The Stories We Tell (or: Legalities in Labeling)

eat at your own peril

In what is not an uncommon experience for food allergy gumshoes (I was going to say Food Allergy sleuths, but that is the title of my friend Jessica’s fantastic blog and I don’t want to encroach on her territory!), I was told just last month that if I had any questions about the safety of a food item, I should just not purchase it.  Last year the version from a restaurant was “we don’t know what is in our food, you shouldn’t risk it.”  To hear from a seller of shaved ice that I could not see the labels for his syrups and that I should not purchase anything was puzzling because water and sugary syrup is not a bad market for sweet sellers.  You’d think they’d want to include more people.

But I don’t mind being told that someone doesn’t want my custom, it is just that the blame often lies with over lawyering.  It also comes up when discussion gets to stock epinephrine (access and administration).  Now, that gets under my skin a little bit.  Seems to me I need to clear the air on this one for myself and my sister/brother attorneys, as I promise that the knee jerk reaction people have (to think lawyers are stirring the pot or being polemic) is not entirely true.  I believe that litigation and the adversary system can hone and focus practical issues in an ever changing world of challenges to health, happiness, and safety.

In law school I took a products liability course and if you ever want to fear just about every activity or item known to modern man, it is a great class to take.  (The professor was the fantastic Pavel Wonsowicz (now at UCLA) and I mention that because he was brilliant and hilarious.)  At any rate, there is a lot of misinformation when it comes to public perception of tort (a civil wrong as opposed to a criminal one) law as I learned even at that stage in school because I know all too well some of the stereotypical cases used to imply that we are a litigious country.

I’ll mention, for example, the “McDonald’s coffee case” (Liebeck v. McDonald’s).  In short, the public heard in snippets about the perception that a woman received a big payday because she spilled coffee on herself after obtaining it at a fast food drive-thru.  The disturbing untold element is that the Plaintiff’s case looked at what the company knew about how hot they intentionally made their coffee and the foreseeability of harm to customers or that they arguably ignored warnings in the form of hundreds of prior complaints about scalding coffee.  Does, for example, their claimed desire to have coffee stay hotter longer as drive-thru customers make their way to their destination tip the scales when compared with the increased risk of third degree burns like those suffered by the octogenarian Ms. Liebeck?

When you start breaking down your assumptions about motivation and responsibility, you start to understand the struggle between the letter of the law and the spirit.  We can know instinctively that people should be careful with a cup of hot coffee but as a society where does defaulting to personal responsibility end?  Can/should corporate entities be allowed to enjoy protection from liability, profit from consumers, and then not be responsible themselves for the strategic decisions made in product delivery and development?

Swinging back to the food disclosure issue, if a customer with food allergies were to eat at a restaurant without informing the staff of their disease and experienced a reaction, generally we could say that a reasonable restaurateur would not anticipate that their patron could have a reaction.  Even so, could we argue in the face of the epidemic of food allergies that a restaurant should be on notice in a general sense and therefore make affirmative disclosures about the contents of their food?  And while I’m asking questions, what would be so bad about disclosure of ingredients to shift the burden of deciding whether to consume an item onto the consumer?  Refusing service is not the only way to protect against liability, after all.  In the labeling context, the manufacturer that labels with a default “may contain milk” warning, for example, is refusing to serve the milk allergic customers in the same way the restaurant that tells me I should not risk purchasing their food for my child.

The decision to exclude in this case is most likely an economic one.  A great read is Jonathan B. Roses’ 2011 Food and Drug Law Journal article entitled “Food Allergen Law and the Food Allergen Labeling and Consumer Protection Act of 2004: Falling Short of True Protection for Allergy Sufferers.” (You can download the full pdf here.)  Roses writes:

Because of the expense of analysis required to determine if trace amounts of allergens are present in foods, or the risk of contamination in a food production or processing facility, manufacturers have a substantial cost-savings incentive to simply place precautionary warnings on all their products, ensuring protection against potential allergy litigation.

Volume 66 No. 2, pg 229.

Oddly enough, the manufacturer or food service entity may be concerned with monetary risks but I submit that it might be even cheaper to engage in safe food handling and appropriate disclosure because the benefits would reach beyond just avoiding being sued by someone secondary to an allergic event.  A little prevention and mindful safety could prevent food poisoning, even.

For all the fear of litigation, Roses’ article indicates that only 6 cases from 1992 to 2000 regarding anaphylactic reactions.  Id. at 232.  This could be because of extensive settlement and the fact that the case law that is out there can be contradictory.  If a person has a rare allergy, it might not be foreseeable that the allergen would require disclosure but if the person has a common allergy, courts have found that the allergic individual should foresee that a given food item contained that allergen.  Id. at 234.  Take a minute to digest (unintentional pun!) that contradiction and you’ll see the way we chip away at concepts to create law.  A new case occurs and we look to the prior ones to see what precedent was set.  Often the case law is such a mess than there has to be legislative intervention to change the way things work faster than would be the case through the progression of court cases when they frequently end in settlement anyway.

I have been working on this post, turning over my approach in my mind over and over only to not have a satisfactory way to distill my unease into clear terms.  Brevity has never been my strong point but the benefit of a blog as a writing space is that I don’t have to write something comprehensive, I can mull and ponder and post at my own pace.  Tort litigation is not the only thing on my to do list as it intersects with food allergy, but much like the famed McDonald’s case, it is my hope that if you encounter the argument that a policy is the product of “frivolous” litigation, there is more than meets the eye.  Much like the incomplete food allergy label there’s a bigger story lurking in the wings.

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In September I’ll be speaking on a panel at the Food Allergy Bloggers Conference (of which I am a co-owner) about some of the legalities that come up in blogging (we’re having an Intellectual property attorney as well as an attorney with experience dealing with online defamation cases speak on the same panel).  If you have anything you’d like us to try to cover, be sure to let me know by getting in touch.  More details are at FABlogCon.com.

Disclaimer: I’m a Nevada licensed attorney and solo-practitioner but this is in no way legal advice or intended to create an attorney client relationship.  The State Bar of Nevada does not certify any attorney as an expert.  

Stock Epinephrine in Nevada Schools and Onward to Restaurants and More

Today, thanks to a heads up from Caroline of GratefulFoodie.com, I was able to attend the Nevada Legislative Committee on Healthcare Interim Legislative Session hearing.  In Nevada, we only have legislative sessions every other year.  Last year was a great year for food allergy advocacy as Senator Debbie Smith championed Senate Bill 453 regarding Stock Epinephrine in Nevada Schools.  The bill eventually passed with unanimous votes in both branches of the state legislature.

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Getting Ready to Start

This was not my first time on the fourth floor of the Grant Sawyer Building near downtown Las Vegas but it certainly was my quickest visit as our contingent was called up right after the public comment section of the meeting.  I was able to visit a bit with representatives from Mylan (makers of the “Epi-pen” epinephrine auto injector) and their Nevada lobbyist as well as the co-leader of our local Food Allergy Parent Education Group, Susanne Stark, Senator Debbie Smith, and Chef Keith Norman of the South Point (and most recently board director at FAACT).

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Senator Smith Addressing the Committee

Senator Smith began by letting the committee know about the success in the last year with stock epinephrine in Nevada. She poignantly told of how when the bill passed we did not know when it would be needed but now we did (Andrue Casado being one of the lives saved). The work is not yet done, she cautioned, because access can extend to restaurants.  Colin Chiles of Mylan would next expand on this point by referencing other states where unique situations were covered like New York summer camps and Alaska hunting guides carrying stock epinephrine.

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Susanne Stark and Chef Keith Norman Speaking About Expanding Stock Epinephrine

Susanne followed with her account of the uses of stock epinephrine in private schools that were open to acquiring it and how in Clark County, Nevada alone there had already been 20 uses of stock epinephrine since the bill passed last summer.  Keith spoke about his experiences in food safety and the need for epinephrine in restaurants and the like.

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Kacey Larson Offering Testimony from Carson City via Video Feed

Attention turned to Kacey in Carson City, brandishing the front page of the Reno Gazette Journal featuring Andrue Casado and how his life was saved when he had his first ever anaphylactic reaction at school in Reno. After some closing remarks by Senator Smith, the committee chimed in with their words of support and personal experiences with food allergy. Senator Jones and Senator Dondero Loop had direct family connections. Senator Jones’ wife recently had an anaphylactic reaction and Senator Dondero Loop’s family member navigated food allergy at a time when epinephrine autoinjectors were not prevalent or the norm.

From Left to Right: Senator Debbie Smith, Homa Woodrum, Keith Norman, and Susanne Stark (Courtesy of Susanne Stark)

From Left to Right: Senator Debbie Smith, Homa Woodrum, Keith Norman, and Susanne Stark (Courtesy of Susanne Stark)

We laughed at taking a “selfie” after the hearing but I think it is a great way to make sure everyone is in the photo. Thank you for sharing this photo, Susanne! I care deeply about each of these great individuals and get chills just thinking of the difference each of them is making in their work. Senator Smith for her work for Nevada, Susanne (and her co-leader Debbie Bornilla) for the parents and the community in Las Vegas as a support group leader, and Chef Keith for making so many happy and safe.

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After the hearing Susanne raised the question to Mylan’s representatives about expiration dates on epinephrine (we were advised to feel free to return Epi-Pens with shorter than one year until expiration when issued as the pharmacy can readily exchange them for “fresher” stock).

Excitingly for me, Colin informed me the Mylan headquarters in Pennsylvania are a great space as I am traveling tomorrow to Pittsburgh to see it for myself at the invitation of Mylan. I was not sure if I could/should accept the opportunity when it was offered to me a few weeks ago but I think what I learn could be useful to the work we are doing in Nevada. Granted, this will require a lot of disclosure on my part as my plane trip, transportation, hotel, and meals are being covered and that does create the appearance of bias but hopefully longtime readers will know that I value my editorial independence. I look forward to sharing my experience especially since it will be my first time away from my children overnight (well, except for the night I was in the hospital in labor with my son and my daughter was home with my mother in law).

I will miss my kids tremendously and am very nervous about all the new social situations but there’s a sliver of excitement about the trip and getting to see the other attendees at the “Mylan Summit” April 10-11. Here we go!

The No Biggie Bunch (Review and Indiegogo Campaign)

"No Biggie!"

My food allergy dollars allocate in priority to:

1) Injectable epinephrine
2) Safe chocolate
3) Safe food

Now all they need to make is an epinephrine auto-injector case with a spot for emergency chocolate and snacks, right?  My daughter would totally be on board with it if it was pink, blue, and purple. What I mean to get at, in my signature roundabout way, is that the first place I go when I need food allergy related reading material is my local library (and even inter-library loan) before buying books (or usually in lieu of buying them). So I have to admit that I was aware of the No Biggie Bunch series of books for quite some time before I ever investigated further because our local library did not have any copies. We were missing out on a neat quartet of smart, well illustrated, and accurate food allergy reads for the younger set.

No Biggie Nutrition Facts

I met Heather Mehra, co-creator of the No Biggie Bunch books (with Kerry McManama and Michael Kline), and her husband at the Food Allergy Bloggers Conference last November and they are some of my favorite people because of their authentic exuberance for kid lit, awareness, and their family. I flipped through one of the books for the first time when I visited with Heather and the quality of the series was readily apparent. I excitedly purchased two books for my children and when they shipped to me I was generously gifted the other two books in the series as well, all signed (thank you so much again Heather)!

No Biggie Bunch books

The No Biggie Bunch should be in libraries and a new Indiegogo campaign aims to make that happen. Contributions fund distribution costs associated with putting the series in libraries across all 50 states. In the first week of the campaign, for example, $30 covers one set of four books for a library as well as two books for a school library dear to the contributor’s heart. Six books (retailing for $14.99 apiece normally) disseminated with sound and approachable food allergy discussion for just $30 is a great deal and I wanted to use it as the nudge I needed to get around to writing about the series here.

Peanut Free Tea for Three

This was the first of the series that I read and I had to get it for my daughter.  Three friends gather to have a tea party and are totally supportive of one another’s food allergy circumstances.  They bring their own safe food, something very familiar in our family, and have a wonderful time.  A main topic in this one is cross contamination with jelly because a knife may have had peanut butter on it during a prior use.  The book also models collaborative imaginary play.

Trade or Treat Halloween

The No Biggie Bunch each have single allergies, as well as one member that has no food allergies.  This really works for kids with multiple allergies because they can identify with more than one character in the books.  In “Trade or Treat Halloween” the kids are able to enjoy trick or treating with the knowledge that they’ll trade their haul for safe options.  Last year we had our first trick or treat outing and my kids handled it very well.  Greta, allergic to wheat, is excited in this story because she trades all her candy for stickers to decorate her room.


Dairy Free Dino-Licious Dig

There are no adults in the No Biggie Bunch books so the situations and dialogue are very accessible to elementary school and pre-school children.  Davis can’t share Natalie’s cheesy crackers when she offers them on a playdate because of his dairy allergy but both Natalie and Davis handle things in an upbeat way.  Davis’ “No Biggie Bag” has just the safe snack he needs and the two can continue with their adventure.  The attitude toward food allergy is very factual but supportive.  I see the children in my daughter’s class being very understanding on a regular basis.  Like Natalie, they want to share but know they need to keep their classmate safe.


Sports-tastic Birthday Party Book

We’ve covered tea parties, Halloween, and the run of the mill playdate. . .I saved the hardest scenario for last – the birthday party.  Scotty’s birthday cake is safe for some but not all of his friends but they are prepared with safe treats of their own.  As a mother I feel a pang of sadness when I read this book because of course we want our children included in those activities that others take for granted but to my children this book reflects the reality of birthday parties for them.  We plan and prepare and shop and bake so we can celebrate with their friends so that the focus of the day is not on the sugar rush (though that is an added benefit) but on having a great time together.

"No Biggie!"

“Along with my princess crown I packed my own jelly in my No Biggie Bag.”

The illustrations by Michael Kline are bright and cheerful and the characterizations are forward thinking – the friends have varied cultural backgrounds and diverse interests but love getting together.  I hope you’ll consider supporting the Indiegogo campaign to get these books into more libraries!

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The books are really focused on models of good habits when managing food allergies, so for books that cover allergic reactions I’d recommend The Princess and the Peanut: An Allergic Fairytale and The Bugabees: Friends With Food Allergies to round out your library collection.  

I am a volunteer contributing reviewer of books, music, and movies over at VegBooks.org if you’d like to check my recent posts there: Philip Reid Saves the Statue of FreedomThe Lego Movie (2014)In a Heartbeat (CD), Patty’s Secret, Bronto, Friend of Ceratops, Violet Mackrel’s Natural Habitat, and Monster on the Hill.

Food Find: Enjoy Life Foods’ Dark Chocolate Regular Size Morsels

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I love what Colette Martin wrote about holiday baking – it is great to see everyone firing up their ovens but baking is a year round thing in our house.  Since you may be pondering holiday -focused baking right now, I thought this review could include a roundup of some chocolate baking ideas I’ve already featured on this blog.  If you are shopping for the allergy friendly baker in your life, I must suggest books by Colette Martin (amazon affiliate link), Cybele Pascal (amazon affiliate link), and Kelly Rudnicki (amazon affiliate link - thank you to my friend Alison for my copy!).  I met all three ladies at the Food Allergy Bloggers Conference and they are just as gracious and amazing as I had hoped.  My friend Elyse snapped this picture of me with Cybele that I will always treasure:

Me (on the left) with Cybele Pascal (on the right)

Me (on the left) with Cybele Pascal (on the right)

I was able to taste Cybele’s chocolate chip cookies (amazon affiliate link) at the conference and they were great!  Very cool to see more shelf stable options for grab and go sorts of days.  As usual, I digress.

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Back to the main subject of this post - Enjoy Life Foods’ Dark Chocolate Regular Size Morsels (my free sample is pictured above between the mini chips and the mega chunks from our own stash) are just now rolling out!  I haven’t seen them on store shelves yet but I received a bag free from Enjoy Life to review and they are our new favorite.  They even have five less calories per serving compared to the mini chips (related to being a bit less sweet I am guessing).

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The posts below can feature any variety of Enjoy Life chocolate (substitute freely!).

Chocolate Chip Cookies

Chocolate Chunk Blondies

Holiday Shaped Chocolate (featuring Erewhon Cereal)

Chocolate Covered Chocolate Cupcakes

Double Chocolate Chunk Cookies

Gingerbread Boys with Chocolate Buttons (or a Gingerbread House)

Chocolate Covered Strawberries and Chocolate Covered Sunbutter Balls

Allergy Friendly Thin Mints

All of the ideas featured here are top 8 allergen free.  As full disclosure, this is actually our first holiday season with new safe foods (read more about that here).  Happy baking!

Food Find: Enjoy Life Chewy Bars (Revisited)

Enjoy Life Chewy Bars

This is about as late as I’ve ever gotten with a product review.  I took photos of the free Chewy Bars I received in the mail from Enjoy Life Foods for review purposes on October 8th and it is already November 14th.  The good news is that during that time the Cocoa Loco bars have made it to Las Vegas store shelves and they are the bee’s knees (modern definition of course).  Which will lead me to point out that there are no photos of said variety of bars.

Enjoy Life Chewy Bars

Exhibit A: The only bar that survived for photographic purposes.

We opened the Sunbutter Crunch bars first and they were just as good as they had been previously.  The Caramel Apple and Mixed (formerly “Very”) Berry varieties had improved (more consistent) texture and a more balanced taste.  The packaging for each bar now leaves less space around the bar but they are actually the same portion they’ve always been.  As a packaging and design nerd I really love all the details in the box redesign as well.

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I tasted the Cocoa Loco bars last because I was worried that the recent recipe change (which I first blogged about in an update to my original review of this line of bars) would alter my favorite flavor.  The newer version is richer and reminiscent of those Little Debbie chocolate brownies I used to eat as a child.  Delicious!

I was bemoaning on twitter that I couldn’t find all varieties locally to Joel Warady, Enjoy Life’s CMO the funniest thing was that when I got to meet him in person at this year’s Las Vegas FARE Walk one of the first things he asked me was whether I had found the Cocoa Loco bars on shelves.  That’s the level of detail you get with the folks at Enjoy Life.  I was humbled by their post about the Food Allergy Bloggers Conference as it captured much of what Jenny and I were setting out to do with encouraging personal connections with sponsors instead of a traditional expo format.  Joel also spoke to E and asked her what her about her allergies and told her that none of those things are in any of their products.  That they wouldn’t be in their products.  Oats are a tough one to avoid in the top 8 free arena so I’ve always appreciated that there are no oats in Enjoy Life products.

At any rate, to state what must be obvious, I love this company.  So many other families feel the same way because they are not afraid to keep changing and adapting both for continued product quality and innovation.  A dear friend of mine was able to take a few hours away from her family to come to the conference and I knew I had to introduce her to Joel.  We had a great chat (he even told us what Costco will be carrying from Enjoy Life soon!) and made sure he knew that Enjoy Life was a lifesaver to so many food allergic families.  I’m sure he’s heard that before but it is true.  We leave the allergist’s office with a diagnosis and turn to other sources to figure out what to do next.  We read labels and call companies.  Enjoy Life “gets it.”

Our options have broadened since E outgrew her wheat, soy, milk, and egg allergies but we still love Enjoy Life’s bars, cookies, chips (chocolate and lentil) and stock up often.  E and her friend K are able to share snacks on playdates because they can both have Enjoy Life treats – how neat it must be to make products that are impacting childhood memories in a positive way.

By way of a teaser, my next Enjoy Life review is going to be of their new dark chocolate morsels and we can’t wait to try them!  I have a few ideas for recipes that can incorporate a darker chocolate especially as holiday baking season approaches.

Thank You: FARE Walk Directors Dana and Duane Gordin

Dana and Duane Gordin addressing the FARE walk crowd on November 2, 2013
Dana and Duane Gordin addressing the FARE walk crowd on November 2, 2013
Dana and Duane Gordin addressing the FARE walk crowd on November 2, 2013

Dana and Duane Gordin addressing the FARE walk crowd on November 2, 2013

I am still formulating something to write about the first Food Allergy Bloggers Conference that happened last weekend and thank yous are a huge part of the thoughts rattling around in my mind.  (I am loving everyone’s recaps!)  This thank you is a little time sensitive because Duane Gordin, part of the rock star FARE walk team that includes his wife, Dana Gordin, is running in the Las Vegas Rock ‘n’ Roll Marathon on Saturday, November 17th.  Duane has been training for a 4 hour finish for his 26.2 mile journey through Las Vegas at night and is carrying with him the names of FARE walk supporters for each mile he conquers.

Nevada State Senator Debbie Smith with Duane Gordin at the 2013 Nevada FARE Walk (image courtesy of Carolyn Moassessi)

Nevada State Senator Debbie Smith with Duane Gordin at the 2013 Nevada FARE Walk (image courtesy of Carolyn Moassessi)

Dana and Duane helped me find the South Point as our venue for the conference and introduced me to Chef Keith and so many other wonderful folks.  Dana and Duane – you are appreciated and loved!  As fundraising from the Las Vegas Walk is still open, I wanted to share this message from the Dana Gordin about the race on Saturday:

Here’s Duane’s extra motivation to finish the Rock n Roll Marathon in under 4 hours.  Thanks to the many who gave to help find a cure for Scott, Matthew and the 1 in 13 children with a potentially life threatening food allergy.  He has a list of each Team Gordin donor that he’ll use to motivate him during each mile of his 26.2 mile race.  (Due to anonymity requests, just initials here.  He has the full names on his list.) 

However, he doesn’t have any donor names for miles 1 thru 5.  If you haven’t had a chance to donate, please do so now and get your named added to his motivation list.  Donate at Team Gordin:

MILE INITIALS

1

<none>

2

<none>

3

<none>

4

<none>

5

 <none>

6

M. G.

7

A. B.

8

P. D.

9

S. C.

10

C. M.

11

R. S.

12

J. G.

13

J. W.

14

K. W.

15

R. D.

16

T. S.

17

B. H.

18

B.R.

19

M.K.

20

P. N.

21

D. E.

22

R. L.

23

A. S.

24

C. W.

25

J. M. G.

26

S. P.

Thank you so much for the tremendous support!!!

Is Costco’s Kirkland Organic Rice Milk Being Discontinued?

Costco Ricemilk

Costco Ricemilk

One of my most read posts on the blog is actually about Kirkland Signature (aka Costco’s store brand) Organic Rice Milk.  I often get comments asking about it but recently there’s been an uptick in discussion online about whether the item is on the “pending/delete list.”

I called Costco‘s main number (1-800-774-02678, then press zero to speak to a representative) today to find out why people might be getting this information.

First, the good news Las Vegas and most around the country: Kirkland Ricemilk is in stock in all Vegas area stores and won’t be deleted.  There are no notes about deletion and there is nothing wrong with any product batches (there was speculation that if there was an item deletion it was temporary and related to quality control).

The bad news for those of you being told of deletions on a local level:  Stores that do not experience sales levels to justify carrying the product may very well be ceasing to carry Ricemilk.  If you are in one of these areas, call Costco and let them know how important the product is to you and your family.  I made sure to let them know on the phone that Costco is important to many food allergy families.  In fact, I’ve heard Costco will begin to carry Enjoy Life Foods products sometime in the next months so the food allergy epidemic has to be on the company’s radar.  You can also see about Costco Business delivery in your area.

Hopefully this information is helpful, I’ve had great luck calling Costco corporate in the past and this time was no exception.  I even shared a laugh about my Costco-nerd status to the representative when I said I hadn’t seen the ending of the price change at all on Ricemilk (which is usually a signal of an item being deleted from stock lists).

Thank you so much to readers and commenters that alerted me to their concerns.  Blogging and social media matter, it is part of why I’m so excited to be helping to plan the First Food Allergy Bloggers Conference taking place in Las Vegas next month.

On the subject of Costco, I was thinking it would be great to create a resource of food allergy friendly finds at their stores – I know I buy safe items with good labeling whenever I see them in our local warehouse.  Feel free to comment about safe options for your family and I will try to include some of them.

Update (December 2013):  A helpful commenter, Steven, found out the following (I’ve posted his comment here so it is easy to find and I certainly feel your pain if you’re in one of the regions listed below):

“After further email conversation with costcocare@costco.com I’ve learned that Kirkland Signature Organic Rice Milk will no longer be stocked at Costco Warehouse stores in the Southeast, Northeast, and Midwest regions. Too, Costco Business Delivery in those regions is discontinuing delivery of the product once current stock is depleted. It appears then that only the Northwest, Southwest, and Texas regions will continue to carry the milk. (Yep, Texas is its own region). So, if you live East of the Rockies—excepting Texas—it’s time to find an alternative.”

“An Emerging Epidemic: Food Allergies in America” and Nevada SB 453

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If you follow food allergy topics online, it is likely you’re already aware of a television special funded by FARE and Mylan Specialty (makers of the “Epi-pen”) that aired this morning.  I watched the special, narrated by father of a food allergic child, actor Steve Carell, online (click here to stream the entire program, thank you to Selena of Amazing & Atopic for sharing the link).  It is called “An Emerging Epidemic – Food Allergies in America” which is very fitting.

I’ll admit to crying a few times.  When you identify so keenly with something it is hard to escape reliving scenes from your own life.  I wonder how the program will impact people that don’t live with food allergies.  I wasn’t sure what to expect when I pressed “play” – it certainly is not something you want to watch with little ones because it comes right out and talks about fatalities with images of hospitals and a child in peril.

I think the program put faces to the issue but the questions I get as a parent of a child with food allergies were glossed over a bit.  For example, I’d say people ask me why there is an increase in the incidence food allergy and what causes food allergy.

The special mentions the hygiene hypothesis, which is one our pediatrician brought up most recently at the children’s 3 and 5 year well visit.  I brought up a lot of the other theories that I’ve been reading about and she hadn’t heard of them.  So to not present any of the other theories might perpetuate the implication of parental fault (which may be my “mommy guilt” talking).

The coverage given to oral immunotherapy is promising and exciting but there are already reports that the gains in treatment may not be lasting.  I know I love disclaimers but ending on the note of one treatment may diminish the impact of the program’s message.  Then again, as a food allergy mom I want to feel hopeful, I want to feel like people are working to help further research and awareness.

I have been feeling unsure of whether it is the best thing to keep this blog going but there is a part of the program where Dr. Ruchi Gupta mentions her mission to achieve safety for her child and others and it captured why we share and reach out.

As I wrote previously, I gave a presentation at my daughter’s school about food allergies.  I was then asked to write something for our school newsletter recently on the subject of food allergies and I decided to cover the new epinephrine law passed this summer in Nevada (using some of my notes from last year).  I want to be sure I thank my husband, my mother in law, my sister in law, Jenny (Multiple Food Allergy Help & FABlogCon), Missy (Marketing Mama), Elizabeth (Onespot Allergy & EpiCenter Medical), Tiffany (Food Allergy Fun), Caroline (Grateful Foodie), and Dana (The Las Vegas FARE Walk).  Each of them reviewed drafts of the following at various stages and provided valuable feedback.  I love this community, I know I say it often but I really and truly appreciate the support!  

I don’t know if this will be included in the newsletter in its entirety but I wanted to share it here in case it is of use to any of you out there in trying to raise awareness and impact the safety of all in the face of “an emerging epidemic.”  If you need my citations/references to feel free to leave a comment and I’ll get them to you.

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New Epinephrine Law Could Save Lives at School

During this summer’s 2013 legislative session, Nevada unanimously passed Senate Bill 453. The bill mandates that public schools obtain and have authorization to use injectable epinephrine (private schools are authorized but not mandated to obtain epinephrine). This allows them to save lives in the face of the rising risk of food allergies among children and anaphylaxis deaths nationwide. The New England Journal of Medicine has said that four of six deaths from food allergy occur in schools and are associated with delay in treating reactions with epinephrine

Anaphylaxis is associated with symptoms that may include hives, swelling, rapidly closing airways, and more. While not completely understood, anaphylaxis is essentially an overreaction by the immune system to any number of external triggers, including food. Estimates currently are that one in thirteen children suffers from food allergies. The most common food allergens are peanuts, tree nuts, milk, eggs, soy, shellfish, fish, and wheat. While some children might outgrow food allergies, they need protection at home, school, and play while their immune systems are so affected.

What does this development mean for students as they begin another school year in Nevada? Much like any person would obtain a prescription from their pharmacy, Nevada schools are now able and required to obtain and fill prescriptions for injectable epinephrine. Currently there is a program for schools so that each school can keep epinephrine injectors on hand without cost (the “Epi-pen” brand in this program). Discovery Charter School is making arrangements to obtain these free injectors to protect students and staff alike from known or undiagnosed food allergies. The Center for Disease Control reports that 25% of anaphylactic reactions in schools occur without a prior food allergy diagnosis.

During the legislative process, some wondered if epinephrine could cause more harm than good if used when it wasn’t needed but this is not the case. The side effects of mistaken use are mild and are greatly outweighed by the benefit of immediate use when needed. The only time giving epinephrine could be a problem is if a student has a heart disease but even so, physicians still feel that in a life and death situation, the epinephrine is worth the risk. So adverse reactions are rare and epinephrine is easy to administer to the thigh and even through clothing.

How does SB 453 help? In the case of an allergic anaphylactic reaction, epinephrine is most effective when used quickly. That means that a child who does not have their own prescription for injectable epinephrine would not even have the medicine at hand. The stock epinephrine could save that student during the delay in time for emergency services to arrive. Minutes make all the difference.

In Virginia, where a similar bill was passed, children have already had their lives saved because of stock epinephrine. A fifteen year old boy in Virginia was stung by a bee and two injections (the injectors are always provided in two-packs) stabilized him so that emergency personnel could assist him further.

I appreciate [my daughter's school's] embrace of training associated with food allergies and recognizing the signs of anaphylaxis. If you have any questions please feel free to get in touch with the school nurse. You are also welcome to contact me at [email]. Learn more about supporting the cause of awareness and a cure at http://www.foodallergywalk.org/lasvegas (the food allergy walk on November 2, 2013 at Green Valley Ranch’s The District is great for families — there will be a face painter, game truck, and more!).  I also encourage you to seek the assistance of a physician if you suspect your child has food allergies.

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School has been going wonderfully so far and it is the support of a caring community of staff, families, and friends that make all the difference.  Thank you for reading and being a part of that community.

Elsewhere…

Vegan, Allergy Friendly Kickstarter Campaign
Vegan, Allergy Friendly Kickstarter Campaign

Great Articles

On the food allergy front, there have been some great articles and posts recently that I wanted to highlight because they’ve enhanced my knowledge of the development of allergies:

Protect Your Digestion, the First Line of Defense Against Food Allergies by Dr. Eva Untersmayr - This article is fascinating, if I’d seen it before my presentation last week I would have had to mention it.  Be sure to explore the fantastic website AsthmaAllergiesChildren.com (the site’s founders will be at the Food Allergy Bloggers Conference, see the agenda for details).

From the outside in: How eczema could lead to food allergies by Iona Twaddell – I am trying not to let mommy guilt get to me when I read research articles but I do confess to wondering often whether using Aveeno lotion (which is oat based) with my daughter is related to her severe oat allergy.  I was directed to this article via the twitter feed of Anne F. Russell BSN, RN, AE-C (who will also be a conference speaker and helped us proofread the conference brochure I created… download the brochure here as a pdf - thank you Anne!).

Genetic glitch at the root of food allergies? by Jessica Martin, PhD – I love how Jessica breaks down concepts.  The other day she e-mailed me a detailed response to a question I had and hopefully you’ll see it on her Food Allergy Sleuth site soon.  When she bought a ticket to the conference I was thrilled because I can’t wait to meet her.

Food Allergy Walk and Food Allergy Bloggers Conference

I have a fundraising page again this year for the Food Allergy walk here in Las Vegas, Nevada on November 2, 2013.  I’m on the walk committee and also a co-founder of the Food Allergy Bloggers Conference that will be kicking off with the walk and running through November 4, 2013.  So it will be a big weekend for Food Allergy in Southern Nevada!  We need team members and virtual walkers are welcome!  If our team raises $1,000 before August 31, 2013 our team name will appear on the official walk t-shirt!  We’re just about halfway there, donate and/or join today!

(If you’d like to have a chance to win tickets to The Wizard of Oz at the Smith Center, check out the team page of Young Artists Supporting FARE – a $10 donation during their raffle period earns an entry.)

An Allergy Friendly Kickstarter Campaign

Ending September 10, 2013, here is a Kickstarter campaign that might be of interest – it involves a top 8 allergen free, vegan candy that I’ve backed and you may want to as well!  Premium Chocolatiers needs to raise funds for the equipment necessary to manufacture their vegan marshmallow coated with chocolate and candy.

The way the Kickstarter website works is that if the funds needed to achieve the stated goal aren’t raised, the campaign doesn’t get “funded” and none of the money pledged is charged.  They’re almost halfway to their goal with two weeks left and I’d love to see this idea take off.  $7 gets one bag of “No No’s” shipped to US addresses sometime hopefully in time for Halloween, so check it out here.

The VanSquigglebottoms-to-be

Something with a deadline that is a little further into the future is the fundraising campaign my friends Jessica (not the same Jessica I mentioned above) and Jeff have launched that involves changing their last name to “Van Squigglebottoms” permanently and officially if they raise $1,000,000.00 for Oxfam on or before December 31, 2013.  I hesitated to donate only because I like their names as they are but then I got to thinking that I love the positive approach they’re taking.  They care passionately about the causes associated with the less fortunate and they’re willing to do something off the wall to get the attention they feel this cause needs.  You can see their fundraising page here and I can assure you that even the smallest donation will cheer Jessica and Jeff on.  Even if all you can do is spread the word about their fundraising efforts, that may prompt someone else to donate.

Children’s Literature (and Music!) Reviews

Finally, it has been a while since I rounded up my latest Vegbooks.org reviews.  I’ve even had the chance to review some music which was a lot of fun.

Mind of My Own (CD)

Say Daddy

Where to Sleep

Steam Train, Dream Train

Memoirs of a Goldfish & Memoirs of a Hamster

Paper Son: Lee’s Journey to America

He’s Been a Monster All Day

Blink of an Eye (CD)

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School starts tomorrow and E turns 5!  It is exciting and surreal at the same time.  Have a great week, all!

Food Find: Enjoy Life Decadent Bars

Enjoy Life Decadent Bars

Enjoy Life Decadent Bars

It is always a happy occasion when a box bearing the Enjoy Life Foods sticker arrives at our door, though I did hesitate briefly when offered these bars to review (I was not compensated in any other way) because it had been hovering at 105 degrees Fahrenheit of late.  Vegas summers don’t kid around.  Luckily, putting the entire shipping box into the fridge the minute these arrived seemed to have protected these sweet treats.

In the interest of full disclosure, this was not my first taste of the new Enjoy Life Decadent Bars.  I ordered a Gluten Free Saver special a while back and though the kids adored them from the get-go, my husband and I were disappointed because of our own high expectations.

Speaking of our high expectations, I was at work the day the initial box arrived and my husband sent me this picture with the suggestion that I hurry home:

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…followed by this picture to assure me that our children “wouldn’t suspect a thing.”  It still cracks me up with the parenthetical:

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At any rate, my husband and I weren’t planning to buy Decadent Bars again because we still preferred Chewy Bars.  I think it is like when your favorite musical artist puts out an album that is good compared to other music in general but isn’t your favorite compared to their own previous work.  I know I feel disloyal when I don’t adore a song by Morrissey but sometimes it does happen.  I love Enjoy Life because they are not only top 8 allergen free but oat free which is a specific allergy my daughter has (her allergen list is currently: oat, peanut, tree nut, and sesame).

At any rate, though these aren’t the revelation Plentils were in our household, I’m so glad I gave these another chance as I now have some tips for getting the most out of the experience.  My husband and I agreed they were much better with the following caveats:

1) Don’t expect the flavors to match the names exactly - Chocolate Sunbutter is the most accurate of the four varieties, with Cherry Cobbler coming in second.  The Chocolate Sunbutter has a drizzle of chocolate and isn’t as sweet as the other flavors but in a very good way.  It lets the Sunbutter shine through.  The Cherry Cobbler seems to have other reviewers split about the strong fruity/tart flavor but it ended up being my favorite the fist time around because of the white glaze and the cherry notes offered something unique.  That said, the S’mores and Cinnamon Bun Decadent Bars weren’t what I expected.  Still a nice treat but they both had a strong date flavor that hides any intended marshmallow-esque (that’s a word, right?) or cinnamon ingredients.

2) Refrigerate the bars before enjoying - The first time I bit into the S’mores variety it was not what I expected but on the second go-around I found that the graham cracker texture comes through much better upon refrigeration.  This may not be a problem where you live but our house is always about 80 degrees.  The drizzles on the bars are more noticeable when they are refrigerated as well.  

3) Share with a friend (these are too sweet for adults to eat in one go) – When I initially heard the new line to follow the awesome Plentils from Enjoy Life involved more snack bars I wasn’t sure why.  We love the Chewy Bars so I worried the Decadent Bars meant the Chewy Bars may be phased out, however, once we ate these I realized they are very much a candy bar and therefore in a different market niche.  Colette Martin remarked in her own review of these bars that these fall in the treat category and I agree.  It seems that kids across the board love these, while I find kids are usually split 50/50 when we share Chewy Bars with the kids’ friends.  Something to consider as you decide on the right mix of snack foods to keep on hand.

Overall, these are a great option to add to your arsenal but see how you like each flavor on its own merits and make sure they’re kept on a refrigerator shelf out of reach of certain small individuals (who will remain nameless) that have figured out how to open candy bar wrappers.

Enjoy!