When a Food Challenge is Unsuccessful

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Superman has had 8 food challenges, and 6 of them have been SUCCESSFUL.  He’s passed, soy, oat, cherry, strawberry, almond, and mixed tree nut.  The two that have been UNsuccessful have been baked egg.  You can read HERE about his first baked egg challenge when he had an anaphylactic reaction. Ironically, this time around it was almost an exact replay of his first baked egg challenge.  The one exception, is that it happened so much faster this time.

When a Food Challenge is Unsuccessful~Mom Vs. Food Allergy

 

At 9:20 I took a picture of Superman and I after his first “dose”, 1/4 of a cookie.

When a Food Challenge is Unsuccessful~Mom Vs. Food Allergy

Right after his first bite of baked egg cookie.

At 9:52 I took a picture of him right after he had his shot of epinephrine.

What happened in just 30 minutes, was something I want you to learn from, so you can see the progression of an anaphylactic reaction.

Superman first ate 1/4 of the chocolate chip cookie.

About 5 minutes later he got really sleepy.  I didn’t think much of it at first (except a flashback to his first baked egg challenge), because he had trouble falling asleep the night before due to being excited and a bit nervous.

He started rubbing his eyes here and there.

He complained that his stomach was hurting, and thought he might have to go to the bathroom.  My husband took him to the bathroom, since he hadn’t had a bowel movement in a couple of days (sorry, TMI….but part of this equation), but he didn’t have a bowel movement.

It was time for his  vitals check (every 15 minutes during food challenges) from the nurse and the doctor.  We alerted them to his sleepiness and the doctor said his heart rate was normal.  Normally, our allergist said, heart rate would rise in the effect of lethargy from an anaphylactic reaction.  Because of the stomach pain, sleepiness, and rubbing of the eyes we decided to wait an extra 15 minutes before we gave him the next “dose” of cookie, which would have been 1/4 of a cookie.

Superman went back to watching his movie, while we waited to see if he could have the next portion of cookie.

About 6-10 minutes later he was complaining of even more stomach pain.  We convinced him to try the bathroom again, still truly thinking it could either be hunger (food challenges are done on an empty stomach, so he’d had no breakfast) or a bit of constipation.

As he stood up to go to the bathroom, his face got pale and he said something to the effect of, “I don’t feel good” and “I need water”.  I got up to get the nurse or doctor, and as I walked out the door I could hear him vomiting behind me.

At that point the doctor was walking in and it was no question that he was experiencing an anaphylactic reaction as he vomited a second time.  Epinephrine was given immediately and the reaction stopped in its tracks.  I’m going to say that again.  The REACTION STOPPED IN ITS TRACKS.  I’m repeating that to remind you of the life-saving power of epinephrine and why you should carry TWO auto-injectors with you at all times.  (I’m pretty passionate about spreading that news.  Epinephrine has saved my child’s life 3 times now, and I’ll sing it’s praises until there’s a cure for food allergies.)

When a Food Challenge is Unsuccessful~Mom Vs. Food Allergy

After his shot of epinephrine, and asking for a band-aid.

Why did we go ahead with this food challenge?

Our allergist, my husband, and I, felt he was really ready.  His most recent blood test results were very low.  Despite a small positive reaction on a skin test last year, everything still showed a green light for a BAKED egg challenge.  According to this article on American Academy of Allergy Asthma and Immunology (AAAAI), those that can tolerate baked egg are more likely to outgrow their egg allergy and then tolerate regular egg.

His component testing results were:

Egg White specific IgE 0.75.
Ovalbumin is 0.89, and ovomucoid is 0.35.

Ovalbumin is the main protein found in egg white, making up 60-65% of the total protein.
Ovomucoid is a trypsin inhibitor found in raw egg white.

I found this article interesting as I was researching ovomucoid.

Do I regret doing the food challenge?

No.  I can’t beat myself up over something that I made an educated decision on.  I never would have agreed to it if there was any doubt in my mind.  Our allergist was completely surprised that he didn’t pass, and I know he wouldn’t have suggested the challenge if he doubted that it would be successful.  What I learned from this experience is that LETHARGY is his first symptom to an anaphylactic reaction upon ingesting baked egg.  We are to use his auto-injector upon known ingestion of an allergen, or suspected ingestion with the symptom of lethargy.

What’s the takeaway?

Food allergies are unpredictable.  Food allergies are different for everyone, including the type of reaction, and not excluding a person’s tolerance for an allergen.  What I DON’T want you to do is compare your child’s blood test results to my child’s and make a prediction, or base decisions off of our experience.  What I DO want you to do, is talk your board certified allergist about future food challenges and make a plan based on your set of allergies and testing results.

P.S. **Never do a food challenge at home.

The good thing is that he was able to still enjoy a birthday party that afternoon with friends at the local splash park.  He took it easy while I watched him like a hawk for a biphasic reaction.

When a Food Challenge is Unsuccessful~Mom Vs. Food Allergy

Having fun at the splash park!

**Disclaimer:  I am not a medical professional or doctor and this website is not intended for medical advice.  Please consult your board certified allergist for medical advice.  Do not attempt food challenges at home.  In an emergency, call 911.

Has your child had a an unsuccessful food challenge?  What did you learn from it?  Please comment below and share your thoughts!

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Mylan School Access Program Has New Offerings

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In Ohio last spring, the stock epinephrine bill passed.  I obviously was thrilled, even though we are homeschooling (for now).  If we were to send Superman to school, he’d go to the private school where my husband works.  I was so disappointed to hear last week that the superintendent of that private school has declined to take advantage of having free epinephrine auto-injectors in the building.  “Why?”, I asked my husband.  “He doesn’t think they’re necessary…”, my husband told me. Both of us were stunned to think that a person in charge of hundreds of children wouldn’t want life-saving medication on hand in the event of an allergic reaction in an adult or student.

Before I had children, I used to teach in a public school, and I had to demand the list of medical conditions of my students (which I was entitled to) so that I would know what to do in the event of a medical emergency.  I KNOW that I would have been interested in a child’s allegric history.  I KNOW that I would have wanted undesignated epinephrine in the school, JUST IN CASE.  Now that it’s possible, school districts are declining it. Unbelievable.

Mylan School Access Program:  New Offerings

The Mylan School Access Program has some new offerings that I’m hoping will make it easier and more enticing for school districts to obtain undesignated epinephrine for their campuses.  Here’s what it includes:

· Four EpiPen or EpiPen Jr Auto-Injectors: With a qualifying prescription, each calendar year schools can apply online to receive two EpiPen 2-Pak® cartons, two EpiPen Jr 2-Pak® cartons or one 2-Pak of each kind.
· Anaphylaxis: Know It. See It. Treat It. Training Video: The video is available on DVD or for download at EpiPen4Schools.com.
· EpiPen® Trainer: Designed to practice administration technique, the EpiPen Trainer contains no drug product or needle.
· EpiLocker™: A brightly colored unit to store the free EpiPen and/or EpiPen Jr Auto-Injectors received through the program, so they are easily identifiable in the event of an emergency.
· Replenishment Offer: Qualifying schools that use the free supply of EpiPen Auto-Injectors to respond to anaphylaxis may order a replenishment supply at no additional cost.
· Online Order Process: Schools may now submit and track their orders online.

The EpiPen4Schools resources are designed to not only support school access to epinephrine, but also to provide schools with tools to instruct appropriate staff on how to follow an anaphylaxis action plan, which includes avoiding allergens (if known), recognizing the signs and symptoms of anaphylaxis, having access to two epinephrine auto-injectors at all times and seeking immediate emergency medical care if anaphylaxis occurs.

I’m interested to know…has your school district obtained their free epinephrine auto-injectors?

 

 

 

*A school will only receive EpiPen Auto-Injectors in accordance with all applicable laws. The school must submit a valid prescription in order to qualify for this program. There is no requirement for a school to purchase additional EpiPen or EpiPen Jr Auto-Injectors, or any other Mylan Specialty products.

Indications
EpiPen® (epinephrine) 0.3 mg and EpiPen Jr® (epinephrine) 0.15 mg Auto-Injectors are for the emergency treatment of life-threatening allergic reactions (anaphylaxis) caused by allergens, exercise, or unknown triggers; and for people who are at increased risk for these reactions. EpiPen and EpiPen Jr are intended for immediate self-administration as emergency supportive therapy only. Seek immediate emergency medical treatment after use.

Important Safety Information
EpiPen Auto-Injectors contain a single dose of epinephrine, which you inject into your outer thigh. DO NOT INJECT INTO YOUR VEIN, BUTTOCK, FINGERS, TOES, HANDS OR FEET. In case of accidental injection, please seek immediate medical treatment. Epinephrine should be used with caution if you have heart disease or are taking certain medicines that can cause heart-related (cardiac) symptoms.

Tell your doctor if you have certain medical conditions such as asthma, depression, thyroid disease, Parkinson’s disease, diabetes, high blood pressure and heart disease, have any other medical conditions, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. Be sure to also tell your doctor all the medicines you take, especially medicines for asthma. If you have certain medical conditions, or take certain medicines, your condition may get worse or you may have longer lasting side effects when you take the EpiPen or EpiPen Jr Auto-Injector.

The most common side effects may include increase in heart rate, stronger or irregular heartbeat, sweating, nausea and vomiting, difficulty breathing, paleness, dizziness, weakness or shakiness, headache, apprehension, nervousness or anxiety. These side effects usually go away quickly, especially if you rest.

Talk to your healthcare professional to see if EpiPen or EpiPen Jr Auto-Injector is right for you.

Please see the full EpiPen.com for Prescribing Information and Patient Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

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