Thanks for posting this one, GN.
I will have to read it later when I have a little more time to soak it up.
Okay-- coming back.
VERY good writing overall. Outstanding. My one major quibble is this one:
An EpiPen will prevent death if it’s used within 20 minutes of exposure,
mechanistically, that is not true. "Will" there is incorrect. "Can" is appropriate, but I didn't like the implication that there is something magical about 20 minutes. I can't think of a single instance in which my DD's reactions have taken that long to manifest, and her most severe ones have often been with a speed and vengeance that is difficult to even comprehend, never mind describe to someone who hasn't seen it.
There are recorded deaths which have ocurred within 5 minutes or so of the exposure, and there are some which have been recorded even WITH timely intervention including epinephrine. That, in my mind, is one of the things that creates a real barrier to getting accommodations in place re: avoidance. Most people think "well, you have that pen thing," never understanding that it may simply be too little, too late even if it is administered
at the same TIME as the exposure, at least in some cases.
There is evidence that having a parent or a grandparent who smoked — even if the child was never exposed to smoke — is a risk factor for food allergies, as is living in an urban area with elevated pollution.
That is fascinating to me-- and something that I had not heard. Hmmm-- provoking food for thought, that.
Nadeau stresses that oral immunotherapy is still experimental. Her patients are not cured; they are desensitized enough that they can tolerate their former allergens. The reason that she doesn’t call it a cure is that the child must continue to eat a maintenance dose of the food every day to avoid regaining the allergy. She often explains to her patients, “If you get off it for three days, you may become sensitive again.” An egg-allergy trial found that when patients were taken off the maintenance dose for a month, roughly 60 percent regained the allergy (and there was no way to predict who those patients would be).
YES. THIS.