Tag Archives: health

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).

Lessons From a Teen Food Allergy Tragedy

Allergic Living has advice on how to respond to a severe allergic reaction, particularly when to administer epinephrine and seek emergency medical treatment.

At first she didn’t show any symptoms and her mother gave her a dose of antihistamine; but in 20 minutes the systemic reaction began. Her father, a physician, gave her three doses of epinephrine, but it wasn’t enough to stop the rapid-fire chain of events. She began vomiting, her throat swelled to the point where she could no longer breathe and she went into cardiac arrest. She died in his arms.

Natalie’s story has spiked fears among Allergic Living’s readers, in particular parents of children and teens with food allergies. It has also raised questions about just what to do in case of an accidental allergen ingestion, so we turned to two experts for answers.

The key takeaway: you can’t always be sure a mild reaction will stay mild, because it takes time for the body to absorb the food. I was fortunate enough to survive learning that lesson, exactly one week before Natalie Giorgi’s death. All I lost was an afternoon and the $200 co-pay for the emergency room. It could have been so much worse.

In related news, we’re going to be doing the FARE Walk for Food Allergy again this year to raise funds for food allergy research and education. In addition to promoting awareness and research, they’ve been working on increasing availability of epinephrine in schools and providing resources and training for parents, schools, healthcare providers, restaurants, food manufacturers, etc. If you’d like to contribute, here’s our fundraising page.

Originally posted in two overlapping posts on Tumblr (which included the quote) and Google+ (which included the fundraising appeal).

Promising Peanut Allergy Treatment

Allergic Living reports on a peanut allergy treatment study that shows a great deal of promise. Called sublingual immunotherapy, or SLIT, it’s surprisingly simple: Introduce a small amount of peanut protein in drops beneath the tongue each day, slowly ramping it up over time.

After 44 weeks of the daily doses, 70 percent of those getting the peanut powder could tolerate at least 10 times more peanut in an oral food challenge before showing symptoms than they could have at the outset of the study. In a follow-up challenge at 68 weeks, they could tolerate about twice as much again.

It’s a similar premise to allergy shots, which work well for airborne allergens but not for food. And while I’m creeped out by the idea of deliberately ingesting something that I’m used to avoiding because it could kill me (this has to be done under medical supervision!), like so many other things it’s all about dosage. It makes sense that it could work.

The main drawback is that 30% of the participants didn’t show improvement, though the people running the study suspect that it’s a matter of finding the right dosage for each patient.

The article mentions another problem being that the amount tolerated is relatively small: they could eat the equivalent of two peanuts before experiencing allergy symptoms.

I say: Two peanuts? Are you kidding me? I would LOVE to be able to safely eat that much!

So it’s not enough to eat Thai food or PBJ. It would mean I can stop worrying so much about cross-contamination! I’d still carry my epi-pen around, but I’d feel a lot safer about, say, drinking a milkshake at a restaurant that also serves peanut butter shakes, or eating an eggroll at a place that also has kung pao, or eating a chocolate chip cookie that’s been stored on the same shelf as the peanut butter cookies.

One question I do have is how effective it is at reducing sensitivity to similar allergens. Would taking the peanut treatment help someone tolerate legumes better, or are they different enough to require a separate course of treatment?

Ticked off by Meat Allergy

Allergies to nuts, grains, vegetables, seafood and milk are common. Allergies to meat? Much less so. But that’s starting to change.

A few months ago I read about adults (author John Grisham in particular) developing an allergy to red meat after being bitten by ticks.* And not just a low-level allergy like your face turning red — we’re talking full-on hives and anaphylactic** shock, the kind of thing that requires you to carry an Epi-Pen to make sure you keep breathing long enough to reach the emergency room.

Researchers have determined that the lone star tick’s bite can cause the body to produce an IgE antibody for a sugar called alphagal, which is found in mammal meat.

The result: from then on, you’re allergic to meat.

CNN calls it mysterious. Allergic Living calls it baffling. It’s certainly weird compared to “usual” allergies, and the fact that the reaction is usually delayed by a few hours makes it hard to diagnose, but we’re ahead of the game in understanding it: Unlike most allergies, we know what causes this one.***

With most allergies, we know the process, but we don’t know what gets the ball rolling to begin with. We know that in people who are allergic to a food, exposure to it causes an IgE antibody reaction that triggers a massive release of histamines that sends the body into some level of shock, but we don’t know why some people have that reaction and others don’t.

There are a lot of ideas being investigated, with varying amounts of supporting evidence, but there’s still nothing we can point to and say: “This caused you to be allergic to nuts” or “That caused you to be allergic to milk.” Advice to parents concerned about keeping their child from developing allergies is all over the map.

That’s why Katie and I are walking in this year’s Walk For Food Allergy. The event raises money for the Food Allergy and Anaphylaxis Network’s mission to support allergy research, spread awareness (you’d be amazed at how many people dismiss allergies as inconsequential or even bogus), provide education and advocacy for people living with food allergies.

Walks are being held across the country over the year. We’ll be walking in the Los Angeles event in October. If you’d like to help, you can donate or join our team here:

» Sponsor me in the Walk for Food Allergy. [Edit: updated link for the current fundraiser]

Thank you!

*Naturally, this was a few days after I hiked a severely overgrown trail without taking precautions against ticks, so I freaked out a bit, but I also hadn’t found any ticks when I got home from the hike.

**Fun fact: Chrome’s spell-checker doesn’t know “anaphylactic,” and suggested such helpful alternatives as “intergalactic” and “anticlimactic.” Not sure about the former, but I get the impression a lot of viewers suffered “anticlimactic shock” when watching the Lost finale.

***Or at least we know what primes it. There’s still the question of why only some people who are bitten by the lone star tick go on to develop the allergy.