Feeding Tubes and Food Allergies

A few weeks ago, my husband's grandmother got a permanent feeding tube. At 95 years old, this was only one in a line of medical interventions addressing her declining health for the last several months.

Despite her various health issues, she has not taken this transition well. And who can blame her? Food is tied to so many of life's rituals and pleasures. Food itself gives us pleasure and no matter how limited our diet, we take pleasure from some of the foods that we can eat. It is part of our survival. We enjoy food so that we will eat so that we will live.

Her socializing is someone crippled at the moment anyway with hospital stays, but I keep thinking of how much this will impact nearly all of our interactions with her. This is a woman who loves food. A woman who is renowned in her circles for her crab salad and pear pie. A woman for whom Christmas would not be complete if she couldn't give family members homemade fudge and pecan tarts (the latter of which I, of course, have never tasted.)

This is also a woman who long ago admitted that she doesn't need more stuff, and to whom we have mostly given consumable gifts as well. Wine, Kahlua, and other alcohol; our own homemade cookies; and meals to help her out. What sort of gifts do you give a person who doesn't want more things and now cannot eat?

Not eating is even slowing her recovery. During a previous stay at a rehab center, she had 3 long walks every day on her way to and from the dining hall for meals. If she was unwilling to do any other physical therapy, she got that much exercise, at least. Now she doesn't even get that, plus she's missing out on the social time of meals.

She does get to drink a little water and try eating some easy-to-swallow foods when a speech therapist comes by, but that's all. (And by the way, the liquid nutrition prescribed to her contains dairy and soy. Just an allergy side note.)

During this time, I can't help but think about the parallels between her current situation and the lives of people with food allergies. As we all know, food allergies limit us in social situations that involve food. Getting a feeding tube just exacerbates these situations. It's like all-of-a-sudden being allergic to everything, but without the cross contact risk.

Something else I've been thinking about is that this situation just goes to show that while food allergies aren't fun (in fact food allergies can often suck) there are still many other and worse things that can happen to us. I'm grateful that our family can still eat out as long as we are careful of ingredients. I'm grateful that we have fun food rituals and can enjoy our favorite meals and desserts. I'm glad that we are all healthy so long as we avoid our triggers. I'm glad that food allergy living forces us to cook more from scratch and so we are eating healthier, more wholesome food most of the time. And I'm glad that we are learning so much about nutrition and can teach our children healthy eating habits, so that hopefully we can all remain healthy long into our twilight years.

My husband's grandmother has made miraculous recoveries in the past, so we are all hoping that she can regain her throat strength and her overall strength, and begin feeding herself again. Because no matter how allergy-friendly you slice it, food is a very important part of our lives.

Auvi-Q Recall

Troubling news just in: ALL Auvi-Q autoinjectors currently issued are being voluntarily recalled by Sanofi because of potentially inaccurate dosing. Allergic individuals who have Auvi-Qs should still use them until a replacement can be obtained, but you should contact your doctor for a prescription for a different auto-injector as soon as possible.

"The recall involves all Auvi‑Q currently on the market and includes both the 0.15 mg and 0.3 mg strengths for hospitals, retailers and consumers. This includes lot number 2299596 through 3037230, which expire March 2016 through December 2016."

Sanofi has received 26 reports of suspected device malfunctions. No deaths are associated with these malfunctions. Sanofi is is arranging for return and reimbursement of all recalled products.

"Customers with questions regarding this recall can go to www.Auvi‑Q.com and call1‑866‑726‑6340 Monday through Friday 8 a.m. to 8 p.m. ET for information about how to return their Auvi‑Q devices. Customers may also email cs@sanofi.com. Sanofi US will provide reimbursement for out of pocket costs incurred for the purchase of new epinephrine auto‑injectors with proof of purchase."

Update: Please call EITHER 1-877-319-8963 OR 1-866-726-6340. Sanofi US previously noted that, due to the high volume of calls, callers may have received a message that the line is down. They are asking consumers to please call back and try both numbers if this happens. 

This sucks on all sorts of levels, folks. Sorry to have to report. Take care of yourselves!

"Sanofi US Issues Voluntary Nationwide Recall of Auvi‑Q® Due to Potential Inaccurate Dosage Delivery

Sanofi US is voluntarily recalling all Auvi‑Q® (epinephrine injection, USP). The recall involves all Auvi‑Q currently on the market and includes both the 0.15 mg and 0.3 mg strengths for hospitals, retailers and consumers. This includes lot number 2299596 through 3037230, which expire March 2016 through December 2016. The products have been found to potentially have inaccurate dosage delivery.

If a patient experiencing a serious allergic reaction (i.e., anaphylaxis) did not receive the intended dose, there could be significant health consequences, including death because anaphylaxis is a potentially life‑threatening condition. As of October 26, 2015, Sanofi has received 26 reports of suspected device malfunctions in the US and Canada. None of these device malfunction reports have been confirmed. In these reports, patients have described symptoms of the underlying hypersensitivity reaction. No fatal outcomes have been reported among these cases.

Auvi‑Q (epinephrine injection, USP) is used to treat life‑threatening allergic reactions (anaphylaxis) in people who are at risk for or have a history of these reactions. Auvi‑Q is packaged with two active devices and one trainer device in a corrugate box. Auvi‑Q was distributed throughout the United States via wholesalers, pharmacies and hospitals. All Auvi‑Q is being recalled.

Sanofi US is notifying its distributors and customers who include doctors, pharmacies, wholesalers and other customers in the supply chain by letter, fax, email and phone calls and is arranging for return and reimbursement of all recalled products.

Customers with questions regarding this recall can go towww.Auvi‑Q.com and call1‑866‑726‑6340 Monday throughFriday 8 a.m. to 8 p.m. ET for information about how to return their Auvi‑Q devices. Customers may also emailcs@sanofi.com. Sanofi US will provide reimbursement for out of pocket costs incurred for the purchase of new epinephrine auto‑injectors with proof of purchase.

Customers should immediately contact their healthcare provider (HCP) for a prescription for an alternate epinephrine auto‑injector. In the event of a life‑threatening allergic reaction (anaphylaxis), patients should only use their Auvi‑Q device if another epinephrine auto‑injector is not available, and then call 911 or local medical emergency services. Customers should contact their physician or HCP if they have experienced any problems that may be related to taking or using this drug product.

Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA's MedWatch Adverse Event Reporting program either online, by regular mail or by fax.

Complete and submit the report Online:www.fda.gov/medwatch/report.htm or by Regular Mail or Fax: Download form www.fda.gov/MedWatch/getforms.htm or call1‑800‑332‑1088 to request a reporting form, then complete and return to the address on the pre‑addressed form, or submit by fax to 1‑800‑FDA‑0178

This recall is being conducted with the knowledge of the U.S. Food and Drug Administration.

Sanofi US is committed to patient safety and the quality of Auvi‑Q, and will continue to work closely with customers and regulatory authorities to resolve this issue in a timely manner."

More Details from auvi-q.com

Additional Information

What is the potential or theoretical risk if the recalled product is administered to patients?

The current manufacturing issues are not related to the drug epinephrine. However, the products have been found to potentially have inaccurate dosage delivery. If a patient experiencing a serious allergic reaction (i.e. anaphylaxis) did not receive the intended dose, there could be significant health consequences, including death because anaphylaxis is a potentially life‑threatening condition.

You say this is a voluntary recall, but did the FDA advise you to recall Auvi‑Q?

We discovered these issues as part of our routine manufacturer quality review and reported our findings to U.S. FDA. As a precautionary measure and in cooperation with the FDA, we are voluntarily recalling all Auvi‑Q currently in the market.

What should U.S. consumers do if they have this product?

People with an Auvi‑Q device are being asked to call 1‑866‑726‑6340, Monday through Friday, 8 a.m. – 8 p.m. ET for information about how to return Auvi‑Q. They may also email cs@sanofi.com. They should also immediately contact their healthcare providers for prescriptions for alternate epinephrine auto‑injectors. Details about reimbursement will be available on www.Auvi‑Q.com as soon as they are available.

Will patients have to pay for their replacement medication?

Initially, patients will need to pay for their replacement device. Sanofi US will reimburse patients for the full out‑of‑pocket cost when they receive a new epinephrine auto‑injector.

Have you alerted healthcare professionals?

Yes, we have actively been in contact with healthcare professionals.

What drug can be substituted as the replacement for Auvi‑Q?

Auvi‑Q is one of three epinephrine auto‑injectors available in the U.S. The other two are EpiPen® and Adrenaclick®.

What should a patient do if the Auvi‑Q product they have fails to work?

Please immediately call 911 or local medical emergency services for emergency medical attention. Any adverse event that may be related to the use of this product should be reported either to Sanofi US or to FDA's MedWatch Program.

Do you expect to ultimately reintroduce this product in the U.S.? If so, when?

Our focus right now is on patient safety and resolving the issues. Once our investigation is complete and we have corrected any related issues, we will announce our future plans at a later date.

Teal Pumpkin Cake Behind-the-Scenes

In case you missed it, I did a guest blog post for Kids with Food Allergies on October 22nd. Follow this link to see the tasty recipe!

I thought I'd post a few behind-the-scenes pictures of that cake, in case anyone is interested in more details.

I didn't put any ingredient pictures on my guest post, so if you're wondering what brands I used, here they are:

Lillabee Gluten Free Flour

Kroger Granulated Sugar (in the big bin)

Kroger Apple Cider Vinegar

Kroger Baking Soda

Morton Sea Salt

Mexican Vanilla

Mostly Kroger Spices (the Spice Islands Cinnamon was given to me by someone)

The Aquafaba is in the small rubbermaid bin, it's from Kuner's No Salt Added Garbanzo Beans

My Pumpkin Puree is in the larger rubbermaid bin. It's homemade

Other successful flours included:

All-purpose wheat flour. If it doesn't need to be gluten free, it works well with the regular stuff

Pamela’s All-Purpose Flour

Deby’s Gluten-Free Food All-Purpose Flour Blend

UNSUCCESSFUL flours included:

Bob’s Red Mill Gluten Free 1 to 1 Baking Flour

Kathy P’s Brown Rice Flour Mix

Bella Gluten-Free All Purpose Baking Mix - sort of worked, not perfect but not horrible

It's funny taking pictures for a blog post, especially a guest blog post. I spent a good deal of time making my house look Martha Stewart-worthy, but only about six square feet of it. I thought it was funny to capture some of the kitchen mess and the random toys my son left on the floor near where I was working. (My house is actually much messier than you can see here, but there weren't many good angles to capture the table and the mess.)

Here's one of the bundt cakes fresh from the oven. You can really see the texture well in this photo.

My frosting ingredients. I was trying to make this corn-free too, but I don't know exactly where corn can hide, so it may still be in the Earth Balance or the Rice Dream.

Teal food coloring. I got this tube at Hobby Lobby. (This does have corn in it.) I try to limit food dyes in most of our food, but when it comes to cakes they're just too much fun. I'm sure you can get a pretty color that is close to teal using some of the natural food colorings that are starting to become available.

Quick! Get a picture of the cake before adding the frosting, just in case I totally screw it up!

Partway through frosting it. In the back, you can see a spot where I screwed up the frosting and scraped it off before starting again. The final coat of frosting covered what was left of the aborted attempt.

Me piping KFA's Teal Pumpkin face on the cake

Kal watched me make this all day long--the day I finally did the decorating he was off from preschool. After being gently asked and sternly told to leave the kitchen several times, I couldn't say "no" to a sweet picture with him in it!

Blueberry Oatmeal Doughnuts

I'm taking another break from the blog today and letting Dean provide another post and recipe for you. He's the one who makes special breakfasts around here, most of the time. I just sit back and let it happen!


Hello, Dean is back for a guest post and time for part 2 of my Mother's Day Brunch doughnut extravaganza. If you missed part 1 with my chocolate chocolate chip doughnut recipe fear not. It can be found here.

This is the reason I wanted a doughnut pan in the first place. It was one of the first eggless doughnut recipes I found on Pinterest. Now it's not my recipe, I modified it only slightly due to what ingredients I had on hand. The original can be found at the Bear and Lion website.

(What is it about photos needing to be shot at an angle like this?)

Free From:  Egg, Peanut, Tree Nut, Soy, Fish, Shellfish (still happy about those last two). It could be modified to be top 8 free.

Ingredients:

• 2 cups rolled oats (To be honest I didn't know what rolled oats were and didn't want to take the few minutes to Google it. I was on a time crunch after all. I used what I had: quick oats.)
• 1 1/2 cups whole milk (All I had was 1% milk, not as flavorful, but healthier.)
• 1 1/2 cups flour
• 1 Tbsp baking powder
• 1/2 tsp salt
• 1/4 tsp cinnamon
• 1/2 cup light brown sugar
• 1/2 cup unsalted butter
• 1 tsp vanilla
• 3/4 cup frozen blueberries (I really like blueberries so I added a full cup.)

Glaze: (optional)

• 1 1/3 cup powdered sugar
• 3 Tbsp milk
• 1 tsp vanilla extract

Directions:

Preheat oven to 400 degrees. Spray doughnut pan with nonstick cooking spray or grease it however you like.

Mix oats and milk in a medium-sized bowl. I pulverized the oats with our magic bullet blender into a fine powder. I wasn't sure how our kids would react to oatmeal in it. The powder blended in nicely.

In a large bowl, mix together the dry ingredients, making a well in the center. 

Melt the butter. Add in the liquid ingredients, the oatmeal mixture and the blueberries.

Mix until just combined. Now these blueberries seemed big to me and I didn't want to have some sections/bites to not have a blueberry, so I used a spoon and smashed them up a bit. 

Be careful not to over mix!

Fill doughnut pan to the top. 

Bake for 16-18 minutes until golden brown.

Be careful not over bake!

Let them cool on a wire rack and enjoy!  Makes a dozen doughnuts.

The original recipe didn't call for a glaze, this is more like a doughnut shaped muffin. I thought it could use a little extra something, it was for Mother's Day after all! So I used the glaze recipe from the fried doughnut recipe here.

To make the glaze: In a small bowl, mix powdered sugar and vanilla. Add the milk and mix well. Dip each doughnut in the glaze and coat it well. Place back on the cooling rack to allow excess glaze to drip off.

Once again I didn't get a final picture with the glaze on. Just a zoomed in image of one on a mother's plate. Next time, remember? I promise.

These were well received, but not as much as the cream cheese frosted, chocolate chocolate chip doughnuts. Surprised? The boys didn't like these that much, but I thought it was a good tasting doughnut that is a little bit more healthy. Until my next blog post, don't forget how super you are!

Do you have a favorite doughnut recipe you found on Pinterest?

Linking up at Allergy Free Wednesdays

Teal Pumpkin Cake - Guest Post on Kids With Food Allergies Blog

The fabulous folks over at Kids with Food Allergies asked me to write them a guest blog post for Halloween. And what better way to embrace the holiday and its wonderful, inclusive movement than with this delicious Top-8-Free Pumpkin Cake?!

Head on over to their blog to find out how to make it!

http://community.kidswithfoodallergies.org/blog/teal-pumpkin-spice-cake-recipe-1

I hope you're all getting your teal pumpkins ready and are stocking up on non-food treats this year! Have a Happy Halloween and #KeepItTeal!

Jack-Teal-Lantern's Halloween Safety Tips

Meet Jack-Teal-Lantern. He's a teal pumpkin who loves spreading joy and inclusiveness to all children, no matter what health conditions or dietary restrictions they have. And today, he wants to make suggestions for how to have a Fun and Safe time trick-or-treating when you have Food Allergies.

Jack-Teal-Lantern's Halloween Safety Tips

 

1. Carry your Epi with you when out trick-or-treating, going to parties, and everywhere else! And most importantly, use it if you need it!
2. Don't eat any candy while you are out trick-or-treating. Not at all. Not even things you've eaten safely before. Candies can change from year to year so you don't want to take any risks.
3. If someone tries to hand you candy that you know is unsafe, it is okay to politely say "I am allergic to that, may I have something else instead?"
4. Always be polite. No one is required to give out candy, so don't be rude if all they have is candy you can't eat. Either accept it with a "thank you" to trade with someone else, or politely decline. No one will appreciate you being rude about someone's candy selection. Not even your parents.
5. Look for teal pumpkins! Remember that houses with teal pumpkins will have something non-food to give out, which means you can score great toys or craft materials to enjoy! When you see a house with a teal pumpkin, be sure to ask for the non-food treats and say a great big Thank You for supporting kids with food allergies!
6. Print out a few small Teal Pumpkin Project fliers and take them with you while you trick-or-treat. Some people hand out non-food treats even if they've never heard of the Teal Pumpkin Project. At these houses, give them a flyer, thank them for having something that isn't food, and encourage them to put out a teal pumpkin next year.
7. When you get home, read all of the labels with the help of a trusted adult. Sort your candy into three piles: one for safe candy, one for unsafe candy, and one for candies you think are safe but which aren't labeled. If you or your parents have the chance you could check the labels on the "uncertain" pile before the stores sell the rest of the candy packages. (But if you can't find out, then don't eat those!)
8. Figure out a way to get rid of your unsafe candy. Remember that it is perfectly good food to other people. Whether you're handing it out to other trick-or-treaters, setting it out for the Switch Witch, trading with friends, or selling your candy to a dentist (who will then ship it to our troops), there are lots of ways to safely and efficiently get the candy you can't eat out of the house.
9. Don't begrudge your parents or siblings a taste of the candy you can't eat. Everyone likes different things, and everyone can eat different things. Just remind them to wash their hands and brush their teeth after.
10. Remember that you aren't the only kid with food allergies. Be mindful of the allergies of other people, whether they are your friends, your siblings, or your parents. Keep candies that they can't eat away from them, and remember to wash your hands. (This applies to taking Halloween candy to school with lunch, too.)
11. Don't take risks. No matter how much your friends or siblings like a candy you are allergic to, taking a taste isn't worth having a reaction. Chances are you won't like the candies you're allergic to anyway.
12. Don't forget Halloween safety rules that all kids must follow, including only going to houses with lights on, staying with a grown-up (or at least with your group of friends), watching for cars before you cross the street, etc.
13. Have fun! But always remember to be safe!

Pizza Sauce

I've been making homemade pizza a lot lately. I thought it would be fun to make my own crust, but that meant I also needed my own toppings as well. We had a few jars and frozen packets of sauce, but I thought most of those were too sweet. Then I remembered this recipe, which my mom used to make while I was growing up. I'm happy to report that it tastes just as good now as it did back then!

Pizza Sauce
(top 8 free)

Ingredients

• 1 Tbsp olive oil
• 2 cloves garlic
• 16 ounces fresh tomatoes (or 16oz can tomatoes)
• 8oz can tomato sauce
• 1 tsp dried oregano
• 1 tsp dried basil
• salt and pepper

Directions

1. Blanch your tomatoes: drop tomatoes in boiling water for 1 minute, then pull them out with a slotted spoon and plunge immediately into cold water. Peel off the loose skin and discard.

2. Mince your garlic. Drain the tomatoes and chop them.

3. Heat oil in a saucepan over medium heat. Add garlic and cook for 1 minute. Add tomatoes, tomato sauce, oregano, basil, and salt and pepper to taste.

4. Cook until thickened, stirring frequently, about 20 minutes. Makes enough for two pizzas.

It freezes well, too. Eat half tonight, and save the rest for your next pizza night!

We do movie night every Friday, when we eat downstairs in front of the TV. Pizza makes a great meal for movie night!

Use on your favorite pizza crust and with your favorite toppings!

And the beauty of homemade pizza is each person's toppings can be personalized!

Proudly geeking out over our Enterprise-shaped pizza cutter! 

What toppings would you use with this pizza sauce?



Linking up at Allergy Free Wednesdays and Gluten Free Fridays

Too, too many

Can anyone explain what it is about this time of year? Nearly a year ago, I was lamenting that I wanted to crawl back under a food allergy rock and not pay attention to all of the deaths that were happening, one on top of the other. Now, here we are in mid-October and we've had three in the span of the last month. The summer months were blissfully sparse in news of food allergy deaths, and yet here we are, a few months into the school year and prepping for fall/winter holidays, and the deaths are piling up. And all of them teenagers. Can anyone speculate as to WHY?

We know teenagers are the highest-risk group, but even so, I'm beginning to dread this time of year. Is it because the beginning of the school year is a time when people to want to fit in? Impress their friends and new classmates, and admitting to (or properly preparing for) food allergies seems like a waste of time or, worse yet, uncool?

Or is it that with all the newness of a new school year, sometimes our safety precautions get forgotten? Even returning to the same school is new--new grade, new locker, new teachers, new clothes and backpack, new supplies, new classmates, newer and harder classes. Is this just too much for the teenage mind to manage?

Or could it be that with school celebrations and upcoming holidays, food is more prevalent and part of our celebrations, and when we're surrounded by so much bounty it's easier to slip up?

I don't know if any of my speculations are part of the big picture, but I do know that this seems to be a dangerous time. Please take care of your loved ones this year. Our kids may hate it when we constantly remind them of the same thing, over and over, but keep reminding them to bring their epinephrine--to school and when going out with friends. Make sure the school office has a backup, even if your teenager is (hopefully) self-carrying. Set alarms, download apps, post notes by the door, wait by the door with epi in-hand.... but do whatever it takes to make sure your kids remain prepared. And if YOU have allergies, don't leave home without it either.

Epi will save a life. Let's all take care of each other this holiday season.



Morgan Elizabeth Crutchfield
October 5, 2015
http://allergicliving.com/2015/10/09/north-carolina-teenager-dies-from-food-allergy-reaction/

Simon Katz
September 21, 2015
http://www.denverpost.com/news/ci_28864937/chatfield-high-student-dies-after-eating-smore-containing

Andrea Mariano
September 18, 2015
http://allergicliving.com/2015/09/19/first-year-college-student-dies-of-severe-allergic-reaction/

Sprouted Bean Potato Topper

I'll confess that I love a hot lunch. Just throwing a sandwich together at lunchtime fills my stomach, but doesn't satisfy me as much as something warm from the stove. Last week, I needed to use up some potatoes that were going to go bad, and also use up some of the monster kale plant in my garden. So I experimented and came up with this!

This is my Sprouted Bean Trio, from CostCo. It cooks really fast, about 5 minutes of boiling and 10 minutes to rest. Easy Peasy. For this recipe, I used 1/2 cup.

Usually I cook the beans in water and drain the excess, but I wanted a gravy, so I cooked it in Beef Better Than Boullion. I used about 2 cups of broth (2 cups water and 2 tsp Better Than Boullion.) This was a bit more than the beans called for, so I would definitely have broth left over.

I added three leaves of ginormous kale from my garden. After removing the thick stems, I cut the kale into thin strips and tossed in into the pot to cook with the beans.

After about 7 minutes of boiling (I think the beans need a little more time than the package calls for) I added a tablespoon of soy sauce and used cornstarch to thicken what was left of the broth into gravy.

Here it is after cooking and thickening.

I added this to the top of a baked potato and topped it with chopped green onions. It turned out to be really tasty, and I had enough for about three meals! (Hubby likes the simplicity of a sandwich or a potato with a can of chili, so I had this all to myself!)

What are you making this week?





Linking up at Allergy Free Wednesdays and Gluten Free Fridays

Snow Pea Salad

An old coworker of mine turned me on to this salad many years ago. Snow peas were one of the best things that grew in my (then) new garden, and I needed more ways to serve them. This recipe rocks, both in its simplicity and in its great taste!

Snow Pea Salad

Contains dairy

Ingredients

• Snow Peas, cut to bite-size
• Chopped red onion
• Chopped fresh mint
• Feta cheese (roughly 8oz)
• 4 Tbsp olive oil
• 1/2 tsp salt
• 1/8 to 1/4 tsp black pepper

Directions

Cut the ends off your peas, and string them if necessary. Then chop them into bite-size pieces (halves or thirds.)

Dice your red onions and chop your mint.

Mix your vegetables together. Proportions are eyeballed, but you want a majority of peas and not enough onion to overpower.

Add the feta and toss.

Mix olive oil, salt, and pepper (to taste) and pour over salad.

Toss and serve!

I love snow peas and am so sad that the season is mostly over. I was so glad to get a batch from my in-law's garden to make it one more time this year! Yum!

Linking up at Allergy Free Wednesdays and Gluten Free Fridays