Food Allergy Counseling

Food Allergy Counseling
Sloane Miller, MFA, MSW, LMSW, Psychotherapist; Specialist in Food Allergy Management, Speaking At Mylan Specialty / EpiPen Event (© Noel Malcolm 2013)

Saturday, May 30, 2009

WFD Family Event, June

FA Families in The NYC Tri-State Area:

Come join me for some allergy-friendly BBQ and so much more on Sunday June 28, 2009 at 11:30am. Details on the Worry-Free Dinners site.

And for you NYC/Tri-State-based allergic adults, I'll be announcing a summer event for you very shortly. Stay tuned.

Thursday, May 28, 2009

Indications for Autoinjectors of Epinephrine

I had a brief chat with the Dey folks at the FAAN conference a few Saturdays ago. Did you notice that the indications for when to use your Epi-pen have changed? What’s the difference and why should you care?

For a more formal answer I turned to colleague board certified allergist Dr. Matthew Greenhawt whose bio is here. Here's what Dr. G had to say:

Dey Pharmaceuticals (Napa, CA) recently modified the prescribing indications for EpiPen® and EpiPen Jr.®. Formerly, the prescribing indications were limited to those with a history of having an anaphylactic reaction, overlooking the potential of those with milder reactions to have more severe reactions upon their next encounter. The indications now recommend use “in patients, who are determined to be at increased risk for anaphylaxis, including individuals with a history of anaphylactic reactions.”

The distinction is an important one, allowing the physician a liberal interpretation of who needs the device to include anyone who they feel may be at increased risk of anaphylaxis. Most allergists were likely following these “new” indications all along, as the medical literature has long supported this practice. However, this wording change may provide incentive to primary care and emergency room physicians to prescribe more devices, which will ultimately protect more at risk individuals.

A person “at increased risk” for anaphylaxis should be interpreted broadly, and include persons with milder food induced or insect sting induced symptoms, in addition to those with a history of recurrent angioedema or anaphylaxis without a known provoking cause, to name a few examples of how this could apply.

As an allergist, my rule of thumb has always been to consider anyone who has shown even mild evidence of the potential to react to food or a sting as someone at future risk of anaphylaxis, because no individual can accurately predict the severity of one’s next allergic reaction.

Current data has clearly shown the association between fatality (at all ages) and the lack of having an available epinephrine auto-injector.

*As always, if you are concerned that you may be at risk for anaphylaxis and are interested in exploring if you need an epinephrine auto-injector, discuss your concerns with your allergist as soon as possible.*

Not everyone who feels they are at risk may actually need the device, as one must actually have evidence of a condition that would place them at risk.
If you do not have an allergist, discuss with your primary care physician if a referral to an allergist is necessary. And, most importantly, once you are prescribed a device, it should be carried with you AT ALL TIMES. Having the device at home while you are having a reaction outside of the home is akin to not having the device at all.

Well said Dr. Greenhawt, thank you!

Additional resources from Dey Pharmaceuticals :
--a video on how to use your epi.
--a slide presentation about allergic reactions.

Wednesday, May 27, 2009

Freezer Tips, New York Times

The more we read about our national food supply being contaminated, (see recent New York Times articles) the more we are all hoping to avoid those contaminations. For those of us with special dietary needs, it makes sense to buy less processed foods; even allergy friendly ones have plenty of allergen or pathogen recalls. When we, any of us, food allergic or not, buy and make whole foods, not processed foods, we cut out the middleman, the food processor where so many things can go so wrong.

So say you went crazy at the farmer’s market after reading a post where I say, well, exactly what I just said: there’s are no nuts in carrots AND eat more whole foods. You happily snap up all the whole fruits and vegs, whole grains, lean meats, organic diary and good fats that you can fit into your hemp recycled tote bag. Excellent.

However, if you’re like me, single and sometimes cooking for uno, there’s only so much you can and should eat in a day, which means a lot of leftovers or food spoiling because you bought too much or made too much.

What to do?

Aha-you can freeze stuff! Yes, a freezer is a great option (and it comes attached to most fridges). But how to utilize it to the max? I use my freezer sparingly because it tends to kill food. If I leave anything in there for over a month, it’s ovah: freezer burned, dried out or tasting of freezer (not a good taste). But I’ll keep things in there for a week or two until I can get back to it or run out of the fresh goods. What I’d really like is an article to tell me how to work with my freezer optimally.

Mark Bittman to the rescue. For many of us, the freezer is just the final step before the garbage and that truly is a waste. Bittman outlines some very clear steps as well as a food/freezer chart of sorts. (He did a funny feature a while back on the underused broiler and now he hits us again with the freezer and some tips about how to use it effectively.)

My favorite tip since I keep mostly vegan/vegetarian at home is how to freeze rice and beans: “I’m tempted to say that you should never cook beans or grains without making more than you need. Freezing them (covered with water or cooking liquid, leaving room for expansion) works that well, and saves loads of time.”

So go out there to your local farmers market, stock up and then stock up your freezer; just don’t leave it in there too long!

Friday, May 22, 2009

Food Allergies, Teens

Teens are a high risk group normally but add to that they’re food allergic and you have a potential recipe for disaster.

I’m heartened to see the excellent Anaphylaxis Canada is addressing this population with a new site, in partnership with bloggy FA buddy Kyle Dine.

If you have a food allergic teen or a teen on their way to college next year or know of one, I urge you to check it out.


From the press release:

Anaphylaxis Canada Launches

A website for pre-teens, teens and young adults at risk for anaphylaxis

Anaphylaxis Canada is responding to the growing public health challenge of keeping pre-teens, teens and young adults with potentially life-threatening food allergies safe, by launching a new youth awareness strategy. This strategy, the first in North America, is aimed at reaching out to teens to talk about challenges they face on a daily basis in a format that they can relate to. As such we are pleased to introduce a new interactive website,

The website has a number of unique features including:

· In-depth resources and information specific to teens & young adults on risk management strategies

· Website content created by teens for teens through our Youth Advisory Panel (YAP)

· Accessible resources for over 250,000 young Canadians at risk for anaphylaxis and thousands more worldwide at no cost

· First online teen resource available in French (summer 2009)


Pass it along!

Thursday, May 21, 2009

Ginger Ale, New York Times

I’ve been talking about ginger ale for a while on this blog as my mocktail of choice (but not with egg whites thank you not so much Flatiron Lounge).

At home during the winter months, I drink a cup of ginger tea with raw honey daily; in summer I keep ginger lemonade sitting in the fridge mixed with either agave or maple syrup for sweetener.

This week the New York Times did an article on how ginger ale is sweeping the nation’s bars with its spicy goodness. (Might also be why Pete Wells was asking on for ginger juice near Port Authority last week, funny.)

Here's the link to the New York Times article and here's their ginger ale recipe.

My version: I use peeled, sliced fresh ginger, lemon, agave or maple syrups and mint if I have some around. Garnish with organic crystallized ginger, oh boy!


Not yet a ginger fan? Ginger is a rhizome (a root); great for upset tummies and supposedly has antibacterial effects i.e. can help your immune system fight off colds and such. It’s cheap, stores well and long outside of fridge, can be used in cooking both sweet or savory dishes.

So get your ginger on, fresh ginger ale is a great way to start.

Wednesday, May 20, 2009

Food Safety

So last week, I took the national Servsafe course through the National Restaurant Association, which also prepped me for the NYC’s Department of Health food handler’s certification. (I tweeted about on Twitter). Now I know way more than most non-food service professionals about what *should* be going on in the kitchen to reduce the possibility of pathogens in your prepared foods. And yes, the training includes a section about food allergens and how to reduce cross contamination. Suffice it to say, if every restaurant really did what they were instructed to do regarding cross contamination alone, there would be far fewer allergy accidents and pathogens flying around.

Case in point. On Saturday, brunch at Peter’s Gourmet, server did major no no: scooped ice with my water glass and served me ice water in said glass. If glass were to break in the ice bin, that would be a physical hazard and a violation. And that’s just a violation I can see. Oy.

Anyway, I’m now all primed to see violations, everywhere. And it seems big food companies are expecting you to have that same information at your fingertips (so they don't have to).

The New York Times ran a story this weekend about how big food manufacturers are placing the onus squarely on the consumer's shoulders to ensure their food safety with processed food products:

"So ConAgra — which sold more than 100 million pot pies last year under its popular Banquet label — decided to make the consumer responsible for the kill step. The “food safety” instructions and four-step diagram on the 69-cent pies offer this guidance: “Internal temperature needs to reach 165° F as measured by a food thermometer in several spots.”

And yet how many of us have food thermometers (I have one in my oven but not an immersion one, yet)

From New York Times : “For more than a decade, the U.S.D.A. has also sought to encourage consumers to use food thermometers. But the agency’s statistics on how many Americans do so are discouraging. According to its Web site, not quite half the population has one, and only 3 percent use it when cooking high-risk foods like hamburgers. No data was available on how many people use thermometers on pot pies.”

There's something off here.

If I’m making a chicken pot pie from scratch, then yes, it’s on me to ensure that I’m creating safe dish for me and my family to consume.

But if I buy a food from you, ConAgra, should you be ensuring that same thing?

Confused about food safety in the home, check out this governmental backed consumer site: Partnership for Food Safety Education.

Tuesday, May 19, 2009

all® Free clear

“Laundry detergent allergies” gets a lot of hits on the Allergic Girl blog. And I know why. So often laundry detergent is the culprit for eczema, unexplained rashes or skin irritations. I’ve even had itchy eyes and been sneezy from a strongly perfumed detergent on clean clothes so much I’ve had to rerun them in clean water. Annoying.

More and more mainstream companies have realized that the consumer (that would be US) wanted less odor from their detergent as well as a less harsh product for their skin and have made new products to keep up with that demand.

All is one of those companies.

Recently, they contacted me to ask if I would try their all® Free clear product.

Sure, why not?

Coincidentally I was talking with an allergist friend who mentioned that this is the detergent he uses for his family (he has two young children): all® Free clear. Cool, it really is recommended by at least one allergist.

I’ve been using all® Free clear for the past three or four washes and I’ve found that it’s truly low on perfume-very little smell at all-my clothes seem clean and I’ve had no adverse skin issues when wear the newly washed clothes.

So seems to be a triple win for big detergent.

Have any of your tried all® Free clear? Thoughts? Issues? Like? Dislike?

Monday, May 18, 2009


My mother has been on a smoothie kick recently and has been dying to buy me the machine so I can make them too.

“But I already have a blender; I don’t need another machine,” I reply.

I really don't have room on my counter top. Between allergen-friendly food samples, a small rice cooker, an electric kettle and dry goods like oats, raw sugar and pasta, well, real estate is scarce. NYC kitchens are notoriously small, even for well-known New York Times food writers.

However, mother and the New York Times are right. The hot season is coming around, again, when all I'll want to eat is something cool and sweet - no more stews or soups or large hunks of meat.

So it’s nice to see this piece in the New York Times about blended smoothies, a reminder to dust off the blender and start blending.

Thursday, May 14, 2009

Food Allergy Twitter Party

Talk to me in real time May 15th at 12pm EST through Twitter!

Join me and lots of your favorite food allergy bloggers (and win prizes!) during the Food Allergy Twitter Party this Friday, May 15 hosted by Food Allergy Buzz (whom I met last week at the FAAN Tarrytown conference) and Best Allergy Sites.

The party will take place at 12 Noon EST and at 10:30 PM EST. (I'll be on the Noon-12pm slot).

To follow or participate in either party time, visit or another Twitter real-time dashboard of your choosing and type in #foodallergy. This will take you to the party where you will see the streaming conversation.

More directions here.

Hope to see tweet with you tomorrow!

Monday, May 11, 2009

FAAN Conference, Tarrytown

I’ve never been to a Food Allergy & Anaphylaxis Network (FAAN) event before. My assumption was that it was mainly focused on families and kids and, as you know, I advocate for adults with food allergies.

What I discovered was that the daylong seminar was a great primer (and reminder) for newly allergic folks; geared toward for families and extended families of food allergic children but appropriate for food allergic adults too.

(I Tweeted the whole times, lots of interesting info bits: Foodallergybuzz was there too tweeting away:

I couldn’t possible summarize hours worth of incredibly valid and valuable information in one post. All I can say is: Get educated, get motivated, connect with community and get reliable information. If there's a FAAN event in your city, consider attending.

If you have food allergies and want to learn how I dine out successfully (among other strategies for survival), join me for a family or adult Worry-Free Dinners event either in NYC, or selected cities, throughout the year.

Whether you or your family has been newly diagnosed or you’ve had food allergies a long time, it’s always worth it to continue to educate yourself, to meet and connect with others in the food allergic community and to know you are not alone.

Thank you FAAN for an educational and fun day.

Friday, May 01, 2009

Tarrytown Food Allergy Conference

I’ll be in Tarrytown on May 9, 2009 for my first food allergy conference sponsored by FAAN.

If you’re there too, let me know!


Press release from FAAN:

FAAN’s conferences offer insight on the most recent research findings about food allergy as well as discussion and networking opportunities with families, caregivers, teachers, child care providers, and school staff. Special sessions are also held for teens, nurses, and registered dietitians.

Topics at the all-day conference also include strategies for avoiding reactions, how to eat well with food allergies, emergency preparedness, tips for dining out with food allergies, and lessons learned from reactions in schools.

In Tarrytown, Dr. Hugh Sampson, a nationally respected leader in the field of allergy research, will be a featured speaker. Sampson is a professor of pediatrics and immunobiology at the Mount Sinai School of Medicine and chief of the Division of Allergy & Immunology in the Department of Pediatrics, Director of the Jaffe Food Allergy Institute, and Dean of Translational Biomedical Science at The Mount Sinai Medical Center.

“The FAAN Conference is one of the best resources for the latest information on food allergy,” Sampson said. “Everyone, from the newly diagnosed to the seasoned veteran, will walk away with a better understanding of dealing with food allergies.”

The Tarrytown conference will run from 8 a.m. until 5 p.m. and will be held at the Westchester Marriott, 670 White Plains Road.

For more information or to register, visit or call (800) 929-4040.