When my peanut allergic son was 5, he suddenly blurted out "Mom, don't worry about me, if I eat a nut by mistake and it kills me, I can just hit the re-do button and get another life, like in the video game." I became really scared that his child-like innocence prevented him from understanding the potential adverse ramifications of his own food allergy. The sad truth is that there are no do-overs or magic reset buttons if you get it wrong with a nut allergy, only tragic endings.
While speaking at the Food Allergy Research and Education (FARE) dinner, a slide went up behind me listing all the food allergy fatalities during the past year. Names have since been added to the growing list, and in the last two weeks alone, there have been two teenage allergy deaths. There seems to be some chilling similarities amongst the two -- both were teenagers and both had left their life saving epinephrine auto-injectors at home. What both the general population and even some food allergic families don't quite understand is that just because your prior reactions to a food were considered mild does NOT accurately predict that you will or will not have a fatal or near fatal reaction in the future. That's why the most important prescription you leave from an allergy diagnosis is for an auto-injector (i.e. the EPI-PEN or Auvi-Q), concurrent with the admonition to ALWAYS carry it on your person.
In general, adolescence is a time fraught with experimentation and risk. As a society, we recognize this and put certain safeguards in place. Teenagers are in many ways living in their own microcosm of the adult world. In many states, you may receive a license as a teenager, but there are certain age related limits, such as how many people can be in the car and even a curfew on when you can be out on the road. There are limits placed on alcohol by a having a legal drinking age in place to attempt to curb drinking and driving. Too often, teenagers think they are invincible and it is no surprise to find out that medical studies have shown that teens are at the highest risk for having life threatening food allergic reactions.
As food allergic parents, we are fearful every day when we send our children out into the world, that they might not come home. There is such vitriolic commentary on social media hurled at food allergic parents who advocate for their children. People are simply outraged at being asked not to send in that peanut butter and jelly sandwich in kindergarten. Let us remember that children, especially when they are young, often cannot protect themselves. Just like my then 5-year-old believed on that day that he was invincible, any young child may not truly understand the potential danger.
As we have defibrillators on the wall in many public entities, wouldn't it behoove us to have life saving epinephrine auto-injectors in public places like schools and airplanes? Tragic stories like the two teenage deaths bring faces to the research that asserts delayed administration of epinephrine can lead to fatal consequences. Time is of the essence, which is why there is legislation recently introduced in the Senate that seeks to replace the unlabeled epinephrine ampules currently on planes with easy to use auto-injectors. Many states have passed epinephrine stocking laws for schools, allowing staff to administer epinephrine auto-injectors to any person who warrants treatment, not just those with a prescription. Steps like these may mean the difference between life and death for a food allergic person, as well as a person who does not yet know they have developed an allergy. I would be remiss not to point out that data shows that approximately 20-25% of stock epinephrine in schools was administered to children whose allergy was unknown at the time. Fifteen million Americans have food allergies, and since so many more people are unaware that they have an allergy until that first bite, let's try to take steps to make sure that the first bite is not a deadly one.