Consumer Advocacy Conference Wrap Up

I enjoyed another FABulous conference in Denver this past weekend with many of the top food allergy bloggers and consumer advocates.

This conference was the brain child of Jenny Sprague, who continues to run the conference along with Erica Dermer and Keeley McGuire.

Erica Dermer, Jenny Sprague, Keeley McGuire

My son was diagnosed with food allergies 20 years ago…before Facebook, before the Internet, before there was a support group or any food allergy conference, and before any food labeling law. About the only thing that was around was a very kind allergist who gave me copied materials from a non-profit group called Food Allergy Network (through several name iterations, it has now become FARE – Food Allergy Research & Education). It was a lonely place, and my neighbors certainly didn’t understand what it was like to try to raise a child with food allergies.

Going to the conference this weekend, I was most reminded of how grateful I am that there are so many people in the “food allergy world” now. Bloggers, parents, allergists, dietitians – all shared their experience, their knowledge, the latest research and hope. It’s not a group in which I ever aspired to be a member, but as I continue to walk the road of parenting a child – now a young adult – with food allergies, I am so thankful to be able to do so with a large group of friends.

Here are a few highlights from the conference:

All four national food allergy advocate groups – Allergy & Asthma Network, Food Allergy Research & Education (FARE), Food Allergy & Anaphylaxis Connection Team (FAACT), Kids With Food Allergies (KFA) -along with Kaleo discussed their new initiative to address food allergy bullying called No Appetite for Bullying.

Zac Chelini, a young adult with multiple food allergies, also spoke about his experience with bullying in grade school and beyond. If you’ve experienced bullying, or know someone who has, you can submit the experience on the website  referenced above and help raise awareness of this very important issue.

The expo at the Conference is the best I’ve ever seen. It’s so wonderful to get to sample new products and foods – many of which are top 8 allergen free or more!

Enjoy Life Foods

Enjoy Life Foods is a regular at expos and conferences, and for good reason. Their foods are free of the top 8 plus they are made without casein, potato, sesame and sulfites.

Kiss Freely

Kiss Freely is all natural, gluten and allergen free makeup, lip gloss, face paint and body cream. Their products are free of the top 8 allergens plus free of sesame, shea butter, peas, coconut, avocado and sunflower seed. I love the new body butter I discovered at their booth!

Allergy Superheroes

Allergy Superheroes empowers and protects allergy kids with their t-shirts, slap bracelets, buttons and Teal Pumpkins. Their focus is consistently positive and creative!

Angie & Steve of Sit By Me Bakery

Sit By Me Bakery is a Colorado duo baking without gluten, wheat, dairy, egg, soy, peanut, tree nuts (they do use coconut*), fish, shellfish, seeds, potato, corn, yeast, artificial colors, and preservatives. They provided many of the sweets for the conference. Steve was nice enough to provide a cinnamon roll for my son, Morgan, to try. It was a hit!

Morgan Smith, skipping the last of his meal, to eat a Sit By Me Cinnamon Roll!

The swag bags from the expo are filled with so many wonderful new treats, that I had to stop by my son’s place in Denver to share many of the goodies!

Free2b Foods Founder, David Lurie, and Nicole Smith, AllergicChild

Free2b  never allows peanuts, tree nuts, dairy, gluten/wheat, soy, egg, shellfish, fish, coconut, corn, mustard, or sesame in their plant or products. They are also free from artificial sweeteners, flavors, colors, sulphites, GMOs, hydrogenated oils and transfats. David continues to develop new products in an attempt to make them taste even better than their “original” counterparts.

There were probably two dozen more companies and products at the expo, so these are just a sample of a few of them. If you’re in Colorado, you REALLY want to come to this conference to sample all of the exciting new products every year.

Evan Edwards of Kaleo & Nicole Smith of AllergicChild

For the past two years, Kaleo has been a major sponsor of the Conference. Evan Edwards is not only a founder and executive with Kaleo, he’s also a food allergy patient and parent. Which means that he’s just one of us. He participated in many of the sessions, learning about new research, and sharing his experience. It’s wonderful to have a pharmacy executive who is so down-to-earth. Kaleo has doubled in size as they continue to produce the wonderful Auvi-Q epinephrine autoinjector.

In separate blog posts, I will provide you some information that was shared about recent research and how to manage parental and child anxiety surrounding food allergies. Watch for those soon!

Thank you to everyone in attendance for a wonderful weekend!

Food Allergy & Anaphylaxis

Recent Research on Fatal Food Anaphylaxis

The American Academy of Allergy, Asthma & Immunology recently released research on fatal anaphylaxis based upon research of deaths in the UK, France, Canada, Australia and the USA. They looked at fatalities from drug and venom anaphylaxis in addition to food anaphylaxis.

The research found that “Up to 5% of the US population has suffered anaphylaxis.” They found that fatal anaphylaxis is rare, and while drug anaphylaxis is increasing, fatal anaphylaxis to venom and food is stable. The time periods looked at for each country varied, but was at least for a time span of 10 years.

Emergency-Room-ER-1

The research found that “infants and young children have the highest reported rates of food-related anaphylaxis and subsequent hospitalization, fatal food anaphylaxis in this age group is very rare indeed.” The highest risk for fatal food anaphylaxis occurs in the second or third decades (10-19 years old; and 20-29 years old). Most of the fatal food anaphylaxis occurred in people with a known food allergy where many of the previous reactions were not severe.

Another risk factor was the delayed use of epinephrine. This risk factor is the easiest to correct. Always carry your epinephrine autoinjector if you have been prescribed one!

Asthma is a risk factor for fatal food anaphylaxis, which was noted in approximately 70 to 75% of fatalities in the UK and Australia data. Yet, the data didn’t distinguish whether poor asthma control was associated with a fatal outcome.

Other risk factors were alcohol, recreations drugs and remaining standing upright in anaphylaxis. The researchers postulated that alcohol “or recreational drugs may, through disinhibition, increase the likelihood of accidental allergen exposure, mask the early warning signs of anaphylaxis, or suppress physiological responses to hypotension.” Also, alcohol can increase the absorption of food allergens into the intestine because of increased permeability.

In this research,  which foods caused the fatal anaphylaxis was not reviewed.

What are the takeaways for food allergy families from this research?

  1. Always have an epinephrine autoinjector within arm’s reach!
  2. Be very mindful of teens and young adults and whether they are practicing a vigilant lifestyle around their food allergies. This training starts young, and children watch what we parents do, not what we say.
  3. In our son’s school Health Care Plan, our doctor stipulated that should he experience any type of reaction, he should be laid down flat with his knees bent. She also stated that he should never be sent to the office, walking down the hallway, should he be feeling the beginning of an allergic reaction.
  4. If your child has asthma, we have always been told that it’s important to keep it well managed to afford the best possible outcome if an allergic reaction occurs.
  5. Have a frank, honest talk with your child about alcohol and drugs and the impact on all the areas of their life, but especially the consequences when managing food allergies.

If you’d like to read the full text of the research you can do so here.

Food Allergy & Anaphylaxis, Research for a Cure

A Little Doctor Chat About Food Allergies

At the recent FARE (Food Allergy Research & Education) walk in Denver, my son, Morgan, and I had the opportunity to have a long chat with Dr. David Fleischer of Children’s Hospital of Colorado. The conversation brought up a lot topics around living with severe food allergies.

2017-08-12 08.50.52 HDR

When Morgan was 14 years old, he was sent by our allergist in Colorado Springs to see Dr. Fleischer, who was then at National Jewish Health in Denver. Morgan was going to have a food challenge to eggs and to pinto beans, and she didn’t want to have the challenge in her office because of Morgan’s past severe reactions and anaphylaxis to foods.

Morgan had to go through a battery of tests – a skin prick test and a blood test to ensure that his levels to both foods was low enough to warrant a food challenge, an asthma FENO (Fractional exhaled nitric oxide) test and numerous other breathing tests – before undergoing the food challenges. I was very impressed with the thoroughness of Dr. Fleischer, and the fact that the hospital prepared all the food to ensure proper dosing for the challenge.

He passed both challenges, which were done on separate days. Now 7 years later, we run into Dr. Fleischer at anything food allergy related in Colorado, and he always remembers Morgan and me. He’s very committed to assisting children with food allergy, eczema, and asthma and their families.

During our conversation at the FARE walk, we covered many topics. The most interesting topic was all of the ongoing research to find a cure for food allergies.

Morgan has never had an interest in participating in any of the studies, and at this point he is likely too old to do so under the guidelines of many research studies.  At 21 years old, Morgan is accustomed to living with allergies to peanuts, tree nuts, sesame, fish and shellfish. He’s not interested in eating any of these foods, and he’s definitely not worried about cross contact to the point of limiting his activities. He is appropriately vigilant, and takes the time to prepare for any events that include food, and always carries his Auvi-Q’s.

For other food allergy families, who aren’t interested in trying out treatments, or participating in research studies, our family “gets it”.

Dr. Fleischer had commented that for Morgan, life is easier managing food allergies than being a study participant in the hopes of gaining tolerance. It was nice to get affirmation from Dr. Fleischer that Morgan can live a complete life, with all kinds of opportunities and adventures, managing his food allergies throughout adulthood.

 

 

 

Eosinophils & Mast Cells

Mast Cell Disorders and Other Medical Conditions

Through the years I’ve shared our stories of managing food allergies (in our now college age son). Rarely have I shared stories about our adult daughter with celiac disease and mast cell issues. This time, I’m going to share about her recent experience, since there are so many things we learned.

Earlier in July, Michaela got overheated while being outside in the Colorado sun enjoying a festival. She was mostly inside a tent, but since there was no electricity, the air was stale and approaching 100 degrees. She estimates she drank 8 bottles of water during 4 hours of being at the festival trying to keep herself hydrated. She knew that she needed to keep pushing the fluids, even if it activated her interstitial cystitis.  It’s a constant balancing act for her to drink enough to stay hydrated, but not end up in the bathroom every 30 minutes.

She began to feel drained and went back home and drank more water thinking she was still dehydrated. Her first mistake, we learned, was to not drink fluids with electrolytes. With her mast cell disorder centered in her gut, she is very careful to eat only organic foods and pure water. She doesn’t drink Gatorade because of the coloring in it, but there are electrolyte alternatives, we’ve since learned!

A few hours later she began vomiting every few minutes and having diarrhea, and felt thoroughly awful. At that point, I felt she probably needed an IV of saline to help her body get regulated. On a Sunday evening, there wasn’t any choice but to go to the Emergency Room. At the ER, we told them about her mast cell disorder and wondered if she could be triggered by the heat of the day and having a mast cell reaction. The nurse on duty was somewhat aware of mast cell issues, which was nice. They put in an IV, gave her saline, and Zofran (to ease the nausea), and gave her oxygen since her pulseox was low. She still wasn’t feeling great, so they gave her 25 mg of Benadryl with some extra saline so it wouldn’t burn on the way in.

Shortly thereafter, she began saying “I feel so disconnected” over and over again. Then, within a few minutes, she had a grand mal seizure right in front of my husband and me!

We’ve been through a lot of medical issues with our children through the years, but nothing compares to the horror of observing a seizure of this magnitude. It lasted for about 20 seconds, which seemed like 20 years. She was frothing at the mouth, with a horrible guttural sound emanating. Her arms were drawn up to her chin, wrists bent, while her face and chest turned beet red. Her eyes rolled back into her head and she became unconscious. We screamed for help and the medical staff came running and gave her 2 mg of Ativan.

Once the seizure stopped, they took her in for a CT scan of her brain to see if there was something occurring there, and she had another seizure, from what we were told, during the scan and received another 2 mg of Ativan.

Since we were at an Urgent Care Facility that transforms to an ER in the after hours, they needed to get her to a hospital for observation overnight. She was transported by ambulance to St. Francis Hospital, and my husband joined her for the ride while I drove behind in the car. She was completely unable to respond to any commands during the ride to the hospital. My husband said that the EMTs kept talking to her trying to get her to squeeze a hand or say something. There was no sign of any cognition or awareness at that point.

I called our son, Morgan, during my drive to let him know what was occurring. He is in Denver working this summer, and by this point it was 10 pm. He jumped into his car to make the hour drive to the hospital.

By the time I arrived, she was processed into a room. We were told there was nothing on the CT scan that would indicate it was a brain disorder causing the seizure. The hospital doctor thought that it was too much water, and not enough electrolytes since her sodium count was at 126. (Her normal sodium count is 140 from previous blood tests).

Morgan arrived by 11:30 pm and walked into the room, got really close to Michaela’s face and called out her name. It was the first sign of any recognition or response when she mumbled “back hurts” and then a tear rolled down her cheek when he was talking with her.

She slowly was able to respond to commands, but was completely confused as to where she was and why. We would go through the entire story, and 15 minutes later, she would ask again, “Where am I?” It was frightening, and we worked on not jumping to conclusions.

My husband remained in the hospital overnight with her, while Morgan and I went home to catch a few hours of sleep. All night she was writhing in back pain as the doctor and nurses tried to figure out why. They took an x-ray, which showed nothing broken in her back, and they summarized it as muscle spasms from the seizures.

The next day Michaela was sent home with instructions to do a follow up with a neurologist and her primary care doctor. The chest x-ray showed no issues of aspiration, so we felt she’d do better at home getting some sleep. She had virtually no short term memory though. We were frightened that there was a serious cognitive issue occurring, and spent a lot of time Googling seizure side effects and the aftermath.

Within 24 hours of her release, she was running a 103 temperature, and back to the emergency room we went – this time to the ER attached to St. Francis hospital. The ER doctor was concerned about meningitis, so a spinal tap was ordered in the ER. It thankfully showed negative. Then the chest x-ray came back and showed that she had aspiration pneumonia. She was hooked up to an IV for saline, and put back on oxygen because her oxygen percentage was plummeting into the low 80’s.

There wasn’t one doctor or nurse who was aware of mast cell activation disorders, so we were explaining over and over again what medicine to give her and what not to give her. Thankfully, each person was receptive enough to listen and to learn.

She was put into the hospital overnight again. She began receiving IV antibiotics immediately. She cannot tolerate Tylenol or any NSAIDS (NSAIDS are a mast cell degranulator and not recommended for those with mast cell issues). Therefore, the nurses brought cool cloths and ice packs to bring her temperature down.

Her back pain was still horrific, so she was started on an IV pump of Fentanyl, the only pain medication suggested for mast cell patients, other than Tramadol. That began to help the pain subside, and to allow her to rest.

The neurological tests were ordered while she was in the hospital. She had an MRI and an EEG of the brain. Nothing appeared to be abnormal, which was an incredible gift. The short term memory loss, we were told, was a normal by product of the seizures and should get better over time.

An MRI of her lumbar spine showed two bulging disks, which were the source of all her back pain. It was postulated that the seizure caused these, which is amazing that the body can hurt itself so badly!

2017-07-13 20.18.40

Since Michaela owns a pet sitting and dog walking business, she was trying to keep up with everything while in the hospital. The short term memory loss made for some interesting issues as I tried to work her phone and to ensure all the dogs, cats, and pet sitters were taken care of! At one point, I had to ban her from being on the phone unless I was there to ensure she didn’t schedule something and then forget!

While she was in the hospital, my husband and I were running home to cook her safe foods to eat and then transporting them to her room. There was nothing on the hospital menu that was organic. And the hospital had no refrigeration that we could use, so we were bringing coolers from home or getting ice from the nurse’s station and adding it to mini tubs in the room to keep her food refrigerated.

It was a very long week. By Friday, we were both so exhausted from tag teaming. I slept in the hospital for 3 nights (if you’d call 3 hours of interrupted sleep really sleeping!) and then went home for a short nap. After that I monitored her pet sitters and her business during the day. My husband slept at home and then cooked safe food for her. He worked from her bedside during the day, and continued to train doctors, nurses and CNA’s about mast cell issues and celiac disease.

The infectious disease doctor wanted to release her with oral antibiotics since she’d had 3 days of IV antibiotics by the time she was being discharged. We nixed that idea since she has had so many gut issues with antibiotics, and were thrilled that she was tolerating the medication as well as she was. The doctor agreed to have a PICC (peripherally inserted central catheter) inserted into her arm to her heart, and to have her Dad and I taught by a home healthcare nurse how to administer the antibiotic every 6 hours around the clock for another 5 days.

In the almost 4 days she was in the hospital on the second round, we ran into only one CNA who had heard of mast cell activation. She had just taken a biochemistry class in school where it had been discussed. There were so many conversations where we had to explain what could occur if she was triggered by, for example, contrast dye in an MRI. There is so much need for the medical community to be trained on Mast Cell Activation!

Once home, we began the around the clock antibiotic administration. It was almost like a feeding schedule of a newborn baby.

After being on antibiotics for a few days at home, she began to experience burning mouth – a sign of oral thrush. We then added Fluconazole to her list of drugs administered through her PICC line.

When she visited her primary care doctor, as a follow up to the hospital visit, he thought that the heat had triggered a mast cell “event” creating the massive purge of vomiting and diarrhea that she experienced. On top of that, her not drinking electrolyte water created a sodium imbalance. The two issues combined to drop her sodium suddenly, creating the seizure. That was his best guess as to the cause of the seizures. We may never know for sure. However, we’re very grateful that it doesn’t appear to be anything related to her brain function.

She visited a wonderful chiropractor that has helped to re-align her back so that the 2 bulging disks are slowly dissipating.

With mast cell issues, and the various autoimmune diagnoses that she has, keeping her body in balance is a daily struggle. She has learned that she’s going to have to be FAR more careful about being in high temperatures and getting overheated. She’s also discovering many electrolyte drinks to enjoy.

It’s amazing what the body can go through, and that it can heal! We so appreciate all the love and prayers you have provided to her and to our family through this harrowing episode.

College with Food Allergies, Food Allergy & Anaphylaxis

Non-Food Allergy Related ER Visits

If you’re like me you’re prepared for an ER visit for an accidental food allergy exposure – even if you hope it never happens! However, when there’s an ER visit for a non-food allergy related event, different issues can come up in the hospital, and it’s vitally important for our grown children to know medical details about themselves. We learned and confirmed this firsthand this past weekend.

swedish

My college age son is working and living in Denver this summer. He awoke last Saturday morning feeling like he was catching a cold. Within a few hours, this turned into severe stomach pains above and around his navel, especially on the lower right side. After 7 hours of feeling worse and worse, with oncoming rounds of nausea, he called my husband and I via Facebook messenger (more on that detail below!) We went through the usual questions of “did you eat anything new?” and “what are your symptoms?”

After listening to his complaints and the severity, we were concerned about an appendicitis or a gallbladder attack (since gallbladder removal is common in my family). He hadn’t eaten anything new, and didn’t feel like he was dealing with anaphylaxis presenting itself differently. We felt he needed to get to the ER to be seen by a doctor and to have tests run. We have learned to not mess around with medical issues with Morgan, with his past history of anaphylaxis and other illnesses in college.

After learning that he was alone in his apartment – all 3 roommates were out of town – we needed to figure out what to do at 8pm on a Saturday evening to get him to be seen by a doctor. He was feeling so awful that he didn’t feel like he could drive, and  didn’t want to wait an hour for us to drive to Denver to pick him up. After several text messages, he was able to find a friend in Denver willing to come pick him up and take him to the ER at Swedish Medical Center, which is less than 2 miles from his apartment.

His phone battery had been ceasing to stay charged, along with the phone having a shattered screen, so everything was being coordinated on an iPad with no data plan utilizing Facebook messenger on wifi, and texting, with no “regular” phone voice communication . Oy!

Morgan was picked up by his friend within 10 minutes, and we jumped in the car for the one hour drive to Denver. Thankfully that late at night there was less traffic. The same route during the day could take twice as long, and believe me every minute feels like an hour when you’re trying to get to your child in the ER.

Once we arrived, Morgan had already met with the physician’s assistant, reviewed his food allergies, and explained that he has had adverse reactions to pain meds (vomiting) when she offered him some pain relief. The PA ordered a blood draw, an IV saline drip, and a CT scan of his abdomen. When she heard that Morgan was allergic to shellfish, she wanted to ensure that the iodine dye in the CT scan was going to be safe. (Note: this is an old allergy myth that those allergic to shellfish will be allergic to iodine. The proteins are not the same, and therefore there is no risk. However, you can be allergic to iodine, and those with mast cell issues can have severe reactions to contrast dyes.)

We were very impressed with the thoroughness of Swedish Medical staff – physician, physician’s assistant and registered nurse – and their attention to the details of Morgan’s allergies and allergy history. I’d rather they be extra cautious about his food allergies than to blow past the long list of food allergies that he has (peanuts, tree nuts, sesame, fish and shellfish). They also listened to his history of pain medication issues, and honored his wishes to not take any of these medications.

This was the first time that he’s been over 21 years old at an ER. My husband and I were basically observers. All forms were signed by him, and all medical questions were answered by him. Of course, the required copayment was paid by us, since as a student, he is still on our insurance!

It took only a little over 90 minutes from the time he entered the ER to receive results of the blood tests and CT scan. Very impressive for a Saturday night! The CT scan showed no stones in the gallbladder, and the appendix appeared to be fine. Therefore, the stomach cramps could be from the virus he had, from an ulcer, or the start of some issue much larger – like the gallbladder or appendix – and it was too early for them to see anything on the scan. Who knows exactly what it could have been, in other words!

We rang in Father’s Day at midnight waiting for a little medication to be delivered. The IV saline drip was definitely helping Morgan feel better, even though he didn’t believe he was dehydrated. The doctor gave him a ” digestive cocktail” of Pepcid, Maalox, Lidocaine and Benadryl, which tasted awful but helped the stomach and intestinal cramping tremendously. He also walked out of the ER with prescriptions for more Pepcid and Zofran, an anti-nausea drug.

One of Morgan’s roommates had arrived back at their apartment while he was at the ER and was willing to be ‘on call’ should anything happen overnight necessitating assistance. As a Mom, this was a hard one – to let him go back to his apartment instead of coming home with his Dad and me. He’s a young man now, and he believed this was the best choice for him.

At the time of this writing, he is feeling much better and we’ve chalked up the ER visit to “who knows”! We’re very grateful Morgan knew to not wait until the middle of the night to ask for help. And we’re also grateful for the staff at Swedish Medical who treated him with utmost care and respect toward his food allergies and his wishes.

It is vital for our children with food allergies to know the details of their food allergies and medical history. I’ve written a blog post here about what we ensured Morgan knew before he went to college. Morgan’s previous issues with pain medications aren’t considered an allergy, but they are definitely pertinent for him to share with a doctor.

My husband and I enjoyed a traffic-free drive home to Colorado Springs in the early morning hours of Father’s Day grateful that no surgery is in Morgan’s immediate future. And hoping that he gets his phone fixed this week!

Food Allergy & Families

Food Equality Initiative (FEI) Provides Food Allergy Hunger Relief

FAI

Food Equality Initiative (FEI), based in Kansas City, Kansas, provides hunger relief for those with celiac disease and/or food allergies through its pantry of safe foods for families in need. As its website states, “Food Equality Initiative, Inc. (FEI) is a recognized non-profit, public benefit corporation established in 2014 by Emily Brown and Amy Goode, to support the low-income food allergy and Celiac communities by providing safe, healthy gluten free and allergy friendly food, nutrition education and advocacy.”

For those of us managing either food allergy or celiac disease, we know how expensive it is to purchase safe foods. Yet, imagine if you couldn’t afford to purchase safe foods for your child! And to make matters worse, when you went to a food bank, there were no safe foods for you to obtain. Or imagine if you applied for WIC (Women Infants & Children) only to find out that there are no substitutions for peanut butter, milk or whole wheat bread. This is why FEI was created.

FEI is advocating for WIC substitutions in addition to the following, as quoted from their website:

  • Establish best practices for the charitable food system to identify, sort, store, and distribute special diet foods
  • Establish nutrition policies that reflects the needs of food insecure individuals with special diets in school and community settings.
  • Push for legislation that provides Insurance coverage of gluten free and allergy friendly foods for a medically necessary diet.

The amazing part of FEI is that not only do they have a pantry in Kansas City for families with food allergies & celiac disease to shop in. They could also box and ship safe foods to families requesting such from around the USA if they had more funding. This all costs A LOT of money!

This is where FEI could really use the assistance of the food allergy community. There are many areas of the USA where families are in need of having a pantry of safe foods set up, similar to what FEI has created in Kansas City. If you have the desire to create this in your community, please contact FEI through their website here.

Donations of money are always appreciated.  You can donate directly to FEI on their website here.

If you’re reading this blog post and need assistance in affording safe food, please click here for more information about qualifications.

I applaud Emily Brown and Amy Goode on creating this wonderful organization, and I encourage each of you to support families in our community that can’t afford to provide safe foods for their children by donating your time or money to FEI.

For more information about FEI, you can read this article or this article by Allergic Living.

School & Food Allergies

Food Allergy Awareness Week 2017

Food Allergy Awareness Week is May 14-20 this year. Several of the food allergy non-profit groups have resources and suggestions for you to increase food allergy education and awareness in your community.

FARE (Food Allergy Research and Education) has resources and links here. FAACT (Food Allergy & Anaphylaxis Connection Team) has ideas of activities here. Kids with Food Allergies has social media awareness tools here. Turn It Teal has a listing, and an ability for you to suggest a location, of all buildings lit in teal (the food allergy awareness color) during the week here.

FAAW

There has been a big push to get elected officials to declare the week with a proclamation. I’ve always felt that unless this is followed by specific education, and awareness information disseminated to the public about food allergies, or a food allergy awareness event, there is little gain for the food allergy community with a piece of paper.

When my son was in school at a public K-12 school district, our Food Allergy Task Force would create a press release for each of the 30 schools in the district (elementary, middle and high school) detailing information about food allergies – how many children have food allergies, what the symptoms of an allergic reaction are, and how to have fun without food! These public service announcements were very valuable and generated discussions for families, teachers and administrators. This Task Force is celebrating 10 years of existence this spring, and continues to create more food allergy awareness throughout the school year.

For May 14-20 of this year, create some food allergy awareness in your family, with friends and/or in your community! It may save a life.

College with Food Allergies, Interviews, Travel/Eating Out & Food Allergy

AllerTrain Allergy Training for Chefs

Betsy Craig and her husband, Rocky, started AllerTrain, an ANSI accredited food allergy and gluten-free training course offered by MenuTrinfo (which, according to their website is “dedicated to bettering the food-service industry by providing two major services: Certified Nutritionals and food allergy/ gluten-free identification and education”.) The course teaches foodservice professionals about the top foods causing food allergies, proper protocol for preparing food so to avoid cross-contact and to how better serve diners with special dietary needs. This will help restaurants avoid food allergy related incidents, and prepare them to handle such incidents, should they occur.

AllerTrain by MenuTrinfo (3)

Where did the idea of AllerTrain originate and how long have you been in business?

AllerTrain was born out of my original business MenuTrinfo (mash-up of the words menu – nutrition  – information).  Once we set up our company nutritional software for industry in 2010 my husband realized he could tag allergens in menu items for the restaurants we provide nutritional service for.  I knew that in order for it to help those with food allergies, and this new movement of gluten-free, that training needed to be in place to make a difference.  Having food allergy friendly food was only step one in keeping diners safe and meeting special dietary needs.

I reached out to others in the food safety, restaurant, food nutrition, and training space to begin to build a training program I called AllerTrain.  This was October 2010.

Can you explain AllerSTAR and MenuTrinfo?

AllerSTAR takes learning objectives taught in the AllerTrain educational programs and makes them singular training points taught through a monthly poster and toolkit program.  This is to enhance the learning in AllerTrain and also to keep the topics of food allergies, gluten free and proper standard operating procedures on top of mind.  This poster training program is for all employed at a restaurant or college who does the month AllerSTAR program. Teach, test and sign off on the learning object creates ownership with the industry and staff at any food location that takes part in AllerSTAR.

I’ve seen that you’re training many chefs in colleges who have Sodexo. What other groups are you training?

Sodexo was a clear, eager and super helpful early adopter partner for AllerTrain but we have many folks who have trained within AllerTrain courses.  Folks at almost all Ivy League schools, key brands like Eat’n Park in PA, Glory Days Grill in the New England area, a part division of Panera Bread in TN, WV and VA, Cattlemen’s Steakhouse in CA, universities and colleges throughout the US (in the FARE college training program and out).  College food service management companies like Parkhurst, Culinart, Aramark, and Chartwells.  Many different private schools, a number of public K-12 districts, hundreds of schools in Texas, Training centers throughout the country, Amtrak, over 300 health officials in Virginia, over 75 food service professionals that work within the federal prison system, Food service managers at airports in a number of major cities, the head of F&B for the Olympics, and the list goes on and on…..

Can you tell us what is involved with training a chef at a restaurant and the staff?

A combination of training of the disease of food allergies, Celiac and intolerances, best practices for front and back of house, policy and procedure assistance and emergency protocol.   Ongoing training is also a major key to keeping folks trained and confident.

Does your training cover cross contact?

Yes there is a great deal of focus on cross contact.  It is key to successful food prep, cooking, delivery and satisfaction.

Do you suggest that restaurants and dining halls use separately colored utensils in the preparation of meals for food allergy and/or gluten free customers?

We fully and completely promote this concept and encourage the use of separate colors for food allergies and Gluten-free.  We use the same color for both of these special dietary needs, as the method to keep people safe is the same.  That is also why we teach both in AllerTrain. The teaching and tools are the same and desperately needed for success.

Do you provide ongoing training for a site and their employees? Or is it just a one time training?

Ongoing training is addressed through the AllerSTAR program.  Also many locations and universities have their staff go through AllerTrain once a year despite the fact the certificate is good for 5 years.  They want to keep the information top of mind yearly.

Thank you so much Betsy for creating this wonderful program to keep those with food allergy safe when dining out or in college!

 

School & Food Allergies

Why Betsy DeVos’ Confirmation is Personal to this Food Allergy Mom

If you’re worried that this is going to be a political tirade – never fear. Instead, I want to share with you our family’s experience about the value of the Individuals with Disability Education Act (IDEA), Section 504 of the Rehabilitation Act, and the Americans with Disability Act on my son’s education.

mj5yrs

When my son, Morgan, started kindergarten in the Fall of 2001, we had already experienced every private preschool in our city denying my son entry. There was minimal food allergy awareness at that time, and no one had heard of a child reacting to touching peanuts! Preschool teachers and administrators were afraid to learn how to administer the EpiPen and didn’t want to take on the liability OR they didn’t want to provide an allergen free classroom. Therefore, they said they didn’t want him as a student.

This was heartbreaking to my husband and I. We had no idea what it felt like to be denied schooling for our child. I had big thoughts about filing a lawsuit against the various preschools, however I soon realized that I didn’t want to fight for Morgan to be admitted to a school that didn’t want to take proper care of him.

I continued my search, and my son finally landed in a public preschool within our school district, where the teachers were more than willing to provide an allergen-free classroom and to learn how to administer the EpiPen should that be needed. Thankfully, he had a wonderful experience, and never had an allergic reaction since they removed all of his allergens (peanuts, tree nuts, sesame, fish and shellfish) from the classroom.

Once he started kindergarten, the elementary school counselor had the foresight to put Morgan on a 504 Plan.  She had already met with the school district 504 Coordinator prior to the start of the school year, and had received approval. This provided accommodations for him to have equal access to the curriculum. The Plan was pages long outlining classroom safety, EpiPen training, field trips, playground monitoring, and stipulations for all the other classrooms he would visit in a school day being allergen-free in addition to many other items.

This was long before the ADA Amendments Act of 2008 when eating was added as a “major life activity”, so the school district was really stepping out to put Morgan on a 504 Plan, (which he kept from kindergarten through 12th grade). I know many of you reading this are likely still fighting for all the 504 accommodations you believe your child needs. We were completely blessed with a school district who not only understood the law, but also were child-centered and wanted to create a safe, educational environment in which every child can learn.

Parents of other children in the classroom (and the school!) weren’t happy about the accommodations, especially if it meant that their child couldn’t eat a Snickers bar for snack. The school Principal kept a strong backbone, and stood up for Morgan (and me!) more times than I can count. She knew the law, and she knew what was right and what was necessary for Morgan to be in school safely.

If you’ve been reading my blog (and newsletter before that), you know that we had many ups and downs through the years battling other parents bullying and ignorant teachers. Yet overall, our experience was good, because 1) Morgan never did experience an allergic reaction and 2) if there was ever a question that the 504 Plan wasn’t being followed, a Team meeting was immediately called and the Plan prevailed.

During Morgan’ senior year of high school, he applied for and received the Boettcher Scholarship, a 4-year, full ride scholarship (available only to Colorado high school seniors) to any Colorado college of his choice. Only 40 scholarships were given his graduation year, which makes it the biggest honor of any Colorado senior. This is what equal access to the curriculum can yield from a Free Appropriate Public Education.

086

With all of our experience as a backdrop, when I read about the confirmation of Betsy DeVos as the Secretary for the Department of Education, after a hearing in which she, at best, is confused about the IDEA, and at worst, doesn’t realize it is a Federal law, I think of my son. What would have happened to his education had he not been admitted to an elementary school because of his food allergies? Or if he had been admitted, but had to worry every day about allergens in his classroom? You can’t learn in those situations. And it’s why we food allergy parents need to ensure that the IDEA remains in the forefront of Ms. DeVos’ mind as she seeks to revamp the entire public education system.

 

 

 

 

Food Allergy & Families, Holidays & Food Allergies

The Wonderful Sit By Me Bakery!

I’d like to introduce you to Steve & Angie of Sit By Me Bakery, a Branson, Missouri based company that creates wonderful cakes, pies, bundtlettes, cupcakes and cinnamon rolls that are baked without wheat, dairy, egg, soy, peanuts, tree nuts, fish, shellfish, seeds, potato, corn, and yeast! And they deliver!

Steve and Angie (2)

For those of you who have attended the Food Allergy Bloggers Conference in Denver, you got to taste these wonderful treats! Not only are they delicious, they are also beautiful!

FAblogcon (2)

Hello Steve & Angie! Could you please share with us what food allergies your family manages?

Hi! Thank you for interviewing us! I (Angie) am allergic to milk, tree nuts, lettuce, and yeast. Steve is allergic to eggs, soy, and corn, and lives with Celiac Disease. Our oldest son is allergic to tree nuts. Our youngest son is allergic to tree nuts, soy, shellfish, and a long list of seeds.

How did Sit By Me Bakering come into being?

I write a blog about mental health and chronic pain issues, and Steve is an environmental scientist.

A year ago while at Enchanted Grounds, a coffee shop that sells board games, and hosts gaming meet-ups, I turned to Steve and asked if he thought we could open a similar establishment, geared toward the food allergy community. He said yes! That’s how Sit By Me Bakery was born.

Are your children part of the baking process? What do they think about this wonderful business? 

While they do cook and bake, our sons do not help with business baking. They are, however, willing to be taste-testers, which seems like a great job, but actually requires a good measure of courage! They are excited about our business and we’re grateful for their interest and encouragement.

How did you find yummy recipes for cinnamon rolls, cakes, bundtlettes, pies and cupcakes without the top 8 plus without yeast, corn, seeds, potato and corn?

We started by converting old, basic recipes from the Betty Crocker Cookbook, but it didn’t go well. We read a lot, studied ratios, and began building recipes from scratch. Our current bakes are the culmination of five years, countless tears, and many, MANY experiments in the trash! Remember those taste-testers I mentioned? You can thank them for our delicious bakes! They worked very hard!

Bundtlettes (2)

What is your best selling item?

When we first began, people mainly purchased cupcakes, but now cinnamon rolls are the clear winner! We often hear, “it’s been years since I had a cinnamon roll!” or even more touching, “my child has never had a cinnamon roll, and now they can!”

Do you plan on having a store front in the future?

Our vision is a commercial space where we serve desserts and coffee, and host meet-ups for food allergy individuals and families. It would also be great to meet the needs of more people by shipping bakes and getting our mixes onto market shelves.

 

Is there anything else you’d like to share? 

Thank You to Colorado’s food allergy, Celiac Disease, and EoE community! We look forward to growing into a bakery that not only delivers your birthday cakes, but also invites you into a safe space for a slice of pie and a coffee.

Thank you Steve & Angie!

Nicole’s Note: I ordered a cake from Sit By Me Bakery for my son’s 21st Birthday to be delivered to his apartment near the University of Denver  (when the company was still located in Denver) to surprise him. I’ve always had to bake cakes for him because of the cross contact issues in all the bakeries near our home in Colorado Springs.

2017-01-26 13.19.44

My son said the cake was absolutely delicious – it’s the chocolate cake with vanilla frosting and ganache on the top – and a wonderful way to celebrate his birthday with his 3 roommates!

*** UPDATE ***

Angie and Steve experienced a sudden change of circumstances and subsequently moved their family and business back to their previous home of Branson, Missouri in January 2018. Their storefront bakery will open in Historic Downtown Branson in May 2018, and they look forward to serving both the local community and tourists. They visit Denver frequently, and have plans to make deliveries a part of those trips. In addition, some Sit By Me Bakery treats will soon be available for mail order! Angie and Steve thank the food allergy community for their continued support.

New Address:

Sit By Me Bakery

200 N Commercial St, #210 Branson, MO 65616

Eczema & Rashes, Food Allergy & Families

Kiss Freely with Allergen Free Products!

KF_logo_roundlabel2

Kiss Freely products are free of the 8 major allergens and then some!  They avoid the use of other potential allergens such as sesame, shea butter, peas,coconut, avocado and sunflower seed. Below is an interview with Jennifer Kurko, the Founder of Kiss Freely, to find out about these wonderful products.

Hello Jennifer. Can you tell us how you thought of creating Kiss Freely?

My oldest daughter was diagnosed with multiple food allergies when she was 9 months old.  I really thought we were beginning to navigate life with food allergies pretty well.  Until one night when I kissed my daughter on the cheek and she broke out in horrible hives.  I knew it was not from the food I had eaten because we keep a house that is free from her allergens.

It actually wasn’t until a few days later that I realized it was my lip balm.  It contained almond oil,  Up until that moment, I had not thought to look at what was in personal care products.  I went through everything in the house and threw out almost all our lotions and lip balms.  All my makeup.  I wasn’t able to find a safe line of products and as most food allergy moms know, you are already making a ton of food so making my own lip balm didn’t seem like too much of a stretch!

From there I began making body butter and make up.  Friends began asking me to make them products.  My daughter one night at dinner said, “I can’t be the only one who needs special lip balm.  You should sell them.” We formed Kiss Freely so that people who did need “special” lip balm and other products would have those options.

What allergies do you manage in your household?

My oldest daughter is allergic to dairy, eggs, tree nuts, peanuts, sunflower seeds, flaxseeds, beef and sesame.  My youngest daughter is allergic to eggs and is in the process of being tested for EoE and celiac disease.

What makes Kiss Freely so special for the allergy community?

Kiss Freely is unique in that it is the only cosmetics and personal care items to cater to the food allergy community.  It is top 8 free.  I also took great care to make sure we did not include other highly allergic ingredients so we are free from a lot of thing such as coconut, sunflower, corn.

I completely understand cross contamination.  Our workshop is top 8 free.  We use dedicated equipment for all our products.

I also wanted the products to be as natural and environmentally friendly as possible, so all our products are vegan.  We use organic ingredients whenever possible.

I also take custom orders.  They are my favorite because I know someone is able to participate fully in an activity or finally wear their favorite color lipstick after years of being allergic to it.  I make a ton of custom dance orders and I am in the process of making the black under eye color for a young baseball player. I cry every time I get a picture of the person wearing our products.

What is your top selling product(s)?

Orange lip balm is our best seller.  Our face paint is a close second though!

 lipbalm_orange (2)

 

I love the face paint that you sell. Have you had any customers that can’t tolerate this product? 

It was so nice to see so many kids get to use face paint for the first time! We have not had any customers who could not tolerate it.  I try to use the least amount of ingredients as possible in every product.  The products are simple, natural and  that really helps most people be able to tolerate the ingredients.

I see that a portion of your income goes back to food allergy organizations. Which non-profits do you support?

We have supported FARE and FACCT both locally and nationally.  We also really like to be involved with supporting local allergy  and advocacy groups.  That’s the wonderful part of growing as a business is being able to give more back and be able to make a bigger impact in the food allergy community.

Is there anything else you’d like to share with us?

We are always looking to create new products.  We hope to have shampoo and mascara in the next few months.  Longer term, we hope to create a safe sunscreen.​

Thanks so much Jennifer! 

Note from Nicole: My daughter, who has celiac disease and a mast cell disorder loves these products. She too has had multiple reactions to other makeup and has thoroughly enjoyed the products made by Kiss Freely.

Food Allergy & EpiPen, Food Allergy & Families

Comparing the available Epinephrine Autoinjectors

There will be 3 epinephrine autoinjectors on the market effective February 14, 2017: the EpiPen, Adrenaclick and the Auvi-Q. All three devices are available in a Junior strength for children, and an adult strength.

Listed below are the pros and cons of each of these devices based upon my experience and upon the information available on their websites:

epipen2pack

EpiPen manufactured by Mylan

The EpiPen has been around since 1977, and owned by Mylan since 2007. There has only been one recall that I’m aware of, which was in 1998 when Meridian Medical Technologies manufactured the device. Almost 1 million devices were recalled since they weren’t providing effective doses of the medication.

The EpiPen training video states that the device needs to be held for 3 seconds after administration.

Pros:

  • The EpiPen currently has the largest share of the market, which means that more people have been trained on this device than any other.
  • A trainer comes with every prescription.
  • The used EpiPen has the needle protected with the orange cap.

Cons:

  • The price! Currently the brand name 2-Pak is around $600+ without a coupon. The generic EpiPen will cost you $300, and no coupon is available.
  • With a generic EpiPen available, and the Adrenaclick (generic epinephrine), your insurance company may not cover the brand name drug.
  • The size. Carrying a 2-Pak is bulky, and many young men really balk at this.
  • The short lifespan. Generally the EpiPen expires within 12-14 months, and you’ll likely have to ask the pharmacist for the furthest out expiration date to get this.

generic-epi

Adrenaclick manufactured by Amedra Pharmaceuticals

The Adrenaclick has been on the market since mid-2013. The training video states that it needs to be held for 10 seconds after administration.

Pros:

  • The cost at CVS pharmacies. With a $100 coupon, the cash price is $9.99.
  • The lifespan. Adrenaclick’s have an expiration date at least 24 months out.
  • Less bulky than the EpiPen.

Cons:

  • No trainer comes with the package. You will need to contact the company and request to have a trainer sent to you. You can do so here.
  • Fewer people have been trained on the Adrenaclick in school systems and elsewhere. This may change as more people purchase the device and bring it to school, etc.
  • The cost at approximately $400 with high deductible policies if you don’t purchase the device at CVS.
  • The needle is exposed after use.
  • You need to pull both tabs off of both ends of the device before administering it. This can make for confusion as to which end to use for injection, even though it has a red tip. Seconds count in an emergency, and a layperson may have more difficulty with this.

auviQ-eai-device

Auvi-Q manufactured by Kaleo Pharmaceuticals

The Auvi-Q was originally manufactured by Sanofi, and was introduced in January of 2013. A recall of all devices occurred in October of 2015 when two dozen of the devices were suspected to have not administered the correct amount of medication. Sanofi no longer manufactures Auvi-Q. Instead Eric and Evan Edwards, the inventors of the Auvi-Q, brought the manufacturing back to their company, Kaleo Pharmaceuticals. Both Eric and Evan, and their children, have life threatening food allergies.

The Auvi-Q training video states that the device needs to be held for 5 seconds after use.

Pros:

  • The device can talk anyone through the administration of epinephrine.
  • A trainer comes with a prescription.
  • Size. It’s about the size of a thick credit card, which makes it easy to carry in a front pocket for men.
  • Cost. Kaleo is promising $0 out of pocket cost, even for those with high deductible insurance!!
  • The needle is not exposed after use.
  • The makers of Auvi-Q have food allergies themselves, as do their children. In other words, they are one of us – the food allergy community AND they have a social conscience when it comes to pricing autoinjectors.

Cons:

  • The previous recall may be on some people’s minds; however, with the manufacturing moved in-house, I believe this issue has been resolved.
  • The lifespan of at least 12 months. But if you’re paying $0, I don’t believe that’s as big of an issue!
Food Allergy & EpiPen, School & Food Allergies

What’s the big deal about CVS & the Adrenaclick?

NBC Nightly News ran a story on January 12, 2017 entitled, “CVS to Sell Generic Version of EpiPen as Cigna Drops EpiPen” in which I was interviewed.

 

I was the woman at the end of the video clip who isn’t so thrilled about the Adrenaclick being offered for $109.99, and I’d like to tell you why!

generic-epi

First off, there’s a confusion that the Adrenaclick is the generic EpiPen. This is not true. In fact, a local CVS pharmacy that I called tried to tell me that the Adrenaclick is the generic EpiPen!

(Side note: Mylan is offering the brand name EpiPen as a generic at a $300 price tag for a two-pak. The brand name’s price tag currently runs upward of $600, however there are coupons that can bring the price down by up to $300. Cigna also announced on 1/12/17 that they will no longer be honoring prescriptions for the brand name EpiPen, only the generic.)

If you want your allergist to prescribe an Adrenaclick, you will need to have a prescription specifically written for the medication. And if your allergist is like ours, they may not prescribe it. (More on that later).

Next, to obtain the $9.99 price that’s quoted in the video for an Adrenaclick, you may need to pay out of pocket the $109.99 at CVS, submit a rebate form to the company, and wait for the $100 refund. To me, that’s not the same as a $9.99 price at the pharmacy. And remember you have to purchase the device at CVS in order to get this price.

As I said in the clip, I’ve been trained on the Adrenaclick. It isn’t near as easy as the EpiPen to use, nor is it as easy to train others, (especially since the package DOES NOT come with a trainer). It was for this reason that our allergist was not willing to prescribe Adrenaclick for our son prior to his study abroad in the fall of 2016. With him being in different countries where different languages are spoken, and eating different foods, she didn’t want to exacerbate the issue with him having a new autoinjector that he hadn’t ever used before nor had never trained anyone else how to use.

Many K-12 schools and school nurses are not trained on this device yet. If you plan on purchasing this autoinjector, make sure that everyone who could potentially need to administer it has ample training and feels comfortable using it. What may seem obvious to you or me, as an allergy parent, isn’t so obvious to a school administrator or teacher as far as the difference in this device and the EpiPen.

The Adrenaclick training video states that the device should be held for 10 seconds, instead of the current 3 seconds for an EpiPen. And, if you use the Adrenaclick, the needle remains protruding. I always disliked this about the EpiPen prior to its most recent redesign. I very much like that now the used EpiPen has the needle protected to ensure that no injury occurs after injection.

I am excited for competition in the marketplace, and I’d love nothing more than to have an epinephrine autoinjector cost just next to nothing!

I’m really excited about the reintroduction of the Auvi-Q, which should occur within the next few months. What’s really great about it is that it talks the user through the steps to administering it!

The Adrenaclick is just too similar to the EpiPen to cause enough confusion for the administration of the device to be compromised. It’s not a good alternative for our family.

 

 

 

Food Allergy & Families

Be Prepared – Shelter in Place with Food Allergies

1 Comment

Today in Colorado Springs, we’ve been having horrifically high winds. So high, in fact, that some residents in our city have been asked to “Shelter in Place”. windstorm

Several years ago, I wrote about Emergency Planning for Food Allergies & Asthma, but I geared the blog post more toward having to leave your home in an emergency.

Shelter in Place requires that you remain in your home or the location where you currently are situated. This can be very problematic if you haven’t stocked up on your child’s safe foods or medications at home; or if you are stuck in a store without an EpiPen!

Here are some of the ways that we have ensured that we are always prepared should a Shelter in Place be activated for our home, or activated when we have left our house:

  • Discuss with your family every individual’s needs, and have a box, envelope or carrying case for all items listed below.
  • Always have two unexpired epinephrine autoinjectors on hand. (This means that autoinjectors are always carried, even if eating isn’t planned). At home, we have at least two more as a backup, plus multiple sets of expired EpiPens, just in case!
  • Have a working nebulizer, along with unexpired medications, and clean apparatus tubing and mouthpieces. This is difficult to keep on your person when leaving your house, so we had an inhaler and spacer with us at all times, when our son was younger and his asthma was more active.
  • Have extra asthma medications and spacers on hand.
  • Any other medications that your child may need – Benadryl, Zyrtec, etc. – need to be on hand and within expiration dates. We always keep at least a 30 day supply of all medications.
  • Keep safe foods in large quantities on hand. Running down to the last slice of safe bread, or allergen-free milk, before re-ordering will make for grumpy children. And it will inevitably occur when you can’t run out to the store, or when Amazon is unable to deliver!
  • Now is not the time to try out new foods. Sticking with standard favorites, and products that you know are safe will mitigate any cross contact with an allergen.
  • Always bring a cell phone with you when you leave your home. If you end up sheltered in place, you can contact other family members to let them know where you are.
  • When our son was younger, we never left the house without safe snacks tucked into my purse.
  • Many customers in Colorado Springs lost power for hours of the day today. This is a VERY unusual situation in our city; however, if this occurs frequently in your location, be prepared! Obtain a battery operated nebulizer, or if you have to, have a generator on hand.

The key with food allergies and asthma is to ALWAYS be prepared – at home or away from home. Hopefully, you will never experience a shelter in place, but if you plan beforehand, the experience can be a mild inconvenience instead of a tragedy.

Travel/Eating Out & Food Allergy

Stein & Vargas files complaint against American Airlines

1 Comment

mary-vargas

Stein & Vargas, LLP, a civil rights firm based in
Washington, D.C. and committed to the principle that all people have full and equal access to all parts of society. Stein & Vargas, LLP has a special interest in the rights of individuals with food
allergies.

On December 28, 2016, the firm filed a complaint against American Airlines  for targeting and discriminating against individuals with peanut and tree nut allergies in violation of the Air Carrier Access Act.

Here is the press release from Stein & Vargas regarding the complaint: https://home.allergicchild.com/wp-content/uploads/2016/12/DOT-Complaint-Filed.pdf

And here is the complaint: https://home.allergicchild.com/wp-content/uploads/2016/12/Complaint.pdf

Anyone with an allergy or an allergic child who has been denied preboarding by American Airlines can file a complaint here – our voices matter: http://airconsumer.dot.gov/escomplaint/ConsumerForm.cfm

This is very exciting! I’m very hopeful this will at least begin the process of having procedures and policies for food allergic travelers on airlines.

 

Food Allergy & Anaphylaxis, Food Allergy & Families, Interviews

Allergy Superheroes!

1 Comment

allergy-superheroes

Hello Dean & Eileen! I’m thrilled to be able to interview you today about your company, Allergy Superheroes. I love the empowerment that comes for kids with food allergies being superheroes. 

Eileen: Thanks Nicole! We love focusing on the positive too. There’s no better analogy for food allergies than kryptonite. If Superman can have a weakness and still save the day, then our kids can too!

Please tell us how your company came into being.

Dean: When our boys were diagnosed with food allergies, it wasn’t really a life-altering experience like it is for most new families since Eileen has a lifelong experience with it. But when they started school we became acutely aware that the rest of the world doesn’t really get it yet. When we realized the kryptonite analogy, we combined our love of superheroes with that positive message to help get the idea of food allergies across and spread awareness.

I especially loved the teal leaf bags you had available for Halloween. What are your highest selling products?

E: Our teal pumpkin products did really well this past October, especially the candy buckets. In general our slap brasingle-dose-benadryl-bottles-allergy-superheroes-food-allergy-2celets do really well (and we’re about to release them in more allergens) and everybody loves our single-dose liquid medicine bottles.

slap-bracelets-food-allergy-superheroes-2

Born out of my desire not to carry a full (not to mention heavy) bottle of liquid Benadryl with me all the time, those have really made my purse lighter and everybody else loves them too. But my personal favorite is our “I have a kid with a food allergy, you bet I’m a SUPERMOM” travel mug.

D: I sometimes wear the slap bracelets even though I don’t have any food allergies. It helps to spread awareness and they’re a lot of fun!

What food allergies do your two boys have? 

E: Our older son is allergic to egg and peanut, though he is finally starting to outgrow the egg and he’s been handling it in baked form for a little more than a year. Our younger son is just peanut. Both of them have a big question mark around some of the tree nuts though, because introducing those has been problematic because of my allergy to them.

How do they feel about being a part of your company?

E: They love it! Modeling usually requires bribery of chocolate to get everyone through it, but they love being part of this and they know it’s something special. We have overflowing file folders of the artwork each of them has drawn of our characters.

super-fam-comic-background-food-allergy-superheroes-2

D: Our boys are really into superheroes, so they love the idea behind the business and our characters. They wear their food allergy superhero shirts a lot and love helping to come up with new ideas on how to spread awareness. It really is a family venture!

Can you share a story of superpower one of them has enjoyed in life?

D: Our oldest is very active and outgoing. He has no issues with talking about his food allergies and spreading awareness about them. When a birthday party comes up, his friends know about his allergies so they make sure their parents talk to us so that their birthday treats will include him! He also loves to draw and we can see him doing a lot of the artwork side of the business when he gets older!

Eileen, you have had food allergies all your life. What was it like growing up in the 1980’s with food allergies? 

E: Different, very different. There are times that I look back and just shake my head. I actually wrote a blog post a few months ago about how my “food allergy mom” life is easier than my mother’s was, where I highlight a bunch of resources and improvements. This could really be the subject for a novella since so much has changed, but some major points:

It was harder to get diagnosed and get proper medication–I had an anaphylactic reaction to eggs at 12 months, but the only prescription I received upon leaving the ER was for Benadryl (it wasn’t OTC), and we weren’t sent to an allergist or even told to avoid eggs (my mom avoided them anyway.) I had some smaller reactions and then another anaphylactic one to nuts in the months before my 4th birthday, and then I was finally prescribed epinephrine, but I wasn’t tested for allergies until I was 6. (By then there was no trace of an egg allergy.) And that was the only testing I had done as a child.

Most people hadn’t heard of food allergies. I did a lot of explaining and so did my parents, but it was rare to encounter anyone who had previously heard of allergies or could accommodate them.

There weren’t very many of us. I was unique in my dietary struggles, though I don’t remember feeling down about it very often. I was in middle school before I finally met one other kid who had food allergies. (I think my mom secretly hoped we’d become best friends and look out for each other, but he and I never hit it off.)

Epinephrine was carried in single doses and was basically seen as a last resort. We weren’t told to use it unless things got really bad. The whole concept of always having two doses and using epi “first and fast” is actually a pretty new concept (and one I’ll confess that I struggled with. Benadryl got me through so much in my youth, so the thought of using epi preemptively and then sitting around bored in the ER for 4+ hours was something I did not get behind for a long time.)

We didn’t have the internet. As a result, news of food allergy deaths seldom reached our ears so our perception of the risk was less. That may have put us at greater risk, but probably also reduced our anxiety level. But on the other hand, we didn’t have many resources available to us, either. My mom used to receive a monthly newsletter from a now-defunct allergy and asthma organization, and most of the articles were on asthma. If she’d had access to the community we have today, I’m sure our lives would have been a lot different–certainly a lot less isolated.

D: Nowadays, awareness is growing, but there is so much more work to be done. It’s hard to fathom going through that with virtually no awareness or support at all. The kids and parents of that time period and earlier are real superheroes in my book!

How did you manage to stay safe in school, dating, eating out without the awareness that’s available today?

E: I’m going to start by saying that I was pretty lucky to “only” be allergic to tree nuts. If I’d been allergic to, say, dairy or wheat, or if egg had stayed with me, I’m sure things would’ve been a lot harder, because I would’ve encountered them a lot more. Tree nuts aren’t as widely used, so my life was not as restrictive as it could have been.

My mom considered it a victory to actually get my EpiPen into the nurse’s office, though she has repeatedly expressed doubt that anyone there would’ve known how and when to use it. We put a lot less emphasis on inclusion back then and mainly focused on “do what you need to do to stay safe.” The world isn’t nut free, and my mom wanted to make sure I understood that I couldn’t always participate in shared treats. When foods came into the classroom I would ask questions, and sometimes I would just do without. I don’t think I ever had a backup stash at school. I don’t think that even occurred to my parents.

I think I started self-carrying around 5th grade, which I’m pretty sure made my parents feel safer. I had a fanny pack that year, then somewhere along the line I just switched to carrying it in my backpack. I don’t have very distinct memories of any of that, it just sort of happened when it happened. I got a fairly good handle on what I shouldn’t eat by then, and I can’t recall any school-related reactions beyond early elementary school.

Telling boyfriends about my allergy was definitely a priority. We had a “no kiss” rule growing up if my parents ate something I was allergic to, so that transferred over to dating. Generally, I would tell guys that they shouldn’t eat nuts while we were out. I wasn’t forward enough to add “or you can’t kiss me,” at least not early on, but no one ever challenged my rule, either. I can’t say I put any thought into what they’d eaten previously–but then, the first supposed “peanut butter kiss of death” didn’t happen until I was in my 20s, so that was another danger that I simply wasn’t aware of, nor did I fall victim to it. But I didn’t date a whole lot, either.

(Dean here, she was worth not eating any tree-nuts before or during our dates for that goodnight kiss!)

Something else that is very different today is awareness of cross contamination. Some might argue that cross contamination doesn’t have much awareness, but when I was little there was none–and I mean none. We were never warned against it by our doctors, foods never labeled for it, and the general principle we lived by was “don’t eat anything with nuts actually in it.” We knew you couldn’t pick nuts out, but even the concept that you couldn’t use the same knife was something we learned (painfully) the hard way. There were a handful of reactions from my childhood that we traced to contamination as we struggled to figure out the concept, and some other “mystery” reactions that must have been from CC.

Kissing, cross contact–basically, these things had to happen a few times before doctors, patients, the news, and lawmakers figured out the pattern and started doing something about them.

So when it came to restaurants, we did a lot of educating. It wasn’t uncommon for me (or my parents) to explain what food allergies were to restaurant staff–and after we learned about shared knives and foods touching, we told them not to do that, either. Whether any of them actually took precautions in the back is debatable–but on the other had we were pioneers, laying the foundation policies that restaurants are adopting today. It’s a wonder that we ate out at all–but without the internet shoving food allergy deaths in our faces every few months, the danger of that happening also seemed farther away. At times we coasted through on ignorance and luck.

Is there anything else you’d like to share?

E: It’s been great getting to be part of this community since we started up a few years ago–it’s such a welcoming and positive space. I also blog at www.allergysuperheroesblog.com and I started that up because I wanted to share my perspective of dealing with two generations of food allergies–my outlook is different since I’ve been through it myself, but caring for your allergic child is definitely different than managing your own allergies, too. Most of the time we don’t see the after effects of the things we’ve done, but it’s really all about helping people. On the rare instance that we get feedback that we’ve helped someone, or given good advice, or made someone feel more confident about the future, that’s when we know that we’re doing the right thing. We love all of the connections we’ve made over the past few years!

D: It really is the most fantastic community to be a part of! We’ve met a lot of amazing people and we’re continually inspired by them. And when we get to meet them in person at conferences like FABlogCon, it truly is a SUPER experience.

Thanks so much!

Thank you Nicole, we’ve loved chatting with you!

Food Allergy & Families, Interviews, School & Food Allergies, Travel/Eating Out & Food Allergy

Disability Rights Attorney & Food Allergy Mom, Mary Vargas

1 Comment

mary-vargas

Hello Mary. It’s wonderful to interview you today. Can you please tell us how you became involved in disability law, especially as it relates to food allergies and anaphylaxis?

I’ve been a disability rights lawyer for almost two decades. I started my career at the National Association of the Deaf doing disability discrimination litigation. When my own child was diagnosed with food allergies and subsequently turned away from a summer camp because of his allergies, my worlds collided. I found myself in the uniquely familiar position of advocating for inclusion but this time I was advocating for my son. I realized that if the child of a disability rights lawyer was denied access because of food allergies, there was work to be done.

What food allergies does your family manage?

I have three boys and only my youngest has food allergies – peanuts, tree nuts and shellfish.

What lawsuit(s) have you litigated that pertain to food allergies and anaphylaxis?

Stein & Vargas, LLP has a special interest in pursuing litigation that will create safe and equal access for people with food allergies. We’ve litigated a number of cases throughout the United States on behalf of people with food allergies who have experienced discrimination whether it be in employment, education, or access to programs and services. Among the complaints we have pending now are a complaint against Young Shakespeare Players East in which the United States Department of Justice has concluded that Young Shakespeare Players East discriminated against my 11 year old client on the basis of his food allergies and retaliated against my 13 year old client for advocating for her friend’s rights. We are also co-counseling on a case with Laurel Francoeur against Panera on behalf of a child who had an anaphylactic reaction after being served a grilled cheese sandwich that contained peanut butter despite notice that the sandwich was for a child with a peanut allergy.

From your experience as an attorney, is there anything that a food allergy family should be aware of or take action on to ensure the safety and inclusion of their child in school? 

The most important aspect of safety and inclusion at school for food allergic kids is the development of a strong and positive relationship between the school and the parents. The focus cannot be on highlighting where plans failed, but on building long term trust and commitment. Even the most knowledgeable and well-meaning schools will fall down sometimes.

You are a Co-Founder of  Allergy Law Project. How did that come into being?

Allergy Law Project was the brainchild of Laurel Francoeur who approached Homa Woodrum and I two years ago about the need for reliable legal information in the food allergy community. There is incredible power when parents of food allergic kids put their brains together for the good of the community.

I love the blog post called “A Seat at the Table – Bringing Allergy Friendly Food to Restaurants“. You said that’s the question you are asked the most. What can a family do, in the moment, if a restaurant forbids them to bring in outside food? Is it necessary to bring along the state law to reference or is there some other statement that can be used to allow outside food?

Generally, families can ask calmly and respectfully to speak with the manager. Explain to the manager that your party is looking forward to enjoying the food that the restaurant offers but your child cannot safely eat the food. If after calmly talking this through and explaining why it is necessary for your child to bring safe food in order for the rest of the dining part to eat at the restaurant the manager still refuses, you may need to go higher up the chain. You might send a politely worded letter to the restaurant owner to educate them about food allergies.

Many food allergy families are concerned about Donald Trump’s comments about “streamlining” the Department of Education and curbing the role of the Office of Civil Rights. What can food allergy families do to protect their child and do you think that is likely to occur?

I have grave concerns about the impact of the incoming administration on many aspects of the work we do. The Office of Civil Rights within the Department of Education, the Office of Civil Rights within the Department of Health and Human Services, and the Disability Rights Section all have a critical role in ensuring compliance with our federal rights. Significant cuts in staffing could jeopardize the ability of these agencies to safeguard rights and changes in philosophy could undermine enforcement actions throughout the United States. There is so much at risk and already resources are stretched tightly. I’m also concerned about the potential rollback of food safety regulations that has been threatened. My hope is that the allergy community has the potential to speak loudly and in concert to defend important rights.

If someone reading this feels they need legal advice pertaining to a disability law question, how can they contact you? Stein & Vargas, LLP’s website is www.steinvargas.com. Folks are welcome to contact me with questions through the website.

Thank you very much Mary!

Ms. Vargas is committed to ensuring full and equal access for all individuals. She has litigated cases pursuant to the Americans with Disabilities Act and the Rehabilitation Act throughout the United States in federal and state courts.

Ms. Vargas also represents women who are denied access to reproductive care and coverage. She has successfully obtained full coverage of late term abortion claims through insurance appeals. She also speaks nationally on issues including women in law, movement building, discrimination, pain, food allergies and anaphylaxis, and reproductive rights. Ms. Vargas is a co-founder of and blogger for the Allergy Law Project.

Prior to joining Stein & Vargas, LLP, Ms. Vargas was a staff attorney with the National Association of the Deaf.  Ms. Vargas was a 1998 Skadden Fellow and a 1994 Truman Scholar. Ms. Vargas was the 2010 recipient of the Advocacy for People with Pain Award from the American Academy of Pain Management. She wrote for the American Bar Association, Mental and Physical Disability Law Reporter.

Ms. Vargas obtained a B.S. in deaf education from the College of New Jersey, and a J.D. from the University of Connecticut, School of Law. While in law school, she was appointed to the Client Advocacy Board and served as student director of the Yale Law School, Advocacy for Persons with Disabilities Clinic.

Ms. Vargas is a member of the bars in Connecticut and Maryland.  She associates with local counsel around the country in bringing cases of special importance to individuals with disabilities.

Food Allergy Bloggers Conference

Food Allergy Bloggers Conference Weekend Wrap Up

1 Comment

 

img_1246

The Food Allergy Bloggers Conference was held in Denver, CO this past weekend, and wow was it fun! The conference is more than just about blogging, there’s also a “disease” track that offers wonderful speakers who spoke about research that their children were involved in; doctors who detailed eosinophilic disorders, parenting tweens/teens with food allergies and much more! There are many gluten-free bloggers who also are a large part of the attendees. And the Expo is amazing – so many new products for food allergy individuals and new foods to sample.

I started off the weekend learning more about Instagram Stories, Facebook Live, Snapchat and more! You can see the proof of my learning Snapchat above!!

img_1247

Jenny Sprague is the Founder and Manager of the conference. It is a year-long mission to put on this great conference, and every year she does more amazing things.

At the Welcome Dinner, we heard from Eric and Evan Edwards, the Founders and Co-Inventors of the Auvi-Q.  They shared their personal experience of having life threatening food allergies – and the fact that their children also have them – hence it is personal for them to bring back the Auvi-Q as soon as possible. And they are planning on doing that before June 2017, at a “very low price” even for those with high deductible insurance policies. I asked them about this price, and it sounds like they are shooting for below $50!! The two met with several of us bloggers to find out more of the issues we’ve had gaining access to epinephrine autoinjectors at a low price. I came away feeling that they really are invested in helping our community, and as they said, “this feels like home” to be with the food allergy world!

2016-11-05-13-26-29

Saturday was filled with presentations, not the least of which was my husband, Robert’s, and my presentation on Parenting Your Tween/Teen with Food Allergies.

2016-11-05-07-14-30

We shared our experience and stories about raising our son, Morgan, and the various challenges and opportunities we had to empower him as a self-advocate through his tween years of school, campouts, overnight field trips and sleepovers. And through his teen years of homecoming, prom, dating, kissing and alcohol awareness. We had great audience participation and questions.

img_5499-2

We were thrilled that our daughter, Michaela, was able to join us for the conference. Also, FAACT was the sponsor of our presentation. Eleanor Garrow, President & CEO of FAACT, is shown above with our family. We were definitely missing our son, Morgan, who is currently studying abroad in England.

2016-11-05-12-32-36

One of the best parts of the conference is getting to meet in person bloggers and authors whom I’ve only met online. Above is Cookbook Author Cybele Pascal, on my right, and Allie Bahn, Miss Allergic Reactor, on my left. It’s so great to connect with these wonderful women!

img_1253

And what would a conference be without a couple of superheroes from Allergy Superheroes? Love these two who marched around the entire conference in capes!

I was able to stay in the Denver Renaissance Hotel, for the first time, because Keith Norman was the first chef willing to take on feeding me! And believe me, that’s no easy feat with my mast cell and eosinophilic esophagitis diagnoses. I have so much appreciation for Keith’s willingness to provide safe food for all attendees.

2016-11-05-09-13-14

The conference continued on through Sunday, although our family had other plans, so we had to leave early. It was an amazing weekend, and one that I’m already planning to attend next year!

 

College with Food Allergies, Pet Allergies, School & Food Allergies

Emotional Support Animals and Students with Pet Allergies

1 Comment

support-animal-1

There is a new issue that I’ve been hearing about frequently on college campuses, and it affects our children with pet allergies: emotional support animals.

For those students who have severe animal allergies (like my son, Morgan) living in the same dorm as these emotional support animals can be hazardous. An emotional support animal differs from a service animal, according to the National Service Animal Registry in that “an Emotional Support Animal (ESA) is an animal that, by its very presence, mitigates the emotional or psychological symptoms associated with a handler’s condition or disorder. The animal does NOT need to be trained to perform a disability-specific task, whereas a service animal does.

All domesticated animals (dogs, cats, birds, reptiles, hedgehogs, rodents, mini-pigs, etc.) may serve as an ESA. The only legal protections an Emotional Support Animal has are 1) to fly with their emotionally or psychologically disabled handler in the cabin of an aircraft and 2) to qualify for no-pet housing. No other public or private entity (motels, restaurants, stores, etc.) is required to allow your ESA to accompany you and in all other instances, your ESA has no more rights than a pet.

You’ll also need to be prepared to present a letter to airlines and property managers from a licensed mental health professional stating that you are emotionally disabled and that he/she prescribes for you an emotional support animal.

My son lived in a college dorm for 2 years, and in that time, there was a HUGE increase in the number of students with emotional support animals. At the University of Denver, they recognize that the needs of a student with severe pet allergies are equal to the needs of a student with an emotional support animal. However, the only way that a school is going to know that your child has severe animal allergies is for the paperwork to be completed and medical documentation provided.

My son was placed in a dorm on one end, and the students with animals were placed on the other end. That way there was no shared ventilation, which could have exacerbated his asthma.

I’ve recently heard of two situations at two different universities where a student brought in an emotional support animal without having paperwork completed until AFTER moving in. In both cases, the roommates were unaware that there would be an animal prior to moving in. And to make matters worse, in each case, at least one of the roommates had severe pet allergies, but had neglected to tell the university of such.

Both situations have caused a large amount of stress for all involved, and the university is caught in the middle of which student needs to move out and which needs to stay.

My suggestion: if your child has severe pet allergies (and this would also include children in K-12) make sure to have the paperwork completed so that the school is aware of these allergies. This will allow for any accommodations needed, such as no contact with the animal, no field trips where the animal is present, and no shared vents with the room where the animal is located. Prior to placing a child with a pet in your child’s classroom, or allowing a college roommate to have a pet, other arrangements can be made.

 

Eosinophils & Mast Cells

Healing through Traditional Chinese Medicine for EoE/Mast Cell Diagnosis

I have been a patient in Dr. Xiu-Min Li’s private practice for about a year now, and it was time for me to meet her in person. We have been having once a month telephone appointments. Meeting Dr. Li in person was like meeting a rock star! She and I hugged each other like long lost friends, having spoken on the phone for a year.

I have written about Traditional Chinese Medicine (TCM) before, and you can read that blog post here.

Most of Dr Li’s patients travel to New York City to meet with her before they start treatment. However, it is VERY difficult for me to travel, and being an adult, she was willing to consult with me after receiving a battery of blood tests and endoscopy results for my eosinophilic esophagitis and mast cell disorder diagnoses. I also have IgE allergies to several foods – peanuts, onions and corn.

Because of these diagnoses, and gut issues every time I try a new food, I am currently eating just 4 foods: organic chicken breast, organic turkey breast, organic broccoli and Cascadian Farms organic hash browns. (For some reason, those potatoes, having been parboiled to perfection, work for me while homemade hash browns parboiled do not.) Mast cells and eosinophils are crazy!

When I travel I must either bring these foods or be able to purchase them. And because all of these foods are low in calories, I eat 6 times a day, about 2 hours apart. I have to cook all the foods for my stomach to tolerate them – not that I would be eating raw chicken! But even raw broccoli doesn’t work for me currently.

My recent trip to meet Dr. Li felt like a big accomplishment. I was able to stay with a fellow food allergy Mom, and to use her kitchen to cook all my meals. I ordered my food from FreshDirect and had it delivered to her apartment prior to my arrival. What a wonderful service that is in New York City! And what a wonderful friend I have to put up with me cooking non-stop!!

As far as the Traditional Chinese Medicine that I’ve been taking – I’ve been on a cream IIIvb, which looks like avocado dip, and I apply it once a day, every day. I’ve recently begun an herbal foot bath, which is all that I can tolerate currently. Most of Dr. Li’s patients use herbs in a “real” bathtub, however I am currently too sensitive for that. The combination of these two treatments, which permeate the largest organ – the skin – have begun to decrease my body’s sensitivities. I have yet to begin to swallow any TCM treatments. Again, most patients are able to start with this, but my system is still in need of healing more before I will be able to swallow any teas or pills. Dr. Li’s protocol is not something that I could manage myself, and I couldn’t go to a local store to purchase the herbs. I feel very grateful that I have a doctor, with such knowledge, managing my care.

I realized how much better I’m doing when I was asked by Dr. Li to rate my improvement. I’m far less reactive to smells and contact with the environment. I have much more energy. (That’s the real issue with mast cell degranulation for me – it zaps my energy). And I’m far less anxious. I really want to eat different foods, and Dr. Li thinks that’s in my not-too-distant future. She wants to try some Chinese vegetables because it’s something I haven’t ever eaten, so hopefully my mast cells won’t recognize the food as an invader!

For me, TCM is more about how I feel than any blood test result. We aren’t trying to cure any food allergy. I’m willing to not eat a few foods that I’m allergic to…I’d like to be able to eat all those other foods that currently I can’t tolerate because of the mast cell/EoE issues!

Dr. Li suggested that I purchase a pressure cooker to cook the meats that I eat to make them more easily digested. Upon returning home, I immediately purchased an “Instant Pot”. What a wonderful little device! I can cook my chicken in 15 minutes, while my potatoes are cooking on the stove. This allows me to always eat fresh, and to cease microwaving foods to reheat them, which Dr. Li wants me to quit doing – “as much as possible in our busy lives”. She’s always so patient and kind!

instant-pot

I’m continuing to increase the amount of cream that I apply, and to increase the amount of herbs in my daily foot bath. It’s so exciting to feel healing occur in my body.

The various medications that I’ve been on – Ursodiol, Zyrtec, Zantac and Ketotifen – only mitigate symptoms. They do nothing toward a true cure or healing. I’m grateful to have them, and I’ve been able to decrease the amount of medication that I take daily since starting on the TCM protocol.

The future looks very bright!

 

 

 

 

College with Food Allergies, Food Allergies & Study Abroad

Preparing for Study Abroad

I’m leaving on Monday, August 1st to study abroad! I’ll be traveling with friends for the entire month of August through Iceland, Spain, France, Italy, and Greece; then, I’ll be in Denmark for a month completing a research project; and then I’ll be at a host university in Lancaster, England from October to mid-December. Crazy times!

I’m beyond excited to embark on this adventure of a lifetime.

The planning for this process admittedly started before my Freshman year at college even began. I was excited! The University of Denver has an incredible set-up: during your junior or senior year, you can study abroad at any partner program or university (they have over 160) in over 80 countries around the world. You pay DU your normal tuition, housing, and fees and they take care of the costs at your host program or university! And, with a 3.0 GPA or higher, DU students can also qualify for the Cherrington Global Scholars program, which helps cover visa fees and flights to and from your program! Truly, DU makes it super easy to study abroad.

I knew from the get-go (as I discussed in a previous post) that I would need to study in an English-speaking country where I would have control of my food intake — so homestay programs and shared kitchen set-ups wouldn’t work. I narrowed it down to a variety of programs in the UK, New Zealand, and Australia, but eventually settled on Lancaster University. It’s quite a good school and has a variety of academic + fun programs I can get involved in!

Lancaster Castle
Lancaster Castle

LU

I left all of the study abroad stuff on the backburner until this past fall, when all the study abroad applications begin. After investigating all of my options at Lancaster, I decided to pursue independent research. I had no idea (originally) what my research would be about but I knew it sounded cool and I wanted to take advantage of the opportunity of studying abroad. As a Public Policy major, I’m really interested in how different governments structure their economies, health care systems, and other public sector services. I mulled around a bit with the idea of looking into the National Health Service (NHS) in the UK since it’s so different from the US health care system; but, after doing a lot of research and reading (I kid you not I read three PhD dissertations and two books and forty-odd academic journal articles), I settled on conducting research in Denmark on the way they treat small & medium-sized businesses.

I now knew that I would be spending a considerable amount of time in Denmark conducting this research and I would have to do it before my program began. Lancaster’s term starts late (the first few days of October), so I knew I had September to conduct my research.

And then, I decided that traveling with friends sounded like a cool idea — why not? I’m over there already and my flights were paid for by DU. After many months of figuring out immigration issues and friends committing and then finding out they weren’t able to, my two close friends (Thomas, my first year roommate, and Danny — or DK for short) and I decided to travel together for all of August! We didn’t really have much planned until mid-May, but we knew we wanted to see a lot of Italy.

021

So, the run-down for the next four-and-a-half months came to look like this:

  • I’ll be traveling with Thomas and DK through Iceland, Spain, France, Italy, and Greece.
  • I’ll be staying in Copenhagen, Denmark for the full month of September.
  • I’ll be attending my study abroad program at Lancaster from October to mid-December. I get home December 18th.

I am blessed to have a full-ride scholarship to DU that helps pay for my study abroad experience at Lancaster. I also applied and was awarded grants to help fund my research in Denmark. I started saving over two years ago for my study abroad experience and am also using all my personal savings to help fund my travels and other fun excursions! The point being I started planning for this incredible experience a long time ago, both financially and mentally.

Health & Safety Abroad

This was a top priority for me from the get-go. I knew (from other bloggers and food allergy families) that international travel was completely possible, even if I didn’t speak all of the languages. My Spanish is a little rusty, and I definitely don’t know how to explain anything in French or Greek, so I knew I’d be flying blind. I admit, that’s scary! But, I knew I could prepare successfully for my travels abroad and remain 100% safe.

I downloaded the Google Translate app, which can help translate things on the spot — you can even take a picture of something and it will translate it!

I also downloaded AllergySmartz, an app for my iPhone that allows me to select my food allergens and it churns out a prepared chunk of text describing my food allergies & cross contact issues in multiple different languages to give to a waiter who may not be fully fluent in English. It’s essentially a digital chef card in multiple different languages!

DU also helps its abroad students by automatically getting them membership to International SOS, a company that delivers 24/7 emergency help and advice. They don’t provide health services, but they can call an ambulance or help notify a US Embassy in case of a national security issue. DU requires all of its students call International SOS before they leave to get advice on health & safety while abroad.

My call with International SOS was fantastic. After getting a security overview of all of the countries I was traveling to (and advice to watch out for pickpocketers and such), I got to speak with an actual medical doctor (!) about my food allergies and traveling abroad. He helped clarify that I should carry a doctor’s letter to get my medication through immigration (and what should be in that letter), to always watch out for cross-contact issues in restaurants, and to always carry my EpiPens. It was really great to talk to a doctor who was so knowledgeable on food allergies and travel.

This is, in many regards, the ultimate test of self-advocacy. I’m already really quite good at advocating for myself, but to do it other countries and across languages certainly tests my own limits. My mom helped research potential issues in food overseas by reaching out through her various social media groups to figure out what other things could come up. I found out lupine flour, a flour used a lot in baking across Europe, cross reacts with nuts, and therefore isn’t good for me with peanut and tree nut allergies. Definitely going to avoid that! I have the absolute faith and confidence that I’ll be safe and I know how to take care of myself.

For medication, I’ll be carrying two EpiPens with me at all times, and I’ll have an extra two in my backpack. Because they have become so expensive, I’m traveling with EpiPens that are expiring in August of 2016 (this next month) – these are my two backups. We ordered the two new ones from Canada Drugs and got the MEDA brand, the European drug manufacturer of EpiPens, to make sure I was safe for all of my travels. They cost ~$220. I will be keeping the new ones with me. This is a definite risk, but from conversations with my allergist, the EpiPens won’t become extremely ineffective in the couple months past their expiration date. They may or may not be 100% effective, either, but we simply can’t afford to spend $220+ for a second new pair of EpiPens. I’ll also have other prescribed medication in my backpack at all times.

I researched labeling laws for the EU and the UK. Thankfully, no regulations will be changing due to Brexit in the coming months, so I’m in a sweet spot to come to the UK (especially since the pound sterling is weaker against the dollar)! Over 85% of Danes speak fluent English, so I know I won’t have too many issues communicating in restaurants regarding my food allergies. However, most of their labels are solely in Danish. I’ve become familiar with important words (mainly my food allergies) in Danish to quickly identify those while reading labels in a grocery store.

Traveling & Living

For the next 4+ months, I’ll basically only have a backpack’s worth of belongings. Since I’m traveling for the duration of August, I’ll only be carrying the things I absolutely need. Thomas, DK, and I are traveling mainly by trains, so I can’t be carrying around tons of luggage — it’s inconvenient, heavy, and unnecessary. I’ll have all the necessities, but nothing really more — clothes for different kinds of weather, some hiking shoes, flip flops, swimsuit, my medication, and some electronic & utility stuff, but that’s about it.

For August, we’ll mainly be staying in hostels or AirBnB. We used HostelWorld to find the best hostels (stayed with hostels rated 8.5+ upon the advice of a friend). We were able to check their no pet & no smoking policies, plus cost and living situations. All of our AirBnBs were strategically placed in cities we were staying longer in: for example, we’re spending 5 nights in Rome, so we got an AirBnB so we could cook our own food if we wanted, wash clothes, and so forth. All of the AirBnB’s we chose are non-smoking and pet-free!

The AirBnB we're staying in Rome -- for only $90 / night!
The AirBnB we’re staying in Rome — for only $90 / night!

In Denmark, I’m renting an AirBnB for the whole month. It’s also pet-free and smoke-free and the owner is even giving me a bicycle to use while I’m there! Truly a wonderful set-up. It has a kitchen and a refrigerator and I get to truly take care of myself for that whole month!

While in Lancaster, I’ll be staying in a studio dorm room. I’ll have a bed and bathroom and a small kitchenette to cook all of my food. I can take a short bus ride into Lancaster whenever I need to buy more food. It is also pet and smoke-free!

Final Thoughts

I’ve prepared just like any other student studying abroad & traveling internationally — making copies of my credit cards, passport, immigration letters and documents, making sure my housing is set up at Lancaster, booking trains — and I also prepared as someone with food allergies. I’m going to be cautious. I’m not going to be eating crazy dishes without knowing, for certain, what will be in those dishes.

And, I know, I’m going to have the time of my life! I’ll post an update probably once I get to Lancaster in October. Until then!

College with Food Allergies

Staying Safe in College (and Life)

DU#2

I want to talk about staying safe at college. For many of you, that’s many years off; for others, it’s right now! College is an exceptionally exciting time. You are free from a parental burden, you are living on your own, figuring out life for yourself, and taking on all of your own responsibilities. You have to figure out when you go to class, if you even want to go to class, when to complete homework, when to eat, when or if to exercise, when to hang out with friends, when to go to bed, and so on. There’s a lot of new personal responsibility!

And to top it off, you have to manage your food allergies. You have to make sure you carry your own epinephrine autoinjectors without a (friendly?) reminder from Mom. You have to ask people about what food they’ve eaten before you kiss them at a party. You have to figure out where you’re going to eat. This can be unbelievably scary for parents since this might be the first time they don’t have supervision of your food intake or at least even a general knowledge of what you’re eating, where you’re eating, if you’re eating, etc.

Then there are questions of accommodations — can you feel safe in your dorm room? Will your roommate be willing to accommodate your food allergies? How about the dining halls? Will you have access to a kitchen, and if so, do you feel safe using it?

Really, the questions are endless. They are so endless, in fact, you can scare yourself out of going to college and living your life. So, for the moment, stop asking yourself all of those questions.

Let’s focus on what you can do: you can advocate for yourself.

This is the fundamental principle of staying safe in college, and in life. You must be able to self-advocate. This also isn’t something you wake up one day and know how to do; it is developed over months and years of practice. Self-advocacy is a skill that every food allergic child must learn. It may be scary for your parent to let you learn how to self-advocate because it requires you to step outside of your comfort zone, learn how to tell people about your food allergies, learn the potential consequences of not telling someone about your food allergies, and get yourself into situations in which you must self-advocate. But, let me tell you something: it’s a lot scarier to go out into the real world and not know how to advocate for yourself.

Self-advocacy, at its core, is made of two main components:

  1. Speaking up.
  2. Managing risk.

Speaking Up

Self-advocacy, and therefore staying safe in college and in life, requires you to speak up. You must be able to tell other people about your food allergies, set boundaries around what is acceptable for your safety, and demand nothing less.

To do that, you first must become comfortable with the idea that you have food allergies. Too often, we become the victims of bullying and indifference. We become identified solely as the “food allergic kid” in the class who forces everyone else not to eat PB&J’s or bring in certain foods. We’re teased for it, and in some cases, our life is threatened simply because other kids don’t understand the severity of our food allergy. I had a young boy chase me around the playground in 1st grade with a peanut butter cracker chanting, “I’m gonna kill you, I’m gonna kill you!” The good news? He and I became really close friends after he better understood why what he did was not only wrong, but dangerous.

Time and time again, we are told that we are different, that food allergies make us different. And it becomes difficult to accept the reality that we do have food allergies, that we are different, that our health and safety is threatened by a plate of fish or that croissant with almonds. And, what I still struggle with, is that I have to make other people live that reality with me. I have to ask my date to not eat any of my allergens just in case we kiss later. I have to ask my friends in the middle of Italy not to eat at this one restaurant even though we are starving after walking for 8 hours straight because most of their menu is seafood and I just don’t feel comfortable eating there.

But.

Your life is too important to not speak up. You have to accept that you have food allergies, that you (may) wear a MedicAlert bracelet, that yes you have to explain to every waiter at every restaurant you eat at that you have food allergies. Because food allergies is not a badge of shame, but a badge of pride. Be proud of your differences. Recognize that everyone has them: you have food allergies, she has two moms, he has Crohn’s, she has dyslexia, he can’t stand horror movies, she’s afraid of heights, he gets cold easily, and so on. The beauty of food allergies is that it adds another dash of diversity to the incredible mixing pot of humanity. You are incredible and never let anyone tell you differently.

So speak up. Especially when it feels like an inconvenience, speak up. The first day I was in Copenhagen, I ate at a local cafe with a friend and ordered a simple sandwich. I was exhausted after a full day of traveling, on and off metro stops, planes, and walking everywhere. I almost didn’t ask, because I thought it might be safe. But I did, because I’ve trained myself time and time again to always ask. And it was a good thing too: the bread on the sandwich contained sesame.

Could you imagine what would have happened if I hadn’t asked? The sandwich would come out. I might recognize that it has some weird seeds in the bread, I might not. If not, I eat the bread and then go into an allergic reaction. And even if I do recognize it, then I have to explain to my waitress about my food allergies and then force them to remake the sandwich. All of that could be avoided in the first place.

Never be afraid to speak up. Always put your safety first and never settle for less.

Managing Risk

The second part of self-advocacy provides guidelines around what to do after you speak up. After you explain your food allergies to a waiter, to a friend, or to your roommate, there is an infinite combination of responses. They may be the most accommodating and kind person you ever met; or, the dish you ordered and almost every dish on the menu at the restaurant isn’t safe because of cross contact issues.

Managing risk is the really difficult part of self-advocacy, because it requires you to train your “good judgement” muscle. Like any muscle, you need to work it out for it to strengthen.

I want to give a real-life situation that I encounter at college most days: during lunchtime at the University of Denver, the dining hall has a mix of different stations. There’s a salad bar, a pizza station, a grill station, a soup station, and a variety station that differs everyday. I usually go to the grill station because I know the food selection usually contains safe food.

Why? Because previously in the year, I spoke up. I talked with the head chef in the dining hall and got to understand what food they use and how they prepare their meals. I worked hard to make sure the food I was eating was safe. And, if I have any questions at all, I can go directly to the head chef and ask!

That’s very different than ordering at a restaurant. At a restaurant, especially the ones you’ve never been to before, there’s a high amount of risk on dishes you’ve never eaten before. “Good judgement” says that I need to ask about their food preparation practices for my safety every time. And even if I go back to the same restaurant time and time again, I still speak up.

“Good judgement” is simply following this creed:

Safety is your first priority, so always prioritize your safety. Safety is maximized when there is little to no chance of the food actually containing your allergens and little to no chance of cross contact issues in the food.

Really, there’s not much more to it. You have to learn how safe you feel at restaurants and your parents and doctors can help with that. You probably shouldn’t eat french fries that are cooked in the same oil as their fried shrimp; but, if your chicken is prepared separately from the salmon, you’re far more likely to be safe (if you have shellfish or fish allergies, for example).

Final Thoughts

There is a lot more personal responsibility in college, from school to friends to sleep. You get to add in managing food allergies into that mix.

I personally know how…intimidating it can feel. I was in a new city, in a new room, with new friends, taking new classes at a new school, and I had to figure out what the heck I was going to eat! But my Mom and Dad helped me from a very young age to understand how to speak up, how to manage risk with good judgement, and how to maximize my safety. That’s all self-advocacy is.

You may have a roommate that isn’t accommodating to your peanut allergies, and you’ll have to set those boundaries, especially if he or she is constantly storing open jars of Nutella in the room fridge. Like, that’s just blatant disrespect. Your safety comes first and never convince yourself otherwise.

I haven’t had an allergic reaction since age 10 (to fish on a camping trip when I really had no idea I was allergic to fish). You should never accept the “reality” that you may have an allergic reaction. If you’re having allergic reactions, minor or major, you may need to work on strengthening that “good judgement” muscle. If you’re constantly in situations where you don’t feel safe, you may need to evaluate how well you speak up about your needs.

Do I go to restaurants where they serve seafood? Obviously, yeah. Do I allow my friends to order seafood? Yeah, nearly all of the time. Do I personally order seafood? Obviously not. Do I go to college parties? Not really. Do I deal with drunk friends? Yes, of course, it’s college. Do I eat out with friends? Absolutely! Do I usually have influence over which restaurant we go to? Yes. And so forth. Those are the boundaries that I have set, through good judgement, as acceptable for my safety. You need to figure out yours.

Self-advocacy assures you are kept safe. Really, college is just like any other area in life where you deal with food allergies. Instead of talking to an airline’s customer service about their peanut policy, you talk with the university’s Disability Services Office, or their Housing department. Instead of training your teacher at a 504 Plan meeting, you train your friends. And so on.

College is such an exciting time. It’s merely one part in a big journey through life and food allergies are simply one small part of that adventure.

You are always welcome to ask me any questions or voice any concerns you have to me. Send me an e-mail at [email protected]!

College with Food Allergies, Food Allergies & Study Abroad

Travel, Travel, Travel Abroad! 

I’m writing this sitting in Copenhagen, Denmark after traveling for 30 days through 11 cities in 5 countries. I started in Reykjavik, Iceland and ended in Athens, Greece and visited nearly everywhere in between.

Needless to say, I’m a bit tired.

This past month was fantastic. I cannot even begin to explain how much impact this last month has had upon me. I was a bit skeptical when everyone said “travel will change you in unimaginable ways.” Well, I can say with certainty, it does.

This past month has also re-affirmed a sincerely held belief: having food allergies doesn’t limit you from anything. After ordering food in dozens of restaurants across Spain & France, eating gelato from the best shops in Italy, and having authentic Greek food in central Athens, I know that food allergies are simply another part of traveling.

Threesome in Florence

I traveled with Thomas (my first year roommate and best friend #1) and DK (best friend #2) for the month. They were absolutely hilarious to travel with and we had an absolute blast. Both Thomas and DK knew about my food allergies and were incredibly supportive and accommodating. They had been previously trained in how to use an EpiPen and were aware of cross contact issues. Most of the time, they were more worried about me being safe than I was!

It would take too much space to give a detailed play-by-play of each meal in each city, so I will give a review of where I went and what I saw and then move on to the important takeaways and lessons from this amazing travel experience.

My Itinerary

Thomas & I flew out on August 1st and did a one-night stopover in Reykjavik, Iceland. It was our first city and it was a wonderful first stop. Even though we only had two full days in the city, we got to experience a very different city (in style and living) than most of Europe. If you have the chance, do a free stopover in Iceland with IcelandAir. They’re an excellent airline! We traveled via regional trains for the remainder of our journey.

We departed in Reykjavik and entered mainland Europe, beginning with Barcelona. We spent three days in Barcelona and got a real taste of what it’s like to live there (hint: most people wake up past noon and stay out late). We got to see La Sagrada Familia, a huge cathedral designed by Antoni Gaudí that is still under construction! It’s world famous. But we also ate at markets, got to see the Mediterranean, and walk around a really great city.

La Sagrada Familia

After Barcelona, we left to meet DK in Montpellier, France. With only one night, we only saw the main attractions: a cathedral, a large Arc de Triomphe and attached park, and the great medieval architecture. We got kicked out of our Airbnb (more on that later), so our time was cut a bit short. After Montpellier, we arrived in Marseille, France for two nights. We walked so much in Marseille, but we got see incredible views, churches, and history in France’s 2nd largest city. It was by far my favorite French city. After Marseille, we left for two nights in Nice, France — we mostly slept since we were recovering after Marseille and spent the rest of our day on the world famous beaches. As a note, there were armed French military patrols every 200 meters walking around the streets and along the beach due to their recent terrorist attacks.

Trio in Italy

After Nice, we arrived in Milan, Italy after a brief 3-hour stopover in Genoa, Italy. We got to see the famous Il Duomo and three other incredibly historical churches, a medieval fortress, a museum, and ate world-famous pizza at Spontini Pizzeria. Our two nights in Milan felt really short but that’s mainly because we walked 12+ miles each day we were there! After Milan, DK went to see his cousin in Cinque Terre, a gorgeous coastal area of Northern Italy near Florence; Thomas and I went to Venice instead. Venice was by far my favorite city from the whole trip: picturesque canals, small shops and churches scattered all over the island, and a ton of history. We spent three nights in Venice.

We met back up with DK in Florence and spent a short three nights in Florence. Florence was the ideal “Tuscan” city: a giant cathedral (the Florence Duomo) surrounded by red tile roofs in a picture-worthy valley. We spent most of our time in art galleries and museums (the Uffizi and the Accademia, where Michaelangelo’s David is held). We could’ve easily spent a week in Florence, partly because we found the best gelato shop in all of Italy!

Trio in Vatican City

After Florence, we moved on to Rome. We spent a total of a week in Rome, but stayed in two different areas to add some variety. Our whole group got to see Pope Francis for his Sunday Angelus and now we can claim we have shirts blessed by the Pope! We also got to see all of the Vatican Museums and St. Peter’s Basilica, plus multiple museums and Roman historical sites. I ventured out to Tivoli, Italy by myself for a half-day in Villa D’Este, a 16th century villa with incredible gravity-operated fountains. After 7 days in Rome, we were definitely exhausted.

But no matter! We hopped on a short plane to Athens, Greece (via Aegean Air, another excellent airline) to conclude our trip. By this point, we were pretty darn tired so we split our days between relaxation and seeing historical sights. Still, we got to see a plethora of Ancient Greek history sites and museums.

Threesome in Athens

Upon reflection, Thomas and I realized we kind of moved “backwards” in history — Iceland was the “newest” country, founded in about 800 CE. And we moved all the way back to the cradle of Western civilization in Athens, Greece, which dates as early as 8,000 BCE. It was an incredible journey through history and through Europe!

Scariest Moments

I think there were a few moments that definitely top the list of “what the [heck] just happened?”

  1. We got kicked out of our Airbnb in Montpellier. This isn’t as bad as it sounds, but it is fun to say. Our host said we needed to be out of the Airbnb before “12am” — knowing that many Europeans (especially those less fluent in English) could mistake 12am with 12pm, I asked him if he meant 12am or noon. He re-affirmed 12am. As it turned out, he meant 12pm. Most of the French (and elsewhere) use 24h time, so time after 12h is expressed as 13h–23h instead of 1pm to 11pm. It was a simple mess-up, but his cleaning lady came a-knocking at 12pm. Luckily, we were there by accident since DK needed to grab his water bottle! Unfortunately, his cleaning lady didn’t speak any English so we roughly communicated through Google Translate to figure out why she was there and how much time we had to leave (about 1 minute). We hastily packed everything and ran out apologizing (Je suis désolé !). We explored Montpellier with all of our stuff on our backs until our train left for Marseille.
  2. We were in a restaurant in Marseille, France and I decided to have a dessert — creme brulee! It’s a classic French dessert and it’s really a set recipe. However, their creme brulee was served with a side of raspberry sauce and almonds. I asked for them to leave off the almonds on the side. Thomas and DK got a separate dessert — but when they came to serve the desserts, they didn’t get Thomas or DK’s right (they served them the wrong dessert) so I had an “OH BOY” kind of moment, waiting for the creme brulee to come out with nuts on the side. They actually first entirely forgot about my dessert for about 5 minutes once they corrected their previous mistake with Thomas and DK, but they eventually got it out and it was completely safe, no nuts anywhere.
  3. We were at a restaurant in Athens, getting a late lunch. Our waiter was an older Greek man and his English wasn’t great — although, on the whole, Greeks in the service industry seem to know more English than the French or Spanish do. I explained to him that I couldn’t do any sesame, and he smiled and nodded his head and put his hand on my shoulder and said “it’s no problem, all safe.” I wasn’t entirely convinced. But he served food that was completely safe, since I found out from another waiter their bread was made in-house and didn’t contain any sesame. (Whew)

Most Successful Moments

Obviously I had a couple run-ins with danger, but there were far more successes.

  1. Every meal I ate while traveling, which meant about 90 meals were entirely safe at a variety of restaurants in a variety of countries, explained to servers who weren’t usually fluent in English. So, I only had two mix-ups out of 90 — that’s a stellar record.
  2. I ordered a a simple peach tart in Nice — basically baked peaches with a peach sauce. The waiter actually double checked with three cooks about the processing of the peaches before he came back to the table and informed me that the peaches have cross contact issues in their kitchen with nuts they use in other dishes. How incredible! 
  3. This gelateria! IMG_2343 (2)
  4. This restaurant in Venice!Italian MenuThis restaurant in Rome!
  5. IMG_2144

Those are some highlights (and I actually just realized while writing this that all of those moments were from Italy). Every waiter in Europe that I’ve explained my food allergies to completely gets it. They don’t ignore it and they double check with the kitchen on my meals. Really, truly good service even with a slight language barrier.

Lessons & Important Takeaways

There was a lot I knew coming into my travels. I planned for months in advance for which cities we were visiting and where we were staying. I double checked airline policies for serving nuts (Iceland Air and Aegean Air are two fantastic airlines). I knew I would have to avoid chocolate at all costs because chocolate is usually made with nuts across Europe, and I would avoid it even if they told me their chocolate wasn’t. I even checked immigration restrictions on medicine and bringing EpiPens® into different countries.

But there’s so much I simply learned by traveling. In no particular order:

  1. Never, ever, ever believe your food allergies are an inconvenience. Thomas and DK were wonderful companions and always supportive in finding restaurants with safe menus. After walking 10 miles in Venice one day, Thomas and I were famished and we found a good looking restaurant, but about 75% of their menu was solely seafood (which Thomas enjoys). I didn’t feel totally comfortable with the place even though I could eat there, but it was Thomas who was the really uncomfortable one since he didn’t want us eating there for my sake — how’s that for great friends! He decisively said “no, let’s find somewhere else.” We did. Never convince yourself or your friends that it’s okay to put yourself in danger, because it’s not.
  2. Always restate your food allergies to the waiter multiple times while ordering. Before I ordered, I would tell them “I have food allergies. All peanuts and nuts, sesame, shellfish, and fish,” in English. If they looked confused or weren’t totally fluent in English, I’d pull out my phone and show them the list in whatever language they spoke. Then I’d order my food. Then I’d restate my food allergies. By that point, the waiter or waitress was like “yes, yes I got it,” which made me feel even safer!
  3. Carry all your important documentation in one area and have digital copies available. I feel as if this is a good travel tip in general, but especially for those of us with food allergies. I had a bright red folder in my daypack (that I carried on to flights as well) that contained copies of doctor’s letters for immigration that allow me to carry my medicine, my passport, all of my credit cards and ID cards including health insurance, a copy of proof of health insurance, and a copy of bank statements (really for my travels in the UK). I had all of these documents also saved digitally so I could print them out if necessary. I also had printed verifications of everywhere we were going to stay (AirBnB’s and Hostels) along with flight confirmation information. This way, I had any and all information I needed at anytime I needed it on my person. In case it was stolen, I also had digital copies I could print out.
  4. If you want control over your meals, use AirBnB. I should become some sort of brand rep for their company because I absolutely adore AirBnB. Basically, you can “rent” out another person’s apartment or a room in their apartment for as long as you would like. There are hundreds of options in each city. We stayed with top-reviewed places and top-reviewed hosts (called SuperHosts) so we assured our experience would be a good one. Through AirBnB, we stayed in an apartment in a 13th century monastery, a 5th floor apartment with a grand view of Marseille, a first floor apartment with a river view in Florence, a gorgeous apartment near the Vatican, and a top-floor apartment with a rooftop view of Rome. Oh and a spacious apartment in Athens that had a view of the Olympian Temple of Zeus. And for the most part, we didn’t spend more than $30 or $40 per person, per night. When shared between three people, it becomes really quite cheap to travel via AirBnB. Since you have access to a kitchen, you can cook or at least have a place to store food you can eat at anytime. We stayed in our fair share of hostels, but they’re simply not as flexible or easy to use for food.
  5. Bring an emergency supply of snacks. This should be a small bag of some kind of emergency food. I always bring NutriGrain bars, and those staved off hunger on a couple of train rides. You might end up in a situation where you can’t eat safely or you need to catch a train instead of eating due to bad planning (did that one…). It’s always good to have a guaranteed safe option available.
  6. Please always carry your epinephrine autoinjectors. That’s a no brainer.

Final Thoughts

I could probably write pages and pages more — and I just might eventually! For now, those are the top takeaways.

After Greece, Thomas and DK left for Zurich, Switzerland to meet DK’s family. They’ll be finally settling down in Salzburg, Austria for their study abroad program in the next couple of days. I left for Copenhagen, Denmark where I am now completing a research project on small business performance and growth.

City

International travel can seem scary, I totally get that. I had a lot of fears about communicating with different people in different languages and still feel that the food served would be “safe.” But, it is entirely possible. You have to plan ahead, of course, but once you’re there, you have to figure it out somehow. If you explain you have food allergies, you may be surprised at how many people are willing to help and make sure the food is going to be safe and delicious. You can always figure a way to make it work!

Simply: Food allergies do not prevent you from doing anything in life, unless you let them.

Questions about travel or study abroad programs? Send me an e-mail at [email protected]. I’d be happy to answer any and all questions you have about my travels or about planning for yours!

Food Allergy & EpiPen

EpiPens in Denmark

Hi everyone! It’s Morgan. I’m currently researching small business growth in Denmark at the moment, but I decided to take a quick reprieve from my research and look into EpiPen® pricing here in this country.

SONY DSC
Copenhagen!

The recent outrage over Mylan’s price increases certainly has made international news. Heather Bresch is now viewed as a challenger to Martin Shkreli as worst CEO of a pharmaceutical company, ever. Good.

Seeing all the news and congressional inquiries started to make me think: why does the US have this problem? Is it only a US issue? Why can Mylan get away with this blatant price gouging?

Doing a full cross-country comparison among developed countries in North America and Europe would take a few weeks, so I decided to examine how Denmark does it.

Background

Denmark has a publicly funded health care system with mixed governance structures: the national government sets health care goals, policies, and tax structures while regional and municipal governments oversee the delivery of health care and process payments and reimbursements.

All Danish citizens qualify to be a part of the health care system and self-identify into two groups:

  1. Group 1. 97% Danes select to be in Group 1. It’s entirely free to visit a general practitioner (GP), but you need to get a recommendation to visit a specialist. If you visit a specialist upon recommendation of your GP, it’s entirely free.
  2. Group 2. 3% Danes select to be in Group 2. You can visit GPs or specialists at your pleasure and don’t need recommendations. All GP visits are free, but there’s only partial coverage of costs for specialists.

Denmark offers on-the-spot reimbursements for pharmaceutical costs (more on that later) and it doesn’t matter if you’re in Group 1 or 2.

Pharmaceutical Delivery

Let’s say I’m the CEO of a pharmaceutical company. Let’s call this company Molfyne and say it mainly produces anti-depressants. Let’s also assume that I’m licensed by the Danish government to produce and sell pharmaceuticals in Denmark.

Molfyne would need to apply to the Danish Medicines Agency, a national agency, to have its drug recognized and sold in Denmark. I would need to file an application with the Danish Medicines Agency (DMA) and tell them my selling price of my drug to Danish pharmacies. I also submit documentation regarding the effectiveness, side-effects, and value-added of the drug (among other information) to DMA and wait for their response.

csm_DMA_ff426c29c7

DMA determines whether the drug will be reimbursed or not based on those factors. It’s not entirely clear from my research whether DMA “negotiates” with my company over my price offered, but I suspect there might be a little negotiating.

Then, if approved, my anti-depressants are bought either by Denmark’s hospital drug procurement company (called Amgros) or by private wholesalers who sell to local pharmacies. If a patient is prescribed my drug in a hospital, there’s no co-pay or any payment since any and all pharmaceuticals are provided by the hospital and payed for by taxpayers.

If a patient is prescribed my drug by their GP or specialist and needs to buy it from a local pharmacy, they are reimbursed on-the-spot by the Danish government on a tiered system. This means that if a drug cost $50 and they qualified for a “$10 reimbursement,” they would only pay the pharmacy $40. This tiered reimbursement system is determined by how much you’ve spent on pharmaceuticals this calendar year. These tiers are 2015 numbers and are adjusted annually.

(DKK refers to the Danish Krone, their currency; $ is US Dollars)

  • You pay out of pocket up to DKK 925 ($138)
  • You get a 50% reimbursement for DKK 925 to DKK 1515 ($138 — $227)
  • You get a 75% reimbursement for DKK 1515 to DKK 3280 ($227 — $491)
  • You get an 85% reimbursement for expenses higher than DKK 3280 ($491)
  • You get a 100% reimbursement for expenses higher than DKK 3830 ($574)

To translate this, if I need to get $200 worth of drugs in February, I pay $138 out of pocket, and get 50% off the remaining $62. But if I need to buy $200 of drugs in June, I get the 50% reimbursement on the leftover of the second tier ($27 worth), and get a 75% reimbursement on the remaining cost. It means the more drugs you need to purchase, the less expensive it gets for you.

There’s only one catch: reimbursements are calculated based on the least expensive generic product. Pharmacies are required to issue the least expensive generic product, unless a doctor says otherwise (this is unusual). So, if your doctors says “not the generic one” you may have to pay a bit more, but it is still heavily reimbursed.

EpiPens in Denmark

Denmark makes it really easy to find out how much drugs cost across the board: they even have a website (http://www.medicinpriser.dk/) you can explore. It is in Danish, but you can select “English” in the upper right to view it in English.

If you search “EpiPen” you get this screen:

epipens

Notice that there are three items for 0.3 mg doses (the Stryrke column) from three pharmaceutical companies: 2care4, Orifarm, and Meda (the Firma column). Look at the consumer price (far right column)! 440 DKK is the equivalent of about $66. This means that you would pay $66 for an EpiPen® (a single one, not a two pack). The Meda EpiPen® costs 446.15 DKK, which is about $67. Really not much difference between the companies.

I was blown away seeing this. $66 for one EpiPen is cheap, even though it is an increase from previous years. Furthermore, if I have other drug costs from the year and need to get an EpiPen, this could cost me $33 (50% reimbursement), or ~$16 ($75% reimbursement). That’s quite inexpensive.

Lastly, drug companies are only allowed to adjust prices every other Monday, and they must be publicly recorded with the Danish government. There is also a law-binding agreement between an association of pharmaceutical companies (called Lif) and the Danish Ministry of Health to only raise drug prices ~1.5% every 4 years. Only some companies, like Sanofi and Pfizer, are a part of this association.

What’s the Trade-Off?

Obviously, this lower price for an EpiPen® is not happenstance. But, before we get to taxes, I’d like to note two important changes in the Danish system:

  1. Drugs available to hospitals are negotiated by one sole entity. There is a “monopsony,” a literal single buyer in that market (Amgros). Amgros is the only entity that provides Danish hospitals drugs and therefore drug companies have to negotiate with Amgros to sell their drugs. This means an emergency responder or a hospital does not need to worry about using an EpiPen® since the price is reasonable.
  2. Drug reimbursements are approved by a national health authority, the Danish Medicines Agency. As I clarified earlier, I can’t find too much about the DMA negotiating with drug companies, but I bet they wouldn’t approve reimbursements for drugs that are exorbitantly expensive, which means Danes wouldn’t have access to them by any practical means.

On to taxes.

You pay 8% on all gross income — regular income, wages, pension benefits, and so forth. There are deductions for interest dividends up to about $7,000 a year.

Then, you pay the following national income taxes (2014 rates):

  • 5.83% for incomes between 42,900 DKK to 421,000 DKK ($6,420 to $63,100)
  • 15% for incomes above 421,000 DKK (above $63,100)

You also pay between 23% and 28% to your municipality (averaging about 24% across Denmark). They’re merging their national healthcare contribution tax (3% for 2016) into their national income taxes over the next few years, but you pay that too. In total, you could pay upwards of about 57% of your income to governments of various levels every year. That’s a lot of taxes.

Oh and there’s a 25% value-added tax (kind of like a sales tax) on all goods.

Benefits

The Danish government provides a lot more than just universal healthcare in exchange for those taxes. There’s extensive unemployment insurance, social security, education (including higher education), job training, and vocation schools. Plus you get the “normal” benefits like paved roads and national security. This kind of system is referred to as the “Scandinavian welfare model.”

Lessons for the United States

Health care is a complicated system. There are pharmacies, health insurance companies, pharmaceutical companies, medical device manufacturers, hospitals, emergency providers, private practices, and so much more. Denmark decided to basically keep most of that private (only doctors at hospitals are “public employees”; most health care providers are private employees) but fund it all publicly. They figured out ways to keep regulatory compliance low and efficient.

It’s also important to note there are a lot of differences between the United States and Denmark. Geographic size, population, and regional inequalities all play a role. If you live in a rural region of Denmark, you’re going to get the same kind of schooling or access to health care as kids in Copenhagen — that’s not necessarily true of Mississippi versus Minnesota. Denmark is only 5 million people large; that’s barely the size of Colorado. And, of course, it’s a tiny maritime nation on the north end of Germany versus half of the North American continent.

Nonetheless, I think there a few key takeaways:

  1. The US needs to get serious about price negotiations. The Economist recently ran an article on EpiPen® pricing and the failures of the US system (note: there might be a paywall). It’s illegal for Medicare, our nation’s largest health insurance entity, to negotiate with drug companies on pricing. Only private health insurance companies can do that and they’re heavily constrained in their negotiating — only in 6 broad categories. The idea behind this choice was that competition would result in lower prices, but it obviously hasn’t worked. From the article: “As a result America spends 44% more on drugs per person than Canada, the next-highest.”  That isn’t working. A publicly funded entity like Amgros could help lessen the price of drugs across the board, but it’d be very politically unpopular.
  2. The US needs to get serious about pharmaceutical influence in politics. Denmark spends about 9.8% of its GDP each year on healthcare (12.4% of that total expenditure is on pharmaceuticals) and pharmaceutical companies comprise about 13.5% of its exports. Pharma is big in Denmark. To compare, all machinery exported by US companies comprised 13.7% of our exports. The Danish government has every reason to bolster their pharmaceutical industry and loosen regulations, but they don’t. On the flip side, as the Economist article pointed out, “[Mylan’s] chief executive, Heather Bresch, heads the generic-drugs lobby and is the daughter of an American senator.” There’s some questionable influences in American politics over our regulation of and choices regarding the pharmaceutical industry.
  3. Lastly, the US needs to get serious about insurance reform. Drug companies are notorious about offering coupons and deals for many of their more expensive drugs, especially if your insurance doesn’t cover their drug. They do this so they “look good” and can avoid regulation by Washington. But, they don’t do this for insurance companies. Insurance companies have to pay for the expensive drugs without the deals some consumers gets. In the long-run, that raises insurance prices for everyone. The Affordable Care Act (y’know, Obamacare) only did so much to combat that and, in some cases, ran counter to that goal by causing insurance price increases.

We need some serious healthcare reform. Most of it is going to be opposed because (from the Economist, again) “the only thing that Americans detest more than an expensive drug is a bureaucrat who says they can’t have it.” But, there are obvious lessons from countries around the world who have effectively dealt with price gouging by pharmaceutical companies like Mylan.

Food Allergy & EpiPen

What SHOULD Mylan do about EpiPen’s Price?

It has been a firestorm over the last week with consumers, doctors, and the media calling out Mylan for its price gouging of the life saving medication, EpiPen. While Mylan CEO, Heather Bresch, argued that the problem is with the health care system instead of with Mylan in particular, Mylan did come to the PR table to provide further discounts to consumers.

Heather BreschThis is too little and too late, especially for the thousands of consumers who have already scrimped and saved to purchase EpiPen 2-Paks for their children to take to school this year. Nothing monetarily was provided for any family who has already made purchases.

Additionally, this appears to be a public relations tool to not only stabilize their stock price (which has dropped almost 11% over the last three days), but also to quell all the media attention.

What should Mylan REALLY do? Here’s what I’d suggest:

  1.  Give Heather Bresch her walking papers. She has been a controversial figure with her MBA credentials having been called into question, and the EpiPen price increases were destined to be an issue if anyone had had the foresight to see the writing on the wall. Let her take the fall for this and wipe the slate clean. She has stated that EpiPen is “her baby,” so she is responsible for the price gouging.
  2. Cut the EpiPen 2-Pak price to $300, the price it was in 2013-14. With their new $0 copay card value of $300, this would allow consumers to pay nothing. It would also be decreasing the cost of the product for insurance companies portion of the prescription – which we consumers are still paying in the form of higher premiums.
  3. Make Anaphylaxis 101 a non-profit. It’s going to be difficult for Mylan to find a spokesperson now that both Sarah Jessica Parker has stepped down and Kelly Rudnicki, a Food Allergy Mama, who is a beloved figure in the food allergy world. Making the website Anaphylaxis101.org would allow for some good to be coming out of Mylan toward the food allergy community. And put a few members of the food allergy community on that non-profit board of directors!
  4. To further that thought, Mylan needs to get a PR makeover. The best way to do that is GIVE, GIVE, GIVE to the allergy community and to apologize for what they’ve done with raising the price of EpiPens beyond what American consumers can afford. Americans love a redemption story, and it’s time for the old Mylan philosophy of greed, corporate tax evasion and executive compensation packages to be burned to the ground. What can rise is a new company, with the philosophy of collaboration and innovation.
  5. Lastly, Mylan needs to take the HUGE amounts of profits that they made from EpiPen sales and put the money into research of an auto-injector product that meets the needs and desires of consumers: small, lightweight and a stable shelf life of 2 years or more.

Mylan could be a hero to the Food Allergy World if they’re willing to make amends and give up their current corporate philosophy. Become the company that our children would want to work for! If not….then I cannot wait for the competition that’s forthcoming in the epinephrine auto-injector market!

Food Allergy & Anaphylaxis

What to do about the high cost of EpiPens!

I recently wrote about The Scary Price of EpiPens. There have been numerous articles online about the increasing price, and various suggestions of how to mitigate the issue.

Here are just some of the articles:

High price of EpiPens spurs consumers, EMTs to resort to syringes for allergic reactions

Mylan’s EpiPen price increases are Valeant-like in size, Shkreli-like in approach

Allergy sufferers caught between EpiPen price hike, health plan crunch

Martin Shkreli Weighs in on EpiPen Scandal, Calls Drug Makers ‘Vultures’

I love this idea that Dr. Dave Stukus has for decreasing the cost of EpiPens:

Dr Stukus Tweet on EpiPens

I have been interviewed by numerous news agencies about the high price of EpiPens and I have told each of them that Mylan’s high prices would be better understood IF they were creating a smaller EpiPen and/or if they were working on extending the expiration date of the product to 2 or 3 years from the current 12-24 months. Since neither of these are occurring from every response that Mylan has provided to the media, I can only assume that they are increasing the price to pad their profit while enjoying their monopoly status.

I decided to write my two US Senators and my one US Representative and ask them to request an inquiry into Mylan’s pricing practices. Here is the gist of the letter that I wrote (and please feel free to copy/paste and add your pertinent information):

Hello Senator/Representative ____________________________
You may have seen the recent Denver Post article titled, “Allergy sufferers caught between EpiPen price hike, health plan crunch”. We are very dismayed at the rising cost of the EpiPen for no good reason. There are 15 million Americans with food allergies, and the EpiPen is providing $1 billion in sales for Mylan, the manufacturer of the EpiPen.

Certainly, part of the issue is the changing prescription coverage for those of us with high deductible health plans. Another part of the issue is Mylan who have raised the price of the autoinjector astronomically since 2007 when they purchased the patent.

My recent trip to purchase an EpiPen yielded a price of ________ for a 2-Pak EpiPen prescription for my child. Mylan offers what they call a $0 copay card, which actually maxes out at $100. Therefore, the cost of the prescription would still be ___________ for our family. We could not afford to pay for the medication.

This is lifesaving medication for my child, who has anaphylactic food allergies to _______________.

In the past, we would have purchased four to six 2-Paks of the medication for safety’s sake.Our child will have an expired EpiPen 2-Pak as his backup. This is not ideal, and we are not alone in having to make these difficult financial decisions.

I would like to request an inquiry into Mylan’s practice of huge price increases for this drug, when there have been no improvements at all.
Mylan currently has no real competitors other than a generic alternative, Epinephrine USP, which would still cost us $400 with our insurance. Without competition, we consumers have no real hope for change, hence the need to ask for your assistance.

To date, I have received one response from Representative Doug Lamborn:

13737733_1223184607714797_8035253427722210515_o

Plus I received a phone call from Senator Michael Bennet’s office telling me that he has a contact at Mylan that he will speak to regarding this situation.

I just saw this post today from Minnesota Senator Klobuchar:

Koblar

Please write to your US Representative and Senators! We, the food allergy community, don’t have to accept these price increases.

College with Food Allergies, Food Allergies & Study Abroad

Encouraging my Son to Study Abroad

1 Comment

Many of you have read my son, Morgan’s, recent posts about studying abroad with food allergies. If you’ve missed them, please read them on his Morgan’s New Corner blog here and here.  He wrote extensively about the details of what it took for him to be able to study abroad safely. He will be traveling throughout Iceland, Spain, France, Italy & Greece in August; doing research in Copenhagen, Denmark in September, and studying at the University of Lancaster in Britain from October through December 18.

As a parent, it was difficult to wrap my head around him studying abroad when he first brought up the subject prior to leaving for college. At the University of Denver, approximately 70% of the students study abroad – generally in their junior year. There were seminars about studying abroad for parents to attend during the Parent portion of the Freshman Orientation Week. I sat through those discussions and wondered how we, my husband and I, would ever be able to support this endeavor! Yet we both agreed that this was an opportunity not to be missed, if it was possible. It was going to take plenty of preparation, but the good news was – Morgan would be doing that instead of me!!

Over the past 2 years of college, Morgan has shown more maturity in being able to handle the details of his medical care. He has also become far more organized, and took on looking into the schools abroad that could accommodate his needs for safe food. Since middle school, he has been responsible for ALWAYS carrying his EpiPen 2-Pak, which he does ALWAYS. He knows how to recognize an allergic reaction in himself, and how to teach others. He can also teach others how to administer his EpiPen. He has vast experience with traveling by himself, and in groups, and keeping himself safe.

Since he doesn’t speak a second language, we knew that he would need to have an English speaking country for his study abroad, and thankfully he agreed with that wholeheartedly. I remember speaking with a father at a Parent’s Weekend at DU who was telling me that his son went to Australia for study abroad and loved it. He then mentioned that his son has a peanut allergy. I commented that it was probably easier to manage his peanut allergy in an English speaking country. The Dad said that he’d never thought of that! For some parents of children with food allergies, there is a different level of vigilance than what we’ve practiced.

We have chosen the vigilant lifestyle, based upon Morgan’s past allergic reactions. I can’t imagine being cavalier about where Morgan chose to study. It was also important, however, that Morgan take responsibility for ALL parts of the study abroad. This included whether the college/university had classes that would fit into his major; whether he could find a living arrangement that would keep him safe; and which airline he would choose to fly to his various destinations.

There are so many pieces of this puzzle to put together, and we allowed him to be the Project Manager of this adventure. He learned about an app called Trello that he was using with another project at school. This became our go-to place for listing all the details of what needed to be done prior to his departure. He would list various items that he knew he needed to provide to get into the country; and I listed other items important to me. Together we made it happen, and I also had to quit micro-detailing him to death. At 20 years old, he had shown how responsible he was, and I needed to trust that whatever happens abroad is for his highest and best good.

2016-08-01 11.03.14

Yesterday, we took him to Denver International Airport. I couldn’t believe that we were at the launch point! The years of teaching him how to be safe with food allergies were going to get the biggest test yet. He has a written plan for the cities he will be visiting detailing where he’s staying, and he’s checked out various markets and restaurants. He’s going to purchase a SIM card in each of the countries he’s visiting to be able to communicate with us and with others. We will be communicating through Skype while he is abroad, however he told me to expect a weekly update – not daily! He will provide a map “touch point” every time he enters into a new city while traveling during August. This will allow us to know he has safely arrived. He also provided us with his detailed itinerary for the month of August, so we know where he’s planning on being. He’s traveling with two DU friends – one of whom flew with him. The other one, they will meet in France.

2016-08-01 14.20.35

It’s not easy to allow our children to grow up and participate in college life! I cried many a tear yesterday, and hugged him three different times before he got on the escalator to head to TSA. I’m so excited for this adventure for him. And I’ve already counted the days until his return – 139 to go!

 

 

Food Allergy & Anaphylaxis

The Scary Price of EpiPens

epipen2pack

Have you been to the pharmacy recently to purchase an EpiPen 2-Pak? If you have a high deductible policy like our family does, you may need a nitroglycerin pill when paying for the prescription!

We have an Anthem HSA (Health Savings Account) insurance policy with a high deductible. What this means is that we pay $4000 of a deductible before our insurance kicks in to cover any cost of prescriptions. This means that my son’s most recent prescription was going to cost us $600!! Yep, you’re reading that correctly.

I thought this wouldn’t be an issue since Mylan is offering a $0 copay card that’s easy to find all over the Internet.

EPI006CC_CoPay_7_0

However, the fine print states that the maximum amount of monetary coverage is $100. Therefore, Morgan’s prescription would still cost us $500. And we generally purchase two 2-Paks, a month apart, so that he always has one 2-Pak on his person, and the other 2-Pak is an extra set for his dorm room in college. That’s $1000 – of very important insurance – but it’s for a purchase that you hope to never have to use. And in fact, in the 19 years of having EpiPen Jr.’s and EpiPen’s prescribed, we’ve only used one autoinjector. It was certainly needed, and we were very grateful to have it. Yet there are many families who cannot afford to purchase even one 2-Pak of this drug at the current costs, and that’s dangerous.

For those of you thinking about a generic alternative, I too looked into that. The generic device is called the Epinephrine USP :generic-epi

While this may be a wonderfully, cheaper alternative for some (depending upon your insurance coverage), this prescription was quoted by Anthem at $400 for a Two-Pack with our insurance.

As most of you know, there is no other alternative currently since the Auvi-Q has been pulled from the market in a full recall of the device.

We eventually purchased two EpiPen autoinjectors made by Meda (the European based pharmaceutical drug company that Mylan recently acquired) from Canada Drugs for $225. They were shipped to our home in a styrofoam package to ensure temperature stability, and had an expiration date 14 months into the future. Never did I think I’d be happy to purchase 2 EpiPens for such a high cost.

What is going on with the cost of EpiPens?

I’ve done a little research that I’d like to share with you:

As I said before, we’ve been purchasing EpiPens for 19 years. Some years, we’ve had great insurance that covered the entire cost of several EpiPens. Other years, we paid $100 or less. It’s been only in the last few years that the price has been skyrocketing.

Previous to 2011, I was able to purchase just one EpiPen at a time. In fact, it wasn’t until 2011 that Mylan began selling only the 2-Paks when the National Institutes of Health suggested that patients have immediate access to two doses of epinephrine. We always purchased an abundance of extra EpiPens (and Jr’s) to ensure we always had one at arm’s length, and the cost was rarely an issue. But for some people, purchasing just one EpiPen would be preferable to none – yet, this is no longer an option.

The Affordable Care Act has certainly changed the nature of insurance, and thereby the cost of medical care for consumers. Depending upon your insurance company and coverage, you may not even be aware of the increase in the cost of EpiPens…or you may be selling off your couch to afford this vital medicine. From what I’m hearing from our insurance agent, more and more insurance companies are moving toward covering less and less of the costs of prescriptions.

Then, there’s Mylan, the company that makes EpiPens.  Mylan purchased the rights to manufacture the EpiPen in 2007 when the device had a wholesale price of $57, and the cost of the epinephrine in the device was about $1. Mylan has increased the wholesale price by 400% since then, while the cost of the epinephrine remains at about $1.

The spokespersons for Mylan will say that they don’t set the retail price, but any college business student can tell you that the higher the wholesale price, the higher the retail price. And if Mylan is counting on their $0 copay card to be the catch all for the price of an EpiPen 2-Pak, then they need to have the copay card be truly worth $600!

For those families who don’t have the money to pay for an autoinjector, they will likely have to rely upon a school’s stock epinephrine. Yet, these cost increases also affect schools and emergency services who cannot afford to purchase the drugs, even if Mylan did give away devices for free in the first years after legislation was passed to allow stock epinephrine in schools.

CNBC’s September 28, 2015 article, “Drug prices: Which companies may be the next targets?” pointed out that the price of EpiPens increased 27% , on average, each year between 2011 and 2015. The number of prescriptions rose 9.5%, on average, each year from 2011 to 2014. This made for an average increase of 42% per year of sales, to more than $1 billion. The EpiPen provides about 40% of Mylan’s operating profits says researcher ABR|Healthco. EpiPen margins were 55 percent in 2014, up from 9 percent in 2008, ABR|Healthco estimates.

Marketing the EpiPen autoinjector has been CEO Heather Bresch’s key focus. In terms of market share, she’s basically got a monopoly. I anxiously await a viable competitor, which will hopefully bring the price of epinephrine autoinjectors down. Sadly, there aren’t any contenders on the horizon. I’ve seen several prototypes, but many require assembly, which would be extremely difficult to expect a Good Samaritan to be able to do in the middle of anaphylaxis.

Mylan has not only been increasing the cost of EpiPens, but also several other generic medications that they manufacture. There is a point where the market will not allow this to continue. Congress has stepped in before (remember Martin Shkreli?), so there’s always the option of writing your Congressional Representative and/or Senator to let them know how the price of EpiPens affects your family. I believe we are at a tipping point, but it’s going to take hundreds of thousands of us to make noise to get anything to happen.

Lastly, there’s the CEO, Heather Bresch. Heather Bresch had a total CEO pay of $18.9 million in 2015 while shareholders saw a 4.1% decrease in returns. In the last year, the stock price has dropped 38%. Don’t get me started on the faults in our US corporations that believe that any employee is worth that kind of money – especially when it’s based upon overcharging families for vital medication.

Ms. Bresch has a long history of questionable business practices and personal ethical issues. See the following articles for more details about this: “Despite critics of corporate pay, perks persist” and “Who Benefits? – Rising Generic Drug Prices and the Case of Mylan’s Conflicted Property Purchases”

So what’s your family going to do?

Something needs to change, and soon, or we’re going to be hearing about children going into anaphylaxis with no EpiPen nearby because the family couldn’t afford to purchase a 2-Pak.

 

 

 

 

 

 

College with Food Allergies, Emotional Aspects of Food Allergies, Food Allergy & Anaphylaxis

Food Allergy Awareness Week 2016 Follow Up

It’s amazing how much more food allergy awareness there is in 2016 than there was in 1996 when my son had his first reaction – a contact one at that – to peanuts! Twenty years makes so much difference, yet there is still a long way to go.

Christmas 1996

Rare is there a preschool that doesn’t have some awareness of food allergies; however, there are so many colleges that need to be educated. Day cares have protocols for children with food allergies, yet employers don’t have any idea what’s coming as our children age and need special accommodations in the workplace!

And don’t get me started on discussing airlines and their needs to serve peanuts, or warm nuts in First Class! We still have a long way to go to create more awareness of our children’s needs and civil rights.

There have been several key items that have occurred in the last 20 years. The main item was the Food Allergen Labeling and Consumer Protection Act which was passed in 2004 and became law on January 1, 2006. The top 8 food allergens must be labeled in words a child can understand as a result of this law. It is so much easier than it used to be to know if a product is safe.

There has also been the American with Disabilities Act Amendments of 2008 which defined eating as a major life activity, and therefore paved the way for life threatening food allergies to be considered a disability.

There is now an abundance of ongoing research occurring to find a cure for food allergies. When my son was little, there was nothing, and very little funding for research. The only “cure” was complete avoidance of the offending food.

I’m convinced that in the next 20 years, there will no doubt be a cure. In the meantime, living with food allergies is not as lonely as it used to be – sadly, there are so many more children being diagnosed each day. And the Internet has definitely made the food allergy world bond and be able to reach out to more families.

AllergicChild has been online since January 2000. We’ve been sharing our family’s experience of traveling, sending our son to school, and basically every aspect of our lives as it relates to food allergies. My son, Morgan, has detailed his life since he was 9 years old for the AllergicChild audience.

Morgan & Friends April 2016

 

Morgan has shared his personal experience about preparing for trips alone and with school groups, about college and what it took to find the right school. He also shares all his writing from the age of 9 through the present, and how food allergies have affected his life. I encourage you to visit our blog to read more of his posts. You will see that your child has an amazing future ahead!

Thank you for all your support and encouragement through the years. One day, when we have a cure, we won’t need Food Allergy Awareness Week. In the meantime, let’s continue to trudge this road and support one another!

 

Travel/Eating Out & Food Allergy

Dealing with Airlines While Traveling

140113013811-southwest-airlines-story-top

Planes are the trickiest for those of us with nut allergies. Airlines are not always friendly to nut allergies and it is up to the airline to determine their policy regarding peanuts and other nuts on the airline. You should do a quick Google search for your airline and nut allergies: for example, I’d search “Southwest nut allergies.” Most airlines will have their policies easily accessible on their website grouped in with their “Disability Accommodations” or similar.

All of the airlines will have some kind of disclaimer that reads: “We cannot prevent passengers from bringing products containing nuts or other allergens onboard our flights. Therefore, we are unable to guarantee a nut- or allergen-free flight. Attempting to do this would create a false sense of security for passengers with severe allergies. We encourage passengers who are allergic to nuts to consult with their doctor regarding the safety of air travel.” It’s true that you’ll be stuck in a metal tube with limited ventilation for a few hours while flying and exposure to nuts in flight could cause serious issues, so you will want to consult with your doctor about the safety of air travel. However, this shouldn’t dissuade you from flying, especially because different airlines will have different policies regarding flying.

Most airline websites will have a section devoted to accommodations and there should be a small section about nut allergies. There are a few different kinds of policies airlines have:

  • They won’t serve nuts if they are given notice.
    • Southwest is famous for their “Peanut Dust Allergy” document. You’ll mark that you have a disability – a “Peanut Dust Allergy” – when you book your flight online (or you can call Customer Service and they can do this too). When you get your boarding pass, you’ll also have a printed slip that says you have a peanut dust allergy. You present this to the service representative near your gate and they will give you an extra copy and a pre-board slip (see below) that you will give to the crewmember aboard your flight and they will not serve nuts on your flight. This doesn’t mean it will be a nut-free flight as other people could have nuts, but they will usually make an announcement asking passengers to refrain from eating nuts as well. They’re fantastic!
    • Delta changed their policy a few years ago, so you just need to notify the crewmember that you have a peanut allergy and they won’t serve nuts. It’s very similar to Southwest’s policy, just more informal.
  • They will allow you to pre-board to help wipe down seats.
    • Southwest allows you to pre-board if you show you have a Peanut Dust Allergy document to the service desk next to your gate. Basically, this allows you to board before everyone else, find a safe seat, and clean your area before anyone else gets on your flight. I’d highly recommend this if you fly Southwest.
  • They will give you a “buffer” zone.
    • This seems to be the predominant policy from airlines that do accommodate allergies in some way. United, AirCanada, JetBlue, Alaska Air, and many other airlines will offer to create a buffer zone of one to three rows on either side of your row. The crewmember will ask all of the people in the buffer zone to not consume any nuts and they won’t serve nuts to those rows, if they serve nuts at all. JetBlue, WestJet, and AirCanda and a couple other airlines don’t serve nuts on their flights but will still offer a buffer zone to prevent other passengers from consuming nuts on the flight. This can be useful to help assure a safe surrounding.
  • They won’t accommodate at all.
    • American Airlines is rather infamous for this. They don’t serve peanut products, but they do offer warmed nuts for first class occupants and will not grant buffer zones or even allow you to pre-board to wipe down seats.

Obviously, flying is the most complicated form of travel simply because different companies have different policies regarding food allergies. My best experiences flying have been with Southwest. I know other families have had great experiences with WestJet, JetBlue, and Air Canada as well, but I’ve always flown Southwest. The combination of a pre-board, no nuts served, and relatively inexpensive rates to most places in the country have served me well.

There are a lot of online resources regarding traveling – just do a quick Google search and you’ll find a host of blogs and other resources to help you decide.

The airline is one of the most important considerations when you’re traveling as a group. It’s likely that your teacher or coach will be booking flights without regard to your food allergies or food allergy policies. You must tell them ahead of time if they’re booking on an airline that is not friendly to food allergies and explain why it’s important to have accommodations (at least a buffer zone) on a plane for your food allergies, if you have a nut allergy. If your teacher or coach has already booked flights for the trip, you must decide whether you are comfortable flying the airline and have a thorough conversation with your teacher or coach about other ways you could get to your destination if you’re not comfortable flying the same airline.

IMG_0063

(Example Southwest Boarding Slip + PDA Document)

College with Food Allergies, School & Food Allergies

Top 10 Dating Tips for Teens with Food Allergies

Morgan & Friends April 2016

Tip #1: Carry your auto-injector (please do this anyway)

Make sure you carry your auto-injector with you all the time. Certainly, you should be doing this anyway whether or not you’re on a date. Make sure you have them on your person: they should be within your arms length whether you carry them on your person or in a bag. A purse could suffice as long as you don’t leave your purse lying around anywhere. Your auto-injector is the single most important thing you need to have just in case something happens (we’ll hope nothing does).

Tip #2: Tell Your Date… Really.

You can’t assure your safety without telling your date about your food allergies. It doesn’t have to be awkward explaining it to them! It could go something like this:

“Hey, so I didn’t know if you knew, but I’m actually really allergic to [x]. I could get really sick – even die – if I eat any of food that has it.” You don’t have to explain that kissing could create a problem (yet) unless they ask. Make sure you clearly list out your allergens and make sure your date knows that you could get really sick and/or die if you make contact with those food allergies like kissing someone. When you make the problem sound serious, your date will take it seriously.

If you’re on a dinner date, then tell them about this on the drive over to the restaurant. Lock the doors so they can’t escape! Just kidding. But really, tell them about your food allergies. If you can choose a place for dinner, make sure you choose a place with lots of safe options for both of you (i.e. Red Lobster may not be the best choice if you have a seafood allergy). If you’re meeting at the restaurant, make sure to tell your date before he or she orders.

Tip #3: Kindly make your date order a safe dish.

Usually, it works really well to immediately follow the “I’m allergic to [x]” with “I’d really appreciate it if you didn’t order anything I am allergic to.” If you’re on a date with someone, hopefully they’ll be super accommodating to your food allergies. If they’re not, you probably shouldn’t date them. Keep an eye and ear open to make sure the food they order is safe.

Tip #4: When explaining food allergies and cross contact issues to the server, make sure to say “we” and not “me.”

As is good practice, you should tell the waiter or waitress about your food allergies when you order food at a restaurant. However, make sure you say “We can’t have any of these foods so if you could mark it on both of our orders.” Whether or not your date actually has food allergies is irrelevant. Making sure the food they order is prepared safely as well mitigates problems that could occur later in the night (like a kiss). If your date asks, explain it like this: “I just wanted to make sure that all of the food on this table was going to be safe.” You don’t have to explain your desire to kiss them to get it past them. They’ll be understanding anyway.

Tip #5: Tell Your Date (Yes, Really, Again).

Have you not told them? Sheesh. You need to tell your date! You must tell them. They can’t keep you safe – heck, you can’t keep you safe – if you don’t tell them about your food allergies! They could have had a plan to take you to Texas Roadhouse but they wouldn’t know that was a bad idea if you didn’t tell them about your peanut allergy (for example).

Tip #6: Making the move: don’t make it too awkward

So it’s time for the kiss. Maybe it’s the end of the first date. Maybe it’s the end of the second. Whenever this time comes, you don’t need to make it awkward. The reason I prefer dinner dates is because I can assure that the hours before a kiss is possible contain safe food. That mitigates problems from the kiss. Hopefully (although this is not guaranteed), they are also hygienic and they brushed their teeth before they went on the date with you. You can’t assure this happens but dinner dates lengthen the time between consuming unsafe food and the ensuing teeth brushing with a potential kiss.

However, if you’re simply seeing them at night after sports practice (for example), you should ask them what they had that day. You wouldn’t want to be kissing them if they just ate a PB&J sandwich with their team for dinner and you’re allergic to peanuts. That’s not a good combination. You need to set that boundary and say, before you kiss them: “Did you eat anything that I’m allergic to today?” It can help if you list off those allergens if they’re unsure. If they just wave it off and say “no, no, I didn’t,” pressure them! Make them confirm. You don’t need to make them list off every item from every meal of the day (unless if you want to), but you do need to make sure they haven’t eaten anything unsafe in the past few hours. I know that this doesn’t keep the “moment” intact, but your life and safety is far more important than kissing someone (even if they are superbly attractive).

If you don’t feel comfortable kissing someone after a dinner date (even if they ate safe food) because you don’t know what they ate earlier in the day, it is completely okay to ask them what they ate throughout the day. It doesn’t have to be an extensive list, but frame it as if you’re concerned and you really want to kiss them but you just want to be safe. Or, you can simply postpone the kiss for another night (even if that isn’t the best solution, it is the one that keeps you safe).

Tip #7: Over for dinner? Come early or be the chef!

Your date has invited you over for dinner – oh no! Even if you’ve told them about your food allergies, you can’t guarantee that they’ll be as good as you reading labels and preparing safe food. You can either come early and read all the labels (explaining to your date that you just want to make sure all the food is safe). Even if your date assures you that all the food is safe, read the labels anyway. Make some excuse about being weird and paranoid and that you just want to make sure the food is safe, even though you trust that they have read it. Also, if you want to be extra safe, make sure they clean pots and pans before they start making dinner. You never know what has been cooked in those pans previously. Personal note: I’ve cooked a balsamic sauce in a pot before and even after three thorough cleanings, I still get a hint of balsamic in anything I cook in that pan. Needless to say, some food can stick around in the pans (especially if they’re poor quality pans like mine are).

Your other option is to be the chef! If your date invites you over for dinner and you don’t/can’t come early, insist on cooking. That way, you can bring all the safe ingredients and tools to make safe food. You can even invite them over to your place for dinner.

Tip #8: Meeting the parents: Go to a safe restaurant or be the chef!

Your boyfriend/girlfriend is now wanting you to meet their parents. That’s intimidating anyway – there’s no need to make it more complicated, confusing, or stressful with your food allergies. Your date’s parents may not fully understand your food allergies, even if it’s been explained it to them multiple times. That means there is a possibility for mistakes – and that’s something you want to avoid.

You can first invite them to a safe restaurant. If there are safe options available, kindly ask your date to order one of those and again use the “we can’t eat any of my allergens” statement from Tip #3. If you wish, you can also ask your date’s parents to order food that couldn’t cause issues. For example, I do ask for them not to eat shrimp pasta since we’re in such close proximity. I’m not going to be partaking in it, but it makes me feel uncomfortable. I’ve never had a negative reaction to this request since they can forgo one night without their shrimp pasta.

You can also be the chef! Offer to bring your food and pans to their house to cook a family meal. You can also invite them over to your house and cook them a meal. That may be a nice meet-and-greet opportunity as well between your parents and theirs.

Tip #9: Know safe “staple” foods and brands for easy shopping and food.

Eventually, you may find yourself in constant company with your boyfriend or girlfriend. It’s important to know go-to brands of food and restaurants. If they become hungry, you can simply say “how about [x restaurant]?” That way, you always have a safe option in the back of your head. This works great especially when you are with friends of your boyfriend or girlfriend; they can all enjoy good food and you can have safe options.

For long-term relationships, knowing safe brands of food means you can answer their parents’ requests about what food you would like. If you find yourself at a grocery store needing food, you automatically know which brands are safe and which aren’t.

Tip #10: Please train them.

Unfortunately, most people don’t know anything about food allergies or how to administer an epinephrine autoinjector. Train them! If you don’t train them about signs of an allergic reaction or how to administer your auto-injector, they cannot help you in times of emergencies. It doesn’t take long and it’s a very important part of keeping safe.

BONUS TIPS

Bonus Tip #1: Long-term relationship tip: give them a toothbrush and toothpaste to store in their car

This may seem like a weird one, but it’s important. Maybe your boyfriend or girlfriend accidentally ate a KIND bar during a break at work and they’re seeing you later that night. You want to mitigate any possibility of having issues from kissing them later that night, so give them a toothbrush and toothpaste to store in the car.

Obviously, it’s preferred if they don’t eat any of your allergens. That sacrifice may be difficult for some and it’s up to you whether that’s a deal-breaker in the relationship. You must determine the boundaries you are willing to live with. Personally, I would prefer them not to eat anything I’m allergic to (and I voice it clearly) but I’m not super strict about it. I understand that they will be eating nuts every once in a while, but I make sure they are fully aware of the consequences. If you’ve been dating a while, it may be time to have a conversation about whether they’d be willing to give up eating a food you’re allergic to – but that’s all up to you.

Bonus Tip #2: Avoid Alcohol

Let’s ignore the fact that underage drinking is illegal. There are two parts to this.

First, alcohol allows you to do stupid things. It hinders your ability to think straight and you could end up accidentally eating something while you’re drunk that you’re not supposed to because you forgot to read the label. Usually when you’re drunk (in high school and college), you’re surrounded by other drunk people. Those drunk people will most likely be unable to help you if you eat something you’re allergic to because either a) they can’t think straight like you, or more likely b) they don’t know how to administer an autoinjector in the first place.

Second, a lot of alcohol contains food allergens and they’re not required to label it. This quite literally means your first drink could be your last. You could be your diligent ol’ self and promise to only have a sip of something even after reading the labels on the alcohol, but you don’t actually know what it is in it because they aren’t required to put it on the label. For example, Bombay Sapphire contains tree nuts and it appears nowhere on the label.

I know alcohol seems enticing and helps you “fit in” with friends. Most people respect your decision if you say “no” to their offer of a drink; however, if they continue to pressure you into drinking even after you’ve said no, then it is time for you to leave the party and maybe even find a different friend. In this instance, your life is on the line and you need to choose responsibly instead of “fitting in.”

Bonus Tip #3: Enjoy your dating life!

Life is too short to take it too serious. You should always try and keep yourself as safe as possible and I hope the above tips help out with that. Remember: you’re on a date! You’re supposed to have fun with this guy or girl who you like and who you think is really attractive. Don’t let food allergies ever stop you from dating. Be yourself and have fun! It’s a date.

College with Food Allergies, Food Allergies & Study Abroad

Studying Abroad in College with Food Allergies

Studying Abroad is a rite of passage at the University of Denver, where I attend college. There are numerous steps for every student to prepare appropriately for being in another country for a school quarter or semester. For me, adding food allergies into the mix, generates even more necessary preparation!

The University of Denver (where I attend college) is #1 in the nation for study abroad participation rates. Nearly 3 in 4 students at DU study abroad, typically during the fall of their junior year. I kid you not, it seems like the entire junior class disappears during the fall and magically reappears in the winter. DU makes it excessively easy to study abroad: they partnered with over 130 universities and study abroad programs around the world in dozens upon dozens of different countries. With a good GPA (3.0+), a student is eligible for the Cherrington Global Scholars (CGS) program. If you’re eligible for CGS, you pay DU the normal tuition and housing costs for a quarter; in return, they pay for tuition and housing at your host university abroad and reimburse visa and flight costs (among a few other things). It really makes studying abroad superbly easy (plus, they have an easily searchable database of available programs!)

I knew this coming into freshman year and I’ve spent a long time looking at the programs available. I knew a few things:

  • Unless I magically became fluent in another language, I would need to go to an English-speaking country. The language barrier present in trying to explain my food allergies to chefs or other people in a country that does not predominantly speak English would be a challenge that puts my life at risk. That was unacceptable so I knew I would have to look at an English-speaking country in which to study abroad.
  • I could not do a homestay program. This is especially true in non-English speaking countries. In a homestay, I would have little to no control over the food served and thus would be putting myself in danger. I knew a homestay would not work.
  • Most importantly, I would have to find a university or program that had classes that interested me and was in a country that interested me! I wouldn’t want to study abroad in a country that I didn’t like or at a university/program that offered no classes that interested me. That wouldn’t be fun and I want to have fun while studying abroad.

I found a few programs around the world in the UK, Australia, and Ireland that interested me. After narrowing it down, I found an awesome program at Lancaster University in the United Kingdom. It’s about 3 hours away from London (by train) in rural England and it’s ranked as a pretty good university!

Lancaster

Because I love to plan ahead, I knew this was the program I wanted to attend before I even started school my freshman year (last year). It had all of the academic courses that I desired, and the housing was on the university campus with access to a kitchen.

bg-logo

I did a bit more research into the program at Lancaster during the winter & spring of my freshman year and realized that the dormitory system may throw a wrench in my plans. Lancaster is set-up in a college system. Each college has its own dining hall, common areas, and living spaces. The majority of the dorms were set-up in a shared kitchen style, meaning that food would be stored in a shared refrigerator (or two) and everyone would have access to the same pots and pans to cook. That posed a lot of cross-contact issues both in storing and preparing food. I knew that I could probably buy my own pans and pots while I’m there, but I couldn’t mitigate contact between my food and other people’s in the same refrigerator. I made a judgment call and determined I didn’t feel safe with that option.

I found that some colleges have a “private ensuite” option: I have a kitchen and storage and a bed all to myself in my own self-contained suite. This mitigates a lot of the issues that could arise in a shared kitchen facility. I became really excited since I knew that the option was available! I just had to find out if I could secure a “private ensuite” while I study abroad.

I dug into Lancaster’s website and found their disability office contact. I sent an e-mail with my concerns (explaining my food allergies, their severity, the problems with shared kitchen facilities, and the possibility of a private ensuite). I heard back from the office and they said that it was a definite possibility! They remarked that it wasn’t a preferred set-up for a study abroad student simply because it limited my social interactions with other people, but they said my health always trumps those concerns.

I was really excited. I knew that I could study abroad and find safe housing at my host university. I started to research labeling laws for the UK and got some help from the Anaphylaxis Campaign in the UK in identifying the regulations. Since the UK is a member of the European Union (EU), the EU’s regulations apply to all UK manufacturers and producers.

At the University of Denver, the Office of International Education (OIE) supervises all of the study abroad programs. Students get a study abroad advisor depending upon their country and that advisor helps answer any questions regarding studying abroad and helps coordinate all of the application process.

I told my OIE contact person about my food allergies and why homestay/shared kitchens would not work. I wanted to reconfirm through him and his contacts at Lancaster that a private ensuite option would be available for studying abroad. The staff at Lancaster confirmed this! I would need to submit some medical documentation, coordinate with the disability office, and include the request on my study abroad application, but otherwise, everything was a go!

After spending the last few months coordinating with OIE, my academic advisors, and Lancaster University, I decided to add a month of research in Copenhagen Denmark, prior to the start of the school quarter at Lancaster. The research will be within my two majors: economics and public policy.

Copenhagen

Denmark is also, technically, an English-speaking country. 86% of Danes are fluent English speakers, meaning that I won’t have problems assuring my safety in urban areas. I’m still securing a lot of the details around my research since it is a relatively new adventure! I know I’ll be staying in a no-pet and no-smoking Airbnb in Copenhagen for the month, with access to a fully-furnished kitchen. This makes it really easy to make sure I’m safe: I buy all of my own food and cook it myself! I’m still researching labeling laws in Denmark, but given that they are members of the EU as well, I’m sure their regulations are very similar to the UK’s.

I’m so excited to have this opportunity to study abroad, and to do so with my food allergies handled in a way that makes me feel safe!

 

 

 

College with Food Allergies

The Trials & Joys of Finding an Off-Campus Apartment in College

My son, Morgan, has been living on campus for two school years, which is required at the University of Denver. We did a lot of work in preparing the cafeteria and his roommates through the years to properly address his allergens and safety-zone needs. If you’d like to read two of the blog posts we have written about preparation, please read, THE FIRST QUARTER OF COLLEGE BY MORGAN SMITH and STARTING COLLEGE – WE’VE WORKED TOWARD THIS GOAL FOREVER!

Now, it’s time for Morgan to move off-campus for his Junior and Senior year. He will be studying abroad for the Fall 2016 quarter in the UK at the University of Lancaster; however, waiting until he returns in December to find a place to live will likely yield him no safe place! Therefore, time is of the essence now, 9 months in advance, to secure housing.

We have lived in our family home for over 22 years. We have ensured that the home is allergy-safe for Morgan. We put in tile floors years ago, and added Air Conditioning, which many people do not have in Colorado. We have HEPA filters on the furnace, and have no pets. Basically, our home is and has been a safe haven for Morgan, and it was the only home he lived in prior to going to college.

I hear from many parents who assume that living off-campus in an apartment is easier for food allergic students than living on campus in a dormitory. That may be true in some cities; however, Denver is seeing a population explosion and rentals are scarce and over-priced. For Morgan, living in a dorm and eating in the cafeteria has worked extremely well, especially since DU Dining Services are well-versed on food allergies. And, on-campus housing is cheaper than any off-campus apartment or shared home.

DU housing

Food allergies are just one part of the equation for Morgan. He also has mild asthma and pet allergies. Therefore, he has to find a place to live that has central air conditioning, no pets, no smoking, with roommates willing to not eat his allergens, AND come in at a price that’s below his scholarship stipend! That is a difficult combination!

He immediately was able to find the roommates he wanted to live with, and had a discussion about his food allergies to ensure they were okay with his needs. With that hurdle jumped, the real issue began – Denver is big on dogs. And many college students have pets, so about 85% of the available houses and apartments allow for pets in the DU neighborhood. Of the 15% remaining, most do not have air conditioning! That narrowed his selection of available apartments to about 3 buildings.

Thankfully, he started early and has just signed a lease with three other young men to live in a 4-bedroom apartment that has AC, no pets, and no smoking. These transitions are difficult for this Mama to stomach; however, I know that Morgan is making wise decisions of who to live with, and I’m hopeful that this apartment lives up to its promises!

College with Food Allergies

A Robot for High School, And She’s Now in College!

Many of you may remember a previous interview I did with Lauren, a 14 year old high school girl who had a robot for high school because of her inhalant dairy allergy. If you haven’t read our blog post, INHALANT DAIRY ALLERGIES & A CREATIVE SOLUTION – A ROBOT! – you can do so here.

Lauren is now in college at the University of Northern Colorado, and I wanted to interview her, and her mother Melissa, about her experience through the rest of high school. Also, I wanted to see how she is managing in college without having a robot!

Lauren

Lauren – you were 14 years old when we last interviewed you. How was the rest of high school for you with your dairy allergy? Did you continue to have a robot go to school for you?

The rest of high school was amazing! After using the V-go, my friend had told me about a charter school that was able to accommodate my food allergy. They even banned pizza, and implemented a desk cleaning before each class at the school for me! Everyone was so accepting of my allergy. I still stayed away from food areas and washed my hands often. Except for the occasional hives from dairy contamination, I had no severe reactions while I attended.

Were there any more instances of anaphylaxis during your years in high school?

Not while I was actually at the high school, but during the summer of my junior year I had a really bad one at a women’s retreat that I went to with my mom. There was a miscommunication with the staff that tried accommodating me in terms of food at the camp. I had accidentally eaten a piece of bread with dairy in it. It was a very scary ordeal, considering we were in the mountains & the response time up there is a little longer. I was scared and not sure what was going to happen but after 5 hours, 3 Epipens, 14 times trying to find a place for an IV, 2 Inter muscular injections, a breathing treatment, and lots of prayers the doctors stabilized me! Now I am much more careful and I always make sure my food is extra safe!

How did you prepare for going to college at the University of Northern Colorado?

I set up an appointment to meet with disability services at my school. They were absolutely phenomenal with working with us to make UNC a safe place for me to go. They got me an on campus house where I have a separate, safe apartment. I also took the time to talk to my professors about my allergy.

What made you choose UNC?

I chose UNC because I wanted to go away to college but I knew I really needed to be close to home in case I had a reaction. UNC was a perfect choice because it was only an hour away from my parent’s house. Additionally it had the major I was interested in. Plus, it’s awesome to see family and not have to cook your own food on the weekends!

What is your current living situation at school? How do you ensure that you don’t get near dairy?

I am in a house with a self-contained apartment on campus, I have other girls who live in the same house with me but they are on a totally different side. When I first moved in, I made them all aware of my anaphylaxis, and the severity of it. They are awesome and completely understand the seriousness of my allergy. Whenever I want to hangout in the main house, they make sure to not cook using dairy and they clean the house for me! Two of the girls are from Colorado and two are from Germany, and all have been so supportive and amazing to me, and they are actually some of my best friends now.

What are you planning on majoring in academically?

I am studying Audiology and Speech pathology and I love it! It’ll definitely be awesome to help people with hearing and balance issues one day as an Audiologist.

Have you been able to have a summer job? If so, what “food threats” have you run into with working?

In the past I have lifeguarded during the summer. It was actually a very good fit for me! I have never had a reaction at the pool, and I carry a protective mask in case I ever have to perform CPR. I also talked to my boss about my situation and I let her know that my safety is just as important as the patrons I am guarding, since in order to keep them safe I have to keep myself safe. During my time guarding, there were food parties but I didn’t have to worry about it because the guests couldn’t bring the food near or in the pool. It was definitely an awesome job!

Melissa – when we last interviewed you, Lauren was participating in Dr. Li’s Traditional Chinese Medicine (TCM). Did this treatment help Lauren at all?

Lauren is still taking the herbs. When we started the herbs we simply wanted her to be able to go inside school or the grocery store without having a severe reaction, since there was a time before the treatment that it became impossible to be inside places where food was being warmed up because her body seemed to be even more hyper sensitive then usual. We think this treatment might have helped, since (unlike before the herbs) she has been able to be inside schools, food establishments and other public places without her throat immediately closing. She has no reaction when we simply walk past a pizza place anymore (where as before she would react)

Still, if the dairy is being cooked close enough, she does still react. But at least we are headed in the right direction.

What accommodations did you and Lauren request for her in college?

We asked for them to find a place for her that would be safe from dairy. This was quite the challenge, since we live in a dairy filled world. They came up with a self-contained apartment on campus. Separate from the rest of the house. She is able to cook for herself & steers clear of any areas where pizza or food is served. This has been enough to keep her safe at school.

It was very difficult for me to pass the baton of “health watch” over to my son when he went to college. How have you been able to do that with Lauren’s severe dairy allergy?

Passing the “health watch” baton over to Lauren has to be one of the scariest experiences that we STILL struggle with daily. The good news is that since she’s been gone, she has proven herself to be a good self advocate in keeping herself safe. She did have two anaphylactic episodes since she’s been away (one could have been avoided with better diligence but the other could not) Lauren was in fact able to treat herself immediately with her epinephrine and called 911 for help. Her fast response is always critical in her outcome, and she is well aware of that, she also knows that her body keeps needing more epinephrine after the first one or two shots wear off. For me the scary part lies with the ambulance, and hospital personnel, who seem unaware sometimes how fast her reactions or biphasic reactions change in the blink of an eye. It’s paralyzing for us to think about “what if’s” So this is when we had to put our trust in Lauren & ask God to take over, so we wouldn’t lock her inside our house and never let her out.

Thank you Melissa & Lauren for inspiring hope in all of us!

School & Food Allergies

Mylan and Disney new Show-and-Tell Scout book

Show-and-Tell-Scout-cover-image-297x300

I received an email today telling me about the new Mylan and Disney digital book, “Show-and-Tell Scout”. The email went on to state, “Mylan and Disney are excited to announce the launch of the “Show-and-Tell Scout” digital book, an educational storybook aimed at raising awareness about anaphylaxis (a life-threatening allergic reaction) in the school setting. An estimated one in 13 children in the U.S. lives with a food allergy, putting them at an increased risk for anaphylaxis. Because anaphylaxis can occur anywhere and at any time, it’s important to educate all families about food allergies – even those not managing a food allergy at home.

“Show-and-Tell Scout” follows the story of Scout, a young fox living with potentially life-threatening (severe) allergies to milk and peanuts. We learn about his severe allergies and the importance of being ready to respond should he experience anaphylaxis.

The “Show-and-Tell Scout” digital book is available exclusively on, which provides allergy-friendly resources for families, including recommendations, tips, and real-life stories from experts and parents.  The “Show-and-Tell Scout” digital book is available exclusively on MyAllergyKingdom.com, which provides allergy-friendly resources for families, including recommendations, tips, and real-life stories from experts and parents.”

I think this is a great idea for these two companies to combine efforts to put out information on food allergies. However, there is a lot of information that I don’t agree with in the text of this book.

Here is the email I sent to the team that emailed me: “Thank you for forwarding the book to me. It’s exciting that Disney and Mylan are launching this book.

I wonder if there’s a possibility of changing the language in this book prior to releasing it to everyone? There are several items in the book that just aren’t correct:

On the page about Mrs. Fox telling the teacher on the first day of school about Scout’s allergies – based upon our experience and thousands of others – no teacher wants to hear about allergies on the first day of school. For the success of a child with food allergies at school, it is ALWAYS recommended to have such discussions months in advance of the school year starting.

Secondly, no parent is going to be allowed to train a teacher how to administer an epinephrine autoinjector. In every public school, it will be the responsibility of the school nurse to do this type of training. I believe it is required by law in our state of Colorado.

This is a somewhat detailed point, however any child who accidentally eats one of their allergens would never walk to the nurse’s office. The nurse would bring the epinephrine autoinjector to the child. It is dangerous for a child in anaphylaxis, or where anaphylaxis is a potential, to remain upright and walking.

Other items that I noticed, and that I believe other food allergy families would notice, is that Scout is sitting with children eating his allergens. This can be a dangerous practice, especially for young children who spill food, and for those exquisitely sensitive to their allergens.

Lastly, many children with severe food allergies will have a 504 Plan in addition to a severe allergy action plan. Of course, this plan would only be available in public schools, but might be worth a mention in the back of the book.”

While I believe the intent of the book is good; I’m not supporting the book as it is currently written. I’m hopeful that an edit will be forthcoming soon.

 

 

Research for a Cure

Where to Donate Your Money Toward Food Allergy Research

donate cash

As a follow up to my recent blog post, FOLLOW THE MONEY: WHERE IS YOUR DONATION TO A FOOD ALLERGY NON-PROFIT GOING? I’d like to make a  few suggestions about donating directly to research for a cure for food allergies.

Many readers suggested that I look into EAT – End Allergies Together – a new non-profit focused solely on funding research, and promising that 100% of net proceeds will go to research. I have communicated with the founders, Kimberly Hall and Elise Bates, via email and was told that they will inevitably have some expenses as they go forward for staffing, etc. and they still promise that at least 80 cents of every dollar will go toward funding research. That is a phenomenal percentage, and well worth looking into if you want to fund food allergy research. Below are their Food Allergy Research Areas. You can make a request for a specific area, such as gut bacteria, for your donation to fund.

1. Food Desensitization
e.g., oral immunotherapy, sublingual immunotherapy, transdermal patch therapy

2. Medication Treatments
e.g., XOLAIR (Omalizumab), herbal formulas

3. Basic Science (root cause)
e.g., genetics, T-cell immune response, gut bacteria

I recently wrote about the DBV Technologies Epicutaneous Immunotherapy “Peanut Patch” in my blog post, FOOD ALLERGY RESEARCH & THE PATCH. While DBV does not allow individuals or non-profit food allergy groups to donate to their research, it is available for you/your child to participate in a research study. Information about this participation is detailed in the blog post.

I also recently wrote about Traditional Chinese Medicine in my blog post, FOOD ALLERGY RESEARCH & TRADITIONAL CHINESE MEDICINE. Dr. Xiu-Min Li is the only doctor researcher in the USA practicing both Traditional Chinese Medicine, although her work is confined to immune conditions such as allergies, not the full range treated by other herbalists and acupuncturists, and doing research on TCM to cure food allergies, eczema, asthma, etc. There is information in this blog post about donating directly to her research.

Lastly, some people choose to donate their time and expense to research by becoming involved in a research study. This is a great way to donate to food allergy research. Of course, there are always medical risks with any research participation such as anaphylaxis, eosinophilic esophagitis or other immune system issues. You and your family will have to decide what level of risk you are willing to undertake. There may also be travel costs in order to check in with a doctor on a regular basis. If you’re interested in participating with a research study, ask your allergist whether you and/or your child is a good fit. Many research studies have qualifying criteria to become a part of the study. You can find current research studies at https://www.clinicaltrials.gov/

 

 

 

 

 

 

 

Research for a Cure

Food Allergy Research & Traditional Chinese Medicine

As Albert Einstein stated, “No problem can be solved from the same level of consciousness that created it.” Therefore, I’d like to present researched treatment which corrects many of the behaviors in the immune system that cause allergies – – Traditional Chinese Medicine (TCM.) And, in my opinion, it has the best chance to truly CURE food allergies.

I recently wrote a blog post about TCM, “TRADITIONAL CHINESE MEDICINE: THE “CURE” FOR FOOD ALLERGIES?” wherein Henry Ehrlich details information from his book, “Food Allergies: Traditional Chinese Medicine, Western Science, and the Search for a Cure“. Henry’s new book, Traditional Chinese Medicine, Western Science, and the Fight Against Allergic Disease, will be released in May 2016.

I have been a patient in Dr. Li’s private practice and am currently using a TCM cream to lower the inflammation in my body to help heal my Eosinophilic Esophagitis and Mast Cell Disorder. I am thrilled with the results so far, and have seen a much higher level of energy for myself and less medication needed to manage my symptoms.

Dr. Xiu-Min Li is the only doctor in the US practicing both Traditional Chinese Medicine, although her work is confined to immune conditions such as allergies, not the full range treated by other herbalists and acupuncturists, and doing research on TCM to cure food allergies, eczema, asthma, etc.

Dr. Li has been involved in the medical field since the late 1970’s when she got an MD in both Chinese and Western medicine at a Chinese medical school in Zhengzhou, China. She went on to study integrative clinical pediatric immunology in Beijing, and then clinical immunology at Johns Hopkins Medical School in the US. It was here that she worked with Dr. Hugh Sampson, a foremost food allergy researcher. Dr. Sampson’s support of Dr. Li’s research has been key in moving it forward.Dr Li&Sampson

It is the combination of her knowledge of Chinese medicine and the Western medicine of allergy and immunology that is creating groundbreaking research toward curing food allergies.

There have been multiple research reports regarding Dr. Li’s research in the Journal of Allergy & Clinical Immunology. You can see a partial list of her research here.

In addition to her research, Dr. Li has a private practice with patients, infant to adult, using creams, herbs, and teas, in combination or individually, depending upon the specific allergic issues that are presented. With my sensitive gut, I was not able to tolerate swallowing any teas at first. Therefore I am using a cream, which I apply to my entire body daily. I laugh when I tell people that I am like the witch Elphaba from Wicked – an entire body of green! I will soon graduate to soaking in herbs and then swallowing the tea.

Since my experience with Dr. Li’s protocol is more recent, I’ve interviewed two Moms, Selena Bluntzer and Deirdre Olsen, who discuss why they chose Chinese Herbal Medicine treatment and their daughter’s progress under Dr. Li’s care:

Selena, What made you and your child choose to pursue treatment with Dr. Xiu-Min Li?

My daughter has multiple food allergies, asthma, and eczema. I had researched various treatment options for years, and after a friend of mine made plans to have her children see Dr. Li, I realized it could actually be a reality for us, as well. We live in Texas, so it wasn’t an obvious thought for me to pursue treatment so far away. However, Dr. Li’s research and treatments had been the only ones that gave me a real sense of a possible future cure. There is no other researcher/practitioner in this space, to my knowledge, whose work encompasses the “whole condition” – addressing all of the stages of the “allergic march” – eczema, asthma, allergic rhinitis, food allergies, etc.

Morgan Bluntzer & Dr Li

My daughter sees Dr. Li in her private practice clinic, which she manages independently of her work at Mt. Sinai. While Dr. Li is a researcher at Mt. Sinai and manages a full scale lab plus a production site for her medicine, she is also the only food allergy researcher that has a clinical practice. Patient data from her clinical care is used to fuel her research endeavors, the same way that other researchers use the findings from their closed clinical studies. She is constantly innovating and refining her numerous treatments. She is able to treat her patients as patients, not as study participants, so she can improve her medicine as she helps us. We are definitely receiving personalized medicine, as our protocol is tailored to my daughter’s specific needs. My daughter likes and trusts Dr. Li, which really helps with the treatment process.

Deirdre, What made you and your child want to participate in the Chinese Medicine research?

Our daughter (now 13) was diagnosed by 24 months with severe food allergies, eczema and asthma. It was very overwhelming. We were constantly going to the dermatologist and pediatrician to keep her skin and lungs under control.

Jacklyn 012 (2)

We live in NYC and after seeing a number of dermatologists and allergists we finally met Dr. Paul Ehrlich. During a visit after another skin flare up, he looked at my husband and I and said, “I really would like you to consider seeing Dr. Xiu-Min Li.”  We were in a vicious circle of flare up, steroid cream, calm, then it would start all over again. Jaclyn had allergic dark circles under her eyes, and her skin as well as her entire immune system was always “on alert” ready to attack. We spent many years like this.

We met with Dr. Li for two hours on the first visit. We took copious notes and hung on every word she said- and still do! Our daughter (then 9) took to Dr. Li who has a sweet, patient and loving demeanor. After spending so much time with us, we decided to start TCM with Dr. Li.

When did Jaclyn begin using TCM?

Jaclyn started 5 years ago and has had amazing results. Her quality of life has increased immensely. Her once off the charts IgE at 6600 is now hovering just below 800. She is able to eat a number of foods that she couldn’t 5 years ago. She is cleared for food challenges to egg, hazelnut, coconut and brazil nut in the upcoming months.  She rarely, if ever, needs a puffer. She rarely gets sick now. Her skin is clear and smooth for 4 1/2 years.

Has Jaclyn had any type of reaction?

Jaclyn has not had any adverse reaction to the herbs. A few times she felt nauseous after a bath or starting a new capsule. In this case we contacted Dr. Li and she dialed back the dose or eliminated it.

Have you noticed any decrease in reactions to her allergens? Or any changes in overall health?

Jaclyn had contact eczema. Everywhere we went we put down a towel or sheet so she would not break out. We have not done this in 4 1/2 years.  Where she used to get 4 colds a winter, she is down to 1 a season now.  Jaclyn’s seasonal allergies are also much better. She still is allergic to a number of trees and pollen but no where near where she was.

Jaclyn’s overall health is much better. She is rarely sick. She eats well and is comfortable in her own skin.

Thanks Selena and Deirdre for sharing your experience!

If you’re interested in learning more about Traditional Chinese Medicine, please check out the TCM website here. There is also a Facebook page, Chinese Herbs for Allergies for anyone interested in the TCM treatments.

Lastly, if you would like to find out more about Dr. Li’s specific programs and studies currently open to funding, you can speak to either: Susan Weissman, a parent of a patient who volunteers her time as her fundraising coordinator. You can reach her at [email protected]; or Erica Edwards at Mount Sinai who can be reached by phone at: 212-659-8500.

For those of you ready to donate to find a cure for food allergies, you can support Dr. Li’s research at Mt. Sinai by making a check payable to the Icahn School of Medicine at Mount Sinai.

In the memo portion, make sure to write Dr. Li – Chinese Medicine for Food in Jaffe

Mail check to the following address:
The Mount Sinai Development Office
Attn: Erica Edwards
One Gustave L. Levy Place, Box 1049
New York, NY 10029-6574