? able reaction

21 replies [Last post]
By Sarahb on Tue, 03-20-07, 01:20

My son had a possible reaction at school last week. He was given the epi first, then they called 911. The EMT's arrived first, then me , the medics from the hospital. It was really questionable whether it was a true reaction or not. I could tell that the 6 guys were all looking a bit puzzled. I let them give benedryl and rode with ds in the ambulance to the hospital. The ER doc said it didn't look like a typical reaction to him...but he couldn't say that it wasn't either. DS seemed fine....he was observed for a while and then we took him home. DH went back to the school to question everyone.

I really have no answers...and we haven't changed anything that we are doing .. I figure if it really was a reaction we will know soon enough.... so here is what happened..

a piece of banana bread was put on a table behind my son...about 18 inches away. The bread was made in a facility that processes peanuts. DS did not touch or eat it. (so we think) the children had not started to eat it either.

the teacher heard my son cry - he was covering his nose...he said that his nose hurt...he had a lot of mucos and started crying and turning red...they took him out of the room...the aide attending to him said his face was red, she offered him water he refused, he started shaking and teeth chattering (it's not cold here) and she looked on his chest, legs and back and said that there were red spots on his back and now his scalp was red. She gave the epi. When I got there...within 5 mins of the epi he was not red....he had no marks..he seemed fine...but a little shaky. My first sense of doubt was from looking at the emt's and medics reactions and my son looked fine.

So IF he reacted...he either ate a piece of that bread...the teachers were horrified when we suggested that might have happened... or he could be airborne sensative and if that's the case I guess we will know soon enough because he will react again. i just don't know what to do with that "possiblity".....I don't want to make major changes when we are pretty uncertain that a reaction happened at all. DS had had a virus and was also being uncharacteristically emotional...he had also been complaining about his legs/knees hurting that morning - which could just be from growing -he's a tall kid.

So i am posting to see if this rings any bells with anyone....if I have missed anything or if you think I am looking at this the wrong way or if there are questions that I need to be asking please please let me know.

Our current comfort zone is that we feed him nothing that is shared lines or facilities with peanuts. He has no other allergies and mild excema. All food he eats is from me. But I would hate to limit his contact with the outside world based on an inconclusive reaction.

oh...and the next day...he was as chipper as ever!

my thoughts are that I should start a food log...report this to his allergist...and make sure that I communicate to his teachers if he is the slightest bit "off"

I really apprecaite any thoughts on this.

thanks

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By bethc on Tue, 03-20-07, 15:01

Boy, that's a hard one. How old is he? Do you think he might have just impulsively taken a bite of the bread? Was he snacking also at the time, and how completely sure of the safety of his snack are you? It seems so unlikely that he'd have an aerosol reaction from something just made in a facility with peanuts.

It sounds like a suspicious group of symptoms and it seems like a good thing that the people at school took it seriously and treated it. You know, getting a shot of Epi can just turn around a reaction really fast sometimes and it can seem like they're fine by the time the paramedics arrive. I know people on this board have had paramedics be doubtful that there was anything wrong with someone because the Epi shut down the symptoms quickly. And they don't necessarily return. So just because he was fine later doesn't mean it wasn't a reaction.

If it were me, I'd keep asking him about what happened beforehand. And I'd consider anything you know he ate, even if he's eaten it before. You may never sort this one out. Or he may have another similar reaction someday that you know is from peanuts, and you'll think, "Now I know that's what it was." It's so hard sometimes. I'm glad he's okay!

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By Peg541 on Tue, 03-20-07, 15:49

Exactly. I think the epi and Bendaryl and ride to hospital were well done. All of his symptoms sound like a reaction to me.

Do you think he's afraid to tell you he did eat some of the bread?

Maybe you can let him know we are all learning and sometimes we make mistakes. You won't be angry but you really just want to know so you can help him learn how to keep safe.....

Good luck. It does not sound like an airborne reaction and how wonderful it is to know the epi worked so well.

Peg

__________________

Peggy

Son 22 Allergic to peanuts, tree nuts, tomatoes, soy, milk, oats, fish.

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By Sarahb on Tue, 03-20-07, 17:09

Thank you both for your responses.

He's 3 and half.

We immediately thought that he probably snuck a bite of the bread...but the teachers said no way...that he is the first to tell you that he only eats food from mom and dad...and I don't think any of the bread was missing...and I really think his teachers would have said if there was a piece missing. I asked him directly but very gently and told him that it was ok to tell mommy and that we are just learning and need to keep him safe, etc...and he tells me no. He also told me that he didn't have a reaction. He said he was just freaking out. His words.

He hadn't had any of his snack yet that day. He did have strawberries that morning and he hasn't been tested for them but has eaten them many times. That is a question for me...could it have been the strawberries - either new allergy or xcon.?? I ate the rest of the berries and won't give him anymore unless we are going to be with him. *lightbulb* He had strawberries last night in some homemade mixed berry ice cream.....no reaction..but different source of berries. (this is maddening)

So....yeah we told the teachers that they did the right thing and were very thankful for that....but I don't think that my husband and I are convinced that it was a reaction. Maybe that's wishful thinking on our part.

Another thing I didn't mention is that the teacher aide who made the decision to do the epi is ESL and her first language is Spanish. Her communication is not the best...she speaks english well but never seems to answer my questions...maybe she doesn't understand it as well as she speaks it? Her daughter is PA and she recently gave another child at the school and epi in a clear ingestion reaction...she got a lot of praise for that. I'm not saying that she did this for praise or that she was wrong to do it....I just don't know. I really want her to have been wrong.

Am I supposed to or should I be giving the teachers some kind of thank you gift for this? I guess if it were a clear reaction I would without question so I probably should since I don't want them to doubt themselves. On the other hand I don't want them to give that epi too quickly and I really wish they had given him benedryl first.

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By Peg541 on Tue, 03-20-07, 17:59

It does not matter if you thought it was actually a reaction. You were not there.

Luckily the teacher was there and she thought it was reaction enough to treat. And I think successfully.

How can we make ourselves believable if an injection of epi looks like a cure? That is tough. The paramedics came and scratched their heads because your son looked fine but in fact he did not look fine to the teacher moments earlier. And the paramedics should have known that.

Please don't look at the epi as a last resort or a BIG BIG decision to be made. Be thankful that teacher did what she was supposed to.

None of us no matter how experienced we are can predict how far a bit of redness, salivation and a bit of a rash can go. Added up they all sounded to me like a good reason for Epi and Benadryl. And look you have three bodily systems involved with these symptoms.

You can send a letter to the school commending the action of that teacher. I don't think you need to get her a gift. Your child's life is her gift! Make sure the letter goes into the teacher's file and she can use it as part of a resume in the future.

Don't second guess her or yourselves. More kids die while some well meaning but scared adult is sitting around in a "wait and see" attitude.

Do you really want to give the responsiblilty to a teacher to decide epi or Benadryl? Maybe when your son is older and can be 100% sure of what happened to cause the event he can consider Benadryl first but the rules are Epi first then Benadryl. There was no clear reason for the "reaction" so the teacher (I feel) did the correct thing.

What does your son mean by "freaking out." I mean what caused him to freak out? It sounds and looks so much like a reaction I would want to know more about the freaking out. Those are big words for a little guy like that. I know we use them all the time but a little guy coming up with that? Is he talking about that feeling of doom that comes with anaphylaxis? Three is a bit young to be able to describe this, he felt awful and maybe did not know how to describe it.

For sure he did not like the epi and the paramedic fuss but again I wonder was he too scared to tell you he had eaten something forbidden.

And yes check the berries.

This is how we learn, by dissecting these situations.

Peg

__________________

Peggy

Son 22 Allergic to peanuts, tree nuts, tomatoes, soy, milk, oats, fish.

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By Greenlady on Tue, 03-20-07, 18:05

"On the other hand I don't want them to give that epi too quickly and I really wish they had given him benedryl first."

In my opinion, there's no such thing as giving an epipen "too quickly." I've read again and again about the dangers of giving bendryl first - it can mask the more serious symptoms and by the time the caregiver realizes how bad things are, it can be too late.

To my mind (although I'm not a medical expert), it does sound like an allergic reaction, and an epi was the right treatment. More than one body system was affected, and the chattering teeth in particular is distressing because it might have indicated a drop in blood pressure, which is very dangerous. Also, "freaking out" is actually a possible symptom - it's usually described as a "feeling of impending doom."

I totally understand why you don't want this to be an allergic reaction, but if it was one, then the epi was the right decision, and if it wasn't one, the epi (and not benedryl) was STILL the right decision. Bottom line, your son is fine.

You might consider finding a translator to talk with the caregiver to make sure you have all the details right. I hope you figure out exactly what happened soon!

Take care.

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By Sarahb on Tue, 03-20-07, 20:34

It does matter if I think it was a reaction (or not) only to determine future safeguards. I am not really questioning what they did. I put him in thier hands and I trust them. They did the right thing. I have to trust the teacher and aides to make these decisions - that or homeschool.

Benedryl is first on our action plan not epi. She gave the epi because he refused water and she was taught that they refuse water it is because they can't swallow....so you skip to the epi. But given the multitude of symptoms...epi first is understandable. We told her and the administrator that we think she did the right thing. We are not questioning what she did outwardly....but we want to know at the same time if it was warranted or not. I think part of my not being convinced that it was a reaction is that the symptoms were communicated to us in drips and drabs after multiple questions. Each time we ask we got a little bit more or DIFFERENT information.

Uh...my little guy is amazingly verbal and mature for his age. He is way ahead of his peers. He got so tired of our questions that he just wont answer anymore. I am afraid also that while he is very bright...he's also a bit unreliable. When I asked him if it was a reaction he said "no I was just freaking out" ? I think this weekend I am going to make banana bread with him and see if I can bring it up or if he brings it up.

You guys so far are the most convinced that it was a reaction....the ER doc and the EMT's, etc weren't although they wouldn't rule it out. The ER doc practically ruled it out...but wouldn't quite go there.

I hear what you are saying...about the epi working to well...we are treating it as a reaction....and will use it as needed for use in future school plans, etc. But without more information are not going to change our safety zone, etc yet.

I really appreciate the "talking to" you guys are giving me. I just don't think that I am going to have the answers on this one.

Oh...and your opinions are as valuable to me or more than an ER doc! Not that he wasn't good....but he doesn't live it.

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By notnutty on Tue, 03-20-07, 22:24

Sarah: I understand you questioning. We gave our ds epi once and after thought "was it really a reaction." I think asking this question is 100% normal and should be pondered, especially if you weren't there. I think it matters.

I think the school did the right thing by giving epi...I would rather they not wait...however, I also wonder if he had a reaction, especially since the source of the suspected reaction was not close to your ds AND your ds did not ingest it AND it was only a x-contaminated food. It seems suspect to me.

You may never have the answer. I think in time you will understand his allergy better and understand the way his body reacts.

__________________

No longer a member.

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By Sarahb on Tue, 03-20-07, 23:28

thanks nonutty

it's just so hard...because at school (and most of the time at home) my son is the most amazing happy almost perfect child...they have really never seen him act like a typical 3 yo..... I have seen him act like a typical 3 yo and that can include crying, turning red, not answering, huffing (which could look like teeth chattering) and lots of snot...

so was he just "off" because of a virus and frustrated with his "work" (Montessori) OR could that virus have affected his allergic response and made it much more sensative?

I typed it all up and am going to send it to the allergist and see what she thinks.

I think I am going to put together a little care package for his teachers with my new found baking and ice cream making talents. They must think I am a robot because I am so calm about it all...

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By Adele on Tue, 03-20-07, 23:40

It sounds like a reaction to me, too. I've also had flushed face and shivering as part of what I think was a reaction. I was also coughing until I gagged.

I found this on: [url="http://www.flash-med.com/anaphylaxis.asp"]http://www.flash-med.com/anaphylaxis.asp[/url]

"Often people will develop itching, cough, shivering, and flushing. Sometimes people will experience swelling of the throat and tongue associated with difficulty breathing."

[This message has been edited by Adele (edited March 20, 2007).]

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By Sarahb on Tue, 03-20-07, 23:48

Ug [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img]

So what do you think...he ate the bread? he reacted to airborn particles in the bread? he reacted to something he ate that morning? something on the table?

Dh checked out the table for any smudges, etc...it was clean...had been cleaned the night before and no food had been on it since the previous days lunch...

the school is "nut free" and I know that his teachers would not let any child eat pb or any obvious nut product ....even before they went nut free she was making the PB eaters move away from my son.

UG!

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By Adele on Wed, 03-21-07, 00:00

You'll probably never know. Maybe one of the kids had a peanut butter cereal or even a PB sandwich for breakfast and had residue on his hands - then touched your son's hands - and he put his fingers in his mouth.

This is what frustrates me about PA.

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By Peg541 on Wed, 03-21-07, 00:41

I'd put money on him eating the bread. He's just a little guy.

And believe me smart and mature are two very different things. My DD is 24 now, she was reading at three, smart smart smart but growing up has been tough for her, even today she admits she is a late bloomer.

My DS is the same in many ways.

I'd be careful overthinking this one. You may never find out why this happened and IF he did eat some of the bread now he knows. It's the way we learn.

Good luck to all of us.

Peggy

__________________

Peggy

Son 22 Allergic to peanuts, tree nuts, tomatoes, soy, milk, oats, fish.

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By Daisy on Wed, 03-21-07, 01:18

My 2 cents...

Sounds like a reaction...possibly to residue on another child that he had contact with or surfaces another child touched?

Was this banana-nut bread (tree-nuts)? It would probably be a stretch for him to react to peanut from "may contain" or "processed on shared lines" if he did not *eat* it. Does he eat eggs?

Small note: Our school has made classrooms nut-free on a case-by-case basis. Our little car-pool fellow was just covered in PB after breakfast most mornings last year. One of his table-mates was severely allergic, so I would always remind him to go straight to the bathroom and wash-up before entering his classroom.

One day he was running late and got in my car with a bagel. I was coughing and gagging before I could even exit their subdivision. Asked him what he had. "A bagel." My DD noticed it was a PB bagel. I was still coughing terribly. (Was not known to be PB allergic at the time.) Had him throw the rest of his bagel out the window when I stopped to drink Benadryl. Rode with the windows down the rest of the way. I immediately felt relief! I had been avoiding eating nuts because of a tree-nut allergy, but I soon realized I could not be around peanuts, either.

When the Epi works like it should, your child is fine right after, like night and day. (My DD could throw a doozy of tantrum, but not spots.) And it is not unusual to feel "freaked out" when you're having an allergic reaction. It's kind of a signal that something is wrong, and you need to do something now!

Glad he's all better. Don't blame you for wanting all the information, but don't rely on the paramedics/ER Docs when they did not witness the reaction. I have been in full-blown anaphylaxis before and it has been completely missed. Actually had to convince the Doc it was "for real". I have also had very mild symptoms that were noted immediately by an observant triage nurse before I even told him what I was there for...something about my posture and breathing stance he noticed right away.

So glad your school is pro-active.

Daisy

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By cam on Wed, 03-21-07, 01:28

I too would want to do the same kind of questioning you are doing here to try to sort through what happened and if any changes need to be made. It sounds like you have handled things so well with the school (and that they handled things well, which is so reassuring), and I think that's great how you typed it all up for the doctor. The only couple of thoughts I had were that maybe even though no one ate any of the bread, a teacher touched it in unwrapping it or something and then touched something else or your child...just one thought that came to mind. Another is that our allergist has strongly voiced his concern with how little emergency responders often know about food allergies (and it sounds like you already are putting more stock in others' opinions on this). When my son had his big reaction (the one that informed us about the allergy, directly after eating something with peanuts), he had a very clear and severe reaction to peanuts but it resolved on its own within 30 minutes without medication (it was a clear epi situation, we just didn't have it yet because we didn't know about the allergy). The emergency responders were joking with us and not in the least bit concerned--my son was still drooling profusely when they were here, which the allergist says indicates he couldn't swallow because his throat was closing. I guess I'm just sharing this as further evidence that even though he seemed fine when they got there, it could have been a true allergic reaction.

Mostly, I just want to say I would be doing the same questioning and would have the same desire to want to be able to tie it to something else since it is a confusing situation. I'm glad your son didn't seem too shaken up by it, and that the preschool obviously takes things very seriously. (And it seems you handle and look into things extremely well!)

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By Greenlady on Wed, 03-21-07, 02:32

Hi Sarah - I didn't mean to say that it didn't matter whether it was an allergic reaction or not. What I was trying to say that in any case, benedryl wouldn't have been the right answer (if it was a reaction, it might not be enough, and if it wasn't a reaction, then it wouldn't be necessary), but I hadn't realized that your action plan specifies benedryl first.

For us, if there is a reaction, it is always epipen first, then benedryl. Again, there have been people who've died after taking benedryl and waited for the symptoms to get better.

I know that some PA folks who get frequent hives with no other symptoms will take benedryl for those, but everything I've read indicates that if more than one body systems is involved, then the epipen is indicated.

Hope that makes sense.

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By doreen on Wed, 03-21-07, 02:38

In my experience ER doctors have never diagnosed anaphylaxis for my two kids, but I know they were reactions. It sounds like a reaction, and it's hard when you can't pinpoint it to the second. It's actually really frustrating, but just be grateful you have a teacher you can rely on because there are so many out there who wouldn't have recognized the signs or would have waited. Heck, one of our preschools gave my daughter a cupcake with M&Ms, then lied about it after I found out from my daughter! Anytime you need to question it this much, then it was likely a reaction. Sometimes you never know.

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By joeybeth on Wed, 03-21-07, 04:13

i would consider the possibility of there being pb or some other peanut residue on the table or chair where he was sitting. we've had that happen. it's baffling. my kids have gotten it onto their hands and then rubbed their faces before. my girls are what i would call very sensitive and they've had definite contact reactions and aerosol reactions but never had an aerosol reaction to a "may contain." not to say this couldn't happen, but it hasn't happened to us, as far as i know.

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By CVRTBB on Wed, 03-21-07, 05:54

I agree with JoeyBeth and the rest who think it was a reaction. I would have given my son the epi in a reaction presented the same way. My son has had an anaphalactic reaction from sitting at a cafeteria table in early morning care at school (before school started- as you said... no visible residue, table washed the day before). So, yes, it can happen!

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By cam on Wed, 03-21-07, 11:53

One other thought was wondering whether the preschool would consider changing their policy not to allow any baked goods--even if he is not eating them--due to risk of cross-contamination? That is the policy we agreed on with my son's preschool for next year. They won't allow them for birthdays or anything. (I know that gets at wanting to know specifically what caused the reaction and whether or not changes in comfort zone should be made, as you wrote in the beginning...)

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By Sarahb on Wed, 03-21-07, 17:27

Thank you all once again for your responses. I read them all to DH last night.

I'll let you know what the allergist says.

One thing I thought of last night....did anyone see my Trader Joe's thread? Where the checker was eating a peanut butter bar while checking my order out?

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By sebastian on Sun, 04-01-07, 07:50

I feel for you! I cannot stand not knowing the source of a reaction. My DD has had so many mystery reactions that it is maddening.

Even if it was not a reaction, it was still good that they used the epi. I would rather them use the epi rather than to wait and see. My daughter had an allergic reaction at a church function and I had trained her teacher to give her the epi just in case.
I came back to pick her up and she was in full blown ana. and the teacher was just carrying her around (epi bag in hand) while she was wheezing and coughing.I shudder to think what would have happened if I had not shown up then to administer the epi. (and of all things, this was the first time I had ever left her alone for this weekly event at church)

Hugs,
Shelley

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