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Special Needs Spotlight: Sam

My name is Emalee.  I am almost 32 years old. I am a licensed marriage and family therapist. I have been married for almost 11 years to Mike. He is an attorney in Salt Lake City. Our son Sam is two years old. We also have a naughty dog named Atticus. My husband and I went to grad school after we were married, and so we postponed having children. In 2007, we found out that we were pregnant with our first baby. We miscarried that baby right at the end of the first trimester. If you wish, you could read about that experience on Molly Jackson’s blog,www.agoodgrief.com. I had the priviledge of being her first guest poster.  About a year later, we found out that we were pregnant again, and again toward the end of the first trimester (after I had seen that precious heart beat on two separate occasions), our baby girl died.  Four months later, I found out that I was pregnant with Sam.  My son has SEVERE food allergies. He has had anaphylaxis 10 times in one year (he is only 2 years old), and has even been hospitalized. He is the light of our lives and is named after the Old Testament prophet, Samuel. His name means, “God Heard Her.”
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Miggy:  So your son Sam, suffers from very severe food allergies.  Although this isn’t typically thought of as a special need, it certainly has altered your life and the way you care for your son.  So how do you classify your Sam’s condition and how do you explain it to other people so they understand the seriousness?
Emalee:  I have not really thought about how to classify Sam’s allergies. He certainly does have “special needs.” He is allergic to: eggs, peanuts, tree nuts, wheat, oats, green beans, peas, white potatoes, grapes, bananas, pineapple, coconut, and avocado. No, I am absolutely not kidding!! Think about eliminating all of those foods from your family’s diet. It is a challenge to come up with meals for Sam. I also have to prepare and carry around all of Sam’s meals if we are going anywhere. I just do not trust that other people will not cross-contaminate (see the avocado story below for an example) and even if they were very careful, I do not know if food will be available that Sam can eat. He also wears a medi alert bracelet sometimes (it is really hard to get a 2 year old to wear a bracelet—even if it does have cool animals on it), and I always have to carry Benadryl and two epi pens (which inject epinephrine which is adrenaline). Also, many kids who suffer with food allergies have asthma and eczema. Sam has both. I have to carry an inhaler and have a nebulizer in my home. During the winter, I try to stay in as much as possible because the air in Utah can get very dirty. I have not found anything to manage Sam’s skin really well. Any help I could get with that would be great.
I have had to really advocate for Sam by educating people about food allergies. Many people think about food allergies the same way they think about seasonal allergies. They think he may sneeze a lot or get a runny nose if he ate a peanut. Sam’s food allergies are life-threatening. If he eats the foods to which he is allergic and is left untreated, his throat could swell preventing breathing and/or his blood pressure could drop and he could die.
Miggy:  When did you first realize Sam had food allergies?  Did you realize how serious it was right away, or did it take some time?  And do you know all the foods he is allergic to, or is this list constantly growing?  
Emalee:  When Sam was six months old, his pediatrician said we could try rice cereal. Sam did not tolerate solid foods well, and the doctor and I thought that he just might not be ready. When he was nine months old, we tried again. He would throw up a lot and cry when we gave him certain solid foods. I thought he probably had acid reflux. We did not try again for a while. His pediatrician and I began to worry that something may be structurally wrong with his stomach or esophagus. She recommended that we think about doing some further tests. We scheduled an appointment with a pediatric gastroenterologist for an endoscopy consult.
Before our appointment with the GI doc, Sam turned one. At his first birthday party, I made him a smash cake. It contained the ingredients a normal cake would, such as eggs and flour. Sam played around in the frosting (made with meringue powder which contains eggs), and began getting welts all over his body. He also began throwing up. I made an appointment the next day to see his doctor and she advised me to see an immunologist (a doctor specializing in asthma, eczema, food allergies, etc.). The immunologist did a scratch test and his back lit up like a Christmas tree. She also did a blood test to confirm. She told me that Sam had severe food allergies. At this point, I did not know how serious Sam’s condition was. I knew theoretically that anaphylaxis could occur and that it could be fatal. My immunologist told me that out of her 300+ patients, only about 3 needed to use their epi pens per year and only 2-3 needed to be hospitalized. I just thought that I would keep certain foods away from Sam and would carry some Benadryl and epi pens. Easy peasy. I did not think I would ever need to use them, nor did I think I would ever be in a life-threatening situation.
The next day (seriously), I was at my mom’s house. Sam found a cashew on the floor and ate it. He got welts all over his body and began to throw up. I just stood in the bathtub holding Sam while he threw up all over me. I was on the phone with the doctor’s office and they told me to give him Benadryl, which I did. In total, Sam threw up over 100 times. I did not know it at the time, but he was in anaphylactic shock. I am extremely lucky that he did not die that day. I made a mistake by relying solely on the advice the pediatrician’s nurse gave me. I do not think that even she understood how serious food allergies could be.
Many people, even a few medical professionals, think you only need to watch for breathing problems with an allergic reaction, and as long as the patient is breathing, everything else will be okay. That is not necessarily the case. Technically, anaphylaxis means that two or more systems (usually gut, skin, and lungs) are being affected. If two or more systems are affected, it means the problem is systemic. It also means that blood pressure can drop which can be fatal. Since the cashew incident I do not hesitate to take him to the emergency room or to his pediatrician’s office. I should have a room named after me because of all of the co-pays I have paid over the last 18 months (totally worth it). It took me one day to understand the seriousness of Sam’s situation.
There is no possible way to test for all the foods to which Sam may have allergies. The list is constantly growing. For example, we did not know he was allergic to avocado. One day, I cut an avocado and did not wash my hands before I handed some cheese to Sam. He ate the cheese and went into anaphylactic shock. He was admitted into the hospital and given epinephrine and steroids. While we were there, a nurse gave him a stuffed dog which he actually named Avocado.
Miggy:  Explain how Sam’s allergies affect your day-to-day life?
Emalee:  Managing Sam’s allergies are relatively easy if I stay home. My home is pretty safe for him. I have no peanuts, tree nuts, or grapes in my home. Ever. I do have foods that Sam cannot eat (bananas, bread, and chocolate) but they are pretty secure, and because Sam is a big-time climber, I have to keep a constant eye on him anyway. My life becomes more difficult when I leave home. Both sets of grandparents try to be very respectful of Sam’s allergies, as do his aunts and uncles. They vacuum when we come over, they try to limit eating to certain rooms in the house, they try to avoid foods that will hurt Sam, and they try to keep a supply of Sam-friendly foods in their houses. Going to birthday parties makes me nervous. Think about what is served at normal birthday parties for kids. Peanut butter sandwiches, cake, ice cream, grape juice, etc. All of these could hurt Sam. My friend and I toured a candy company in the spring. Some of the candy contained nuts. Not only could Sam not eat any of the candy samples handed out to the other kids, but he could not touch anything either. Needless to say, it was not a really fun experience for either of us. Even building gingerbread houses with his cousins was nerve wracking for me. Sam’s house was made of graham crackers (which contain wheat– one of his less-serious allergies). A lot of the candy that my family purchased contained wheat, potato starch, or was processed in a facility that processes nuts. Sam could not even touch that candy. Sam’s house was decorated only with marshmallows and he could not eat them after because they had touched the graham crackers.
Sam’s allergies have made me realize how much of life revolves around food. We celebrate with food. We console with food. We remember with food. When all of that changes, life changes too.
Miggy:  What are the biggest worries you face regarding Sam and his allergies?  
Emalee:  Without sounding too dramatic, I am worried about Sam dying from anaphylaxis. In all, Sam has had anaphylaxis ten times. He has been hospitalized once. I am worried about what happens when he goes to school, to camp, to a friend’s house, etc. Most deaths from food allergies occur outside the home and many occur during the teenage years. For teenagers, being able to identify with peers is of the upmost importance. If all of Sam’s friends are eating oreo cookies and he is eating carrots, he may decide to join in and eat that oreo. That is a choice that could have dire consequences. This brings me to my next worry which is that Sam will feel left out. We went to his cousin’s birthday party today and all of the other kids were eating cupcakes while Sam ate a rice krispie treat. This is not a big deal right now when he is 2 and loves rice krispies (who doesn’t!), but I worry about what happens when he gets older.
Miggy:  Now for a lighter question, have you ever had any funny conversations/moments you never imagined due to Sam’s allergies?  
Emalee:  This Halloween, my husband and I took Sam to a trunk-or-treat. There were probably 30-40 of our neighbors handing out candy. Almost every single person either brought special Sam-friendly candy, or dug through their buckets looking for something he could eat. I got a little teary thinking about how many of our friends had made special preparations for us and really cared about Sam. At the end of the night, Sam got to keep some of the special, safe candy and turned the rest into the Halloween Fairy for some matchbox cars. This was a great solution for us because Sam still got a special, fun, safe Halloween and we got some peace of mind and did not even have to worry about Sam being hyped up on sugar.
Also, because Sam is my only child, I do not know what it would be like to have a child without food allergies. A few days ago, I dove across a room like a mad woman to yank a cookie away from my 2 year old nephew. Everyone looked at me like I was crazy. I just said, “Sorry. I forgot that other kids can eat these.”
Miggy:  What are some of the misconceptions regarding food allergies?  How can people best respond to you and Sam when first learning about his allergies?  
Emalee:  Like I said earlier, I think the biggest misconception is that allergies are not that serious. They are potentially fatal, but they are really manageable if you are careful.
The best way for people to respond to Sam and I is with curiosity, respect, and kindness. I have only had a few bad experiences with others regarding Sam’s allergies. One was when a woman told me that she would not feel comfortable having him over at her house. I really do understand her concerns, but it still hurt my feelings. Sam is an awesome kid and he is worth the effort of vacuuming and securing harmful foods. The other was when the mother of another child in one of Sam’s church classes insisted that her child be allowed to bring grapes to class. This made me angry because I felt like she did not care about my son’s safety. However, when I thought about it, I realized that she just did not know the seriousness of the situation. Once we talked, she was very kind and agreed to leave her grapes at home.
I also wanted to emphasize that I have been extremely lucky. Almost everyone in my life has been so supportive. People have gone out of their way to create a safe environment for Sam. Our church even did a first-aid training especially for him. It was so awesome.
Miggy:  Since having Sam and dealing with this new way of life, what is the biggest lesson you’ve learned?  
Emalee:  I think that I have learned that we all have hard things to deal with. I have also learned that I can do hard things. People tell me all the time that they could never deal with a child who had such severe food allergies. I want to say, “Sure you can. What other options would you have?” I have also learned that for me, this takes a village. Keeping Sam safe is much easier when I have a lot of help.  I have also learned that the love I feel for my son makes up for the loss of nutella. I really love and miss nutella. I still eat it when I am somewhere without Sam, but it makes me feel guilty—kind of like I am cheating on him or something.
Probably the most important lesson I have learned is a lesson I am fortunate to learn over and over again. Harry Stack Sullivan once said, “We are all much more simply human than otherwise.” Sam is a normal 2 year old boy. He loves cars, dogs, other kids, and running around. He may have some unique challenges, but in the end, he wants the same things we all want. He wants to learn, to grow, to live, to be accepted, and to love and be loved. I want that for him too.
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I want to thank Emalee for participating and for sharing her beautiful boy Sam with us…and I love that bit about Nutella.  I would miss it too!  This definitely opens my eyes to the sobering realities of food allergies.  Additionally, this makes me want to be more supportive of families that I may interact with in the future who have children with food allergies.  
So thank you Emalee!
 
Thanks everyone for reading and have a Happy New Year!
 
Hugs, 
Miggy
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