WEBVTT - Operation Achoo!: Treating Kids with Allergies 0:00:01.520 --> 0:00:04.400 Welcome to Katie's Crib, a production of Shonda Land Audio 0:00:04.480 --> 0:00:14.520 in partnership with I Heart Radio. Hi everybody, and welcome 0:00:14.520 --> 0:00:18.200 back to Katie's Crib. Today we are discussing bump bump 0:00:18.239 --> 0:00:23.880 bomb allergies. When you have a new baby, you're super 0:00:23.920 --> 0:00:27.080 scared of an allergy attack, just always, and not even 0:00:27.080 --> 0:00:28.920 like a baby, even when they're like older. You're just 0:00:29.040 --> 0:00:31.840 constantly scared of allergy attacks always from the get go. 0:00:32.200 --> 0:00:34.959 People are giving you advice of what diapers, detergent, to use, 0:00:35.040 --> 0:00:37.240 body lotions, and then forget about it when they start 0:00:37.280 --> 0:00:40.600 eating food. Um, once we get into nuts and eggs 0:00:40.640 --> 0:00:43.599 and shellfish, and you hear stories about kids throats closing, 0:00:43.600 --> 0:00:49.160 and it's basically just complete alarmist, insane fear all the time, 0:00:49.280 --> 0:00:51.680 or at least that's how I felt. Also, my husband 0:00:51.760 --> 0:00:54.319 is literally allergic to everything, like when you do those 0:00:54.320 --> 0:00:57.880 little prick things, the fifty things on your back, forty 0:00:57.920 --> 0:01:00.720 eight of his rise up, but none of his are 0:01:01.200 --> 0:01:03.920 the death ones, but they're all all like, he's basically 0:01:03.920 --> 0:01:05.880 allergic to every single fruit and vegetable and whatever. So 0:01:06.560 --> 0:01:10.280 I was convinced when I had my son, like he 0:01:10.360 --> 0:01:13.399 was going to be the most allergic kid on the planet. Um, 0:01:13.440 --> 0:01:16.280 so here to bless us with their expertise and ease 0:01:16.360 --> 0:01:19.720 my anxiety and hopefully some of you all out there 0:01:19.760 --> 0:01:23.720 listening is Dr Tricia Lee and my dear friend and 0:01:23.800 --> 0:01:29.680 fellow mom and lawyer, Julie Feldman, Um Doctor Triciallie is 0:01:29.680 --> 0:01:33.720 an adult and pediatric allergist and immunologist. She's board certified 0:01:33.720 --> 0:01:36.000 with the American Board of Pediatrics and the American Board 0:01:36.000 --> 0:01:40.120 of Allergy and Immunology. Her research has included clinical trials 0:01:40.120 --> 0:01:42.720 and asthma and food allergy, and she has published articles 0:01:42.760 --> 0:01:46.200 and presented at national meetings about immune deficiency, food allergy, 0:01:46.240 --> 0:01:50.920 and infectious disease. Julie is a super fancy entertainment lawyer 0:01:51.000 --> 0:01:55.000 who has two little girls who do both face serious 0:01:55.040 --> 0:01:59.000 allergies and um she's been in this world as a 0:01:59.040 --> 0:02:02.480 mom for a few years now. Um So, Julie, let's 0:02:02.520 --> 0:02:06.360 start with you talk to me about your two daughters, 0:02:06.400 --> 0:02:10.959 their ages differences, and what they're allergic to and what 0:02:11.040 --> 0:02:13.280 were their initial symptoms which I can repeat those questions 0:02:13.280 --> 0:02:15.280 back if there were too many of months. Okay, So 0:02:15.440 --> 0:02:18.320 I have two girls. Alexandra, who we call Ali, is 0:02:18.320 --> 0:02:21.560 my older one, and she's three now. And my baby 0:02:21.639 --> 0:02:25.360 Isabella we called Izzy, is sixteen months and they're cute. 0:02:26.400 --> 0:02:29.400 Not that that matters, but let me tell you, getting 0:02:29.440 --> 0:02:32.840 the picture of the two of them anytime is a gift. 0:02:33.400 --> 0:02:36.760 So what are they both allergic to? Doctor Tresuali is 0:02:36.880 --> 0:02:40.360 Julie's doctor allergist who has saved her life, who has 0:02:40.360 --> 0:02:43.160 saved my life on so many occasions, and my emotional 0:02:43.200 --> 0:02:47.359 stability on so many occasions. So they are both allergic 0:02:47.400 --> 0:02:50.680 to eggs and peanuts, and Isabella is also allergic to oats. 0:02:51.639 --> 0:02:55.720 Oh my god, I can't. But they're also which makes 0:02:55.720 --> 0:02:59.480 it more complicated allergic differently so my older one Ali. 0:02:59.720 --> 0:03:02.800 Her allergies are kind of what you think of your 0:03:02.840 --> 0:03:07.600 throat closing anaphylaxis, typical allergies UM that most people are 0:03:07.639 --> 0:03:11.440 afraid of. Isabella has a what I understand to be 0:03:11.480 --> 0:03:15.240 like pretty uncommon or you know, more rare digestive but 0:03:15.440 --> 0:03:19.160 very serious allergy where when she eats her trigger foods, 0:03:19.240 --> 0:03:22.080 she'll start throwing up to the point where her body 0:03:22.120 --> 0:03:24.240 kind of may not be able to balance itself, so 0:03:24.760 --> 0:03:28.680 she needs UM. She would need so many boose thumps 0:03:28.760 --> 0:03:31.280 right now. Even with this I mean, this is crazy. 0:03:31.440 --> 0:03:33.480 So if she throws up that much, it's like rush 0:03:33.520 --> 0:03:37.080 to the hospital. Situation exactly called doctor Lee, go to 0:03:37.120 --> 0:03:39.960 the emergency room. I was in an ambulance, right, I 0:03:39.960 --> 0:03:41.520 was want to say two weeks ago, I was in 0:03:41.520 --> 0:03:42.880 an ambulance. I don't think I even told you this 0:03:43.040 --> 0:03:46.360 wasn't what My eyeballs just became saucers. I was an 0:03:46.440 --> 0:03:49.000 ambulance on the way to the er because Izzy had 0:03:49.040 --> 0:03:51.360 a bad reaction. And this is when we confirm that 0:03:51.440 --> 0:03:54.680 she is also has this allergy. The acronym for it 0:03:54.800 --> 0:03:57.760 is f pies um, but she has an allergy to 0:03:58.000 --> 0:04:02.760 peanuts as well, and so her her allergy is also 0:04:02.880 --> 0:04:06.520 it happens it's a delayed reaction. So Ali's happen immediately 0:04:06.520 --> 0:04:09.440 after you eat the food Izzy as are about two 0:04:09.440 --> 0:04:13.320 hours after starting to name than what it is, because 0:04:13.480 --> 0:04:16.000 you in movies it's like the kid eats the peanut 0:04:16.080 --> 0:04:18.120 and it's like we're in the emergency room. We're dying. 0:04:18.279 --> 0:04:20.880 But like for her to have a delayed reaction, that 0:04:20.960 --> 0:04:23.320 must be hard to do an elimination sort of diet 0:04:23.360 --> 0:04:26.359 and figure out what the triggers, especially since there's no 0:04:26.480 --> 0:04:28.839 testing for this type of allergy, so you can do 0:04:28.920 --> 0:04:32.640 skin tests and blood tests for the anaphylactic type allergy. 0:04:32.760 --> 0:04:34.760 So when you think you might have something, you go 0:04:34.839 --> 0:04:37.159 to doctor Lee. She tests them all, she figures it 0:04:37.200 --> 0:04:38.799 all out, and then she tells you what to avoid. 0:04:39.400 --> 0:04:43.039 For f pies, there's no test. You basically have to 0:04:43.080 --> 0:04:46.640 eat foods trial it for depending on the food like 0:04:46.640 --> 0:04:48.839 a you know, several days to a few weeks to 0:04:48.920 --> 0:04:51.480 see if you start having an issue from it. And 0:04:51.520 --> 0:04:54.000 the other thing for that is that some of the 0:04:54.080 --> 0:04:56.719 more common foods for f pies allergies are not ones 0:04:56.760 --> 0:04:59.000 that you would think about. So chicken and rice and 0:04:59.040 --> 0:05:01.680 banana and not a hat out are all an oats 0:05:02.040 --> 0:05:05.560 are all really high risk foods, so they don't fall 0:05:05.600 --> 0:05:10.400 into the dairy, eggs, peanuts category. You normally think of, um, 0:05:10.560 --> 0:05:18.080 what was um the first symptom you saw with UM, 0:05:19.880 --> 0:05:21.760 I'm trying like which way do we want to go first? 0:05:21.800 --> 0:05:24.040 I'm like, you're older or you're younger, which, by the way, 0:05:24.240 --> 0:05:26.000 when you had Izzy, I was like, this kid isn't 0:05:26.040 --> 0:05:28.200 gonna have any allergies because she was put through such 0:05:28.240 --> 0:05:31.120 a ringer with your first and I was like you, like, 0:05:31.160 --> 0:05:33.640 you're done you're like, you're done. You did it, like 0:05:33.680 --> 0:05:37.839 you survived. And now we have number two who has 0:05:38.160 --> 0:05:41.480 a lot of allergies and they're different, right, So so Alie, 0:05:41.480 --> 0:05:43.360 it's funny because we went to we sat at a 0:05:43.400 --> 0:05:45.440 coffee shop across the street from an emergency room to 0:05:45.480 --> 0:05:47.920 give Alie peanut butter for the first time. Because I'm 0:05:47.960 --> 0:05:52.280 just type a anxious person. That makes you a great lawyer, well, 0:05:52.320 --> 0:05:55.080 thank you, and it also makes me, you know, a 0:05:55.200 --> 0:05:58.720 difficult wife and you know a mom like so sitting 0:05:58.760 --> 0:06:01.760 across this room leaving peanuts for the first time exactly, sorry, 0:06:01.800 --> 0:06:04.039 dragged my husband with me. Didn't give her a whole lot, 0:06:04.080 --> 0:06:06.160 but she was fine, like it was everyone just that 0:06:06.320 --> 0:06:09.680 I was up. That's Julie. And she overreacted and then 0:06:09.720 --> 0:06:12.400 a few you know, she had that a few more 0:06:12.440 --> 0:06:15.280 times and things seemed to be okay. We introduced eggs. 0:06:15.360 --> 0:06:18.159 She seemed to be okay with eggs. She then had 0:06:18.960 --> 0:06:21.760 a few hives or like like of a rash that 0:06:21.800 --> 0:06:23.640 we're like, h what is this And again it wasn't 0:06:23.640 --> 0:06:25.400 the first time she had had eggs, so we didn't know. 0:06:26.000 --> 0:06:28.360 We gave her egg whites, thinking that egg whites were 0:06:29.279 --> 0:06:34.000 less you know, allergic allergy complete opposite. Most people who 0:06:34.000 --> 0:06:36.679 have egg allergies are more allergic to the egg white 0:06:36.680 --> 0:06:39.039 than to the egg yolk, So hell knows that. We 0:06:39.160 --> 0:06:41.640 just learned that here on Katie's grip folks exactly. So 0:06:41.680 --> 0:06:43.560 there you go. I messed that up, and that's when 0:06:43.600 --> 0:06:45.960 Ali's face started blowing up, her eyes were getting swollen, 0:06:46.000 --> 0:06:48.679 her lips were getting swollen. So we rushed over the doctor, 0:06:48.680 --> 0:06:51.039 got that agil. She kind of settled down from there, 0:06:51.680 --> 0:06:54.479 But after that was when I went over to doctor Lee. 0:06:54.680 --> 0:06:57.080 We also had been avoiding dairy just because she had 0:06:57.120 --> 0:07:00.919 had some digestive issues and really bad reflux, and so 0:07:01.400 --> 0:07:04.279 we didn't know if she had a digestive allergy to 0:07:04.360 --> 0:07:06.680 dairy or if there could also be something more of 0:07:06.720 --> 0:07:11.000 an anaplaxis dairy allergy. Ali did outgrow her dairy allergy 0:07:11.120 --> 0:07:15.240 right before she turned three. Now, Dr Tricia Lee, do 0:07:15.400 --> 0:07:19.320 you normally meet moms and their kids when we're at 0:07:19.360 --> 0:07:23.360 this sort of crisis mode? Um? Does it vary when 0:07:23.520 --> 0:07:26.160 do they come to you? So normally it's after the 0:07:26.200 --> 0:07:28.880 first reaction, and for some of those families that takes 0:07:28.880 --> 0:07:31.480 them in to the emergency room, and the emergency room 0:07:31.520 --> 0:07:33.960 physician will say okay, now you need to see an allergist, 0:07:34.120 --> 0:07:36.200 or if it not even taken them to the emergency room, 0:07:36.240 --> 0:07:38.560 just to the general pediatrician's office, then they will be 0:07:38.600 --> 0:07:41.920 referred to the allergist. UM. Very rarely am I seeing 0:07:42.480 --> 0:07:47.160 um sort of a new diagnosis before the first reaction. UM. Nowadays, 0:07:47.200 --> 0:07:49.840 with sort of new recommendations and pushed to get children 0:07:49.840 --> 0:07:53.360 in tested early introduction, a lot of these high risk 0:07:53.440 --> 0:07:56.400 kids meaning moderate to severe egma will be sent before 0:07:56.400 --> 0:07:59.480 they've even eaten anything I see, right, So there's also 0:07:59.520 --> 0:08:02.440 the kids that are having crazy skin stuff happening before 0:08:02.440 --> 0:08:05.800 they've even eaten solid foods. And sometimes I'll see four 0:08:05.800 --> 0:08:08.679 eight week olds and then we're not really doing food 0:08:08.680 --> 0:08:11.440 testing at that time. UM, it's really probably not acuratetil 0:08:11.440 --> 0:08:13.840 close to four months old, UM, but sort of following 0:08:13.880 --> 0:08:16.480 along there. So sometimes we're capturing it before they actually 0:08:16.480 --> 0:08:19.320 eat it. UM. But most of the time my suggestion 0:08:19.440 --> 0:08:21.880 is to to eat the food and then sort of 0:08:21.880 --> 0:08:24.520 go from there. The problem with skin testings it's not perfect. 0:08:24.600 --> 0:08:26.480 You can get a lot of faults positives. For example, 0:08:26.480 --> 0:08:28.200 if you go to local mall tore that people have 0:08:28.200 --> 0:08:29.880 a positive test of peanut, they eat it and they're 0:08:29.880 --> 0:08:33.040 fine with it. So testing is just not accurate, and 0:08:33.040 --> 0:08:35.120 so you can end up with a lot of false positives. 0:08:35.480 --> 0:08:39.240 UM sort of unknowingly unfortunately. I feel like when we 0:08:39.240 --> 0:08:41.960 were kids, they would wait awhile to test it. Now 0:08:42.000 --> 0:08:44.720 there's all these new stuff saying like give them small 0:08:44.880 --> 0:08:48.959 doses before even the age of one, exactly, and that 0:08:49.040 --> 0:08:51.480 was actually UM. Probably part of the problem in the 0:08:51.600 --> 0:08:54.440 United States when food allergy increased in the United States 0:08:54.720 --> 0:08:57.199 was when the ap had recommended delay an introduction of 0:08:57.280 --> 0:09:01.160 these foods for that reason. Part of the reason is 0:09:01.600 --> 0:09:05.040 UM more from a choking hazard perspective in the sense 0:09:05.080 --> 0:09:06.839 of like nut, you're not going to feed a four 0:09:06.880 --> 0:09:11.079 month old nut. But nowadays, with nut butters and nut powders, 0:09:11.120 --> 0:09:14.040 it's much easier to accomplish. UM. A lot of times 0:09:14.040 --> 0:09:17.959 I'm hoping to even capture that family before the first introduction. UM. 0:09:18.000 --> 0:09:20.880 So now there's some data to support sort of moisturization. 0:09:21.200 --> 0:09:24.719 So from day one of life to moisturize head to toe. UM. 0:09:24.840 --> 0:09:30.880 Every day I'm imagining a one week old being slathered 0:09:30.920 --> 0:09:34.360 in peanut butter. That's not what you mean. I'm glad 0:09:34.400 --> 0:09:38.200 you clarify, So what do they do somewhere like a 0:09:38.400 --> 0:09:42.439 cream or vasselin just what you would moisturize your skin with. 0:09:42.760 --> 0:09:45.920 And the concept is the or the hope even is 0:09:46.000 --> 0:09:48.920 that if we can prevent sort of eggs ma starting 0:09:48.920 --> 0:09:52.040 and progressing, then maybe we could prevent this progression into 0:09:52.320 --> 0:09:56.320 UM food allergy. UM even to the extent of UM 0:09:56.720 --> 0:09:58.760 a little bit of data to support that if you 0:09:58.800 --> 0:10:01.000 touch an allergy with your hands, like if you were 0:10:01.000 --> 0:10:02.880 eating a peanut butter and jelly sandwich, to then not 0:10:02.960 --> 0:10:06.280 directly touch your kids skin. UM. There is a hypothesis 0:10:06.320 --> 0:10:09.880 out there that UM, these kids are seeing allergens through 0:10:09.880 --> 0:10:12.120 their skin first as opposed to through their gut, and 0:10:12.120 --> 0:10:15.320 then they're forming an abnormal reaction so in the reverse 0:10:15.360 --> 0:10:18.720 sance as well not putting foods on the skin. So 0:10:19.000 --> 0:10:21.480 UM in England, UM, some of their food allergy increase 0:10:21.520 --> 0:10:24.480 after they started using things like coconut oil and the egsma. 0:10:24.559 --> 0:10:26.480 So until the kids eating the food. I don't really 0:10:26.960 --> 0:10:30.240 prefer food products on the skin, got it, But from 0:10:30.280 --> 0:10:35.040 there with food introduction, I think early what first like 0:10:34.880 --> 0:10:38.920 I vasoline. Vassoline is like one product and no one's 0:10:38.960 --> 0:10:45.280 allergic to it. Y, Seravey, Vanning cream or good brands um. 0:10:45.320 --> 0:10:53.440 Even Aquifer though has vanolin in it. I'm so glad 0:10:53.559 --> 0:10:56.440 on this podcast because I'm switching it up. I feel 0:10:56.440 --> 0:10:59.280 like vascaline is like what we used kids like a 0:10:59.320 --> 0:11:02.800 head to toe grease the kid up every single diaper change. Um. 0:11:02.840 --> 0:11:04.760 But then you know, close to four or five months, 0:11:04.760 --> 0:11:06.360 and this is going to pin a lot on the 0:11:06.440 --> 0:11:08.520 child developmentally speaking in the sense of can they hold 0:11:08.520 --> 0:11:10.480 their head up and are they thrusting their tongue out? 0:11:10.600 --> 0:11:13.360 But just starting eating, we just don't know until you 0:11:13.360 --> 0:11:15.640 eat it, like you just got to eat um. And 0:11:15.679 --> 0:11:18.080 so starting sort of early with fruits, vegetables, and then 0:11:18.080 --> 0:11:21.280 pretty quickly going through sort of those top eight allergens 0:11:21.679 --> 0:11:26.120 um all so, milk, egg, wet fish, shellfish, peanut, tree, nuts, sesame, 0:11:26.200 --> 0:11:29.120 soy um and generally speaking in in order of like 0:11:29.240 --> 0:11:31.920 weed and then milk and then egg um and then 0:11:31.960 --> 0:11:34.920 obviously peanut very soon. And they also now have it 0:11:35.000 --> 0:11:37.720 in pouches. So there are brands where you give your 0:11:37.760 --> 0:11:41.160 baby like these, like many pouches that have these different 0:11:41.200 --> 0:11:44.120 allergens in the pouches. So even though they can't eat 0:11:44.120 --> 0:11:47.240 a nut or an egg or like soy like things 0:11:47.280 --> 0:11:51.080 like that they can be exactly. So that's what we 0:11:51.080 --> 0:11:53.880 started doing for Isabella because we were trying to introduce 0:11:53.920 --> 0:11:56.520 everything early. I mean, when you say, what point do 0:11:56.280 --> 0:11:59.240 you to Dr Lee start seeing patients for Isabella, I 0:11:59.320 --> 0:12:01.440 was like, I'm pregnant, now tell me what to do. 0:12:01.480 --> 0:12:04.880 It's like she's born, now tell me what to um. 0:12:04.920 --> 0:12:08.079 But so we gave her all of these pouches as 0:12:08.120 --> 0:12:10.439 early as we could. You know, when she was having 0:12:10.720 --> 0:12:16.720 a symptoms of Isabella with being allergy is different, right, 0:12:16.760 --> 0:12:19.240 So when we gave when we gave her one of 0:12:19.280 --> 0:12:22.440 the pouches that had egg in it, she was fine. 0:12:22.600 --> 0:12:24.600 We put her down for a nap. We well, first 0:12:24.640 --> 0:12:27.559 we had tested everything on the skin testing with Dr Lee, 0:12:27.559 --> 0:12:30.720 so we felt okay trying it at home. Then two 0:12:30.720 --> 0:12:33.960 hours after she threw up and it was she's a 0:12:34.040 --> 0:12:36.520 baby baby, so you're kind of like this a spit up? 0:12:36.679 --> 0:12:38.480 Is it? Like? So you're kind of like, as a 0:12:38.520 --> 0:12:43.440 second kid, is it a coal qualifying? So I called 0:12:43.480 --> 0:12:46.400 Actor Lee and she's like, okay, well, I don't want 0:12:46.400 --> 0:12:48.319 to say that. We're not going to try egg again. 0:12:48.440 --> 0:12:51.319 We'll see, like let's just like let's be aware of it. 0:12:51.760 --> 0:12:53.880 So and she didn't even tell me what f pies 0:12:54.040 --> 0:12:56.240 was or anything like that. She hit it from me 0:12:57.080 --> 0:13:00.200 and so then there's like nobody this is. Yeah. So 0:13:00.240 --> 0:13:02.679 the next time we gave her egg, we gave her 0:13:02.760 --> 0:13:04.240 the same page and we tried to do it at 0:13:04.240 --> 0:13:06.920 a time when she wasn't sick. She's like, they're like 0:13:06.920 --> 0:13:09.200 that we kind of knew her baseline of where she was. 0:13:09.360 --> 0:13:12.080 And she threw up again about two hours later. So 0:13:12.120 --> 0:13:14.600 I called Dr Lee again. I'm like, what do I do? 0:13:15.200 --> 0:13:18.120 And that's when she said, Okay, Isabella has f pies 0:13:18.200 --> 0:13:22.360 and here's what we do. And PIES stand for food 0:13:22.360 --> 0:13:26.640 protein induced innercalitis, which is why I say F pies. 0:13:27.240 --> 0:13:31.599 Is that like what it's called F pies? No, that's no. 0:13:31.720 --> 0:13:34.760 I feel like that's there's an I C D tinko 0:13:35.000 --> 0:13:38.160 for the diagnosis of f pies. It's like a I 0:13:38.200 --> 0:13:39.880 feel like it's a rare group of people who know 0:13:39.920 --> 0:13:42.480 what it means. But among the people that have this allergy, 0:13:42.520 --> 0:13:46.280 that's what it's called or how we refer to it. UM. 0:13:46.360 --> 0:13:49.319 So a lot of times you think, oh, my kid 0:13:49.400 --> 0:13:51.400 is sick and I have a virus. You also don't 0:13:51.400 --> 0:13:55.240 think when you're giving your baby bananas or wheat cereal 0:13:55.360 --> 0:13:58.120 or these foods, and they're throwing up two hours later, 0:13:58.160 --> 0:14:00.040 and you're giving it to them at multiple times. That 0:14:00.080 --> 0:14:02.920 they're throwing up multiple times, you don't realize that it's 0:14:02.960 --> 0:14:06.079 related or an allergy. Almost think it's acid reflux or something. 0:14:06.160 --> 0:14:11.000 Right like at first, like the vomiting is so bad, 0:14:11.200 --> 0:14:13.440 you do go into the emergency room, especially as like 0:14:13.440 --> 0:14:16.040 a first time parent, um, and sort of time and 0:14:16.080 --> 0:14:21.480 time again, Um, the emergency room is not connecting it 0:14:21.520 --> 0:14:23.800 as well because it's so delayed in the sense of 0:14:23.800 --> 0:14:26.000 its two hours later, and a lot of times it's 0:14:26.040 --> 0:14:28.560 not within the first even a few ingestions. I've seen 0:14:28.600 --> 0:14:31.560 it within the first ten ingestions, for example, So like 0:14:31.640 --> 0:14:33.920 the first five times, like okay, you sort of marked 0:14:33.960 --> 0:14:36.000 that food off your list, You've done it. You don't 0:14:36.040 --> 0:14:37.880 even think about it. You're now then combining it with 0:14:37.920 --> 0:14:40.480 other things. You know, the kids thrown up a few times. 0:14:40.520 --> 0:14:42.040 You go into the emergence room. Just seems like a 0:14:42.120 --> 0:14:45.520 virus every single time. So I felt really lucky that 0:14:46.360 --> 0:14:48.480 we had is about throw up twice and Dr le 0:14:48.560 --> 0:14:50.120 knew exactly what it because you already had it all 0:14:50.120 --> 0:14:52.720 in place. I had my system in places, so I 0:14:52.760 --> 0:14:55.280 was like, Okay, now I'm calling our nutritionist because we 0:14:55.680 --> 0:14:58.760 started working with a nutritionist for Ali because she being 0:14:58.800 --> 0:15:02.200 allergic to eggs at the time. Dairy. You want to 0:15:02.240 --> 0:15:05.480 make sure it's getting the food exactly and the nutrients 0:15:05.480 --> 0:15:07.520 she's supposed to be and she's tiny and so she 0:15:07.640 --> 0:15:10.240 wasn't gaining weight, so we needed to really be on 0:15:10.320 --> 0:15:11.880 top of it and make sure that she was going 0:15:11.920 --> 0:15:15.680 to thrive despite her food restrictions. So and it was 0:15:15.680 --> 0:15:17.760 funny because the day before I had a conversation with 0:15:17.800 --> 0:15:20.880 the nutritionist and she was like, Isabella is not Ali. 0:15:21.040 --> 0:15:23.320 You have to like take steps and start feeding her 0:15:23.640 --> 0:15:26.880 more proactively and not be so afraid of things. And 0:15:26.920 --> 0:15:29.840 then I called her back. You were like you were wrong, 0:15:30.280 --> 0:15:33.520 and and then I called her back the next day. 0:15:33.560 --> 0:15:36.760 I'm like, so Isabella has f pies and she's like, 0:15:37.360 --> 0:15:39.800 oh boy, She's like, now we need a whole new 0:15:39.840 --> 0:15:42.600 game plan. So at least felt fortunate that I had 0:15:42.680 --> 0:15:45.240 that support system in place, because it's when you find 0:15:45.280 --> 0:15:47.360 out about it at first, and you don't know anything 0:15:47.360 --> 0:15:49.280 more than just kind of the stuff that you're afraid of. 0:15:49.720 --> 0:16:02.000 It's very overwhelming. Oh, I want to ask you, um, 0:16:02.240 --> 0:16:05.720 so do you recommend Dr Lee, do you recommend when 0:16:05.760 --> 0:16:08.040 people start introducing foods like the sort of thing where 0:16:08.040 --> 0:16:10.440 it's like you do the same thing every day. I 0:16:10.480 --> 0:16:13.800 also know women who like wrote like they did the 0:16:13.880 --> 0:16:15.600 same food every single day for lunch and then they 0:16:15.600 --> 0:16:17.640 moved that food tonight and then they introduced a new 0:16:17.680 --> 0:16:20.840 food in the lunch time. Is that ye know that 0:16:20.920 --> 0:16:24.520 it has to be so I was like, this is 0:16:24.560 --> 0:16:27.760 making me nuts, especially for like fruits, vegetables, and meats, 0:16:27.760 --> 0:16:30.560 because generally they're not going to be an issue. Um 0:16:30.680 --> 0:16:33.200 for some of those highly allergenic foods, you know, I say, 0:16:33.200 --> 0:16:35.480 start with a small amount gradually increase. Doesn't necessarily have 0:16:35.520 --> 0:16:37.440 to be in consecutive days. Not really doesn't have to 0:16:37.440 --> 0:16:39.440 be at the same time. No, so maybe day one, 0:16:39.560 --> 0:16:42.200 day three, day five, day seven. The goal is just 0:16:42.280 --> 0:16:45.280 to get to a full serving, which generally I would 0:16:45.320 --> 0:16:47.640 say with peanut, it's like to teaspoons of peanut butter 0:16:47.720 --> 0:16:50.920 peanut powder, and you've done it multiple times. So normally, 0:16:50.920 --> 0:16:53.120 and I'm taking a history from a patient, that threshold 0:16:53.160 --> 0:16:55.720 for me is five times. The problem, particularly in a 0:16:55.760 --> 0:16:57.840 four six month old, is they're not getting that much. 0:16:58.000 --> 0:17:00.720 They're not getting anywhere close to two teast, So you've 0:17:00.760 --> 0:17:02.440 really got to push the amount because a lot of 0:17:02.440 --> 0:17:05.080 times that allergy is not going to be obvious until 0:17:05.080 --> 0:17:07.320 we've had enough to make it obvious, which is probably 0:17:07.320 --> 0:17:09.800 why for Ali, we didn't realize that at first because 0:17:09.800 --> 0:17:12.480 she had had so little, like a little tiny of 0:17:12.520 --> 0:17:15.720 eggs and peanuts, so it wasn't until later on that 0:17:15.760 --> 0:17:19.399 we saw her reactions. My next question for Julie is 0:17:21.240 --> 0:17:26.120 do you ever get like judge moms about because I know, 0:17:26.320 --> 0:17:29.080 as a mom of someone who's dealing with some pretty 0:17:29.119 --> 0:17:32.280 scary allergies, I've seen you as a mom in action 0:17:32.400 --> 0:17:35.119 and you have to be the advocate for your child, 0:17:35.520 --> 0:17:39.040 meaning you're asking all the other mom's questions, who are around, 0:17:39.119 --> 0:17:41.560 what's in it? Did Ali grab it? Like all that 0:17:41.600 --> 0:17:44.600 kind of stuff? Because it's on you? Um and so 0:17:44.720 --> 0:17:48.000 have you had issues with that kind of thing we have? 0:17:48.200 --> 0:17:50.600 I have to say I've been really lucky with close 0:17:50.640 --> 0:17:54.200 friends and our community who understand that you know, this 0:17:54.280 --> 0:17:56.920 is serious and important, and especially our close friends who 0:17:56.960 --> 0:17:59.680 know everything that kind of we go through regularly, they're 0:17:59.680 --> 0:18:03.040 more apportive about it. It gets harder as there's school 0:18:03.080 --> 0:18:06.000 and birthday parties and things like that where and I 0:18:06.119 --> 0:18:09.320 try very hard to not feel like I have to 0:18:09.359 --> 0:18:11.879 control what everyone else is doing, but do what I 0:18:11.920 --> 0:18:15.879 have to to protect the girls. So you know, now 0:18:15.920 --> 0:18:17.800 they can eat pizza as long as I make sure 0:18:17.800 --> 0:18:19.800 it's from a place that doesn't have egg in the dough, 0:18:19.800 --> 0:18:22.680 because sometimes they do. When we get a birthday party invitation, 0:18:22.760 --> 0:18:25.920 I'll respond yes, so excited, and then I also say, 0:18:25.960 --> 0:18:28.440 are you planning to do pizza or other food? Ali 0:18:28.520 --> 0:18:30.480 has allergy, so just let me know so I can 0:18:30.520 --> 0:18:33.680 plan accordingly. Like I don't, I don't expect everyone else 0:18:33.720 --> 0:18:36.080 to make an accommodation for us. I mean, if you 0:18:36.080 --> 0:18:38.080 tell me that you're gonna have a peanut butter birthday cake, 0:18:38.119 --> 0:18:40.359 then we're not going to go because then I can't 0:18:40.400 --> 0:18:43.520 do it. And if it's brunch and you're having eggs 0:18:43.600 --> 0:18:46.120 and like that's your scrambled eggs is your meal, then 0:18:46.160 --> 0:18:48.720 I'm not going to go. But if you're having something 0:18:48.760 --> 0:18:52.800 that has you know, eggs in it or things where 0:18:52.840 --> 0:18:55.600 you know, I kind of have to balance the balance 0:18:55.640 --> 0:18:58.440 it and also educate Ali as she gets older, because 0:18:58.480 --> 0:19:00.960 she's gonna be responsible for herself and so not that 0:19:01.000 --> 0:19:02.879 I would ever leave her to her own devices at 0:19:02.880 --> 0:19:05.919 this point. But she's she's pretty good. I mean, she 0:19:06.080 --> 0:19:08.760 just turned three, and she knows what she's allergic to. 0:19:08.880 --> 0:19:12.240 She knows what Isabella is allergic to. She knows there's 0:19:12.280 --> 0:19:14.640 a song that she sings that has her rules of 0:19:15.160 --> 0:19:17.399 what to do and liked her this song Did you 0:19:17.440 --> 0:19:24.120 write this? Daniel Tiger? Daniel Tiger and three? Or what's 0:19:24.119 --> 0:19:25.880 the song? Can you sing it for us? Is a good? 0:19:25.960 --> 0:19:31.119 Oh my god? No? Is it like I can't eat um? 0:19:31.200 --> 0:19:34.760 What are her ones again? Eggs and dairy and she 0:19:34.800 --> 0:19:37.600 can do darry now. I grew out a dairy and 0:19:37.760 --> 0:19:41.040 I can have that now. But she has these, she 0:19:41.400 --> 0:19:43.400 has the tools and Daniel Tigers. It's basically the song 0:19:43.400 --> 0:19:46.640 in Daniel Tiger has three rules in it, Um, don't 0:19:46.640 --> 0:19:49.480 eat the food that you're allergic to, ask before you 0:19:49.520 --> 0:19:51.760 eat something new, and if you don't feel well till 0:19:51.760 --> 0:19:54.679 a grown up. And so Ali knows those rules and 0:19:54.760 --> 0:19:57.159 so she will be somewhere, you know. She was talking 0:19:57.200 --> 0:19:59.760 to her other best friend who turned three the other 0:20:00.160 --> 0:20:02.639 and her friend was like, Ali, I'm going to have 0:20:02.680 --> 0:20:05.840 a frozen cake at my birthday, like so excited, and 0:20:05.920 --> 0:20:09.879 Ali goes, that sounds great. Does it have eggs and peanuts? 0:20:09.880 --> 0:20:12.200 Because I can't have eggs and peanuts And her friend 0:20:12.320 --> 0:20:15.639 was like, I don't know. Like her friend was like, 0:20:16.040 --> 0:20:19.440 but so I have in my freezer a bunch of 0:20:19.600 --> 0:20:22.399 cupcakes and cookies that are safe for Ali that I 0:20:22.440 --> 0:20:25.080 will defrast And I always tell Alle, I say, oh, 0:20:25.160 --> 0:20:27.960 today So and So's birthday, there's gonna be cupcakes. She'll 0:20:27.960 --> 0:20:29.880 say did they have eggs and peanuts? And I say 0:20:29.920 --> 0:20:32.320 they do, so we can't eat them, And then say 0:20:32.400 --> 0:20:34.960 I'm going to bring one for right And she's excited 0:20:35.000 --> 0:20:37.840 by that. So she's she's really good about it so far. 0:20:40.320 --> 0:20:42.520 And I love Daniel Tiger. Oh my god. Yeah, we 0:20:42.560 --> 0:20:45.440 are big fans of Daniel Tiger. Now, UM, I was 0:20:45.480 --> 0:20:48.320