Tag Archives: health

Predictive Frameshift

I’ve been thinking a lot about Robert J. Sawyer’s Quantum Night the last few months. It links human cruelty, psychopathy, and mob behavior to the nature of consciousness, mostly focusing on the main characters but playing out against a global crisis brought on by a rising tide of xenophobia.

More recently, I’ve been thinking about Frameshift. His 1997 novel deals with (among other things) eugenics, Neanderthals, Nazis, and health insurance companies doing everything they can to avoid covering people with pre-existing conditions.

I can’t imagine why that keeps coming to mind….

Why would you risk eating out with a food allergy?

On every news story about someone who experienced a severe allergic reaction outside the home, there will be someone who says, “If it’s that dangerous, why would you even risk it? Keep your kid at home and make all their food yourself from scratch all the time!”*

Let’s think about this.

A car could kill your child. Today, tomorrow, years down the line. This is not a hypothetical. This is a fact, and it’s a risk that you live with.

Why on earth would you risk letting your child cross the street? Keep them at home! Don’t let them out of the house in case someone jumps the curb!

That’s…not exactly practical, is it?

You don’t keep your child inside 24/7 to avoid cars. You take them outside, with precautions. You teach them to stay on the sidewalk, cross at corners and crosswalks, and look for cars before crossing. You walk with them until they’re old enough to walk safely on their own.

You rely on drivers to follow the rules of the road…but you still look both ways in case someone’s distracted or feels entitled and plows through a red light anyway.

And then your children can live their lives out in the world instead of being frightened recluses who hide in the basement whenever a car goes by.

You can’t eliminate risk 100%, but you can manage it.

The exact balance is going to be different for each person with an allergy.** But it’s not unreasonable to expect the food industry to follow basic safety procedures to avoid cross-contact — and to not introduce a danger that wasn’t there to begin with.

*Even if you have the time to prepare every meal at home, there’s still the risk of mislabeling or cross-contamination in the supply chain. Right now, there’s an ongoing recall of baked goods produced with peanut-contaminated flour. A year ago, supplies of cumin were tainted with peanuts. That impacted everything from prepared foods down to bulk-bin spices. Everyone’s at risk with the massive listeria recall of vegetables, allergies or no.

**Heck, it’s different for each of my allergies, and I’m one person. I’ll cheerfully walk into a coffee shop that serves almond milk and soy milk, but won’t set foot in one of those burger places that plops a bin of peanuts on the table. Even with my Epi-Pen. That’s just playing live-action Frogger.

Dosage Matters: The Car Analogy

It’s clear that many people online don’t understand the concept of dosage or concentration when it comes to substances of any sort (food, drugs, additives, environmental factors, chemicals*, radioactive isotopes): Something can be harmless or even beneficial in small amounts, but dangerous in large amounts.

Trivial examples:

  • You need salt for neural function, but if you drink sea water you’ll get sick.
  • Vinegar is dilute acetic acid. It’s useful for cooking and great on salads. Highly-concentrated acetic acid is corrosive.

Think of it like turning the steering wheel on your car (or the handlebars on your bike, if you prefer):

  • Turn it too far, and you go off the road, lose control, spin out, or otherwise crash.
  • Turn it just right, and you change lanes, avoid an obstacle, or go down a different road.

Also, most things will have multiple effects, some positive and some negative. (Consider aspirin: pain relief, fever reducer, blood thinner, but high doses can cause ulcers.) The balance of how strong each effect is will change with dosage, so you might have a strong positive and mild negative at one dosage, and a mild positive and strong negative effect at a higher one, and at an even higher dose even the positive effects would become negative as described above.

So the next time you see a warning about how hazardous something is in high concentrations…think about whether that has anything to do with the level at which people are actually exposed to it in the typical case.

*Remember: Everything is made of chemicals, including raw organically grown food.

What people don’t do after allergies send them to the ER

Wow. A study finds that only 54% of patients experiencing an anaphylactic episode requiring an ER visit or hospitalization get an epinephrine prescription within a year, and only 22% visit an allergist or immunologist in that time. (via this week’s FARE newsletter)

The article treats this as an education/compliance issue, but I have two big questions:

  1. How many of these patients discussed the incident with their regular doctor? It’s possible that more than 22% followed up with a doctor, just not with a specialist.
  2. How does insurance coverage correlate? If you don’t have insurance, it’s expensive to see a specialist, and expensive to get an Epi-pen (though there are generics now that are a bit cheaper)…especially after you’ve just received a bill for thousands of dollars for the emergency room.

Regarding #2, the study looked at “healthcare claims,” so if I’m reading that correctly, they may have only looked at people who do have insurance. If that’s the case, I wonder if it would be possible to break it down by type of insurance: HMO vs. PPO, do they charge a higher co-pay for specialists, etc. Our current system could do a lot more to encourage preventative care.

For the record: The first thing I did when I got home from that San Diego trip was to order a replacement Epi-Pen, and Monday morning, I called up my allergist to schedule an appointment. But then, I already had an allergist, a prescription, and insurance.

Help me raise funds for FARE and their mission to promote food allergy research, education, and advocacy.

Fundraising Time: Walk for Food Allergies

Ice cream bowls and peanuts.September. How the time flies, huh? It’s time to start focusing on autumn plans, and one of those is the 2013 Walk for Food Allergy, coming up in Long Beach at the end of October. This will be our third year participating in the event (you can see photos from last year), which raises money for FARE* and their mission to promote food allergy research and education, and to advocate on behalf of people living with severe allergies.

Fifteen million people have food allergies in the US alone, including six million children. For us, just eating is a constant source of risk.

ER Monitor and Comic-Con WristbandI left Comic-Con in an ambulance this year because I had two sips of a coffee drink with peanuts in it. I knew right away, but the shop had to call the owner to confirm it because the mix wasn’t labeled. It could have been worse, though. I walked out of the emergency room that evening. One week later, a 13-year-old in Sacramento didn’t make it to the hospital. Surviving Comic-Con meant more than usual this year.

We can’t cure allergies yet. We don’t know how to prevent them from developing in the first place. There’s only so much each of us can do to avoid our particular triggers if people around us don’t know — or worse, aren’t willing — to be careful with food they handle and to know what’s in it.

That’s where organizations like FARE come in. They sponsor research into identifying the causes of allergies and finding treatments. They provide training materials for the food industry. Over the last few years they’ve been pushing for stock epinephrine in schools, since many allergic children experience their first anaphylactic reaction at school, before they’ve even been diagnosed with an allergy. This year they’ve also been trying to combat allergy-related bullying.

You can help by sponsoring us in the walk. Your donation will help FARE work toward long-term solutions through research and more immediate solutions through education and advocacy. We’re in this together, and need your support.

*FARE (Food Allergy Research and Education) is the merged organization made up of what used to be FAAN (Food Allergy and Anaphylaxis Network) and FAI (Food Allergy Initiative).