October 29, 2012

Close calls and lessons learned

So grateful to see my boys happy and full of life!

"I don't have 'an impending sense of doom'..."

The sentiment of these words are supposed to relieve but I can assure you, this was not a statement I ever wanted to hear from my 7-year-old.

On Friday afternoon I packed the kids, our costumes, and some safe treats and began our long drive to my husband's workplace which was hosting a family-friendly Halloween party.  About ten minutes into our 50-minute commute, I realized that I had forgotten my sons' two EpiPen Jr. Auto-injectors at home.  This created an annoying but necessary 20-minute detour back home.  EpiPens -- absolutely can't leave home without them especially if the destination includes the possibility of eating anything.

Prior to the party I had exchanged email with my husband's office manager who organizes all the parties.  K is aware of my kids' milk and nut allergies as she suffers from celiac disease and an allergy to soy, so at company parties, there is always a safe dessert for my kids.  I always double check anyway especially since peanuts and tree nuts are allergens not shared by K and my kids.  K confirmed that there would be whoopie pies that would be dairy-free, gluten-free, soy-free, and nut-free except for coconut.  Awesome.

When we arrived at the party, food was still being set up by the company's caterers.  K, always the hostess with the mostess and so protective of our kids, showed me the allergy-friendly buffet section.  The area had been designated although there weren't any signs to give guests a heads up.  There were trays of designated safe desserts that my kids immediately helped themselves to.  And K showed us boxed meals of spaghetti and meatballs that were supposedly made with Daiya Vegan Shreds.  K looked over the boxed lunches and realized that some had regular sugar cookies in them -- she quickly let me know that the cookies might not be safe so avoid those.

My husband picked up a couple of boxed lunches (all of the other party food had dairy except for the guacamole and chips) and headed back to his office with the kids so that they could eat there.  As I was scoping out the rest of the buffet offerings, the catering manager came out to check on the set-up.  He paused at the allergy-friendly table and said to no one in particular, "The staff shouldn't have put these boxes here.  This pasta has gluten."  I froze up.  Then asked, "I was told these boxes are all dairy-free.  Is that right?"  "No, no.  The pasta is dairy-free but these meatballs have cheese on top. See?"

I flew out of the room, literally yelling out for my husband, "JARVIS!  JARVIS!  THE FOOD HAS DAIRY!  DON'T FEED THE KIDS!  THE FOOD HAS DAIRY!"  Looking back at it now, I can laugh at my dramatic Star Wars-like proclamation but at that moment it was serious, heart-pounding panic.  I was glad to have our homemade safe foods although the kids were so enamored with the sweets and cool cherry fizzy water and captivated by music, costumes, and festivities that they didn't really want to sit in a private office and eat dinner.  Fair enough.

An hour into the party after munching on a whole lot of guacamole and chips I finally had a chance to let my guard down.  We took a break from the heart-thumping music and foosball and retreated back into my husband's office.  I popped in one of the bite-sized allergy-friendly cupcakes we had picked up.  Yum!  Then I bit into a whoopie pie.  I could definitely taste the coconut but then a familiar texture and taste made me slow down my chewing.  Then I completely stopped in disbelief.

OH MY GOD.  THERE ARE WALNUTS IN THIS DESSERT.

At that moment, I went into adrenalin-pumping, disaster-ready mode.  "THERE ARE WALNUTS IN HERE.  DID YOU GUYS EAT THIS?!?" I blurted out.  Ryken looked horrified - probably mirroring my own expression - and cried, "Mommy, I ate one!!"  Ryken and Callan had both eaten the whoopie pies -- Ryken may have eaten two.

I quickly got the EpiPen Jr. packs ready, a move that immediately brought on cries of protest and flinching from Ryken.  We quickly assessed when it was that Ryken and Callan ate them (one hour before and, for Ryken, just minutes before) and whether they felt funny.  Callan did not feel anything.  However, Ryken admitted, "My tongue felt itchy.  I told Daddy that my tongue felt itchy."  "Does your mouth or throat feel itchy, funny, or thick?  How's your stomach feeling?"  Apparently this particular reaction never advanced past his tongue and lasted for a little while after consumption.

As time passed and there were no new symptoms, I calmed down a little.  I asked Ryken, "Did you think that the itchy tongue might be an allergic reaction?"  He admitted to us, "It felt like that time when my mouth was itchy after Trader Joe's."  That had been his first and only experience with walnuts, when he had eaten a small sample containing walnuts.

My immediate questions:
(to Ryken)  Why didn't you tell Daddy it felt like when you had eaten walnuts before??
(to my husband)  Why didn't you stop what you were doing and make sure everything was okay??
(to myself)  Should I have talked directly with the catering manager??  Should I have completely avoided the food altogether??

As we waited longer and the kids seemed to be out of danger, we talked as a family about how lucky we were to have avoided anaphylaxis.  And then we talked about what we could all do better next time.  We reviewed the common symptoms of reaction and came up with important steps in the future:

For my kids:  Speak up immediately, loudly, if they feel something is not right.  Be very detailed about how they are feeling.  If you feel the way you have felt during another reaction or if you are feeling something in your throat, mouth, or stomach, this can be a serious allergic reaction.  Getting a shot can be scary but never let that stop you from telling a grown-up right away.  The EpiPen may seem scary but it will save lives -- but only if it is administered in time.

For my husband or any other caregiver:  If someone complains of feeling funny especially in their throat, mouth, or stomach, stop what you are doing.  Make sure you have the EpiPen ready.  Reactions can progress swiftly and they will not be the same every time.  Remember: side effects from an unnecessary epinephrine injector are minimal (increasing heart rate followed by extreme tiredness).  Potentially saving your loved one's life is priceless.

For me:  It is a huge risk to feed my kids' party food even when I have tried to track down all information on ingredients and their safety from potential allergens.  If I haven't been able to communicate directly with the chef, how can I trust the food?  Catered situations run an even bigger chance of cross contamination from the same hands handling multiple buffet items, mix-ups in the placement of allergy-friendly foods (like the gluten-full, cheesy spaghetti and meatballs lunches in the GFCF table), and lack of communication between party guests and head chef who may not be there at the event.

As the walnut exposure drama unfolded, I couldn't help but think of Brian Hom, who lost his 18year-old son BJ in an allergy-related tragedy.  Meeting Brian Hom and hearing him retelling his final minutes with his son, BJ, are forever stuck in my mind.  Ten minutes transpired between the moment that BJ complained that his throat was hurting and when he passed away from anaphylaxis to trace amounts of peanuts in a buffet dessert.  Ten minutes.

I am really grateful that we avoided disaster.  Aside from sharing my close call with others, all I can do is critique our actions and better prepare ourselves for the next allergic reaction.  This is a good reminder for all of us to stay vigilant and keep reviewing prevention and symptoms of reaction with your family, especially in this high season of food-centered holidays.  And always carry your EpiPens.

 



October 22, 2012

Halloween for a Food Allergic Family

At our house, you know Halloween is approaching because I have furry fabric dust bunnies in every corner of the house, scraps of fabric where there used to be a chair for sitting, and the sewing machine quickly becoming a permanent fixture on the dining table.  Logan, with his obsession at counting down the days to things, reminds me daily that Halloween is right around the corner (a mere 9 days away!).

Not only does Halloween mean costumes, but Halloween parties at school, and trick-or-treating with actual candy and very few actual ingredient labels.  Although it's still one of my most beloved holidays, Halloween remains a huge source of worry and stress.

I am determined this year to not only have a safe Halloween, but a fun one.  As in, I am not going to overextend myself and do so much that I can't stop and enjoy the holiday.  No.  This year, I am keeping it simple.  Hey, that doesn't mean it can't still be special.

A few tips on how to keep it simple this Halloween:

1.  With the kids' food allergies, I just won't take the risk of letting them eat any of the candy they collect.  They've never had it, so they won't ask for it.  OK, they might ask for it; but in the end, they know it might not be safe and definitely not worth a stomachache or a visit to the ER.  Even worse, even if your child has had a particular candy, the treat-sized versions may have a different ingredient list or may be made in a different facility than their full-sized counterparts.  And of course, the ingredient list is left on the plastic bag and not on the individual wrapper.  So knowing what's safe and what's not on Halloween night becomes a risky business.

Instead, let the kids trade in their booty for another favorite treat or known safe candy, buy the candy from them (I think we used to get paid a penny or nickel per piece), or offer up a small toy or book--a small price to pay to keep safe!

2.  If you're staying at home to treat the trick-or-treaters, your lovely and helpful children are inevitably getting their hands into your basket of goodies.  Being the allergy-conscious people you are, you will probably be giving out a non-edible treat, like the old school spider rings or glow sticks, spooky stickers, tattoos, or a plethora of other stuff offered in bulk in almost every variety store from now until the 31st.  Alternatively, you could elect to distribute something from BAAAB's Top Ten Best Halloween Candy List, all free of the top 8 allergens.

3.  As much as I love doing what Martha does on Halloween, splitting myself amongst all the parties and overseeing trick-or-treating this year is enough.  I probably don't need to be creating papier mache pumpkins, hanging snake vellum lanterns, or working on some other intricate and time-consuming piece of homemade decor that I coveted so much in my pre-kids era.

So I let the kids go crazy on crayons, scissors, glue, and construction paper, and they came up with some really creative stuff (to stick all over our front windows).  To get a bit more fancy, try taking the lead on Deep Space Sparkle's Starlight Pumpkin Art Lesson, requiring oil pastels, tempura paints,  chalks (I got away with using white oil pastels instead of the chalks), and black construction paper.  Last year, we got creative with felt and other things we had around the house to spice up our home for Halloween.

This project was perfect for my 5-year-old!

Here is my 3-year-old's interpretation of spooky grass!

4.  Halloween fun doesn't always have to mean having sweets.  You can incorporate spooky goodness into healthful Halloween snacks and meals too, like the Creepy Crawly Spider Burgers we tried out last year.

5.  For past years' parties, I've made egg, dairy, and nut-free chocolate chip pumpkin muffins, courtesy of Trader Joe's Pumpkin Bread and Muffin Mix, Ener-G Egg Replacer, and Trader Joe's semi-sweet chocolate chips.  Even the biggest pumpkin skeptics adore these muffins!

For your kids' Halloween parties, consider bringing JELL-O this year.  I purchased these Halloween molds and JELL-O kits for just $4 at Walgreens, and they just took a few minutes to prepare, and a couple hours in the fridge.  Or, create your own orange and purple layered jello, following this basic procedure I used for our red, white, and blue striped JELL-O Squares.  You can use your own molds or cookie cutters, or just make a tray of good old orange or purple JELL-O.


Just add 1-1/4 boiling water to one 6 oz. package of  JELL-O Gelatin

Spray molds with cooking spray or grease lightly with oil,  chill in the fridge for a couple hours, and remove with a little help of your knife.

Irresistible!

Or use the same recipe and pour layers into small cups, one by one as they chill.

Make sure you take lots of pictures, more than you or they ever wanted to take. The costumed pictures are among my favorite and most cherished of the year. They won't fit nor will they likely be interested in wearing this year's costumes again.  And as much as I hate to admit it, the magic of Halloween will someday wear off.  One day, my eldest will announce that he will not be wearing a costume and that trick-or-treating is a thing of the past.  So for the present, relax, enjoy, and snap away!

October 15, 2012

Sweet Potato Kale Pizza

There are so many things about parenthood that I never really "got" until I become a mom.  The sleep deprivation, the endless loads of laundry, how the care of a small baby can truly fill up a parent's whole day, the continuous cycle of cooking, eating, and cleaning.  As my kids get older, some of the daily responsibilities have been replaced: the kids need some supervision but not constant one-on-one attention, caring for the kids includes taking them to school, sports, library, and other extracurricular activities; there aren't the nighttime wakings but the days are sure busy enough to still leave me worn down and cranky by dinner time.  And speaking of dinner time, that's certainly one event that remains on the daily schedule!

I get into a rut with cooking from time to time so I'm always looking for something new and healthy but easy.  As I was strolling through Trader Joe's I picked up a couple of favorites I hadn't bought in a while -- organic sweet potatoes and pizza dough.  Could I make something with those ingredients?

A minute or so on my smartphone and I pulled up a recipe that fit the bill from the blog Two Peas and Their Pod.  Short list of ingredients including nutritional powerhouse kale.  Easy preparation.  Minimal cooking time.  This fit the bill!


My kids enjoyed the sweetness of the sweet potatoes.  I liked that the vinegar brought a bit of tanginess to the pizza and that the kale didn't have a pronounce flavor or texture that would earn them protests from the kids.  The pizza is not only tasty but the sweet potatoes are chalk-full of fiber, vitamin A, and vitamin C.

The recipe can easily be adapted to eliminate common food allergens.  My family is fine with wheat so we used whole-wheat Trader Joe's pizza dough.  If you are managing a wheat allergy or gluten intolerance, check out Udi's ready-to-use pizza crust (they do contain eggs), Schar pizza crusts (they contain milk), or Ener-G's pizza shells (free of wheat, gluten, dairy, eggs, soy, and nuts).  If you are local to the Bay Area, Mariposa Bakery makes a delicious gluten-free, vegan, nut-free crust that I have written about here.


Sweet Potato Kale Pizza
Adapted from Two Peas and Their Pod's recipe

1 favorite pizza dough or crust
1 large sweet potato, peeled and cut into 1/8-inch or 1/4-inch thick slices
1/2 cup of red onions, thinly sliced
2 Tbsp olive oil, divided
1/2 to 1 packed cup of kale, stems removed and torn into bite-sized pieces
1 Tbsp apple cider vinegar
1 to 2 cups of safe mozzarella-style cheese (we use Daiya Vegan Shreds, which are free of the top 8 allergens.  LOVE this!)
Salt and pepper to taste
  1. Preheat oven to 400 degrees F.
  2. Toss together sweet potato slices, red onions, and 1 tablespoon of olive oil.  Season with salt and pepper if you so desire.
  3. Spread out sweet potatoes and onions in a single layer on a baking pan.  Bake for 10 minutes.  Remove pan from the oven and flip over the sweet potatoes.  Bake an additional 10 minutes or until sweet potatoes just begin to brown or crisp around the edges.
  4. While sweet potatoes are baking, roll out or hand-stretch the pizza dough.  Place on a pizza stone or pan with cornmeal to prevent dough from sticking to the cooking surface.  Brush dough/crust with 1 tablespoon of olive oil.  Top with mozzarella or cheese alternative.  
  5. In a separate bowl, toss kale leaves with apple cider vinegar. 
  6. When sweet potatoes and onions are done cooking, remove from baking pan and add on to the pizza.  Sprinkle kale on top.  Add fresh ground pepper to taste.
  7. Follow the directions for temperature and time for cooking your chosen pizza crust.  (I cooked my pizza with Trader Joe's pizza dough crust at 450 degrees, for 12 minutes.)  Cool for 5 minutes before slicing.  Serve immediately.

If you have time for homemade pizza crust and are fine with wheat, try this recipe:

White Whole Wheat Pizza Dough Makes two thin 17"x11" crusts
Adapted from AllRecipes.com's Amazing Whole Wheat Crust Recipe

1 1/2 cup warm water (110 degrees F)
1 tsp agave nectar (if not agave, honey or sugar would be fine)
1 Tbsp active dry yeast
1 tsp salt
1 tsp garlic powder
Additional spices such as oregano and basil
3 1/2 cups white whole wheat flour
1 Tbsp olive oil plus more for greasing bowls
  1. In a bowl or cup, combine warm water and agave/sweetener of choice.  
  2. Sprinkle dry yeast over water and stir to dissolve.  Set bowl aside for 10 minutes to allow yeast to activate.  (I usually put the bowl in a warm environment like the microwave to help the yeast dissolve.)
  3. In a separate large bowl, mix together salt, garlic powder, and flour.
  4. When yeast has completely dissolved, there will be a thick layer of foam over the mixture.  Pour water mixture into the flour mixture.  Add the 1 tablespoon of oil.  Knead the dough for about 5 to 10 minutes or until the dough is smooth.  
  5. Set aside to rise in a large oiled bowl, covering loosely with a towel.  Let it rise (and double in size) for 1 hour.
  6. After 1 hour, divide the dough into 2 balls for 2 thin pizza crusts.  Let them rise in separate bowls for another hour.
  7. To make crusts, roll out or hand-stretch the dough to fit large cookie sheet pans.

Enjoy warm homemade pizza and the sweet taste of root vegetables as we head into fall!

October 8, 2012

Top Ten Reasons to Walk for Food Allergies: October 13

We are gearing up and getting excited about our walk on Saturday: we're lining up our tennis shoes, breaking out the sunscreen, and filling those water bottles!  I know some of you have been on the fence about joining team Get Allergy Wise on walk day, so I thought I'd give you a bit of inspiration.



Here we go, the top ten reasons to join us and walk for food allergies!

1. Registering is easy and free!  Just go to the San Jose FAAN Walk for Food Allergy homepage,
click "sign up,"
click "join a team,"
enter team name "Get Allergy Wise,"
click "search for a team,"
click on "Get Allergy Wise,"
click "Join Team," and start your online registration.

Still not sure?  Just show up at 9 am on Saturday, October 13 at Lake Cunningham Park in San Jose, 2305 S. White Road.  Register on event day by filling out just one form per family.  So simple.

2. FREE Parking.  San Jose has waived the usual $6 parking fee for FAAN walk participants!  So go ahead and park for free, and better yet, donate that $6 back to FAAN!

3. Munch on FREE samples from walk sponsors like Sunbutter, So Delicious, and Enjoy Life!  Try their newest products and add a few more allergy-safe snacks to your weekly shopping list.

4. Get a bit of exercise with the whole family!  We can get those feel-good endorphins going and burn a few calories while we're at it.  A great way to kick off the weekend!

5. Come hang out with Get Allergy Wise family!  Irene and I and our collective 5 kids are looking forward to meeting and chatting with all of you!

6. Kids will enjoy the FREE activities, like the bouncy house, Games2U Video Van, rock climbing wall, face painting, and more!

7. San Jose weather in October promises a perfectly partly cloudy day with a high of 71.  Get out of the city fog and into some warmer weather!

8. Kids get FREE t-shirts, just for walking!  All adults who raise over $100 will also get t-shirts, so get out there and start collecting donations!

9. Raise money for a cause near and dear to our hearts.  Support food allergy awareness, education, and search for a cure.

10. Come to celebrate the life of BJ Hom, who teaches us how important it is to spread the word about food allergies and to always be prepared.

A few last words from 8-year-old "Tristan, A Boy With Food Allergies" (my first attempt at an iMovie...don't be too hard on me!).

video

October 1, 2012

Food For All: highlights from one district's experiences with food allergies

I had the privilege to attend a parent education forum put on by San Ramon Valley District's Parent Support Network, a group that provides support for families whose children have a special need.  This was the district's first education night concerning food allergies, a topic that concerned parents proposed to the committee. 
Kyle Dine opened the evening by performing his song, "Never Keep a Reaction a Secret".

Parents such as GAW reader, Lori, helped to pull together a panel of speakers.  The panel was comprised of two parents of kids with food allergies, a principal who collaborated with parents to create an allergy-friendly campus protocol, middle school counselor, district nurse, local allergist and school parent, and food allergy musician and educator Kyle Dine.  The special needs liaison solicited parents to email in questions the day before the panel discussion and, with that, the direction and flow of the night was determined.

I was impressed and inspired by the efforts of the San Ramon community and those who serve families that manage food allergies.  I would be lying if I didn't tell you that part of me dreamed of moving to the district~

Here were my major takeaways:

Kyle Dine, food allergy musician who has multiple food allergies:
-Shared that the hardest aspect of growing up with food allergies was the social part.  He never wanted to feel like a burden to parents or friends.  He just wanted to be treated like any other normal kid.
-As a child, his parents trained him to advocate for himself.  He carried his own EpiPen, was given the responsibility of ordering his own food and asking all the necessary questions about ingredients and possible cross-contamination.
-Believes the most effective way to educate families about food allergies and keep food-allergic children safe at school is through classmates.  Children are empathetic and "really get it" when food allergies are explained.  Children do not want their friends to be hurt.  They will often go home and ask their parents not to pack nuts, milk, or other allergens that would harm their food-allergic classmate. "I have never once heard a child say, 'Eating peanut butter is my right.' "
-Shared that the most powerful and effective communication to a class about a student's allergies was a personal letter, not written by the parent but coming straight from the allergic student.

Dr. Matthew Lodewick, allergist:
-Explained that any given exposure to an allergen can trigger anaphylaxis.  There is no evidence to support that there is a progression of intensity in reactions.  Reactions can look different each time so if someone asks, "So just how allergic is your child?" tell them a reaction can be anaphylactic.

-And because any reaction can lead to anaphylaxis, Dr. Lodewick says, "My preference for the first medication administered is always EpiPen.  Then you can give Benadryl."

Connie, mom of a milk/nut-allergic child:
-We as parents are our children's strongest advocates.  Always speak up.
-Working together is key to building a safe environment.  Keep an open mind and understanding about the various and many non-allergy needs that staff also have to juggle, and be willing to do your part and be willing to compromise.
-Do not ban foods but teach kids to hand-wash and wipe mouths after all eating.  Educate kids about your child's food allergies through a classroom presentation (check out Michelle R's) and class Q&A with your child.
-Shared that she accidentally injected herself with the EpiPen Jr. while training another adult.  "It was the best thing that I did," she confided, because she got to experience the side effects firsthand.  Connie explained that she could feel her heart racing a bit but thought it was just the adrenaline rush of realizing her mistake.  After about an hour, she could hardly keep her eyes open.  The combined symptoms were mild and short-lived and she would not hesitant to administer the medicine to her daughter at the first signs of any reaction.


Brian, dad of a child with milk allergy and Celiac's Disease:
-Encourages parents to talk about their child's food allergies at Back To School Night (with the teacher's consent)
-Ask parents to contact you if/when they are going to bring in a class treat so that you may suggest or bring in a safe alternative for your child.  Assure classmates' parents that you are not asking that their family bans foods from school. 

Shawn Wells, Bollinger Canyon Elementary principal:
-Has worked with a dedicated group of parents to create an allergy-friendly community at her elementary school
-Open communication between parents, principal, nurse, and teacher is critical for creating a safe and inclusive environment for children with food allergies
-Bollinger Canyon introduced an allergy pals table.  Kids are free to eat there if they do not have any of the allergens in their lunch.  The table was monitored by a paid staff person.  Those who have finished eating any offending allergens may move to the table only if they have washed their hands and wiped their mouths.  While being free of unsafe foods, a big draw of this table is that friends across grades or from different classes may choose to sit here as long as their lunches are safe.

Julie Damgen, middle school counselor:
-Have a meeting with the middle school counselor to make sure all allergy information is passed on from your elementary school
-In San Ramon middle schools, there are some classes and electives that are food-based.  Again, notify counselors ahead of time so that accommodations can be made.

Sharon Dodson, district nurse:
-Contact nurse and teachers in the weeks before the new school year begins to educate about your child's allergies, past reactions and symptoms (though keeping in mind that new symptoms may occur at any time), and protocol.  School staff appreciate to know these details ahead of time so that accommodations and safety measures are in place from day one.
-All district teachers are trained on how to administer an EpiPen Jr. and EpiPen.  However, a teacher has to also be willing to administer the EpiPen when needed.  It is also important for staff to be trained with CPR.

Brian Hom, organizer of the Bay Area FAAN Walk and father of BJ Hom who died of anaphylaxis to peanuts:
-Echoing Dr. Lodewick's warning, Brian shared that his son BJ died of anaphylaxis without ever having any previous anaphylactic reactions.  Brian wondered if a proactive district such as San Ramon was working on stocking its schools with emergency sets of EpiPen auto-injectors.  Schools can take advantage of current California Ed Code 49414c and Mylan Corporation's generous offer for free EpiPen twin packs so long as they complete the paperwork and have a general prescription from a physician.