Back to School with Allergies

Sending a child back to school, or to school for the first time, can be stressful at best, but for an increasing number of parents this milestone is made even more fraught by the worry of keeping them safe from a severe allergy. Allergies are increasingly common; approximately 1 in 50 children are now allergic to peanuts or tree nuts, meaning it’s likely there will be a handful of children with severe allergies in most schools.

Severe allergies often cause a serious and life threatening reaction called Anaphylaxis which typically occurs within minutes of exposure to the allergen. It occurs when the body’s immune system overreacts to a substance (peanut, milk, egg etc) that it perceives as a threat; these reactions must be treated immediately with adrenaline and prompt medical treatment.

As any parent with a food allergic child will confirm, daily life is laden with potential dangers. But there are some simple ways you can help to minimise the dangers and help your child to live as normal a school life as possible. With clear communication and some forward planning school life can be as inclusive as possible.

Tips for parents … at home

• Speak confidently and calmly to your child about their allergy. Children are never too young to be involved in managing their own allergy. Even small children who are learning to read can be shown how to look at labels and look for key words. EU legislation introduced in 2014 means allergens must be identified in bold writing on all packaging which makes it even easier to identify risk.
• It is essential that your child is allergy aware, no matter how young. You must impress on them that they cannot share or swap their lunch with anyone, no matter how tempting; a colourful sticker on the inside of their lunch box will remind them and others not to share food.
• Depending on age and maturity, consider training your child in how to use their auto-injector. This will help to empower and involve them.
• Consider purchasing an allergy wristband for your child to wear, particularly very young children. A simple Google search will bring up many options; Irish company Allergy Lifestyle stocks a range of inexpensive colourful options for children.

Tips for parents … at school

• Arrange to speak to your child’s teacher directly about their allergy. It’s essential that you convey the seriousness of the allergy, without frightening or being overly demanding.
• Ask in what instances might food be used or consumed in the classroom and together identify times where your child’s allergy may become an issue. Examples include using Smarties or M&Ms for counting in maths, using empty recyclables for art and projects or any nature projects that involve nuts, grains or seeds.
• Provide the school with an emergency kit for your child; ensure your child’s name and ideally a photograph are on the front. Inside should be two auto-injectors, an Emergency Plan, antihistamines, asthma inhalers and other medications as prescribed. Ensure your child’s medication is kept in date and replace before the expiry date.
• Ensure that the school understands that if there is any doubt about whether to give adrenaline or not, it should be given. The consequences of not giving it could be fatal.
• Provide the teacher with a bag of safe treats for your child to be used throughout the year as needed, safe snack ideas and ask if you can contribute safe snacks to any class parties.

Three key questions for parents to ask:

•  Where will my child’s adrenaline injection (Epipen, Jext or Anapen) be kept? Ideally, adrenaline should be kept in their classroom or with the child but schools will have their own specific policy. Adrenaline must be kept in an obvious and accessible place and must never be kept in a locked office or cupboard.
• If the need arose, who would administer the injection? Has training been provided to staff who are the main carers for your child? If not, you may wish to give the class teacher an informal demonstration of the injector while they await formal training. Trainer pens are useful for this. As mentioned before it is extremely helpful if your child is familiar with the auto-injector!
• How will the rest of the staff be made aware of the allergy? Often schools place a poster with the name, photo and allergy of children with severe allergies in a visible place in the staffroom to help with this. Offer to make this poster if necessary!

There are many resources available on the Anaphylaxis Ireland website, including a resource pack for schools entitled Managing Chronic Health Conditions at School (which was sent to most schools in September 2011) and at the Anaphylaxis Campaign's website.

Banana and Chocolate Chip Bread

This is one of my favourite go-to baking recipes! It's so simple and quick and everyone loves it. I've posted it here today in honour of the Anaphylaxis Campaign's #acbakeoff competition!

Recipe: (adapted from a Mary Berry recipe)
1 ripe banana
1 tbsp milk (substitute alternative such as rice milk for dairy allergy)
50g butter
75g self raising flour
75g sugar
1 egg
lots of dark chocolate chips/ chunks

Method:
1. Preheat the oven to 160c/ 325f/ Gas 3 and line a loaf tin with parchment or greaseproof paper
2. Use your hands or a fork to mash the ripe banana in a mixing bowl
3. Place the flour, butter, milk, sugar and 1 egg in with the mushed banana and mix using an electric whisk
4. Mix in the chocolate chips
5. Spoon into the lined loaf tin
6. Bake for 40 minutes approx until golden brown
7. When baked, turn out onto a wire rack to cool for a few minutes
8. Slice, serve and enjoy!!!

PS: If you decide to do a double batch, bake in two tins and freeze one for later :)

My complaint to a Central London bar/ restuarant

Below I've posted my complaint to a London venue regarding an incident that left me speechless and fuming yesterday. In hindsight I should have left immediately (while making a scene!) but I was too speechless to even think. I've decided not to name the restaurant here.

> I regret you inform you that I had a highly frustrating and distressing visit to your restaurant yesterday. Upon being seated, I asked if there was an allergy menu and was told no. I was asked how severe my allergy to peanuts was, and I replied severe, and was promptly told 'since everything seems to say may contain nuts' in shops and that as X was a bar venue rather than a restaurant it was unlikely there would be anything I could eat on the whole menu. I found this rather baffling since there was nothing on the entire menu with peanuts in it and asked the waitress to speak with the chef and ask his advice on whether anything might be suitable. She seemed annoyed by this and told me she would bring information but that then it would be my responsibility to decide, meanwhile telling me it was her legal responsibility and she'd had training. 

A few minutes later she returned telling me the chef had said the hummus might not be suitable, and as she had some written allergen information in her hand I looked back at the menu to check other options. She seemed extremely irritated that I still planned on ordering something and by my follow-up enquiry, rudely told me 'that she'd told me all she could, talked to the head chef and manager, had spent a half an hour talking to me and now everyone surrounding was waiting for their drinks because of all this' (ridiculous in every way). I was left speechless at the suggestion that somehow my couple of very brief questions around allergy information, which as you know are now a legal requirement, was somehow irritating her and preventing her from doing her job. 

After asking to look at the written information myself, I chose the nachos, without jalapeños and asked the waitress to give the kitchen a written chef card which I use in every restaurant as a visual reminder to the kitchen. This was rudely handed back to me as not necessary as I was sarcastically told 'everyone there now knew about my allergy'; yet ironically my nachos arrived with jalapeños so clearly the message was not that clearly delivered to the kitchen after all. I have never experienced such an awful attitude to severe allergies and it has severely dented my confidence in your restaurant. 

I hope that you will follow up and provide extra training to your staff on simply spending a couple of moments answering a few basic questions for customers who take their life in their hands when they eat out. If you have decided that people with severe allergies should be encouraged to go elsewhere to eat, you should make that clear with a message on your menu or window, but do you want to alienate a group of customers for the sake of not providing guidance on what's in your food? <

Live from the TRACE study...

As I write I am lying in a hospital bed as part of the TRACE peanut study... it's 4.25am. I'm here overnight as part of a sleep deprivation element to today's challenge. So far I've been allowed just two hours sleep between 1 and 3am.

Why am I here? It's all in the name of science. Medicine can never be expected to move on unless people who suffer with illnesses give some time to be prodded. In this case though, we're not looking for a cure, it's more to do with improving day to day life for people with peanut allergies. Anyone who has closely scrutinised a label will understand the prevalence of 'may contain nut traces' labels. Most manufacturers don't even bother telling you what nut they are referring to, rendering the warning useless and vague. This increases the chance of someone 'risking it' since they can't properly decide on the risk anyway.

The TRACE Peanut Study aims to address this by finding out exactly how much peanut will cause an allergic reaction in those with a peanut allergy by conducting ‘challenges’ on around 100 people. The focus area of the study is on two ‘extrinsic’ factors known to influence allergic thresholds (exercise and tiredness).

In the next few hours all hands will be on deck and I will start process of ingesting the one thing I spend my life avoiding. Watch this space!

New Years Resolution: Do you know how to react to a reaction?

Trying to think of new year’s resolutions? Consider these questions...

• Are your Epipens always within reach?
• Can you use them properly without instructions?
• Will you use them when needed or are you afraid?

Back in February 2014, I came face to face with these questions when my food was accidentally contaminated with peanuts at a London pub. Shortly after I began to feel extremely ill, with wrenching stomach cramps and hay fever like symptoms. A few minutes later, I felt a burning sensation all around my neck and began to be unable to catch my breath. I glanced in the mirror and knew straight away; the tell-tale swelling all over my face confirmed anaphylaxis was developing. As I was already experiencing breathing difficulties I needed to act fast. If you were in my position at that moment, would you know how to react?

EpiPen® and EpiPen Jr® are auto-injectors used for the emergency treatment of life-threatening allergic reactions (anaphylaxis). Epipens are designed so that you to use them, without assistance, to give time to seek emergency medical treatment. You do not need someone to do it for you. Spending a few minutes every few months refreshing yourself on how to use your Epipen will give you the confidence to use it when you need it. Your mantra needs to be HAVE IT, USE IT.

Using an Epipen is simple:

1. Remove from the protective plastic case

2. Pull off the blue cap completely

3. Place the orange tip on your outer thigh (through clothing or tights is fine)

4. Push the Epipen into your thigh until you hear a click sound, and hold in place for ten seconds

5. Remove it, place safely back in its case and massage the injection site for a few seconds

6. Call 999 if someone has not done this for you already. Remember you can contact emergency services free of charge, from any phone in the EU by calling 112.

Taken from http://www.pharmacydirect.co.nz/images/textarea_images/2step.png

* If you are alone it is extremely important that you self-adminster your Epipen BEFORE calling 999. Doing it the other way around could be fatal.

Always err on the side of caution and use your Epipen if you have reason to believe anaphylaxis is developing. Using an Epipen when not needed is unlikely to cause any ill effects. On the flipside, not using your Epipen, or using it too late, could possibly cost you your life... so USE IT.

I did not take any antihistamines during this reaction; paramedics told me this was the right thing to do as it allowed them to give me a full IV drip dose of more powerful anti-histamines once I was in the back of the ambulance. These worked immediately. Personally, I would question the usefulness of over the counter anti-histamines during an anaphylactic reaction and would suggest always reaching for your Epipen. What does help is a few puffs of a reliever inhaler such as Ventolin.

Another issue to consider is where is your Epipen at any given time? If you are in the car and have a reaction, will you be able to get back to that kitchen cupboard in time? If your child’s Epipen is in school, but a reaction develops halfway home, will you be able to react in time? I cannot stress enough the importance of having your Epipens ALWAYS within arm’s reach, and being able to use it. While adrenaline is a life-saving medication, it cannot save your life if you don’t have it or use it. The difference between being prepared or not prepared could be the difference between life and death.

So ask yourself, are you properly equipped to react to a reaction?