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A Race to the Emergency Room & Why the Price of EpiPens Matters

August 20, 2016 •  one comment.

 •  Blog, News, Uncategorized

On October 1, 2013, a 14 year old boy had an allergic reaction that would take his life. On the one year anniversary of his death, I sat down with his mother. Today would have been his 17th birthday.

She reached out again last month with a very urgent email: “Robyn, the price of Epipens are skyrocketing. Families can’t afford them. Can you help me get the word out?”

I was stunned. Here, she had suffered the unimaginable, the loss of her teenage son, and she was asking to help others.  Where does a love like that come from?

Screen Shot 2016-08-22 at 5.16.42 PMThe heart of a mother. It stopped me in my tracks, because countless parents have reached out over the years. I’ve sat with those who have lost their children to a food allergic reaction.  They don’t stop loving that child just because he or she is gone. They put that love into action.

And as I began sharing this, focusing on the meteoric increase in the price of Epipens, up almost 500% since 2009, other parents began sharing their stories, too.

So today, on what would have been Gio’s 17th birthday, we are sharing the story from his amazing mother again.

A mother does not stop loving her child because he is gone. If Georgina is any indication, she loves him more.

Please meet my beautiful friend, Georgina. Her story is below:

When Giovanni was around 18 months old, I made chicken with a peanut sauce. After one bite, Giovanni began to get hives, his eyes swelled…. I called our pediatrician, who told me to give Giovanni a dose of antihistamine and bring him in. Once there, our pediatrician said Giovanni must be allergic to peanuts and advised me to keep an eye on him and to give him antihistamine as directed. His symptoms did not get any worse that day, and we left with a referral to an allergist.

After going to the allergist, Giovanni was diagnosed with allergy to peanuts and other things. I remember the nurse giving me a prescription for antihistamines and an epinephrine auto-injector and showing me how to use it in case of an emergency. I wasn’t given a food allergy management plan. I don’t remember there being any sense of this as a life-or-death situation – just a diagnosis, prescriptions, and the recommendation that we follow up with our pediatrician.

So from then on, that is what I did. Giovanni’s pediatrician was his “go to” doctor for everything. When we asked about seeing a specialist, our pediatrician stated that he would treat Giovanni first.

Giovanni had a few allergic reactions to peanuts. We never thought these reactions were severe. He would usually vomit, get some hives, and have a bit of scratchy or tingly throat. After a dose of antihistamine, symptoms seemed to calm down and go away on their own. Thinking back, these reactions would be considered anaphylaxis, and were severe.

I followed up with the pediatrician, who said I should give Giovanni antihistamine since his reactions were mild, and he should be okay. We were never told that epinephrine must be used for certain symptoms, only that it could be used if we really thought he needed it. But, since he never had a bad reaction, I didn’t think he needed it. That was the extent of our anaphylaxis management planning.

A Severe Reaction

On October 1, 2013, Giovanni and I were settling in early, happy that homework was finally done early, dinner and chores were done, and we were going to be able to enjoy movie night together – just him and me – for the first time in a while since school had started. Giovanni had just started at Holy Trinity High School, so homework, studying, and sports left little time for relaxing and leisure. We popped the movie in and had our snacks ready. One was a snack mix of mini cookies, pretzels, almonds, and M&M’s. I usually always bypass the full food label and go right to the bottom of the ingredients where they usually have an allergy disclaimer. I had read the back of the bag, and all I saw was “MAY CONTAIN TREE NUTS.” Good, I thought, he is not allergic to tree nuts.

I gave Giovanni a few pieces of snack mix from the bag, but within seconds he was saying, “Oh no, there are peanuts in here!” I said he was wrong and read the ingredients again. Although there was no “peanut” disclaimer, it did actually have peanuts as a main ingredient. I just didn’t read enough! I don’t know how in the world I didn’t see it.

I immediately gave Giovanni a regular dose of antihistamine and said we should go to Premier Care, the after-hours clinic, just to be safe. Then I gave him a second dose of antihistamine just as back up. Giovanni was only feeling a little scratchiness in his throat and was giving me a hard time about getting dressed to go to clinic.

At this point, I should have called 9-1-1.

I said let’s go now, just to be safe. The epinephrine auto-injector was on the table right next to my purse, and Giovanni asked if he should use it. I said I didn’t think we needed to, that we should just get to the doctor. I threw all the meds into my bag and left. On the way out, Giovanni asked if he should vomit, since that is usually what happened in the past. I said if you need to then try, but he couldn’t.

Premier Care is about a seven-minute car ride away. Giovanni was still talking on the drive there. He had his inhaler with him and used it a few times. I kept telling him not be nervous, that he was going to be okay. We got to the office, and it had JUST closed. No one answered the door. Giovanni began to panic. We jumped back in the car and immediately started to look for the epinephrine auto-injector. We couldn’t find it.

At this point, he was still okay. He was still talking, just more scared now. I still was thinking we were okay. Now I had to drive to the emergency room, which was about another seven minutes away. All I could do was focus on getting there without crashing, I was beeping my horn and had my hazard lights on, taking every red light I could safely run and reassuring him every minute that he was going to be okay, that we were almost there, to just hold on another minute.

We were around the corner from the hospital when Giovanni must have felt something serious, and he said, “I can’t mom, I don’t want to die.” I was yelling, “No! No! That’s not going to happen. We’re here. Just hold on. I’m there in two seconds.” He didn’t respond.

I turned down the street to the emergency room and realized he was quiet. I grabbed his hand and said we’re here, but I realized he was cold. I looked at him, and he was blue. I started screaming and beeping as I drove to the emergency room entrance. There were people outside and I was screaming, “Help, my son has peanut allergy. He passed out. I need to get him inside!” They all ran over, and I remember about five of us struggling to get him out of the car. At the same time, emergency room staff came running out with a wheelchair, and we threw him in it. I was just screaming, “Help him, please! He is having an anaphylactic reaction to peanuts.”

Staff were running through hallway, yelling “We need a table now!” as I ran behind screaming “Please, help him!” That was the longest hallway ever. Then these nurses stopped me and took me into a small room while they took Giovanni away, and I had to wait and wait and wait. I had called my husband when we were leaving the house and told him what was happening and that Giovanni was okay. Now I had to call and tell him to get to the ER right away.

It was nearly an hour later when a doctor came out to brief us. She told me how they worked on Giovanni for quite a while, that his heart had stopped and that he had been without oxygen for about 3 minutes, but that they were able to save him. They told me he was on a respirator. I was finally able to see him. He was unconscious and needed to be transported to a pediatric ICU.

Giovanni was in a medically induced coma for several days in hopes of alleviating the trauma caused to his brain from lack of oxygen, but he got worse when they tried to bring him out of the coma. Doctors re-induced him into the coma in hopes that he would recover. But after three weeks of exhausting all measures to try to save him – after many hopes and prayers – Giovanni’s body just couldn’t sustain the injury to his brain, and he passed away on October 18.

I am grateful that I was able to hold my little boy in his bed, along with his dad and his sister, and was surrounded by every one of his closest family members, every one of them holding hands, holding each other up, while he crossed over to finally be in peace.

Lessons Learned

His physician was our pediatrician for more than 20 years. He didn’t take his allergies serious because he wasn’t educated enough about them. When I called him from the emergency room to tell him we are in the ER and why, he just said that there wasn’t anything to do, that the hospital doctors would be the one taking care of him.

The next time I heard from him was 10 minutes after Giovanni had passed away. My cousin had answered the phone, he was calling to see how he was. And didn’t really have anything to say. He never called, did not send a card, did not come to his funeral nothing. I still can’t believe it.

The night of his accident we were to be picked up from other hospital he needed to be transferred to hospital With PICU unit, the head nurse from this other hospital was (unbeknownst at the time) sent to be his angel, our angel. She told us she had just gotten back from an all day conference on food allergies and EpiPen importance. I have kept in contact with her and just the other day called on her to help me figure out how I can reach out to the entire medical field, re: American pediatric association. I am trying to figure out the best way to reach them to express the importance of global change of education to all physicians, nurses, ems, to follow one basic protocol when administering life saving information about food allergies.

Giovanni’s Legacy

When I asked Giovanni’s mom to tell me about her son, the sports he played and his friends, this is what she shared:

He was such a beautiful boy. So loving, caring, helpful. Loved life. He is so very much missed by all. His sister is all alone without him. His friends loved him so much. They still contact me from time to time to see how we are.

The one thing that is consistent when they speak of him is how beautiful his smile was, how he was so happy, always goofing off, making everyone laugh; he knew if you were having a bad day he would ask if you were ok and find a way to make you feel better.

Giovanni had just started high school at a private school, it was a big change for him but he loved it. EVERY single student in that school came to his wake/funeral. They all told us what an amazing kid he was, so many said even though they didn’t get a chance to actually speak to him they remember his infectious smile and that he was always making someone laugh.

Giovanni was an amazing athlete. Since the age of 5 he was playing baseball, soccer, football, basketball. His first love was football but a few years ago decided that baseball would be his career. He was known everywhere he went. Everyone wanted him on his or her team.

Right before the accident he had just gotten back from a travel team tournament that weekend. He was going to be a major league player no doubt. He was an honor student. A best friend, his father’s pride and joy, he was my whole life. He was my Protector, my son, My friend, my SOULMATE!

Communities from so many Towns have come together to remember Giovanni. In the town where dad is from, Our Lady of Peace school, one mom who has a food allergic child and is on the board had their food allergy policy revamped and dedicated to Giovanni. When Giovanni was in school at all times his friends/teachers all were very cautious and mindful of his allergies. His two very best friends were also allergic to peanuts /nuts and some other things as well so it was always a comfort knowing that he would be safe with them.

There was always a smile on his face. He was running from the time he woke up to the time he went to sleep. And even when he was sleeping he was still a restless sleeper. He was a star athlete. He was a best friend. He was the best brother. He was my little boy, my little man. He took care of me, and I took care of him. He was my friend, my partner. He was the reason I did EVERYTHING I did. He was his dad’s pride and joy. His dad is lost without him. He was an honor student. He knew to be helpful, to be of service, to be respectful. He knew how to seize the day and run with it.

Giovanni’s loss is felt not just here in our family, in our community, but all over the country. Giovanni’s loss is awful, it is heart wrenching, it doesn’t make sense. If it has taught us one thing, it is that we know we don’t want anyone to ever have to feel the pain that we feel.

What Do You Want People to Know?

We want to help educate and advocate for all families living with food allergies. We want everyone to know that food allergies are serious. Some people think it’s not that big of a deal, that food allergy parents tend to overreact, and for the simple and lucky reason it hasn’t yet affected them.

“How many more lives need to be lost to prove it is a big deal?”

Food allergies can mean life or death. In the past two months, it has become apparent just how true that statement is. Two more little lives have been taken in our community due to a peanut allergy. More people need to be informed about the dangers of food allergy, including healthcare professionals and parents. If you have a food allergic child, seek consultation with a board certified allergist who has expertise in food allergy. Allergist evaluation and periodic routine follow up are recommended steps in the NIH food allergy guidelines for caring for food allergic children. It is important to do your own research and be your own advocate. Find the very best doctor you can, and even if he’s a little farther away, it may be worth it to go those extra miles. If you advocate for your child and do the research, it is possible that you may be able to help your doctor form the best treatment plan possible for your child. If you are not happy with the treatment or feedback, then find a new doctor. Do not settle! If you reach a point where you are not comfortable with just your primary care physician managing your child’s food allergy, then you have to have a frank discussion with this provider about your desire to involve a food allergy expert in the care.

Know the Signs and Symptoms

The most important information we want everyone to know is that when there are signs or symptoms of anaphylaxis, administer your epinephrine auto-injector (such as an Auvi-Q or Epi-Pen). This is the first line of treatment for anaphylaxis! Always have your epinephrine auto-injectors available. It is wise to have two doses available because some people may need a second dose. Do not hesitate to use this when it is needed! It can save a life. Epinephrine use has virtually no downsides or bad side effects beyond increasing the heart rate and blood pressure, and possibly causing some temporary bruising and pain where the device was injected. Most importantly, make sure you have a written anaphylaxis management plan provided by whoever is managing your child’s food allergy. This must be reviewed until you know it like the back of your hand, and you are comfortable with the steps. The physician creating this plan must be able to clearly explain to you what symptoms require antihistamine, and what other ones can only be treated with epinephrine. It is your responsibility to master this plan, and be ready to act should the need arise.

If you should have to treat your child with epinephrine, call 9-1-1! Call your local ambulance service and tell them that a child is having an allergic reaction and may need more epinephrine. (An ambulance should be called not because epinephrine is dangerous but because the allergic reaction could be severe, needed to be treated with epinephrine, and may require more treatment). Even if you are unsure if your child needs the epinephrine, don’t hesitate. Don’t let fear take over. It won’t harm your child if it turns out not to be needed, but it will harm your child if you don’t use it, and it was needed!

You have some incredible goals. Will you share them?

I have many goals to conquer but educating people about this is at the top of my list And I will be heard if it’s the last thing that I do. Thank you for listening. ❤

Important Resources:

“May contain” labels on our food packaging are voluntary. The Food Allergen Labeling and Consumer Protection Act (FALCPA) was passed by Congress to ensure that there would be clearer labeling of food for the millions of people with food allergies. As of January 01, 2006, all food products regulated by the FDA must be labeled in a specific way to identify the eight major food allergens, but there are exemptions and loopholes.

It is painfully clear that not enough parents are aware of these exemptions and voluntary labels. To learn more, please click here.

Read the ingredient list and label all the way through. Do not rely on the “May Contain….” or “Contains….” statements at the bottom of the ingredient list. It is a voluntary statement and not required under the food allergy labeling law.

To learn more about the sign and symptoms of food allergies, please click here.

To learn more about the Food Allergy Labeling and Protection Act and what is voluntary and how to protect your loved ones, please click here.

To read Giovanni’s full story, please click here.

To help prevent another food allergy death, please share this.

To sign the petition urging an investigation into the skyrocketing price of Epipens that are putting lives at risk, please click here

10 Tips for Talking to Your Child’s School About Food Allergies

August 19, 2016 •  no comments.

 •  At School, Blog, Do One Thing, Uncategorized

Written By Daniella Knell for SunButter

Daniella2Sending your child with food allergies off to school can be overwhelming. Trusting others to keep your kid safe is probably your #1 priority! For me, educating myself and others was the only way I could create a safer learning environment for both my children and their caregivers.

As food allergy parents, we constantly wonder, “What if something happens?” In my opinion, a more productive question is, “Does the person taking care of my child know what to do if and when something happens?”

It is all about education.

That’s the key to making sure that your answer to the above question is, “Yes, my child is in good hands.” When people don’t understand food allergies, they don’t know how to protect people who have them. The first step is educating—educating yourself, educating your child, and educating others. This guide will help you educate those around you most effectively.

1. Attitude

To effectively educate others, you will need to partner with your school. Know that your attitude sets the tone. This will make or break how your school will or won’t work with you. If you go in with a steamroller approach with demands, you’re likely to meet resistance. Have you ever heard the saying, “you catch more flies with honey than vinegar?” Approach your school with a positive, understanding attitude and you are more likely to see positive, understanding results!

2. Resources

Find Educational Resources YOU Trust. You can direct others to these resources and use them to bolster your position. They will also help you remember that you aren’t alone! Here are links to some of my favorites.

  • FAACT – Food Allergy & Anaphylaxis Connection Team FAACT is currently my favorite because I find them the easiest to navigate and LOVE their primary focus on education. TheirSchool Curricula Program offers ready to share presentations for the classrooms, beginning with K thru 3.
  • FARE – Food Allergy Research & Education FARE’s ‘Be A Pal: Protect a Life’ program spotlights Alexander the Elephant and his circle of food allergy friends. I still use portions of this program when presenting to preschool and early elementary school children.
  • KFA – Kids with Food Allergies KFA hasan entirepage dedicated to keeping kids with food allergies safe at schools, including free guides and handouts!

3. FAAP

Find a Food Allergy Action Plan (FAAP) YOU Like. Your allergist fills out this form outlining actions to be taken by a caregiver in the instance your child has an allergic reaction while in their care. Here is one place you can start: Children’s Physician Network Food Allergy Action Plan

4. Management Plan

Figure out WHAT KIND of Management Plan Your Child Will Need. IHP? IEP? Or 504? If your child has life threatening food allergies, they may be considered as a qualified student with disabilities under the Americans with Disability Act (ACT) Amendments Act of 2008.Section 504 of the Rehabilitation ACT of 1973 requires that the school district to provide a “free and appropriate education” (FAPE). Then again, this will depend on whether they are attending a school receiving ANY federal funding, and laws can vary from state to state. DON’T be overwhelmed! Your allergist can help you out!

The following links will offer your more information regarding 504 Plans, IEPs and IHPs.
FAACT 504 Plans
FAACT Individualized Education Plans (IEPs)
FAACT Individualized Health Plans (IHPs)

5. Gather Resources

Find some books and videos you like. My favorites include: the ENTIRE No Biggie Bunchseries, The BugabeesThe Princess and the Peanut, and the Alexander the Elephant Who Couldn’t Eat Peanuts – Gets a Babysitter

6. Create a School Food Allergy Binder

Put together useful Resources and have a copy available to share with the nurse and teacher. I would also include some kind of handy labels you can use to mark ‘SAFE’ snacks or a snack box for your child. Any kind of label will work. Here’s an example of the ones I personally designed: S.A.F.E. Food Allergy Labels.

7. Flyers

Find samples of food allergy flyers on line which you like. Just type in ‘peanut free’, ‘allergy free’ pics in your favorite search engine and you will find ALL kinds of different flyers you can use. Have these different options available to share with school personnel.

8. Meet with People

Meet with the Principal. Meet with school nurse. Meet with your child’s teacher. This is your opportunity to meet with everyone and explain your concerns. Let the individuals know you’re wanting to partner with the school to create a SAFE and enjoyable learning environment for everyone. It will be at this time you will find out what previous experiences these individuals have had in managing food allergies. You may be pleasantly surprised. You may be disappointed. Most importantly, you will be prepared to decide what direction you need to go in moving forward with your school.

9. Have Your Child Meet with ALL of the People They Will Meet

This is the opportunity to show your child all the individuals around them whom are working to keep them SAFE. Don’t underestimate the NEED for your child to need to feel this comfort. They don’t WANT to feel singled out, but they also need to feel SAFE.

10. Get Involved!

Set up a time to go in and read stories, show a video, whatever it is you want to do to make learning about food allergies FUN! In the beginning it may be nerve racking.

Daniella Knell, owner of Smart Allergy~Friendly Education, is mother to two children with food allergies. You can find her displaying her public speaking skills in local schools and hospitals, blogging, and presenting allergy~friendly smoothie videos. For allergy~friendly ideas for your household, visit Daniella’s website, FacebookLinkedIn and Twitter.

 

A 17 Year Old Writes: “You Can Do It!” on Life With Food Allergies

August 10, 2016 •  10 comments.

 •  Blog, News, Uncategorized

kayleighpetersKayleigh Peters is a 17 year old who decided to share a few thoughts for parents of little ones with food allergies in a Facebook group.  Her post went viral in the food allergy community and was shared immediately.  It is honest, heartfelt and so true, and it shines a light on food allergies and what it teaches us.

Meet Kayleigh, one amazing high school girl:

“Hi, I’m a 17 year old who has lived with a severe (as in contact and airborne reactive) allergy to peanuts since I was born.

Later I added soy and tree nut, and I am now peanut, treenut, soy, lentils, beans, peas, and wheat allergic.

I know that some of parents on this page are just now becoming introduced into the severe allergy world, and I want to offer some reassurance from the child perspective. I went to a public elementary school. I was given a “peanut-free table” at lunch even though on Thursdays the cafeteria served PB&J sandwiches. I ended up in the Nurses office every Thursday.  I wasn’t able to play on the playground because of the contact, but still went to class with all the other children.

Throughout my elementary school years I became very close with the school nurse, but I never used my Epi at school even if I know I probably should have. The first time I used it I was 8 years old and I was at a birthday party. I ate peanut butter cup ice cream and within 5 minutes I couldn’t breathe. My parents weren’t there and the friends parents had to give me the Epi and call the ambulance.

This was probably the most terrifying moment for my parents when they got the call. But, I want to tell all of the parents out there that I turned out okay. I was raised in the time before the severity of allergies was understood, but I was still able to live my life.

Severe allergies are scary. I know this as well as anyone. I also have severe asthma. I’ve been in and out of the hospital all my life.

Yes, it’s harder for me to go out to eat or go on the same adventures that the other kids my age go one, but I still live my life.

Don’t let allergies hold you back or hold your child back. Everyone has obstacles in their lives.

Those of us with allergies have to learn til read labels, advocate for ourselves, inform others about who we are, we learn to scan crowds for candy bars being eaten by others, we learn to wipe down seats and tables, we learn to answer weird questions like “what happens if I eat it then lick you?”, we learn how nice the EMSA people can be.

Everything is a learning experience. But we can do it. Do not feel that you have to seclude yourself from the world because of you or your child’s allergies. Yes, this world is scarier when you have allergies. Yes, there are many many people out there who do not understand what we have to go through. But it is our job to not give up. We have to educate those around us. We have to keep living.

I just felt that sometimes that sort of thing needs to be said.

-From a girl who has lived with severe allergies and asthma all her life and has still gone to France for 2 weeks without her parents, dozens of road trips, public schools, airplanes, restaurants, and is going to Bangladesh in a month.

It’s going to be okay. It’s a scary world, but you are all strong. Your child will learn so much. They will be strong, independent, self-advocators.

You can do it.”

Sexy and Safe with Food Allergies

February 14, 2014 •  no comments.

 •  Blog, News, Uncategorized

Today, 1 in 13 children in the United States has a known food allergy.  On top of that, many others learn of their food allergies when an allergic reaction sends them to the emergency room.  It is becoming all too common.

An allergic reaction to food now sends someone to the ER once every three minutes in the United States.

And as mindful as we are about the foods that we feed our children, things begin to change when they head into middle school, high school and college.

Allergens can be hidden everywhere, and as our children become teenagers and young adults, a new campaign out of the UK highlights another unsuspecting place that allergens  are tucked into.  The image speaks for itself, giving new meaning to the phrase “Practice safe sex.”

More information is available at http://www.anaphylaxis.org.uk

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Food Allergies & Food Sensitivities: What You Need to Know

January 2, 2014 •  49 comments.

 •  Blog, News, Uncategorized

Written by Robyn O’Brien, founder of the AllergyKids Foundation, author of The Unhealthy Truth

Today, one in eleven children struggle with asthma, and one in four are affected by allergies. The incidence of allergy has increased significantly over the past two decades, and allergy to peanuts has more than doubled from 1997 to 2002. Approximately 30 million children – more than 1/3 of our kids – are affected by one of these four new childhood epidemics. This is not something we can just accept.

The official statistic holds that allergies affect some 7 million Americans, including about 6 percent of children below the age of three. That information comes courtesy of U.S. Food and Drug Administration Deputy Commissioner Lester M. Crawford, J., D.V.M., Ph.D., speaking before the Consumer Federation of America on April 22, 2002. But that data is now almost ten years old.

Since then, the only update we’ve had is from the Centers for Disease Control and a report issued in 2008 that said that there has been a 265% increase in the rate of hospitalizations related to food allergic reactions.

This begs explanation.

An allergy is basically an overreaction by your immune system to a protein that it perceives as a threat—for example, the proteins in particular types of food, the dust mite protein, or pollen. For people without allergies, these proteins are harmless. But if you’ve got an allergy, your immune system sees these proteins as dangerous invaders.

To drive the invader out, your immune system mobilizes all its resources: mucous, to flush out the intruder; vomiting, to force it out; diarrhea, to expel it quickly. Such conditions may make you feel sick, but they’re actually evidence of your body’s attempts to get well.

A key aspect of the immune response is known as inflammation, characterized by one or more of four classic symptoms: redness, heat, swelling, and pain. Inflammation doesn’t occur only in allergic reactions; it flares up whenever your body feels threatened, in response to a bruise, cut, bacteria, or virus as well as to otherwise harmless pollen, dust, or food. Scientists now believe that much of our immune system is found in our digestive tracts, where many of these inflammatory reactions occur in the form of stomachaches, cramping, nausea, bloating, and vomiting.

Ironically, the immune system’s inflammatory reaction—meant to heal and protect the body—often causes more problems than the initial “invader” in the cases when allergic reactions become life-threatening.

Common Symptoms of Food Allergy: Immediate Reactions

* rash or hives

* nausea

* stomach pain

* diarrhea

* itchy skin

* eczema

* shortness of breath

* chest pain

* swelling of the airways to the lungs

* anaphylaxis

Food Allergies and Food Sensitivity: Our Immune System Overreacts Again

At first glance, the distinction between “allergies” and “sensitivity” may seem like a meaningless word game. But understanding the relationship between these two conditions is crucial to grasping the true nature of the allergy epidemic—and to seeing how even the supposedly healthy foods in our kitchens may be harmful to our health.

As we’ve seen, allergies are an overreaction of our immune system, a kind of exaggerated response to a perceived danger. When a child comes in contact with these proteins (peanut, egg, wheat, etc.) her immune system “recognizes” the protein as dangerous, just as it would have seen the danger in the bacterium that causes pneumonia or the virus that causes mumps. In response, her immune system creates special “fighter” proteins called antibodies designed to identify and neutralize the “invader.”

These fighter proteins are known as immunoglobulin E, or IgE for short. When they’re released into the bloodstream, their purpose is to “seek and destroy” the invader, which they do by creating one or more of the classic food allergy symptoms, such as the hives, or the diarrhea with which other children respond, or, in more extreme cases, the anaphylactic shock that can kill a child within minutes.

The classic IgE response occurs within minutes or even seconds, because IgE proteins are some of the most aggressive antibodies we know. That immediate IgE response is the defining characteristic of an allergic reaction.

Food sensitivities start out in a similar way. If a “sensitive” child is exposed to a protein that his system perceives as a threat, he’ll manufacture another type of fighter protein, known as Immunglobulin G, or IgG. Although IgE and IgG antibodies play similar roles, they produce somewhat different—though often overlapping—symptoms.

A crucial difference between the two, though, is their reaction time. The less aggressive IgG antibodies typically produce a delayed response that might not appear for hours or even days after the child has consumed the offending food.

So even though food sensitivities and food allergies both produce painful, inflammatory, and potentially dangerous responses, this delayed reaction time has led many doctors to give food sensitivities second-class status. Partly that’s because they don’t present an immediate and obvious threat to children’s lives: only the IgE proteins trigger anaphylactic shock, for example, and in that sense, only the IgE proteins can kill (though the IgG reaction can have serious long-term consequences). I also think that traditional doctors tend to downplay the importance of nutrition, frequently dismissing the idea that such symptoms as earache, eczema, crankiness, brain fog, and sleep problems might be related to a child’s diet.

However, an article in The Lancet, Britain’s most respected medical journal, casts another light on the subject. The article referred to doctors who use elimination diets—diets that begin with a very limited, “safe” array of food choices and then add potentially problematic foods back into the diet, one by one.

The reason to do an elimination diet is to identify which foods in your diet might be triggering symptoms like skin rashes, fatigue, or stomach ache. Often, some foods affect us without our realizing it and we live with the symptoms, taking medicine to alleviate the suffering. But if you eliminate these foods from your diet, you may find that your symptoms disappear. What becomes even more interesting is that when you reintroduce the offending food, you may suddenly suffer drastic symptoms which make it clear that the food was indeed triggering one or more problems. An elimination diet can sometimes reveal with dramatic speed that a particular food you’ve always believed was harmless is actually causing such chronic symptoms as headache, digestive problems, and even more serious complaints. Masked by your daily diet and by the slowness of the food-sensitivity reaction, the offending food does its dirty work without ever realizing that it is the culprit behind your—or your child’s—disorders.

When you take a break from eating that problem food, however, and then add it back into your diet, you see how powerful its effects are and how responsible it may be for a seemingly unrelated problem. Foods that you thought were safe for you turn out to be highly problematic, indicating the presence of a previous undiagnosed food sensitivity. As a result, the authors of the Lancet article conclude that the prevalence of food sensitivity (referred to in the article as “food intolerance”) has been seriously underestimated.

Certainly, food allergies are far more dramatic. Whenever you read about a kid who died within minutes of eating at a fast-food joint or after breathing in the peanut dust from a friend’s candy wrapper, that’s an “IgE-mediated” food allergy. They’re fast, they can be deadly, and I’m glad doctors want to give them the attention they deserve.

But I also think doctors should be looking at delayed reactions, too, the “IgG-mediated” responses to food sensitivities. And some doctors do look seriously at both. Most conventional doctors, though, tend to focus on IgE immediate reactions. I think there are lots of reasons why they should view the two types of reactions as part of a larger, single problem.

First, both reactions have the same ultimate cause: the immune system’s overreaction to apparently harmless food. According to internationally acclaimed author and physician Kenneth Bock, M.D., there’s also quite a bit of overlap between IgE and IgG symptoms. Both can contribute to inflammatory responses in multiple body systems.

True, the delayed IgG reactions are less likely to cause hives and are more likely to produce a host of apparently vague symptoms, such as headache, brain fog, sleep problems, joint pain, fatigue, and muscle aches. But both the immediate and the delayed responses are immune system problems triggered by a supposedly “harmless” food.

Conventional doctors’ tendency to separate “IgE-mediated” food allergies and “IgG-mediated” food sensitivities into two separate problems has the effect of minimizing the allergy epidemic. Remember, IgE allergies, IgG sensitivities, and asthma—three similar ways that our immune systems can overreact—are all on the rise. It makes sense to find a doctor who is willing to address all three as symptoms of a greater underlying issue.

Common Symptoms of Food Sensitivity: Delayed Reactions

* fatigue

* gastrointestinal problems, including bloating and gas

* itchy skin and skin rashes like eczema

* brain fog

* muscle or joint aches

* headache

* sleeplessness and sleep disorders

* chronic rhinitis (runny nose), congestion, and post-nasal drip

Four Take-Aways:

1. Even if your kids can’t talk, their skin speaks volumes! Did you know that the skin is a person’s largest organ? Even when your kid is too young to tell you how he feels or too used to her symptoms to identify them (when kids hurt all the time, they don’t know they hurt!), you can often read your child’s condition in his or her skin.

Does your kid have eczema? Does he get rashes around the mouth, especially after he eats a certain food or swallows a certain beverage? Rashes around the knees, elbows, or armpits? Does he have “allergic shiners”—that is, dark circles under the eyes?

These are all inflammatory reactions, signs that the body is trying to rid itself of what it perceives as “toxic invader.” In your child’s case, that “toxic invader” might be an apparently harmless food, to which your kid is either allergic or “sensitive.” Keeping that invader away from your kid may bring relief from symptoms—and it may clear up other problems, such as brain fog, crankiness, sleep problems, inattention, acne, and mood swings.

2. The toilet bowl has a lot to tell you. Your kids’ bowel movements, not to be too delicate here, also speak volumes. Runny poops are a sign that a person isn’t properly digesting his food. And indeed, as we got the allergens out of some children’s diets, poops tend to firm up.

3. Chronic ear infections are often a sign of dairy allergies. In some cases, milk may have ill effects like eczema, upset stomachs or chronic ear infections for children who are allergic or sensitive to it.

4. Find a doctor who is willing to work with you, test for both IgE and IgG allergies and sensitivities and to address the important role that elimination diets can play in managing allergic symptoms like eczema, ear infections and chronic mucous.

Disclaimer: Always discuss individual health inquiries and medical issues with a qualified personal physician and/or specialist. Robyn O’Brien/AllergyKids is not responsible for medical decisions made by any one person. The professionals who share their knowledge, discussions, minutes, handouts, agendas, and other products do not constitute medical and/or legal advice and should not be relied upon as such. Always discuss individual health inquiries and medical issues with a qualified personal physician and/or specialist.