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, December 27, 2016

Interview: Dr Dave Stukus, Food Allergy Testing Study, Pediatrics, 2016

“Primary care doctors often use the wrong test to diagnose food allergies in children, new research shows.”  - Reuters

Dr. Dave Stukus conducted that new research and in an Interview on Henry Erlich’s blog on the Asthma Allergies Children website,  Dr. Dave further explained why he did the study:

“…The idea for this study originated from patients being seen in our office every day. We routinely receive referrals for evaluation of suspected food allergies in infants and young children, many of whom already had serum IgE testing performed. Sometimes they have foods taken out of their diet based upon these results. Many times, parents are told to withhold introduction of new foods based upon these tests. Rarely, we see patients develop a new allergy to a food they were eating regularly without problems but produced IgE towards; the food is removed based upon testing and then, when reintroduced weeks or months later, they develop a new allergic reaction to that same food they were previously eating without problems. So, yes – this felt like it was a big problem but had not previously been objectively assessed or characterized on a wide scale, which is what we sought to do.” 

You can read more of that excellent interview here.

You can also read about food allergies and testing here on Huff Po.

I had a chance to interview Dr Dave about his study in Pediatrics: Use of Food Allergy Panels by Pediatric Care Providers Compared With Allergists. Read more below.

***

 
An individual walks into their doctor’s office and says I think I have a food allergy. What *should * happen next?

If someone suspects they have a food allergy, they should first discuss with their primary doctor. Many patients may request testing or feel their symptoms are due to an allergy, but there are a lot of questions/details that need to be asked before any type of testing should be performed. My advice to anyone concerned about food allergy: discuss with your doctor and be prepared for lots of questions! This is essential in trying to figure out the best diagnosis. If, after that discussion, you have ongoing concerns or a food allergy diagnosis seems likely, then allergists can be extremely helpful.

However, regardless, first and foremost, a detailed, thorough history should be obtained. The first step in diagnosing a food allergy is being thoughtful about the patient’s concerns, including the specific foods they are worried about, their symptoms, the timing of symptom onset, symptom duration, and reproducibility of symptoms. When it comes to food allergies, milk, egg, wheat, soy, peanuts, tree nuts, fish and shellfish account for up to 90% of all reactions. Any food can cause a food allergy, but fruits and vegetables are unlikely causes of IgE-mediated allergic reactions.

Many people may experience any number of adverse reactions after ingestion of a food, but food allergy reactions occur pretty fast (within minutes or 1-2 hours later), occur with every ingestion regardless of form; if someone is allergic to milk for instance, then they will have symptoms after eating cheese, yogurt, ice cream, etc. And have objective symptoms such as hives, swelling, wheezing, and vomiting.

Sometimes when a patient explains their history it becomes clear that their history is more consistent with a non-allergic intolerance, such as difficulty digesting lactose, which can cause bloating and stomach pains, for example. Sometimes the history reveals chronic conditions such as heartburn or inflammatory bowel disease as more likely culprits but none of those are food allergy symptoms.

Lastly, the history is really what helps make the diagnosis and testing should be used to help determine the likelihood that the diagnosis is correct. If a patient comes in and requests food allergy testing to a long list of unrelated foods (For example: milk, grains, fruits, seafood, spices), or cannot identify any specific foods as potential causes of their symptoms, then it is very unlikely that they have a true food allergy.  


According to your study "Use of Food Allergy Panels by Pediatric Care Providers Compared With Allergists", frequently, what * is * happening next?
Unfortunately, we found that blood testing for a large panel of food allergens is occurring almost half the time when food allergy tests are ordered by primary care clinicians. Instead of testing for individual specific foods suggested by a clinical history, these arbitrary panels are being used a lot of the time. 


Why is this a problem?
The problem with ordering a large number of tests for foods is that there are high rates of false positive results. This means that many more patients will have a ‘positive’ test result compared with patients who actually have true allergy. 

Blood IgE levels are reported on a scale from 0.1 to 100. Anything above 0.35 is often reported with a big exclamation point beside it, which increases anxiety among both patients and providers.  IgE tests are often misinterpreted and poorly understood by the primary care clinicians who order them. 

Anyone can order these tests, but they really should only be ordered by clinicians who understand how to interpret the results and apply them to their patients. Allergists receive special training and board certification to perform and interpret IgE tests, but other clinicians can learn to do so as well.  

The detection of IgE to a food by testing reveals sensitization. About 30% of all people are sensitized to common food allergens, or will have an elevated level on testing. However, only about 5% of all people are truly allergic to foods. So, if you make a diagnosis by testing alone, then the majority of people will be misdiagnosed as having a food allergy.  

IgE tests are far from perfect and should never be considered to be ‘positive’ or ‘negative’. The size of the test result indicates the likelihood that allergy is present. Levels mean different things for different foods, and predictive values have only been established for a few select foods.

The best test to determine if someone is allergic to a food is to eat the food. If immediate onset, reproducible symptoms do not occur, then they are not allergic. The problem with these panel tests is that they include an assortment of foods that patients are usually eating without problems. When the results come back elevated or interpreted as ‘positive’, many patients are then advised to take those foods out of their diet, even when they were eating them for years without problems. Children, especially, can be harmed as parents may be told to avoid giving them foods they haven’t tried yet due to these test results.  Aside from being misdiagnosed and having to carry an epinephrine autoinjector when one may not be necessary, people can suffer from nutritional deficiencies when food is restricted from their diet. 

Lastly, if a sensitized person (elevated IgE on testing) is eating a food without problems, their immune system is tolerant to that food. If that person removes that food for an extended period of time, their immune system may then become allergic to that same food. Recent studies have shown this can happen in roughly 15% of young children with eczema who have foods removed based upon testing. Now clinicians as a whole are actually creating harm for these patients…and that’s a big problem. 


Why this may be happening?
Lack of understanding of food allergies and testing by pcps is multifactorial but likely related to demands on their time and challenges in keeping up with an ever-growing body of evolving scientific evidence and changing clinical guidelines. Limited access to board-certified A/I consultants for patient referrals or A/I training programs for residency elective rotations may contribute as well. 

So what are potential next steps for primary care physicians?
Education and dissemination of best practice. The Choosing Wisely series has been in existence for almost 5 years and one of the top evidence-based recommendations is to avoid the use of indiscriminate IgE panels in the evaluation of suspected food allergy. Unfortunately, it can take decades for research and clinical guidelines to permeate and then change practice. 

Primary care physicians are fantastic resources for patients given their long-standing relationships with families and ability to care for a wide assortment of conditions. However, given their time constraints, it is nearly impossible for them to remain as up to date as possible on the latest research or guidelines from every specialty.

One way to help educate is through publications in widely read peer reviewed journals. Presentations at local, regional, and national meetings can help as well. Social media and blogs such as yours may also help reach a segment of physicians.
Ultimately, we may need to find a way to limit the availability of food allergy panels by laboratories or provide point of ordering education/alerts to clinicians. 

What, if any, are potential next steps for the food allergy community?
Education and dissemination of best practice. I hope that we can all help provide education to others and serve as a reliable resource. Unfortunately, food allergy tests are widely available and in some states, patients can order online without a physician’s order! We all need to work together to help increase awareness and understanding of these tests can and can’t be utilized.

Thank you Dr. Dave!

***
BIOGRAPHY
Dr. Dave is a board certified allergist/immunologist and Associate Professor of Pediatrics at Nationwide Children's Hospital and The Ohio State University College of Medicine. His research interests include dissemination of evidence-based guidelines and best practices as well as use of mobile health applications to improve self management of asthma for children and teenagers. Dr. Dave is active on social media with his Twitter handle @allergykidsdoc and has been invited to train physicians on the use of social media at regional and national conferences. He is also a regular contributor to patient education through published articles on Huffington Post, US News and World Report, and kevinmd.


Dr Dave Stukus

Monday, December 19, 2016

Allergic Girl Blog: First Time Here?

I was inspired to write a "First Time Here” post this post after seeing it on another blog: Dinner: A love Story. Especially as this my tenth year blogging (wow, I know!) and the blog has grown over the years, as have I, I thought: I really need to do this now. So here, goes.

(Still have thoughts or questions after reading the below, you can always find me at sloane.miller@allergicgirl.com)

Want to know all about me and about severe life threatening food allergies and how I can help you? Read my book Allergic Girl (Wiley, 2011). You’ll get to know me, my life with severe life threatening food allergies and how, as an adult, I handle life, dating, working traveling and living, all safely and while still having fun and how you can, too!

ABOUT THIS BLOG: 
I’ve had food allergies since infancy and asthma and allergies since childhood. I am anaphylactically allergic to all tree nuts and salmon; I avoid all fish and shellfish. I’m also allergic to eggplant and some types of melons and have OAS to other fruits and veggies when the season hits. I’m an asthma girl which is currently in remission, unless you put an animal in my lap (please don’t put an animal in my lap). I have environmental allergies year round and eczema (mostly in winter). After a lifetime on daily medication for asthma and allergies, I currently take nothing, unless I need to, as directed by my board certified medical professional.

I have food intolerances and those are completely new. Wheat and soy (and sometimes diary) do not agree with my stomach, at all, and since 2004, I’ve eliminated those items from my diet. It was a struggle at first; I could have easily lived on bread with butter, they're delicious together! But as I was so tummy-ill, I had to eliminate and adjust and I did. All of my recipes are free from my allergens *and* my intolerances. You can search in my blog under the recipes tag and you will find lots of good, easy recipes that are also free-from.

Follow me on social to see what I’m eating right now. I'm on Twitter, Facebook, Instagram.

I’m very healthy, like ridiculously healthy. And that statement does not conflict with above paragraphs. You can manage atopic disease  - asthma, allergies, food allergies and eczema - and be ridiculously healthy. Mental, emotional and physical health are of utmost importance to me and, to be honest, a deep source of personal pride. Especially after a childhood of sickness with so much asthma and so, so, SO many allergies, to be a healthy, strong, vital adult is a gift I give to myself, over and over again. 
  
I started my blog in August of 2006 to see if any adults were out there who were living well, dining out and having fun whilst managing severely, life threatening food allergies. Within six months the New York Times contacted me to comment on a story they were writing about dietary restrictions. Yes! Cool! Want to see some other fun press, have a look at my press links.

My other purpose was to see if adults wanted support around the emotional issues particular to us, like our anxieties, fears, insecurities around managing life threatening food allergies. As a trained and licensed mental health provider, I was uniquely qualified to offer this kind of support.  Here’s more about my educational background.

This has been my career for the last decade: I’m a private practice psychotherapist specializing in food allergy management. I work with children, families and adults all around lifestyle management. I speak at conferences, patient advocacy groups as well as train other mental professionals. Contact me if you want me to come and speak to your group.

These days, blog-wise, I'm focusing on cooking more and getting even more creative in the kitchen. So this blog is going to be really chock full of recipes. You can search in my blog on the upper left hand corner for an ingredient (fish and nut-free though!) and you will find lots of good, easy recipes that are also free-from.

Fun non-blog fact:
I have a new hobby – musical improv. We create narrative musicals based on audience suggestion. It’s like a giant puzzle that we all, including the musicians, figure out in real time, on stage, in song. It is incredibly demanding and challenging, silly, playful and so much fun; a privilege to be able to do. I perform in and around New York City. You can find more about my indie team and when we’re performing next on Facebook.

Still have thoughts or questions after reading the above, you can find me at sloane.miller@allergicgirl.com.


Monday, December 12, 2016

Interview: Stichting Voedselallergie, Allergic Girl


I met with Marije of Stichting Voedselallergie, a food allergy group from the Netherlands over the summer.

It was fascinating to meet another food allergy advocate from another culture; we had so much in common! She wrote about our meeting in their newsletter (see above). If only I could read Dutch!

Just another instance of knowing: we are not alone.

Monday, December 05, 2016

Recipe: Orange And Yogurt Pancakes With Strawberry Jam – Nut-Free, Gluten-Free

I had to take a test bite - yum!

It just takes an extra step to elevate a dish. In this case, I added plain yogurt and orange zest to my pancake batter and topped it with my homemade strawberry quick jam. The combinations of these flavors are simply excellent. And allergen-friendly. (NB: For the dairy, feel free to substitute in your favorite dairy-free milk and yogurt options.) 

This is barely a recipe but boy, are those few extra steps worth it.

***

Recipe: Orange And Yogurt Pancakes With Strawberry Jam – Nut-Free, Gluten-Free

Make a batch of strawberry jam

Pancakes
1 cup Bisquick Gluten-Free Pancake Mix
1 large egg
½ cup plain whole milk yogurt 
½ whole milk
1 splash oil
Zest from an orange (wash the orange rind thoroughly)

Mix all the ingredients together. If the batter is too thick, add another splash of milk. Cook pancakes as directed. Once cooked, add your favorite maple syrup and a few spoonfuls of strawberry jam. Try not to swoon.


See the flecks of zest?!

***

An alternate option would be to use orange-cranberry relishPerfect if you have leftover relish from the holidays or are looking for a festive recipe for cozy weekend mornings.

Yogurt pancakes topped with orange cranberry relish - ooh yum!


Do everything above but top with orange-cranberry relish and don’t look back!

Wednesday, November 23, 2016

Allergic Girl's Thanksgiving Day Menu 2016

I’m hosting this year and doing all of the major cooking for just 7 of us so super easy.

Green salad (with olive oil and lemon dressing)
Braised short ribs
Boiled creamery potatoes (with butter)
Steamed Brussels sprouts (with butter)
Pumpkin pie 
Cranberry cake (nut-free)
Whipped cream
Vanilla Ice cream

Here's the table:


Here's my plate:

I did get a picture of dessert as we were having such a nice evening.

Hope you had a wonderful and saef holiday!


Monday, November 21, 2016

Allergic Girl's Thanksgiving Day Advice: Focus On The Fun



As we gear up to travel, gather, sit down and dine remember food is not the focus of the holidays. I know it feels like it, and the pressure can be immense but really it’s not the focus. 

The focus of any holiday event really is togetherness, family (whether by birth, marriage, partnership and/or choice) and above all, love.

Keep that in mind this week for Thanksgiving and as we head into the holiday season.
  
And if you looking for some menu ideas, have a look at my InstagramFacebookTwitter feeds.


Happy Holidays!

Monday, November 07, 2016

Recipe: Easy Pea Soup, Vegan, Nut-Free, Gluten-Free




When I was a child my dad used to make the best pea soup. It was thick and smokey; it had tons of flavor and was overall so delicious that it’s a stand out in my childhood food memory bank. 

I think the secret was pig knuckles (or ham hock). 

I called him just now to ask him what was in that magical pea soup of my childhood, and he started rattling off several different varieties he had developed over the years.

“No, no. Not with flanken (steak) and not that other one. The one we had on 35th street. Was it…pig knuckles?” I asked.

“Oh yeah, it was pig knuckles. That was a great one,” he said.

I didn't add pig knuckles to mine (where does one even get pig knuckles?!) but I did throw together a vegan version, with ingredients I had on hand in my cupboard and larder. I bet you have these at home, too!

***

Easy Pea Soup, Vegan, Nut-Free, Gluten-Free
Makes 3 one-cup servings (can be doubled easily for more volume)

1 cup dried, green split peas, sorted and rinsed
1 small onion chopped
1 carrot chopped
3 garlic cloves, minced
1 bay leaf
Salt, pepper to taste
Olive oil
Water

In a large, heavy bottomed pot, sauté onion in olive oil on medium heat until fragrant. Add chopped carrot, sauté for a few minutes, then add minced garlic and sauté until all is fragrant. Add bay leaf, rinsed peas and about 6 cups of water. Bring all to a boil and then simmer until the peas have broken down and softened and flavors melded.

Serve over the grain of your choice or with potatoes or safe-for-you bread.

Tuesday, November 01, 2016

Recipe: Salted Brown Butter - Cinnamon Sugar Crispy Rice Treats, Attune Foods [Sponsored]

Salted Brown Butter - Cinnamon Sugar Crispy Rice Treats

Doesn't that look insanely good? It is BEYOND good.

I adapted a few recipes including my own to create this cinnamon sugar rice crispy treat that is beyond good. It’s made from Attune Foods' Erewhon cereal that is gluten-free and according to the Attune Foods website: “Made in a peanut-free, tree nut-free, dairy-free facility.” Read more on their website.

I sampled slices with a cinnamon sugar dusting and without. Both delish!




Recipe: Salted Brown Butter - Cinnamon Sugar Crispy Rice Treats
Adapted from smitten kitchenKitchen Konfidence and Well Plated 


Cinnamon sugar for sprinkling
¼ cup sugar in the raw (or any sugar you like)
1T cinnamon

For the treats
4 Tablespoons (1 stick) unsalted organic butter, plus 1 T extra for the pan

1 10-ounce bag Kraft Jet Puffed marshmallows

1/4 teaspoon coarse Morton’s Kosher salt

5 ounces Erewhon Foods Cinnamon Crispy Rice Cereal (half a 10-ounce box) 


Butter an 8" pie pan (any handy cake or pie pan will do depending on how tall your want your treats, I like my tall!). 

In a large, heavy-bottomed pot, melt butter over medium-low heat. Keep your eyes on it - the time between when the butter solids begin to brown and the point where it burns is wildly fast. It will melt, then foam, then turn clear golden and finally start to turn brown and smell nutty.

(Here’s a video from Food52 about how to make brown butter – even though it’s French name is translates to nut butter there are NO NUTS involved.)

As soon as the butter takes on a nutty color, turn the heat off, remove the pot from the heat and stir in the marshmallows, one tablespoon [1T] of the cinnamon sugar mixture and the salt. The residual heat from the melted butter will be enough to melt everything. Stir until the marshmallow mixture until it is mostly smooth; I like leaving some lumps of marshmallows for a little textural surprise.

Stir in the cereal until all ingredients are incorporated. Spread mixture into the butter-prepared pan. (I use buttered hands to press treats into pan, works like a dream.)

As the mixture cools, sprinkle the cinnamon sugar mixtures over the pan of treats. Let cool and enjoy!


Add caption
Thank you, Attune Foods*!

(NB: *My policies regarding sponsored posts.)

Monday, October 31, 2016

Food Allergy Counseling: Maintaining a Healthy Lifestyle, Planning Your Meals

Have you noticed that many of my pictures via social media are of the same meals? 


Weekly breakfast
Weekend breakfast

You’re not seeing double, nor are these pictures old: very often, I eat the same thing every day.
Black bean and cheese quesadilla lunch
Homemade vegan lentil soup, +Enjoy Life Foods chocolate

This is another one of my my healthy habits / diet tips:  I maintain a set rotation of meals. This equals a stable caloric daily intake and, for me, a stable weight since college.

It’s less about my food allergy needs (I’m allergic to all nuts and seafood) nor my dietary intolerances (soy, milk and wheat) and more about having a routine. I love routines, and when dining, it takes the guesswork out of what I’m eating and when. 

If you’re trying to figure out what you want to eat when you’re hungry or over hungry or don’t have healthy options ready that can equal poor decisions or at least ones that don’t support a healthy lifestyle. If you have meals planned out or in a routine of what you’re dining on, it takes the guesswork and the “hangries" out of the equation.

So that’s my tip: plan out your meals or have your meals on a rotation, take the guesswork out of what you’re eating, and keep your caloric intake stable.

Wednesday, October 26, 2016

News: KALÉO ANNOUNCES 2017 U.S. RETURN OF AUVI-Q®, Press Release, October 26, 2016

UPDATE: 2/14/2017 - Here's more from www.auvi-q.com - "AUVI-Q® (epinephrine injection, USP) is available by Rx! Have it shipped to you starting 2/14! Enroll here".

UPDATE: January, 2017: Auvi-Q release date is set to February 14, 2017. Here's the press release from kaleo.


AUVI-Q is coming back!

Here is a great interview with the owners of kaleo by Allergic Living magazine.

Here is the kaléo full press release below.

(NB: I have been previously paid to consult with kaléo, Inc.)

***

PR Newswire, RICHMOND, VA. (October 26, 2016) – Kaléo, a privately-held pharmaceutical company, today announced that it will reintroduce AUVI-Q® (epinephrine injection, USP) auto-injector to the U.S. market in the first half of 2017. AUVI-Q is a prescription medicine used to treat life-threatening allergic reactions, including anaphylaxis, in people who are at risk for or have a history of serious allergic reactions.

“Today’s news represents an important milestone for the life-threatening allergy community, which has suffered from a lack of epinephrine auto-injector options for far too long,” said Evan Edwards, Vice President of Product Development & Industrialization at kaléo. “As the inventors of AUVI-Q, my brother and I have dedicated our lives to researching and developing an innovative epinephrine auto-injector that would do for severe allergy sufferers what the AEDs did for cardiac arrest in the community; namely a product that could assist and guide even an untrained user through a life-threatening emergency.”

AUVI-Q is a compact epinephrine auto-injector with industry-first features, including a voice prompt system that guides a user with step-by-step instructions through the delivery process, and a needle that automatically retracts following administration. AUVI-Q is engineered to help patients and their caregivers to confidently administer epinephrine in life-threatening allergic emergencies.

After regaining the rights to AUVI-Q, kaléo conducted a thorough manufacturing assessment and invested in new technology and quality systems to ensure accurate, reliable and consistent delivery from the product. AUVI-Q is manufactured on an intelligent, high-tech, 100% automated robotic production line with more than 100 automated quality checks on each AUVI-Q, ensuring a streamlined and consistent production process.

“For the millions affected by life-threatening food allergies, an epinephrine auto-injector serves as a lifeline,” said James R. Baker, Jr., MD, CEO and Chief Medical Officer at Food Allergy Research and Education (FARE). “These lifesaving devices must be accessible and affordable, and Americans should have options when it comes to selecting the right auto-injector for their family.”

Eric Edwards M.D., Ph.D, Vice President, Product Strategy at kaléo, added, “As a patient and parent of children with life-threatening allergies, I know how the moment of an allergic emergency can unfold- with panic and fear- and that is why I believe and trust in AUVI-Q, not only for myself, but also for my children and other families who might have to depend on it. Driven by this reality, kaléo strives for flawless manufacturing to ensure each AUVI-Q is built to exceptional quality standards.”

Kaléo is aware of the epinephrine auto-injector access and affordability challenges confronting patients and is working to engage with various stakeholders, including wholesalers, insurance companies, pharmacies and pharmacy benefit managers, to ensure that all patients regardless of insurance coverage, have affordable access to AUVI-Q.

“We believe that patients should have options when it comes to epinephrine auto-injectors for life-threatening allergic reactions,” said Spencer Williamson, President and CEO of kaléo. “When a health care practitioner prescribes AUVI-Q, determining that it is best for a patient, we believe that the patient should be able to obtain the product without insurance barriers or being subjected to a high out-of-pocket cost. As we prepare to make AUVI-Q available once again in the United States, our priority is to return AUVI-Q to the market as an epinephrine auto-injector alternative that all patients can afford.”

“We are very excited about patients once again having a choice in epinephrine auto-injectors,” said Eleanor Garrow-Holding, President and CEO of the Food Allergy & Anaphylaxis Connection Team (FAACT). “As food allergy advocates and families personally affected by food allergies, we understand that each person with food allergies has individual needs and comfort levels. Those living with life-threatening allergies deserve innovative products and choices that meet their individual needs. As such, we are grateful that patients will have options when selecting their potentially life-saving epinephrine auto-injector."

The latest updates regarding the return of AUVI-Q will be available to members of the public who register online at www.auvi-q.com.

###

About Anaphylaxis 
Anaphylaxis (pronounced ana-fuh-lak-sis) is a serious allergic reaction that happens quickly and may cause death. Anaphylaxis can occur as a result of exposure to allergens including tree nuts, peanuts, milk, eggs, fish, shellfish, soy, wheat, insect bites, latex and medication, among other allergens.

About AUVI-Q 
AUVI-Q® (epinephrine injection, USP) Auto-injector is a prescription medicine used to treat life-threatening allergic reactions, including anaphylaxis, in people who are at risk for or who have a history of serious allergic reactions. AUVI-Q contains epinephrine, a well-established, first-line treatment for severe, life-threatening allergic reactions that occur as a result of exposure to allergens including food such as peanuts, tree nuts, fish, shellfish, dairy, eggs, soy and wheat; insect stings or bites; latex and medication, among other allergens and causes.

Invented by twin brothers Eric and Evan Edwards, a physician and engineer who each suffer from life-threatening allergies, AUVI-Q is a compact epinephrine auto-injector with industry-first features, including a voice prompt system that guides a user with step-by-step instructions through the epinephrine delivery process, and a needle that automatically retracts following administration. In emergencies such as anaphylaxis, it is often individuals without medical training who need to step in and deliver potentially life-saving rescue therapy. AUVI-Q was designed – through careful analysis of the situations where epinephrine is used and with significant input from the allergy community that relies on it – to reflect Human Factors Engineering (HFE). HFE is about designing products or systems that are easy to operate and, most importantly, support correct use, with the goal to remove the potential for error.

Indication 
AUVI-Q® (epinephrine injection, USP) is a prescription medicine used to treat life-threatening allergic reactions, including anaphylaxis, in people who are at risk for or have a history of serious allergic reactions.

Important Safety Information 
AUVI-Q is for immediate self (or caregiver) administration and does not take the place of emergency medical care. Seek immediate medical treatment after use. Each AUVI-Q contains a single dose of epinephrine. AUVI-Q should only be injected into your outer thigh, through clothing if necessary. If you inject a young child with AUVI-Q, hold their leg firmly in place before and during the injection to prevent injuries. Do not inject into veins, buttocks, fingers, toes, hands, or feet. If you accidentally inject AUVI-Q into any other part of your body, seek immediate medical treatment.

Rarely, patients who use AUVI-Q may develop infections at the injection site within a few days of an injection. Some of these infections can be serious. Call your healthcare provider right away if you have any of the following symptoms at an injection site: redness that does not go away, swelling, tenderness, or the area feels warm to the touch.

If you have certain medical conditions, or take certain medicines, your condition may get worse or you may have more or longer lasting side effects when you use AUVI-Q. Be sure to tell your healthcare provider about all the medicines you take, especially medicines for asthma. Also tell your healthcare provider about all of your medical conditions, especially if you have asthma, a history of depression, thyroid problems, Parkinson’s disease, diabetes, heart problems or high blood pressure, have any other medical conditions, are pregnant or plan to become pregnant, or are breastfeeding or plan to breastfeed. Epinephrine should be used with caution if you have heart disease or are taking certain medicines that can cause heart-related (cardiac) symptoms.

Common side effects include fast, irregular or ‘pounding’ heartbeat, sweating, shakiness, headache, paleness, feelings of over excitement, nervousness, or anxiety, weakness, dizziness, nausea and vomiting, or breathing problems. These side effects usually go away quickly, especially if you rest. Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

Please see the full Prescribing Information and the Patient Information at www.auvi-q.com.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

About kaléo (kuh-LAY-oh) 
Kaléo is a pharmaceutical company dedicated to building innovative solutions for serious and life-threatening medical conditions. Our mission is to provide innovative solutions that empower patients to confidently take control of their medical conditions. We believe patients and caregivers are the experts on how their medical condition impacts their lives, and are an integral part of our product development process. Each kaléo product combines an established drug with an innovative delivery platform with the goal of achieving superiority and cost effectiveness. Kaléo is a privately-held company headquartered in Richmond, Virginia. For more information, visit www.kaleopharma.com.



Monday, October 24, 2016

Food Allergy Counseling: Maintaining a Healthy Lifestyle, Preparing Your Produce

My haul from Costco today

A follower on my Instagram account asked me how I eat all those luscious cupcakes and weekend pancakes and still stay slim?

And it’s true, I do eat pancakes almost every weekend and cake, cookies and/or chocolate whenever I want.

So, how do I do it?

I will be posting my strategies and thoughts on my Allergic Girl Facebook page, here on my blog and on Instagram.

Today my tip is about food prep, supporting your diet goals and setting yourself up for excellence.

I shop two or three times a month at Coscto for my fruit and veg; I eat that much fruit and veg daily.

Above is a picture of what I bought today. 

And below is a picture of what I did for about 30 minutes when I got home i.e. I washed, chopped, prepped, bagged and Tupperwared everything so it’s all nice and ready to grab.


My fridge after food prep

Need a snack? Sliced apples and oranges are ready. Want a salad? Look, one’s already made and waiting! Isn’t that glorious?

Part of the challenge when you buy a ton of fruit and veg is that they need preparation: chopping, slicing, coring, peeling, etc.. The prep can be a barrier to eating all of that wonderful produce and it can end up sitting in bags, rotting in your fridge in just a few days. All that wasted goodness, health and cash.

So, by taking some time when I get home from shopping and prepping fruits and veg, getting them closer to being ready to eat, I cut out that challenge and make it so much easier to grab a healthy snack, setting myself for excellence and supporting a health diet with healthy habits.


Monday, October 17, 2016

Recipe: One Pan Turkey Scramble




What to make with eight ounces of frozen ground turkey thigh? 

I typed that into Google and  Simply Recipes's "Mom'sGround Turkey & Peppers" recipe popped up. I love the Simply Recipes site and this recipe was so easy: turkey, peppers, onions, garlic and chili powder. 

I used shallots (had no garlic) and halved the recipe and was so yum. I had made a batch of brown rice and put it right over but would be on top of a great salad, too.

Thank you, Simply Recipes!

Monday, October 10, 2016

Food Allergy Counseling: Emotional Agility in Children and Adults

This is a fantastic, short article from the New York Times Well section on how to embrace your child’s emotional experience and teach them to embrace it as well; also works for adults!

“How children navigate their emotional world is critical to lifelong success…Dr. David offers four practical steps for helping a child go through, rather than around, a negative emotion and emerge ready to keep going — feel it, show it, label it, watch it go."

Read more here on the New York Times website.