Everything can change in an instant
The above photo is a candid reminder to myself how fast things can change in an instant for severely allergic children. Pictured here, he was so excited to be eating Oreo wafers, his reward for being a trooper during our regular allergist review.
Mere seconds after this photo something was not right. The smile disappeared and his face turned an ash grey. He stopped eating, handed me the pack of the biscuits, and said
“mummy I can’t eat anymore. My throat is itchy.”
He then slumped over my lap and started to cough. That position somehow did not agree with him, so he sat up, and started clawing at his throat. I Frantically asked him if he was ok. He looked at me with a mixture of confusion and fear. I wasn’t quite sure if his inability to talk was reeling from the shock or actually going into shock. But his eyes said it all:“ HELP ME!”
This one was serious
We’ve had fairly serious reactions before, but this was the first time he was unable to talk. I frantically reached into my bag for his emergency kit and swiftly gave him the maximum dose of antihistamine as instructed by doctor for severe reactions.
The next moments were incredibly tensed. Here we were in the middle of a busy hospital filled with patients, nurses and doctors. But a deafening silence was all I heard…along with my pounding heart. I remember running the options through my mind:
If anaphylaxis happens, who do I ask for help? I would need adrenalin, maybe an oxygen machine too? Wait I have an Epipen. I remember taking the Epipen out of it’s casing. I remember my mind racing to recall the Epipen trainings I had gone through and conducted so many times.
Check expiry date of Epipen done. Remember to take out blue safety release. Remember orange end to thigh muscle. I silently recounted these steps as I watched Corey intently for any advancement of the allergic reaction. After what felt like eternity (which in truth was probably only 5 to 10 minutes in reality), he mustered a “mummy” and looked more like his usual self.
We dodged yet another bullet
I was still holding the Epipen as we headed back up to doctor’s office. By this time Corey could walk again. I wasn’t quite sure what we needed to do, and I remembered thinking we better check his breathing for wheeze. Anyhow, doctor’s clinic was the best place to be in case a secondary reaction recurred quickly. For severe allergic reactions, secondary reactions can occur hours after the initial reaction, even in the absence of new exposures to the allergen.
Doctor had a packed clinic that day, but there were a few medical students shadowing him. They helped me to listen to Corey’s lungs for wheeze. Thankfully his breathing was fine and I waited another 15 minutes gathering my wits, before deciding he was ok enough for us to go home.
Suffice to say we had dodged another bullet in our allergic journey. Like the storm rain cloud that appears just as one reaches the beach, this incident overshadowed the positive skin prick results that day which showed his dairy allergy had improved by 50%.
Corey’s been doing so well this past year. His eczema is well under control, he stopped having random mysterious reactions in school.I felt confident enough to let him try new foods this year. So beginning this year, I started letting him eat Oreo cookies. For those who don’t know, Oreo cookies do not contain milk and egg in their ingredients. But that doesn’t mean it’s safe from cross contamination because the same factory that produces them handle these allergens and more.
I rely heavily on accurate package labelling to assess whether a food is safe for Corey. Unfortunately, labelling standards in South East Asian produced products are poorly controlled. Even though in Singapore we have labelling laws that require the major allergens to be declared, consistencies are abound when the same product is produced in different countries. Even production in different factories can mean different standards or allergen handling.
My complacency and poor judgement in giving him 2 different packaging of the same product
When Corey had the reaction, he had first eaten a packet of Mini Oreos made from Indonesia. Picture below. He had eaten this one before without issues.
After he finished the mini Oreos, he asked for the other Oreo packet which was the Oreo wafers pictured below. The allergen declaration for these wafers was different in that peanut was not included as a possible cross contamination ingredient. And these wafers were made from another country altogether, Vietnam.
He only made it through one stick of these Oreo wafers before the reaction. Which caused the reaction? I don’t know. As I write this, I am making a mental note to share this information with our allergist to see if we can narrow down which allergen he had reacted to. Short of getting Corey to eat them again, I suspect we may never truly find out which allergen it was.
As an experienced allergy mum, I should have known better. I gave him 2 different versions of Oreo and did not scrutinise both packaging beforehand. My mum guilt plagues me that whenever he’s doing well, I let my guard down and something happens.
Lesson learnt: never ever take the same product for granted. Even the difference of manufacturing facility or country can mean heightened risk of cross contamination. In this case, my human error resulted in his reaction and thankfully we live to tell this tale.
Dissecting my allergy mum’s emotions after an allergic reaction – the anxiety is real.
As you can probably tell by now, vigilance fatigue is a very real issue for allergy parents of highly allergic children. It doesn’t ever get better unless our child outgrows the allergy.
The emotional trauma I experience in these allergic reactions is hard to describe. I can only imagine it to be trauma one experiences when suddenly faced with a potentially life threatening situation.
I don’t know what is the average number of traumatic experiences a normal person goes through in a lifetime. For me, the number I have gone through is a few times each year since Corey was born.
Skeptics might wonder if I’m over dramatising these reactions. But in that moment where my heart is racing, my palms are sweating and I’m recounting all the things I am supposed to do in an emergency medical situation, the fear of losing my child felt very very real, to me.
Scary to Imagine the things I can’t control…
Maybe the part that scares me the most is I won’t be able to protect him from every invisible trace of his allergens. The situation only gets worse when he enters primary school next year. Because at 6 years of age, he still needs a trusted adult who will administer emergency medications swiftly and timely when necessary.
I’ve heard horror stories from allergy parents who have encountered pushback from Singapore primary schools who resists administering antihistamine medications.
Additionally, will his teachers be able to watch him as closely as I do with another 30 boys to care for? I’m not so certain and it scares the crap out of me.
So how do I protect him?
My friend and fellow allergy mum Penny puts it best when she said that we can do our best to train caregivers, advocate and prepare. After that, we have to hope for the best and know we’ve done whatever we can.
Forging ahead with a baked milk challenge and exploring oral immunotherapy.
I know I can take active steps to control certain factors to mitigate the risk of exposure like packing his snacks from home. To further reduce the risk of serious reactions, I need to know facts about how severe his condition is now and in the near future. The best way to find out is to do more food challenges and possible explore starting him on oral immunotherapy sooner.
Proper and as accurate a testing as possible has provided the best information for me and our allergist to make strategic calls on how to proceed with protecting Corey. I urge all parents to seek professional registered allergists’ help when investigating chronic eczema and allergic reactions. As opposed to relying on home remedies or other anecdotal therapies which might risk your child’s health.
So that’s where we are at. Next up, read about my mental and physical prep for food challenges and also my journey into exploring oral immunotherapy as a means to have Corey achieve some desensitisation of his allergens.
Credits and Disclaimers:
All opinions and views expressed herein are the author’s own and not anyone else’s. Any quotes from medical healthcare professionals are written from the author’s perspective and should not be construed as medical advice. Every child and every symptom is different thus it is important to seek advice from a professional allergist or dermatologist for your unique situation. All images and pictures on this website are copyright of the owner of this website and cannot be used or downloaded without permission.
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