Positively Beautiful: Life or death consequences of peanuts and beyondJust a few weeks ago, Natalie Giorgi attended summer camp near Sacremento, Calif., with her family. After singing songs around a campfire, snacks were shared, and Natalie carefully chose a Rice Krispies treat, as she had done at this camp in previous years.
By: Dr. Susan Mathison, INFORUM
Just a few weeks ago, Natalie Giorgi attended summer camp near Sacremento, Calif., with her family.
After singing songs around a campfire, snacks were shared, and Natalie carefully chose a Rice Krispies treat, as she had done at this camp in previous years.
She and her parents were always careful since she had a peanut allergy. Unfortunately, she tasted peanut butter when she bit into it and spit it out immediately. She found her parents, told them what had happened and was given a dose of Benadryl to ward off an allergic reaction. She had never experienced a severe reaction before, but she and her parents always carried medication, just in case.
Natalie felt fine and wanted to return to her friends and the fun of camp, but her parents insisted that she stick close by so they could watch her. Twenty minutes later, she felt weak and vomited. She began to have trouble breathing and was given an Epi-Pen by her father, a doctor. Then, she was given a second and then a third dose.
Unfortunately, her airway continued to swell despite emergency treatment including CPR, and she died from her allergic reaction.
This story breaks my heart, perhaps because I put myself in the shoes of her doctor father, unable to save his daughter despite treatment. The family was prepared and knowledgeable. He responded in text-book fashion, but it was not enough. Perhaps they should have headed for the ER immediately. But the outcome may have been the same.
Food allergies are on the rise for reasons that researchers don’t completely understand. The most common culprits are eggs, milk, peanuts (which are actually legumes not nuts), tree nuts, soy, wheat, shellfish and fish. Egg allergies are the most common, but peanut reactions seem to be the most likely to cause life-threatening anaphylaxis.
Other foods can cause anaphylaxis, too. One of my staff members has a severe allergy to orange. Despite great caution, she has had a couple of emergency room trips due to anaphylaxis caused by accidental exposure.
Allergic reactions can vary in severity from mild tingling around the mouth to life-threatening anaphylactic shock. Reactions tend to become more severe with more exposures, so even if a person has not had a severe reaction in the past, he or she may still be at risk for anaphylaxis.
Anaphylactic reactions can be caused by medications and insect bites as well. One of my brothers experienced anaphylaxis to a bee sting at the lake last summer. He had never had a reaction before. His arm swelled immensely and he became short of breath.
We gave him Benadryl and an Epi-Pen Jr. that belonged to my little nephew. He felt a little better, but we made a frighteningly fast trip at 85 mph to the ER in Detroit Lakes, Minn., where he was observed for a couple of hours. I have restocked the Epi-Pen stash at the lake, and he now has a supply at his home, too.
Food allergies account for more than 200,000 ER visits every year, according to studies done by The Food Allergy Research & Education group (www.FoodAllergy.org).
Some people complain food allergies are over-hyped and that parents are overly anxious.
I think there is a major confusion between true food allergy and food sensitivity, and we can do better about distinguishing them.
Natalie’s death points out that despite lifelong caution, accidental exposure to allergenic foods can and does occur. We take care to prevent accidents as much as possible in so many aspects of life, and people with food allergies should be treated care and respect.
This may mean careful hand-washing, a peanut-free zone in the school cafeteria, SunButter instead of peanut butter, preparing or purchasing special school snacks or a flight without a package of peanuts.
Beyond strict avoidance, there is hope. Studies out of Duke University and Allergy Associates of Lacrosse, Wis., indicate giving extremely tiny, controlled doses of the offending food might help patients develop enough immunologic tolerance to protect them in case of an accidental exposure. Research continues on this option to assess safety and efficacy, and do NOT try this at home.
Rest in peace, Natalie. Your parents will crusade on your behalf to save other kids.
Dr. Susan Mathison founded Catalyst Medical Center in Fargo and created PositivelyBeautiful.com. Email her at firstname.lastname@example.org.