What the what?!

Every so often a patient comes into my office with symptoms of an allergic reaction (hives, facial swelling, itchiness) to which neither patient nor myself can find a cause.

Today, I am that patient.

When husband woke up at 2am to feed the baby, I started scratching my fingers and had trouble falling back asleep.  Eventually, I did and woke up at 8am to the sound of the kids playing in their room and the baby babbling away.  I became aware of my fingers, hands and arms being itchy as well as my feet.  I got up to put my contacts in and got the shock of my life when I looked in the mirror.

Both of my upper and lower eyelids were swollen.  I had trouble getting my eyes open enough to put the contacts in, but I managed after a bit of effort.  I woke up husband and he thought I’d been crying.  And then the itching started again – my hands, arms, and fingers.  I was scratching so hard I thought I might break the skin.  I immediately took two doses of Reactine and got into the shower.  Whatever antigen I was reacting to, I wanted it off my skin immediately.

I hadn’t used any new skin care products, creams, soaps or detergents recently.  These are the first questions I usually ask any patient who comes to my office looking the way I did.  Thankfully, I had no respiratory symptoms which would have indicated some kind of anaphylactic reaction.  All I could think of was what we ate for dinner last night.

Husband purchased two fresh red snapper at the local grocery store last night.  We ate the fish with broccoli, cauliflower and rice and shared a bottle of white wine.  The last time I ate snapper was back in 2008 on my honeymoon in Jamaica.

Could it have been the fish?  Or the sulphites in the wine?  I’ve never had a reaction like this in the past.  I’ve never had any kind of allergic reaction.  It’s so strange.

Now I know how my patients feel when they come in to see me, seeking answers, and all I can do is shrug.

So, so strange.

Caution: Allergies

Day 14 – January Daily Blog Posting Month

Thankfully, our family has no issues with food sensitivities. Husband has some mild ragweed and cat allergies but that doesn’t stop us from having two cats, nor does it really affect his enjoyment of summertime.  If anything, it’s a minor inconvenience.

For others, allergies are a significant part of their family. Having a child with an anaphylactic allergy is be extremely stressful, especially if it’s a food allergy and especially when that child is in school.  In the U.S., the incidence of anaphylactic allergies (be it related to food, environment, or medication) is estimated to be as high as 50 per 100,000 person-years.  There is a difference though between perceived allergy and true allergy, as this study in 2006 demonstrated.  Anaphylaxis is estimated to be fatal in 0.7-2 percent of cases (http://www.uptodate.com/contents/anaphylaxis-symptoms-and-diagnosis-beyond-the-basics?source=see_link).  Food allergies, particularly in the United States, is estimated to affect 6-8 percent of children under the age of five years and up to 4 percent of the general population.

Still, growing up, I don’t recall anyone having a food allergy.  Do you?

Last year, in my daughter’s JK class, there was another child who had a gluten allergy so we were kindly asked to refrain from sending any gluten or wheat products in her snack.  Now, the school is also nut-free (of course), so needless to say it definitely limited what we could send.  For example, I couldn’t send any crackers.  My kid loves crackers.  Sure, I could spend $7 on a box of gluten-free crackers, but I’m not going to on principle.

I don’t mean to sound insensitive, but why has our society deemed it necessary to alter school policy such that nuts and gluten are now banned?  What’s next?  Milk products?  Eggs?  Where does it end?  Why should my child not be allowed to bring a peanut butter sandwich because there might be another child in her class who is allergic?  My child knows not to share food.  She knows to wash her hands after meals.  If she were the one with a peanut allergy, she would be told not to eat anything that wasn’t sent from home. She would have an Epi-pen on her person and she would know how to use it.  And I believe at the age of five, she would understand that if she eats anything not sent from home, she could get very, very sick.  She knows not to cross the street without looking and without a grown up.

As a physician I am wholly sympathetic to the parent who has a child with an anaphylactic allergy.  I will sign whatever form is necessary for that child to be allowed to carry an Epi-pen.  But as a mother?  Totally different story.  Now, I do understand that if I indeed had a child with an anaphylaxis, I would likely be tooting a much different horn.  But I don’t have a child with an anaphylactic allergy and until I do, I will continue to be bothered by the fact that I can’t send her to school with a peanut butter and jam sandwich.  It’s not my problem that another child has a food allergy and I kind of resent that it’s being made to be one.  In the news recently, I heard that a mother in another city is launching a human rights case asking that her school district ban all dairy and egg products because her daughter, who is allergic to both, has repeatedly come home “wheezing” after being exposed.  I’m truly sorry for that mother, to have to deal with that kind of allergy.  It sucks.  It really does.  But if she wins this case, and now dairy and egg products are banned from all schools, what on earth are kids going to eat?

End rant.