A Little Bit Can Hurt (13 page)

Conor's mother calls his epinephrine auto-injector his lucky charm although Conor prefers the Irish lucky charm he wears. Out of an abundance of caution, he carries both! Not inclined to tempt his luck, the teen admits to being "sort of a picky eater" because of his food allergies. Although Conor has outgrown his egg allergy, he doesn't like to eat eggs. He adds that he has no desire to eat chocolate because he is concerned it may contain nuts or may have been manufactured in a facility that processes nuts.

Conor is one of only a few people in his grade with food allergies. Another student has a milder nut allergy, and a teacher has a nut and shellfish allergy. Although Conor's nut allergy is the most severe of the three, he says it hasn't been a major problem. "...I don't really eat many sweets, candies or cookies or stuff so I've never really had a problem there. I've actually found it really interesting because...all over the lower school and kindergarten and parts of the middle school there are all these...nut-free zones now...There's been a large increase in nut allergies in the last few decades, I think."

Regarding nut-free zones, Conor asserts, "I think that's a very good policy for younger children who might not have the...maturity to pay attention to what they're eating." In middle and high school, "I think that a person would be mature enough at that point to make sure they're not eating something they shouldn't."

Conor's girlfriend is highly aware of his food allergies. She's careful to watch what she eats when they're out so that there's less chance of him being exposed accidentally.

Conor has gone on several overnight school trips that he says didn't require special preparation. In response to that, his mother claims he's simplifying the matter. She shares a different perspective. "From the beginning, we've made it real clear to [his private school] what his allergies are...All of the teachers and school administration knew since he was very small...he could not eat [eggs and nuts]." She elaborates that when the middle school scheduled camping trips, the school was good about accommodating Conor's food allergies by purchasing safe foods for the trips, but sometimes he would just bring his own food.

Conor recalls that on most overnight school trips he could eat the food provided and his nut allergies didn't stop him from participating. In fact, Conor went on an overseas school trip to France. Fortunately, several teacher chaperones were able to accurately translate menu items and inquire about nuts. In addition,
Conor brought with him a helpful list of French words for every kind of nut. At times, Conor had to refrain from eating foods he was not sure were safe, a frustrating experience for him. He confesses that not knowing whether a food is safe and having to ask restaurant staff multiple questions while others are waiting can be embarrassing. All in all, however, Conor describes his high school trip to France as a success.

In addition to flying overseas, Conor has traveled by air many other times. He brings his own snacks or sometimes orders a special allergy-free meal when available. Once, however, his nut allergies significantly affected his opportunity to travel internationally. His parents were traveling to Thailand on business for a few weeks and were thinking about bringing Conor, but they were concerned about the presence of peanuts in so many Thai dishes. They considered the idea of bringing Conor's food but ultimately decided not to bring their son because of the length of their stay and the considerable risk to him.

As the parent of a teenager, Deb thinks she is pretty typical in asking Conor every morning, "Now do you have your EpiPen
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?" She feels a certain amount of security while he's at school with trained staff but does worry about when he's old enough to drive and may be alone. It's her hope that over the past years she has taught Conor to take his nut allergies seriously but not to the point of obsession. She encourages other parents of food-allergic children "to find out all that you possibly can about allergies in general and the particular allergies that have been an issue for your child...Find out all that you can about what to expect and what to look out for...It's a very difficult thing...because it's a life-and-death situation, but then walking across the street can be life and death. So I guess it's trying to find that balance..."

Just as Conor has learned to adapt and excel athletically despite the limitations of his left leg, so has he learned to adapt to his nut allergies. He refuses to let them deter him. What is his advice to others with food allergies? "...Watch what you eat. Just be careful, but don't worry too much about it...Don't let it run your life!"

POSSIBLE NEXT STEPS:

1. Does your food-allergic teenager know when and how to administer his or her own epinephrine auto-injector?
   
2. Does he or she carry at least one epinephrine auto-injector, preferably more, and Benadryl
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   in a backpack or purse?
   
3. Does your independent teen carry identification and medical information such as a MedicAlert
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   ID for safety while away from you?
   
4. Do your teen's friends know about his or her food allergy as well as how to recognize and treat a reaction?
   
5. If your child is going on a school trip, do the trip chaperones know about your child's food allergy and how to treat an allergic reaction?
   

14

THEODORE

"You have to be your own safety net."

A well-rounded and outgoing student, Teddy is a high school senior who plays the trombone and is captain of his school's tennis and soccer teams. In addition, he's involved in theater and recently landed the lead role in the play Rhinoceros by Eugene lonescu. Teddy played Berenger, apart that required him to memorize almost a thousand lines and a three-page monologue as the finale.

T
eddy is allergic to Brazil nuts. When he was seven, his mother gave him some Brazil nuts to taste. To his knowledge, he had never eaten one before and recalls what happened as a result. "I ate it, and promptly my tongue was twice the size it was supposed to be. It was hard to breathe, and I couldn't swallow...It didn't progress to the point where I actually couldn't breathe or went into full anaphylactic shock." Teddy's mother wisely gave him Benadryl
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at the first sign of his allergic reaction and sought medical attention. Soon after, Teddy was diagnosed with a Brazil nut allergy and given a prescription for an epinephrine auto-injector.

Another time, Teddy ate something that contained traces of Brazil nuts and suffered a reaction that again involved his tongue swelling. In that incident, Teddy administered his epinephrine before the reaction progressed and sought medical attention. Regarding the experience of injecting himself in the thigh with an epinephrine auto-injector, Teddy says, "It wasn't that bad. It was just really surprising and unnerving. It didn't actually hurt very much." By the time Teddy reached the hospital, his symptoms had resolved.

Teddy attributes the fact that he's had only two reactions to being diligent about reading ingredient labels and careful when dining out. At restaurants, he requests the waiter consult with the chef regarding ingredients. Fortunately Brazil nuts are not very common, a fact that Teddy admits is a double-edged sword because he sometimes lets down his guard.

While Teddy recognizes the importance of carrying his epinephrine auto-injector, he admits he isn't always consistent about doing so. At school, he keeps his auto-injector in his backpack. Elsewhere however, he doesn't have a convenient way to carry it. He knows not to leave his epinephrine in his car where extreme temperatures can destroy the medication. However, the epinephrine auto-injector doesn't fit in his pocket, and Teddy says that as a guy he lacks an effective solution like carrying a purse.

Teddy is proactive about managing his food allergy in advance of overnight school trips. "I alert everyone...That's done through forms and things, but I also tend to do it myself...[I also] make sure [I] have an EpiPen
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there in an accessible spot." While Teddy informs school staff about his food allergy, he prefers to rely on himself to administer his own epinephrine auto-injector.

Teddy's food allergy has not proven to be a problem with regard to dating, traveling or being teased. Teddy can't think of anything he can't do because of his allergy, though he does wonder how a Brazil nut tastes. He admits the most difficult part of having a severe food allergy is "remembering to stay vigilant."

His advice to others with food allergies is to "ask about ingredients. Don't be afraid to inquire about any food or anything. Be your own advocate about it. It's really your own responsibility to monitor [your food allergy]...The sooner you can learn to ask about ingredients yourself, the better."

Next year, Teddy will attend college where he plans to study physics and theater and play a lot of Frisbee. What does Teddy foresee regarding his future with his food allergy? He says with a smile, "My dream is to never have another encounter with Brazil nuts [and] to live a Brazil nut-free life for the rest of my life, which is not an unattainable goal."

POSSIBLE NEXT STEPS:

1. Have you considered carrying the Auvi-Q™ epinephrine auto-injector that fits comfortably in a pocket?
   
2. Have you considered alternatives to carrying your epinephrine auto-injector in a purse or backpack? Search the web for medication carriers suitable for your lifestyle.
   
3. Do you know how and when to inject epinephrine and seek medical attention?
   
4. Have you trained others to administer your epinephrine for you if you lose consciousness during an allergic emergency?
   
5. Have you investigated what food allergy protocols are in place at the college you plan to attend?
   

Section 5

ADULTS

"Time ripens all things; no man is born wise."

~Miguel de Cervantes

M
any adults with food allergies developed them as children and have likely seen the changes in food allergy awareness, thus providing a helpful historical perspective. However, food allergies can develop throughout life. Shellfish and tree nut allergies often first manifest as a reaction in an adult. Avoiding the food allergen is crucial to the affected individual's safety. Numerous adults have coped with food allergies for decades using common strategies such as eating safe food alternatives, label reading and avoiding cross contact. Yet, avoiding the offending food allergen may still present unique challenges in social and work situations. Despite careful planning and questioning, accidental exposures sometimes occur.

Section Five celebrates two food allergy veterans. You will meet:

• Alicia who, despite a lifelong peanut allergy, maintains a positive attitude and doesn't allow her food allergy to constrain her life; and
  
• Linda, a devoted mother who became ill as a teen after eating shellfish while she was celebrating her graduation from high school.
  

15

ALICIA

"She almost died."

Alicia's food allergy has never kept her from her love of fine dining, the outdoors or traveling. While lobster and pizza are her favorites, she has sampled all types of cuisine on three continents. Alicia asserts, "So it really has not affected me at all...There are thousands of other things out there to eat."

N
ow an adult, Alicia has been allergic to peanuts since she was a small child. When asked how food allergies were handled in school when she was a child, she exclaims, "They weren't! They just weren't...When I was in school, they didn't do anything."

Turning the clock back several decades, eight-year-old Alicia is excited about celebrating International Day at her elementary school. It's a fun break from the normal school routine, and parents are bringing in a lot of exotic dishes from around the world for Alicia and her classmates to enjoy. One of the parents serves an African side dish of greens. Despite the fact that she's allergic to peanuts, Alicia doesn't think to ask about ingredients and eats the greens.