Monday, January 25, 2010

Choosing an Epinephrine Auto-Injector

by Kelley Lindberg

In the first part of January, the pharmaceutical company Sciele Pharma announced that it is now offering a new epinephrine auto-injector, called Adrenaclick.

This makes three companies I know of that offer epinephrine auto-injectors in the United States, plus one more in Europe, Australia, Asia, and Canada.

The three brands of auto-injectors that I know are available in the United States are EpiPen, Twinject, and now Adrenaclick. The additional brand available in Europe is called Anapen.

I am not a doctor, so don’t accept what I say as medical advice. But I’m going to describe what I’ve learned from my pharmacist, allergist, and my own online research about these, in case you’re wondering, like I am, what the differences are between these auto-injectors.

All of the brands appear to use the same medicine, adrenaline (also called epinephrine), to treat anaphylaxis caused by allergic reactions to foods, insect stings, or other allergens. The three brands in the United States all seem to offer two dosages: 0.15 mg for smaller body sizes (younger kids) and 0.30 mg for larger kids and adults. The Anapen appears to come in 3 dosages (0.15 mg, 0.30 mg, and 0.50 mg).

So if the medicine is the same, what’s the difference between them?

As far as I can tell, the only significant differences are in how the auto-injectors work and whether your insurance has a preferred brand (which can mean some cost savings for you).

The new Adrenaclick appears to work almost identically to the EipPen – a single injection of a pre-measured dose in a pen-shaped injector, which you administer by pressing the injector against the outer thigh and leaving it there for 10 seconds. To administer a second dose, you use a second auto-injector. (The EpiPen instructions require more of a “jabbing” motion, while the Adrenaclick instructions say to place the auto-injector against the thigh, then press it firmly to inject the needle.)

The Twinject contains two doses in a single pen-shaped injector, so it is more compact to carry. However, only the first dose is administered automatically through the pen. To administer the second dose, the Twinject instructions tell you to remove a syringe from the container, stick the needle into the thigh, and press the plunger to administer the pre-measured dose. It doesn’t look difficult, but for people with needle phobias, it could be a little harder to see and use. But the space savings in having both doses in a single container make the Twinject more attractive to some users.

The Anapen looks most similar to the EpiPen and the Adrenaclick – a single dose auto-injector. However, instead of jabbing the pen against the thigh, the Anapen instructions tell you to press it to the thigh, then press the red button at the top of the pen to inject the needle.

Beyond the mechanical differences of how the auto-injectors are administered, there doesn’t seem to be a significant difference between them. So check with your insurance company to see if they have a preferred brand. If they do, they will sometimes cover that brand at a lower co-pay, so it’s worth it to ask.

Monday, January 18, 2010

Girl Scout Cookies and Food Allergies

by Kelley Lindberg

If you are related to a Girl Scout, know a Girl Scout, work with someone who has a Girl Scout, or find yourself anywhere within a half-mile radius of a Girl Scout, chances are good you know what time of year it is – Girl Scout Cookie time.

Everyone loves Girl Scout cookies. Or maybe we just love those cute little pig-tailed Warren Buffets trying every trick in the book to convert their mountain of colorful boxes into cold, hard cash. Buying Girl Scout cookies used to be a no-brainer. I’d buy a box or two from every Scout I knew, eat them, and then breathe a sigh of relief that I was safe from big eyes and big calories for another year.

Now, however, it’s not quite as easy, because I have to deal with food allergies. Fortunately, the mother of one of my pint-sized calorie pushers tracks down allergy information for me every year to let me know which cookies I can have in my house. This year, as usual, there are only two types that are safe from nut and peanut contamination: Thin Mints and Samoas. (Note that the Samoas do contain coconut, so if you’re allergic to coconut, avoid them.) Samoas -- yummy cookies topped with caramel and coconut, then drizzled with chocolate -- have always been my favorites, so that’s lucky for me.

Fortunately, the manufacturers the Girl Scouts use comply with federal law to label allergens. Here’s a link to this year’s Girl Scout Cookies ingredients and allergen warnings.

Sadly, all the cookies contain milk, wheat, and soy. None contain egg, though, so if that’s your only allergy, it looks like you can go wild!

It seems like the Girl Scouts add another type of cookie periodically. Wouldn’t it be wonderful if next year, they came up with an allergy-friendly cookie? Especially since this is an organization of, by, and for kids, who have anywhere from 3% to 8% chance of having food allergies themselves, it seems to me that incorporating a food-allergy-friendly cookie would be a big step towards continuing the Girl Scouts’ goal of inclusion.

I’m not the only one thinking along these lines this year. I ran across the High Tech Dad’s blog, where he is also advocating that the Girl Scouts champion allergy-aware cookies in their food drive. Their organization is so big, and their reach is so extensive, they could reach a lot of people and raise a lot of awareness. They might even find that they increase sales by uncovering an entirely new market for their fund-raising efforts. More importantly, they would include those girls in their troops who are allergic and who aren’t comfortable handling all those boxes of cookies they’re supposed to sell. Right now, I imagine a lot of girls have to sit out the cookie sale and miss out on the contests and camaraderie of selling cookies with their friends.

Until that day, however, check the ingredients labels so that you know whether you can order any cookies this year. If you aren’t accosted by a Girl Scout this year but you want to order some, let me know and I’ll hook you up with my cookie connection (who will ship orders of five boxes or more with free shipping!).

I’ve already placed my orders. I can’t wait!

Monday, January 11, 2010

Learning New Things

by Kelley Lindberg

I didn’t list “learn new things” as one of my New Year’s resolutions. I really didn’t. My brain is full enough as it is, and I worry that if I learn something new, it will shove something old and important out the back door, like my phone number or my son’s name or the words to that old Kansas song.

But here I am, eleven days into the new year, and I’ve managed to learn a whole bunch of new things. For example, my son got a Wii for Christmas, and I got myself the Wii Fit Plus game. So I’ve been learning that my body is in terrible shape. I’ve learned about muscles in strange places that can become sore, even though it doesn’t seem like they’re doing anything. I’ve learned that my right side is way wobblier than my left side. I’ve learned that the animated Wii personal trainer who’s teaching me how to do yoga sports an ugly streak of sarcasm, despite his boyish good looks.

But my physical inadequacies aren’t the only things I’ve learned this year. I’ve learned that the only way I’m going to get my cookbook sold is to send it to publishers who might be interested in publishing it. Hmm. That’s kind of a novel thought. So I’ve started doing just that.

I’ve learned a bunch of new ways to cook things in the last eleven days, because I’m re-energized about my cookbook and about cooking in general now. My family keeps looking shocked as we sit down to the table and they discover yet a new creation. So far, my experiments been turning out really well. So I’m shocked, too.

Speaking of experiments, I’ve learned that nothing ruins a 5th grade science fair experiment measuring which bird feeder the backyard birds prefer than a marauding hawk that attacks and eats a hapless finch on the back fence a few days before the experiment starts, and scares every bird away from the neighborhood for weeks. But because of that, my son and I have learned a few interesting lessons about recovering from experiments gone awry, so that’s been okay, too.

I’ve learned that when all your friends go on diets, it’s hard to go to breakfast with them because they talk about how much weight they’ve lost and they order things like cottage cheese. So then I eat less, too. And that’s a good thing.

I’ve learned that I can prepare a new presentation to give to a group of writers with just a few hours’ notice, and that I no longer get nervous before a presentation. That’s a good thing, because I have several presentations coming up in the next few weeks. And I’ve learned that I’m glad I can be a last-minute “Help! My speaker canceled. What are you doing tonight?” kind of person.

And I’ve learned that the older my son gets, the more loving he gets. I don’t know… maybe he made a New Year’s resolution to hug his mom more, or maybe he’s just delirious with joy over getting a new Wii, but I’ve been adoring the extra attention no matter what the reason.

So here I am, learning new things despite every intention. Enjoying new things. Welcoming new things.

I may be an old dog, but these new tricks aren’t as bad as I thought. And guess what? I still know all the words to that old Kansas song. “Carry on my wayward…” no, wait. How does that go again?

Monday, January 4, 2010

Making a Habit of New Year's Resolutions

by Kelley Lindberg

So, how are those New Year’s resolutions going? Mine are going… um… hang on a minute. I have to go wash the potato chip grease off my fingers… OK, I’m back. Well, my resolution to cut back on potato chips isn’t going too well. And my resolution about keeping the house clean? Yeah, that hasn’t gone very well, either.

The big one, though, is about trying to use my time more efficiently. Right. That’s a bust, too. I’m trying to cram some exercise into my schedule, and it’s taking way too much time away from everything else, so I can tell it’s going to get dropped pretty soon, and I’ll be right back to complaining about my inefficient but familiar routine.

I’m not sure why I bother thinking about resolutions. My habits are old and ingrained, and I don’t change until I absolutely have to. And that generally means lives have to be at stake. I don’t think I’m alone in this.

That’s why changing a family’s eating habits and diet because of newly discovered food allergies is so challenging. But guess what? Most of us successfully do it. Why? Because lives really ARE at stake.

But there’s something good about habits, too. Although it may take a while to establish a new habit, once you have, it becomes just as easy to maintain as the old habit was. It eventually works its way into our routine, and we once again find ourselves on autopilot, flying through our day with the new habit firmly in place.

When we first learn that we have to eliminate something like milk or eggs or wheat from our diet, it feels like an enormous earthquake ripping through the landscape of our lives. But we have no choice but to pick up the pieces and start to rebuild. Soon we’ve found new brands that are safe, new recipes that we like, new ways to add a substitute nutrition source back into our diet. In a month or two, we find that the aftershocks have lessened to the point where we go entire days without noticing them. Another month or two after that, and we’re cruising in the fast lane again, with most of the new detours familiar now and well-marked.

That new eating habit is now a part of us, just like our old ones were. And when we stop to look at how far we’ve come, we take a deep breath and feel pretty good about ourselves. So if you’re just starting out on a new diet, whether it’s because of food allergies or other health goals, take heart. It looks hard at first, but you know deep inside that you’ve created habits before. You can create this one, too.

I keep telling myself that. And you’ll be proud of me – I didn’t eat as many potato chips today as I usually do. Maybe there’s hope for those other New Year’s resolutions, too.

Let me know how your resolutions are going!