Always on alert

Posted on: Wed, 01/18/2006 - 4:19am
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Published: Tuesday, January 17, 2006

Always on alert
Children with peanut allergies require constant vigilance

By Debra Smith
Herald Writer

L isa Olson-Kelly got the call she dreaded while teaching sixth-period math.

Her 4-year-old's day care provider was on the line: Andrew was in trouble.

His parents would later learn that another child had eaten a peanut butter sandwich near Andrew.

It's not clear if their son touched the sandwich or merely smelled it. But for the Everett boy, who's allergic to peanuts, the encounter was enough to set off a life-threatening reaction.

Andrew's face had turned red and was beginning to swell. A fleck of peanut protein had triggered anaphylaxis, an acute allergic reaction of the immune system.

Without treatment, his airways would swell closed and his blood pressure would plummet. He would be dead within minutes.

Gripping the phone, Olson-Kelly told the day care provider to give Andrew a shot of epinephrine to temporarily stop the reaction. Andrew always carries an EpiPen, an injector of pure adrenaline, to day care.

Take off the cap, Olson-Kelly said, put his back to your chest, stab him in the leg and count to 10.

Olson-Kelly heard Andrew's screams over the phone and knew it was done. When she arrived at the Everett day care a few minutes later, she found her son so puffed and swollen his eyes wouldn't open.

The ambulance was there already, and six paramedics were struggling to insert an IV into the writhing preschooler.

"His coloring was all wrong," Olson-Kelly recalled. "He was screaming and crying. He just grabbed onto me."

Paramedics took Andrew to Providence Everett Medical Center Pacific Campus, where he received additional treatment.

He made a full recovery. But it's unlikely he'll outgrow his allergy to peanuts.

For the rest of his life, food and all the places it's consumed, will require a degree of caution unknown to most people.

"I don't think the public knows how scary these allergies are," said Andrew's mother. "This isn't poison ivy ... people die from this. It's scary."

Andrew is one of a small but growing number of children with peanut allergies.

All food allergies are on the rise, and allergies to peanuts are one of the most serious and the most misunderstood by the public.

It only affects a small fraction of the population, but it can be a frightening diagnosis for families living in a peanut-saturated society.

Allergic reactions to peanuts kill more people than nearly all other food allergies combined, mainly because reactions can be severe and sudden.

Peanut allergies are responsible for about 100 deaths and 15,000 emergency room visits each year, according to the Food Allergy and Anaphylaxis Network.

It can take very little exposure to set off a reaction. A mere whiff of peanut butter is enough to cause a reaction in some cases. That's why many airlines have banned peanuts. More commonly, the culprit is a snack offered by a well-meaning adult.

Living with peanut allergies

The severity of these allergies is enough to turn any sensible parent into a peanut-Nazi.

"It gets really ugly," said Dr. Paul McBride, an allergist at The Everett Clinic. "Parents have to become policemen for every place their child goes."

After Andrew's allergy was discovered, all peanut products were banned from the house.

Andrew's mother, Lisa Olson-Kelly, met with her son's teacher to explain the severity of the allergy and how the EpiPen works.

Andrew's teacher stopped eating her morning peanut butter toast.

"She said, 'I miss it, but I am too scared he'll have a reaction,'" Olson-Kelly said.

The family keeps EpiPens at home, in the car and in his teacher's desk at school. Andrew's mother keeps one in her purse.

The no-peanut philosophy is ingrained so deeply in their family, Andrew's 5-year-old sister, Sarah, who is not allergic, will hold up her hands and back away when she's offered a snack with peanuts.

Wendy and Jim Alt of Marysville take a similar stance in their home. Their son Sam, 10, is allergic to peanuts and latex.

His reaction to peanuts has been moderate: He developed welts around his mouth after taking a bite of candy containing peanuts.

The problem for Sam and any other person with a peanut allergy is it's impossible to tell how severe the next reaction will be.

Sam Alt's parents live with what they call "a baseline of fear." His mother isn't comfortable with extended stays away from home. Summer camp isn't on his list of things to do.

"It does stress me when he's out of my sight for a long period of time," Wendy Alt said.

Nut-free zones

As more children develop these allergies, some schools and day cares are instituting nut-free zones. Even if children don't have an allergy, they may be asked to stop bringing foods that contain peanuts. Homemade treats are a thing of the past in most classrooms.

In Everett public schools, a container of peanut butter used to sit open in the cafeteria for kids to make their own sandwiches.

That practice and others changed several years ago when a boy in Spokane died after eating a peanut butter cookie on a school field trip, said Debbie Webber, manager of food and nutrition for Everett Public Schools.

Peanut butter sandwiches are still served in the cafeteria, but kitchen workers now prepare and wrap the sandwiches in the kitchen. Kitchen staff members no longer bake peanut butter cookies either, because there's a risk of contaminating other baked goods.

Webber attended a workshop on food allergies and trained the district's kitchen managers on the seriousness of peanut allergies.

Parents can ask for nut-free zones in the cafeteria. At Penny Creek Elementary School in Everett, for instance, several tables are designated "nut free."

"We're in a school setting, and we can't control what other kids bring from home," she said. "Yet we still need to take it really seriously."

There are no laws regulating peanuts in schools or day cares; the responsibility is left primarily to families to sort out.

This is largely how it should be, McBride said. Peanuts remain a cheap source of quality protein for most of society, he said.

He doesn't believe there should be legislation banning peanuts or even schoolwide bans. However, a peanut-free zone in the class of an affected child is appropriate, especially when children are too young to understand the ramifications of their own allergies, he said.

Parents of children with these allergies need to be proactive about educating people their child regularly comes in contact with, and that education includes how to use the EpiPen, he said.

They can send their child with a backpack full of safe snacks, for instance, and teach the child to eat only what's in their bag.

"The parents that are very bright quickly figure out they can teach their child what they can and can't do," McBride said. "They take adults out of the equation."

Reporter Debra Smith: 425-339-3197 or [email]dsmith@heraldnet.com[/email].

Posted on: Mon, 01/23/2006 - 7:33pm
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Tom
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Joined: 01/22/2006 - 09:00

We need more articles like this as a proactive measure. Instead of just the report of deaths that we so often hear about.

Posted on: Mon, 01/23/2006 - 9:41pm
melissa's picture
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Joined: 07/05/2004 - 09:00

Thanks so much for posting this...I plan to give it to the preschool committee considering my plan to have a pn free room...it has all the points/info I wanted to convey!
Melissa

Posted on: Mon, 01/23/2006 - 7:33pm
Tom's picture
Tom
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Joined: 01/22/2006 - 09:00

We need more articles like this as a proactive measure. Instead of just the report of deaths that we so often hear about.

Posted on: Mon, 01/23/2006 - 9:41pm
melissa's picture
Offline
Joined: 07/05/2004 - 09:00

Thanks so much for posting this...I plan to give it to the preschool committee considering my plan to have a pn free room...it has all the points/info I wanted to convey!
Melissa

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