Food Allergy Support

Discussion Boards => Adults with Food Allergies => Topic started by: jenavy21 on January 28, 2014, 06:49:00 PM

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Title: UPDATE (original post)
Post by: jenavy21 on January 28, 2014, 06:49:00 PM
UPDATE!!

I met the new allergist today.  He seems nice.  Asked questions and listened.  A couple of times he skipped ahead and then when he would ask new question and I would answer he would bring it back to fill in the gaps.  Had me do a bunch of blood work since I need to be off antihistamines for skin test.  Said he will see me back in 4 weeks to go over blood results and wants me to write everything down in the mean time.  At that point he is hoping I can be off allergy meds for long enough to do skin testing if needed.   They took 16 very large vials.  Tested 55 food items and all the environmental and animals for this area. 

Told me to make the cll when it comes to epi.  That it is a fine line and that better to be safe than sorry, but to also try to stay calm during reaction to make sure that if I am panicking I don't make it worse.  Said more than likely it is the same food allergens possibly being complicated by environmental changes or irritants.  And to just remember and to reassure myself that it is not normal to all of a sudden to react to what seems like everything.  So on Mar 5th, I ill get results and we will see what happens in the mean time.  Until then I am supposed to avoid as much as I can. 

Title: Re: Consultation tomorrow
Post by: CMdeux on January 28, 2014, 07:01:21 PM
Take copies of:


Emergency Action plan-- and get help from your doc to fill one out that meets your needs

Anaphylaxis Grading Chart-- this is sometimes a useful tool to discuss past reactions, and to decide what your decision tree/flow-chart/protocol looks like for your action plan.



1.  What should you be avoiding right now?

2.  Is there any benefit in doing a MUCH more limited elimination diet and slowly reintroducing foods once you have your reactivity under control again?  No? Maybe?

3.  Any special instructions re: emergency treatment that YOU should be aware of (and insist that ER staff follow)?  For example-- waiting 4h even if you have to do it in the ER waiting room after a discharge?

4.  Which allergens seem to be MOST probable in light of your reaction history at this point?

5.  How many doses of epi should you be carrying?

6.  How often should you be seen during follow-up?

7.  Anything that you need to know or seem to be missing?

Title: Re: Consultation tomorrow
Post by: CMdeux on January 28, 2014, 07:02:48 PM
The nurse sounds like a real keeper-- very kind.  :)  You might want to consider a medic-alert bracelet even though you can't (yet) specify allergens with a lot of certainty.  Might be another thing to discuss.

Oh-- maintenance meds.  That would be another thing.  What and when, and forever?  Or how long?

Title: Re: Consultation tomorrow
Post by: jenavy21 on January 28, 2014, 07:08:39 PM
Thanks!!   My husband and I had been talking about med bracelet a while ago with original peanut, sesame, and soy.  But at the time it seemed like if I was really good at avoiding we would be ok.  Now not so much.  I am printing that stuff out now to go with reaction history. 
Thanks again!!
Title: Re: Consultation tomorrow
Post by: momma2boys on January 28, 2014, 07:10:14 PM
I hope you get some answers! Allergies suck.  :grouphug:
Title: Re: Consultation tomorrow
Post by: LinksEtc on January 28, 2014, 08:47:47 PM
I would discuss what to do if you have coughing/wheezing after eating or having a possible contact exposure.

I noticed in this thread that you used an inhaler & Benadryl, but it is important to give epinephrine if those symptoms are due to anaphylaxis.
Looking for some Help and guidance!!

Here is an example of an allergy plan you can print:
http://www.foodallergy.org/document.doc?id=234

If you do have a sesame allergy, maybe the allergist can go over the labeling rules a little more with you.  (We can also help you with that.)

I hope the appointment goes well.


 :grouphug:
Title: Re: Consultation tomorrow
Post by: Janelle205 on January 28, 2014, 09:01:06 PM
If I remember correctly, you have asthma?  I would ask the doc for some advice on determining what is asthma and what is a potential allergic reaction.  On a positive note, epi will treat both, but if you are having frequent asthma flares, you don't want to be using that all the time.
Title: Re: Consultation tomorrow
Post by: jenavy21 on January 28, 2014, 09:12:58 PM
Thanks!!  I am working on getting over the Epi fear.   They gave it at the hospital last Thursday.  And the last 5 days or so have been HELL.   I know I should have gone back to hospital and used the Epi again at least twice, but I am still scared to give the injection to myself and to need it so often.  Which means we really need to figure out the trigger so we can eliminate it.  After my mom so reaction last Thursday she has been pushing for me to go back to hospital as well, but it is hard to do with 3 kids.   Don't really have time to be sick.  I am sure it sounds really stupid.  And I have been reading and listening to the Benadryl can't save you, but I am still afraid that I am going to use it too soon or when not needed and put myself in cardiac arrest.   

I am hoping Dr can give me clear cut answer to make me feel better about having to use it.  So I am looking for a clear cut answer to if this then do this.  Hoping he can give that.  But more importantly I am hoping we can figure out what the trigger is to get rid of it.  I do know that I am physically drained right now and can't keep going reaction after reaction.   

I was told back in October 2011 (when they gave me the Epi) that I have Sesame, soy, and peanut allergies.  I thought I was doing well reading the labels, but now not so sure.  When we were in New York, a lot of labels had sesame mentioned, because a lot of the things we ate either came from canada or where smaller companies that sent things to Canada and Canada labels for sesame.  I didn't realize that the US did not and now that we are in AZ I hardly see anything labeled for trace amounts of sesame.  I have it narrowed down to a few things:  either something has changed and new allergies, environmental allergies complicating things, or those 3 allergies have gotten significantly worse. 

As far as I have seen.   My reactions occur fairly instantly.   Even contact in the air at the store is happening within minutes.  If I eat something I normally know within a bite or two that it was a mistake. 
Title: Re: Consultation tomorrow
Post by: jenavy21 on January 28, 2014, 09:16:51 PM
I will ask about determining difference between asthma and reaction.   That is something I feel stupid to say that I don't realize.  It feels like my throat is tightening and last Thursday that is what did happen, but it started out feeling more like asthma.  I am having a hard time explaining it.   Because I get very dizzy and lot's of pressure in my head with the tightness in chest and throat.  I guess I have been trying to use my throat as determining factor on epi.  Last Thursday my voice got very hoarse and at hospital when they checked throat and everything said it was swollen so gave epi.   Since that day although my throat has gotten tight it hasn't gotten that hoarse.   I am not sure if that is a good determining factor or not but that is what I have been using.
Title: Re: Consultation tomorrow
Post by: CMdeux on January 28, 2014, 09:22:08 PM
One more thing to ask--

-- if this IS a new allergen, what is it most likely to be?  Another seed?  A legume?  Or a treenut?  (Could be any one, given the statistics and the existing allergies-- allergist's opinion on this one-- assuming a great allergist-- would be quite helpful).

Any advice for "safe" foods to begin Operation Reaction-Free would probably be quite helpful, too.  We can certainly help you here, of course, but it would be good to hear a good allergist's ideas there, too. 

So-- many allergists like the analogy of a teacup-- that is, overflow of the "cup" being a reaction or allergy symptoms.  Everything allergen exposure adds a bit to that "cup" and gives you less chance to "empty" it in time.  Ergo, it takes LESS to push you into overflow.  Any chance that something in your new housing situation is "filling up" your allergy cup close to overflow and making you WAY more reactive?  Pets?  molds?  Dust? Pollen?  (It's already tree pollen season in places out here in the west-- particularly the southern part of the west).

Title: Re: Consultation tomorrow
Post by: LinksEtc on January 28, 2014, 09:35:04 PM
Thanks!!  I am working on getting over the Epi fear.   

And I have been reading and listening to the Benadryl can't save you, but I am still afraid that I am going to use it too soon or when not needed and put myself in cardiac arrest.   


Have you read this blog post?  I really like it.
http://www.asthmaallergieschildren.com/2012/12/09/food-allergies-prescribed-injectable-epinephrine-know-practice-carry-use/

Hopefully, the allergist will be successful in working with you to figure out your allergens.  That, along with some improved food label reading skills, should hopefully reduce the number of reactions you are having.  Having said that, if you are experiencing anaphylaxis, you really should use epi & call 911. 


http://www.foodallergy.org/treating-an-allergic-reaction
Quote
Epinephrine is a safe drug, with the risks of anaphylaxis outweighing any risks of administering the medication. Extra caution is only needed for elderly patients or those with known heart disease where an increased heart rate could be problematic. Nonetheless, epinephrine should be used to treat anaphylaxis in these individuals.
Title: Re: Consultation tomorrow
Post by: CMdeux on January 28, 2014, 09:48:58 PM
Right-- properly administered (intramuscularly) EPI is really, REALLY low-risk for all but a tiny handful of people with specific cardiac abnormalities.

If you happen to BE a person who is taking promethizine, or has a vulnerability to aortic dissection or a known aneurism risk, then by all means worry and discuss with your doc-- but otherwise, know that your risks are WAY lower in unnecessarily using epi than from NOT using it if you're wrong and it is needed.

Really-- LOW risk.  No worse than a sudden fight-or-flight response on the body.    So if you watch horror movies okay, you're good.   :grouphug:
Title: Re: Consultation tomorrow
Post by: LinksEtc on January 28, 2014, 09:53:51 PM
I didn't realize that the US did not and now that we are in AZ I hardly see anything labeled for trace amounts of sesame.


All advisory warnings (ex. - "made on the same equipment", "made in the same facility", "may contain", etc.) are voluntary for all allergens, even for ones like peanut.  Not seeing a warning does not mean that the food is safe.

With sesame, sometimes there is horrible cross-contamination, but sometimes manufacturers don't really care or label for it because sesame is not considered a "major food allergen".

Plus, sesame can be an actual ingredient in the food, but "hide" under terms such as "flavor" or "spice".

Don't forget to also consider non-food products like makeup.

There is a lot of good label info here:
http://www.kidswithfoodallergies.org/resourcetopic.php?topic=pfood-safety-labeling

With sesame, you have to be a bit of a detective ... which is what this thread is about  :) .
What do companies tell you about their labeling practices for sesame?

Here is some more info on sesame:
http://www.sch.edu.au/health/factsheets/joint/?sesame_free_diet.htm


Title: Re: Consultation tomorrow
Post by: jenavy21 on January 28, 2014, 10:10:44 PM
LinksEtc,
Thank you for that blog.   I had not read it before.  I don't know why I am so afraid of it.  But when not having a reaction I can tell you when I should.  Then when reaction starts there is always this part of me that just freezes a bit and doubts everything.  That feeling of I am going to make it worse.   I will definitely talk to doctor about it tomorrow.

I will check those threads out too!  I know a couple years ago I learned about the sesame in things like lip gloss.   My lips were so chapped and kept getting worse and worse and worse until bleeding and I was having some wheezing.  Turns out the lip stuff I was using by Burt's Bees I believe had sesame.   >:(

CMdeux,
I like the tea cup analogy.  I can see where that might be playing a part right now.  Because it just seems I am way too sensitive right now.   I will ask what he things about possible new allergies and what he suggests for safe foods.   I know allergies here are already pretty bad and most of my environmental allergies that are off the chart are allergens in AZ.  Will environmental allergies affect food reactions that way?  I know that is one question I have.  We also have pet questions, even though we only have a bunny inside, he seems to be really bothering me with his litter (we use cat litter) and seems to have strong ammonia smell.  But also want to be checked for parrots, dogs, horses (was mildly before, but 20 on property), chickens, cows etc    As those are the animals on property.   Also with parrots their seed has peanuts, sesame sticks, etc.  So need to figure out how sensitive I am to the ones outdoors and although my parents have a very large house, is it a problem inside their house (they have a macaw and african grey).

I can watch horror movies ok and don't have conditions mentioned.  I know I have to get over it!!!  I am working on it.    ;)
Title: Re: UPDATE (original post)
Post by: jenavy21 on January 29, 2014, 06:01:18 PM
Put update in original post. 
Title: Re: UPDATE (original post)
Post by: CMdeux on January 29, 2014, 08:11:32 PM
Excellent!

I'm really, really glad that you have an allergist who is willing to take a lot of time with you.   I sincerely hope that blood testing doesn't give you as many questions as answers-- it can, sometimes.  But it sounds like your allergist is a good fit for your needs right now.

:)

Title: Re: UPDATE (original post)
Post by: twinturbo on January 29, 2014, 08:22:00 PM
I am relieved for you. Hopefully this is the first step towards getting settled.
Title: Re: UPDATE (original post)
Post by: LinksEtc on January 29, 2014, 08:24:26 PM
Tested 55 food items and all the environmental and animals for this area. 

Wow, that's a lot.  Are there that many foods that are suspect based on reaction history?


Told me to make the cll when it comes to epi.  That it is a fine line and that better to be safe than sorry, but to also try to stay calm during reaction to make sure that if I am panicking I don't make it worse. 

Did he give you a written "food allergy action plan" aka "emergency care plan"?


So on Mar 5th, I ill get results and we will see what happens in the mean time.  Until then I am supposed to avoid as much as I can.

That's a long time to avoid as much as you can.  Did he give you more guidance on what kind of diet to follow?

Until you get the reactions under control, you might try (if ok with your allergist) sticking to very simple ingredients and cooking things from scratch.  Not a lot of processed food.  A lot of whole foods ... fresh fruits & veggies, items with 1 ingredient on the food label, meat without added ingredients like injected solutions, etc.  Keep a food diary of everything you're eating and write the details of any reactions.  If you react to something, don't eat it again unless the allergist tells you otherwise.
Bring the food diary with you to your next appointment.




Title: Re: UPDATE (original post)
Post by: jenavy21 on January 29, 2014, 09:59:17 PM
Yeah it was a lot of blood too!!   My reaction history is firm with peanut, sesame, and soy.  I think he is looking to see if some of the fruits and vegetables coordinate with environmental allergies.  For example: strawberries and avocados have started causing problems within a few minutes of eating them.  But I was eating them constantly for over a week straight with no issues, then one day BAM.   That is how original Sesame, soy, and peanut were for me.  So that is scary for me to want to eat anything, when I start eating something for a while and then have problems all of a sudden.  He stressed to me that, that is not typical of allergies at onset.  So he is pretty certain there would be something else.  And if there are reactions to those "new" foods, he thinks it would be caused mainly be cross pollen contamination and not lead to anaphylaxis like the others do. 

Originally the testing I had done was specific to environment and what I had eaten for original reaction.   He really wanted to do skin testing, but decided best not to take me off all the meds just yet.  I have also been getting red on arms, chest, and face that burn badly.  He said that prednisone can also cause that so he wants to see if I get off of that for a couple weeks if that improves or gets worse.  I think he picked 4 weeks to make sure all lab results were back and to give me the greatest chance of being off antihistamines for at least a week so he can scratch test what he wants at that time.  And so I can have detailed daily information for him, for over a long period of time.

I have been cooking things from scratch since 10/2011.  That normally means bread and stuff too.  Even normally make own sorbets etc.   With moving I have not been as good and have made stupid mistakes like the pita bread, which I won't be repeating.   So back to everything from scratch, and everything simple.  For at least next few weeks and also no shopping in craft stores.  =(  And to be very careful with grocery stores etc or any other location.   He said he doesn't want me to live in a bubble but for the next few weeks to basically live in bubble so we can figure this out. 

We talked about Epi plan for both asthma and reaction.  He didn't give me anything written.  But we went over it a few times.  And he said to trust my instinct and for me to make the call.  That it is a fine line on whether you need to use Epi.  And unfortunately if you don't take it at that time, then it can be too late.  On the flip side he really doesn't want me to have to use epi every day like how these reactions have been hitting.  That it is more important to get rid of the trigger by staying away from as much as possible so that can be eliminated.  Also stressed that he knows reactions can be scary, but to remember to try and stay calm.  And by doing so that will help me know whether or not I should use Epi.
Title: Re: UPDATE (original post)
Post by: CMdeux on January 29, 2014, 11:27:15 PM
He sounds like a good and very thorough allergist.  I think you may have found yourself a keeper.   :yes:
Title: Re: UPDATE (original post)
Post by: lakeswimr on January 30, 2014, 06:38:34 AM
I was struck by the very same quotes Links posted.  I hear what you are saying in your reply and see that your allergist is very thoughtful.

A few thoughts that may or may not be off base from me after reading what you wrote are that sesame is a food that doesn't have to be listed on food labels based on FDA rules so maybe some of your reactions are actually to unlisted sesame.  The only way to know if a food has sesame is to call companies.  It is essential to do this for anything with any ambiguous wording like, 'spice' or 'natural flavor' but my child has had reactions to foods even when there wasn't any ambiguous wording in the ingredients.  This is because many foods are produced on the same lines with sesame and not cleaned the way they would be for things like peanuts and 'Top 8' allergens.  So, I try to call companies about every product before giving a food to my son.  Once I call once and know their labeling practices I don't have to keep calling.  Nabsico/Kraft treat sesame as a 'Top 8' allergen so I know I can go by their label alone.  Other companies do not and so calling them is very important.

I also wonder about cross contamination of your foods.  I'm not sure how long you have been dealing with food allergies or how careful you are about what you eat and where you eat.  I hear you are making your own foods from scratch which is great as long as the ingredients you use are allergen-free.  I have found even some basic ingredients like some flours, oils, etc can have cross contamination with allergens so it doesn't hurt to look at those things as well.

It is certainly possible to develop food allergies at any time.  It is not that likely to suddenly develop a bunch of them.  I tend to always suspect a reaction was to a known allergen that somehow got DS's food xcontamed than that a new food allergy developed, although my son has developed new food allergies past the time he had his original set. 

I think you should have a clear, written emergency plan of when to epi.  Going by your best guess alone doesn't sound like enough of a plan to me.

Here is a link to a sample plan.

http://www.foodallergy.org/document.doc?id=234

It is a bit different than my son's plan.  I know what your allergist is saying but I still think he should give you a clear, written plan so things are objective as to whether you should epi or not or as objective as they can be.
Title: Re: UPDATE (original post)
Post by: CMdeux on January 30, 2014, 09:31:04 AM
Well, but our allergist has never "given us" an emergency action plan in writing, either-- simply gone over the anaphylaxis grading chart, discussed which symptoms merit immediate epi, which ones merit wait-and-see-- assuming NO known exposure, I mean.

With known exposure we epi either way.


I do think that fully vetting all of your basic ingredients with some phone calls to manufacturers is a good idea.  If you post brands/sizes in Manufacturers here, others may be able to help you (or confirm what CSR's tell you with separate phone inquiries).

Title: Re: UPDATE (original post)
Post by: twinturbo on January 30, 2014, 09:40:39 AM
I understand the message to be, from doctor to patient I can tell you the clinical but ultimately trust your judgment because her threshold to inject might be stronger (and more correct) on intuition for this initial miasma of unknown rather than be a complete slave to the flowchart.

They're going to get there together but he's only met her once, believes her and will help with the labs, interpretation and advice over time. OP is in a tough spot and I suspect doc knows it.

But that's my take on interpreting second hand reporting via a post. I could be way off.
Title: Re: UPDATE (original post)
Post by: LinksEtc on January 30, 2014, 10:21:59 AM
This is no secret  :) - I am a big fan of the written plan (a nice little rhyme there  :))

I agree with TT about not being a complete slave to a flowchart, and that there is a place for judgment, but I just see so much value in good written plans. 

A copy of dd's FA plan is with her epi's that I carry.  I am pretty comfortable with FA stuff at this point, but if she has a rxn, I want that objective plan there that I can look at (especially since if she were to have a significant reaction, I might not be thinking as clearly as usual). 

So many people talk themselves out of giving epi when it really should have been given ... with a written plan, it reminds people that some symptoms are "epi symptoms", it shows/reminds what the doc recommends based on objective guidelines, etc.

Plus, it can help with credibility issues (ex - with EMT) ... "I was just following the plan that my allergist gave me." 

FWIW ...
http://www.foodallergy.org/treating-an-allergic-reaction
Quote
Have your doctor create a written Food Allergy & Anaphylaxis Emergency Care Plan so that you and others will know what to do in the event of a reaction.



Not passing judgment ... written or not, the most important thing is that you understand the symptoms of anaphylaxis and know how to treat it.   :heart:

Title: Re: UPDATE (original post)
Post by: twinturbo on January 30, 2014, 10:56:12 AM
^co-sign the above as a gold standard. OP, I think, presents early on in this relationship with her doc at a somewhat anomalous position. I got the sense they're going to get there together and for now this first time meeting he doesn't want to mess with her mojo since he knows for a fact she will self-inject. On the other hand that's a buttload of inference on my part.
Title: Re: UPDATE (original post)
Post by: jenavy21 on January 30, 2014, 01:01:11 PM
For the most part we do everything from scratch.  No seasonings at all.   The only herbs I use are fresh grown.  I do use salt on occasion and pepper.  We do use real butter and for the most part stay away from oils (olive oil on occasion) and there is a canola mayonnaise I have used before but not recently.  While we know the sesame is complicated, he really does believe the problem is more with nuts.  Some of these reactions are happening more on inhaled and they didn't before.   But because where we are living, there are nuts all over that it is possible I am just being over exposed and making problem worse, which could account for major increase in reactions.  Also since I am the one who does most of the cooking, we really have little room for cross contamination.  Our home is a nut free home.  And while my kids do eat cereal on occasion and other snacks, we make sure not to get anything with nuts etc in them. 

We will be able to compare blood levels to those drawn a couple years ago, so hopefully that will give us some insight as well.  He REALLY wants to do the skin test, but we are trying to figure out how to get me there.  My gut instinct says this is a nut issue.  And because they are everywhere around me it is just getting worse.  I could be wrong but I think the peanut is going to come back significantly elevated compared to before.  But we will find out.

When it comes to injecting.   I have had 3 reactions now in past week, not from eating anything.  I tried staying away from parents house to see if that helped some and didn't notice much.  So tried to eat dinner there last night and after being inside for about 30 mins, reaction started.  I took the liquid children's benadryl and pepcid as soon as I felt anything and my throat and chest relaxed.   I did get barky cough and have palpitations after and very funny feeling in chest.  But I didn't use Epi because the other symptoms relaxed.  I am thinking that I was dehydrated from blood draw earlier and that led to some of it.  But in a case like that would you use Epi?   The grading chart doesn't help me much at that point because I am not feeling tightness anymore.   And that is why I am kind of stuck.  Yes there are birds in their house, but they are also outside my house.  So really hard to get completely away.
Title: Re: UPDATE (original post)
Post by: twinturbo on January 30, 2014, 01:15:31 PM
Qualified yes. On paper those are 2 systems, and with respiratory with known history that's an automatic. Yet it doesn't make sense that you'd have to do it this often.
Title: Re: UPDATE (original post)
Post by: jenavy21 on January 30, 2014, 02:29:02 PM
That's the trigger we are trying to find.  If it is in fact nuts.  And I have gotten that sensitive from over exposure.  It explains a lot.  If it is not then something is missing.  So in meantime I am just trying to avoid best I can and writing all down so he can see if he can help make the connection.  The breed parrots on their property and have TONS of other animals (horses, cows, chickens, etc etc etc)  Yes they have a lot of land, but for me where ever I go I am always around that stuff.  So in meantime Trying to determine the trigger.  If it is in fact nuts then we will have to figure something out.  He said yes people can be that sensitive, but not as common.  So it is possible that it is peanut and tree nut, which would make it even more stuff around me that shouldn't be.  You would have to see their property to understand.  It isn't a normal residential community.  They have a lot of land.  And this normal area for me to be as we have always lived in a residential community.   
Title: Re: UPDATE (original post)
Post by: CMdeux on January 30, 2014, 03:03:35 PM
Yes, I understand-- and it makes complete sense that he's leaving it more or less up to you to determine what to do in an individual kind of way, given the uniqueness of your situation.    Do study that anaphylaxis grading chart, though-- and kind of have a dividing line in YOUR mind that tallies with that-- some symptoms are in a grey area, for sure-- but the ones that impact blood pressure and breathing, not so much.

ANYTHING that is in that life-threatening zone, you really have to use epinephrine.   :-/  Yes, spontaneous recovery happens more often than not even with those-- but if you get it wrong, you're dead, and if you delay too long, same story-- you can be unrecoverable by that time.  KWIM?

Frequency makes it so hard emotionally to actually DO that, though.  I know.
Title: Re: UPDATE (original post)
Post by: lakeswimr on January 30, 2014, 03:32:08 PM
Well, but our allergist has never "given us" an emergency action plan in writing, either-- simply gone over the anaphylaxis grading chart, discussed which symptoms merit immediate epi, which ones merit wait-and-see-- assuming NO known exposure, I mean.

With known exposure we epi either way.


I do think that fully vetting all of your basic ingredients with some phone calls to manufacturers is a good idea.  If you post brands/sizes in Manufacturers here, others may be able to help you (or confirm what CSR's tell you with separate phone inquiries).

I think all allergist should give their patients a clear, written emergency plan.  If the grading chart works for you that's a written plan.  Giving nothing in writing and telling people to go with their gut is a red flag in my opinion or not the standard of care I would expect from a good allergist.
Title: Re: UPDATE (original post)
Post by: lakeswimr on January 30, 2014, 03:41:49 PM
For the most part we do everything from scratch.  No seasonings at all.   The only herbs I use are fresh grown.  I do use salt on occasion and pepper.  We do use real butter and for the most part stay away from oils (olive oil on occasion) and there is a canola mayonnaise I have used before but not recently.  While we know the sesame is complicated, he really does believe the problem is more with nuts.  Some of these reactions are happening more on inhaled and they didn't before.   But because where we are living, there are nuts all over that it is possible I am just being over exposed and making problem worse, which could account for major increase in reactions.  Also since I am the one who does most of the cooking, we really have little room for cross contamination.  Our home is a nut free home.  And while my kids do eat cereal on occasion and other snacks, we make sure not to get anything with nuts etc in them. 

We will be able to compare blood levels to those drawn a couple years ago, so hopefully that will give us some insight as well.  He REALLY wants to do the skin test, but we are trying to figure out how to get me there.  My gut instinct says this is a nut issue.  And because they are everywhere around me it is just getting worse.  I could be wrong but I think the peanut is going to come back significantly elevated compared to before.  But we will find out.

When it comes to injecting.   I have had 3 reactions now in past week, not from eating anything.  I tried staying away from parents house to see if that helped some and didn't notice much.  So tried to eat dinner there last night and after being inside for about 30 mins, reaction started.  I took the liquid children's benadryl and pepcid as soon as I felt anything and my throat and chest relaxed.   I did get barky cough and have palpitations after and very funny feeling in chest.  But I didn't use Epi because the other symptoms relaxed.  I am thinking that I was dehydrated from blood draw earlier and that led to some of it.  But in a case like that would you use Epi?   The grading chart doesn't help me much at that point because I am not feeling tightness anymore.   And that is why I am kind of stuck.  Yes there are birds in their house, but they are also outside my house.  So really hard to get completely away.

Are you sure it wasn't a reaction to the birds in their house and not to food?  What you describe is how I feel when I'm in a pet store.  Having birds *outside* one's house is not likely to cause a reaction in a person allergic to birds.  Having a bird IN the same house, yes, that can certainly cause a reaction.  I'm very allergic to birds. 

The plan we have is that if we know or suspect my child is having a reaction to a food and he has any  of the symptoms listed on his emergency plan we epi.  Certainly we epi for throat tightness and chest tightness!  If you think you are having a food reaction you should epi for those symptoms.  Every emergency plan would call for the epi for either of those symptoms BY THEMSELVES if it was from food!  The fact that you do not have a written plan concerns me.

Benadryl has no life saving capabilities.  It is for comfort only and for seasonal allergies.  It can't stop anaphylaxis that is going to progress from progressing. 


If you are allergic to sesame and you are not avoiding it 100% by taking the steps I mentioned in my post then you can be having reactions to sesame.  Are you certain you reacted to sesame in the past?  If you are allergic to it you should be avoiding it 100%.  There is no way to tell if your sesame allergy is more or less serious than nuts.  Past reactions are not a reliable indicator of what future reactions will be like.  If you are allergic to sesame you could have a severe reaction to it even if  your past reactions were not that severe.  If you are having mystery reactions I'd start with being extra careful with known allergens.  I'd also avoid pets that cause you issues. 
Title: Re: UPDATE (original post)
Post by: CMdeux on January 30, 2014, 03:48:07 PM
Again, though-- this is clearly a work in progress with the allergist, and also with the living situation (she's living in a place where she KNOWS that it's not really "safe enough" but currently doesn't have a better option at the moment-- she's living in a place that breeds exotic psitticines-- parrots).  So "get the birds away from you" isn't a solution-- moving is the only real answer if that turns out to be the problem, and she has a baby and a deployed spouse, and is on a waiting list for .gov housing.  At least where she is, she has family to help her out and she's not completely alone (also not good in this situation as sole caregiver).

Fluid situation-- that's how I read it.  The close follow-up with the allergist is a good sign, I think, and she DID cover a lot of territory with the allergist.  It's just that they really aren't (yet) in a position to judge what a solid action plan is eventually going to look like.

I think Jenavy is doing the best that she can, and I'm thinking that even if her allergist isn't perfect, he's probably better than 90% of what's out there.   :heart:

Title: Re: UPDATE (original post)
Post by: lakeswimr on January 30, 2014, 04:14:26 PM
If it is the birds she ought to get on a daily antihistamine for now and maybe an inhaled steroid and albuterol as needed.  I agree, it sounds very complicated. 

I think even if the situation is being figured out at this time, she needs to know exactly what to do if such and such happens. 

Title: Re: UPDATE (original post)
Post by: rebekahc on January 31, 2014, 12:47:05 AM
I'm pretty sensitive to environmental peanut exposure and I'm positive I would be having a terrible time living where you do.  My eyes and lips swell, I wheeze, my face flushes, I get hives on exposed skin, itchy throat, etc. just from being in the same room with a kid eating a PB&J sandwich.  It seems the birds eating peanuts and cracking the shells creating lots of peanut dust that then gets blown around in the wind would be a much more intense exposure.

When I react from environmental exposure, I remove myself from the area and see if symptoms subside before considering epi.  They always have.  For you, it's more difficult because you can't really escape it.  I would suggest showering to remove residue, but I'd be afraid the steam and heat could make your symptoms worse.  Any chance you can get away from your parents' place for a few days and see how your reactions go?
Title: Re: UPDATE (original post)
Post by: twinturbo on January 31, 2014, 12:06:25 PM
There's one method that might help you towards pinning down your allergens or at least eating with less likely contamination. Neocate.

Neocate is a medical food with all essential nutrients you may have heard of the infant formula with the same name. There's a version for adults. I'm not saying be on it forever but to hold your food source as a control it could be useful. It would be pretty hardcore for a month or two but if you can do it there might be some use as you add foods back one at a time.

I've had to do it with one of my kids it isn't fun. But it is one possible option.
Title: Re: UPDATE (original post)
Post by: CMdeux on January 31, 2014, 01:22:46 PM
It would give you zero contamination risk from food prep, that's for sure-- without being there to see, it's hard to know if that is necessary...

but yes, worth consideration, I think.
Title: Re: UPDATE (original post)
Post by: jenavy21 on January 31, 2014, 01:42:45 PM
They are testing for birds as well to make sure it isn't a pet thing.  And in the mean time, my parents are switching their food to peanut free to see if that makes a difference.  We have not ruled out that it could be a pet thing, but given past history and what we know are allergies for certain, their seed seems more probable.  I know my mom cleaned out their cages yesterday (big cage) so we will see.   I am on a daily antihistamine for H1 and for H2 right now with Benadryl as needed.  But because I am staying on that for the time being, he can't do skin testing.  Once I get some of this down we are going to try to stop one and then the other so I can be off of it for at least a week before follow up.  That way he can do skin testing to answer questions and then we will cross challenges next if needed. 

The original reaction I had, several years ago, was when I was eating sesame seeds and soy sauce.  It was no surprise those came back positive.   I am being extra careful and read all the notes and suggestions about sesame to make sure to avoid it completely to rule that out.  I personally believe nuts are more likely the problem, but doing everything to be on safe side. 

It's funny because we thought this was best thing for us to be here.  lol  Never could have imagined that it wouldn't be the safest place for me.  But we are trying to do the best we can.  My parents have definitely had a chance to see how scary the reactions can be and are doing everything to help me figure it out.  Luckily I will get to see my hubby this weekend so we can try to figure more of it out.

I will keep the Neocate in mind.   I am hoping that we can try to control the environment and be extra cautious and figure this out.  I took my kids to a hockey game last night and surprise there were lot's of peanuts.  Something I hadn't thought about.  I was wheezing before I even knew they were there.  But in that case I was able to take Benadryl and change where we were and it was fine.  So things like that I am just going to avoid for the next month.  We will have lot's of movie nights and game nights at home!  Luckily my kids are still young and enjoy spending time with mommy!!