Monday, January 19, 2009

Countering Hysteria

On January 9, 2009, Joel Stein wrote an opinion column in the LA Times about his belief that peanut allergies in children are nonexistent, a result of mass hysteria by affluent parents who want to feel special. (Read his column here.) On January 15, the LA Times printed a “blowback” response from Robert A. Wood, professor of pediatrics and director of pediatric allergy and immunology at the Johns Hopkins University School of Medicine and member of the Food Allergy and Anaphylaxis Network's medical advisory board, who explained that the disease is an actual disease that affects children regardless of their parents’ financial status or emotional desires. (Read Dr. Wood’s response here.) I’m very glad the Times printed that response. But I also think Joel Stein should hear from some of us “hysterical” moms, too. Here is my own response to Joel Stein.

Dear Joel,

I’m glad no one you love has a severe food allergy (LA Times, “Nut Allergies – A Yuppie Invention,” 01/09/09). I wouldn’t wish that on anyone. The 1 in 20 kids who’ve developed food allergies aren't suffering from hysteria. They're suffering from a condition where a food protein attaches to IgE antibodies on mast cells, causing the mast cells to explode, releasing histamines into the body. This causes a reaction ranging from a mild rash to the shutting down of several body systems, including respiratory and digestive systems. In other words, eating a peanut might give you a rash. Or it might make you stop breathing. It’s unpredictable, even within the same person from one time to the next.

I wish you had been with me last Sunday night at the doctor's office, watching a ten-year-old boy I love swell up and turn red and cold from head to toe. By getting him the medicine he needed immediately, we turned the reaction around and he was fine in a few hours. I suppose we could have told him he was being hysterical and to just get over it. But I'm glad we chose to administer quick medical help instead. I’m not sure your approach would have saved his life.

I'm sorry you think we're inventing numbers. We wish we were. No one knows why our bodies are now identifying normal foods as allergens or why it’s occurring more frequently now -- it probably has little to do with fast genetic mutation, and everything to do with how the chemical environment we live in (which is significantly different than it was thirty years ago) has simply altered our immune systems. That probably also explains the variation between countries, and possibly the increase over the same time period in diseases like autism and hormonal problems in young men.

We didn't choose this disease. Most of us try to minimize our children's risk while minimizing impact on everyone else. But we truly appreciate it when others are willing to accept a few inconveniences to ensure they don't accidentally kill the kid sitting next to them. A few hysterical people, as usual, cloud the issue for everyone else – and those hysterical people can be found on both sides of the issue. Some choose hysteria to get attention from doctors, so their influence is limited to a handful of immediate family and friends. Some choose hysteria to sell columns, so their influence amounts to thousands of readers. Neither is beneficial to those millions of us in the middle who have to find ways to live with the truth of a disease that is scary, but manageable as long as the hysteria is controlled.

Thank you for giving topics like this a little more thought in the future. Lives depend on taking diseases seriously and discussing them rationally.

Mom of a peanut-allergic kid

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