Monday, January 4, 2016

Game Time

December ran over our household like a freight train.

November ended on a tragic note. Our beloved dog, Tucker suddenly passed on November 30th and our grief clouded the entire holiday season. If you're a dog person, you get how heartbroken we are. He was our bestest buddy and the loss of him has tinged everything joyful we faked our way through last month. It also brought some bumps on the road to food allergy freedom.

N had an episode of vomiting after a treatment one night in early November. She was very full from dinner but it was close to bedtime and she needed to get it done. Keep in mind that her treatment dose is a lot of food. It is 4,000mg of protein in powder form that needs to be mixed with something (pudding at that point in time) and enough of it to make it not taste like powder. So, N got too full and got sick (no, she did not make it to the bathroom).

It happened one more time two days later and it was obviously a Pavlovian reaction. Her fear of throwing up made her throw up.

She began to take longer doing her treatments and her sunny attitude began to dim. Then the night Tucker died broke her. She was sitting at the table, eating her dose. Tucker was in the basement very ill. We went into emergency mode. Our dear friend who is a Vet came over and said it wasn't an injury but that he was bleeding internally. We then began the excruciating task of carrying his lethargic body over the ice to the car. The girls came out and kissed him goodbye.

Not surprisingly, after I drove off into the dark with our bestest buddy for the last time, N threw up during her dose. And no, she didn't make it to the bathroom.

She started throwing up a lot. Most of the times she wouldn't even make it half way through. We all knew it was a psychosomatic response and that her gag reflex was charged up. Her head was no longer in the game. I tried yelling at her once to see if I could shock her out of her trance. Needless to say, that didn't work.

It all came to a head one Monday night in mid-December. It was a very long hour of her barely taking nibbles of her dose. The Hubs and I cheering her through every little taste and distracting her with games and activities. Then she threw up anyway. You guessed it, not in the bathroom.

We told her that this was it, she needed to decide what she was going to do. If she kept vomiting, she wouldnt be able to complete the trial. She wasn't keeping enough of her allergens in her body for it work and we couldn't let her throw up several times a week. We talked about all of the freedom and independence she's gained now that the world is so much safer for her. We reminded her of what it would look like if that freedom went away.

We talked and we cried and we talked and we cried. I walked away a few times because I was so scared and angry. I couldn't let my girl take on the role of victim. There is no room for that in her life.

I was up most of the night. She went to bed around 11PM, sad and feeling beaten.

That night, it snowed. It snowed so much that school was canceled and school never gets canceled here for snow. We woke up to our whole world covered in soft, perfect magic. Suddenly, there was nowhere we needed to be. Right in the middle of a personal crisis and an insane holiday season, the snow came and made everything better. We could take a minute when we really, really needed a minute.

N came downstairs the morning of the snow and said she wasn't going to quit. She said she wanted to do this and folks, that was it. She hasnt even flinched. She does her dose in under 30 minutes every day. She identified smoothies as the best way for her to take it and this helps grind the powder up more so she doesnt deal with the grit. She smiles through the whole thing and her game is completely and totally ON.

BAM!

Once again, this little girl of mine has humbled the hell out of me.

So, here we are at day 182 and just a week left. JUST A WEEK LEFT. Next Wednesday and Friday she'll be open challenged. There will be no double blind placebo fun this time, just an outright test of what her immune system is like 36 weeks after she started.

No matter how next week goes, she's gotten herself at least as far as this place where she is heaps and heaps safer than she was 182 days ago. She doesn't have to worry about crumbs and spills. At best, she'll be ordering crepes on the second floor of the Eiffel Tower this summer. And she wont even ask about the ingredients.

Tuesday, November 24, 2015

Joining The Club

We were in the car, driving to the airport. An adventure lay ahead- New Orleans and then a visit with my oldest friend in Mississippi. Just Mommy and Fhizzy Whig! Then it happened. Her tooth wiggled for the first time.

She's been waiting for this moment since her Big Sister lost her first tooth 2.5 years ago. EVERYONE else in Kindergarten (except half the kids I named), have already lost a tooth.

She was more excited about her wiggly tooth than she was about beignets.

Cut to two weeks later and its Thanksgiving Break. The sisters are spending the week sleeping together in N's room. They are inseparable. I'm waiting for them to finish getting ready so I can do the tuck in when they scream simultaneously, "IT CAME OUT!!!!" N had yanked out Fhizzy Whig's tooth!

Finally, she was a member of The Club.

We all scream and dance and eventually decide that they need to go to sleep so that the Tooth Fairy can visit. They are tucked in and I'm reading them their good night poem. I look up at N and her face is red. She burps. You okay? Fine. Just a burp. Then she throws up everywhere.

It's an hour and half after her treatment dose but she had thrown up right after treatment once this week and I'm getting worried. Like the other time, she was very full and barely able to get it down. This was an hour and half later though. Why was she throwing up this time?

More importantly, why does she never seem to get to the bathroom when she throws up?!?!

Fhizzy Whig stays put and I whisk N into the bathroom. I throw towels on the floor and get Fhizzy Whig into her room. The Hubs comes up from the basement and then the smell knocks me out and I'm sick. N is in the shower, crying. Clean up ensues.

I glance in at Fhizzy Whig sitting on her top bunk. Her damp hair is stuck to her little face, she's clutching her stuffed dog to her chest and sobbing. I go in to reassure her and her face tells me that she's utterly heartbroken. She had been SO happy. She had finally lost a tooth. Her sister had been as excited as she was and she was finally a part of The Club. Now, its late and everyone is running around cleaning up vomit and trying to make N feel better.

It was all about her for once and now it was all about N again.

She didnt say that though. She was sad for her sister. She was sad for what happened. She didnt insist that it be all about her.

N said she was scared and wanted to sleep with us instead of in Fhizzy Whigs room. N's room was still in hazmat condition so that wasn't an option. This was crushing. Fhiz understood though. She sobbed but told N she didnt want her to feel scared.

We told N that maybe her sister needed her more than she needed us right then.

Now, everyone is crying and trying to do the right thing. N goes and climbs into the bottom bunk but is still crying. She's scared. Fhizzy Whig's big night is ruined no matter what N does. Fhizzy Whig tells her that she should do whatever she needs to do and that she'll be okay.

Each of them is looking out for the other. Neither are crying for themselves. My Mama heart is sad but proud.

I sigh and agree to pull out the trundle and sleep in there. If they can both do what the other needs, surely the grown up in the situation can too. Everyone (except me) is thrilled now. Everyone can sleep now. Fhizzy Whig has N and N has me.

Somehow, the Tooth Fairy got to her pillow with all three of us in there. 






Monday, October 26, 2015

Week 24- Holding Steady

For the past 4 weeks, N has been on her "maintenance dose."

Huh?

That's the quantity of her allergens that she needs to consume daily. So, she no longer goes up in quantities or "updoses" every two weeks. For N and this trial, that means she is at 4,000mg combined or 2,000mg of egg and 2,000mg of almond. That's a lot more than the 2.5mg she reacted at in the spring when she went through her challenge (remember this?).

The drug (Xolair) takes three'ish months to wear off and she had her final shot eight weeks ago. About two weeks ago, I saw N really start to emerge from the fog brought on by the drug. Her energy and cognition returned. Based on how exhausted I am, She Is Back! In a few weeks I will probably be correcting myself and thinking, "Heh, now she is really back."
 
There have been some feelings. Coming down from the stress of trying (and sometimes failing) to keep a highly anaphylactic child safe for over 7 years leaves a few bruises. I wont speak for the scars she's been left with but we're working on that too.

There is a lot of re-training we need to do and although N can't eat anything she is allergic to outside of her daily dose, we have started having eggs and almonds in the house to normalize it. In 12 weeks it is very likely that she will be able to eat anything and everything, regardless of its ingredients. We realized it would be too odd to go from lockdown in the house to making scrambled eggs for breakfast. So, we are easing into it.

It's weird. It's really, really weird. I shake a little when I put almonds in my smoothie or throw an egg in my salad. Big brown eyes have glared at the other plates at the table. She's Ms. Resilient though so she takes a deep breath and we talk about how weird it is. How exciting it is. How scary it is. How amazing it is. How daunting it is. Then I drink my smoothie and act as normal as possible.

Doo-di-doo. Just drinking a smoothie that would have killed my child 6 months ago. Doo-di-doo.

And the pan I used to cook the egg? It's the cleanest pan in the northern hemisphere. I'm not totally *there* yet. Baby steps, people. Baby steps.

We will take a quick day trip to the clinic on Thursday because her blood and skin need to make their contribution to the trial.  In and out of California in a day. In mid- January she'll do her big challenges. We'll see if the protocol has eliminated her allergic response entirely or if she can only tolerate her daily dose but still needs to avoid her allergens outside of that. The latter is worst case scenario and that is miles ahead of where we started so really, we can't go wrong. The world is so much safer for her than it was when we took a deep breath and jumped into this trial.

We'll take whatever we get. See you Thursday, California.



Tuesday, September 29, 2015

Desperately Seeking A Dull Moment


Here in the Rockies, the aspen trees are at their peak glory. This time of year its like rivers of gold are running down our mountains. The sky is so blue it makes your heart ache. A few hours out in this wild world will settle your frazzled head. We opted to head into the mountains and push our reset buttons.

So, the Hubs was getting his haircut and picking up sandwhiches. I was packing us up for the hike, feeding little girls lunch and giving N her treatment dose (currently 3,000 mg of her allergens combined) before we headed for the hills.

Rush, rush, rush before we reset, reset, reset.

Then N threw up. She was upstairs and she called out to me with a loud and shaky voice. I ran up the stairs and she continued to throw up. She was really afraid, excessive vomitting is a symptom of anaphylaxis. I asked her if she could breathe okay and if her throat or mouth felt funny. She said she wasn't having any of those symptoms so I turned away for a second. I called Lil' Bit to me and quietly asked her to hurry and get my phone and the epipen.

N continued to throw up. Everywhere. To sum it up, none got inside the actual toilet and the Hubs had to pull out a ladder to clean some of it up. Good enough imagery for you? Me too.

I texted the Hubs
Me: come home, N sick
Him: ok. do you still want me to pick up sandwhiches?
Me; no,vomit pouring down walls

Who said that kids kill the romance?!

Anyway, back to the exorcism scene on our second floor.

She was okay. I didn't need to use the epipen because she finished and had no other symptoms. I called the emergency number for the SNP Allergy Clinic and we jointly determined that she was just over full. Her tummy didn't ache before she got sick. Her breathing was fine. She had a big lunch, a green smoothie and then 3,000mg of her allergens mixed with whole milk pudding.

I feel sick just thinking about that much food. 

Lil' Bit really wanted to be with her sister and help but I didn't let her because
1) There was a path of towels through the upstairs and it would be too much for her if she saw how sick N had been and,
2) There was still a chance I was going to be jabbing an epipen into a thigh and Lil' Bit was scared enough.

Since she couldnt get to her sister, she sat under the balcony so her sister could hear her and she tended to N's lovey- Sheepie. She knew Sheepie wanted to be with N but couldnt get to her so she wrapped him in a blanket, read books to him and soothed him. She kept N updated with a continuous monologue that calmed N down better than I could. It calmed all of us down.

Sisters are kind of awesome.

The trial has gone so well for her and this little bump in the road was ugly but ultimately small (except in volume). Still, we had to go to a half dose the next day. Yesterday we went back to a full dose with no symptoms, confirming that it was just an overfull 7 year old tummy that emptied itself and not an allergic response. There were a few tears before hand but she did what she does and faced it with courage.

We got up to those rivers of gold the next day. We ended up not having to rush because everything was ready from the day before and nothing else was on the schedule until the evening. The girls splashed in snowmelt and appropriately oooh'ed and awe'd at the majesty of nature (and my prompts). They hiked with little legs up steep trails and fell asleep soundly after watching the lunar eclipse.

Not all not-so-dull-moments are created equal. 



Monday, August 31, 2015

Traveling without getting intimate with the local ER

I already waxed on and on about how much I love to travel. Now, the How To.

This is going to vary greatly depending on what the food allergies are and how severe they are.

If the allergens you need to avoid include ingredients (milk, egg, wheat, etc) vs just treenuts and/or peanuts then your travel is going to look different. Avoiding a nut is easier than avoiding a drop of milk.

Heading overseas with someone who is prone to anaphylaxis? If your allergen is lurking everywhere, making restaurants and street food off limits with the allergic person (but you really, really want to go!), this is what we have learned:

1) The internet is your very best friend. Use it to plan, plan, plan. Used to flying by the seat of your pants? You might need to alter a few things about how you travel for now.

2) Find a place to stay with a kitchen. The internet has again proven itself to be your soul mate. You can find a place to rent via AirBnB, VRBO, Tripadvisor, etc.  that will have reviews and a kitchen. Hostels usually have kitchens too and many have family rooms so you'll have privacy. You might be groaning about having to cook while you travel. Instead, focus on the fact that you get to travel and that this is just part of your reality. It might not be fun to cook while you're on vacay but at least you're not watching TV and going to the mall.

3) Pack a suitcase with food. I know, I know. But trust me, it's worth it. Plan out each meal for each day. Find out if there is a grocery store nearby to buy produce and meat. Pack extra food in case there is some kind of travel bump. Put a note in English and the local language in the suitcase (politely) explaining why its important not to steal this food. Also pack containers (thermos, lunchbox, baggies, etc) to bring food on outings. I pack food that N doesn't usually get to eat at home so that she can have fun eating. Out of respect, I never order food she would order if it was safe. That's just good manners, in my opinion.

4) Be prepared for the airline to lose that essential suitcase. When we went to Belize last year, I had enough food for 2 full days in my carry on and travel insurance on two of our tickets. If they lost our bag (which they did of course), I could feed N for two days without stress and if it didnt arrive then I would fly us home and leave Lil'Bit and Andy to snorkel without us. Luckily we had our bag after a few hours and didn't need to abandon ship. Like climbing mountains though, don't get so focused on the summit that you make bad decisions. Be prepared to turn around if conditions change.

5) Bring a lot of wipes. When you get on the airplane, wipe down EVERYTHING the allergic person might touch. From experience I can tell you that giving a child an epipen is petrifying. I personally have no intention of finding out how much worse the experience is at 30K feet. Wipe, wipe, wipe! Some airlines will let you do a medical pre-board so that you can wipe, wipe, wipe in (relative) peace.

6) Pack a lot of epinephrine. We travel overseas with six pens, steroids and an inhaler.

7) Know how to get the Eff' Out of Dodge. Have a plan on how to evacuate should an accident happen. Bridging cultural gaps does not include trying to explain that you're not comfortable with a used needle.

8) Carry cards with the allergies and required treatment translated into the language(s) where you are going. Make sure they are laminated. Make sure you know how to read the allergens various names in every language you'll have to function in.

9) Have fun. I know it all sounds really scary and stressful after reading this but trust me, you'll still have an incredible experience and adventure. I've watched my girls get out of their comfort zones. Ive stood by while they looked past another childs poverty and saw just the freedom that child has compared to them. They've grilled me with questions about history and religion as we walk out of historical cathedrals and through caves. At 5 and 7yo, it drives them to ask questions they would never have asked otherwise. They've jumped off a boat, into shark infested waters because the glimpse of the reef was too tempting not to snorkel. These trips connect them to the world outside of their bubble. It's worth the 10 minutes it took to make and pack a safe lunch.

“Travel is fatal to prejudice, bigotry, and narrow-mindedness.”

Thank you, Mark Twain. I couldn't agree more.

The first time I ever flew away from the US was one of the most defining events of my life. It was the 1990's. I was in college and my (totally unreliable) room mate and I had planned to head to Europe for the summer. I picked up extra shifts in the bar and the lab. I picked up a research project to do in Spain and that breathed some life into my suffocating credit card.

I spent hours researching backpacks, small towns and train schedules- before there was the internet. I had paper tickets for planes and trains in hand.

She (of course) bailed out and assumed I would too because what 20 year old girl goes to Europe alone? I wrote a check for the summers rent, put on an overpacked backpack and boarded an Air India flight bound for London.

I have never, ever been the same.

That summer I fended off an attempted rape in a hostel in Lyon, France*. I slept on the floor of a bus in the north of Spain and experienced a riot when a protest got out of hand. I had to give a report to the US military because the cute African American Navy Boys we were walking around with in San Raphael in the south of France were attacked by members of the racist National Front.

I kind of left out those details when I made my weekly calls (with a calling card! from a pay phone!) to my Dad.

More importantly, I stood in front of the Louvre and danced at midnight. I wandered Roman ruins in the dark with only the moon to light my way and breathed in the stories I would never know. I figured out bus and train schedules in several languages. I saw a lot of art and a lot of cathedrals. It never got old. I arrived on a Sunday in a small town in Spain and no restaurants or shops were open. So, I sat down with a family I had never met and spoke spanish and ate tapas until 2AM with a castle 50 feet away. I made friends at every turn. Western History, the Great Wars and the reality of it came into view for me with all of its twists and turns. I started to pick up newspapers and read them with my new eyes. It changed the course of my life.

I also learned that I was an incredibly capable person. I was so glad that my room mate had stayed behind because this adventure was completely mine.

I have since had the extraordinary privilege of jumping across many oceans on many occasions- by myself and with the love of my life. I have lived and worked in another country and that has changed how I live and work here. When I sat there, massively pregnant and fantasized about the world we would show our Bugaboo, Pad Thai in the northern Thailand rainforest came to mind. Croissants outside of Notre Dame! Bike rides to castles! Hikes through ruins!

Well, things havent gone exactly as planned while I was pregnant. I know, shocking, right?

It can be tedious to travel with young children. I think you should do it anyway. It's okay for things to be hard. It will be worth it. You don't need to cross oceans, just head somewhere that isn't right where you are. Lets be honest, going from Palo Alto to Alabama should require a passport. Take them to a National Park. Take them to a city. Just take them.

It can be petrifying and exhausting to travel with a young child who has severe food allergies. It is even worse when one of those allergies is perhaps the most common ingredient in food around the world. Eggs.

We have figured a few things out though. I'll fill you in.




*In case you were wondering if you and your daughter should take a self defense class, the "attempted" part of this story is why I think you should. The (disgustingly misogynistic) French police threatened to charge me because the attempted rapist was apparently in a lot of pain. Ooopss. I also learned to keep the American consulate number close at hand in case the (disgustingly misogynistic) French Police behave badly.

Monday, August 17, 2015

This is what is different

Ice cream shops have a mythical status in most kids lives. Magic happens in the hands of those scoopers. There is one place in Boulder where the ice cream does not have eggs.  However, several flavors have eggs and almonds so when we stop for a cone, the (lovely) staff disinfects a scooper and heads into the hard freezer for a fresh bin of ice cream that hasn't been cross contaminated. Having spent a summer working at Ben and Jerry's in college, I am fully aware of the workout they are getting in the deep freezer.

It takes extra time and usually embarrasses her - other people have to wait and she stands out because of her allergies (and not her awesomeness). Because not one of those college kids has ever done anything but happily oblige when they've seen her big brown eyes, our bill usually includes my 50% grateful gratuity. 

Then I hold my breath while she eats her ice cream and I act normal. You see, that's what I've done. I've acted normal. I never felt normal. I felt really, really scared. I was always scared. So was she. There was constant fear, everywhere we went.

Last week, we went in and just ordered the ice cream she wanted. We read the ingredients and with no special treatment, we sat in the hot sun and chased our melting ice cream down the cones. Just like everyone else.

We only eat in a few restaurants with her. Three restaurant- epi-pen-needed- accidents will do that to you. If we eat somewhere else, we pack her food. That was fine until her pre-tween (is that a thing now?) self started sinking into her long body because of the unwanted attention. When we went to the dinner theater with friends, she waited until the lights went down to pull out her thermos.

Dammit.

But now? I breathe. I'm not always scared. Her world is profoundly safer. Today she ate 300mg of her allergens combined. She does that every day (until Thursday when she starts eating 600mg). That's more than might be on your hands after your lunch so go ahead and give her a hug! Hell, kiss her on the cheek! She'll be fine.

We went to the Rocky Mountain Chocolate Factory. We never went there because their chocolate is cross contaminated with almonds. She sucked down four chocolate coins while strolling along the river. We still need to check ingredients but if you flip her burger and an egg with the same spatula, we wont even know it. We wont be leaving the ER four hours later.

She was petrified but she pushed her way through a rib at a random restaurant. She couldn't eat more than that but that rib, that one rib was glorious and took profound courage. I wonder what bystanders thought while I was pep talking her in the middle of the BBQ joint off of I-70? 

This morning, both girls were driving me up the wall. So? I sent them to the park. Since the dawn of the suburban reality, parents have been kicking kids out to the park to preserve their (lingering) sanity. Now, my sanity stands a (limited) chance. I didn't go with them (I did send the walkie- talkie in case someone needed stitches). Spilled bag of almonds next to the slide? Toddler with a muffin? No worries.

We aren't *there* yet but this place is safer than the world has been since she was four months old. I go looking inside of me for the fear but its gone. There is only a scar. Even if we never go further than this, we can all exhale. Touch is no longer dangerous. Your car doesn't need to be vacuumed before she gets in. We meet new neighbors and don't even mention her allergies.

The freedom and possibilities are making me downright giddy. 

The trial ends at 36 weeks. She hits her maintenance dose at 20 weeks. We are about to start week 14. Who wants to have us over for dinner in October?