Daily Bite: Tristan and Anaphylaxis Scare

We spent all afternoon in the ER today.  Yes, after having an Epipen for Tristan for almost six years of his life, I finally had to use one. 

About an hour after having his usual In-N-Out hamburger with ketchup instead (of sauce) and grilled onions, fries, and a lemonade, he started in on a dry cough and tell-tale tummy ache.  I rushed to get him a Benadryl and Claritin, and two puffs of his inhaler. 

Then the wheezing started, and I got a sinking feeling in my stomach.  I got the Epipen out of his backpack, pulled off the cap while he cried and squirmed on his bed, and administered it for the first time.  Very shortly after that, his breathing sounded better.  I knew I had done the right thing.

Once we were inside the ER, it was a bit of a blur, but I know sometime between saying the words "anaphylaxis" and "Epipen," Tristan was escorted directly in, and was in a hospital gown on a bed with monitors attached by the time I went back.  Much relief.  More Benadryl, steroids for the itching, swelling, and hives that had developed on the way over, and waiting.  We were in good hands (thanks to all the nurses and staff who worked Room 1 at the Pediatric ER today!).

This is Tristan with ice packs tied to his arms and legs.  The itching was unbearable. 

Red, puffy skin was replaced by his smoother, olivey skin by the time we left, and Tristan was actually getting tired of watching an entire season of Phineas and Ferb (they had a DVD player with a very impressive kids' DVD collection).  Sigh of relief...

A few lessons learned:
1. No matter how tired, stressed, or busy, take any possible allergy symptoms seriously.  I was really hoping Tristan's stomachache was nothing, but my instincts told me otherwise.
2. You know you're supposed to go to the hospital after administering the Epipen, and for a few minutes I thought, how inconvenient it would be to spend hours in the ER right now.  I'm so glad my adrenaline and sense kicked in and that we went.
3. Have a go-to place for your at-home Epipen.  If I wasn't home, I wonder if another caretaker would know to find the Epipen in Tristan's pack.  Probably not.  I'm stocking up tomorrow and hanging the pen inside the hall closet door. 
4. Even if you don't expect to be eating anything, please have your Epipen.  Tristan's symptoms didn't kick in until about an hour after he ate. 

As of now, we're still unsure about the cause of his attack.
Tonight, everyone's fine.  Tired, but good.

"Cheeses" - some milk-free options

Vegan cheese makes good pizza possible for milk-allergic families.

If you're a milk-allergic family, you know how tricky it is to make meals without cheese.  Typical kid favorites like pizza and macaroni & cheese aren't exciting options without gooey, salty melted cheese.  Lucky for us, food habits are changing and there are companies producing alternatives to traditional cheese.  But with so many food products on market shelves, it can be daunting to sift through all the choices for a safe and tasty cheese alternative.

A big problem I have is over the confusion brought on by the widely available "soy cheese".  With so many soy replacements for milk products these days (soy milk, soy yogurt, soy ice cream, soy creamer to name a few), "soy cheese" sounds like it must be made from soy and it is -- mostly.  Soy cheeses, which often advertises themselves as "lactose-free" are mainly for people with lactose intolerance, a difficulty in breaking down lactase found in milk.  Soy cheese such as Galaxy Foods' actually still contains milk products in the form of casein (whey), which is not safe for anyone with milk allergies.  The same goes for "rice cheese" -- it still contains milk products.

Unless your cheese alternative says "milk-free", "dairy-free" or "vegan" on it, it probably has some element of milk in it.  All the more reason to continue checking and rechecking those labels!

Here are a couple of vegan cheese alternatives worth your attention:

Vegan Gourmet -contains soy but free of the other top food allergens (milk, eggs, wheat, peanuts, tree nuts, fish, shellfish) 
Follow Your Heart vegan cheeses are sold by Vegan Gourmet, a company that also makes the egg-free mayo Vegenaise.  Flavors include the mozzarella, Monterey Jack, cheddar, and nacho cheddar.

Follow Your Heart/Vegan Gourmet vegan cheeses come in a big, soft block so you'll have to cut them into smaller pieces.  It's not too hard to do with a butter knife but it takes a little time.  And you probably won't get the lovely thin shreds you would from a bag of store-bought shredded cheese.

The kids and I like the Vegan Gourmet mozzarella.  In the past, I've had trouble with the stuff melting properly.  So this time I spent a little more time cutting the block into small strips (think shredded cheese).  The cheese melted better than I expected in a high heat oven for homemade pizza, in our case.  The taste was pretty good.  We were less thrilled by the cheddars which had an overpowering flavor.  I have to say, though, that I don't like sharp or bold cheeses so this might be the reason I wasn't a fan of Follow Your Heart's cheddar version.

I have found Vegan Gourmet vegan cheese at Raley's and Nob Hill Foods for about $5 for a 10 oz. block ($4.50 on sale!).  Not a bad price for a cheese alternative if you're willing to put in the extra time to shred them yourself.

Daiya -free of the top 8 food allergens
Daiya Vegan Shreds is the gold standard of fake cheeses among vegans.  It is free of the top 8 allergens, including milk, gluten, and soy.  Originally sold exclusively to restaurants and food service companies, Daiya has gradually made its way into the hearts, minds, and bellies of milk-allergic and vegan eaters through Whole Foods Markets and a select few natural foods store.  It looks like real shredded cheese, the taste is a pretty good imitation of real cheese, and it melts really well.

Daiya comes in convenient shredded form.

All that perfection doesn't come without a price.  Daiya is not cheap.  Whole Foods sells it for about $11/lb.  I haven't been able to find Daiya at any major supermarket chain so Whole Foods or your local natural foods stores, all pricey I'm sure, might be your only choices.

Do you have a favorite milk-free cheese?  Let us know especially if it's not one of the above. 

Book Reviews: Allie the Allergic Elephant & Cody the Allergic Cow

Cody the Allergic Cow, by Nicole Smith, illustrated by Maggie Nichols

A cow allergic to milk?  Cody is a young cow with a loving family and a passion for soccer, and he happens to have a dairy allergy.  He wears an allergy bracelet, knows to bring his own snacks to games, learns how to identify common milk-based foods, and remembers that having an allergic reaction is no fun.  His mom carries epinephrine in her bag in case of an accidental ingestion.  A simple book for young ones to enjoy and learn from. 

Allie the Allergic Elephant by Nicole Smith, illustrated by Maggie Nichols

Allie is a cute young elephant who is allergic to peanuts!  With simple and engaging language and cartoon-like drawings, little kids will love Allie and her story.  I read it to my boys, 4 and 6, and it prompted a discussion about symptoms of an allergic reaction in a very matter-of-fact way.  I appreciate how the book describes Allie as special and unique because of her allergies.

In the News: New study estimates that food allergies affect 8 percent of all children

Photo by Dan4th/Flickr

In the past, food allergies were believed to impact 1 in 25 children under 18 years of age.  A recent study has concluded that food allergies are twice as common as previously thought, affecting 8 percent, or roughly 1 in 13 kids.  These findings come after analyzing survey data of about 38,000 parents.

Of the reported food-allergic kids of the survey, 40 percent had a history of severe allergic reaction; their reactions seemed to gain in severity as the kids got older; and Asian and African American kids are more likely to have allergies than their Caucasian peers.

CNN and Huffington Post have written articles about the study and the real risks of food allergies.  Both articles are worth reading as they detail the findings and also feature how two families have been forever changed by food-related anaphylaxis.

1 in 13 kids are affected by food allergies...How many kids' in your child's classrooms have food allergies?

Mango Salsa

I remember hovering over a huge bowl of mango salsa last Christmas.  The salsa, which was made by my cousin-in-law, Candice, was addictive.  It especially hit the spot on that wintry Maryland night and the entire bowl was quickly gobbled up by aunts, uncles, and cousins as we waited for dinner.

With summer here and mangoes selling for 37 cents at our local market, I thought of that yummy salsa and decided to make it myself.  I used a highly rated recipe from AllRecipes.com with a couple of minor changes.  My husband and Ryken loved it!  Sadly, veggie-averse Callan wouldn't touch the stuff even though I doubled the mango to entice him.  I guess I'll have to set aside some plain old chopped mangoes next time.

The recipe below made probably 3 or 4 cups of salsa.  (Seriously, it was big.)  The amount of each ingredient is somewhat flexible so feel free to add a little more here and there to get the flavor to your liking.  Eat the salsa with tortilla chips and you'll have the perfect contrasts of salty, sweet, & sour and creamy & crunchy.

Mango Salsa
Adapted from FHIVESHOT's Avocado, Tomato, and Mango Salsa on AllRecipes.com

2 ripe mangoes, diced
1 avocado, diced
2 to 4 medium tomatoes, diced (I like less tomatoes in my salsa)
1/4 cup chopped red onion
1/2 cup black beans
1/2 chopped cilantro
2 Tbsp olive oil
Juice of one lime
3 cloves garlic, minced or 1 tsp bottled minced garlic
1 tsp salt

1. Gently combine all ingredients.  Refrigerate for at least 30 minutes (overnight is fine) to allow flavors to mix together.
2. Serve with tortilla chips or on the side of your favorite Mexican dish.

 

Tiramisu -Dairy-free, Egg-free, Nut-free

Tiramisu.  

Made with sponge-like ladyfinger cookies, mascarpone cheese, chocolate and sometimes the almond liqueur Amaretto, this dessert ranks right up there with Zachary's Pizza as foods I miss most.  My passion for tiramisu was rekindled while staying with family for Christmas and I have been searching and testing for the perfect "safe" recipe since then.

After five months of making different recipes and plenty of eating and tweaking and trying to work off the weight gain, below is what I came up with.  This is at best an 8-hour recipe: the cream needs time to set before layering and the assembled dessert tastes infinitely better when the ladyfingers fully absorb the liquid and cream.  You might have to do on-the-spot adjustments (adding more corn starch) to get the texture of the mock cream filling to your liking.  But having said all that, the taste was delicious and definitely worth making for an insatiable craving or that extra special occasion.  Are the fathers in your life worth the effort?  YES...especially if you get to share the spoils!

Just want to note that, while the recipe I used is dairy-free and egg-free, it is not completely "vegan" as it claims.  Refined sugar, which is in the Tofutti products, is often processed with bone char so these ingredients might not be "animal-free". 

Tiramisu - dairy-free, egg-free, nut-free recipe adapted from Veggywood's vegan tiramisu recipe

Part I: Ladyfinger cookies:

2 cups flour (I used white whole wheat)
1 cup sugar
3 tsp baking powder
1 tsp cornstarch
1/3 cup canola oil
1¼ cup water
2 tsp vanilla extract

1. Preheat oven to 350 degrees.  Grease or line a 9" square pan with aluminum foil.
2. Combine dry ingredients in a bowl.  
3. Making a well in the dry ingredients and add remaining ingredients (oil, water, and vanilla).  Mix everything well until there are few lumps in the batter.
   
4. Pour batter into square pan.  Bake for approximately 40 minutes or until inserted toothpick comes out clean.
5. After the pan has cooled, cut halfway down the pan.  Then, perpendicular from the first cut, cut ladyfingers into approximately 3/4-inch thick strips. I'm usually able to get about 14 cookie strips out of this.
6. Put strips on baking sheet, cut-side down, and bake for an additional 15 minutes or until lightly browned.  Let cool.

Part II: Mock Mascarpone Filling:

1¼ cup soy creamer or soy milk (The original recipe called for Mimic Creme heavy soy cream.  I've used soy creamer and Soy Dream Original soy milk with success but have needed to up the thickening agent.)
1-2 Tbsp corn starch (you can use agar agar powder, too).  Have extra handy in case you want additional thickening power.
2 tsp vanilla extract
1½ cup (one and a half of the 8 oz. containers) Tofutti cream cheese
1½ cup (one full 12 oz. container) Tofutti sour cream
Between 2/3 cup and 1 1/2 cup confectioner's (powdered) sugar

1. Combine soy creamer/milk and corn starch until corn starch is dissolved.  Cook over low-medium heat, stirring constantly to avoid clumps.  The liquid should gradually thicken.  Add more corn starch if necessary. (I always use more than 1 Tbsp but haven't taken an exact measure since I'm always quickly drizzling more in and stirring furiously to avoid clumping.)  I like the texture when it is somewhere between pudding and a thick alfredo sauce.  
2. Remove mixture from heat and pour into a mixing bowl.  Let cool.
3. Add vanilla, Tofutti cream cheese, and Tofutti sour cream to soy-cornstarch product.  Blend together using a hand mixer until smooth.
4. Blend in 2/3 cup powdered sugar.  Taste the cream for sweetness.  Blend in a couple more tablespoons at a time until you get the sweetness you want.  (I end up using between 3/4 and 1 cup.)
5. Cover and refrigerate cream filling for at least a couple of hours to set.

When your cream filling is set and your ladyfingers are cooled, prepare 2 cups of strong coffee mixed with 2 Tbsp sugar.  For coffee-free, kid-friendly tiramisu, prepare 2 cups hot cocoa. (Try this basic recipe with a splash of vanilla extract instead of salt.)   Pour into a bowl that is big enough for the ladyfingers to lie in.

Cream is set?  Ladyfingers and coffee/cocoa cooled off?  Let's assemble your tiramisu!

You will need:

Ladyfingers
Mock mascarpone filling
Cooled-off coffee or hot cocoa for soaking (if you are dairy-free or nut-free, double check if using artificially flavored varieties)
Cocoa powder
Semisweet chocolate bar shavings (optional)

1. Dip ladyfingers in coffee.  I let them sit for a couple seconds on each side until they are heavy with liquid all the way through.  Place a layer of soaked ladyfingers at the bottom of your serving dish.  (I use Corningware square baking dishes which are about 6½ inches across.)
2. Completely cover ladyfinger layer with cream filling.
3. Drizzle cocoa powder on top of cream filling.
4. Repeat steps 1, 2, and 3.  Using a grater or peeler, make semisweet chocolate bar shavings and top the final layer with this if you so desire.

I'm usually able to make a two-layered tiramisu for my husband and me and a one-layered coffee-free tiramisu for the kids using our 6½-inch square Corningware dishes.  Yes, I make more for the grown-ups.  No, I have absolutely no guilt in doing so.  


Another variation:  try a homemade berry sauce instead of coffee or hot cocoa.  I used frozen berries so my results weren't quite so pretty but it was definitely delicious!  With summer fruits ripe for the picking, I might try blueberries with a homemade cherry or strawberry sauce next time.

Happy Father's Day! 

Camp Allergy Education 101

You've searched all over the place to find the right camp for your child.  Some seem more allergy-prepared than others, which is to be expected.  Most of us aren't school teachers, allergy education trainers, or allergy mom bloggers desperately trying to get the word out (I said most of us); so, here are some resources for you to gracefully and with every good intention offer the camp you're interested in.  Go ahead and send them a link to this post!

Start here.
Irene wrote a wonderful post a few months back with links to some fantastic resources, including the Food Allergy and Anaphylaxis Network (my personal favorite).  Under 'education', they've got comprehensive resources for camps and schools, including a 'Back to School Toolkit' with links to printable posters, brochures, and checklists perfect for staff training, phrases to describe How a Child Might Describe a Reaction (Tristan and Logan often say something feels spicy, or that their tongues or lips tingle or hurt), and their five steps to Being a PAL, which can easily be incorporated into camp rules and procedures:
1. Don't make jokes about food allergies.
2. Don't share food with someone who has food allergies (or just not at all)
3. Wash your hands after eating.
4. Ask what your friends are allergic to, and help them avoid it.
5. If a food allergic friend becomes ill, get help immediately!

The You Tube Generation
Many of your child's camp counselors will probably be in their teens, with active Twitter, Facebook, and Youtube accounts (as I'm writing this, they're off to something new!).  For high impact for the tech savvy generation, email the camp a link to a 6 minute youtube video called Kids Living With Food Allergies produced by the Food Allergy Initiative, featuring some very articulate allergy kids speaking candidly about their food allergies (it's hard not to love this video and learn so much from these super cute allergy kids!).

Snacktime
If they'll be serving your child snack or other foods, provide them with cheat sheets for the common allergens.  Finding out if something contains dairy, for example, doesn't always mean searching for the ingredient "milk."  Buttermilk, whey, and casein (and many more) are all other forms of dairy.  As allergy moms, we know that hidden allergens are everywhere; but for others, this is new (and important) information.  If anything, it'll make them think twice about serving up your child snacks without discretion. 

Don't forget to give them some safe snack suggestions for your child, being as specific as possible; or, just send along a stash of snacks for your child labeled with her name).

Wear Your Allergens
If you haven't already, research and find an allergy necklace or bracelet that your child will wear--easier said than done.  Tristan has a dog tag listing all his allergies and meds.  I finally convinced him to wear it to school, but found that the chain actually irritates his skin after a long day of school or play, so he doesn't usually wear it anymore.  Check out STATkids or Allerbling (great for multiple allergies) for some fun allergy bracelets your child is sure to want to wear!  And Jeeto's patches for lunch bags and backpacks are WAY cool.

Everyone Loves a Good Book
Provide the camp with (or refer them to) a allergy-themed picture book that can be read to the children at the camp to open up a discussion about allergies, if possible.  Depending on age, there are lots of good ones to choose from.

With open communication, education, and information, it is possible for your child to thrive at camp this summer.  Get more info about keeping your allergy kids safe at camp, send them off with some peace of mind, and enjoy a little me time!