Allergy Testing Update - Part Two

Disclaimer: I'm about to discuss blood testing, food trials and food challenges.  

This is just a recount of my personal experiences and thoughts.  I am not a doctor, so please discuss any questions you may have with your allergist or physician.  

So, I'm finally getting around to my follow-up to my previous post about Morgan's latest round of food allergy blood testing.  That post focused on the downward trend of her peanut and milk specific IgE (sIgE) levels and her total IgE, but we tested other foods, as well.

I was interested in seeing if we might be able to challenge some foods that were in a questionable "gray area" in her clinical history.  These two foods were beans, peas and sesame.

Beans
The lab tested for a kidney/pinto bean mix.  (How does that work?  Do they blend up both kinds of beans into a single sample?  Are the isotopes identical?)  My allergist previously insisted that I not try beans, as they cross-react with peanuts, but I explained that my daughter eats other legumes, like soy and green beans, without issue.  The value came back as 1.65, which is even lower than my daughter's 18-month soy result, which was 1.95 and she is not allergic to soy.  My allergist agreed that I should be able to try pinto beans at home, as I recall my daughter eating a pinto bean, a couple of times, without incident.  Now, this is all easier said than done, because I have such a hard time deciding on a day to try a new food.  Well, it's not entirely new, but it has been a long time since she had that last uneventful pinto bean.

Peas
When my daughter was younger, I gave her some canned "peas and carrots" and she sprouted a few very tiny, hives on her upper lip.  I think she had eaten "peas and carrots" a couple of times before that, but I just don't remember if any hives popped up those times.  After seeing suspicious spots, I put them on the "no" list.  Though I don't necessarily want my daughter to eat canned peas, pea protein happens to be used in some allergy-friendly substitutes.  The test result came back as 2.29, so the allergist thinks we need to continue to avoid it, since I think she had some kind of reaction to it, in the past.  

Sesame
I don't think my daughter has ever eaten sesame, before.  Her value back when she was 2 1/2 was 15.5 and I felt that was too high to mess with, but the allergist disagreed.  I never challenged it and decided to wait until the latest results.  The sesame sIgE came down to 4.27, and even though the values are from different labs, they were both Phadia 1000 ImmunoCAP tests, so I feel they are pretty comparable.  The allergist said she could do an in-office food challenge for that one if I wanted.  We'll see if/when I get up the nerve to do that.

We also revisited the issue of my daughter's flax seed allergy.  Flax is such a pain in the gazoo.  It's not a Top 8 allergen, so it's not labeled and no companies mention/care about cross-contamination.  Plus, it's the additive du jour whenever a company wants to be able to slap "Omega-3" into their offerings.  I find flax to be the most irritating of my daughter's allergens, as far as management issues go, because it eliminates entire product lines, due to cross-contamination risks.  I'm sure those of you dealing with corn allergies are sitting there thinking, "oh, you think you have it bad?" so I will stop whining, now, but I think I have explained my current feelings for flax.  This is an allergen I'd love to see G-O-N-E.  Two years ago, her labs showed 28.2 and this year they came back 5.65.  With a history of reactions to flax seed, the allergist did not think this one would be ready to challenge for a while longer.  She also thought it wasn't the greatest candidate for an in-office food challenge, because my daughter's reactions, though one was ER-worthy, were delayed.  She said we might have a scenario where we challenge the flax, she looks fine in the office, then in the middle of the night, we wake up with problems.  Therefore, flax is still on the "no" list and we wait another year to see how the numbers change.

Even though I know my daughter is allergic to mustard, I decided to test for it, just to see the sIgE value.  Mustard came back 5.86.  I find it curious that her mustard value is just 0.03 away from coconut, to which she is not allergic.  This just goes to show that each food has its own "scale" and you can't really compare sIgE values of different foods, nor can you really compare other people's IgE too directly, either.  It really is a combination of what the history shows, along with some additional clues that some sIgE values can provide.  The nerve-racking truth of the matter is that we will probably have to challenge many of these foods, at some point, but the silver lining is that challenging them would mean that we're hopeful that the allerg(ies) have resolved.

And so the wait continues...  

Guest Post - Our First Vacation in Allergy World

The following is a guest post by my fellow Allergy Mommy friend, Katie.  Her son is 3 1/2 and has multiple food allergies, along with an allergy to fire ants.  Many thanks to my sweet friend for sharing tales from her travels, to boost my confidence for future trips!

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           My son Edan was born in March of 2010, as perfect as his name implies. ;) He took his first plane rides that year, one for vacation in Colorado and another to celebrate a friend’s wedding in Door County, Wisconsin. Our little guy seemed well on his way to becoming a master of travel. Then, after our world was turned upside down by his allergic reactions to peanuts, eggs, milk, and fire ants in 2011, we did not take another vacation until this summer in 2013.

            My husband signed up for a conference at a resort in Florida, and the first time he offered to take us with him, I laughed. Do you have any idea the kind of preparation that would take, not to mention the increased risk, both in the airplane and once on the ground? My anxiety, well-developed over the last two years of dramatic diet changes and watching my son’s body swell and erupt in hives over and over again, reached heart attack levels at just the thought of it.

            Over time, though, I came around. The opportunity was just too great to pass up, and I did not want to set a precedent of allowing allergies to dictate IF we participate in life’s activities. It was enough that this condition already dictates much of the HOW. I located a Whole Foods and children’s hospital close to where we would be staying, and printed off directions to each from the airport and resort. I also printed a copy of the NIAID’s guidelines for anaphylaxis, since hospitals vary in their familiarity with the current treatment protocols. I created a list of safe meals that required nothing more than a refrigerator and a microwave. I purchased disposable placemats, extra epinephrine, steroids, and large bottles of antihistamine. I confirmed that we would be able to bring these extra liquids on the plane. We found a way to attach the car seat to a suitcase to carry it onto the plane, so Edan’s contact with the airplane seat would be minimized. I learned some new deep-breathing techniques and focused on looking forward to a fun vacation.

            The final luggage tally included one medium-sized suitcase full of clothes, another the same size packed to the brim with food, one small suitcase full of carry-on items, and another one packed with medicines and a soft cooler full of food, plus our backpacks which had various other snacks. We had scheduled our flights with Southwest Airlines early in the day, since we were told that this is when the planes are cleanest. When checking in, we received an extra ticket that identified my son as a “peanut dust allergy” customer. I had printed a notification card from TSA’swebsite to identify my son’s allergies, but we were actually never asked the reason for the extra liquids. We declared them by going through a separate line for “medically necessary liquids”, and TSA agents tested the liquids in unsealed bottles with test strips. Once at the gate, we identified ourselves to the attendants at the desk, where we received a “pre-board” pass.

            Since we were able to get on the airplane before the masses, we had time to wipe down the area around my son’s seat and install him in his carseat. Although that seat was a pain to carry through the airport, once he was in it I was so thankful we had gone to the trouble. His access to the areas where food contamination was likely was very limited, and he was more willing to stay in his familiar carseat than he would have been otherwise. The flight attendant made the generic announcement that peanuts would not be served on the plane due to the presence of a customer with a peanut allergy. I was touched when he followed it up with a genuine plea to refrain from eating peanut products from the customers’ own stashes of food; he expressed a heartfelt concern for my son’s well-being and appealed to the goodwill of others to help keep him safe as well. I will never forget that. Our flight passed without event, much to my immense relief, and we were ready for our adventure in Florida. 

            We knew already that despite the luxurious accommodations the resort provided, microwaves did not fall under the list of necessities in paradise. About 10 restaurants were located within the resort, but due to my son’s long list of foods to avoid (including wheat, peas, beans, melon, squash, kiwi, carrots which all cause mild reactions) and the possibility of cross-contamination with one of his severe allergens that he will react to very small traces of (peanuts, eggs, dairy), this did not feel like a safe option. Therefore, we purchased a small microwave to use during our time there, and left it with the resort when we left, in an effort to pave an easier path for future allergic guests.  A small refrigerator, on the other hand, was included in each room, and we were able to request an extra one to hold the rest of our food. Armed with these appliances along with paper plates and utensils, these were the meals Edan consumed for the duration of the trip:

• Breakfast -  Some combination of bacon, potato, Van’s blueberry buckwheat waffles, Pocono   cream of buckwheat with fresh fruit, and a Zico coconut water “smoothie” every day that I mixed his supplements into
• Lunch - Hotdogs or canned tuna on rice crackers; tomato and/or avocado on the side
• Dinner - Lunchmeat lettuce wrap with mustard or pouched salmon; frozen veggies (broccoli or green   beans).
• Snacks - Fruit (oranges, berries), homemade trail mix, celery or apple with Sunbutter or Barney       Butter, Larabars, and Terra chips (original and sweets/beets).

            All the produce was bought from Whole Foods once we got there, along with the waffles, coconut water, and chips, but most of the other foods were brought from home. The meats were all Applegate (bought from Whole Foods) or US Wellness Meats (ordered from their website and brought from home). I also had the foresight to bring corn tortillas (Food For Life), refried beans (Eden), and nutritional yeast (NOW) to make my son’s favorite “burritos”, but as it turned out, I forgot one vital tool...a can opener! Luckily we had plenty to eat of the other foods (next time, I will plan more carefully and not over-pack so much), so I didn't have to worry about that one.

            Overall, I am pleased with how well this worked out. My son was well fed with safe and healthy foods. Many of these were favorites, and it was a treat for him to get them all in one week. They were all fairly easy to prepare, although I found myself wishing for another couple microwaves every morning. I ate many of these meals alongside him, saving us money on restaurant meals, and saving me the stress of taking my allergic child into a restaurant by myself while my husband was attending presentations.

            We had a wonderful time in Florida, and our flights home were just as uneventful as the one there. I was so thankful for the flight attendants’ and other customers’ patience as we throughly cleaned Edan’s seat each time we boarded a new flight. It’s difficult to explain that every time I am wiping down my son or the environment around him, every reaction he has ever had is chugging somewhere in the back of my mind like a relentless train. The hives and mucus that poured from his body the first time he had eggs, accompanied by the panic of mother who had never seen an allergic reaction before...the alarmingly swollen face after a secondhand peanut contact...the vomiting, diarrhea, and hives caused by a trace of milk in a condiment...the quickly spreading rash and gasping sounds of his labored breathing after the fire ant bites...and his terrified cries of remembered trauma that start as soon as we walk into any hospital. This motivation to avoid adding a story to that heartbreaking collection causes me to take a little more care, and then a little more, and these detailed attentions of an allergy mama, knowing that one more wipe can make the difference between health and disaster, can appear needlessly intricate to the outsider. Our endless preparation and loving efforts paid off, though. My proof was when unpacking after we got home, in the discovery of our Benadryl bottle...with the seal still intact. SUCCESS! :)

Spray-On Sunblock: Chemicals in the Mist

I know I'm a bit late with this message, since summer is winding down, but I want to take a minute to discuss something that has been on my mind for a long time - spray-on sunblock applied in public places.  I'm sure, given the proliferation of spray-on sunblock consumers, that people think this stuff is a great idea, since you don't have to spend time rubbing sunblock on your children.  However, to me, there is something very disturbing about spraying a chemical fog all around your child.  I see those poor kids, holding their noses and squinting their eyes as tight as they can, and puffing out their cheeks, as they hold their breath, while being sprayed.  As soon as the spraying is done, what do they kids do?  They gasp and take in a huge deep breath of chemicals.  Have a look at a popular spray sunblock's ingredient list.

Avobenzone, Homosalate, Octisalate, Oxybenzone, SD Alcohol 40, Acrylates/Octylacrylamide Copolymer, Glycerin, Aloe Barbadensis Leaf Extract, Fragrance, Cocos Nucifera (Coconut) Oil, Mineral Oil.

Sure, there are some "natural" ingredients in there, but the first 4 ingredients are sunblocks and not intended for inhalation.  

The instructions on most bottles say to hold it 4-6 inches away from the skin and spray liberally.  For the
face, they suggest spraying it on one hand and rubbing it onto the face.  Aside from my concern for all the children being sprayed, directly, my most immediate concern is my daughter's asthmatic lungs being suddenly bombarded from all angles, as people pop up spraying their children left and right, when we walk near the lockers, or areas where people get ready to swim.  It's like walking through a mine field.  You're just walking along and suddenly *PSSSHHH* there is this huge cloud in your face and it's hard to avoid.  We try to walk briskly out of the cloud and then *PSSSHHH* another person is spraying.

Nobody wants to dress like this to go to the water park
Image Credit: NBC News

The Environmental Working Group (EWG), that puts out the yearly Guide to Sunscreens, recommends skipping spray-on sunblocks, all together.  In their piece, "What Not to Bring on Vacation," they have "No Spray Sunscreens" as #1 on their list!

1) No Spray Sunscreens

Given the ease of applying them on squirming kids and hard-to-reach areas, these super-popular aerosolized sunscreens may seem like a dream come true. But there’s growing concern that these sprays pose serious inhalation risks. They also make it too easy to apply too little or to miss a spot, leaving bare skin exposed to harmful rays.

Even though the Food and Drug Administration expressed concern in 2011 about the safety and efficacy of spray sunscreens, companies continue to turn them out.

So, I ask you to consider reevaluating your choice of sunscreen, for your own health, the health of your children, and for those around you.  We want everyone to breathe easy, while having fun in the sun!

Image Credit: Mother Nature Network

(For those looking to minimize the use of any type of sunscreen, check out my post on UPF clothing.)

Indoor Air Quality and Lysol Air Filters

Disclaimer: One of the team members working on the new Lysol Air Filter® campaign, also happens to be a reader of my blog, as her child has some "atopic" issues of their own, and so she approached me to get the word out about this new product.  When I heard about the details of the new product, I was more than happy to do so.  In exchange for my post, I have asked for a way to raise money for the Asthma & Allergy Foundation of America (AAFA), which has recently merged with Kids with Food Allergies, and those details will be provided, herein, as well.  I was also provided with complimentary air filters to try.  As always, all opinions are genuine and purely my own.     

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As a mother to a daughter with asthma and allergies, I'm interested in finding everything I can do, to provide a healthy environment.  When my daughter was first diagnosed with asthma, they gave us several tips for improving our home environment.  They suggested room air purifiers, replacing carpet with flat flooring, etc.  We were also told to change the air filters for the air conditioning unit, on a regular basis.  Before that, I don't think we even knew the last time we had changed them, or the size of the filter.  It wasn't something that was on our minds.  

Often times, the first thing that is suggested is a room air purifier, but really one should start with the "lungs" of the entire house.  They say that we, here in America, spend up to 90% of our time indoors, and I believe that is pretty close, given that the weather has been less and less hospitable outdoors.  Changing the home air filters is an inexpensive and very effective method of improving home air quality.  

I was very excited when I heard about the new Lysol Air Filters, as they are the first ones to be Certified Asthma & Allergy Friendly™ by the Asthma & Allergy Foundation of America.  This is a trusted endorsement, in my eyes.  I first learned of it when I bought my daughter her asthma-friendly Buttercup doll.  You can read about their certification standards, here.

I will admit that one of my first questions about the product was "does it have Lysol on it?"  Given my daughter's asthma and food allergies, I am concerned about the ingredients in every single product used in our home.  I was assured that there is no Lysol on the product, as it uses a mineral-based antimicrobial agent to inhibit the growth of bacteria.  The product is also unscented, which is a plus, in my book.  I was also impressed by the allergen-reduction statistics for the product.  In their test studies, it has been shown to:

reduce pollen by 95 percent

reduce dust mites by 92 percent

reduce pet dander by 85 percent

Though we do not have pets, I think this would be of great interest to those with furry friends.  Also, visitors can unknowingly bring pet dander into a pet-free home.  We are certainly sensitive to pollen and dust mites are known to cause all kinds of maladies like headache, fatigue, eye irritation, respiratory irritation, and even skin irritation.

I am happy to be making the switch to Lysol Air Filters.  We've already been in the habit of changing our filters, regularly, and it would make me feel even better using a filter that is Certified Asthma & Allergy Friendly.  If indoor air quality isn't something you've given much thought, as I know I certainly didn't before, consider looking into starting with one of the most basic, yet core components and give these air filters a try.

Check out this page, for information on where to buy Lysol Air Filters (also known as furnace filters).

You can also check out my Healthy Home board on Pinterest, for more clean air ideas.