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I could use some help. Not long ago, I posted about my DS having hives in reaction to a bee sting. He's 10, has been stung by bees multiple times before with only one severe, non-allergic reaction. That was about a month ago. FWIW, I wasn't happy with his pediatrician's response, but that's a bit on the back burner at the moment.

 

Yesterday, he had a severe reaction to something he ate (he thinks it was hazelnuts. He ate more than one thing at the same time - oranges, hazelnuts, GF Oreos, Doritos. All he had had before). Whatever it was, his eyes and lips swelled, throat, ears, and eyes itched, he got a bloody nose, sneezed, was disoriented. Later that night he was constipated.

 

Luckily I had Benadryl and the nurse stayed on the line with me ( we were alreadyi n the car, coming home from a field trip when it happened) until we got to the Dr.s, to be sure it didn't progress to the point she needed to get me an ambulance or to the nearest hospital. We were give a twin pack epi-pen and a blood test for allergies (after hours, so from the urgent care Dr).

 

Here's my overwhelmed part. I don't really know what caused the reaction, so I'm really nervous about tonight. I plan on telling him no candy with tree nuts. Is that enough? Too much? The Dr. didn't give us any food advice and the test results won't be back.

 

Why would he suddenly have two allergies in such a relatively short time? He's always had environmental allergies but nothing I would call severe.

 

What can I expect from the test results? She said if it was positive, he was definitely allergic, but he could be allergic and have it come back negative. So, he's definitely allergic to something, if all the tests come back negative, what's my next step? An allergist, of course, but they just have the same negative results.

 

My brain is a muddle. Thanks for any help.

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:grouphug:

 

Food allergy and anaphylaxis network is a good resource. Google them.

I'd avoid all the foods he ate when he had the reaction until getting results.

My son is allergic to dairy and nuts, so the hazelnuts and doritos would have done it for him.

You may want to keep a food diary for a while to help figure things out as well.

 

Food allergies are particularly nasty and testing has false results which can be very frustrating. Keep medications with you at all times. If there's a reaction, medicate. You're at the toughest part right now.

 

I would avoid all nuts for now, but I also would keep a record of all food eaten and any reactions until you can get to an allergist.

 

Good luck! :grouphug:

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Get thee to an allergist as soon as possible. In the meantime, avoid all nuts and anything processed in a facility that has nuts in it, and see if you can get a pair of epi-pens in the mean time. Get an medic alert bracelet for nuts if they have them (which reminds me that I need to get a new one for penicillin).

 

Allergies can start at any time in your life, including severe reactions such at the one here.. I was able to eat nuts until I was in my mid forties, when many of them started to make my esophagus swell.

 

Allergy tests are not fool proof. I had the same type of reaction to penicillin once, but my allergy tests come back negative for it. Of course, it's been decades since I had it, but I am probably still allergic.

 

Also, I highly recommend getting an ELISA test for IgG reactions (allergy tests are for IgE reactions.) It's not uncommon for sensitive people to have both.

 

I highly recommend going onto a rotary diet. If you do an ELISA test, they should give you one. This reduces the likelihood of developing more reactions.

 

Finally, I suggest getting allergy tests for environmental allergies as well. Certain pollen allergies can lead to reactions to certain foods with similar proteins (I learned this the hard way), but often cooking those foods denatures the proteins so that they can still be eaten (NOT with nuts and not with such a strong allergy--I'm talking about an oral reaction with itching but no hives.)

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:grouphug:

 

You need an allergist.

 

I would avoid all those foods until you get your results. It is very likely the hyazelnuts though. I'd avoid all tree nuts including foods that have "may contain tree nuts" type warnings on their packages. Avoid sesame and mango too until you know as they cross with some tree nuts. One nut is certainly a possibility but very often kids will have allergies to more than one and it seems he has the potential to develop some new ones with exposure right now anyway. One tree nut allergy is, according to allergists, a blanket tree nut allergy anyway and you've got reason to think that's your issue. So I recommend strictly avoiding all of the tree nut/sesame/mango world until you know what you're dealing with.

 

You have an epi pen set and that's great. Read up on anaphylaxis signs. Any two body systems and you epi pen and call 911. You do not benadryl and wait to see if it gets worse because epi pens given too late will not always be able to stop a reaction. And too late can be very early in the reaction. Don't wait and see. Hopefully you won't have any reactions until you get the results. :grouphug:

 

Why now? Well there is something called a bucket theory of allergies. The body builds up with other allergic reactions, eczema, asthma, or some combination of those and when that bucket gets "full" it spills over on new things. The theory would say that your son is at his tipping point maybe with that bee reaction and so now he's super reactive. Beyond that even adults suddenly develop severe reactions. My husband has had no allergies in his life. At 37 he developed an anaphylactic reaction to buckwheat of all things.

 

When my son had his first anaphylaxis he was really struggling with environmental allergies and asthma. I think it was a bucket for him as he hadn't reacted to tree nuts before (he had lots of trace in his diet). We just tipped the scale on him. You may be in the same spot.

 

It will get easier in time.

Edited by sbgrace
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Avoid all pit fruits, too, not just mangoes & sesame, as some nut allergies can cross react, at least until you've been tested I forgot that you had epi pens! There are some good books with food families listed in them that can help you until you get tested. It's common for people to be allergic to more than one tree nut even if they are in different families. My nephew has had an epi pen since he was 2.

 

:grouphug:

 

You need an allergist.

 

I would avoid all those foods until you get your results. It is very likely the Hazelnuts though. I'd avoid all tree nuts including foods that have "may contain tree nuts" type warnings on their packages. Avoid sesame and mango too until you know as they cross with some tree nuts. One nut is certainly a possibility but very often kids will have allergies to more than one and it seems he has the potential to develop some news ones with exposure right now anyway. One tree nut allergy is, according to allergists, a blanket tree nut allergy anyway and you've got reason to think that's your issue. Anyway, avoiding the whole thing until you know is wise.

 

You have an epi pen set and that's great. Read up on anaphylaxis signs. Any two body systems and you epi pen and call 911. You do not benadryl and wait to see if it gets worse because epi pens given too late will not always be able to stop a reaction. And too late can be very early in the reaction. Don't wait and see. Hopefully you won't have any reactions until you get the results. :grouphug:

 

Why now? Well there is something called a bucket theory of allergies. The body builds up with other allergic reactions, eczema, asthma and when that bucket gets "full" it spills over on new things. The theory would say that your son is at his tipping point maybe with that bee reaction and so now he's super reactive.

 

When my son had his first anaphylaxis he was really struggling with environmental allergies and asthma. I think it was a bucket for him as he hadn't reacted to tree nuts before (he had lots of trace in his diet). We just tipped the scale on him. You may be in the same spot.

 

It will get easier in time.

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Get thee to an allergist as soon as possible. In the meantime, avoid all nuts and anything processed in a facility that has nuts in it, and see if you can get a pair of epi-pens in the mean time. Get an medic alert bracelet for nuts if they have them (which reminds me that I need to get a new one for penicillin).

 

Allergies can start at any time in your life, including severe reactions such at the one here.. I was able to eat nuts until I was in my mid forties, when many of them started to make my esophagus swell.

 

Allergy tests are not fool proof. I had the same type of reaction to penicillin once, but my allergy tests come back negative for it. Of course, it's been decades since I had it, but I am probably still allergic.

 

Also, I highly recommend getting an ELISA test for IgG reactions (allergy tests are for IgE reactions.) It's not uncommon for sensitive people to have both.

 

I highly recommend going onto a rotary diet. If you do an ELISA test, they should give you one. This reduces the likelihood of developing more reactions.

 

Finally, I suggest getting allergy tests for environmental allergies as well. Certain pollen allergies can lead to reactions to certain foods with similar proteins (I learned this the hard way), but often cooking those foods denatures the proteins so that they can still be eaten (NOT with nuts and not with such a strong allergy--I'm talking about an oral reaction with itching but no hives.)

 

Can you tell us more? How do we find out about the rotary diet and ELISA test? How do I find a good allergist? Our ped did my dd's IgE. Thanks.

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Thanks so much everyone. I got completely overwhelmed googling (is there any candy not exposed to nuts :( ) . I'll have to take it one step at a time. Unfortunately, he already ate some sesame and had diarrhea. We're lucky that was all.

 

He's anxious so I'm trying not to freak him out while still getting the severity. He thought (as did I) that if he avoided the things he ate yesterday and nuts he would be o.k.

 

I taught him to use the epi-pen until he could do it independently. He said he wouldn't eat any candy that hadn't been checked. I e-mailed his pediatrician (who I'm supposed to see for the results) and said I wanted a referral to an allergist instead.

 

I think I've done everything I can except :chillpill:

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My ds is allergic to tree nuts and peanuts and more. For Halloween, I take safe candy without peanuts or tree nuts or made in a facility with the same for him in my purse. He carries a plastic pumpkin and goes up and takes candy and tries to avoid nut candies when he can but it really does not matter since he does not eat any of the halloween candy since it is too risky IMHO. By bringing him safe candy and having a special safe treat at home, it allows him to enjoy trick or treating without eating the goods! I try to emphasize the positive and that he is not missing out on anything by eating our own special treats instead.

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Candy that might be ok for ds is the following but always, always check ingredients of every single food and ingredients!

 

dum dum lollipops

some plain hershey bars and some kisses are labeled without the "made in a facility with..." which should be safe

some smarties may be safe

milk duds

tootsie rolls

 

 

Avoid mixed bags of candies unless all candies are safe in the bag. Always check ingredients and for statements which can be tricky to find. No home made goods unless you make yourself (we follow this rule all the time). No bakery goods since most bakeries use nuts. No asian/chinese/japenese foods. Avoid eating out. Wendy's is ok. Always carry dual pack epi-pen on ds's person and in your purse as back up. carry Benadryl too.

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O.k., thanks. I'm taking down lists of candy and definitely not going anywhere without the epi-pens.

 

I'm sorry, one more question. The doctor last night said to only give the epi-pen if he has trouble breathing. Honestly, I felt as if if I had had it in the car yesterday, with all of his symptoms and needing to ask him constantly, "Any trouble now? Now?" I would have given it.

 

But, I know the pharmacist gave DH bad info when he told him to call a Dr. after administering and the patient info says in capital letters to go to emergency.

 

I guess, how do you know when to give it? Obviously, I don't want to wait too late.

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Your doctor is wrong about the epi pens.

 

This is a really nice powerpoint about use here. http://www.hrhs.net/content/nurse/epipen.ppt The end of it is what you need. It's made for schools so they know what to do but it's the same for you.

 

Look especially at the symptoms and body systems involved so you get a very good idea of what it would look like. His symptoms may be different from one time to the next.

 

Any two body systems is anaphylaxis. I think most would say any severe symptom is anaphylaxis (like throat swelling). Very often, but not always, anaphylaxis will have a skin/especially hive component. But not always.

 

Any anaphylaxis symptoms are epi pen, 911, benadryl. In that order. Do not wait to see if it gets worse. Statistically most kids who die have had epi pens. It just took too long to get there. Too long as in minutes in some cases. I don't mean that scary, though it is, but just to emphasize that the doctor's advice is dangerous. You don't wait. When in doubt, even, epi is what our allergist always says.

 

Our allergist's protocol also says any known exposure to the allergen we treat it like anaphylaxis immediately.

 

Remember-symptoms are epi pen, 911, benadryl. The problem with driving to the ER is epi pens can wear off quickly. Sometimes it takes two just to tamp down the original reaction. They are meant to buy a bit of time for an ambulance to reach you with life saving equipment.

 

On candy I would stick with dum dums, smarties (check that package but I've never seen an issue with them), and Hershey bars that do not have a cross contamination warning. Hershey's is very good about labeling for any potential tree nut cross. Their plain chocolate bars have always been ok here but full size only. The tiny bars often have cross contamination warnings on their packages. Always read the package and stick with companies you know label for cross contamination.

 

I just caught he might be gluten free? Is that true? Gluten free products almost always have cross contamination with tree nut or sesame. We lost pretty much everything (my gluten free flours, prepared things like gf breads I used to use, gluten free cereals, etc.) If you guys are gluten free I can help you convert if you're also dealing with a tree nut and sesame allergy. That's us and I found safe things for us to eat. I just have to hunt my lists.

 

If that's your situation you need to make your stuff from scratch for now and don't use any GF flours unless you know they aren't produced with tree nuts or sesame. Think potatoes, green beans, and chicken type things. Amy's gf products always have nut warnings but they are of an abundance of caution. They are very careful with their production lines when it comes to tree nuts and gluten. So we eat those products sometimes.

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Thanks so much everyone. I got completely overwhelmed googling (is there any candy not exposed to nuts :( ) . I'll have to take it one step at a time. Unfortunately, he already ate some sesame and had diarrhea. We're lucky that was all.

 

He's anxious so I'm trying not to freak him out while still getting the severity. He thought (as did I) that if he avoided the things he ate yesterday and nuts he would be o.k.

 

I taught him to use the epi-pen until he could do it independently. He said he wouldn't eat any candy that hadn't been checked. I e-mailed his pediatrician (who I'm supposed to see for the results) and said I wanted a referral to an allergist instead.

 

I think I've done everything I can except :chillpill:

He absolutely needs to know how to use the epi independently.

 

And he absolutely should not be responsible for self-administration.

 

Sometimes that works out. Or sometimes the patient becomes too anxious or otherwise unable to administer the dose themselves. This goes for adults, too. See item six in the list on this allergy website.

 

You've gotten good advice here. Many of your questions should be answered by a good allergist. An allergist should not just give positive/negative results. A good one is going to offer counseling and support while interpreting the often tricky results of allergy tests.

 

:grouphug:

 

O.k., thanks. I'm taking down lists of candy and definitely not going anywhere without the epi-pens.

 

I'm sorry, one more question. The doctor last night said to only give the epi-pen if he has trouble breathing. Honestly, I felt as if if I had had it in the car yesterday, with all of his symptoms and needing to ask him constantly, "Any trouble now? Now?" I would have given it.

 

But, I know the pharmacist gave DH bad info when he told him to call a Dr. after administering and the patient info says in capital letters to go to emergency.

 

I guess, how do you know when to give it? Obviously, I don't want to wait too late.

Read this and this from Anaphylaxis Canada. Actually, the whole site is good, as are other ones already mentioned.

Even if you aren't Canadian. :)

 

I'm uncomfortable with what your pharmacist said only because I was asked, in the middle of a reaction, "are you having trouble breathing?"

 

I was gasping for air as well as showing other signs of anaphylaxis. But I said, "no" because I didn't feel like it was hard. First, I was more in pain (in my GI tract) than anything. Also, I was not all there anymore.

 

And, I often don't feel like I'm having an asthma attack, either, until it has gone pretty far. A patient isn't always the most reliable source of info.

 

Luckily, the EMT saw I was in trouble and started treatment anyway.

My allergist gave us an "Action Plan" that lists all the symptoms one by by and she checked off which med to administer for each symptom. Good to have in the ER since some are less familiar with anaphylaxis than others.

Edited by Clairelise
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I wanted to mention something else. Epi pens kick back on you. The instinct can be to go with the kick back and pull it out. The tester/practice pens don't kick back so it can be a surprise if you ever have to use the real thing. You guys need to know jab it in firm to the thigh skin (through pants--they are made to do that) and hold it down expecting a pull back from the pen.

 

I don't know if you want to, or even should, look at this but this person has a blog post explaining why your doctor is wrong about looking for breathing only or taking a wait and see with benadryl approach. http://anothermomsfoodallergyjourney.wordpress.com/2008/01/16/when-to-use-the-epi-pen/

 

Basically, epis can be life saving early. Every minute into the reaction it's harder to turn it around. And the early reactions can be blood pressure drops/cardiovascular collapse. You want to epi before that.

 

Do not necessarily rely on him to give you accurate information in the middle of a reaction. He may well not be able to give the epi to himself in a reaction either.

Edited by sbgrace
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I just caught he might be gluten free? Is that true? Gluten free products almost always have cross contamination with tree nut or sesame. We lost pretty much everything (my gluten free flours, prepared things like gf breads I used to use, gluten free cereals, etc.) If you guys are gluten free I can help you convert if you're also dealing with a tree nut and sesame allergy. That's us and I found safe things for us to eat. I just have to hunt my lists.

 

If that's your situation you need to make your stuff from scratch for now and don't use any GF flours unless you know they aren't produced with tree nuts or sesame. Think potatoes, green beans, and chicken type things. Amy's gf products always have nut warnings but they are of an abundance of caution. They are very careful with their production lines when it comes to tree nuts and gluten. So we eat those products sometimes.

 

Last I checked Bob's Red Mill GF products were also processed with tree nuts. But as far as I know, King Arthur GF mixes are tree-nut, peanut, and soy free. But, OP, you'll learn that you have to check labels every time for allergens because ingredients sometimes change.

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I have anaphalactic tree nut allergies. The worst is hazelnuts. My heart races, my throat swells and have the worst stomach pain (think childbirth) for hours.

 

I carry an epipen everywhere and benadryl melt strips. I'm superdiligent about watching labels. Did the doc talk about melt strips? Do it right away and it can drastically help it from escalating.

 

Oh and i can have peanuts. Peanuts are legumes and aren't in the same family as tree nuts.

 

Also, does your dc have outside allergies? If so, it's possible it is oral allergy syndrome rather than a true tree nut allergy. It happens in some people with severe outdoor allergies . Some foods have chemically similar to those the person is allergic to. If the person's immune system is hyperactive (high levels of allergens in the air) the person's body reacts to certain foods in a weird way. Hazelnuts, fruits, and raw tomatoes are the most common reactions. If it is, that's good news as oas rarely truly becomes anaphalactic.

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I remembered the kids with food allergies forum (excellent, you might want to join) has information about candy.

 

http://community.kidswithfoodallergies.org/displaycontent/content/how-to-read-Halloween-candy-allergen-labels'>http://community.kidswithfoodallergies.org/displaycontent/content/how-to-read-Halloween-candy-allergen-labels

 

Notice the dum dum and smarties--those are why they are often recommended. http://community.kidswithfoodallergies.org/displaycontent/content/how-to-read-Halloween-candy-allergen-labels Notice also sesame and may contains aren't label requirements so you are safer sticking with known safe stuff. Hershey's isn't mentioned on that post but they have an excellent reputation for labeling carefully.

 

My flour products back then were mostly Rob's Red Mill and those are nightmares for tree nuts. There are gluten free sources though that will be safe for your son if it turns out you need that.

Edited by sbgrace
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1. Sesame seed allergy is super tough. They're hiding in so many foods you'd never suspect and often unlabeled - this article briefly describes the problem.

 

2. If you have to use the EpiPen, you need to go to the ER. This has been said above, but I wanted to say it again. Reactions can be bi-phasic. You think you've fixed it, but you've just taken care of the first hump with another coming. For this reason I'd never drive one of my reacting allergic children to the ER alone in a car.

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My dd had already a wasp allergy but was on shots for a number of years when she developed a citric acid allergy that causes anaphalexis. Soon after that, she went to get her wasp allergy shot and reacted anaphalactecly. The allergist lowered the dose to 1/10 of an wasp injection and she still reacted anaphalactectilly. I think her body was just over primed by the other allergy reaction and then reacted excessively to the one she already had had problems with. I think the same thing is probably happening to your son.

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Oh man. I didn't notice in your post you said he appears to have reacted to sesame. I'm sorry to read that.

 

Sesame is a pain to deal with. It's not a required allergen label and it hides in a lot of stuff--especially cross contamination. A lot of spices, crackers (esp gluten free) and commercial breads have sesame cross contamination. The oil hides in weird stuff too (even sugar candies).

 

McCormick single ingredient spices are as safe as you can get with sesame. They are pretty careful with their cross contamination for their individual spices. I did not find any other sesame safe spice companies.

 

Sesame is also tough to test accurately for. I don't understand why exactly but it has a relatively high percent of false negative results which isn't terribly common in other food allergens. So a person can test non-allergic and still be allergic to sesame and it happens more often than with other foods.

 

When my son was diagnosed I was scared and so overwhelmed. I left the allergist's office with all this information and then went home and called companies to find out I was going to have to get rid of almost everything we were eating or at least it felt that way. But it's really not a big deal now. The only hard thing is finding or bringing safe food everywhere for him but even that we've adjusted to. It gets easier. I feel like you get all this information and might feel like you're drowning in it. It gets easier.

 

The most important thing is to make sure you know the signs of anaphylaxis and remember it's epi, 911, benadryl in that order. Also do see an allergist as soon as possible.

Edited by sbgrace
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Can you tell us more? How do we find out about the rotary diet and ELISA test? How do I find a good allergist? Our ped did my dd's IgE. Thanks.
I had to get the ELISA test prescribed by a wholistic MD who was listed on the DAN! site (I got tested & am not on the autism spectrum). You may want to google them, find a lab & see if you can find out who does them in your area. Rotary diet--a good book on this is Marjorie Hurt Jones's http://www.amazon.com/Allergy-Self-Help-Cookbook-Marjorie-Jones/dp/051712002X . However, the doctor I went to said that I could eat something several times in a day as I have many sensitivities & allergies. This is general. If you get an ELISA test you should get a rotary diet made up for you.

 

Thanks so much everyone. I got completely overwhelmed googling (is there any candy not exposed to nuts :( ) . I'll have to take it one step at a time. Unfortunately, he already ate some sesame and had diarrhea. We're lucky that was all.

 

 

I think I've done everything I can except :chillpill:

 

Candy--you can make it homemade. I cannot have Hershey's.

 

Candy that might be ok for ds is the following but always, always check ingredients of every single food and ingredients!

 

dum dum lollipops

some plain hershey bars and some kisses are labeled without the "made in a facility with..." which should be safe

some smarties may be safe

milk duds

tootsie rolls

 

 

Avoid mixed bags of candies unless all candies are safe in the bag. Always check ingredients and for statements which can be tricky to find. No home made goods unless you make yourself (we follow this rule all the time). No bakery goods since most bakeries use nuts. No asian/chinese/japenese foods. Avoid eating out. Wendy's is ok. Always carry dual pack epi-pen on ds's person and in your purse as back up. carry Benadryl too.

 

I'd be careful as many candies have other additives kids can be sensitive to. I have found some good choices in the special/natural foods sections. This is also the best section to find safe foods as some brands try to avoid a number of problem foods to get a larger market, I think. HOWEVER, more and more "junk" gluten free & nut free foods are appearing & those are ones I find the worst for other things I'm sensitive to.

 

Not every ingredient has to be listed on the label. eg Pure maple syrup can have oil (never peanut oil that I've ever heard) used to make boiling it down easier, but it's never, ever listed.

 

Bob's Red Mill is something I don't buy.

 

I often try to by foods I know we can have in bulk, such as gluten free oats (not Bob Red Mill). I buy it in large quantities from a supplier that processes ONLY oats and nothing else. This isn't always easy, and hopefully you don't have to be that careful.

 

Avoid commercial ice cream even if no nuts are listed as they cannot clean their stuff well enough unless they say that they never use nuts. My nephew can't eat any of it as he's been allergic to peanuts since the second time peanut butter touched his lip. Thankfully his parents are both MDs & his dad knew what to do (and he wasn't at the babysitters, although she was very familiar with that stuff.)

 

You cannot rinse nut oil off of anything with water, and with nothing if it's on food already. Yes, people have died because their epi pen was in the car or not close enough. If your dc is at ps, the epi pen must be in the same room, not at the nurse's office as it can be too late. Never store your epi pen in the glove compartment even if the MD says to--that's wrong. I have one in my purse & one at home & I carry Benidryl. I take allegra every day, but am allowed to take one Benydril if something else happens. I've never had to use the epi pen, thankfully, because I found my nut allergy while on an antihistamine, but DON'T take Allegra, etc for food allergies. I take it for my environmental allergies which are year round. And, yes, 911 as soon as you've used the epi pen.

 

Ideally, your house should become nut free. My sister asked my mother to give her other dc peanut butter when they were at my mother's house without the eldest, but never has any at home. Or at least she didn't. My nephew is 18 and away at university now.

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Is there something like dum dums without artificial coloring that you all can recommend and think I can find easily? My son loves but can't have ring pops and maybe I can find something for him for a treat.

 

Unjunked is a brand with no artificial colours or flavours, but I'm not sure if it's nut free.

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