504 question....reaction history to school

Posted on: Tue, 01/30/2007 - 2:28am
chanda4's picture
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Joined: 12/14/2006 - 09:00

Okay, when you are putting all the info for the 504 together(I am working on the reaction history for my son). Do I try and list *every* reaction he's ever had to each food allergen, or do I list only the anaphylaxic reactions, or only the emergency ones(he's never gone to the ER)....he's had a few *close-calls* like dipping his finger into cake batter(or eating green jeelo, turned out to be pistachio pudding....) and his throat squeezing....looking back I should have done the Epi, but we just gave Bendryl and after an hour it passed. Would I note those reactions but maybe put *emergency treatment should have been sought* so they know it was severe....just I was the dummy that didn't act? He's had about 4-5 of those(I should-have but didn't etc....) does that make sense??? Thanks [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig)
Savannah-1 (milk and egg)

Posted on: Tue, 01/30/2007 - 2:50am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

I would be emphatic about the severity of the symptoms YOU observed. Use the anaphylaxis grading chart, and point out that your child has a history of grade 3 symptoms.
DO NOT mention that you "should have.... but didn't." That will be confusing.
DD has never recieved epinephrine. But I do not mention that. In anyone's estimation, she is very very fortunate to be alive to tell that tale. We don't tell people that she's never had epi administered. Just that she has a history of grade 4 anaphylaxis with cardio involvement and extremely RAPID onset. (which is the underlying reason why epi hasn't ever been used-- it has just been too fast) Remember-- anaphylaxis is still something of a medical mystery. Nobody really knows why some people die from it and other people come through it sans meds. DD "came back" in spite of no epi. Not because it "wasn't that serious."
I wouldn't confuse the isse with too much info. Especially with the school. Think about what they [i]need[/i] to understand and then provide them with the information they need to do so.
JMO.

Posted on: Tue, 01/30/2007 - 2:56am
anonymous's picture
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Joined: 05/28/2009 - 16:42

In the 504, we listed what prior reactions were, but not what caused them (specifics, in other words).
Something like... Past reactions: hives, coughing, anaphylaxis.
We have kept everything fairly simple, I think. Straightforward.

Posted on: Tue, 01/30/2007 - 3:08am
chanda4's picture
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Joined: 12/14/2006 - 09:00

Okay, I am confused now, lol!!
So should I offer a list of reactions like....
6/03 Jake tasted a piece of peanut butter toast, after spitting it out, 5 min. later his tongue was swelled and hanging out of his mouth and lips were swollen, face red. Breathing remained normal. Treated with Bendryl, swelling gone wihtin 1 hour.
how would you list that reaction...that detailed or less??? THANKS [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
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Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig)
Savannah-1 (milk and egg)

Posted on: Tue, 01/30/2007 - 3:52am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Can you give us some context? Is this a school form you're filling out? What is the question (on the form) that you're answering?

Posted on: Tue, 01/30/2007 - 4:07am
Gail W's picture
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Joined: 12/06/2001 - 09:00

I have my dd's paerwork in front of me and on the IHP there is a section called[b] IV. Background Information / Nursing Assessment[/b] and in that box it states, [i]"Mariah has had allergic reactions in the school setting as a result of touching peanut residue on objects and has experienced two anaphylactic reactions as a result of ingestion prior to her entrance into elementary school. Her asthma places her at high risk for anaphylaxis. See permanent record for medical assessments."[/i] There are 3 or 4 letters from her allergist in her permanent file, plus copies of her lab reports.
edited to fix a typo
[This message has been edited by Gail W (edited January 30, 2007).]

Posted on: Tue, 01/30/2007 - 4:08am
chanda4's picture
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Joined: 12/14/2006 - 09:00

Thanks Gale...I am typing up the info I will need to present to the school for his 504. Don't I need to(or isn't it best) if I provide a list of reactions he's had in the past??? Or should I just not even worry about it? I have a list of about 25-30 reactions, never administering an Epi, and ranging from just welts around eyes to him telling me his throat is squeezing. Is that something that would help them understand his reactions, or would it give them too much info? Thanks [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
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Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig)
Savannah-1 (milk and egg)

Posted on: Tue, 01/30/2007 - 4:18am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Where are you at in the process? Is this for eleigibility?
Ideally, if possible, your allergist could share your child's past history. Is that possible?

Posted on: Tue, 01/30/2007 - 4:24am
chanda4's picture
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Joined: 12/14/2006 - 09:00

Oh, the allergist does...I thought I provided all that.
I will have our letter by Fri for the eligibility meeting...I was just hoping to get some stuff *prepared* now....to get the process moving.
Thanks [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
------------------
Chanda(mother of 4)
Sidney-8 (beef and chocolate, grasses, molds, weeds, guinea pig & asthma)
Jake-6 (peanut, all tree nuts, eggs, trees, grasses, weeds, molds, cats, dogs, guinea pig & eczema & asthma)
Carson-3 1/2 (milk, soy, egg, beef and pork, cats, dog, guinea pig)
Savannah-1 (milk and egg)

Posted on: Tue, 01/30/2007 - 5:00am
Gail W's picture
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Joined: 12/06/2001 - 09:00

Quote:Originally posted by chanda4:
[b]Oh, the allergist does...I thought I provided all that. [/b] I will have our letter by Fri for the eligibility meeting...I was just hoping to get some stuff *prepared* now....to get the process moving.
Thanks [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]
I don't know if your allergist will do that or not. Did you ask him/her to include it in the letter? Many allergists are unfamiliar with the 504 process, which is why there are threads dedicated to what to ask the doctor to include in their letter, how to request that, etc. etc.
I preferred that our allergist addressed our daughter's history because it indicated it was part of her medical record and that he was fully aware of it.
But if your allergist doesn't include this in his letter, you can address it too. I think you're right on to have that information on hand for your meeting. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Posted on: Tue, 01/30/2007 - 5:14am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

In my experience, when you are trying to explain the allergy of a particular child to someone unfamiliar with this type of allergy, it is helpful to list the following things:
1. Routes/mechanisms of exposure which HAVE LED TO REACTIONS. (This includes information which would specify whether your child is ingestion, ingestion/contact, or ingestion/aaerosol sensitive.) That will matter a great deal to the school in terms of accommodations which are absolutely [i]needed[/i] within that setting.
2. The type of severity which can be expected. If it is unpredictable (as we all know it can be) then giving the range [i]which has been observed[/i] is likely to be useful. But only if history is a good indicator. For example, a child that has always lived in a nut-free environment but tests class VI, you couldn't say "hives from possible skin contact" and leave it at that for a preschool. KWIM?
3. Other mitigating/risk factors. So in the case of the theoretical younger allergic sibling above, you'd need to explain that asthma and a very high test score indicates that this child is at extremely high risk of anaphylaxis. In our case, the speed of DD's reactions and her sensitivity to ultra-trace amounts by all three routes of exposure leaves her at high risk for a fatal reaction-- even [i]with[/i] treatment. We emphasize that point, and so does our allergist. Avoidance is about all we have, so we are beyond obsessive about it.
I would provide the anaphylaxis grading chart, a checklist of anaphylaxis symptoms THAT YOUR CHILD HAS HAD, as well as which routes of exposure have elicited reactions. That will be what the school needs to know in order to build appropriate safeguards.
I caution against providing them with a detailed reaction history that includes how/who/why-- because it [i]sometimes[/i] gets used to demonstrate that "nobody's perfect" or "if even [i]you[/i] make mistakes, how can you expect us not to?" For that reason, I would stick only to answers about specific reaction symptoms/amount needed/routes of exposure.
[img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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