Treenut allergy in older teens

[*LC]

My high school senior has developed an allergy to a number of tree nuts. The testing was done after she had a reaction to eating mixed nuts. She recognized the reaction, and she got help when it didn't go away. It was treated with Benadryl, which was the only thing available. The allergist has recommended avoiding all tree nuts.

 

Other than with me, this teen doesn't like to make a fuss. She is very involved in sports, school, church, and work, so she is away from home/me a lot. This fall, she will be taking classes at a local college, and she will be going to college a number of hours away next year.

 

What are your tips for equipping a teen to deal with allergies to tree nuts? She eats out frequently, mainly fast food, and I don't see that changing. Since the reaction, she has stopped eating baked goods at church since she couldn't question the baker.

 

She now carries an epi-pen pack.

[elise1mds]

She needs to do her research now and find out where some 'safe' places to eat are. One of my friends is highly allergic to all nuts as well as a laundry list of other items, and she has a short list of places that she can eat (oddly enough, Red Lobster is on that list, though I'm not sure if it's everything on the menu or just some things). If you like, I can ask her. She might also want to check out http://www.allergyeats.com. It's free to have an account. I honestly don't know how families with multiple allergies cope sometimes - you guys are amazing.

[MomatHWTK]

Take a look at this as a starter, sorry if it's upsetting. But the allergies are so very serious and can go so very wrong so fast. :grouphug:

 

It is hard to balance the desire to not over react or over protect with the genuine need to stay safe.

[mrsanniep]

My son is severely allergic to peanuts AND tree nuts and he can eat at McDonald's and Taco Bell, if that makes your daughter feel better (although only certain items). She should still look up allergen/nutrition info for her favorite restaurants online. They should give her a better idea of what dishes she can have. For example, processed foods can contain "hydrolyzed vegetable protein," which means the protein may have been derived from nuts. She needs to watch out for that. Generally we run across that in salad dressings and sauces.

 

One thing to watch out for with nut allergies ... and this is pretty rare, but it happened to my son ... CITRUS SEEDS. To some kids with nut and peanut allergies, accidentally biting into a citrus seed is like biting into a nut. Something about the proteins released when you bite them. Citrus juices are okay, it's just eating the seeds accidentally (or just biting into them, then spitting them out) that causes a severe reaction as well. We had the *lovely* distinction of experiencing this firsthand and our allergist took pics, etc. for an article and presentation because it's not very common.

 

Sounds like she's aware that if she doesn't know what's in something or what ingredients a baker used, she should just avoid that food.

[abbeyej]

One thing to point out to her? Letting a host know that she is allergic to nuts causes a very, very minor fuss (if any at all). Nut allergies are very common these days and most people have at least come across them before. It's just not a big deal.

 

On the other hand, if she has a major reaction that requires Benedryl, an Epi-Pen, possibly a trip to the ER, etc, she's going to traumatize her host. Those around her will feel guilty, frightened, confused... And that assumes that she gets the help she needs in time so that there's no real damage done!

 

She's actually *saving* the people around her all sorts of bother if she's honest and upfront about her allergy. It's a pretty simple one. :)

 

She's wise to avoid baked goods any time she can't speak to the baker. But nuts can lurk in unexpected places. A fellow WTM mom once told of reacting to barbecue sauce that unexpectedly had nuts in it! That's not one I would often think to ask about. Salads are another where it's *always* important to ask.

 

A nut allergy (unless it's just terribly extreme -- and so far that doesn't seem to be the case for her) shouldn't prevent her from eating in restaurants. But she DOES need to learn to speak up and ask appropriate questions before she eats something potentially dangerous.

[dangermom]

What Abbey said. No one wants to accidentally poison a friend or guest! I have a daughter with severe nut allergies and for the most part we've found that people are very happy to hand over ingredient lists and such, and it's not disruptive.

 

The rule that we have found to be absolutely necessary is: if you don't KNOW that it's safe to eat, it isn't safe to eat. Sticking with easily-identifiable items is usually the best plan (veggies, dairy, fruit, and not bought granola bars etc.).

 

Fast food should generally not be a problem.

[Jennifer in MI]

Agreeing with the others. Tree nut allergies are soooooo common. Most restaurants know how to handle it.

 

:grouphug:

[Desert Rat]

Fast food is actually really easy to eat with tree nut allergies. I've got a treenut kid and we can eat at BK, MacDonalds, Arbys, Sonic, In-N-Out, Wendys, TacoBell.... Desserts are off limits. You can go on-line to any restaurant and pull up their allergen menu (it's with the nutrition menu usually).

Applebees and Chilis are both fine. RedRobin is the worst so far. We can't go there at all. They require written requests. Blah.

We try to stay away from Italian (pesto). And we can never have Asian food. When we really want it, the rest of us get chinese and little man gets BK. He isn't allergic on contact so as long as he doesn't touch our food, he's cool. That's maybe 2x a year though. And we're really careful and have gotten comfortable with his allergy and how to avoid foods. I've bought a donut maker and we only eat desserts at home, although Sonic and Dairy Queen are safe.

Check out etsy for cool medalert bracelets. I just got one for ds that is jelly-like. It's very cool! And cheap!

We also got him a cool epi-pouch. That store is called the Ouch Pouch. Great products. I got the pouch that holds 2 epipens so I could have one epi and room for benedryl and my information. Ds really likes it and thinks it's cool so he's more willing to carry it.

I think the most important thing to stress with a teen is the importance of speaking up! It's important to stay safe and it's much more embarassing to have a reaction than it is to ask for allergen information. It's also a good idea to research several restaurants so when she's out with her mates she can suggest one she already knows is safe.

Treenut allergies stink! I tell my ds that all the time when he is sad. I tell him most people have something they have to worry about, at least we know how to take care of his. It's also super helpful that he can read now. I always double check, but it gives him control and power over his allergy. Super important.

[dangermom]

Oh yeah, Chinese is right out, and so is Indian. And Thai. :( She's going to have to learn to cook those herself.

[stripe]

If Bendryl has helped her in the past, I would suggest her to carry a couple of Benadryl in tablet form in her purse in addition to the Epi Pen.

 

And definitely much easier to just tell people she can't eat nuts than get ill. Her host would not ever want that.

[*LC]

I posted a thank you the other day, but it never showed up. I definitely wanted to tell you how much I appreciate everyone's feedback. When I was feeling overwhelmed the other day, I knew right away that The Hive could help. Thank you.

 

I want to thank all of you for helping me with this allergy. My daughter works as a lifeguard for 8+ hour days. There is no long break or fridge, so she takes snack foods and fruit to munch on through out the day. We had just discovered that 2 of the 6 snack foods she brings have nuts. Then I found extreme information on the internet. I needed talking down off the ledge. Thank you for doing that for me.

 

The strange thing is we dealt with a nut allergy years ago in a younger child, who was one of the lucky ones to outgrow them. However, that child had so many food allergies that the nut allergies truly didn't rule out many foods. I think my daughter must have remembered that when refusing the baked goods, because we had not talked about that yet. I know bad mom.

 

She is a picky eater, who doesn't eat Chinese, Indian, or Thai food. She also doesn't like BBQ. That will make this allergy easier.

 

She ordered pizza at the mall the other day, and she asked about nuts. One worker was confused and said, "Why we would put nuts in cheese pizza?" However, another worker got it a bit more and told her they didn't use nuts. She as used the internet to check out the ingredient lists for her favorite places.

 

She is now carrying her epi-pens in her purse. Originally, she had only wanted to bring it if she was going to eat somewhere. However, we talked about the soccer player's death, and she definitely could see herself stopping for an unexpected dinner after a game. She also has Benadryl in her wallet.

 

Thanks again for all of your advice and positive thoughts. She is handling this well.

[MomatHWTK]

:grouphug:

[happypamama]

She should take the epipens everywhere. We take DD10's epipens everywhere she goes, even if she's not planning to be outside (her allergy is to bee stings), just in case.

 

I would also talk with a few people that you trust -- senior lifeguards, friend, youth group leader, family friend, someone at the college -- whomever is likely to be around a lot, especially at eating functions, and I would train a couple of people to use the epipens.

[*LC]

****I would also talk with a few people that you trust -- senior lifeguards, friend, youth group leader, family friend, someone at the college -- whomever is likely to be around a lot, especially at eating functions, and I would train a couple of people to use the epipens.

 

I appreciate the great thought, and I will have her talk to her friends and train them. When I read your comment, I immediately thought, "She must have younger kids." I did exactly what you advised about training others to use the epi-pen when my younger child carried one.

 

However, I can't imagine doing that with this older child. I don't even know who I would train.

 

She is the only lifeguard at her pool, which didn't even have guests there for five hours yesterday. I don't know anyone that goes to that pool. I don't know where she will eat this fall as she will leave her public high school before lunch to go to college, two or four days a week. Two days, she will have only 10-15 minutes after drive time before her class starts. So, I guess she will just eat in the car. The other two days, if she gets that class, she will have 45 minutes, so she may have time to eat in the college cafeteria. I think she would rather use that time for studying than eating. She will leave college to return to high school for practice. She plays two sports in the fall, so I guess she will need to mention it to her coaches. She also coaches preschoolers; I guess she could tell the other teens that coach at the same time. She babysits for a child with Down's Syndrome. She isn't around when we see friends, and we are not around when she sees her friends. She even goes to a different church than the rest of the family. At this point, her life is very separate from mine or the the younger kids. It sounds strange, but I think it is reasonably typical for older teens.

 

She is carrying her epi-pen in her purse, which she has started carrying all the time. She didn't carry a purse in the past, but she plans to put it in her bookbag or sports bag when school/sports start.

 

Your post did prompt me to send an e-mail to an aquaintance, whose teen has a nut allergy and attends the same high school. I can't remember if he plays sports, but she will know about the school's policy for carrying epi-pens, etc.

 

I appreciate your help.

=====

[hsbaby]

Be sure to use extra caution when eating out. What doesn't cause one kid to react, might cause a reaction in yours. For example, I see some people saying their kids do fine at Taco Bell and Sonic. My dd has had reactions both places. I have also learned to talk to a manager at restaurants, not the waitress. The manager usually is more aware of how to properly handle cross contamination. Most times the manager will actually bring dd's food out to her. Anyway, thought I'd throw that out there:)

[Ellesmere]

****I would also talk with a few people that you trust -- senior lifeguards, friend, youth group leader, family friend, someone at the college -- whomever is likely to be around a lot, especially at eating functions, and I would train a couple of people to use the epipens.

 

I appreciate the great thought, and I will have her talk to her friends and train them. When I read your comment, I immediately thought, "She must have younger kids." I did exactly what you advised about training others to use the epi-pen when my younger child carried one.

 

However, I can't imagine doing that with this older child. I don't even know who I would train.

 

=====

 

I'm not sure I'm understanding your message correctly (the quoting isn't showing up properly on my screen) but I really do hope she will train some people she is likely to be around. It doesn't take long to show someone how to use an Epi-pen. I say this because as an adult, when my time came for a very severe reaction, I was unable to self-administer. (I was in my late 20's when it happened.)

 

Had I not been with someone trained to use the pen, I am not sure what would have happened.

 

But I think it's hard to make changes until you are lucky enough to survive an anaphylactic reaction. Even now, I still question the restrictions (carrying the pen everywhere, being extra-careful when I eat alone, etc.) but then I remember what happened. Maybe it is different now that I have kids that watched me have to go to the ER. And I've learned that people don't go into serious condition from anaphylactic reactions because they are so easy to recognize and people always have their meds handy.

 

:grouphug:

as you continue to deal with the condition.

[happypamama]

I appreciate the great thought, and I will have her talk to her friends and train them. When I read your comment, I immediately thought, "She must have younger kids." I did exactly what you advised about training others to use the epi-pen when my younger child carried one.

LOL, yes, I do have younger children; my oldest is ten, and I definitely wouldn't trust her to administer the epipen herself. I wouldn't want even a teen or adult to be responsible for self-administering in an emergency, if I could help it. In her situation, I'd probably start with the coaches of her sports, and someone at her church -- those seem like the most likely occasions for food problems. A coach would also need to know if there are restaurants that are safe or not safe for her, if the team stops on the way home from games.

 

I think a medical alert bracelet might also be a good idea for her. I did not opt for one for DD yet because she's young enough that she's rarely away from us (and if she is, she's with people that I have taught to use the epipens).

 

Do contact her high school, though; when I was in public high school, they had a strict policy about students carrying any sort of medication. I had to get special permission to keep my asthma inhaler with me, rather than locked in the nurse's office (which would be a terrible place for epipens, when every second counts), because I was traveling to a local college as well.

[Ellesmere]

LOL, yes, I do have younger children; my oldest is ten, and I definitely wouldn't trust her to administer the epipen herself. I wouldn't want even a teen or adult to be responsible for self-administering in an emergency, if I could help it. In her situation, I'd probably start with the coaches of her sports, and someone at her church -- those seem like the most likely occasions for food problems. A coach would also need to know if there are restaurants that are safe or not safe for her, if the team stops on the way home from games.

 

I think a medical alert bracelet might also be a good idea for her. I did not opt for one for DD yet because she's young enough that she's rarely away from us (and if she is, she's with people that I have taught to use the epipens).

 

Do contact her high school, though; when I was in public high school, they had a strict policy about students carrying any sort of medication. I had to get special permission to keep my asthma inhaler with me, rather than locked in the nurse's office (which would be a terrible place for epipens, when every second counts), because I was traveling to a local college as well.

In agreement with the bolded, from this website:

"No person should be expected to be fully responsible for self-administration of an epinephrine auto-injector."

And it goes on to explain why.

 

The website is Canadian, so the school info wouldn't apply if you are in the U.S. but I thought the OP might find some helpful info there.

 

This page also has links on the side that especially deal with the teen years.

[*LC]

I see some people saying their kids do fine at Taco Bell and Sonic. My dd has had reactions both places. I have also learned to talk to a manager at restaurants, not the waitress. The manager usually is more aware of how to properly handle cross contamination.

 

Is your dd allergic to just tree nuts or other foods also? Just curious, because those are two fast food restaurants my daughter eats at from time to time. She won't take it for granted and will ask before ordering.

 

Thanks for the tip about talking to the manager. Since she encountered an unhelpful person the first time out for pizza, she might be open to this now.

[*LC]

I wouldn't want even a teen or adult to be responsible for self-administering in an emergency, if I could help it. In her situation, I'd probably start with the coaches of her sports, and someone at her church -- those seem like the most likely occasions for food problems. A coach would also need to know if there are restaurants that are safe or not safe for her, if the team stops on the way home from games.

 

Do contact her high school, though; when I was in public high school, they had a strict policy about students carrying any sort of medication. I had to get special permission to keep my asthma inhaler with me, rather than locked in the nurse's office (which would be a terrible place for epipens, when every second counts), because I was traveling to a local college as well.

 

I'm glad you weren't offended. I just know our parent/child dynamics have changed as she has aged, especially since she started driving. It will change even more when she leaves home in a year.

 

Your post made think about how much time she spends away from us. Today she was for practice from 8 till 10:30. She left home for work at 11:15 and returned at 9:30. She did eat all her meals here though.

 

I will have her to talk to the youth counselor and her club coach, who does like team bonding. The teams she plays for at the high school don't eat after games. Instead, the team, or part of the team if it is a big team, eat together at a restaurant or at someone's house before certain big games. The coach isn't there. Oh, they do have a banquet before and after each season at school or another location. I think I'm remembering one is pot-luck.

 

I'm glad you were able to carry your inhaler with you, where it needed to be. While I don't know this is the actual policy, this school doesn't care about the kids carrying medication. My daughter has chronic hives, so she has carried Benadryl all three years. She also carries something for headaches. She was sick a lot freshman year, with an undiagnosed ulcer, and she carried anti-nausea medicine. If she doesn't have her headache medicine, she borrows from a friend. So, I feel confident she will be able to carry the epi-pens (they would be in her purse, out-of-sight anyway), but I am curious to see how they handle food allergies even though she won't eat lunch there.

 

Thanks again for giving me things to talk with her about.

[*LC]

I'm not sure I'm understanding your message correctly (the quoting isn't showing up properly on my screen) but I really do hope she will train some people she is likely to be around. It doesn't take long to show someone how to use an Epi-pen. I say this because as an adult, when my time came for a very severe reaction, I was unable to self-administer. (I was in my late 20's when it happened.)

 

Had I not been with someone trained to use the pen, I am not sure what would have happened.

 

But I think it's hard to make changes until you are lucky enough to survive an anaphylactic reaction. Even now, I still question the restrictions (carrying the pen everywhere, being extra-careful when I eat alone, etc.) but then I remember what happened. Maybe it is different now that I have kids that watched me have to go to the ER. And I've learned that people don't go into serious condition from anaphylactic reactions because they are so easy to recognize and people always have their meds handy.

 

I'm sorry that I confused you. I was probably just thinking through how much time she spends away from me, which made me realize how much time she spends on her own or with only other teens or younger kids.

 

I read the great links you sent, and in there I read something that puts into words what I messed up earlier. It said teens need to tell their friends and train them on the epi-pen. She is at an independent age, and she has to take responsibility for keeping safe. Not for injecting herself, but for educating those who may be around her if a reaction occurs.

 

The problem is she has now entered a stage of life where a lot of her eating will be done alone or with strangers. I can't think of any changes we can make to alter that. Can you? She will carry her epi-pens with her at all times.

 

I am glad there was someone with you when you had a severe reaction. However, you still eat alone. Like you, she can't be with someone all the time, so she also will have to learn to be extra-careful when she eats alone.

 

I do understand seeing it somehow makes it more real. My daughter became sick and passed out during the summer after an evening run one Saturday night a few years ago. It was hard for me to let her go running with her team on the next Monday morning. I wanted to follow the team in my car. Instead, I insisted she carry Benadryl and make sure she was never in the rear of her group. I did park in a nearby parking lot to wait for her to call that practice was over, instead of going home as usual. It has been more than a decade since my other child had an anaphylactic reaction, and it is still clear in my mind, which doesn't remember much these days.

 

I didn't see the recent reaction that led to my daughter's allergy testing. However, I'm proud of how she handled it. She ate some nuts while at a foreign airport waiting to return home from a mission trip. She felt her throat become itchy; she started wheezing; and she started coughing. She went and found an adult leader to tell her what was happening. When they discovered the airport clinic was closed, they bought Benadryl at the airport store, which she took. I am extremely glad that her reaction wasn't more severe and that she didn't have another reaction on the plane.

 

While we were waiting for the allergy testing, I told my daughter that I hoped she wasn't allergic since I knew from experience what it would mean. (Or, at least I remember what it meant in a much younger child.) She said, "It doesn't matter what the test says. I know I'm allergic, and I'm not going to eat nuts again." Of course, she never liked nuts anyway, so it was easy to say that.

 

Sorry for the ramble. Still thinking things through.