Saw Dr. Wood.. his take about airborne reactions..

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Our visit was great and he was really wonderful. He did answer all our questions and I am so glad we went to see him.

I asked him about airborn reactions. His exact words were: AIRBORNE REACTIONS ARE A MYTH FROM THE INTERNET.

He said the smell of peanut butter will not cause an airborne reaction. He said sitting at a ball field while people ate peanuts was basically safe with a minimal chance of having a reaction. Yes, there will be peanut dust but b/c it is outside, the dust will dissolve (dissipate) quickly so the risks are minimal. He said the greatest risk would be shelled peanuts in a closed environment.. airplanes and restaurants where they actually shell the peanuts.

I was very relieved to hear that...

As for RAST.. he basically said the classes are worthless. Anyone with a score over 30 has the chance of having a severe reaction. There's no way to tell how much peanut a person would have to ingest to have an anaphylactic reaction by the bloodwork. He said there have been people with a score of 16 who have had serious reactions... and there have been people who have a score of 80 who have just gotten hives. Generally there is a higher risk for people with the higher score to have the anaphylactic reaction but it's not always the case. So just b/c your child may have a score of >100 doesn't mean she will always have an anaphylactic reaction. This is good since both my girls have very high scores.

So now he's testing my youngest for tree nuts plus a zillion other things. We are hving the RAST done tomorrow so here's hoping they all come back negative!

I also asked him about shellfish. He said if both girls test neg, it's safe that they are neg and they can have it. But he recommended having the younger ones (my boys ages 1,2) not tested for any of the foods till they are 4. He said they could test neg at age 2 but test positive at age 4. HE said it's much better to wait till they are 4 so as not to expose them now and that way we will be certain at age 4 that they aren't allergic. He said it's fairly rare to test positive when you are older if you weren't allergic around age 4. Of course there are exceptions but he felt fairly comfortable with that.

On Jun 12, 2003

Great information. Okay - I am going to play stupid here. Does this mean that if someone eats peanuts/peanut butter and then comes into close contact but not actually physical contact with a PA individaul that this would not cause a reaction. I ask this becuase just today I had my first confrontation with a coach giving gymnastics classes to 2 PA kids who possibly had just gotten done eating peanuts that he shelled himself. I was worried about oils on his hands and from the possibility of close contact through talking and holding while doing gymnastics.

On Jun 12, 2003

Danielle, I think you have a valid concern if the coach didn't wash his hands with soap and water after shelling peanuts. He could touch equipment and contaminate it with peanut oil and then one of the PA girls could come in contact with it. I've read that it is important to wipe up counters after making PB sandwiches for the same reason.

Samirosenjacken, Thanks for relaying the info from Dr. Wood. I just found out my 23 mo old dd had >100 on a CapRast and I'm still trying to understand all that it means. My allergist isn't as helpful (we're looking for a new one) but did indicate that she shouldn't be in an enclosed space with peanuts (airplane, circus).

Pamela

On Jun 12, 2003

My son broke out in hives all over his torso when my husband picked him up after eating a handful of peanuts. (these were from a can). Regardless, the coach should have already washed hands or be very willing to wash his hands-at least- before working with the kids! He shouldn't be eating on the mats or gym floor anyway!

As far as airborne, many would disagree with his attitude about airborne reactions. I was surprised that he didn't mention that when peanuts or shellfish are cooking they can be particularly problematic. The heating process actually releases the protein that is the allergen. (this is what I understood my allergist to say) When my son was 15 months old or so he had breathing difficulties shortly after passing a nut vendor in a park. My husband has breathing problems if he enters a kitchen where shrimp or other shellfish are cooking.

[This message has been edited by kstreeter (edited June 12, 2003).]

[This message has been edited by kstreeter (edited June 12, 2003).]

On Jun 12, 2003

That is a very interesting comment from him. What is his explanation for all of the people here who have related reactions from smell? And my concern with going to a ball park with people eating peanuts wouldn't be the smell, but the residue left all over the place. Were you happy with your visit overall? Because a blanket statement like that would have put me off a bit.

ETA: I read your post over again and you said your visit was wonderful, so I guess you really did like him. It's interesting that things can come across so differently in person, because obviously his manner in dealing directly with you made all the difference.

[This message has been edited by Kim M (edited June 12, 2003).]

On Jun 12, 2003

samirosenjacken, I'm glad you had a good visit w/ Dr. Wood. How encouraging to hear that the high test scores don't necessarily mean you are in for an anaphylactic reaction.

However.....Feel free to mention to the good doctor that if he is ever out in Southern California he has my invitation to come and meet a "myth" in person [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

I will say that my son does not react in a room where peanuts/peanut butter are sitting in a room untouched. I saw that at a See's Candy store, no reaction. However, when he is face to face w/ someone who has recently eaten peanuts or walks into a small room where others are eating peanuts, he does starting rubbing his eyes, sometimes his face flushes and once it affected his asthma. Thankfully his allergist believes me. At our last visit I was prepared to let him test it if he didn't believe me, but he does.

On a good note, we attended a picnic over the weekend where a ton of kids were eating pb&j (I didn't know it was being served until after we arrived) and my son did NOT react to anyone afterwards. Very encouraging! I think it did help that we were outside.

Again, he did not start out this sensitive, but has become so.

My invitation stands [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Thanks for sharing about your visit!

On Jun 12, 2003

Quote:

Originally posted by samirosenjacken: [b]I asked him about airborn reactions. His exact words were: AIRBORNE REACTIONS ARE A MYTH FROM THE INTERNET.[/b]

I would not trust this doctor. Airborne reactions are not a myth. I have had several when I entered a restaurant where everyone was eating peanuts in the bar area and throwing shells on the floor... sneezing, runny nose, cough. laryngitis.. that is a MYTH???

hmmm.. I think this doctor needs to reserach airborne reactions more.......

how does he explain what happened to me???????????????????

(yes, he said an enclosed environment has a greater risk so maybe he does beloieve in these reactions.. although saying they are a myth doesn't sound very believing to me)

On Jun 12, 2003

I understand that Dr. Wood is supposed to be well respected. However, I totally disagree with what he said about airborne reactions being a myth. I think we have many members here who could prove to him that airborne reactions are not a myth.

I think what really happens is that when our child/we have a reaction, we don't know where to report it to and even if we do (as I now know I can report it to Anaphylaxis Canada here in Canada), then the place that we report the reaction to doesn't tally up reactions, how they occurred, etc., so where exactly does an accurate reflection of reactions (and how they occurred) come from?

So far, I haven't found an answer to that question. I have e-mailed Anaphylaxis Canada (and posted about it here) and I haven't found a place that accurately keeps stats.

So, when I hear a Dr. saying something like this, I just figure he/she has not actually come into contact with a patient that has had an airborne reaction and thereby doesn't believe in them solely because of that.

How do we get our information out there? I'm not sure. But I do really feel this doctor was incorrect.

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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On Jun 13, 2003

Samirosenjacken, I'm glad your visit went well, but I did baulk at his assertion that airborne reactions are myths, especially if he then went on to say that people in enclosed areas are at greater risk - isn't that kinda contradicting himself?

I can understand that just the smell of pn BUTTER may not be as LIKELY to cause a reaction as say, SHELLED pn, but he needs to be more specific in his explanations. I once had a reaction when a friend opened a pack of dry roasted pn near me. I got hives up and down the arm closest to him, and he had not touched me. The only explanation I can come up with is the pn dust landed on me, ie, an AIRBORNE reaction.

Maybe what he meant was that PAs are not likely to react to the smell of pn butter, or someone eating a Snickers, for example, as opposed to breathing in the airborne particles from packs of pn or shelled pn?

Regards

Gwen [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

[This message has been edited by Gwen Thornberry (edited June 13, 2003).]

On Jun 13, 2003

My allergist essentially agrees with Dr. Wood about numbers and classes not meaning much - I don't even know what Kevin's numbers are. He says people with low numbers can anaphylax, and people with high numbers can have minor reactions.

I know that Dr. Wood is highly respected, but I beg to differ with him on the airborne issue. Kevin has had many airborne reactions including one to a friend's breath shortly after he had eaten M&M's. As my allergist says - forget the rhetoric and go by your clinical experiences.

Amy

On Jun 13, 2003

I think there may have been a misunderstanding concerning Dr. Wood's views on airborne exposures. Dr. Wood is a true expert in his field and I am confident that he does not view airborne allergies as a myth.

In reference to notes I took during a conversation with him two years ago: He told me that airborne reactions are indeed possible in closed areas (indoor sporting events, bars, circuses, airplanes, etc.) and to watch out at such places. He said you would probably be ok at open venues.

What he said was the myth was having a reaction from merely opening a jar of peanut butter. Because there is no dust, he said a reaction from merely opening a jar would not be possible.

I hope that this clears up his views on the matter.

On Jun 13, 2003

I think airborne and smell are two different things. Did someone write recently that the smell of a thing does not come from the protein of that thing? The protein in peanut is what causes a reaction.

My son reacted to the air in a room and did not smell peanuts. I am still trying to talk him out of that reaction but I heard his voice and I heard the swollen airways.

I do not know what to think now but my son is going to avoid peanuts period. He is not going to knowingly walk by peanuts if he can help it. Nothing is going to change until he decides to give it a try himself.

My allergist said airborne peanut can get into your eyes as well as your airways. I read when I first started my research that someone can react to a NEW jar of PB being opened in their vicinity. Is it releasing peanut when the seal is broken?

Who knows but my son will continue to avoid any contact with peanuts till proven otherwise.

And thank you so much samirosenjacken because we need this kind of information to make infromed decisions. I now have new questions to ask our allergist in two weeks.

Peggy

On Jun 13, 2003

Quote:

Originally posted by Love my C: [b]

However.....Feel free to mention to the good doctor that if he is ever out in Southern California he has my invitation to come and meet a "myth" in person [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

Thanks for sharing about your visit![/b]

Love My C,

I live in Los Angeles. Where is your allergist in Southern California? Do you know of any support groups in So Cal? Peg

[This message has been edited by Peg541 (edited June 13, 2003).]

On Jun 13, 2003

Peg, Just sent you an e-mail [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Jun 13, 2003

Thanks Love my C. Peg

On Jun 13, 2003

Kami's mom...

That is EXACTLY what he said. He did use the word MYTH and not me but his explanation was as you put it and I tried to put it. He did not dismiss airborne but it's not to the SMELL of Peanut butter b/c there is no dust in PB. That is what I was trying to convey.

On Jun 13, 2003

Quote:

Originally posted by Cindy Spowart Cook:

Just wanted to say I'm glad to see you back here!

On Jun 13, 2003

Peg541,

I believe it was me who wrote that "peanut smell" does not contain the allergen. The allergen is a set of proteins. Proteins in and of themselves are not volatile. In order for them to become airborne, some sort of energy must be added (heat from cooking) or mechanical means used(grinding, crushing, breaking and crushing shells, etc.). Corvalis Mom has indicated that it is physically possible that minute amounts of protein can enter the air spontaneously through a natural process called sublimation. However, we are talking about amounts so small that it would be difficult to measure with the best technology (on the order of parts per trillion). And then, only a portion of that amount would actually contain the allergen. Of course this is all conjecture because the experiments have never been done.

My hypothesis is the smell can actually trigger a protective, hyper-allergic response in PA individuals. Technically, this is a psychosoamtic effect but that does not mean it isn't real. It just means it is triggered by the brain's response to a stimulus. I have explained my hypothesis elsewhere on the boards.

Our allergest had the same response about airborne reactions. But knowing doctors and being a biologist, I can't accept his blanket statement without scientific proof.

Troy

P.S. by the way, this doctor doesn't even do RAST tests because he believes the numbers are so useless. He doesn't want his patients with low values walking out the door thinking they don't have to be careful.

On Jun 13, 2003

Sorry, no time to figure out using the quote function properly here to quote choguy.

"In order for them to become airborne, some sort of energy must be added (heat from cooking) or mechanical means used(grinding, crushing, breaking and crushing shells, etc.)."

As in....Chewing peanuts (grinding) and talking in close proximity, is expelling the air in your mouth (energy) which contain the proteins!

I have seen it happen. My son didn't know people were eating peanuts. He doesn't know what they smell like-never eaten them. It was NOT a psychosomatic reaction.

On Jun 13, 2003

Quote:

Originally posted by Love my C: [b]I have seen it happen. My son didn't know people were eating peanuts. He doesn't know what they smell like-never eaten them. It was NOT a psychosomatic reaction.[/b]

Hi Love My C,

What Troy was saying is that the pure smell of peanut butter may cause a psychosomatic reaction (I may be mis-interpreting his comments but I am taking my best guess).

However, he did say that mechanical, grinding, etc processes would release peanut protein in the air thereby possibly causing a non-psychosomatic reaction.

I guess the point people are making is that it is the peanut protien itself that causes the reaction (ie: traces of peanut dust in the air) rather than the pure smell itself causing the reaction.

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

On Jun 13, 2003

Who and where is Dr. Wood? Angela

On Jun 13, 2003

Thanks, eric. I see what you are saying.

I think what drives me crazy is when people say you can't react to "smell" and while technically I can understand that statement, most people take that to mean that it isn't possible to react to peanut particles in the air. Most people understand that to be one in the same.

If my son is sitting next to a child eating a peanut butter oreo -which he has- and it triggers a reaction in him-which it did-and they argue that it is impossible for him to react-it just drives me a little crazy.

I think I'd deal w/ this a little better if it were me w/ the allergy and not my son. It's hard enough to understand the allergy as an adult, but to try to teach a little one how to recognize symptoms to an unseen allergen and protect himself, it gets a bit nervewracking. Especially when they have asthma as well and you're getting ready to send them off to school. [img]http://uumor.pair.com/nutalle2/peanutallergy/frown.gif[/img]

Thanks for your input. I really appreciate your responses and participation on this site [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On Jun 13, 2003

Thank you Erik for a fine job of paraphrasing me. Peanut smell ALONE is quite different from somebody spitting, coughing, sneezing, and exhaling saliva droplets full of minute pieces of peanuts (sorry to be so graphic). Even exhaling could release warm, moist air with small amounts of peanut protein from somebody who has been eating them. My example is the open, undisturbed jar of peanut butter or the untouched peanut sitting on a table.

I dislike using the word "psychosomatic" because it has so many negative conotations thanks to the medical establishment, but it is technically/scientifically correct. Consider the following definition from Webster's: "of, relating to, concerned with, or involving both mind and body." This is the context I am using the word. Hardly negative and very much real. I wish everyone would think of this definition the next time they read "psychosomatic" rather than thinking, "he says it's all in my head."

Thanks again Erik and I truly believe there could be a rare reaction generated by smell alone.

Troy

On Jun 13, 2003

samirosenjacken, thanks for asking about the amount of peanut it would take to cause a reaction. Guess there's no way to know.

About the airborne thing, Dr. Wood said that "airborne reactions are a myth" but then went on to say that a reaction from pn dust is quite possible in an enclosed environment. Sounds like he wasn't clear on his definition of airborne. If he meant smell, he should have been very clear. Still, it's good to know. I let Ben be around people eating pb, and we have gone to baseball games with peanut shells all over. Of course, Ben's never reacted, so people shouldn't just from our experience.

On Jun 13, 2003

Quote:

Originally posted by angelahensley: [b]Who and where is Dr. Wood? Angela[/b]

Dr. Robert Wood is of Johns Hopkins University in Baltimore, Md and often quoted as a source for food allergies. Here's a few: [url="http://www.fankids.org/FANKid/School/caq.html"]http://www.fankids.org/FANKid/School/caq.html[/url] [url="http://recipestoday.com/resources/articles/pnutallergy.htm"]http://recipestoday.com/resources/articles/pnutallergy.htm[/url] (this also mentions pa.com)

On Jun 13, 2003

Since we are discussing airborne reactions, it is true that it is frustrating when people say they are impossible. For example, if you tell Aunt Clara and Uncle Elmer that you don't want them eating peanuts at your home because your PA child could react to traces of peanut protein in the air ... and then they give you this weird disbelieving look.

Here are a few links that you can show the disbelievers:

======================================

[i]...Moreover, notes Hugh Sampson of Mount Sinai Medical Center in New York, trace contamination of commercial products with peanut proteins is common. At a press conference in Denver this week, he noted that among companies making foods or other goods with peanuts or their derivatives, up to one-quarter of their other product lines may carry traces of peanut, which go unnoted on labels. This happens when equipment isn't completely cleaned before use on peanutfree-product runs, [b]or residues of the legume become airborne in a factory and settle onto supposedly peanutfree goods. [/b][/i]

Science News On-Line

[url="http://www.sciencenews.org/20030315/food.asp"]http://www.sciencenews.org/20030315/food.asp[/url]

=================================================

[i]...People have been known to go into anaphylactic shock after breathing in airborne particles of shellfish or fish allergen in open fish markets. [/i]

The Anaphylaxis Campaign (an independent charity guided by leading UK allergists)

[url="http://www.anaphylaxis.org.uk/common.html"]http://www.anaphylaxis.org.uk/common.html[/url]

==================================================

[i]Q: Have you heard of a peanut allergic person having a serious or fatal reaction just to the smell of peanut/peanut butter?"

A: Yes. We hear such stories not infrequently. Usually we can't be sure the real mode of contact was not traces of peanut material on surfaces such as furniture. We have however had [b]a sensible seven-year-old hospitalised for a peanut reaction after standing next to a friend who was eating peanuts[/b]. The lass was very clear in denying any direct contact or handling of materials handled by the other girl. This could have been aerosol drift rather than the smell. The fact is that some people do react without any obvious contact.[/i]

Asthma and Allergy Information and Research (AAIR)

[url="http://www.users.globalnet.co.uk/~aair/nut_corr.htm"]http://www.users.globalnet.co.uk/~aair/nut_corr.htm[/url]

===================================================

[i]...During 10 PN allergic inhalation reactions, >25 passengers were estimated to be eating PN at the time of reaction. Initial symptoms generally involved the upper airway with progression to skin (w further lower respiratory reactions (no gastrointestinal symptoms). Two subjects were given epinephrine in flight. Asthma was previously diagnosed in 6 patients.[/i]

John Hopkins Allergy and Asthma

[url="http://www.hopkins-allergy.org/news/articles/1999/aaaai/aaaai99_abstract29.html#Top"]http://www.hopkins-allergy.org/news/articles/1999/aaaai/aaaai99_abstract29.html#Top[/url]

====================================================

[This message has been edited by erik (edited June 13, 2003).]

On Jun 14, 2003

Okay, I think I clarified in my head the difference between airborne and smell (and the reactions thereof).

I know that there is another thread running on this topic and wasn't clear where to post this, but I was re-reading this one second so posting here.

I remember a couple of years ago, Claire posted here about an experience her son Christopher had. Her non-PA daughter was allowed to eat her unsafe (to PA people) Hallowe'en candy with very strict rules in place (i.e., handwashing, teeth brushing, etc.).

Christopher was working at his desk, I believe, and his sister merely walked by him on her way to clean herself up (I'll have to see if I can find the Hallowe'en thread or the thread with the story in it) and Christopher had a reaction.

It would not have been an airborne reaction (i.e., to particles in the air). It would have been a smell reaction.

Isn't that why, when (if) we choose to show our PA children a jar of pb, we don't open the jar, we just let them peer at it through the plastic/glass?

I think there are a great number of people that react to residue/airborne/smell. I just don't think, as I posted originally, that everyone automatically knows that they are supposed to contact someone when they or their child have a reaction and even then, as I was told by Anaphylaxis Canada, because we parents are considered lay-people, not doctors, and the reaction was witnessed by us, not professionals (i.e., doctors), it's almost heresay to an allergy association if we report a say residue reaction.

I can report a residue reaction to Anaphylaxis Canada for Jesse for December month last year. However, essentially what they've said to me is that that's all well and good BUT you're not a doctor and how can we prove 100% that it was a residue reaction and not something else?

So, how do they get stats and then how do they decipher what stats they would like to consider accurate?

I think bottom line is that we know for ourselves here, from our experiences with either ourselves (for the big people posting, erik [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img] ) or our children, that airborne/smell/residue reactions DO occur whether or not anyone in allergy association power is willing to hear us or not.

I would love it if there was somewhere where you could report a reaction and the type of reaction would not be questioned because you, the parent, are not a doctor. I would love to see some accurate statistics. But so far, I have yet to find anywhere where you can get them.

That's why I always question when I hear the percentage of PA children/people. How do you (whoever states it) know that? Where does that figure come from?

Now, I did recently *register* Jesse with Anaphaylaxis Canada as being anaphylactic to peanuts. So, is he included in stats issued by Anaphylaxis Canada now?

Actually, I think I'll post this in the other thread as well so it's in both.

Even here, in PA.com, to get an accurate reflection of the number of reactions and types of reactions, every member would have to participate. Or do you think we could simply ask the question and tally up the results based on the number of people that do answer the question? I'm willing to do it.

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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On Jun 14, 2003

Erik, thanks so much for sharing that research. This helps so much when my son explains his own airborne reaction!

And samiroenjacken please don't take this as us not believing you or anything against you. Many of us have dealt with airborne reactions we need recognized and respected. Thank you for bringing this information to us.

Peg

[This message has been edited by Peg541 (edited June 14, 2003).]

On Jun 15, 2003

Quote:

Originally posted by Cindy Spowart Cook: [b]So, how do they get stats and then how do they decipher what stats they would like to consider accurate?

I would love it if there was somewhere where you could report a reaction and the type of reaction would not be questioned because you, the parent, are not a doctor.

I would love to see some accurate statistics. But so far, I have yet to find anywhere where you can get them.

... do you think we could simply ask the question and tally up the results based on the number of people that do answer the question? I'm willing to do it.[/b]

This is an issue that is near and dear to my heart, and one I often post about. In my mind, documentation is the key. (And, BTW, this is where the "debate" thread ended. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] )

My husband and I are very committed to documentation and this is what we, personally, do:

1. Take photos of Mariah's reaction whenever possible. 2. Write down what happened~ the circumstances and the symptoms. (I keep mine on my computer so that I can easily update.) 3. We call each reaction in to our allergist. Every time. Even the mild reactions. 4. We confirm that our school nurse documents any reactions (and any asthma symptoms) that occur at school. She sends her own documentation to our allergist just prior to our visits w/ him. This becomes part of her medical chart. 5. At our regular appointments w/ the allergist, twice a year, I bring in my documentation (printout and photos) so that this information also becomes part of Mariah's medical chart.

Our allergist says he really appreciates all this documentation. He uses it when he attends conferences.

Personally, we think this documentation is the parents' responsibility and should be directed to our allergist/physician. We need our physicians to take forward our experiences to the appropriate places. I used to also report reactions to FAAN, but since they don't keep this information, I stopped.

BTW, I don't mean to discourage anyone from sharing experiences about reactions here, on PA.com. I think it is very helpful and valuable to share our experiences here. But in terms of documentation, I think our physicians are the key. JIMHO, Gail

On Jun 15, 2003

You are so correct Gail. I am sending a list of DS reactions including his "airborne" reaction to his allergist tomorrow! We are the keepers of the flame and we need to pass our information on. Most of us are as well informed as our allergists!

Peg

On Jun 16, 2003

Thank you Peg. We [i]are [/i] the "keepers of the flame". I believe it is our [b]duty [/b]as parents of children with PA to make sure we document as much as possible, and to work closely w/ our allergists to convey this information accurately. If we don't, then who will?

On Jun 16, 2003

I know Dr. Young (author of the Peanut Allergy Answer Book) feels the same way - no such thing as smell reaction. I have heard first hand experiences to the contrary, however.

On Jun 16, 2003

Quote:

Originally posted by Heather2: [b]I know Dr. Young (author of the Peanut Allergy Answer Book) feels the same way - no such thing as smell reaction. I have heard first hand experiences to the contrary, however.[/b]

I think the question is:

How do you know that the smell does not contain traces of peanut protein? If I walk into a restaurant where they are roasting peanuts and I smell peanut in the air, how do I know if the smell is 100% free of peanut protein traces? My question is how would we know the smell is safe as how would we determine the smell is peanut protein free?

Kind of like how do we know if a certain peanut oil is safe, as how do we determine if the oil is peanut protein free?

That's why so many of us avoid peanut smell (and avoid peanut oil) even though they may not be dangerous in every instance (but we would never know for certain).

[This message has been edited by erik (edited June 16, 2003).]

On Jun 16, 2003

[quote]Originally posted by erik: [B] I think the question is:

How do you know that the smell does not contain traces of peanut protein? If I walk into a restaurant where they are roasting peanuts and I smell peanut in the air, how do I know if the smell is 100% free of peanut protein traces? My question is how would we know the smell is safe as how would we determine the smell is peanut protein free?

Roasting peanuts = adding energy that could volatilize peanut protein. You are correct: if you smell peanuts you could never be sure if it comes from roasting peanuts, somebody's breath/sneeze, or just an undisturbed PBJ sandwhich. It is much safer to just get out when the smell is around (especially indoors).

A retrospective analysis of cases presented in the ER is not sufficient due to the many questions of environment and mode of exposure. This debate can never be settled (or MD's educated) until a controlled study is completed. This is the type of study FAAN or similar group should be funding. Of course, then the issue becomes who would volunteer their children for such a study? I know I wouldn't feel comfortable. We're left with indirect studies of trying to measure peanut protein in the air. Like I said, I'm sure something is happening here I'm just not sure what the mode of action is.

Troy

On Jun 16, 2003

Originally posted by choguy: [b] "This debate can never be settled (or MD's educated) until a controlled study is completed. This is the type of study FAAN or similar group should be funding." [/b]

Amen brother! I think if we keep reporting our experiences to our allergists, this type of controlled study is more likely to happen. Don't you think?

Originally posted by choguy: [b]"Of course, then the issue becomes who would volunteer their children for such a study? I know I wouldn't feel comfortable." [/b]

I would. Am I the only one? I look at it similarly to a food challenge. Lots of kids undergo food challenges. Tho my daughter has never undergone a food challenge (because she is clearly too allergic), she did have an "open air exposure" challenge by her allergist at Washington University, and is going to have a "touch" type of a challenge this summer. Both of these "challenges" (airborne and touch) are/will be controlled and conducted in a hospital.

I truly believe that our allergist's willingness to work with us in this manner is due (in part) to our detailed documentation of our dd's reactions and communication w/ him. Again, I believe working closely w/ our doctors is the key to obtaining the type of research study we all desire and would benefit from so greatly.

Gail

[This message has been edited by Gail W (edited June 16, 2003).]

On Jun 16, 2003

Dr. Young pens the article on this very subject in the latest FAAN newsletter. My dh, who I often feel slacks on persuing allergy info, actually caught this and read it aloud to me. He found it very interresting. In all, I found it undermined the validity of peoples' reported airborne reactions or smell reactions. He did address the differences and some true biologic phenmena that explain reactions to smell.

I have medical training and training in research as part of it. There is a basic belief in conventional medicine(which I get annoyed with) that until it is scientifically proven, it does not exist. I did not have time to read everyone here, so excuse me if I am repeating what has been said! becca

On Jun 16, 2003

Quote:

Originally posted by Heather2: [b]I know Dr. Young (author of the Peanut Allergy Answer Book) feels the same way - no such thing as smell reaction.[/b]

Dr. Young authored the lead article in the June/July FAAN newsletter.

Re peanutBUTTER, he states, "...a recent blinded, placebo-controlled trial of children exposed to open peanut butter was unable to document any reactions. (Sicherer et al)"

He then goes on to comment on "airborne" and "aerosolization" exposures, and says, "The presence of peanut protein in the filters of commercial airliners was documented in a study from the mayo Clinic in 1996, confirming the possibility of airborne exposure." He talks about food preparation, steaming,etc

"In summary, inhalation of peanut protein can cause allergic reactions (but usually not systemic anaphylaxis), while odors can cause conditioned physiologic responses."

On Jun 16, 2003

Forgive a newbie for jumping in...

There's an article about this in the latest FAAN newsletter. That article (1) acknowledges that inhaling peanut proteins can cause reactions and (2) suggests smell-only reactions may be psychosomatic (as in the Pavlov's dog response).

IMHO this distinction is a bit academic. The author doesn't offer a practical way to distinguish between symptons of a reaction resulting from the presence of protein and "psychosomatic" symptoms resulting from a conditioned response to smell (Patient's brain: I smell peanuts, therefore I should be having a reaction, so I will.)

Assuming both of the article's points to be true (and acknowledging that's a big assumption for people with experiences to the contrary!), should I be confronted with DS exhibiting signs of an airborne reaction in say a store, would I:

a. assume these to be psychosomatic symptoms and give no treatment?

or

b. treat like symptoms of a reaction and provide appropriate treatment?

Given all the clear evidence I've seen on the importance of immediate access to epinephrine, I think I'd go for (b) as the less risky route.

T.

On Jun 16, 2003

I was writing when Gail W posted her message. (Not a fast typer...) She's referring to the same article I did in my original post.

T

On Jun 16, 2003

Gail W., I think documentation of our children's reactions and giving them to their allergists is excellent if the allergists are going to do something with the information. Well, actually, it's good regardless, but it would be great if the allergists actually did something further with the information they were given.

I do document each of Jesse's reactions, but haven't done the photo thing.

However, we don't have an allergist to share this with (and I don't feel the need for an allergist for him at this point in time).

Even if we did and I gave the allergist the information and then the allergist didn't share the information with anyone else, again how is accuracy of percentage rates of PA children and types of reactions actually gathered?

Truth be told, I think PA.com is the best place to put the information. Even though it comes out in individual threads, individual stories re each child's reaction, at least it is getting put somewhere for other people to see (other than our child's allergist) so that people do see that yes, airborne reactions happen, yes, smell reactions happen, yes, contact reactions happen, yes, cross-contamination reactions happen.

I think most of us, when posting about our children's reactions have been pretty detailed in our experience and let other people, if only other PA parents (which I consider the *most* important) know that yes, this did happen to me/my child and why it happened and perhaps we can even prevent another family from experiencing the horrors that some of ours have (i.e., that's why I keep posting so that no one will have a child nearly die on them from parental ignorance/denial like Jesse almost did).

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

------------------

On Jun 16, 2003

Cindy,

I am hesitant to disagree with you since one of my posts resulted in your absence for some time. I will respond to you with added care and w/ my sincere respect.

I think there are basic 2 ways that the information channels work (sort of, I know I'm being overly simplistic). One way is top-down: physicians read the studies and then apply it to their patients. The other way is down-up: physicans observe issues from their patients/practices and use this "anacdotal" evidence to bring forward new questions to research.

Originally posted by Cindy Spowart Cook: [b]"Gail W., ...Even if we did and I gave the allergist the information and then the allergist didn't share the information with anyone else, again how is accuracy of percentage rates of PA children and types of reactions actually gathered?[/b]

Yes, I agree that this is frustrating. PA is different than say [i]communicable [/i] deseases (like pneumonia, STDs, AIDS, SARS, influenza, etc) whereby healthcare facilities must compile and report stats to their state's Department of Public Health (and ultimately to the CDC~ Centers for Desease Control). Instead, data is proactively collected from surveying. FAAN conducted a big random sample survey a few years ago w/ the goal of trying to more accurately estimate the (then) current % of children w/ PA. I'll try to find it and post the link for you.

Originally posted by Cindy Spowart Cook: [b]"...I think PA.com is the best place to put the information. Even though it comes out in individual threads, individual stories re each child's reaction, at least it is getting put somewhere for other people to see (other than our child's allergist) so that people do see that yes, airborne reactions happen, yes, smell reactions happen, yes, contact reactions happen, yes, cross-contamination reactions happen." [/b]

Is PA.com "the best place" to report reactions? I agree that this is absolutely helpful on an individual basis. Personally speaking, the information here has helped me tremendously.

But I'd hate for PA.com to be the [b] only[/b] place members report thier experiences. I'd hate to see members here discouraged from reporting their information to their physician because it might not be passed on. Or think that reporting it here somehow replaces the need to report it to their physician.

PA.com is a great place to post our experiences. No doubt! Keep 'em coming.

But I will again appeal to members here to report their experiences to their physicians so that they have accurate information. If we don't, how can we expect them to advocate on our behalf? If we don't, they can only operate under the false assumption that our experiences do not exist. Or that such experiences are "myth from the internet".

Gail

[This message has been edited by Gail W (edited June 16, 2003).]

On Jun 16, 2003

I know this is irrelevent to peanuts but does have to do with airborne reactions. I am severely allergic to bananas. I used to eat them constantly and then each time I ate them I would get a slight reaction, swollen lips, itchy mouth etc. It got worse each time and I stopped eating them.

One day while babysitting I was feeding the kids lunch, everything was fine and then one of the kids opened a banana across the table from me and I immediately broke out in hives, my face swelled, my eyes were almost swelled completely shut. Worst allergic reaction Ive ever had. Cant imagine what would have happened if id actually ingested any.

Now I did not touch it, there is NO dust from bananas, she didnt touch anything else that I touched, It was plain and simple from the smell. It was not in my head because I had no idea I could react that bad to something Id eaten all my life. So they can say it is a myth , obviously because it hasnt happened to them.

I think that since so many people claim smell reactions maybe they could take it a little more seriously. Every illness, disease, reaction, etc. had to be proven at one point and there were unwittnessed cases.

On Jun 16, 2003

Quote:

Originally posted by momma2boys: [b]I think that since so many people claim smell reactions maybe they could take it a little more seriously. Every illness, disease, reaction, etc. had to be proven at one point and there were unwittnessed cases.[/b]

[img]http://uumor.pair.com/nutalle2/peanutallergy/biggrin.gif[/img] Exactly.

On May 23, 2005

Quote:

Originally posted by Cindy Spowart Cook: [b]I can report a residue reaction to Anaphylaxis Canada for Jesse for December month last year. However, essentially what they've said to me is that that's all well and good BUT you're not a doctor and how can we prove 100% that it was a residue reaction and not something else?

So, how do they get stats and then how do they decipher what stats they would like to consider accurate?

[/b]

Yes. I completely understand. [i]I've asked similiar questions.[/i] [img]http://uumor.pair.com/nutalle2/peanutallergy/cool.gif[/img]

On May 24, 2005

Quote:

Originally posted by samirosenjacken: [b] I asked him about airborn reactions. His exact words were: AIRBORNE REACTIONS ARE A MYTH FROM THE INTERNET.

He said the smell of peanut butter will not cause an airborne reaction. [/b]

Samirosenjacken, is it possible that he might have said that "Airborne reactions to peanut butter..."(not just in general) "... are a myth from the internet."? By any chance could you have misconstrued his words? If so, this really changes everything about the statement.

I truely believe that this is what he meant to convey. I have heard him talk about airborne reactions before (as you said, airlines and restaurants) not denying that they can certainly happen in certain situations.

I feel that everyone here is jumping to conclusions over what you quoted him as saying.

I mean this in no offense to you. I'm just trying to look at the possibility that you may have innocently misunderstood.

On May 24, 2005

Silly me. Didn't realize that this was a topic from two years ago and was responding as though it was from today. I guess my comments in my last entry are kind of irrelevent at this point. [img]http://uumor.pair.com/nutalle2/peanutallergy/redface.gif[/img]

On May 24, 2005

No, it's really not irrelevant, and I really liked the way you expressed your viewpoint. This is a topic that comes up often, so I don't think a thread on this subject is ever outdated.

On May 25, 2005

Thank you Sandra Y. It's just that when I first read it I thought it was a recent, heated discussion and that everyone was losing respect for this man who really IS one of the best out there. He has been behind many of the studies that have given us facts that we really have needed to know about PA. What would we still not know if it weren't for him? It really worried me that people were outright doubting him based on how one person quoted him. He was not present in the conversation to explain his words which could have easily been misinterpereted.

Again thanks for understanding my point.

On May 25, 2005

When our daughter was two-years-old, too young to know anything about peanuts and by-products, we walked into a store that was grinding up peanut butter. Within minutes she had a reaction. A few months later she reacted to a pb sandwich a neighbor was eating. Again both times she was unaware that the substance was around and too young for a psychosomatic reaction.

Just thought I'd throw that out there.

On May 25, 2005

Two years later, surprised to see this thread up and running.

Jesse has not had a reaction since my original posts in this thread.

If and when he does (touch wood he doesn't), I will report the reaction to Anaphylaxis Canada. I may even report it to NASK.

I will post about it here. I will post the responses that I get from those organizations here.

Jesse does not have an allergist and I don't feel the need for him (or his sister) to have one. If they did, I would also report the reaction to the allergist.

I think it depends on the doctor whether the information gets diseminated (can't spell it right now) or not.

I know that with another health concern of Jesse's his doctor told me that Jesse was now a "case study" that he speaks about when he goes to conferences because what had happened with Jess had never been seen in his profession before.

So, certainly, he has put to positive use (I believe), my son's experience.

Totally agree (and not sure why it was even unclear [img]http://uumor.pair.com/nutalle2/peanutallergy/confused.gif[/img] ) that yes, report it to your allergist, family doctor, pediatrician.

I'm simply unclear as to what these professionals do with the information, if anything.

Just as I still remain unclear as to what Anaphylaxis Canada does with the information, yet I still report reactions to them.

Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

On May 25, 2005

actually, since we are STILL talking about it..

Yes, Dr Wood meant airborne SMELL with peanut butter. NOT airborne peanuts. I thought we had clarified that back 2yrs ago when this post originated.

He actually restated this position at the conference this year that the smell of peanut butter can make a peanut allergic individual feel sick.. but it's not an allergic reaction simply to the smell of peanut butter. The protein is what is causing the reaction and he says there are no proteins being released in a jar of peanut butter.

On May 25, 2005

Thank you for clearing that up for me! I appreciate it. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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