tips for classroom volunteers

I spend most of my time seeing adolescent patients with sports injuries. I am going to put on a different hat today to talk about life as Dr. Mom for a bit, and a very near-miss we had with my daughter a few months ago. It is only because of observant volunteers and teachers, excellent medical care, and perfect timing that this story ends well.

My daughter is allergic to peanuts. We discovered this shortly after her 1^st birthday, when she rubbed a PB&J sandwich all over her face and promptly broke out in hives. Testing through her pediatrician’s office confirmed it. She sees Dr. Kalra in allergy once a year to repeat testing and confirm that yes, she is still allergic to peanuts. Fortunately, she never actually ate peanuts until recently.

At the end of April, I took the afternoon off work to go to her annual allergy visit with Dr. Kalra. I arrived at her preschool at the exact moment her teacher was rushing her into the nurse’s office. Her class had an Easter-egg hunt that day. One of the parents supplied pre-stuffed Easter eggs for her “peanut free” classroom. (Side note – I supplied nothing for the party. I am thankful for parents who can do these things. I am not one of them). My daughter, who had just turned 4 and was extremely excited to find an Easter egg full of candy, promptly stuffed the Reeses cup into her mouth. I am thankful that one of the parent volunteers that day (1) saw her eat it and (2) knew she was allergic. Otherwise, this story would have a much different ending.

I was standing outside the nurse’s office grabbing paperwork for the allergy appointment when the teacher rushed my daughter in by the arm, with the chocolate / peanut butter still smeared on her cheeks (my daughter, not the teacher). I immediately grabbed her medication pack, stuffed her in the car, and called the allergy clinic while driving. Her school was only 5 minutes away from clinic. She had never actually ingested peanuts, and we didn’t know for certain if she would react. I knew she was due for allergy testing, and any medication I gave her would make the allergy testing worthless. I also knew that she could die if she was allergic and we didn’t do anything.

The allergy staff advised me to come to allergy clinic rather than the ED. But, if she started reacting in the car, just pull over, given the epinephrine shot, and go to the ED. I kept talking to her the whole drive and she kept complaining that her tongue was itchy, but that was it. When we arrived at check-in, she had a red spot under the chocolate on her face. Her lips were swollen. She said her tongue was scratchy. She was coughing a little. Those were the only outward signs that there was a very serious problem brewing.

Clinic brought us back immediately and all of her vital signs were fine. The nurse noted she wasn’t moving a lot of air, but didn’t hear any extra sounds like wheezing. Her oxygen level was still good. Then the vomiting started and everything happened at once. Her oxygen level dropped and her lungs filled with fluid. Within seconds, we had the entire clinic staff in the room. They debated calling a Code Blue. I became part of the medical team and assisted in giving her medications to keep her alive – epinephrine, steroids, breathing treatments, oxygen, anti-histamines, etc. Folks, no one should be involved in resuscitating their own child.

We got to go home that day, instead of staying all day for observation, only because of my medical background. I have treated similar situations before (both while working in the urgent care / ED setting, and while doing medical coverage at sports events). I never wanted to do it to my own daughter.

I forgave the parents who supplied the Reese’s cups long ago. (Parenting is hard, and I didn’t even bother to help with the Easter party. I get it.) I’ve been working with the school nurse and teacher to develop a system with less holes in it. My only ask is for parents to do two things.

First, if this is not the type of reaction your child has, then they are probably not allergic. They may be sensitive. My daughter’s eczema

flares up when she has milk products. We try not to give them to her. But if she has milk at a birthday or school party, she isn’t going to die. Using the term “food allergy” too often waters down the meaning. My daughter has a milk sensitivity, but she has a peanut allergy. Peanuts will kill her. Milk costs me more in skin creams. When speaking to other parents and teachers, please specify if they have a sensitivity or a true allergy. No one wants to make your child uncomfortable or give them something they shouldn’t have. But if they do eat it, the teacher needs to know if she should call 911 or just apologize for the mistake. (Side note – There are some less common conditions like Celiac’s or metabolic disorders which limit what a child can eat. I’m not talking about those. They are entirely different). 

Second, be observant when you get notes home from teachers and see signs on doors. Food allergies are real. The letters sent home from the school nurse mean something. The allergy signs on the classroom door are there for a reason. Please pay attention. The extra minute it takes you to check a label in the store before you buy treats for a group of kids is the difference between life and death for my daughter, and other children as well. I’m not saying you can’t feed your children peanuts. Please do so! But please respect that not every child can eat the same things your child can eat. Be more observant when supplying treats for a group.

And for the record, we were able to skip allergy testing this year. She is definitely still allergic.