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Trays of cookies, both homemade and store-bought, cover the fellowship tables after church. Most people can safely enjoy the food and fellowship, but for the three million Americans with peanut allergies, including those in Juneau, those innocuous cookies could be deadly.
Thirteen-year-old Michael Lohrey and 7-year-old Katherine Fritsch are both allergic to peanuts. Their experiences illustrate the challenges faced by kids with peanut allergies.
Michael was less than 2 when his family discovered he was allergic to peanuts.
"My story is a little strange really. My dad had left a spoon with peanut butter on it where I could reach it, and when I licked it my parents noticed I had hives, so I went to the hospital and when I came out they knew I was allergic."
Katherine also broke out in hives on her face when she ate a bite of bagel slathered with peanut butter when she was 13 months old. A subsequent blood test showed that she was allergic to peanuts.
According to a new report published in the Journal of Allergy and Clinical Immunology, the incidence of peanut allergies in children has increased threefold between 1997 and 2008. There is no cure, only treatment of symptoms once an allergic reaction has already begun. Symptoms of an allergic reaction include wheezing, difficulty breathing, upset stomach and vomiting, hives and rashes.
In severe cases, anaphylaxis can occur, where the throat swells up and the person cannot breathe. Other symptoms of anaphylaxis include a severe drop in blood pressure, rapid pulse, dizziness, lightheadedness and loss of consciousness. Anaphylaxis can be deadly if left untreated. Treatment consists of an immediate shot of epinephrine to halt the allergic reaction, followed by close monitoring in the emergency room.
Prevention is the best course of action when it comes to peanut allergies. Both Michael and Katherine diligently avoid any exposure to peanuts. Katherine's family has eliminated all peanuts and tree nuts from their home. This involves a lot more than just forgoing peanut butter sandwiches. Katherine's mother, Melissa, checks the ingredients on all products.
"The key thing to look for on food labels is the phrase 'Processed on equipment that also processes peanuts/tree nuts' or similar wording," she said. "If the label has this statement, then it is not safe even if the item does not contain nuts."
Michael has lived with his peanut allergy most of his life.
"I have to be more careful with what I eat, especially cookies at parties and receptions," he said. "My family does not get to eat as many peanuts or peanut butter as they may like."
Both Katherine and Michael attend public school. Katherine's school has an allergy and anaphylaxis plan developed with the help of her allergist and pediatrician.
Melissa details some of the precautions in the classroom. "When kids bring in birthday treats, I provide a safe alternative for Katherine and Meredith (Katherine's twin sister). At lunchtime, Katherine can sit with her class, but we make sure that there is a one child buffer between her and other kids eating peanuts or tree nuts. The children in the class wash their hands after eating a nut-containing snack or lunch. The kids are very empathetic and work hard to keep the girls safe."
Meredith did not react to her bite of peanut butter bagel at 13 months, but as a fraternal twin she has an increased risk of being allergic as well, so she lives a peanut-free life like her sister.
Michael's school is also aware of his peanut allergy. The school nurse keeps Benadryl and an Epi-Pen (a device designed to inject epinephrine in case of emergency) on hand for him in case of accidental exposure. Michael keeps an Epi-Pen at home as well, and makes sure to take it along on camping trips.
Melissa stresses that Katherine's medications go with her at all times.
"All times means shopping, hiking, boating, rock climbing, ice skating, biking, etc - absolutely everywhere. It's like the old American Express ads - don't leave home without it!"
Katherine has not had any allergic reactions beyond that first incident with the bagel.
"We know that anaphylaxis is a possibility every day," Melissa said. "So far, we have been very diligent and extremely lucky."
Michael has not been that lucky.
"We had cookies Sunday after church," Michael recalls. "I thought I was getting a sugar cookie, but it had peanut butter. That's one of the times I had to go to the hospital."
Another incident occurred at school, also involving cookies.
"In fourth grade, we had a substitute teacher on a day when someone brought in cookies to share. I ate a bite and realized it was peanut butter. I asked to go to the nurse, but the substitute teacher thought I was trying to get out of class and she didn't let me go. Fortunately I did not have a bad reaction that time."
There are ways for the community to support kids with peanut allergies. Most importantly, people need to realize that peanut allergies are serious.
"I think awareness and education are keys," said Melissa.
To reduce peanut exposure in the environment, she suggests such simple actions as washing hands after eating peanut snacks to avoid spreading peanut residue around, or changing the food in your feeders if you're feeding peanuts to the squirrels. Michael suggests better labeling of food in restaurants and at church or potlucks. For example, he says, "Thai food uses peanuts a lot, and Juneau's Thai restaurant does a good job of putting a notice on their menu."
Despite their peanut allergies, Michael and Katherine both participate in community activities like any other kid. Michael says his friends, "don't treat me any different. Sometimes they forget."
Melissa says of Katherine, "We try to focus on the fact that she is a beautiful, smart girl, who also happens to have a food allergy. She is a lot more than just a girl who is allergic to peanuts."