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)

Tuesday, January 29, 2013

Epi-Pen, My 21-Year Anniversary

I’ve had food allergies since birth, asthma since I was a child as well as environmental allergies and eczema. I still manage all of these conditions and carry emergency medications with me at all time.
Carrying emergency medication as a child inculcated me in the myriad ways one can be self-reliant and also the pitfalls of what happens when one isn’t i.e. nurse’s office visits, out of control asthma and allergies and even emergency room visits. I would be called upon often to use my rescue inhaler and take antihistamines, but there was no Epi-Pen in my childhood, my middle school years, high school years not even most of college.

Epi-Pen celebrates its 25th year of being commercially available in 2013. As a child of the 1970s and 1980s, it simply didn't exist. Even after it was introduced, it was not prescribed as readily it is now, nor was it considered the first line of defense. (Read more from the NIH about food allergy guidelines and best practices). I did receive epinephrine multiple times for anaphylaxis but only once I arrived in the local emergency room.

Then in the fall of 1992, about to embark on my year abroad at Wadham College (Oxon), I asked my then-allergist, a top New York City physician who taught and mentored many of the allergist working in the city currently, if I should get an Epi-Pen. His reply was, “Sure, I guess so.” It wasn’t medical negligence; it still wasn’t routine practice back then to prescribe an Epi-Pen.

Since then, I have dutifully carried Epi-Pens around the world. For 21 years, Epi-Pen, along with my other emergency medications (Prednisone, antihistamines and rescue inhalers and my anaphylaxis action plan, before it was called that) have been my constant companions: on dates, to the office, on trips, everywhere. Twenty-one years ago, Epi-Pen joined my arsenal of tools to help me continue to be self-reliant and live an unrestricted life.

So tell me, what is in your tool kit? How long have you, or your loved one, carried an epinephrine auto-injector?


[Disclosure: I have a relationship with Mylan Specialty, makers of the Epi-Pen.]

Wednesday, January 23, 2013

How to Use This Blog

Welcome all new blog followers, Twitter followers and Facebook readers and thank you!
This blog is my home base where I explore life as someone with severe food allergies, asthma, allergies and eczema (i.e. atopic disease) who lives a full life!

Looking for a specific topic? There are three ways that you can search my blog.

On the right hand side of this blog is a label cloud, sorted by the most popular labels, phrases that you are probably looking for, like: “allergies, food allergies, gluten-free, nyc, recipes, etc..” The labels in this cloud are blue and hot, meaning you can click on any one of them and they will bring to all the posts filed under that label.

There are two search boxes, on on the upper left hand corner of the blog and one under the label cloud, type in the phrase you are looking for.

Then, there are hot labels at the bottom of each post that creates a database around that topic. Just click on the label under that post and it will bring up all posts that have been tagged “travel”.

Easy, right?

Happy clicking!

Monday, January 21, 2013

Candied Kumquat, Recipe

I’ve written about kumquats before – little orbs of bitter and sweet orange goodness. They are just so cute and easy to work with and they keep showing up at my local market on sale. So, I was thrilled to see this candied recipe from the New York TimesCandied Kumquats or Meyer Lemons - Recipes - The New York Times. It make a perfect bookend to my kumquat marmalade recipe here. And, next time I see these little guys at my market, I’m going to give it a try. 

Wednesday, January 16, 2013

Feelings, Food Allergy Reactions, Dating

I’ve had The Talk (like here) countless times with new men I'm dating. It’s the one that goes: “I have food allergies. I’m allergic to tree nuts and fish. This is what the symptoms would look like and here is my anaphylaxis action plan. I carry emergency medication; here’s what I would use when. And don’t worry, probably nothing will happen.”

But most often, as adult with food allergies her entire life, The Talk isn’t a main source of social anxiety.* It’s all the thoughts, fears and feelings around the reaction actuality. For example, what happens if I have any kind of allergic reaction (mild, moderate or severe) around this new person? I have feelings just thinking about that possibility. How to start That Talk?

When I’m in doubt about how to have or start a conversation, I think through the very essentials of what I need to express and then I jump in with compassion in my heart and an even vocal tone. If I overthink it or over complicate that initial conversation with too many options, scenarios or tangential strands of thoughts or fears or worries, for a new person, well, it overwhelms them (and frankly, overwhelms me, too).

A new date, a man in my case, wants to know my feelings; however, initially,  they really seem to want, and be able to process, the essentials: what’s the problem, what can they do, what do they need to do and/or how can they help or assist or solve. Sound familiar? 

Major Nota Bene: the above statement is totally and utterly a generalization of how men think and feel. Everyone is an individual. However, you have to start somewhere. More nuanced, tailored conversations can happen later but so often it’s simply about opening the door and that can be the scariest part. My advice: get to what you want and need and jump in. There will be mistakes that's okay. A little like this creative philosophy from John Lasseter, founder of Pixar.

How I opened the door with this date was to remind him of the factual food allergy Talk we had and then to add in a few more details like: "I may be nervous to eat in front of you at a new, untested place" or "I may feel awkward or embarrassed if something does happen" (reminding him again what symptoms might be). I gave one possible scenario/example and then I gave ideal solutions: how he could help best or what kind of support I’d need. (I’m leaving these parts intentionally vague so you can fill in your own challenges and solutions.)

He engaged me in a conversation about my emotional relationship to food allergies and ultimately, I believe, this conversation helped him to get a better sense of where I was coming from, how my feelings may effect my behaviors around food and social gatherings and most importantly, it was another opportunity for us to get to know each other better. Which is the whole point.


To recap:

The Food Allergy Talk is factual, brief and informational.

How to get to the feelings beyond The Talk: add one example of your concerns using feeling words behind the facts, illustrate with one scary (to you) possible scenario; be honest, forthcoming and keep it simple.

*I talk about how to have a successful Talk in my book Allergic Girl and in this e-chapter that you can download for .99 cents.

Monday, January 14, 2013

Udis Gluten Free, Product Reviews

I met with the Udi’s Gluten Free team at Expo East in September 2012, and they had some new products there that I hadn’t seen yet in my local supermarkets; those products are there now. Mainly, French bread and French dinner rolls and their pizzas. They sent me samples to try.

The great: the breads.  Crunchy and crusty on the outside, soft and bread-like on the inside, when these babies are warmed up in the oven it’s almost like eating real bread, at least my memories of it. These two products are a total win.

The really less great: the pizzas. Udi’s Gluten Free has a flattened bread product they call a pizza crust. It’s more like a slightly puffed tortilla and hardens unpleasantly when baked. Sadly, the Udi’s Gluten Free pizzas are simply frozen toppings on that crust which equals something wholly unappetizing and completely unpizza-like. The three pizzas I tried were a total non-win, toppings awful, and "crust" hardened cracker-like substances, tasteless and pretty awful.

 Udi’s Gluten Free: please consdier some more R&D i.e. going back to the drawing board and  creating a yeasty, fluffy, bread-y crust first and then rethinking the flavor profiles of the toppings.

Meanwhile, for your dear readers, I’d stick with the Udi’s Gluten Free white breads, what I think they do best.


Any further questions about their gluten-free status or food allergy policy, please reach out to them directly:

NB: I’m wheat intolerant, not allergic nor celiac; I have been wheat free since 2005 here are some reliable links to the differences between food allergies and food intolerance from AAAAI, WebMD and the NIH.

Friday, January 11, 2013

Trauma, Children, Resources

After the tragedy at Sandy Hook Elementary, there were a flurry of links posted from various reliable organization about how to talk to children experiencing trauma after disaster or how to talk to them about what they’ve seen or heard about a disaster. These are extremely helpful links for those of with severe food allergies who’ve had an anaphylactic response that has been particularly scary as trauma can be associated with that response. These links have some excellent general information to help you spot trauma in your child or in yourself. If you notice these symptoms, contact your board certified medical provider or local support group about support for your family.

National Association of Social Workers (NASW)
The Substance Abuse and Mental Health Services Administration's (SAMHSA)


And a good article about helping a child manage anxiety from Child Mind Institute

Tuesday, January 08, 2013

Udi’s Granola, Recall, December 2012

"Dec. 19, 2012 – DENVER – Udi’s Healthy Foods, LLC of Denver, Colorado, is voluntarily recalling its 12-ounce bags of “Udi’s Gluten Free Au Naturel Granola” with UPC 6-98997-80615-8 and “Best By 041913 12265 1” because they may contain undeclared almonds. People who are allergic to almonds run the risk of a serious or life-threatening allergic reaction if they consume these products." Here’s the full press release from Udi's Gluten Free.

This recall from Udi’s Gluten Free happened right before Christmas. Their granola line was never nut-free; they make a granola with nuts and always have to my knowledge. And accidents happen. Their bread products (muffins, bagels, loaves etc) used to be made away from the granola, and any nuts and was made in a different part of their plant from their bread products. However, I reached out directly to Udi’s to ask them to confirm that. the below is from Udi’s directly:

Thanks for reaching out to us. Our baked goods are completely nut free and made in dedicated nut free facilities.  The only product of ours containing nuts will be our granolas, but these are made in a completely separate bakery from the rest of our gluten free baked goods. This way we can assure that there will never be any cross contamination of nuts in our baked goods.

Most of our granolas do contain nuts, except the Au Naturel. Our nut-free granolas are thus not made in a nut-free facility, but we do have measures in place to clean and sanitize equipment between batches and sequence production in such a manner to avoid nut contamination of nut-free products.


Any further questions, please reach out to Udi’s Gluten Free directly:

Monday, January 07, 2013


There have been a few links recently that have been inspirational to me. Click away and welcome to 2013!

Two generally excellent websites to check every now and then: &

Two artists who work in nature: Michael Grab  and a NPR story about him: A Very, Very, Very Delicate Balance & Andy Goldsworthy. His work can be seen at Storm King Art Center.

For comedic timing there is none better than Abbot and Costello’s "Who's on first?" VIDEO.
And just love love love, Maira Kalman. Here is a twenty minute talk by her from Creative Mornings.