by Kelley Lindberg
I’m feeling a little under the weather today, so I’m repeating a Valentine’s-themed post from last year. Happy Valentine’s Day, everyone!
Valentine’s Day is almost here. Yes, it’s that time of year again… the time for love, romance, special dates – and kissing.
Crap.
Just what we food-allergy sufferers need. Something else to worry about.
For young people, kissing is complicated enough. Think what kisses can lead to – brain malfunctions, ruined reputations, marriage proposals, bad dates, broken friendships, unreasonable expectations, dizziness, pregnancy, forgetfulness, poor fashion choices, high credit card bills, lousy steak dinners… and that’s all in a good weekend.
Now, throw in the fact that food allergens can stay in a person’s mouth for hours after they eat, and suddenly you’ve added “scary trips to the ER” to the list.
My son is only ten. He’s still in the “Oh gross, they’re kissing!” stage. Every time he sees someone kissing on TV, he slaps his forehead as if to say, “What are they THINKING?” I’m encouraging this attitude. As far as I’m concerned, he can think kissing is gross until he’s 35. Or 40. Really.
But sadly, I figure I’ve only got another few years (okay, I admit it, I’m optimistic) before the hormones suddenly turn from “eww” to “oooh.” And then I’ll be staying up late, worrying about all the usual things parents of teens worry about, plus that other one: “Did the girl he’s kissing eat peanuts today?”
Food allergies bring a whole new aspect – a really ugly one – to the already dangerous minefield of kissing.
In 2003, the Journal of Investigational Allergology and Clinical Immunology published a paper called "The Hazard of Kissing When You Are Food Allergic" from Swedish doctors who studied how many allergic people had a reaction after kissing someone who’d eaten the offending food. Their study showed 12% of survey participants had an allergic reaction after kissing. (When they eliminated respondents who “didn’t know” if a reaction was caused by a kiss, the numbers rose to 16%.) That’s not comforting.
As an interesting side note, the doctors surveyed both Russian and Swedish participants. Of those, 12% of the Swedish survey participants reported a reaction, and only 5% of the Russian participants did. I can think of all sorts of jokes here about who you would rather kiss – a member of the Swedish Bikini Team or the Russian Swimming Team, but that would be rude and stereotypical. So I’ll let you come up with your own jokes.
The Mayo Clinic Proceedings website outlines a 2003 case report (apparently 2003 was an extraordinarily bad year for kissing) of a seafood-allergic woman kissing her boyfriend after he’d just eaten shrimp, and then suffering from an anaphylactic reaction and having to go to the hospital ("The Kiss of Death: A Severe Allergic Reaction to a Shellfish Induced by a Good-Night Kiss").
This case report was only one of many that have been showing up with alarming frequency in the literature, so some doctors in New York decided to study how long peanut residue could stay active in the saliva of people who’ve eaten peanut butter, and whether or not brushing teeth or other “interventions” would help get rid of the allergens. They published their results in 2006 ("Peanut Allergen Exposure Through Saliva: Assessment and Interventions to Reduce Exposure"). They studied 38 people. Immediately after eating 2 tablespoons of peanut butter, the subjects’ amount of allergens in their mouth varied “considerably,” but many had levels of peanut proteins high enough to cause reactions. They tested again one hour after eating; at that point, 87% had undetectable levels. Unfortunately, that means 13% still had detectable levels of peanut in their mouth.
When they used interventions to cleanse the mouth immediately after eating peanut butter, such as rinsing or brushing their teeth, the allergens were reduced, but still remained in approximately 40% of the samples. Their conclusion: “Patients with peanut allergy require counseling regarding the risks of kissing or sharing utensils, even if their partners have brushed their teeth or chewed gum. Advice to reduce risks, although not as ideal as total avoidance, includes waiting a few hours plus eating a peanut-free meal.”
Another comment in the study added: “Teenagers with peanut and other food allergies need to be reminded that to stay safe, restraint and patience are necessary even in the most intimate situations.”
Yeah, good luck with that. Parents have been trying to remind teenagers to use restraint and patience to stay safe since they were running around poking spears in angry wooly mammoths.
So what’s a teen to do? Well, here’s what the experts recommend:
1. Tell your date what you’re allergic to, and explain how serious it is.
2. Ask your date to refrain from eating those foods on the day of your date.
3. Ask your date to brush their teeth and wash hands if they have eaten something you’re allergic to, and wait AT LEAST one hour before kissing.
4. Keep your EpiPens with you at all times.
5. Wear a medical ID bracelet, so if you end up unconscious, the EMTs will know what to do with you. A bracelet also is a good way to "break the news" to people -- when they ask what the bracelet is for, it's easy to explain food allergies without sounding like you're fishing for a kiss.
As for us parents, here’s what we can do:
1. Worry.
2. Pray.
3. Trust that we’ve taught them well.
4. Love them.
5. Breathe a sigh of relief when they come home safe with that silly look on their face. Despite the silly look.
6. Keep on the lookout for other teens who also have food allergies, and try fruitlessly to arrange accidental meetings between your child and those other teens.
Personally, I’m going to be creating a “dating application” for my son. All of his prospective dates will have to complete the application, submit to a lie detector test, and provide a $100 deposit for ambulance transportation fees before the date commences.
I can hear my son slapping his forehead now.
Happy Valentine’s Day.
Monday, February 8, 2010
Monday, February 1, 2010
Dip Into It! Food Allergy Dips
by Kelley Lindberg
Can you believe the New Year started only one month ago? It seems like two or three months have gone by. That’s January for you. And of course, the only month longer than January is February – I don’t care what the calendar says.
I was thinking about New Year’s, and I realized I should share a fun discovery I made for the New Year’s party I went to. At a health food store in Layton, I found Tofutti brand sour cream substitute – it’s made of soy, and it’s dairy-free and egg-free.
While it doesn’t take exactly like sour cream, I decided that if I mixed it with an envelope of dip seasoning, it might be acceptable. So I found two brands of dip mixes that are milk- and egg-free: McCormick and Western Family (both contain wheat and soy, however). I tried mixing the Western Family French Onion dip mix into the Tofutti sour cream substitute and it was GREAT! I also used the McCormick Ranch dip mix in another tub of the Tofutti, and it was pretty good. Not quite the same taste as regular ranch, but still good with fresh veggies. But the French Onion dip, I have to say, was really tasty.
McCormick also has milk- and egg-free Spinach Dip and Vegetable Dip flavors, so I’m going to try those, too, mixing them with the Tofutti and some chopped frozen spinach (thawed) and some chopped artichoke hearts.
I love making a new discovery like this – one more option for party fare is always a good thing, right?
Can you believe the New Year started only one month ago? It seems like two or three months have gone by. That’s January for you. And of course, the only month longer than January is February – I don’t care what the calendar says.
I was thinking about New Year’s, and I realized I should share a fun discovery I made for the New Year’s party I went to. At a health food store in Layton, I found Tofutti brand sour cream substitute – it’s made of soy, and it’s dairy-free and egg-free.
While it doesn’t take exactly like sour cream, I decided that if I mixed it with an envelope of dip seasoning, it might be acceptable. So I found two brands of dip mixes that are milk- and egg-free: McCormick and Western Family (both contain wheat and soy, however). I tried mixing the Western Family French Onion dip mix into the Tofutti sour cream substitute and it was GREAT! I also used the McCormick Ranch dip mix in another tub of the Tofutti, and it was pretty good. Not quite the same taste as regular ranch, but still good with fresh veggies. But the French Onion dip, I have to say, was really tasty.
McCormick also has milk- and egg-free Spinach Dip and Vegetable Dip flavors, so I’m going to try those, too, mixing them with the Tofutti and some chopped frozen spinach (thawed) and some chopped artichoke hearts.
I love making a new discovery like this – one more option for party fare is always a good thing, right?
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.
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!
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!
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