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The Danger of Food Allergies: A Letter from an allergist to his family

Published on Jul 24, 2011 with 0 comment

The following is a letter I wrote to members of our extended family and close friends upon learning about my grandson’s allergic reaction to tree nuts.

Dear Family and Friends,

Even though all of you are probably aware of Jacob’s recent severe allergic reaction to a cashew, I feel compelled to follow with my own letter in order to emphasize the severity of this condition.

Jacob was tested last week by an allergist and was found to be highly allergic to:  ALL TREE NUTS:  cashews, pistachios, almonds, Brazil nuts, hazelnuts, macadamia nuts, pecans, walnuts.

What this means is the following:

Jacob can NEVER be exposed to any of the above nuts!

Exposure means:
  a)  when he is in your house, you should have NO NUTS in candy dishes, in food that you’ve prepared, on counter tops—basically anywhere.
  b)  if you have touched a nut, WASH YOUR HANDS.  Touching Jacob with nut protein on your hands can trigger an allergic reaction.
  c) it is imperative that you CHECK LABELS on all processed foods for the presence of tree nuts. And certainly, do not cook with tree nuts as an ingredient if Jacob will be there.
  d) if you have eaten tree nuts, RINSE YOUR MOUTH AND LIPS before kissing him.

Fortunately, Jacob was tested and is not allergic to peanuts which is another category of food altogether, unrelated to tree nuts.  However, because he is a child and will not be able to differentiate between “good nuts” and “bad nuts”, I ask you to also NEVER have peanuts around when he’s visiting.  It’s a small sacrifice when one considers the great danger he faces. [Author’s Note: This paragraph is relevant ONLY if a child has been tested and is NOT allergic to peanuts!]

In light of the above, it is imperative that you learn how to use an Epipen Jr. I recommend the following short video: How to Use and Epipen  He will have to have one with him wherever he goes.  Jacob’s parents have been instructed in its use, and they will demonstrate how to use it to those of you who regularly take care of him.  Sometimes, in spite of all the precautions we try to institute, accidents happen, and we need to be prepared for that.

I would also recommend that you have liquid Benadryl available. If there is a question as to whether he is having an allergic reaction with symptoms such as mild itching, or sneezing, then administer 1 tsp of Benadryl immediately. If, on the other hand, he is breaking out with hives, having swelling of his face, coughing, wheezing, or having difficulty breathing, the Epipen should be given immediately in his thigh, and 911 should be called. If there is ever a doubt whether to give the Epipen or not, give it!  It cannot hurt him.

I am sorry if I’ve alarmed you, but quite frankly, that was my intention.  All too often, people don’t fully realize the seriousness of food allergies, and I felt that I had a responsibility certainly to let our family know the necessary steps to keep our precious little Jacob safe and healthy.

If any of you have any questions, please write me or call me—I’m always available to you.


(Robert M. Cohen, MD)


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