Friday, November 29, 2013

Where Have I Heard This Before?

From Paul Ryan's original health care proposal, which established him in some eyes as tough-minded health policy intellectual with bold and innovative solutions. Such as these:

Provides a refundable tax credit – $2,300 for individuals and $5,700 for families – to purchase coverage in any State, and keep it with them if they move or change jobs.

Provides transparency in health care price and quality data, making this critical information readily available before someone needs health services.

Creates state-based health care exchanges, so individuals and families have a one-stop marketplace to purchase affordable health insurance without being discriminated against based on pre-existing conditions.

Equips states with tools like auto-enrollment programs and high-risk pools, so affordable health coverage can be accessed by all.

Addresses health care’s growing strain on small businesses, by allowing them to pool together nationally to offer coverage to their employees.

Encourages the adoption of health information technology and assists states in establishing solutions to medical malpractice litigation.

Seems like I've heard a lot of this before...

Wednesday, November 27, 2013

Thanks and Thanksgiving at SAGE

Thanksgiving -- a time to give thanks.  As we reflect on the year, SAGE has much to be thankful for during this season.  In no particular order, here are some things we give thanks for at SAGE.

Carrie:
volunteer extraordinaire!
1) Our Amazing Volunteers (and Interns)!!!:  We couldn't grow 3 - 4 tons of food without the help of  the 500 - 600 community members who contribute their time and hard work each year.

2) Our Community Sponsors and Donors: Thanks Samaritan Health Services for supporting financially supporting the education programs out at SAGE.  Thank you to all the individuals who have contributed to the work we do at SAGE, every bit makes a difference and is appreciated!

Sam Health and CH2MHill
employees during Day of Caring
3) Our In-Kind Donors: Nectar Bee Supply provides bee hives, care and expertise, Republic Services provides yards and yards of compost to the garden, Dunn & Co. Tree Service graciously donates wood chips all year long, Gathering Together Farm, Persephone Farm and Peoria Gardens all donate plant starts, Shonnard's Nursery provides seeds,  and the Benton County Habitat for Humanity ReStore provides deep discounts on reused building material.

Stone Soup Sue
4) Our Donation Sites: There are volunteers at hunger relief agencies across our community who help distribute SAGE produce.  We're so glad to have such willing and caring partners as we work to help those in need in our community.  A special thanks to Sue at Stone Soup for transforming our produce into meals every week and to the South Corvallis Food Bank for working to educate their clients when we bring in more unique items like purple mustard greens and bok choy.

5) Our Host: The Corvallis Parks and Recreation Department partners with the Corvallis Environmental Center to let us use the growing space at SAGE.  Thanks city staff for being open to a more alternative way to use park space.


6) Our Community:  This really is a community project.  Thank you to our community.

Note: There are many more things to be thankful for than I could list.  That fact alone makes me thankful and so appreciative of every size, shape and form of community contribution SAGE receives.

With much gratitude, we give thanks!

Cheers,
SAGE Staff




Beans, Beans and More (or Less) Allergenic Beans!

We have a little good news this week: my son passed a home bean challenge for both pinto and cannellini (white) beans last night. Hooray!

At our last allergist visit, they ran the numbers on a number of varieties of beans and many were Class 0, with values like 0.68. My son's doctor thought it was reasonable to try these at home.

Going to stop for a moment and interject: DON'T DO THIS WITHOUT YOUR DOCTOR'S DIRECTION. A lot of things go into whether home challenges are a good idea for your child: how serious the allergen typically is, how far the hospital, how experienced the parents are with recognizing reactions. Many doctors are not comfortable with this at all. But, in our case, it makes sense to do some challenges at home because my son tests slightly allergic to dozens of foods.

He has avoided all beans since around age five, when he started developing new allergies. First it was tuna. Then cashews. Then (to our great surprise), he suddenly became allergic to garbonzo beans, something he had eaten very regularly through toddlerhood. Then it was sugar snap peas. Green beans. Baked beans (a particularly scary reaction that happened at his aunt's house, out of town, without medication in hand). The doctor actually thought it was possible he had something called "idiopathic anaphylaxis" at the time - reactions from unknown causes. However, after we kept a careful journal and did some testing and even in-office challenges, it became apparent he had developed a bean allergy.

At that point, we just started avoiding all beans and peas, which our doctor thought was reasonable. It turns out that 1 in 20 kids can have an allergy to a seed protein that's shared between bean species. If my son had that type of allergy, it was possible even more bean sensitivities would surface.

Fast forward to the start of high school. My son is a very healthy, adventurous eater and he wanted beans back in his diet, so we asked about home challenges at that time. The doctor said "sure."

We followed the same protocol as in the office: start with 1/4 of a bean and double the amount every 20 minutes until he reaches several Tbsps. of the food. The hardest part is that he has to discontinue his antihistamine for 7 days before.

We introduced kidney beans and my son had no problem during the challenge. However, the next day, he threw up after eating chili with kidney beans. A couple days following - exact same result. We all sighed and put it back on the list of foods to avoid.

This time, thankfully, things were different. Both pinto beans and cannillini beans went off without a hitch.

Did my son really outgrow beans this time? Might the FAHF-2 have helped? Or were we just avoiding two varieties that he could have tolerated all along? We don't know.

It's also early days with beans. We could have the same experience as several years back, where he succeeded in the challenge but really can't tolerate beans in his diet.

My husband had a gleam in his eye last night. He said to me for the first time "do you ever wonder if he's just not allergic to anything any more except peanut?" Yes, I wonder. It's time to do an open milk challenge and find out.

Even if he fails, even if the FAHF-2 had nothing to do with any of these successes, I'm still incredibly grateful. The clinical trial didn't just change his body; it changed how we all think about this stuff. We're just not as afraid. (I actually went to bed and SLEPT while his second set of bean challenges were going on!) We understand now that our fear was as big a burden as the allergens. And, we're pushing harder to work through this stuff, even when it's incredibly hard to find the time and emotional reserves to do it.

Yes, I'm grateful. Happy Thanksgiving to all of you celebrating this week!



Follow me on Facebook or Twitter  

Saturday, November 23, 2013

Taking The High Road With Food Allergies (Sometimes)

I was getting all ready to write a post about how grateful I am. You know...one of those count-down-to-Thanksgiving posts where I list all the people or things that have helped me along the way.

And I am grateful. Really. Having virtual friends who have traveled this same food-allergy road is a wonderful gift. I can name so many times when my panic and frustration were alleviated by someone I've never even met in real life, but who took the time to give me a tip, or to console me.

But frankly, my lovely gratitude post went out the window when I received this email from a relative:

What can we bring to share? I have some ideas: Sweet Potatoes glazed with Chutney and Ginger, Green beans with Dijon and Caper sauce, Creamed Green beans with Dill sauce, or whatever you request.   I am aware of [FAB's son] dietary restriction.

My son is allergic to beans. We avoid all beans. Even green beans. The doctor was surprised by this, as green beans are the least allergenic of the bean family, but we even went through the exercise of an in-office food challenge just to prove to everyone he really had developed an allergy. 

That was 14 years ago. 

This particular relative has been at most Thanksgiving and Christmas dinners over those 14 years. She has brought countless problematic dishes. She has said things like "well, a little won't hurt" and "oh, I don't think it has anything he can't have!" My son has been told repeatedly that her dishes are completely off limits for him, no matter what she says.
Nothing says Thanksgiving
like vegetable tofu lasagna!

But here's the kicker: the emails goes on to talk about HER dietary restrictions! You see, she's found the God of Dietary Control over the last few years. She no longer eats animal products. She no longer eats carbs. SO...you guessed it...this email was not really about accommodating my son. This was a not-so-subtle hint about ME accommodating HER.  

Which I will. 

I always do. I have a sister with diabetes who has to count all carbs and watch all refined flour, rice and sugar. I have a brother who doesn't eat carbs at all. I have people who won't eat fish, lamb, mushrooms, mint. I accommodate them all. In many cases, I am only paying back their own care and kindness to my son. 

In this situation, I am clearly not paying back, since she's been so gleefully unaccommodating over the years. So...I will grit my teeth a little and pay it forward, in the hopes that some day, there will be a person out there like me who will accommodate my son even when it's annoying and difficult and she really has a million other things to do than make a vegetable, carb-free tofu lasagna.

Earlier this year at a wedding shower, another sister-in-law (I have a BIG family) who has never attempted to accommodate my son announced how proud she was that people complemented her on her wonderful Christmas cookies. She went on to say "So-and-So even said they were better than your mother's cookies!" I gently reminded her that Grandma's cookies did not contain real milk and butter, and haven't in the 18 years my son has had a milk allergy. It wasn't much of a contest. 

I never want these people to feel how awful it is to stare at a table full of food and to know you can only eat the one thing you brought yourself. To know it's your life and even some of your relatives don't love you enough to ask how to help you, how to include you.

Can I mention the wine when we
all say what we are grateful for?
I am trying to be grateful that I have learned the hard lesson that not everyone is always kind, and we shouldn't base our own life choices on what others do or don't do.

But can you really blame me if I just have a tiny thought about spreading lard through those tofu lasagna layers? 

Follow me on Facebook or Twitter  

Wednesday, November 20, 2013

Best Food Allergy Tweets/Posts From 2013 ACAAI Meeting

Sorry, guys...I've been very busy the last couple of weeks, but just over a week ago one of the largest allergy and asthma conferences, the annual American College of Allergy, Asthma and Immunology, was tweeting its brains out.

Here were the tweets and (virtual) presentations I thought were most interesting:

ACE inhibitors are often used to treat high blood pressure. I believe Lisinopril was the one specifically mentioned. This goes hand in hand with the idea that older patients, especially men, can see changes in the severity of their allergic reactions as they age.

Here's an answer on the question many of us asked about component testing. Just as with RAST, the number itself doesn't matter; just the positive result.

Gross! But yes, give your kids the bobber after the dog/ brother/ mailman licked it.

Conversely, tree-nut-allergic individuals have a 30% incidence of concurrent peanut allergy. 

So stop blaming yourselves, FA mommies! I've said this consistently - Mother Nature would not rig the game so babies needed to be given certain foods at certain times. Our existence on this earth has been too precarious to count on that type of consistency. 

Part two of STOP BLAMING YOURSELF! It doesn't matter what you ate. It doesn't matter what you fed your baby. We don't know how sensitization happens, but it doesn't seem to be through the food itself.

Other summaries and presentations you might like:
If you only read one, read that last one.

Happy Wednesday!

Follow me on Facebook or Twitter  

Sunday, November 17, 2013

Turn Trash to Treasure: An Easy Way to Help SAGE and the Corvallis Environmental Center!

Clear clutter and unwanted items from your home and you can help raise funds for the Corvallis Environmental Center--all year long!  Just take your unwanted items to an ARC Thrift Store where they sell them and donate the proceeds to the CEC.  It easy!  Here's how:

1. Collect Items in Good Condition

Not all donate-able items are eligible, so check out the list of items that will raise money for the CEC:
www.corvallisenvironmentalcenter.org/turn-trash-to-treasure

2. Put a sticker on each eligible item
Stickers are located in a big envelope on the window outside of the CEC office at 214 SW Monroe Ave., Corvallis

3. Drop-off Items at The ARC!
Items can be dropped off anytime during store hours at either location.

The ARC Thrift Stores:
928 NW Beca Street, Corvallis (541) 754-9011
936 Main Street, Philomath (541) 929-3946

Hours:
Monday-Saturday: 10am-5:30pm
Sunday: 12pm-5:30pm

Thanks so much for helping support SAGE and the other programs of the Corvallis Environmental Center!!!

Magical Thinking and Food Allergies

So we got our FAHF-2 clinical trial email notification this week.

No, it's not the trial results. It was just a brief little note:
We are pleased to let you know that study participants have completed all study visits and we are now able to inform you of which treatment arm you or your child were part of (active or placebo).
[FAB's kid] was on active treatment medication.
At this time we can only provide you with your treatment assignment.  We are unable to share any information pertaining to other study participants.  Once the data is fully analyzed and peer reviewed, we will be able to share the overall study results. 
So...good. We weren't crazy.

The problem is that history is always written after the fact. While you're living your way through something, cause and effect are never clear. When people ask us whether the medication has made all the difference in my son's life, I have to just shrug and say "I don't know." There HAVE been some major changes since last winter:
  • He's now eating all soy (including soy cheese) without restriction. 
  • He's eating baked milk in everything without issue. (The only thing preventing us from introducing baked cheese is our own fear and busy schedules.) 
  • While I know some of you really do not like the concept, he is eating "may contain" for peanut without any issues at all, which has significantly increased the number of processed foods available to him, especially chocolate. 
  • He's started to expand his list of restaurants. While we're still not at the point (and probably will never be) where he can just eat something without asking about it, we no longer worry about cross-contamination.
What we don't know is whether we can attribute all that change to the medication. Is it possible that he had already outgrown soy, that he would have tolerated baked milk at this level without the medication, that "may contain" was always o.k. for him, and that we overreacted when it came to restaurants and cross-contamination?

Of course it's possible. Perhaps even likely. 

On the other had, we did see a measurable, really significant change in his tolerance to peanut. It is just as possible that the process that created that new tolerance also affected his response to these other allergens. But we'll really never know for sure, because the other allergens were not measured as part of the trial. 

It's so easy to see how food-allergy families can have such a diverse approach. The actual evidence we have for severity and tolerance may consist of a single reaction when our child was very young. In the years that follow, some people choose to believe their child's allergy has magically disappeared. Others may re-write it as a completely out-of-control, always life-threatening monster.  Our doctors know nothing. We know next-to-nothing. But, being human, we make up stories to fill the gap. 

Thanksgiving is just around the corner again. The spread of food always prompts the inevitable questions: 

How are his allergies? Did the study cure him? Can he eat what I brought now? Will he be able to take the medication again? Do you want him to do it if he can? Was it worth it? Do you think it worked? Will it work for others? 

Our family will be challenged to write the story that goes with this clinical trial. People really hate the very short story we've told up until now: we just don't know.

Everyone wants a definitive ending...even if we have to make it up. It's human nature. 

Follow me on Facebook or Twitter  

Monday, November 11, 2013

Transition Time

"Leaves are falling all around, it was time I was on my way.  To you I'm much obliged, for such a pleasant stay. " - Led Zeppelin's Ramble On

SAGE sure is in a state of seasonal transition.  Summer bounty enjoyed a pleasant stay and now it's moved on its way.  As the leaves have been falling (and delivered in huge piles!), the garden has taken the last month to transition from a space flagrantly bursting with fresh foods to one still full of produce, but more subtle in its glory.  Replacing the showing colors of eggplants, tomatoes and peppers, now there are the bright colors of radishes and beets who's hue only peeks through the soil surface.  Squash and cucumber vines no longer sprawl, now we have bok choy and mustard greens blanketing the soil.   The greens that were a bit lackluster all summer long have now come into their full glory.  Kids are eating the kale raw again, chard is glowing and the broccoli is actually producing delicious side shoots rather than bolting straight away.  This time of year, the greens reign supreme.

Ducks help HP employees mulch!
Phi Sigma Rho sisters help clean onions


To help with this transition into the winter months, we've had 18 work parties in a one month period of time!  The outpouring of community support has been immense and I'm so grateful for all the hard work that has been completed.  The garden is in a better state than I could have imagined.  Thank you to all the groups who have contributed to the clean-up and wheeled hundreds of loads of leaf mulch!  The garden looks amazing and will be protected and nourished throughout the winter so we can continue growing quality produce for those in need throughout our community!





Thanks to the different community volunteer groups: Corvallis Rotary Club, HP Employees, OSU Soils Students, OSU GEO 300 Students, OSU Food for the World Students, Phi Sigma Rho Sorority, Kappa Delta Rho Fraternity, Chemeketa Community College Biology Students, Crescent Valley HS National Honors Society, Crescent Valley HS SEA Club, Leadership Corvallis, and our Tuesday evening regulars!
Colors from the fall/winter garden!

Delicious greens!








Sunday, November 3, 2013

Inclusion and Food Allergies: How Far Is Too Far?

I enjoy hanging out on Reddit. It feels a little like going to a teenager zoo and I consider it an important study tool in the quest to understand my own teens. Yes, there are other people there who are 40+, but for the most part, Reddit is a collection of teens and 20-somethings with too much time on their hands and often a Lord of the Flies mentality.

So I was not all that surprised to run across this one:


The original poster went on to say:
I was the only one in the neighborhood giving out small goodie bags of bite size butterfingers, recesses peanut butter cups,starbursts and other assorted chocolates during halloween. This woman comes back to my house and got angry at me for giving her son candy with peanut butter in it. He ate some and he was having an allergic reaction. How the hell am i suppose to know what her son is allergic to. It wouldn't kill her to be a good parent and monitor what her kid eats instead of blaming me.
I read through some of the almost 2000 comments, trying to keep my anger in check. The oldie but goodies were all there:

"if touching a nut kills you, you’re supposed to die"

"I went to elementary school in the 1960's. I don't remember anyone having any issue at all with foods."

"Your niece might need to be homeschooled..."


Don't get me wrong: I think the mom who did this made a big mistake. I do understand; in the panic of the moment, I have done some crazy things, including calling a food manufacturer in the middle of a reaction to ask about the ingredients.  But suddenly, I had a small moment of insight of how that Roma family in Ireland might have felt after the police took away their child because she looked too blond to really belong to them. Just because one person in your community does something questionable, does that make it o.k. for the rest of society to pour out their hate on all members? Where does all this hate come from?

No, it's not o.k. that the mom blamed the neighbor for her child's reaction. But it's really not o.k. that so many people are willing to jump on the hate bandwagon as a result.

My Reddit comments to that effect were just drops in the ocean, and I suspect a larger response would only make us look crazy. What is the answer? How do we combat this prejudice without seeming over-reactive?

Follow me on Facebook or Twitter  

Saturday, October 19, 2013

kale and sweet potato clam chowder

chowder11AGC
chowder5AGC
chowder2AGC
chowder4AGC copy
chowder4AGC
chowder3AGC

     I've only had chowder two other times before this and it was the creamy, loads of bacon and carbs kind. All the delicious stuff right?  Well this time using milk instead of cream and more sweet potatoes then the mighty white to make a much more lighter healthier version. One that doesn't sacrifice flavor or all the things that make chowder, chowder. 

chowder12AGC copy

CLAM CHOWDER WITH KALE AND SWEET POTATO 
(LACTOSE FREE)

2 pounds small hard-shelled clams, scrubbed
2 slices smoked bacon, chopped
3 cloves garlic, minced
1 onion, chopped

1 cup corn kernels, from 2 cobs or 1 cup frozen
1 large handful of kale, rinsed and chopped
1 celery stock, chopped
2
1⁄2 cups vegetable or seafood stock, low or no-sodium 

2 1⁄2 cups Natrel lactose free milk
1 1⁄2 cups sweet potato, chopped into 1inch chunks 
1 cup mini-red potatoes, quartered
2 tbsp fresh thyme, chopped
1⁄4 tsp cayenne pepper

juice of one lemon
1 large tomato, seeded and diced
1⁄4 bunch scallions, sliced
2 tbsp all-purpose flour
2 tbsp fresh chopped parsley or dill
1 tbsp fresh chopped chives
sea salt and fresh cracked pepper to taste


Preparation:

In a small saucepan over high heat boil the sweet potato and red potato until cooked half way.
Preheat a large stockpot over medium high heat, add the bacon and cook until almost crispy. Add the garlic, onion, corn, celery and kale. Continue to cook for several minutes. Add the flour to the milk and combine. Add the broth, milk-flour mixture both potatoes, herbs and spices. Bring ingredients to a simmer then add the clams. Continue to cook until the clams start to open. Add the tomatoes and lemon juice and season with salt and pepper to taste.
When the clams have opened all the way, the chowder is ready to serve. 

Serves 4-6 

PS. My man loved it. I was lucky if I was even able to get a second helping!

Happy Weekend everyone! 


Saturday, October 12, 2013

Discuss This Food Allergy Research At The Dinner Table Tonight!

FARE's name change ruined
my awesome pun headline
My mom and I went to a reunion this summer with her first cousins, ladies I had not met before. On the way to the restaurant, I was telling my mom about my summer research into intestinal flora and fecal transplant.

The poop had definitely been circulating in the news all summer, with the popular science journals joining in:
We ran into the cousins in the parking lot and introductions and hugs were passed around. Just as I'm opening the door to the restaurant, my mom says "so FAB, tell my cousins what you were just telling me about transferring pooh into people's colons." 

Not the ideal way to be introduced. 

But you can see the difficulty. This is an astonishing new area of exploration in science...and just not great dinner conversation. I'm going to plunge ahead anyway, but be forewarned that you might want to put your snack down before reading further. 

Here's a cartoon to get us started:

From Three Word Phrase - very funny guy!
I first encountered fecal transplant in the literature as part of my day job. It has been extraordinarily successful in treating C. difficile, an often hospital-acquired infection that can ravage its victims. 

If simply transplanting poop from a healthy person into a compromised person can have such amazing results, then why not for other conditions that involve the gut, like food allergies? 

The science of all this is daunting. The human gut contains as many as 100 trillion separate types of bacteria, which is why I always giggle a bit when people talk about "probiotics" as a treatment for food allergies. Typical probiotic supplements contain only the bacteria we can grow outside the body:  usually one of only FIFTEEN strains.
It's a bit like throwing dye into the ocean in the hopes of coloring it red. 

Scientists are working on categorizing these bacteria. One of the more notable efforts going on right now is called the American Gut Project.  That project has already demonstrated that the gut bacteria of older vs. younger Americans, and of Americans vs. less developed countries, is vastly different. All of this comes together very well with the Hygiene Hypothesis II, which says that our decimation of gut bacteria through the use of antibacterials (including triclosan, which I've called the smoking gun for development of food allergies) is at the heart of the rise in intestinal and autoimmune disorders. Even the connection to pets and reduced food allergies makes sense. When we pet our dogs and cats and they, in turn, lick us, different types of bacteria are transferred into our bodies via the skin. Families with pets have different gut bacteria than families without.  

As with everything I read, I am extremely impatient to just cut to the chase. If fecal transplant has the potential to mitigate food allergies, where do we sign up? 

At the moment, fecal transplant is only officially being performed in teaching hospitals, and these facilities are starting to look over their shoulders. Right now, this is an unregulated treatment and the FDA seems to want in on the action. 

On the other hand, if you are adventurous, you can DIY with this helpful Youtube video:


So...all I need is a blender, a way to knock my child senseless so he doesn't know what's about to occur, and a donor! Preferably someone older, whose gut bacteria were colonized before the introduction of antibiotics and the advent of infant formula. Someone in excellent health with an appropriate body weight, who has used only limited antibiotics over the course of their life. 

Gonna see my father-in-law later today. Any suggestions on how to open that topic of conversation? 

Or...maybe I should hold out for the poop pill. At least I could still look my father-in-law in the eye, come Thanksgiving. 

Follow me on Facebook or Twitter  

Sunday, October 6, 2013

Examples of Food Allergy Backlash

I've been pretty busy over the last couple of weeks. So, instead of writing a long blog post, I think I'll just leave a few things here that I've recently run across.

Stores are increasingly putting signs up about allergens. Not all of them are friendly.
This is from an album entitled "Guess What Mark Is Allergic To." His oh-so-helpful co-workers put these notes on food at work.


Someecards has a card for us now.

From Your Food Allergy Is Not My Problem.

Do you guys feel there's more or less of this kind of stuff happening now?


Follow me on Facebook or Twitter