Accommodating severe allergies can be a constant struggle

The aroma was overwhelming, the fragrances so pungent that live flowers and potted plants were driving some church congregants away.
Some members who wanted to attend Christmas and Easter services to be active members of the Westminster United Methodist Church couldn't due to severe allergies and chemical sensitivities.
So, church officials decided to make a change. In a news bulletin came a sweeping announcement, effective Nov. 1, that the congregation would have a fragrance-free policy. Live flowers and plants were no longer permitted inside the church's walls - except for weddings and funerals where pastoral permission is granted - and attendees were asked to refrain from wearing strong colognes or perfumes.
The accommodation was made for the subset of people whose allergies are so severe that they affect their daily lives. Allergies from food, animals or nature can constrain where people go and what they do. Avoiding a reaction involves a certain tact, several local residents said, including scouring product labels, pre-planning for class parties or even homeschooling a child.
Accommodations can be made, such as inside a Carroll County Public Schools cafeteria or on some airlines offering peanuts, but those who suffer from severe allergies remain cognizant of whatever it is that gives them the sniffles, hives or worse.
That's why Westminster United Methodist Church made the new policy - to give those residents a sense of relief, according to the Rev. Mark Smiley, the church's lead pastor.
"We want it to be as easy as possible for people to come and as barrier-free," he said.
Yet an outright ban won't eliminate certain allergy-prone products in some environments, such as in schools. Roughly 5 percent of American children ranging from infants to age 17 had some semblance of a food allergy in a 2009 to 2011 study, according to the Centers for Disease Control and Prevention. And eight food groups account for 90 percent of serious allergic reactions: milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts and tree nuts.
In order to avoid firing up allergic reactions, Carroll County Public Schools helps each child develop a safe plan unique to his or her needs and food allergy. However, it doesn't prohibit other students from bringing certain items to school, according to Marge Hoffmaster, Carroll County Public Schools health services supervisor.
"Unfortunately, it is impossible to ban a particular food product from a school," she said, "because there is no way of knowing whether this granola bar has peanuts in it or that one doesn't ... it would just be virtually impossible to say to a parent, 'Guess what, we don't have any of those items in our school.'"
On each student's emergency card is a spot where it asks if the child has any medical conditions the school should know about, allowing parents to fill out their son's or daughter's food allergy, according to Hoffmaster. School officials will then follow up with the parent to learn about its scope and severity, and all the student's teachers will be notified. They're trained to use an EpiPen, which injects a single dose of epinephrine to assuage a life-threatening allergic reaction.
Each student with a food allergy is eligible for a 504 plan to accommodate them, such as allowing the student to carry their EpiPen. By law, schools must have a peanut-free table inside the cafeteria. To avoid isolation, other students can take a seat, Hoffmaster said, but school officials check their lunches first to ensure peanut products aren't present.
"We can't 100 percent guarantee that there are no products that the child is allergic to," Hoffmaster said, "but we do the best we can."
This system has been working well for Valerie Price's son, who is severely allergic to peanuts if ingested. Adam, a Westminster Elementary School third-grader, used to sit at the peanut-free table, sometimes joined by a friend.
His allergist told him he could sit with his friends if he felt comfortable doing so, which he did starting this school year. Adam is keenly aware of what he can and can't eat - and what he can and can't have.
"If he can't read the ingredients, and they don't have the packaging, he downright won't eat it," Price said.
In some areas, peanuts have become almost a tradition, as "get your popcorn, peanuts here" is screamed at baseball games, and some airlines serve the food as a small, pre-packaged snack.
Southwest Airlines served more than 88 million bags of peanuts last year, according to spokesman Dan Landson, but the distribution of this snack can be suspended for a flight if the passenger lets a customer service agent know when booking a flight or upon arrival at the airport.
"Peanuts have [been] a part of Southwest Airlines culture from the time the airline was formed," Landson wrote in an email. "Customers love the snack which is a staple in our onboard offerings."
Delta has a similar policy to Southwest's, in which customers can call the airline prior to their flight to ask for a peanut-free flight with pretzels and Biscoff cookies as the only snacks served. Other airlines, such as United and American, do not serve pre-packaged peanuts at all, but can't guarantee peanut-free flights, as some in-flight foods might have traces of nuts and other customers may bring such products on board.
Restaurants pose similar problems. Extensive research is involved when Lisa Sullivan, of Eldersburg, takes her family out to eat. But that's a step up from when her then-7-month-old son was initially diagnosed with egg, soy, wheat and peanut allergies.
"For the longest time, we didn't eat out because I had no idea what to do," she said.
The Maryland State Legislature passed a bill during the 2013 session requiring food establishments to display posters related to food allergies starting this March. By Jan. 1, the Maryland Department of Health and Mental Hygiene, in consultation with the Restaurant Association of Maryland and Food Allergy Research and Education, must make this information available on its website, the bill states.
Additionally, it established a task force to study food allergy awareness, food safety and food service facility letter gradings, which is required to author a report by Jan. 1.
Food allergies can be time-consuming and more complex than Sullivan, who doesn't have any herself, knew. Her now 1-year-old son has grown out of his soy and wheat allergies, but initially she was feeding him steamed vegetables and fruits at a much younger age than the typical transition to regular food.
"Of course, you've always heard of people having allergies, but I had no idea of how involved it was, finding foods and places," she said. "It was a wake-up call."
For Mia Faber's son, his allergy is more involved than avoiding certain foods. He's highly allergic to most animals with fur - cats, dogs, horses and more - and simply standing next to a person who has, for example, cat hair on their clothes can cause him to break out in hives in about 10 minutes. He'll start to wheeze; his eyes will begin to swell shut.
"It's frustrating because if you say, 'Oh yeah, my kid has an allergy,' they say, 'Oh yeah, are they allergic to peanuts? Oh, they can't have milk?'" Faber said. "'No, they can't stand next to you.' Some people get it, and some people don't."
This severe allergy is a real challenge, Faber said, particularly because pet ownership is so prevalent in the U.S., hitting a record high with about 68 percent of American households owning an animal. Nearly 47 percent of Americans own dogs, and about 37 percent have cats, according to the 2013-2014 National Pet Owners Survey.
For the first time last academic year, Faber sent her son Luke to public school for sixth grade. Though he would take allergy medicine beforehand, the pills wouldn't always kick in before the allergies flared up. Oftentimes, he'd start to itch, his nose would run and his stomach would hurt in first period, and he wouldn't make it through the school day.
Even though the nurse and the principal were accommodating, Faber decided to homeschool him again this year, as he missed almost a quarter of school last year due to his allergies.
Luke has learned how to keep his allergies at bay, but it's hard because the prevalence of fur isn't always noticeable.
"When I'm meeting an unknown person, I ask for their name, how they're doing, and I ask if they have a cat or a dog to make sure if they do have one I step back - maybe one step - and then continue to talk to them," Luke said.
Avoiding reactions is an acquired skill.
"It's a little tricky," Faber said. "It takes a little bit of finagling."
And it also involves several items that those who have extreme allergies likely know all too well: keeping Benadryl and an EpiPen nearby just in case.

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