Unsure how to handle this year at school

[Gray]

I'm not really looking for black and white answers, but just throwing it out there that I'm not really sure how to handle things at school this year.

We had a 504 set up last year very briefly, but then dd passed the OFC and we cancelled the 504 (our allergist at the time didn't even think dd should have epi).  Still, there were lots of precautions kept in place and, usually, it was a food-free class last year.

This year the class says they are "allergy aware" but I'm not getting warm, fuzzy feelings.  They are letting parents bring in food with no advance warning and all foods are permitted if they have the label (no homemade stuff).  There are several peanut/tree nut allergic kids in the class.  The school mentioned cross-contam risk for homemade stuff, but they seem unaware that advisory warnings are voluntary.  Plus, there is at least one child allergic to an allergen that is not one of the "top 8".  Such policies seem to encourage reactions and, imo, open the school up to liability issues -- I would not want that responsibility of deciding what is safe for those allergic kids.

My dd has epi's and action plans at school, there is a full time nurse, dd has a good amount of tolerance but she still has some risk of ana.  She's had a few minor mystery reactions, but I strongly suspect to something else which we haven't been able to narrow down yet.

I don't think she needs, or maybe even qualifies, for a FA 504, but I think that I at least need to email the teacher and nurse about my concerns about my dd, but I'm not sure what to say. 

[Gray]

A couple more things -

Although I knew it was possible to land in this gray zone after a challenge, I also took a chance that such a thing is uncommon.  I thought if she passed, then that would be great and if she failed, then I would know that all the precautions I used to take were necessary. 

Also, after our experience, (if possible) I would not recommend switching allergists until the 504 is totally complete.  I didn't think it would be a big deal as almost all of the hard work was done, but it didn't work out so good for us.

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ETA - I think I will have to just ask the allergist what level of protection dd needs and how strict we should be and then take it from there.  Hmmm, how to prevent exclusion .

[twinturbo]

When I don't have a solid answer to offer I usually open up with questions. That's a tough spot to be so close to worry free yet be completely in the dark on how far you can push it.

My understanding of a pass is that the history of anaphylaxis remains in context, and the data now bears out looking at a much longer post-pass care plan than previously thought. Therefore my thought there is your child is one who has a history of anaphylactic reactions currently more on OIT than actually passing in the sense that there are no medical restrictions. If DD is still under the care of an allergist for careful monitoring of a maintenance dose I would argue that DD is still under the care of a specialist and though the known potency of the trigger has altered the hidden, episodic condition has not gone away.

If I were to argue for the 504 under these circumstances I would argue that student is not cured, obviously in need of an IHCP for a life-threatening condition thus should be identified as a student in need of aid or service to receive FAPE in LRE (as our chorus goes). The accommodations may change from previous because if DD is on maintenance dose coming into contact isn't an issue. At that point it's mainly about extraneous food coming into the classroom.

Eligibility hinges on the impairment of a major life function. In DD's case this is still true. The only difference is she may not need as many accommodations or the same accommodations as before.

That's how I see it.

[CMdeux]

That's a really good articulation.

Does your allergist still see anaphylaxis as a real risk?  Do you?  From an accidental ingestion-- or just a lapse of judgment?

With dosing, is physical activity limited for any period of time after dosing?  That would be something that would need to be in a 504 plan, I'd think.

Is there asthma at play here, too?  That is another separate, stand-alone qualifying condition.

[Gray]

Before the pass, we were strict in allergy management, as our allergist of several years had wanted us to be.

Now, I hardly worry about things as long as there's not gross contamination of the food.  I always carry the epi's and I try to limit obvious ingestion to what the current allergist wants, but our FA management has completely changed.  I suspect that some of those mystery reactions are showing up now because she is eating a greater variety of foods that were not prepared by me (being exposed to more things)... I don't even want to think about strictly avoiding another food - it would be a nightmare to get dh on board with that.  Personally, I'd probably be ok if she ate some of those school snacks if the allergist was also ok with it.

Yes, I think the allergist & I still think there's some risk of ana, but how much of a risk ... I don't know.

Asthma is an issue, but exercise is not.

I think you're right TT about your OIT & longer post-pass care plan comments.

[Gray]

Well, I spoke with the allergist and we both feel comfortable telling the nurse/teacher to limit ingestion of the obvious allergen -- not to worry about minor amounts or cross-contam.

There was one school form that made me a little uncomfortable the way it was filled out and she was really nice about it and gave me permission to fill it out the way I prefer and send it to her to sign.

She mentioned something about being in uncharted territory with dd's situation which I think is cool considering this is a guru place 

I'm happy that they have allowed me to be gray.

[CMdeux]

That is really great~  I'm glad that the school will be aware and watchful-- rather than forcing you to either pursue "don't ask, don't tell" or to change to a method of management that is not appropriate.

Terrific outcome! 

[Gray]

I'm happy that they have allowed me to be gray.

Not sure if I was clear above  , but I was referring to the allergist. 

[CMdeux]

Well-- okay, I'll be hopeful that the school is willing to go with the terrific advice from the allergist, then.   

[Gray]