The FARE Walk for Food Allergy isn't just about raising money, it's about raising awareness, and one of the things I've learned in the last four years is that there are A LOT of misconceptions about food allergies. I hope you'll learn something here and pass on what you've learned.
What is a food allergy?
A food allergy is an adverse immune system response to food protein. The immune system basically plays out a self-fulfilling prophecy: it believes that a food is harmful to the body, so in order to "protect" the body, it harms the body. The immune system has good intentions, but it's like turning on a sprinkler that floods the whole neighborhood due to the smoke from a birthday candle.
In the case of food allergies, the immune system produces something called IgE. IgE calls up the mast cells and the mast cells fire histamine into the bloodstream.
Histamine
Histamine, you say? I'm allergic to pollen. Is this the same histamine of which you speak?
I'm glad you asked. Yes, it is. You have mast cells concentrated in different places: eyes, nose, throat, lungs, skin, cardiovascular system and GI tract. Pollen gets in your nose and eyes and on you skin and causes unpleasant reactions and sensations. But because food is ingested it also touches all those other places. The more mast cells impacted, the more histamine released. It happens quickly and causes weirdness system-wide:
- Skin: hives, blisters, redness, swelling
- GI: cramping, massive vomiting, diarrhea
- Respiratory: runny nose, watery eyes, severe sneezing, coughing, wheezing, asthma, drooling
- Cardiovascular: sudden drop in blood pressure
One tricky aspect of dealing with food allergies is that it can take a very teeny amount to cause a serious reaction. If the immune system is already on high alert with a cold, for example, it is even easier for a severe reaction to occur. The same person may react severely on one occasion to a very tiny amount and on a different day to a larger amount of the same food. The symptoms of the reaction may be totally different on different days.
Anaphylaxis
If any two of these body system react simultaneously, or if throat and/or cardio symptoms occur alone, the person is experiencing anaphylaxis. It is life threatening. I speak from experience. My husband, my daughter and I have each had it.
My daughter had anaphylaxis (wheezing, face turned blue, covered in hives) at about 6 months old after ingesting what was literally a drop of milk. She experienced anaphylaxis again in 2011 when she first entered the Oral Immunotherapy study at Duke when she was given 1/60th of a peanut. That reaction involved mouth hives and vomiting.
Anaphylaxis can cause permanent damage to the immune system, heart, lungs and brain and each instance of it is very hard on the body in general. It can take a full month to get back to normal.
Anaphylaxis can be deadly. It happens very quickly. In my own anaphyalxis experience, I very quickly lost strength and coordination and could not unzip my purse to get my Epi-Pen. And I was an adult, who understood what was happening and what I needed to do. Kids, not so much. Often kids are scared of getting in trouble for eating a taboo food and are slow to tell a grown up. Or, they don't understand what's happening. Or, they cannot articulate it because of age, or lack of experience, or rapid progression of anaphylaxis.
In the US, between 500-1000 people die each year from anaphlaxis. Every three minutes, food allergies cause a trip to the ER. So many reactions resulting in so few deaths is due in part to the wonderful work of FAAN, immediate access to life-saving Epi-Pens and quick thinking.
Anaphylaxis, Science Edition
In the state of anaphylaxis, the person is dying. The body responds to mast cells being released physiologically with extreme vasodilation in the blood vessels (drop in blood pressure) and broncho-constriction in the lungs (results in inability to breath). There are other physiologic symptoms that occur, but the drop in blood pressure and inability to breathe are what tends to result in life-ending anaphylaxis.
Epinephrine is a chemical that is released by your body, in fact, before you give epinephrine-your body has already attempted to fight the life-threatening state of anaphylaxis. As mast cells are released, the body simply cannot keep up with this demand. Epinephrine causes peripheral vasoconstriction, which elevates the blood pressure (in anaphylaxis, the blood pressure will drop dangerously low and can result in fatal cardiac arrythmias due to lack of oxygen). In the lungs, epinephrine does the opposite. The lungs experience a broncho-dilation (which results in the ability to pass oxygen through the lungs into the bloodstream).
Holy freakin' cow. Anaphylaxis sounds scary.
Dude. Right? I know. Have I mentioned I'm doing a fundraising walk to help cure it? http://www.foodallergywalk.org/triangleNC/shelly
What is NOT a food allergy?
Lactose intolerance, gluten sensitivity and not liking certain foods ARE NOT ALLERGIES. Those things are not fun and they make eating a real pain, but they are biologically different things and not life-threatening. So, people with a gluten and/or lactose thing: I get that you and I are sort of in the same boat, and you want to tell me a relate-able story. Just please understand that if this boat hits an ice berg, the life preservers are reserved for you and we'll be over here sinking into an icy death. Just sayin'.
If you ever have questions about food allergies, please just ask. There's more information coming in the next month. Thanks to those of you who have already donated and/or advocated. Your contributions have provided a ton of life-saving education to other parents of food allergic kids and adult food allergy sufferers.
Will she outgrow it?
No one knows. There's a 20% chance that kids will outgrow peanut allergy by their 5th birthday and most kids who are going to outgrow milk and egg do so before they are 2 years old.
So, the odds aren't in her favor, but we are so lucky to have UNC and Dr. Burks (world renowned food allergy doctor) just down the road. Lucy is currently participating in her third year of an peanut immunotherapy research clinical trial and we hope to start a baked milk immunotherapy program in October.
Immunotherapy, if it works, is helpful because as long as a maintenance dose is taken every single day for the rest of the person's life s/he can eat the allergen. The person is still allergic to it, though, and skipping a daily dose of the food can mean anaphylaxis the next time it's eaten, even if they're been taking a daily maintenance dose for 10 years. Immunotherapy isn't a cure, but it's a way to prevent anaphylaxis from accidental ingestion of an allergen.
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