'I Thought My Son Was Going to Die from an Allergy Attack'

I am a single mother to a 12-year-old boy who has been suffering from allergies and anaphylaxis since he was an infant. Anaphylaxis, as defined by the U.S. National Library of Medicine, is a severe, whole-body allergic reaction to a chemical that has become an allergen (i.e., a substance that can cause an allergic reaction). It is a life-threatening type of allergic reaction.

Allergy runs in our family. My siblings and I all have allergies, but my son is the one with the most alarming manifestations. I first discovered that he had allergies when he was just four months old. I was breastfeeding at that time, and I kept eating egg pie. He would get rashes all over. His pediatrician ruled out neonatal rashes, then referred us to an allergologist. We did a skin test of many allergens, and we confirmed that my son was allergic to egg, among many other things.

Through the years, aside from managing his skin asthma, allergic asthma, and allergic rhinitis, we’ve had to run to the emergency room numerous times after he unknowingly ingested peanuts, or other nuts, or crustaceans. During an anaphylaxis bout, his eyes and lips would swell, and he would develop hives on his face. If it were nuts he had ingested, his throat would feel very itchy.

These things would all happen less than five minutes after ingesting the allergen. Back then, Benadryl was enough to serve as his first-aid treatment before we rushed him to the E.R. to get additional intravenous medication and shots. 

We have always been very careful when it comes to handling his food, and I make sure to inform the school and the parents of his friends about his food allergies, especially since he already attends parties without me or a yaya.

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Worst attack

On July 5, 2014, my son attended his friend’s birthday party, held at a venue that was pretty far from reputable hospitals in Metro Manila. Three hours into the party, I received a phone call from his friend’s mom. She told me that she and my son were on their way to Medical City, after he had eaten a slice of cake, which neither she nor he was aware contained nuts. There was no allergen warning on the cake box.

My son complained of difficulty breathing, saying that it felt like his throat was closing. While in transit, he began to vomit. He was given Benadryl en route several times, because he couldn’t keep it down. At this time, we still didn’t have access to epinephrine auto injectors (orEpiPens, which are injections prescribed for anaphylactic emergencies), so we had to get him to the hospital as quickly as possible.

I arrived at the hospital before he did, and informed the staff that my son was on his way, suffering from his worst bout of anaphylaxis. I had to stay on the phone with my son the whole time he was on the road, to keep him awake and to coach him to focus on his breathing. It was the longest forty minutes of my life.

Once he arrived at the hospital, it took some time for medications to be administered because he had to be fully assessed. It was only when he started vomiting again and his eyes swelled up that the required and requested medications were given. After his condition had stabilized and he had already been observed for several hours, I requested that he be released and transferred to the hospital where his doctors are affiliated, for after-care consultation.

That night, as my son and I were preparing to sleep, he told me that he thought he was going to die, and that he was so scared because he was having such a hard time getting air in. There isn’t a day after that incident that I do not worry about receiving another phone call, either from the school or his friends’ parents. Though he now carries an EpiPen and diphenhydramine ampule (both for fi rst-aid) at all times, and is far more astute when it comes to what he eats, the fear will always be there—especially in our country where there isn’t much allergy awareness.

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What is an allergy?

“Allergy is an overdrive of one’s immune system, which is the body’s defense mechanism against substances thought to be foreign, but are usually harmless substances,” says allergologist Ma. Carmela Agustin Kasala M.D.

Family history is the greatest predictor, says allergologist Dr. Julia De Leon M.D. “If the parents have it, or even if it is just one parent, or if a sibling has it, then the child is already considered high risk for developing any form of allergic disease,” she explains. Around 15 percent of patients have no family history of allergic disease at all.

“Clinical manifestations usually appear as early as the first few months of life. These are the babies who have reactions to milk formula or, if they are exclusively breastfed, sometimes the mothers are taking something their kids are reacting to. It happens, but not very often,” explains Dr. De Leon, who has her clinic at Cardinal Santos Medical Center. “Sometimes you have kids reacting to food that is given to them during infancy. More often, it is one of the top eight foods: cow’s milk, egg, wheat, soy, fish, shellfish, tree nuts, and peanuts.”

Dr. Agustin-Kasala says that anaphylaxis occurs when there is a severe allergic reaction involving multiple organs, such as the skin, eyes, nose, larynx, lungs. According to a census conducted by Dr. De Leon and her team in a tertiary-care government hospital, there were 138 reported cases of anaphylaxis, with one recorded death from 2010 to 2014. The ages of the patients ranged from infant to over 60. The triggers were medication and food. 

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Staying safe

Some children outgrow their allergies, although Dr. De Leon says this is not likely for people who developed allergies as adults. Some parents give little doses of what the child is allergic to, to build up his or her tolerance, but this is risky. Allergen immunotherapy is available—my son is undergoing it for his severe allergy to dust mites, which he cannot avoid, unlike food allergens—but it is a long-term commitment, and it can be costly.

So, what’s a mother to do? The only way to prevent anaphylaxis is to completely avoid the offending food and substances. This requires vigilance, which you will have to teach your child, as well as his or her yaya. Below are a few tips. Still, consult with your physician, particularly for medication that’s specific for the person with allergies.

• Always read the labels of pre-packed food products to check for allergens.

• When dining out, let the server know about food allergies and how severe they are. Read the menu carefully. Make sure there is no cross-contamination with allergens, as just a speck of nut or a drop of the allergen is enough to cause ananaphylactic shock.

• If you are not confident about a particular product or establishment, err on the side of caution, and look for another product or another place.

• If your child already goes to school and attends parties, make sure to inform his or her teachers of food allergies. Inform the celebrant’s parents ahead of time about food and substance allergies, and give them instructions in case of an emergency.

• Request for diphenhydramine and epinephrine kits from an allergologist, or get hold of EpiPens (only available abroad), and have them in your bag and with instructions on dosage and method of administration. My son has his EpiPen on his body at all times when he goes to school or on play dates. I put it in a small belt bag, along with his salbutamol inhaler (to help open up the airway as needed), which he hides under his button-down polo. I have also given the school infirmary an epinephrine and diphenhydramine kit, complete with instructions from his allergologist.

• Have your child wear a medical ID dogtag necklace with allergen information and what medications he needs to be given in case of an emergency, along with the names of his doctors and emergency contact details, including yours.

Awareness is key, and one can never be too careful. Food labels and complete disclosure of ingredients of pre-packed food products go a long way. Restaurants with fully trained staff that are informed about basic allergens present in their food is a big help to us consumers in making fully informed decisions about what to eat. 

As of this writing, I am slowly reaching out to restaurateurs and food sellers to be more conscientious and comprehensive when it comes to labeling their products, disclosing their ingredients, and full yeducating their staff about food allergens and their dangers. After all, awareness saves lives.

This story originally appeared in the October 2015 issue of Good Housekeeping magazine Philippines. Minor edits have been made by the Smartparenting.com.ph editors.

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