Here is another Food Allergy Awareness themed post for you to share with your friends during Food Allergy Awareness Week (or anytime, really! We can always educate and advocate, even when the week is over).
The following are ten food allergy facts that I wish everyone knew:
- Food allergies can be life threatening [and epipens are not always enough]: Many of you reading this already know this, but not everone does, so bear with me. People can (and do die) from anaphylaxis, a life threatening condition that arises from the ingestion of or exposure to an allergen. Recognition of early signs of anaphylaxis, and prompt treatment is crucial, but sometimes this isn’t enough. I have seen and heard of many instances where people take a cavalier attitude about food allergies if they know the affected individual carries an epipen. They often justify their lack or concern about things like cross contamination with phrases like, “What’s the big deal? You have your epipens, right?” This attitude is reinforced and perpetuated by visuals in movies and television where someone has an allergic reaction, uses their epipen, and jumps back up like nothing happened. I wish things were that simple in real life, but they are not. First of all, individuals can feel the affects of an anaphylactic reaction (and it’s treatment) for days, even weeks, after the initial exposure (more on that in a bit). Second of all, people can (and do) die from reactions, even after the administration of an epipen. Sometimes this is due to delayed use of epinephrine, but other times it just wasn’t enough. Sometimes, treatment requires two or more doses of epinephrine; sometimes that still isn’t enough. Then there is also the possibility that an epipen fails to work, due to a defect or manufacturing flaw. There have been multiple recalls on epipens over the past few years, due to potential defects that could affect the way the medication functions, or prevent it from being administered at all. I had quite the scare last year when a few days after using an epipen on my son, I realized the other set we had at home had been recalled. I spent a lot of time wondering what would have happened if I had unkowingly used one of the recalled epipens instead.
- Food does not necessarily need to be ingested for a reaction to occur: Airborne anaphylaxis (anaphylaxis that occurs as a result of inhaling an allergen, via substances such as steam or powders containing an allergen), and contact anaphylaxis (a severe reaction to traces of an allergen on surfaces) are both very real, and very scary. Our family has experienced both on more than one occasion.
- Similarly, a reaction can be triggered by microscopic, invisible to the naked eye amounts of an allergen: When someone reacts to an allergen, they are reacting to a particular protein present in that food. A surface can look completely clean, and still contain traces of those proteins, thus potentially triggering a reaction in a hypersensitive individual.
- Proteins can only be wiped or washed away: The only way to remove food proteins from skin or a surface is to wipe or wash them away, preferrably with hot, soapy water (dish soap is best as it is designed to target oily, greasy substances that can be particularly difficult to completely remove). Also, food proteins cannot be “killed” by disinfectants or hand sanitizer. Hand sanitizer and disinfectant are simply not reliable methods for removing proteins.
- Peanut Allergies are not the only severe food allergies, nor are they the only allergies that can trigger anaphalxis: The Top 8 allergens account for the vast majority of allergic reactions, but every food has the potential to be allergenic. Further, any allergy has the potential to be anaphylactic. There are many individuals, that like my child, are not only only allergic to peanuts, but also foods like milk, wheat, or eggs. There are people that are anaphylactic to foods like cinnamon, garlic, and onion, or anaphylactic to oils and fragrances, such as lavender. Many people, however, have only heard of severe reactions from nuts, and honestly do not know that there are many other allergies that are just as severe. Although my son is anaphylactic to a number of foods (including peanuts), his worst allergy is by far milk, but when people that don’t know us well hear his laundry list of allergies, they tend to hone in on the peanut allergy, and kind of ignore the rest (a scary phenomenon that I am always quick to address). Unfortunately, this tendency to focus only on peanut allergies can be found even within the allergy community. I have had mothers of children with only peanut allergies tell me things like, “Peanuts are the most severe allergy [and thus need to be taken most seriously],” “peanut allergies are the only ones that can cause airborne reactions” (simply not true), and “Peanut allergies are the most dangerous, because foods like peanut butter are the hardest to remove” (peanut butter is hard to clean up, because it is oily and greasy, but there are a lot of foods that contain other allergens, and are just as oily and greasy). This kind of thinking, whether it comes from someone with or without allergies, is potentially very dangerous for people with severe allergies to foods other than nuts.
- Antihistamines should not be used as the first line of treatment during an anaphylactic reaction: Antihistamines (such as Benadryl or Zyrtec) are wonderful medications, and very helpful for a lot of allergy suffererers. They also work great during an anaphylactic reaction when combined with epinephrine, but they should never be used in lieu of an epipen. Doing this can actually mask signs of anaphylaxis, making it appear as if a reaction has improved, when in reality it hasn’t, and may even be worsening. This can result in delayed administration of epinephrine (the only effective treatment for an anaphylactic reaction), and unfortunately, this mistake isn’t always realized until it is already too late. People (often children) have died from using antihistamines only, when an epipen should have been administered instead. There are many, many people that still think antihistamines should always be given first, (and epipen only used as a last resort) when treating anaphylaxis, even within the medical field.
- Allergies are both diverse and complex: There are lots of different types of allergies, and many of these allergies are caused by different things, and even manifest in different ways. Even within specific types of allergies, there is a lot of variability. Please never assume that a person’s allergy is “fake,” because these things are not always black and white. For example, some people can tolerate baked versions of allergens (this can sometimes break down a protein to a tolerable extent), but cannot tolerate it in any other form. Similarly, there are individuals that cannot consume raw foods without a reaction, but they can eat the same foods cooked, and be just fine. So the next time you hear someone ask for a salad without onions because they are allergic, and then order the fajitas, please don’t scrutinize them too much, and try to give them the benefit of the doubt. While there are people that do fake allergies simply because they don’t like a particular food (and believe me when I say, no one is more frustrated by these people than actual allergy sufferers), there are people with complicated, yet very real, allergies that could be put in danger by the wrong person assuming that they are “faking” or “just in it for the attention.”
- Reactions are unpredicatable: Reactions can vary in both symptoms and manifestation, and often get worse upon increased exposures. You should never predict what your next reaction will be like based on your last, because your next one could always be worse. All allergies should be taken seriously–while your last reaction may not have been severe, your next one could be anaphylactic.
- No one knows exactly what causes allergies: There has been a lot of research done on what causes allergies, but scientists have yet to determine a singular cause. Some studies on the subject suggest a genetic component, while others have found correlations between allergies and everything from environment, to antibiotic use, to whether or not parents used baby wipes on their babies. As we all know, though, correlation does not necessarily equate causation. On a sidenote, I am always open to having an intellectual discussion about what may cause allergies, but please don’t tell me (or any other allergy parent) that our child’s allergies were caused by something we did (or did not do). This includes, (but is not limited to) telling a mother that their child has allergies because they did or did not vaccinate, because they ate or didn’t eat a certain way during their pregnancy, because they are “too clean” or “germaphobic,” or because they chose to feed their baby in a certain way. I have personally heard all of these things, and more. When it comes down to it though, there are parents of kids with allergies that vaccinate, and those that do not. There are allergy parents that eat 100% organic, and those that live off of fast food. There are allergy parents that breastfed their kids into the toddler years, and those that formula fed from day one. You get the idea. All in all, us allergy parents hear this kind of criticism way more often than you may think, and often it makes parents feel needlessly guilty, for there is no way to know for sure whether or not these accusations are even true. Additionally, many allergy mothers, especially those newly diagnosed, have found ourselves at some point wondering whether or not something we did (or didn’t do), caused our child’s allergies. We often think to ourselves, what if I did this instead? Would we still be dealing with this? Not only are these ponderings fruitless (because again, we have no way of knowing for sure what has caused our kiddo’s allergies), it can be very harmful to the psyche of a mother, resulting in feelings of guilt, depression, and/or anxiety. If you want to have a conversation on this subject, please do so with compassion, empathy, and the knowledge that there is still a lot of ambiguity in regards to what we do, and do not, know about allergies.
- Even under the best of circumstances, someone that has had an anaphylactic reaction can be affected by it for days, weeks, even months afterwards: As I mentioned earlier, there is a lot more to treating an anaphylactic reaction than just using an epipen, and moving on with your day. Even if symptoms improve, it is still necessary to seek out immediate emergency medical treatment. Most often, this means calling 911, and being transported to the nearest hospital via ambulance. Epinephrine can start wearing off in as little as 15 minutes, thus requiring administration of a second epipen. In general, more than one epipen could be necessary to see improvement. Depending on the severity of their symptoms, anaphylactic patients may need to be put on oxygen, and/or receive breathing treatments. Anaphylaxis can affect virtually any body system, and often affects more than one. Depending on what organ(s) are affected, more aggressive treatment may be necessary, especially if the heart and/or lungs are affected. People that have experienced a severe allergic reaction require careful monitoring (preferably in a hospital setting) even after symptoms appear to be gone, as anaphylaxis can return, sometimes up to 24 hours after the initial exposure. This means you may find this whole cycle repeating itself even after you thought you were in the clear. A hospital stay may be required. Steroids are also frequently given (either orally or intraveneously) during a severe reaction, to help repair any damage that may have been done to the airways, and to hopefully prevent the reaction from resurfacing. These steroids usually need to be continued after the patient has returned home, for up to two weeks. Steroids are not without their own risks, however, and can cause a number of side effects, including (but not limited to) insomnia, appetite changes, irritability, aggression, mood swings, behavioral/emotional changes, and immunosuppression (especially when used often or for extended periods of times). Children are especially susceptible to these changes, and side effects can persist for weeks, even months, after stopping the steroids. Epipens also have their own side effects, that can persist for a couple of days after use, such as weakness, nausea, and dizziness. They can also potentially cause damages to the injection site, in the form of bruising, bleeding, tearing, and lacerations. Then there is the mental trauma involved in experiencing an anaphylactic reaction. The entire experience of having a reaction, getting treatment, going to the hospital, and facing your own mortality can be very traumatic, especially for little ones. It isn’t unusual for chidren that have experienced a severe reaction to have trouble coping with the trauma of the event, and this can be exhibited in a lot of ways, such as refusal to eat, difficulty feeding, behavioral changes, mood swings, anxiety or depression (especially pertaining to food), and new fears, and worries about foods, places, things, and even people. The trauma of an anaphylactic reaction can also extend to parents, friends, and caregivers of the allergic individual, that find may themselves wrought with anxieties and fears pertaining to the welfare of their loved one.
So there you have it—10 Food Allergy Facts I Wish People Knew. I hope you all learned something, and will share this information with your friends. If you or a loved one has one or more food allergies, is there anything you would like to add? Anything that you would want people to know about food allergies?
Please share any thoughts you may have in the comment section below! Thanks for reading! 🙂