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Food Allergy Explained: Basics, Back to School & Beyond

The Michigan Medicine Food Allergy Clinic and its partner food allergy research hub, the Mary H. Weiser Food Allergy Center (MHWFAC), published an excellent video — 'Food Allergy Explained: Basics, Back to School & Beyond'. Sharing here to help equip you to safely and easily navigate food allergic living.

James R. Baker Jr., MD, Director of the Mary H. Weiser Food Allergy Center, explains that this video was created “to provide a quick but comprehensive, evidence-based introduction to the various aspects of food allergy and returning to school.”


The more you know about food allergies, the better you can protect your family from accidental exposures, the better prepared you’ll be to handle an allergic reaction.


Watch the video


The video was the brainchild of Dr. Malika Gupta, MD, and Dr. Jing Yi Sun, MD, members of the Food Allergy Clinic team. Dr. Sun comments, “We hope that this video will help both new and experienced patients not only navigate life with food allergies better, but also gain an increased awareness for the team of support available to them at Michigan Medicine.”


You can watch the video all the way through (give or take about 12 minutes), or skip to specific sections of interest. Your choice!

  • Go to 1:48 for—Overview of an Allergic Reaction

  • Go to 2:27 for—What to Do When You Have an Allergic Reaction

  • Go to 3:42 for—How to Use Different Types of Autoinjectors

  • Go to 6:13 for—Food Label Reading

  • Go to 8:01 for—Tips for Back To School

  • Go to 9:32 for—COVID-related Suggestions for School

  • Go to 10:01 for—How Food Allergy Counseling Can Help You

  • Go to 11:00 for—High Level Overview of Food Allergy Treatments

Thank you to the Michigan Medicine team for this helpful video!



Watch the video

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We’re in this together…


**If you prefer to read, a transcript of the video is included below for your reference

The Michigan Medicine Food Allergy Clinic, through its team of board-certified doctors, nurses and staff, delivers the best quality care and clinical services possible for food allergy patients and their families. The Mary H. Weiser Food Allergy Center (MHWFAC) is the University of Michigan's food allergy research hub. Faculty includes renowned immunology researchers and physicians from the Michigan Medicine Food Allergy Clinic. MHWFAC strives to improve the lives of food-allergic individuals by conducting comprehensive research that will significantly advance patient care, and to expand education, research, and services. MHWFAC is a FARE Discovery Center of Distinction.

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Allergy Force is committed to helping people with food allergies live freely — with less fear, less anxiety, more confidence — through technology and education. The Allergy Force food allergy app is peace of mind in your pocket.


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Credits: Thanks to Michigan Medicine for sharing this video with the Allergy Force community and to Chris Benson on Unsplash for use of the family photo


**Video Transcript


"Introduction (0:21)


Dr. James Baker, Jr. MD, Ruth Dow Doan Professor


I’m Doctor Jim Baker. I’m the Director of the Mary H. Weiser Food Allergy Center. We felt that this year back to school would be particularly difficult for our food allergy families given the disruption from the Covid pandemic. So, we decided to create a video that would help you with back to school and help your schools prepare for this. We have created this video for you to get a quick, a comprehensive, evidence-based introduction to the various aspects of food allergy and return to school. This video is not a replacement for medical advice and for any specific questions related to your child’s allergy, please contact your doctor.


Dr. Malika Gupta, MD, Assistant Professor, Division of Allergy & Clinical Immunology


Now more than ever, families with food allergies need support and a well-formed plan before going back to school. You can watch this video all the way through for a more comprehensive review. Or, get to a specific section for a quick refresher.

A food allergy reaction occurs when a food is recognized by allergy antibodies (IgE) which then can cause a reaction. An allergic reaction can occur within minutes to hours after an exposure to a food. Symptoms of an allergic reaction can vary from being mild to life threatening.


Signs of an Allergic Reaction (1:46)


Dr. Jing Yi Sun, MD, Clinical Fellow, Division of Allergy & Clinical Immunology


Recognizing signs of food allergy is an important part of management. Resources such as the food allergy action plan, which your physician can provide, can help you recognize a food allergy reaction and guide you on what to do. Review this resource with family, teachers, babysitters, friends, and your child so that everyone is familiar with how to recognize a food allergy reaction.


Signs of food allergy are divided into mild symptoms such as itchy mouth or a few hives, and severe symptoms such as repeated vomiting, shortness of breath, wheezing, or throat closing. Most symptoms occur within an hour of eating a food allergen. And many times, symptoms can occur immediately.


When a food allergy reaction happens. Do not panic.


For one mild symptom, such as hives around the mouth, give an antihistamine Lexaterazine (which is also known as Zyrtec) or Di-phenhydramine (also known as Benadryl). Do this as soon as possible and watch closely.


For mild symptoms of two or more body systems such as nausea and itchy throat, or for any severe symptom like wheezing or throat closing, this may be anaphylaxis. Give epinephrine immediately.


If a mild symptom worsens even after taking an antihistamine, give epinephrine immediately.

If you are ever unsure about whether or not to use epinephrine, use epinephrine. The longer you wait, the harder it may be to stop a reaction. Do not rely on antihistamines or inhalers to treat anaphylaxis. In addition, make sure epinephrine auto injectors are not expired and are stored at room temperature to maintain their maximum effectiveness. Avoid exposing them to extreme temperatures and do not leave them in the car or put them in the refrigerator. Always have two epinephrine auto injectors available with you. Some reactions may need more than one dose of epinephrine to treat.


Next we will show you how to use some of the most common models of epinephrine auto injectors — EpiPen, AuviQ and Adrenaclick. Please be aware that our video does not cover all of the available models of epinephrine.


{Use Demonstration}


EpiPen:

Hold the EpiPen like a microphone. Do not place your thumb over either end of the EpiPen. Keep the blue safety cap side away from the body. Remember Blue to the sky; Orange to the thigh. Remove the blue safety cap. Press hard to inject the EpiPen into the muscle of the outer thigh and hold for three seconds. It will make a very loud click. Remove the EpiPen and discard safely. It cannot be used anymore. Rub the injection site and lay down to help the medicine spread throughout the body. You should expect to feel your heart race and for symptoms to improve within a few seconds. Call 911. If symptoms return or do not improve within 5 minutes, inject your second EpiPen immediately.


AuviQ:

Remove the AuviQ from the outer case. The audio instructions will start. Remove the red safety cap. Press hard to inject the AuviQ into the muscle of the outer thigh and hold for three seconds. It will make a very loud click. Remove the AuviQ and discard safely. It cannot be used anymore. Rub the injection site and lay down to help the medicine spread throughout the body. You should expect to feel your heart race and for symptoms to improve within a few seconds. Call 911. If symptoms return or do not improve within 5 minutes, inject your second AuviQ immediately.


Adrenaclick

Hold the Adrenaclick like a microphone. Avoid putting your thumb over either end. Remove the safety caps from both ends. Place the red end of the Adrenaclick at a 90-degree angle perpendicular to the outer thigh muscle. Press hard to inject the Adrenaclick into the muscle of the outer thigh and hold for ten seconds. It will make a loud click. Remove the Adrenaclick and discard safely. It cannot be used anymore. Rub the injection site and lay down to help the medicine spread throughout the body. You should expect to feel your heart race and for symptoms to improve within a few seconds. Call 911. If symptoms return or do not improve within 5 minutes, inject your second Adrenaclick immediately.


Food Allergy Avoidance: Reading Food Labels (6:14)


Elizabeth Hudson, MPH, RDN, Clinical Dietician, Division of Allergy & Clinical Immunology


Avoiding foods that may cause a reaction is very important in preventing food allergy reactions. Understanding how to read food labels is key to avoiding problem foods. Read every food label, every time, to decide whether a food is safe. All pre-packed foods in the United States are required to list if they contain one of the major food allergens. Milk, egg, wheat, fish, peanut, tree nuts, soy and crustacean shellfish, such as shrimp, lobster, or crab. Sesame will soon be added to this list. Other foods may not be listed in the same way that the Top 8 allergens are. Look for these foods in the ingredients section.


There is another section of food labeling called the Precautionary Allergen Label section. This includes phrases such as ‘May Contain’ or ‘Processed in the same facility with’, etc. This indicates that the food may have come into contact with an allergy food even though the allergen is not an intended ingredient in that food. These labels are placed on foods at the discretion of the manufacturer and are not mandated by the FDA. Simply stated, it is not required that food companies use such labels. When in doubt, do not eat the food.


Working with a nutritionist can be helpful in better understanding food labels, knowing what are good substitutes to the foods that can’t be eaten, and creating safe meal plans. Companies can change labels, so it is important to read the label every time you buy it.


Back To School With Food Allergies (7:58)


Dr. Marc S. McMorris, MD, Clinical Chief, Division of Allergy & Clinical Immunology and Medical Director, Allergy Specialty and Food Allergy Clinic (7:58)


Safely living with food allergies is a team effort. It is important to communicate with schools to keep a positive and safe environment for your child. Communication equals education.


Before going back to school please review these essential steps:


1. Speak with your child’s allergist and healthcare team to discuss a plan for going back to school that is appropriate for your child’s age.

  • Get an updated copy of the Food Allergy Action Plan for both your home and school.

  • Also, update your epinephrine and antihistamine supply.

2. The Food Allergy Action Plan and medications need to be turned into the school at the start of the school year.


3. Speak with school nurses and school representatives to come up with a plan in case an adverse food reaction happens at school.


4. Contact your school food director to discuss dining accommodation options for your child.


5. Reach out to your child’s teacher to talk about how to accommodate your child’s food allergies in the classroom. It may be helpful to prepare a special snack box for your child to take to school. For college students, reaching out to dining services, housing services and creating an emergency response plan for your dorm room, dining hall, as well as other areas of campus.


6. Last but not least, make it a habit for your child to communicate about their food allergies on their own behalf and develop age-appropriate food allergy management skills.

  • For older children, place food allergies into the Medical ID section of cell phones so that in the case of an emergency a First Responder can get the information from the phone.

  • It is also a good idea to wear medical alert jewelry such as a necklace or bracelet.


Due to COVID, hand sanitizer use has become very popular, but hand sanitizer does not effectively remove allergens from surfaces. Make sure your child has access to wipes or a place for hand washing with soap and water in case they come into contact with food allergens during the school day. If your school requires students to wear masks, create a plan with your child’s teacher about how to recognize quickly the signs of a food allergy {reaction}. This may require your child to remove their mask to look for signs such as lip swelling or hives around the mouth.


Living with Food Allergies — Anxiety (10:01)


Kim Menzel, LMSW, ACSW, Clinical Social Worker, Michigan Medicine Food Allergy and Specialty Clinic


A food allergy can bring many changes to a family’s every day life. It’s normal to be overwhelmed or anxious. If you’re not sure where to start many allergy clinics offer, or can refer you to counseling.


~Food allergy counseling can guide patients through food allergy appointments, testing and treatments.


~We can address fears that are a barrier to skin prick tests, blood draws, oral food challenges, and oral immunotherapy.


~We can help families develop coping strategies and tools to navigate food allergy management.


~Cognitive behavioral therapy helps identify and reframe negative and inaccurate thoughts, to reframe them to positive, accurate thoughts.


~We can create a game plan for patients and their families, throughout different stages of life to move from infancy to college and beyond.


New Developments in Food Allergy Therapy (11:00)


Dr. Malika Gupta, MD, Assistant Professor, Division of Allergy & Clinical Immunology


There are new treatments for food allergy that are currently being explored. One such approach is oral immunotherapy or OIT for short. This process involves building the body’s tolerance to a food a person is allergic to. The goal of this treatment is to prevent a life-threatening allergic reaction in case the food was accidentally eaten. OIT must only be done under the supervision of an allergist.


There are other approaches that are currently under research. These include immunotherapy in other forms such as patches on the skin or tablets under the tongue. There are also vaccines being developed for food allergy treatment.


If you are interested in exploring new treatment options, please talk to your allergist.


Closing Remarks (11:44)


Dr. James Baldwin, MD, Chief, Division of Allergy & Clinical Immunology


In this video we went over the signs and symptoms of food allergy and anaphylaxis, what to do during a reaction, as well as different aspects of living with food allergies. We hope you found this video helpful. T


This video is not medical advice.


For any specific questions regarding your allergies or your child’s allergies, please contact your allergist.


We’re in this together…"

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