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When Everything Goes Right With a Severe Food Allergy Reaction

Tuesday, May 8, 2018

Atlanta Allergy & Asthma Blog

As an allergist and parent of a now 20-year-old with pine nut allergy, I know I can handle a reaction anywhere, anytime, but could my son on his own?

When Owen was a senior in high school, he had a significant anaphylactic reaction to pine nuts hidden in a sauce that both he and I assumed was safe. He had vomiting, wheezing, and uvula swelling. He was at home with me, so I administered epinephrine and took him to the emergency room.

After that, my son always carried his injectable epinephrine, either Epi Pen or Auvi Q. But, as most parents of a child with a food allergy, I wondered if he needed it when I wasn’t around, would he recognize the signs and use it? As they become teenagers, and even more so when they leave for college or just move out of your home, we question if they will always carry their life-saving device and will they use it, even if they are unsure if they need it? Here is my story with, fortunately, a happy ending.

Owen, now a sophomore at Texas Christian University, is a member of the TCU Swim and Dive Team. At the Big 12 Conference Championship in Austin, Texas, he had just finished in 6th place on the 3-meter board. He returned to the hotel for a team meal, nothing fancy, a typical chicken dinner. He immediately experienced mouth symptoms (itchy and tingling) along with nausea. He asked if there were pine nuts in the meal and the answer, to his dismay, was — YES. My husband and I were visiting that weekend and while walking to our hotel, we got a call from our son. He had immediately used his AuviQ (epinephrine auto-injector) and the team trainer took him to the emergency room. We arrived about 10 minutes later.

Time line: 8:50 pm received diving medal, 9:50 pm in ER with anaphylaxis. He was released to my husband and me. Against his wishes, we brought him back to our hotel room so I could observe him through the night.

12 hours after his reaction he qualified for finals on platform and finished that evening with another 6th place medal!

Lessons to take away from my story:

  1. Always, always, carry your epinephrine auto-injector with you no matter where you are, who you are with, or what you are doing.
  2. Never assume. The school should not have served a meal with an allergen known to affect a member of the team. But ultimately the buck stops with the patient. My son should have double-checked!
  3. Early use of epinephrine makes a huge difference. Use it and use it right away.

I am so proud that Owen recognized his symptoms and reacted appropriately. Yes, I have nagged him about it since his first reaction at age 8, so I guess he was listening, at least some of the time!

Parents… don’t stop nagging, even after your kids are out of your house. Have confidence that your kids will do the right thing. And to those parents whose kids are still living with you, be a good role model. Don’t be afraid to use your epinephrine quickly. Speak with your child regularly about the importance of recognizing the signs of a reaction and the appropriate steps to take if they even think they have ingested their food allergen. Practice using your device of choice and make sure they understand that using it, even if it is a false alarm, will not harm them in any way. Early use makes a huge difference and is often a life-saving one!

-Kathleen A. Sheerin, MD