Wednesday, March 30, 2011

Our first ER visit from food allergies and Entenmann's Little Bites

So-in case you haven't heard, we had our first ER trip for a food allergy reaction yesterday and I'm happy to have our first dose of Epinephrine behind us but also VERY grateful that Alexa is almost 6 and this is the first time we have needed either for her food allergies.  It was scary but it was not as bad as I had imagined so for that I'm also very grateful.  Here's the story and my lessons learned for those of you who have not yet had this experience.  I purchased some Entenmann's Little Bites Muffins from Costco.  The box contained blueberry, chocolate chip, and fudge brownie.  It stated that it contained eggs but otherwise had no other allergy warning.  She has just started eating baked egg so I decided to give them a try.  As part of my usual protocol, I call any new companies to find out if they label for same facility, same equipment or "may contain" peanuts or nut.  For a reason I can not explain, I did not call or look up Entenmann's allergy policy before allowing Alexa to eat them.  Lesson #1-follow your allergy rules and stick to them!!   I gave her one Fudge Brownie Little Bite.  They are about 1 inch around and 1 inch thick.  She ate it and immediately said "Mom, my throat is itchy".  Uh-oh! I gave her 1 teaspoon of Benadryl and asked her to tell me if it got worse.  About 3 minutes later she said "my stomach hurts, I think I need to throw up." uh oh! That made my stomach turn.  We proceeded to the bathroom where I gave her a chewable Pepto Bismol and she decided she was ok and would not throw up- but as we were leaving the bathroom I noticed her forehead was all red and bumpy, then I noticed her upper lip was all red, just under her nose.  I lifted her shirt and sure enough the tell tale signs of a red rash was starting.  This was unlike any previous reactions she has had.  She did not have lip swelling, increased cough (she already had one), or "hives" yet just a weird red rash and red patches but I knew it was getting worse which told me "time for Epi soon".  I gave her another teaspoon of Benadryl and called the Doctor.  Her Dr. recommended that we head to the ER with Epi Pens in hand and if she got better we could always turn around.  As we were on the way to the hospital her "red" rash began to look purple, her hives increased and she got very sleepy-(which I have heard is not from the benadryl but part of the reaction itself).  I checked her pulse, which was strong, and told the driver to "hurry please" while I prayed NYC traffic would part for us and we would arrive quickly.  We were very lucky and we arrived faster than I anticipated and I rushed her in.   They took her pretty much right away (although they made me fill out a form first).  The nurse asked if I'd given her the Epi Pen and I said "No, but I'm about to".  His response was "well next time just give it to her and come".  Easy to say when you've never had to actually do it and the thought is terrifying!! Anyway the Dr. checked her out and said "yeah, she's pretty bad but not horrible, I think benadryl and steroids and we'll watch her." For a moment I was relieved but then I thought "wait, I've heard this tale before from other allergy Mom's and they have advised "don't wait for the Epi-it just delays them getting better and they suffer longer." so I decided to talk to the Dr. again.   In the meantime, Alexa was playing but getting worse, her hives were progressing and her face rash was more purple than before and they still had not given her any medications.  When the Dr. came over I said, "She's getting worse.  I know you don't want to give her Epinephrine, but I've think you should.  She has more than one system involved, she's getting worse even with benadryl and without it she's going to suffer longer."  She was a bit surprised but said, "Well, she'll get jittery and shaky." To which I said, "I'd rather have her shaky and jitter than suffering like this for hours and having it progress unexpectedly." She thought for a minute and said "Well, since she has more than one system involved and it seems to be progressing let's go ahead with the Epiphrine then." PHEW!!! I was still scared but a bit relieved too.  They moved her to a bed and gave her a dose of Epinephrin in her arm.  Literally within 2 minutes her color changed, her rash disappeared and her hives started to fade! Can you say MIRACLE drug? WOW! I was SO relieved.  They hooked her up to heart monitors and we listened to her heart race and flit around for about 10 minutes (which is scary because the monitor keeps setting off alarms and no one comes to check!!) but her color was fine and she was happily coloring so I didn't worry too much.  She was observed for 4 hours but we were very fortunate that she did not have a second, bi-anaphylactic response-thank goodness!! Oh and they gave her a dose of prednisolone (steroid) which she will take for 3 days.  She's tired today and her cough is worse but otherwise she is doing really well.

So, lessons I learned? Stick with your allergy rules and don't be afraid of the Epi-it's your best friend! Two of my food allergy rules that I broke yesterday, 1) no new foods after 1pm in the afternoon ( I gave her a new snack at 3:30pm) and 2) call or research each new company to confirm the allergy labelling policy (broke that one too! Never called or looked them up!).  While I was waiting for the Benadryl to kick in I looked up Entenmann's and if I had seen this first I would have NEVER given her those muffins.  They're policy is as follows: "

We assure you that we adhere to Good Manufacturing Practices as established by the FDA. We take abundant precaution to prevent cross contact of allergenic ingredients between batches and, our bakeries are inspected to ensure that they meet or exceed all regulatory and baking industry standards. We understand that highly sensitive consumers need to know when there is even the remotest possibility of inadvertent cross contact of allergenic ingredients during processing. To that end we disclose that the following allergenic ingredients are used in some of our manufacturing facilities and that inadvertent cross contact is remotely possible: milk, eggs, soy, almonds, walnuts, peanuts and hazelnuts (filberts). Wheat is used in all of our facilities and all of our products as an ingredient. Please refer to ingredient labels on our products for full disclosure of the ingredients used in that product.

If you are not familiar with food allergies, you are probably thinking, well that sounds good right?NOPE! It basically says, "we do what is required to clean the machines" or "we hose them down between runs, peanut/nut residue will remain on the machines and your food MAY contain the allergen".  It also tells me they don't label for same equipment or may contain which are two BIG ones with us-I don't even let her do "same facility"!  I'm 99% sure this reaction was peanut or some other nut and NOT egg related because her previous response to egg has always been fairly mild involving hives around her mouth and has responded to Benadryl quickly-especially baked egg.  This reaction was much more involved and complicated and continued to progress even with Benadryl.  I'm SO happy she is ok and very happy that the hospital staff listened to my concerns.  We've been really lucky that this was her first ER visit and first Epinphrine since being diagnosed more than 4 years ago.  Hope our next one is years away or NEVER! 

Thursday, March 17, 2011

Last minute egg-free feta cheese phyllo "cups"......

We had another home visit scheduled for Alexa's class today.  In case you haven't been following the trend, I managed to get the teacher to agree to "no food" at these visits after the first fiasco but then she went on maternity leave and the flood gates opened and now ALL the parents are providing food at their visits.  So, this leave me checking with each parent before each visit to find out what they are serving and if I need to make a substitute item and/or attend the visit for safety reasons.  The mom for today's visit emailed me Monday to tell me that they were making "feta pies" using egg, feta cheese, and phyllo dough and wrote, "please let me know if would be hazardous to Alexa." I emailed her back immediately and said "Thank you very much for passing this information along.  Alexa is allergic to egg so that will not work for her but if you could email me the recipe, I will try to create a similar item to send along with her on Thursday. Thanks again!" Well, we all get busy with life, and she didn't send the recipe along.   Since I knew this might happen, I bought the feta cheese and phyllo dough and planned to experiment and try to make something similar for Alexa to bring with her.  Yesterday was one of those very busy days and by the time I got the kids to bed at 7:45 p.m. I was exhausted and didn't feel like experimenting in the kitchen but skipping it was NOT an option.  I just couldn't imagine sending Alexa along to the home visit and making her watch while they all cooked and ate the feta pie and she snacked on crackers or whatnot.  I researched some online recipes and found that folding the little triangle thingys looked WAY to extensive and complicated for my tired Mommy brain so, instead I opted to make phyllo cups in a muffin tin.  I mixed together the feta cheese with a little cream cheese, basil, and fresh ground pepper.  I cut the phyllo to smallish squares, fit them into the muffin tins to make a "cup", brushed the phyllo with a little butter, put a small amount of the cheese mix in the center and cooked it for about 7-9 minutes until the edges of the phyllo where well browned and it seemed the bottom dough would be done.  The result was a bit salty for my taste and the phyllo was crumbly in some places and a little underdone at the bottom but not a total failure.  I sent her off to school with 3 in her bag and hope that I hear good reviews tonight.  I'll let you know the verdict.  Oh, life with food allergies is always interesting!!