Comments on: Questions http://www.pediatricallergyindy.com Pediatric Allergist Frederick E. Leickly - Riley Hospital for Children - Indianapolis, Indiana Mon, 30 Aug 2010 14:27:44 -0400 hourly 1 http://wordpress.org/?v=3.0 By: fleickly http://www.pediatricallergyindy.com/questions/comment-page-1/#comment-882 fleickly Tue, 20 Jul 2010 21:32:23 +0000 http://www.leicklystory.com/?page_id=568#comment-882 Great question and a real dilemna. My perspective is that the epi pen is like a life preserver- you would want it close by when you need it. Certainly a child should have one very close by, perferably on their person. Carrying an epin pen is also a function of the maturation level of the child. You have presented one concern about carrying an epi pen and that is the ability of the child to self administer the medications. The other is the child who thinks this is a toy. In these instances it would not be a good idea for them to carry the epi pen. If the young lady can't recognize what is going on and may not be able to respond appropriately or effectively then we need to consider alternatives. When these situations arise we try to compromise. We are all here for the safety and well-being of the child and that must not be forgotten. As the parent, you need to feel comfortable about her new environment. Also, you do not want to have an antagonistic relationship with the school-you need/want a supportive one. Let's find a set-up that works. If there is any chance of peanut products being in the classroom, then the epi pen should be close by for immediate use. A special place, designated for that injector could be arranged so only an adult (repsonsible person) can reach it and get to it fast without fumbling with keys/combinations or other locks. It is all about the safety of the food allergic child and the ability to respond swiftly- within seconds, when an exposure and reaction occurs. FEL Great question and a real dilemna. My perspective is that the epi pen is like a life preserver- you would want it close by when you need it.
Certainly a child should have one very close by, perferably on their person. Carrying an epin pen is also a function of the maturation level of the child. You have presented one concern about carrying an epi pen and that is the ability of the child to self administer the medications. The other is the child who thinks this is a toy. In these instances it would not be a good idea for them to carry the epi pen.
If the young lady can’t recognize what is going on and may not be able to respond appropriately or effectively then we need to consider alternatives.
When these situations arise we try to compromise. We are all here for the safety and well-being of the child and that must not be forgotten. As the parent, you need to feel comfortable about her new environment. Also, you do not want to have an antagonistic relationship with the school-you need/want a supportive one. Let’s find a set-up that works.
If there is any chance of peanut products being in the classroom, then the epi pen should be close by for immediate use. A special place, designated for that injector could be arranged so only an adult (repsonsible person) can reach it and get to it fast without fumbling with keys/combinations or other locks.
It is all about the safety of the food allergic child and the ability to respond swiftly- within seconds, when an exposure and reaction occurs.
FEL

]]> By: Meg http://www.pediatricallergyindy.com/questions/comment-page-1/#comment-879 Meg Tue, 20 Jul 2010 19:03:39 +0000 http://www.leicklystory.com/?page_id=568#comment-879 Dr. Leickly, We are preparing for our daughter's first year in public school (first grade). Upon meeting with the assistant principal earlier in the year I found out that the school keeps epipens locked in the nurse's cabinet. I spoke with you regarding this at my daugther's annual appointment for allergy testing and you said that is unacceptable - that children with severe allergies need their epipens with them at all times. I have not yet spoken with the school regarding your comment however I will be advocating for my daughter - that she be able to have her epipen with her at all times. The catch is that the school handbook, paperwork and the Indiana Code 20-33-9-13 imply that if a child is permitted to carry his or her epipen he or she would also have to self administer. My daughter, at age 6, is unable to recognize her reaction symptoms and would not be able to be trusted to know when to self administer an epipen. Have you run into this problem before? Do you know what the schools of your other patients do? Thank you! Dr. Leickly,

We are preparing for our daughter’s first year in public school (first grade). Upon meeting with the assistant principal earlier in the year I found out that the school keeps epipens locked in the nurse’s cabinet. I spoke with you regarding this at my daugther’s annual appointment for allergy testing and you said that is unacceptable – that children with severe allergies need their epipens with them at all times.

I have not yet spoken with the school regarding your comment however I will be advocating for my daughter – that she be able to have her epipen with her at all times. The catch is that the school handbook, paperwork and the Indiana Code 20-33-9-13 imply that if a child is permitted to carry his or her epipen he or she would also have to self administer. My daughter, at age 6, is unable to recognize her reaction symptoms and would not be able to be trusted to know when to self administer an epipen.

Have you run into this problem before? Do you know what the schools of your other patients do?

Thank you!

]]> By: fleickly http://www.pediatricallergyindy.com/questions/comment-page-1/#comment-486 fleickly Wed, 14 Apr 2010 19:47:10 +0000 http://www.leicklystory.com/?page_id=568#comment-486 Thank you for the question. I have not heard this about soy. It would seem that he has tolerance to soy- having been a major and regular part of his diet. The symptoms may not be consistent with a type I (IgE) mediated reaction. The itch could be- especially if it was due to hives (urticaria), however the other symptoms would not be due to allergy. Exhaustion and dark circles have many different causes. The dark circles are seen in patients who have ocular/upper respiratory tract allergy. Anything that causes nasal congestion and subsequent blockage of the blood vessal can lead to the dark circles. Can you lead me to what you read about this aspect of soy allergy. Could it be that they were refering to some other mechanism of an adverse reaction to food? Let me know. FEL Thank you for the question. I have not heard this about soy. It would seem that he has tolerance to soy- having been a major and regular part of his diet.
The symptoms may not be consistent with a type I (IgE) mediated reaction. The itch could be- especially if it was due to hives (urticaria), however the other symptoms would not be due to allergy. Exhaustion and dark circles have many different causes. The dark circles are seen in patients who have ocular/upper respiratory tract allergy. Anything that causes nasal congestion and subsequent blockage of the blood vessal can lead to the dark circles.
Can you lead me to what you read about this aspect of soy allergy. Could it be that they were refering to some other mechanism of an adverse reaction to food?
Let me know.
FEL

]]> By: Jennifer http://www.pediatricallergyindy.com/questions/comment-page-1/#comment-485 Jennifer Wed, 14 Apr 2010 19:14:17 +0000 http://www.leicklystory.com/?page_id=568#comment-485 I have recently read that a soy allergy can present itself gradually over time and culminate in an unsuspecting anaphylactic reaction. Due to my son's milk allergy he drinks/eats a considerable amount of soy. We now wonder, could soy be causing his exhaustion, frequent itchy face during meals and dark under-eye circles? We have been searching for the cause of these symptoms for almost a year. Sorry, I had trouble summarizing this question! I have recently read that a soy allergy can present itself gradually over time and culminate in an unsuspecting anaphylactic reaction. Due to my son’s milk allergy he drinks/eats a considerable amount of soy. We now wonder, could soy be causing his exhaustion, frequent itchy face during meals and dark under-eye circles? We have been searching for the cause of these symptoms for almost a year. Sorry, I had trouble summarizing this question!

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