Monday, July 30, 2012

10-ish Things Allergic & Atopic People Don't Want to Hear

If you read my blog, you know I've had allergies and atopy for a very long time. So, I've had to tell a lot of people about my conditions. This has certainly become easier as I've gotten older, but there are still some things I really dislike hearing. I don't dislike a lot of things, but inconsiderate remarks certainly make the grade. Here's my top ten list of things people have actually said with responses I wish I'd said. Of course, I'm far too polite to actually say them, but I've definitely thought them. Like my post 10 Great Things About Being Allergic & Atopic, this is tongue-in-cheek and meant light-heartedly.

1. Oh my god. If I couldn't eat (insert food allergen here), I'd die.  
Personally, I find that the threat of death is pretty good for my self-control.

2. You're allergic to eggs, nuts, milk and shellfish? Wow! I guess you couldn't have a peanut butter and shrimp milkshake with an egg. Ha-ha-ha!  
Yeah, I guess not. Tragic, really. Sounds lovely.

3. You must not be able to eat anything at all!  
Yes, that's right. I live on water and air. I'm like a hydroponic plant. Military scientists are actually trying to clone me.

4. Well, you don't look sick.  
That's because I'm not sick. I'm probably healthier than you are and a have a lower risk of certain types of cancer, though it would be impolite to point that out; so, I won't.

5. You're allergic to all of that? What on earth do you eat?  

6. So can you eat cheese or butter?  
Last time I checked, those were made of milk; so, no.
How about cream cheese?  
Still made of milk.
Without cheese.
So, I guess you can't have cheesecake.  
You do know that milk doesn't grow in cartons, right?

7. Well, there's a just a little bit of egg on it.  
Well, I guess I'll just have a little bit of anaphylaxis then. Thank you.

8.  That must be absolutely horrible. 
I would think that living without clean water and access to food and education would be horrible. I guess everyone has different priorities.

9. Your skin looks wonderful!
I'm wearing make-up.
Still, it's beautiful. You're glowing.  
Honestly, it's the make-up.
But, the texture is wonderful. 
Oh....well,, thank you. (Okay, that's clearly one I love hearing. Anyone is welcome to tell me that anytime. You can stop me on the street and tell me that and I'll probably give you a hug or pay for your child's university tuition. One child per compliment.)

10.Wow, you're such a survivor! 
Being that I've never been stranded on a desert island or survived a plane crash in the Arctic, I don't see how that's the case.*

11. You should live in a bubble. Ha-ha!  
A bubble, huh? Haven't heard that one before. Really quite original. Really. Hysterical even.

12. You must have a PhD. in Pain.  
Notwithstanding the fact that you're using a quote from The Simpsons seriously, I don't think that "Pain" is a recognized discipline at any university in the world.

That's the end of the list. Obviously, I'm not advocating that anyone respond to any of these types of ignorant remarks in a rude or sarcastic fashion. As difficult as it may be, it's better to stay calm and explain that the comment in question is not appropriate. Remember a lot of people try to use "humour" in situations where they feel uncomfortable or don't know how to respond. If you have allergies or atopy, you're an ambassador and it's an opportunity to make people think differently and openly. The best thing we can do is educate others (and joke around on blogs).

Is there something you really dislike hearing? Let me know what it is and how you handle it.

*NB: I personally do not like being labelled as survivor. I have been rather fortunate and find the term overly-dramatic for my situation. However, I don't begrudge others with more severe conditions or experiences who wish to use this term as it's likely more apt in their cases.

Monday, July 23, 2012

Keeping Cool With Eczema

Summer Tips for Atopic Skin

I'll be honest. Summer has never been one of my favourite seasons. I'm not a big fan of heat in general. I have no reason to tan, since I've got a built-in self-tanner. Most importantly, I have eczema. My skin doesn't respond well to heat and I'm a bit self-conscious about my skin. Most of my body isn't one colour due to the trauma of eczema. I have areas of hyperpigmentation (lots of pigment and therefore quite dark) and depigmentation (almost no pigment and therefore very white). Plus, shaving isn't always my best friend and can sometimes be an eczema trigger.

However, after all these years, I've found some ways of managing it. I will admit that it's probably easier for girls than boys, simply because girls wear a lot of different styles that men generally don't. However, men don't have to worry about shaving their legs.

Tip 1: Keep it sheer. A tank top covered by a loose, sheer long-sleeved top is a great way to keep cool and covered. Since too much sun exposure is damaging for everyone, this is a great option for anyone, eczema or not.

Tip 2: Skirts & Dresses. No matter the length, these are a great way to get through the summer months. Right now, I've worked my way up to wearing knee-length skirts and dresses, but I have a great collection of calf-length and ankle-length. The latter is great for days when shaving is just not an option.

Tip 3: Linen pants. A pair of loose-fitting linen pants is also an unshaved leg's best friend. If your skin is acting up, it's also not irritating to the skin. The only thing is that linen is incredibly flammable; so, keep away from bonfires.

Tip 4: Light fabrics. Cotton is one of the best fabrics for atopic skin. Thin weaves allow the most breathability, while still feeling comfortable. So, when you're shopping for summer clothes, ditch the heavy cotton shirts and find something light.

Tip 5: Accept what you have. I have very noticeable pigmentation issues on my elbows. Those are never going to go away. Plus, I recently developed keratosis pilaris on my upper arms, a formerly eczema-free zone. However, there is no way I'm going to give up t-shirts or sleeveless shirts. It's not worth it to me.

Tip 6: Skincare. In addition to your existing skincare regime, use sunscreen (physical, not chemical) and take a water mister with you. Sweat irritates atopic skin and a thorough misting with cool water can really help. I use Avène Thermal Spring Water. Throughout the summer, it's part of my allergy/atopy kit.

Do you have tips to get through summer with your skin intact? Let me know in the comments!

Monday, July 16, 2012

Why You Should Eat Foods Your Allergic Child Can't

An Atopic Girl's Perspective on "Disordered Eating"

This post was inspired by reading yet another amazing post by the Allergist Mom: "My Disordered Eating". One of the questions asked is do you avoid eating food your child is allergic to? Part of the answer is related to guilt, since what person wouldn't feel guilty about eating something that someone they care about can't? Another part of the answer is related to contamination and introducing the allergen into the home, but I'm not going to address that since it varies so much. I'm simply writing from the perspective of someone who watches others eat foods I can't on a regular basis.

In the post, there is a picture of the Allergist Mom eating a deviled egg and enjoying it. I love this picture. I think it's so important that parents and siblings are not restricted, as much possible, regarding what they eat.

One of the most important lessons an allergic child, youth or adult has to learn is the difference between fairness and equality. The world is not a particularly fair place for anyone nor is it necessarily equal. However, when it comes to food, equality is the goal. Having an equal experience doesn't mean that the person gets to have the same food as everyone else. It does mean that they partake in the experience equally - a birthday party, an anniversary or a dinner out. They're not left staring at an empty plate while everyone else is enjoying a meal.

Another reason is the basic fact that if you're not allergic, you shouldn't stop eating a food. Especially if you enjoy it. Especially when you're out of the house, that is your opportunity to enjoy yourself. Any parent of an allergic child lives with a constant degree of stress and guilt. If an ice cream cone or a slice of pizza brings you a bit of happiness, it's silly to deny it.

So, if it's not physically harmful, I think it's important for children and youth to see that their parents and siblings eat different foods. It was difficult for me as a child, but as I got older, the fact is that I got used to it. Most importantly, I love the food I can eat; so, I rarely look at anyone else's and wish It were mine. In fact, people usually look at my meal and wish it was theirs.

Quick note: I will now be posting weekly. Look for new posts every Monday on AtopicGirl's Guide to Living and the TalkHealth blog. As always, if you have something you'd like me to talk about - something you want to know - let me know.

Monday, July 9, 2012

Why You Need to Know More Than An ER Doc

This post was inspired by a conversation with some great people who work for an amazing allergy-related social profit organization Canada. At one point, we discussed the misconceptions and misinformation that even some medical professionals have about anaphylaxis. I've certainly been told some odd and incorrect things by people with an M.D. after their names:

1. If you administer your auto-injector, you don't need to go to the ER. FALSE! It's not magic. It just buys you time. Many people need additional medications, including more epinephrine. You are literally risking your life if you don't call an ambulance and head to the hospital.
2. Vomit the food back up and you'll be fine. VERY FALSE! If your throat is closing up, you risk choking or aspirating on your own vomit, making the situation even worse.
3. The third issue was that a paediatric doctor I know didn't know how to use an injector in practice and so injected it and let go immediately. While any amount of epinephrine is better than none, hold down that auto-injector for up to 10 seconds. The pressure also helps prevent silly amounts of bleeding.

So, that discussion led to my quick grievance about the lack of an anaphylaxis protocol in ERs. I have mentioned this before and firmly believe that anyone at risk of anaphylaxis should come up with an ER plan in conjunction with their immunologist or allergist. That plan should be communicated to friends and family in case the person is not able to communicate. Put it on paper and keep it in your allergy kit.

The reason behind this is because ER doctors have done everything from give me salbutomol and nothing else (my asthma does not act up during an anaphylactic attack) to giving me a diphenhydramine drip and then discharging me after two hours even though I was still symptomatic. The recommended minimum is four hours and there was no mention of taking diphenhydramine or watching for secondary reactions for 24-72 hours. One doctor rudely asked me what I wanted him to do while my throat was closing up and no medication had been administered by ER staff. I show no external signs of anaphylaxis; so, this may explain some of the oddities I've experienced, but there's definitely no good excuse.

Despite all of that, I do not blame ER doctors. They're unfathomably busy and have to deal with such a myriad of conditions and patients. Mistakes happen, but not because doctors are reckless or don't care. They happen because they may not have enough specific training (consider the likelihood of knowing every disease and its treatment in the world. Gregory House M.D. is fictionally crazy after all.) or because areas like ERs and ORs involve a lot of people, responsibilities, stress and various, ever-changing situations. If a doctor has a patient crashing in one room, the girl whose face isn't swollen and looks just fine will not seem like a priority, even if she should be triaged as though she is.

Specific steps need to be taken upon admittance and post-care. Doctors also need to realize that anaphylaxis does not look the same in everyone. Even the same patient can react differently at different times. Just as there are now checklists for ORs to ensure that protocols exist and are followed (developed by WHO), I would like to see protocols developed for the ER. This takes a lot of the guesswork away from already busy individuals who should be the poster adults for multi-tasking. Where there is uncertainty, there are errors. Too many people died from asthma attacks in Ontario before proper triage and treatment protocols were developed. So, let's take away the uncertainty.

I will not delve into my opinions of what that protocol should look like, because I am not a medical professional. However, should this post be read by some hospital administrator somewhere, please make a plan. If I know what it should like, your staff can draft it pretty quickly. If you have anaphylaxis or care for someone who has it, make a plan with your immunologist. I'd like to say you can trust an ER doctor with this, but it's just not a certainty.