In With the New

As promised, here are some pictures of our new (new-to-us) ride...

Harper enjoyed showing off the minivan.

The Cockpit

Look at all that glorious space!

Harper is a fan of her new spot in the car.

Harper loves the DVD player - and doesn't argue about the fact that we're only going to use it for long trips (like to Wisconsin)

Ah, trunk space! Room for a stroller and a kid (and probably some groceries).

So we are now the proud owners of a 2003 Honda Odyssey. It is newer than the car we sold, but has twice as many miles on it. That did seem a bit weird, that we would trade for a car with higher mileage, but it really was about the space and not about the condition of the car (my car was in great shape!). It's difficult to find a used minivan with all the bells and whistles, I guess people just drive them until they die. We're hoping to get a couple of years out of this one (maybe even 4?) and then be able to buy a brand new one. Is it too much to hope that there will be a hybrid minivan by the 2013 model year???

Out with the Old

(Don't worry Giselle, I will get to the new car later this week!)


Tomorrow I will turn over the keys to the car I have had for the last nine and a half years.

That car was my college graduation present from my parents (Thank you Mom and Dad!). When they bought it they were originally looking at a two-door version with light interior. My mom argued that the light interior would probably not hold up well and that I would have a hard time getting to a car seat in the back of a two-door. I laughed at this when they gave me the car, but it turned out to be some great thinking on her part.

That car came before my first teaching job, before I met Matt, before I had kids. That car took me to job interview and jobs. That car carried me to St. Louis, Columbus, Minneapolis/St. Paul, Madison, Louisville and Chicago to visit friends. The gift of that car allowed me to take my first teaching job and move back to Ohio. I drove that car home to Wisconsin for the weeks before my wedding. That car has been witness to other events, like Harper's first day of school. It has ferried us safely to doctor and dentist and dog grooming and countless other appointments.

If it weren't for the fact that I didn't have a car payment I don't think I could have afforded to take that first teaching job in a Catholic school, a job with a salary that barely covered rent, utilities, and insurance. And if I hadn't taken that job I never would have met Matt, and, well, the rest is history.

Despite the fact that my dear car felt too small almost from the moment we first had kids, it has served me well. It is as comfortable to me as my favorite shoes and as familiar as my favorite music.

So I may have complained that the stroller took up the entire trunk space. I may have hit my head too many times to count leaning over to strap babies in their seats. I may have wondered what it would be like to drive something new. But I am truly grateful for my little Cavalier.

Tomorrow I will pass it along to a woman (who may wish to remain anonymous!) who has just graduated from college. I hope it serves her as well as it has me.

Balance Sheet

Ah Michael - he is sitting squarely in the middle of an age both wonderful and horrifying. That stage in which mobility is all but fully achieved and there is no awareness of danger. He tries to crawl right off of elevated surfaces like the changing table and the bed - I would like to request doses of both depth perception and fear please.

The eating is horrifying - he LOVES to eat but is, as are most diners his age, sloppy and impatient. If you put food on his tray bite by bite, he's signing for more as soon as his fingers leave his mouth. If you offer a little more at time he picks it up by the fistful and uses both hands to stuff it in, after which he wipes his hands on every nearby surface: hair, his clothes, our clothes, the table, the chair - he doesn't discriminate. Michael is also starting to show distinct food preferences. He's getting a combination of baby food and table food, but we have to feed him the baby food before offering the table food or he won't eat it. If you offer the wrong thing he has no qualms about protesting loudly and throwing food. And of course his wrath rains down upon anyone who dares come near him with a washcloth, so that's fun.

And diaper changes, have I mentioned those? The arching of the back and more exercising of the lungs - sheer joy!

Seriously though, as much as almost-toddlers are little bodies of frustration, there are so many things to love about Michael at this age.

Like how sweet and cuddly he is just waking up from a nap:



And how he talks ALL THE TIME. Harper frequently says, "Michael is sure talkin' up a storm today!" Of course it's 99.9% nonsense, but I love, love, love to hear him babble. I haven't had much luck getting it on tape yet, but I have hope.

I am also finding it amazing how well he is moving around, pulling up, cruising a bit, and figuring out how to get down after he gets up! It amazes me because two months ago he could barely belly crawl across a room.

Aside from the food in the hair, and the arched-back screaming monster who occasionally appears, I find Michael so amusing these days. I could listen to him talk, watch his butt-waggling crawl, and witness his exploration of the world all day long.

So today was Michael's turn in front of the camera. These aren't ground-breaking videos. They aren't even particularly funny or sweet. They are just a little window into our days, and how far Michael has come.

Random Photos and a Random Video

(Look at me and my catchy titles! That one should draw hits from all over the internet!)

So we're in the process of selling my car because of the recent van purchase. It has been parked at the end of our driveway for about a week now. We haven't had a lot of rain during that time and I took some pictures yesterday to show the unbelievable build up of pollen on the car:






All that yellow dust is pollen - wild! No wonder we have such a problem with allergies!

*****

And now a video conversation with Harper:



My favorite part is when she is telling me why she likes Shania Twain and then gets totally derailed as she notices a bug on our window.

And yes, she did accidentally run into her friend on the playground. Who knew preschool could be so rough?

I have no idea what she was saying about the seats on the minivan - let me know if anyone else can interpret that.

Hoot!

Harper is trying to convince me that we should watch a Barbie movie (gag) this afternoon.

"Do you like Barbie?" she asks.

"Meh."

"Do you like ballet, it's a ballet movie!"

"I don't really want to watch Barbie do ballet."

"Mom, don't you like happy endings?"

It's hard to argue with that. But I'm still not watching the Barbie movie with her!

Food Allergy Awareness Week: Loose Ends

So there are still several questions about food allergies, or Harper's allergy, that I haven't answered and Food Allergy Awareness Week was technically over yesterday.

Instead of posting another marathon post tonight, I'm thinking I'll just pick a day here and there to be an allergy day and pull out some of the unanswered questions then. They are all worth discussing!

Incidentally if you have a pressing question that you really want answered, don't be afraid to email me and I can get back to you pretty quickly (despite what my email track record might suggest).

Things that I hope to cover in the future:

• what we think/do about other nuts (tree nuts) and seeds
• our experience with other people "getting it" and cooperating (or not) with our requests
• theories on avoidance vs. early exposure to highly allergenic foods
• research being done and current hopes for treatment of food allergies

I'm so thankful for the positive response I've had to these posts. Of course I'm not technically an expert, but I have spent so much time reading/thinking/talking about handling Harper's food allergy that I believe my experience definitely counts for something.

I'm also really encouraged by those of you who say you've learned something here. I don't ever think the world will (or should) be nut free, but I do hope we can help each other be more sensitive to the special needs of all our kids and find some small ways to make the world just a little bit safer.

By the way, guess what they found under the seats when they were detailing our new (old) van...

Peanut shells!

How glad am I that we didn't let Harper get in to take a look before having it cleaned?

Food Allergy Awareness Week: Technical Stuff In Three Parts

Part One: Prior/Indirect Exposure

A couple of people have asked questions about Harper's level of exposure to peanut products before she had that first reaction. Trust me when I say we were not a peanut free house - not by any stretch of the imagination. Matt at peanut butter and jelly several times a week. We at candy with peanut butter in it, granola bars with nuts in them, peanut butter toast, and at least once a week gave the dog peanut butter inside a rubber chew toy. I know she'd had bites of granola bars which may have had peanuts in them and she may have been exposed through plain M&Ms. In fact we know she'd had at least one exposure before the peanut jar incident, because you can't have an allergic reaction to something without first being sensitized to it. And I know I ate peanuts and peanut butter while I was nursing and while I was pregnant.

In fact, Harper had terrible eczema during the first year of her life - there was one spot on her cheek that was always very raw looking. Our pediatrician sort of dismissed it, kids have eczema and it isn't necessarily a big deal. It cleared up instantly when I stopped nursing her. So I am pretty sure that eczema was a reaction to peanut protein she was getting through my breast milk. I wished I had tried harder to find the cause of it while I was still nursing her. I don't think I CAUSED Harper's allergy with this exposure, but it may have been exacerbated. The allergist told me to strictly avoid peanuts if I got pregnant again and I did not have a single peanut (to my knowledge) while I was carrying Michael or when he was drinking my breast milk.

At the very least I would caution other parents to watch children carefully for signs of a reaction the first several times they eat a highly allergenic food like peanut butter - even if you're sure they've already been exposed to peanut products around your home.

Also - people can develop allergies to anything at any point in their lives. I don't think that means we all need to walk around with epi pens, but just because a child does not have an allergic history with a food doesn't mean they can never become allergic.

Part Two: Testing/Outgrowing a Peanut Allergy

There are different theories out there about how and when children, even those with known allergies, ought to be tested. There are two tests (to my knowledge) for food allergies; one is a blood test and one is a skin test. Harper has had repeated blood tests to check her peanut allergy levels and has had blood and skin tests to rule out other allergies (tree nuts, oranges, sunflower seeds - those are the ones I can think of). Our allergist told us that a negative blood test can leave you 75% certain a child is not allergic and you only get 100% when you pair it with a negative skin test. We have never skin-tested Harper for peanuts as we know from her blood tests and history that she is allergic.

We have Harper tested about once a year. In terms of her peanut allergy we retest her to see how the numbers are trending. When we go in for her peanut allergy testing we will add other tests if there are foods we are concerned about.

Discouragingly, Harper's peanut allergy numbers have skyrocketed since she was first diagnosed. I have read that numbers tend to peak around age three (I can offer no explanation for this, but it is a silly thing that I hold on to) - this year we'll test her again before school begins so maybe we'll find her numbers have stabilized or even dropped some.

Only about 20% of children with peanut allergies outgrow them, and those who do tend to have low numbers to begin them and outgrow them at a young age, typically by about five years old. Peanut (and I believe tree nut as well) allergies are more likely to stick around than some others that are common in young children, like dairy and egg allergies.

A food challenge, done under close medical supervision, is the ultimate way to determine whether an allergy has been outgrown. Harper's numbers are nowhere near low enough for us to consider such a thing.

I get nervous when I hear people talk about "mild" peanut allergies. Everything I have read and been told states that there is no such thing. Peanut allergies are volatile, a past reaction is not necessarily an indicator of what a future reaction will look like, and even people with low numbers can have severe reactions to a tiny amount of peanut protein. We have always treated Harper's allergy as "severe" even when her numbers were low.

Part Three: Medications

Swistle asked specifically about EpiPens and how they work, plus some other questions about what happens when an allergic reaction occurs. Here is my very non-scientific, non-medical, as well as I understand it explanation...

An EpiPen is basically loaded with adrenalene, which can work to reverse the effects of an anaphylactic reaction. Prompt use of an EpiPen during an allergic reaction can temporarily relieve swelling and hives (which can restrict the airway) and counteract a sudden drop in blood pressure, all of which may occur in the case of a severe allergic reaction. Often EpiPens are used in conjunction with Benadryl, and it is my understanding that Benadryl can help combat a minor reaction and provide comfort for things like itchy hives. Benadryl is not going to be life-saving in the case of a severe reaction.

Depending on the severity of the reaction, the medication in an EpiPen can start to wear off after ten to fifteen minutes. With very few exceptions we always carry at least two EpiPens (We are NEVER without one). Most of the time we also carry Benadryl and a rescue inhaler (which is for asthma difficulty and would not help in an allergic emergency). It is helpful for people at risk for anaphylactic shock to know whether their local emergency response teams carry epinepherine and what their response time is likely to be. People in areas where it would be difficult for the paramedics to get to them should have more than two EpiPens available.

In a severe reaction medication would be needed at the hospital and perhaps for several days after - I have heard of people having severe reactions and then having trouble with hives for days afterward.

There is also a risk of something called a biphasic reaction, in which a second reaction comes on hours after the first and often stronger. If we ever went to the emergency room for an allergic reaction and were discharged less than six hours after our arrival, I would wait in a waiting area or lobby until that amount of time had gone by, to be sure we weren't away from medical assistance if a biphasic reaction occured.

One thing our allergist really drilled into my head was the fact that it is always better to use the EpiPen than wait and see. She told us that is the number one mistake patients and care-givers make - waiting too long to use it or not using it at all. It is possible to reach a point in an allergic reaction when an EpiPen will no longer help. That's why, at school for example, Harper's EpiPens are supposed to go with her (carried by a teacher) whenever she leaves the classroom. It's also why we would not agree to a situation where her EpiPen had to be locked in the school office, as many other meds are. In an allergic emergency there really may not be time to run and retreive the EpiPen.

*****

In many ways I feel like my posts this week have been a poor attempt to convey all we've learned about dealing with food allergies - it is overwhelming to attempt to pair the information swimming around my brain down to any reasonable length! For people who are really interested in learning more, and would perhaps like a more proper technical explanation of all of this, I recommend The Peanut Allergy Answer Book.

On a final note - we bought a used minivan today! Yea!

The first thing we did was take it to a car wash to be detailed (really, really thoroughly cleaned) because I want to make sure there is no peanut residue in the van when I put the children in it. I'm telling you, this allergy thing never ends.

Food Allergy Awareness Week: Going Public

Thank you to everyone who was so understanding of yesterday's grumpity post. It does seem like a good time to talk a little more about our forays into public spaces and how Harper's peanut allergy has influenced some of our decisions. I am going to address a couple of comments/questions specifically...

Anne mentioned that her twins go to a peanut free school, but the kids eat peanut butter for breakfast many mornings. They wash up after breakfast, but she wondered if they were putting allergic students at risk anyway (I'm paraphrasing!).

At the beginning of the school year we asked that the children in Harper's class who eat peanuts or peanut butter in the morning have their hands washed (with soap!), brush their teeth, and change their shirts. Whether everyone abides by this we have no way of knowing. The truth is that peanut protein can be stubborn. Hot water alone will not rid a surface of residual peanut residue. And it only takes a very little bit to cause a reaction.

So yes, there is a scenario in which the peanut butter a child eats at breakfast, if not cleaned up, could come to school on little hands. The hands touch a toy in the preschool room. The child with a peanut allergy plays with that toy and a contact reaction occurs. Or said child puts her hands in her mouth after playing with the toy and an ingestion (more serious) reaction occurs.

I think two ways about this:

1) If we want to make absolutely sure we never, ever run into peanut residue we can never leave our house. And we can never invite into our house anyone who has possibly eaten peanuts or peanut butter. Which, for us, for now, is not a realistic way to live. We take a calculated risk every time Harper sits in a shopping cart, picks up a library book, puts her hand on a playground swing, and goes to school.

2) I DO want parents to take the precautions seriously, like Anne does, because as unlikely as it may seem that Harper ends up reacting to something someone ate an hour ago for breakfast, it is possible. My worry is that parents are reading those notices (or not reading them at all I guess) and thinking that we're being too far fetched in our efforts and not following through on things like cleaning up after breakfast. This sort of dismissive attitude DOES put Harper at greater risk, no matter how small.

As much as we tell little kids NOT to put hands and toys (and the ends of crayons and the play food, etc.) in their mouths, they do, and that's why we ask for after breakfast tooth-brushing, too.

Giselle asked if we avoid particular public spaces because parents like her might pack PB&J for messy little kids to eat there.

The answer to that one is yes and no. I do try to avoid places, like a children's museum public eating area, that is likely to have LOTS of peanut residue. It is most often easier to eat at home and plan our excursions around meals. BUT there are plenty of situations where we do have to eat in public spaces and then we're talking again about risk management. I always carry wipes with me (plain water won't cut it, but baby wipes and clorox type wipes are pretty good) and wipe down tables and chairs where Harper would eat. We are extra careful with restaurant booster seats - even if the restaurant doesn't serve nuts, who knows what the previous client brought along for her toddler to munch on. I would NEVER let Harper place her food directly on the table in a public eating place.

In those kinds of situations I actually worry more that kids have eaten peanut butter for lunch, and not had their hands cleaned well before heading back to the play areas - as much as I'd like to, I can't go ahead and wipe down every touchable surface in a children's museum or on the playground.

I don't think any of you should feel bad about bringing peanut products into those kinds of public places (Although it REALLY bothers me when people bring food into "no food allowed areas", keep it in the cafeteria!). I do think it is good sense to attempt to clean up after yourselves and to clean your kids' hands before they head back out to play. I'm guessing most of you would do that anyway, without even considering the benefit to the children who may come along with food allergies. I will admit to having the occasional panicked moments in those types of public places!

If Harper started having many contact reactions (mild or severe) we would probably reevalute how we make our decisions about what is safe in terms of outings.

Chris wondered if eating at the field trip might have been like practice for the time when Harper won't be eating in a peanut-free environment.

It's true that eventually (most likely in grade school) Harper will have to eat lunch in a room where there are people eating peanut butter. We'll not think too much about that tonight, lest I begin to hyperventilate. But for most allergic kids sitting at a peanut-free table is precaution enough. It is possible to be so severely allergic that one would react to the peanuts someone was eating across the room. We don't believe that Harper's allergy is currently that sensitive (knock on wood). For some children their allergies are so severe they cannot attend a school where other students are consuming foods they are allergic to. We are thankful not to be in that situation (knock on wood, again).

Harper probably could have stayed and had lunch with her classmates, but we are constantly evaluating risk. Matt knew that they were finished with the exploring/learning part of their field trip and that Harper wouldn't be missing anything besides lunch if they left early. Better safe than sorry!


Whew! That's enough for this post, if anyone is still reading! There are more great questions to address and feel free to add thoughts in the comments. I am incapable of being short-winded when it comes to this allergy stuff, so you'll have to bear with me this week. Thanks!

Food Allergy Awareness Week: Field Trip Tidbit

Matt accompanied Harper on a field trip today.

Ugh - field trips.

I could say a lot about field trips.

I will say more later.

Today Harper went with all the preschoolers from her school to a dairy. They got to see/feed animals (Harper wearing gloves because we couldn't be 100% sure the goat feed was free of peanut products). They got to watch a video about milking and got to milk "cow statues" (term credit: Harper). They got to sample some of the ice cream made on the premises (deemed safe after I talked to the general manager on the phone for nearly an hour one day last week). They rode a hay-less hay ride. And then they were all supposed to sit down to lunch together.

Even though no less than three information sheets went home about the field trip which asked people please not to pack peanut butter or peanut products in their lunches, people did. So Matt left early with Harper and she had her lunch at home instead of with her classmates. Once again (remember Valentines?) parents either failed to read the notes from school or chose to ignore them.

I was not happy.

A) It's preschool, if you can't read the volume of "mail" that comes home from preschool you are going to have trouble when your kid is in grade school. Or has to apply to college, or summer camp.

B) Ignoring the request that you not send peanut products to the trip could have endangered my kid's life - thanks!

C) I know, it is kind of a pain to make lunch for a four-year-old without peanut butter... Welcome to my world!

Grrrrr.

I totally supported Matt's decision (better safe than sorry) but am once again miffed that there was even a decision to be made.

Food Allergy Awareness Week: How We Found Out

It was May 2006 when we found out that Harper was allergic to peanuts, which was ironic, as "peanut" was one of her main nicknames.

When I taught first grade I had a student one year who was allergic to peanuts, which was the only reason I knew anything at all about peanut allergies before Harper was diagnosed. If I hadn't had that awareness our story might have turned out differently and I am so thankful for everything that family taught me.

The week of Mother's Day I had been to the pediatrician with Harper for her 18-month well-check. At that very appointment I had asked her about giving Harper peanut butter. AT the time she wouldn't eat much meat and I was nervous about getting enough protein into her, as well as just having another option for lunch time. We had no history of food allergies in our family and the doctor said we could probably go ahead and try it, despite the general recommendation that peanuts not be given until at least two years of age. THANK GOD I did not put a bite of peanut butter sandwich into Harper's mouth.

Here's what happened:

We were in the kitchen and (seriously, my stomach aches writing about this) Harper pulled the plastic jar of peanuts from a pantry shelf. She was shaking it kind of like a rattle and I was happy to let her play with the harmless plastic jar while I finished unloading the dishwasher.

A few moments later she managed to get the lid unscrewed and dumped the entire contents of the jar into her lap. My initial concern was that she would try to eat one of the peanuts and choke. I never took my eyes off of her so I know she didn't eat any peanuts, but she did have her hands in the big dusty pile. I scooped her up out of the mess and kind of dusted her off before depositing her in the pack'n'play while I swept up and vacuumed in the kitchen.

I retrieved Harper from baby prison and we sat down at her little table in the kitchen with some crayons. After a few minutes I looked up and noticed she was scratching her arm. Then I saw that she had a few blotchy hives on her arms and as I looked I could actually watch them spreading. I immediately thought of the peanuts and shakily dialed the number for our pediatrician's office.

I breathlessly explained what was happening and when I told her I didn't have any children's Benadryl, and that we were less than a mile from the office, she said to bring her right in. By the time we got to the office one of her eyes was starting to swell shut. They rushed us right back and immediately gave her a dose of Benadryl. Within about twenty minutes it started to work.

Fortunately Harper did not have any breathing difficulty with that first reaction. We were lucky. Lots of families discover their children's allergies when they experience anaphylactic shock after a taste of peanuts or peanut butter. I know one family who found out their daughter was allergic after she reacted to a plain M&M.

We left our pediatrician's office that day with instructions for continuing to administer the Benadryl and I think some steroids to help with the hives. We also had a prescription for epi-pens. And I made an appointment with a pediatric allergist as soon as possible. Our first round of testing showed that Harper was definitely allergic to peanuts. This marked the beginning of a very long journey for us.

This is a topic I feel I could write about forever. I got some great questions last week that I plan to address over the next several days, and keep them coming!

*****
In other news, here's one for the What The Heck file... when I got Michael out of his crib after his nap this afternoon, look what was on the side of his head:





I'm calling bug bites or really unfortunate repeated encounter with crib bars, but if I believed such things I would totally put my money on the fact that aliens have marked my kid.

Nervous Tummy

Right now Matt and Harper are at a local minor league baseball game. We used to go to games fairly often, but, as you can imagine, baseball parks are huge danger zones for people with peanut allergies. I even get nervous when Matt goes to the ball game because I worry about the peanut dust that might enter our cars or the house after he's been to a game. The only reason she went with him is that he had access to a suite through work. When they watch the game from a suite we can have pretty decent control over what food does or does not enter the room. Still, I will feel anxious the entire time they are gone. After I finish this post I will head to the kitchen to clean up dinner and do some laundry and write some thank you notes and whatever else I can do to stop myself from sitting by the phone holding my breath.

Before Michael went to bed I was distracted by trying to take a picture of the two of us:


This seems as good a time as any to let you know that next week, May 10-16, is the 12th annual Food Allergy Awareness Week.

I don't talk peanut allergies too often here, but I have discussed it some and I am occasionally surprised at the way that discussion has helped people who read what I have to say.

I received a couple of allergy questions back in November when I was looking for things to post about every day for a month. So my plan is to address some of those next week as well as any additional questions you might have for me. If there is anything you've wanted to ask about Harper's peanut allergy and how we deal with it, now is the time to speak up! If enough questions/comments arise, I may try to address a different aspect or set of questions each day.

Okay - I'm off to keep busy!

How Could I Possibly Need a Break from Them?

For the most part, Harper is too old to need a nap in the afternoon. She's quite capable of falling asleep at that time, but then can't settle down for bed at night. However, in order to maintain a little sanity, we have often have afternoon "quiet time" during which Michael naps and she plays quietly in her room so I can accomplish something/read/email/ nap myself /etc.

Today things had gotten pretty quiet in there and when I went to investigate I found this mess:


And this sleeping beauty:


Meanwhile, it has been more and more difficult to get Michael to nap, as he has learned to do this:



The first day Michael figured out how to actually get to his feet I had to go back into his room at nap time to lay him down four different times before he gave in. Haha! My will is strong! I can outlast the one-year-old!


Again, I am lacking some cohesiveness with this post. The real reason I wanted to write today is to share the early Mother's Day gift I received last weekend. Matt made arrangements for me to have a day off!

I was given a card containing a hotel reservation for this coming Saturday night, at a hotel near some great shopping, and some spending money! I'll leave Saturday morning and come back late Sunday morning - with plenty of time to celebrate the rest of Mother's Day with Matt, Harper, Michael, and Mike and Ann.

At first I wondered, "Is it sad that I'm so thrilled with a gift that means I get to spend time away from my family?"

But of course it's not sad. It doesn't mean that I don't appreciate them. It's just a wonderful recognition, on Matt's part, that alone time to do something fun can be incredibly restorative. The best thing about the gift is that it makes me feel like Matt really does appreciate the things I try to do for our family, regardless of how imperfectly I may do them.

At Least She's Enthusiastic

So many things have brought me joy in parenting, not the least of which is sharing musicals with my children.