Food Allergy Counseling

Food Allergy Counseling
Sloane Miller, Food Allergy Counselor (Picture © Noel Malcolm 2013)

Saturday, March 30, 2013

Surf Sweets, Review


Disclosure: Unlike Ronald Regan, I’m not a huge jellybean, sour gummy candies nor gummy bear lover. But as I know many of you are, I wanted to try Surf Sweets to report back my findings for you. I’ve heard about Surf Sweets for years from the food allergy community – what a beloved candy manufacturer Surf Sweets is! And I can see and taste why.  Genetically Modified Organism free, gluten-free, casein-free, tree nut free, peanut free – these are treats everyone can enjoy. I taste tested Surf Sweets’ jellybeans, gummy bears, sour berry bears and fruit bears from samples sent to me by Surf Sweets. I liked everything - in truth, they all tasted similar to me flavor profile wise, the major difference was texture - but all delish!

Looking for an option for this coming Easter holiday? Contact Surf Sweets for more info. Looking for some allergen-friendly jellybeans to have on hand, Surf Sweets is a great option. Thank you, Surf Sweets!

Friday, March 29, 2013

Auvi-Q




On January 28, 2013, the Auvi Q epinephrine autoinjector was launched in the United States. Here is the press release from the manufacturer Sanofi US and a quote about this new delivery system for epinephrine, the first line treatment for severe allergic reactions i.e. anaphylaxis: "Auvi-Q is the first-and-only epinephrine auto-injector with audio and visual cues for the emergency treatment of life-threatening allergic reactions in people who are at risk for or have a history of anaphylaxis. The size and shape of a credit card and the thickness of a smart phone, Auvi-Q is a breakthrough in epinephrine auto-injector device design that talks patients and caregivers step-by-step through the injection process."

The Auvi-Q is the brainchild of food allergic twins, Eric and Evan Edwards, who have experienced anaphylaxis and whom I interviewed back in 2008 for Healthcentral.com. Here is the February 2013 New York Times story about them and the launch of the Auvi-Q: "Brothers Develop New Device to Halt Allergy Attacks".

According to Sanofi US: “This new Epinephrine Autoinjector provides users with audible and visual cues, including a five-second injection countdown and an alert light to signal when the injection is complete. Auvi-Q also features an automatic retractable needle mechanism to help prevent accidental needle sticks.”

Sanofi US sent me an Auvi-Q trainer to try. There has been much online discussion about the size being the great selling point. Here it is on my desk, next to my library card and my iMac mouse to see the scale.


The size and shape are novel features, ones that may help previously reluctant patients (like teenagers) carry epinephrine autoinjectors; however, that remains to be seen over the coming months.

For me, the voice commands is of equal value as a novel feature, one that may have greater ramifications. (You can listen to a demonstration here on the Auvi-Q website.) I couldn’t help but think of friends and family, even good Samaritans, who want to help and yet who are completely unfamiliar with epinephrine or autoinjectors. This calm voiced-feature on the Auvi-Q device, telling you how to administer the epinephrine, especially in a high-pressure emergency situation like a severe food allergic reaction, might mean that the device will be used more readily; however, that remains to be seen over the coming months, as well.

One issue I have with the product is one of the supporting documents: the Auvi-Q anaphylaxis action plan. Here is the anaphylaxis action plan created by Auvi-Q. (NB: I have been in contact with the Sanofi US team about my concerns and they have been quick to respond and to look into the matter.)  My problem is with the list of “other” symptoms. Without a qualifier that symptoms show up after exposure to known allergens and/or that anaphylaxis is defined as involving two bodily systems, I fear that those newly diagnosed might be confused about the definition of anaphylaxis and when to administer epinephrine.

*Here are the National Institute of Allergy and Infectious Diseases Guidelines for the Diagnosis and Management of Food Allergies in the United States and the definition of anaphylaxis is on page 25.*   
 
If you are unclear about this Auvi-Q anaphylaxis action plan and have the Auvi-Q device, please consult your board certified allergist about your personalized anaphylaxis action plan.

***

Have you or your family purchased the Auvi-Q? Tell me what you think!


Wednesday, March 27, 2013

10 Tips for Traveling With Food Allergies


Just in time for spring travels, check out the article I wrote for Parenthood.com called: “Tips For Traveling With Food Allergies”

Have more questions?

1. My book, Allergic Girl: Adventures in Living Well with Food Allergies has an entire chapter about traveling and your can purchase it online or in stores; 

2. For free, have a scan through at some past blog posts in the free library on my allergicgirl.com website;

3. Or for a fee that works within your budget, contact me about a short food allergy coaching program today to get your food allergic ones the road to adventures and fun!

Friday, March 22, 2013

Food allergy Coaching Chronicles

The week of April 1, 2013, I’ll start a new series of blog posts called: The Food Allergy Coach Chronicles.

These blog posts will detail useful coaching tools, life strategies in action and food for thought about living your best food allergic life.

Stay tuned for more!

Wednesday, March 20, 2013

International Study, Flying with Food Allergies

Matthew Greenhawt, M.D., M.B.A., M.Sc., of the University of Michigan’s Food Allergy Center and C.S. Mott Children’s Hospital has authored a new study about the risks of flying with a peanut or tree nut allergy published in the Journal of Allergy and Clinical Immunology-In Practice called: International Study of Risk-Mitigating Factors and In-Flight Allergic Reactions to Peanut and Tree Nut.  [Disclosure: Greenhawt is a colleague and wrote about theories of the rise of food allergies in my food allergy lifestyle guide Allergic Girl: Adventures in Living Well with Food Allergies published by John Wiley & Sons in 2011.]

Here is a New York Times Well column about the study: Wisdom From Flyers With Nut Allergies.

And here's more information from a press release from the University of Michigan about Journal of Allergy and Clinical Immunology-In Practice study: International Study of Risk-Mitigating Factors and In-Flight Allergic Reactions to Peanut and Tree Nut:  

“Greenhawt, and his co-authors from Allergy & Anaphylaxis Australia and the International Food Allergy & Anaphylaxis Alliance, asked passengers to answer an online survey about their in-flight experiences.  More than 3,200 people from 11 countries completed the survey. Of those, 349 reported having an allergic reaction during an airline flight.”

The actionable items for all of us flying with a severe food allergy: “Flying with a peanut/tree nut allergy is equal parts frustrating and frightening for allergic passengers.  These eight passenger-initiated risk-mitigating behaviors may help clinicians wishing to advise concerned patients planning to fly commercially,” says Greenhawt, of U-M’s Food Allergy Center.

Passengers with peanut/tree nut allergies who reported taking these actions had significantly lower odds of reporting a reaction:
 

(1) requesting any accommodation
(2) requesting a peanut/tree nut-free meal
(3) wiping their tray table with a commercial wipe
(4) avoiding use of airline pillows
(5) avoiding use of airline blankets
(6) requesting a peanut/tree nut-free buffer zone
(7) requesting other passengers not consume peanut/tree nut-containing products 

(8) not consuming airline-provided food"

Have more questions? Contact your board certified allergist about the risks of commercial flying for your food allergic loved one. You can find allergists through your health insurer, American Academy of Allergy, Asthma & Immunology or American College of Allergy, Asthma and Immunology.

And, Allergic Living magazine had an updated airline and allergen policies chart here.

Monday, March 18, 2013

Response to Food Allergies in the New York Times

The last few days have a been a whirlwind of emotions for the food allergy community. First there was the article in the New York Times called The Allergy Buster as well as a Q&A with the author and food allergy mom on the New York Times blog. In the aftermath of The Allergy Buster's publication, there have been some very thoughtful responses in the on-line discussions, in particular from three of my colleagues.

Dr Jennifer Kim of Mount Sinai Jaffe Food Allergy Institute wrote a response and you can read it on the Jaffe Facebook page. An excerpt: "RE: 'mortality rate is estimated at roughly 1 in 1,000' This is not an evidence-based statistic and was a guess for a specific and highly sensitive patient. We don't have good statistics in truth about fatal food anaphylaxis but registries suggest it is much, much less than the frequently touted 100-200 per year."

Dr Michael Pistiner of AllergyHome.org, with whom I conducted an online Webinar last week for Kids with Food Allergies, wrote a response and you can read what he had to say on the AllergyHome.org Facebook page. An excerpt: "There have recently been talk shows and news stories that are emotionally powerful, discuss the challenges of having a food allergy and present a new 'treatment'. Again, these experimental protocols have exciting potential but are experimental and there is still much to learn."

Dr Wayne Shreffler of the Food Allergy Center at MGH (their Facebook page is here) wrote a formal response. An excerpt: "While food immunotherapy is a promising research treatment, it is still burdensome and risk-laden for patients. The anecdotal reporting of outcomes in these two safety studies, encouraging as they may be, removes them from the larger research context. Currently available data from the small but growing number of studies specifically designed to
evaluate the lasting  efficacy of food immunotherapy remain inconclusive and point to the need for more work."
You can read the full response here.

All of this to say is that I know many of you were excited by the The Allergy Buster article and the promise it seems to hold and then felt dashed by these responses as well as more stories coming out of the American Academy of Asthma Allergy and Immunology annual meeting, like the one on milk oral immunotherapy treatment wherein "...three to five years after completing an OIT study, Johns Hopkins University researchers said that many participants were more reactive to cow’s milk than they had been early in the course of treatment." (Read more here Allergic Living’s article).

Bottom line still is, as of right now, there is no cure for food allergies.

What we do know is that food allergies are real and serious as is the risk for anaphylaxis

What can arm ourselves by having:
  • Clarity about a food allergy diagnosis
  • Avoiding the allergen[s]
  • Understanding and having a anaphylaxis action plan (Here's an example from AAAAI.org)
  • Access at all times to emergency medication, including two epinephrine autoinjectors



Adult Onset Food Allergies, New York Times

I know there are millions of you out there, adults who were never food allergic until boom, something changes your life, forever. Last week’s article in the New York Times called The Allergy Buster prompted Robert Tutton to write about his adult onset allergies to carrots for the New York Times blog, "6th Floor". Are you one of the millions of adults newly diagnosed with food allergies? If yes, I can help you get back into the swing of things. Contact me about a tailored-to-you coaching program today! (Here's more about me and food allergy coaching.)

Friday, March 15, 2013

The Allergy Buster, New York Times

I, like many of you read, this article called The Allergy Buster in this Sunday’s New York Times with great interest. I have mixed feelings about the article that I’m still sorting through. What I don’t have mixed feelings about is the relationship this doctor has with her young patients. She is definitely part of their Team You and I love how clear she is about that:

“If you feel sad or discouraged, you call me — you,” she tells the children, leaning in, entwining her pinkie in theirs and asking them to make her “a pinkie promise” that they will take their dose. She tells patients to call her by her first name, and her light, musical voice and lack of a white coat in the clinic all contribute to the magical different-from-other-doctors place she occupies in her young patients’ minds. She gives them presents on every possible occasion or lets them pick out books or puzzles or Play-Doh from a bucket in the office.”

Here’s more from the author (and food allergy mom) about the article:
Behind the article from the New York Times, 6th Floor Blog: Behind the Cover Story: Melanie Thernstrom on Untangling the Mystery of Food Allergies

Thursday, March 14, 2013

Gluten-Free Irish Soda Bread

Gluten-Free Irish Soda Bread

I saw a recipe on Glutino’s Facebook feed yesterday and thought: "Oh yes, I need to make that."

I haven’t had soda bread in years. I used to bake it from scratch, nut-free of course, before going gluten-free for wheat intolerance in 2005. But I had all of the ingredients just laying around, waiting to be baked: orange zest, caraway seeds, eggs, milk, yogurt, oil and a safe-for-me pancake mix, King Arthur Gluten Free Pancake mix (free from the top 8 allergens).

I baked according to Glutino’s recipe, doing half milk and plain zero fat Greek-style half yogurt, and in an hour this beauty was done.

***

Gluten-Free Irish Soda Bread
Adapted from Glutino’s recipe

1 box (15 ounces) safe for you Gluten-Free Pancake Mix
2 large eggs
¾ cup low-fat Lactaid milk (I did a half mix of Greek yogurt)
2 tablespoons organic olive oil
¾ cup raisins
2 teaspoons caraway seed
2 teaspoons grated orange rind
1 tablespoon oil to brush top of bread

Preheat oven to 350 F.  Lightly oil an 8-inch cake pan. Set aside.

In a large bowl, mix all wet ingredients together plus caraway seeds and raisins. Add the dry pancake mix to the wet mixture. Mix until it comes together, you may need to use your hands. Spread into prepared cake pan.  Brush with 1 tablespoon oil. Bake 35-40 minutes or until top is brown. Cool slightly. Cut into wedges and enjoy.

 ***
 
The verdict: a little dry (it's not like a tea bread, but it's more bready than cakey) but that's how this bread always is to my recollection. Some butter and Bonne Maman apricot jam made it truly spectacular.

I'm officially ready for St. Patrick's Day!

Friday, March 08, 2013

KFA Webinar, Dining Out with Food Allergies

**UPDATE March 14, 2103: Here is the Kids With Food Allergies recorded webinar.**

** Update March 11, 2013: Kids With Food Allergies records all webinars and you can find the archived link on the Kids With Food Allergies website here. For everyone who is registered, they will get a follow-up email with a link to the video.**

Please join me and my colleague, Michael Pistiner, MD of AllergyHome.org for an informative hour on March 12, 2013 where we will talk all about dining out with food allergies in a free webinar  hosted by Kids With Food Allergies.

***

Here are the details:

Kids With Food Allergies Webinar, Dining Out with Food Allergies

Michael Pistiner, MD of AllergyHome.org
Sloane Miller, MSW, LMSW of Allergicgirl.com

Tuesday, March 12, 2013

2:00 pm Eastern | 11:00 am Pacific

FREE Registration 

***

As this webinar is for you, please let us know what you want to know about dining out safely with food allergies.

Submit your questions in the comments section of this blog, via my Twitter feed or Allergic Girl Facebook page or you may contact me privately via email.

Thursday, March 07, 2013

Blue Smoke, Menus

I’ve eaten at Blue Smoke in the Flatiron District of New York City many, many times; I’ve held food allergy events there and worked closely with chefs, management and staff all about food allergy. I haven’t been to Jazz Standard (the jazz club - that’s kid friendly - under Blue Smoke) in some time though and was thrilled to see these additions to their menus, namely symbols for GF and NF dishes. (They also have separate menus as well that list the GF and nut-free items and kids menus.)

Blue Smoke menu at Jazz Standard

I ordered my favorite, the Texas Salt & Pepper beef ribs, and as always, they were delish.

Blue Smoke (the kitchen for Jazz Standard) has all of my needs in their computerized system. Still, like I always do: I called ahead a few days ahead to confirm that they had my food allergy needs and double-checked when the waiter came to take our orders. I confirmed when the order was placed before me and made sure to order well before the show started so I could see my food.

Want to learn more about how to dine out safely and well with food allergies from the leading expert:

My website Allergic Girl Recommends has lists of places I’ve dined well in NYC and beyond.

My book Allergic Girl has an entire chapter with strategies about how to dine out with food allergies.

If you are traveling to New York City, I could be your food allergy concierge. Here's more about my concierge services.  

And, March 12, 2013, I will be co-host of a dining out FREE seminar with Dr Mike Pistiner and Kids With Food Allergies organization. Learn more and sign up here.

Wednesday, March 06, 2013

Food Allergy Advice for Kids, Wall Street Journal


March 4, 2013, the Wall Street Journal wrote up a report by the American Academy of Allergy, Asthma & Immunology’s Adverse Reactions to Foods Committee outlining how and when to introduce highly allergenic foods, which include wheat, soy, milk, tree nuts, and shellfish. Here is a link to the abstract in the Journal of Allergy and Clinical Immunology.

Now, according to the Wall Street Journal, the committee suggests these foods can be introduced to babies between 4 and 6 months; previously parents had been told to wait. 

Confused? So is everyone. 

Robert Wood, director of Pediatric Allergy and Immunology at Johns Hopkins University School of Medicine's best advice:

“Dr. Wood said he tells parent they don't need to feel pressured to do an early introduction. ‘You can do whatever you want because we're not sure what makes a difference, he said.”


Consult your board certified allergist or health professional about the best course of action for you and your family.

Tuesday, March 05, 2013

Lifescript, Anaphylaxis Health Center

I was asked by Lifescript.com to write about my dating experiences with food allergies and anaphylaxis. (Yes, I had an anaphylactic reaction on a date not too long ago.) And here's my article in Lifescript.com’s Anaphylaxis Health Center.

If you flip through the other articles in their Anaphylaxis Health Center, you will see that of their information was created or written by reliable resources like Food Allergy Research & Education or the American Academy of Asthma, Allergy & Immunology.

However, always check with your personal board certified health professional if you suspect food allergies, anaphylaxis or have further questions.