Thursday, February 25, 2010

Food Allergies

I admit that I had dropped off the face of blogworld. Apart from the hustle and bustle of errands, I was also out of commission for a few days with a stomach bug and fever. My kids passed it on to me. Lying in bed half dazed was quite a treat but after a while one itches to get back on track. Getting the bug these days happens quite easily and reminds me of Dickens' London in the 19th century. I think of crammed sheds and murky sludge. And that shouldn't be the case in "modern" New York City.

Another phenomenon that is taking place at an alarming rate is the subject of my new blog article. To my readers who might wonder why on earth I would write about food allergies on a blog about Nonya food, that's because growing up....we RARELY had food allergies, what with all that coconut milk, peanuts, eggs etc. swirling about our dishes. It's a topic very close to my heart because of my daughter's food allergy history. I mean, how could a yaukwee gourmande like me nurture a child who could not appreciate so much of the delicacies her parents gorge on for granted?

Last Friday was a major triumph in our little family. My daughter passed her food challenge for milk - she drank a quantified volume of milk over a span of two hours without consequently throwing up or breaking out in hives. (It's a foregone conclusion that this angmoh-fied little girl will not grow up having kway chap or beehoon for breakfast.) What is a food challenge, one would ask? Every six months of so, children like my daughter would spend a day at the hospital to consume, under strict precautions, a key ingredient that they have previously been allergic to. The child's weight, height, vitals and food diary for the past week are religiously recorded. In most cases, bloodwork is taken, a skin test performed and the little forearm prepped and bandaged in the event that a quick injection of Benadryl or Epinephrine is required. The test starts with small chunks of chicken (if you're allergic to chicken) or muffin (baked milk test), etc. The amounts gradually increase every few minutes and if a symptom surfaces, the test is stopped immediately. Either way, whether you pass the test or not, you stick around the ward for at least two hours before you're cleared for release. My daughter and I enjoy these one day events - we would bring DVDs, practice her violin, I even looked forward to the hospital cafeteria for lunch. Over time, we also got acquainted with the staff and they took delight in seeing my daughter transform from a baby in the austere iron bar crib to a budding violinist.

Back in 2002, one of my best friends got a fellowship at the prestigious Pediatric Allergy division of Mount Sinai Hospital (Ahem, you know who you are). Little did we realize how important this place would become for us. My daughter, in her first few months, was a chubby baby with delicate and smooth baby skin. By her fourth month, she started getting rashes around her mouth. At first, we thought it was because I was not wiping her mouth properly. The rash spread to her cheeks, neck, then her ankles and knees. She was also no longer the cherubic baby with the porky baby thighs. Her weight stayed constant because she was not really absorbing anything. She had bad diarrhea and would projectile vomit. On her first visit to Singapore, everyone began to speculate. "How can you not let her drink water?", "Put some heat rash powder...you know the one in the square tin?", "Mummy would say it is taik angin".....

Back in NY, I made a career out of visiting dermatologists. In fact, a few were Botox specialists to those movie stars who came in the evening by a side door. We changed detergents, bought new bedsheets, even contemplated having to give the cats away. When things got truly bad, we had to smother her in Aquaphor and wrap her up in a bedsheet, arms tied down with a belt. In our lingo, 'mummify her' from scratching. Eventually, one dermatologist at NYU gathered that it had to be food allergies since my daughter would break out in eczema in covered parts of her body.

We were redirected to Mount Sinai Hospital. The skin and blood tests indicated allergies to peanuts, milk, eggs, meat, wheat and fish. The first order was to make me cut back on these ingredients while I still nursed her. I must admit that the restricted diet actually boosted my energy level. But like I said earlier, I'm quite the gourmande and this was too big a sacrifice. The impact for the baby was rather significant. She had to go on soy formula and unlike most Chinese babies, could not do the "fish is good for the brains" quack diet of fish porridge etc. etc. Nor could I share my beloved kaya toast with her for breakfast. Well-meaning folks kept confusing it with gluten-intolerance/celiac disease or lactose-intolerance. I couldn't even explain after a while. Worst of all was the predictable argument I would have with SIA everytime I flew back. My request for "No peanuts" was met with the utmost inexplicable resistance. The CSR would call me to fax over a medical report and verify whether it was a Type 1 or Type 2 peanut allergy. I would then get all curt and tell off "We don't do a Type 1 or Type 2 over here". Later, it turned out that serving peanuts on board was such a component of their branding and to not do so, almost a scandal. In fact, a few passengers would comment "How come no peanuts hor?". Come on.........you should hope that someone on board will not die from anaphylaxis because of peanut 'fumes'. And all those passengers with peanut-contaminated fingers would try to pat my daughter or shake her hands. Eeew.

Paris was not great either. A waitress told me to get real, "Madame, all french fries are cooked in peanut oil. Where do you think you're going to next?". Then a sorbet treat at La Coupole was cross-contaminated with dairy ice cream and by the time we reached the mid level of the Eiffel Tower at 11pm in cold spring weather, I had to strip her after she vomitted. "Alors, look at this mad mother." Of course, I was about to bark back that it was their darn French fries and sorbet that caused the commotion.

At the start of every school year or summer camp, I am required to provide the school with at least three Epipens. One for the schoolbag, one for the nurse's station, and another for a class communal backpack that follows the class, even when they go down to the gym. So imagine the number of little friends who also have food allergies.

There are various theories as to why food allergies have become so prevalent. Here, I pay homage to my friend, the allergist. She can post her knowledge. All I can theorize is that food as we knew it is no longer the same. Something is always engineered to be bigger and better and brighter. Together with the slew of vaccinations that make our kids healthier to combat chicken pox, measles....the little antibodies within are twiddling their thumbs to attack their newest foes...in this case, allergens like peanuts which traditionally, were cheap, abundant and flavorful enough to be thickening agents in sauces (think satay and gado gado), or as American as PB&J. Yet, how do we explain the other food allergens such as sesame, coconut, soy among others? Or the fact that a forty year old friend who drank soymilk while growing up in Malaysia is now allergic to soy?

Hopefully, with a carefully managed regimen, children outgrow their food allergies. Mine can now consume meat, milk, wheat, fish to make for a more varied diet. I know many parents who do their own 'food challenges' at home, though I personally wouldn't push it. Leave it to the medical experts. I hope and pray that future generations will not succumb to a real life situation of "Cloudy with a Chance of Meatballs". And I think of those who live dangerously with a severe peanut allergy, and hope that we will find a solution soon enough.

For more information, check out www.foodallergy.org or the Food Allergy Initiative.

2 comments:

Terrence said...

Thanks Sharon. My niece has severe nut allergies.

Lynette said...

Thanks for that post! Thankfully, most kids will outgrow their food allergies.

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