Food allergies among children is a growing public health concern in the United States. I have been a nurse since 2012, and have worked with children of all ages with a number of different conditions. However, I do not think I have ever been more nervous than what I was on January 31, 2017 when my three-year-old son had an allergic reaction after eating a single cashew. This is a day that I will never forget, because I felt like I did so many things wrong as a mother and a nurse.
At about 4 o’clock in the afternoon, I was finishing my shift at Mercy Pediatric Clinic when I got a phone call from my father apologizing for giving my son a cashew. I did not think anything of it. Jaxon was three years old and had no problems with eggs, peanuts, and peanut butter, so I knew—or so I thought– that he did not have any allergies. I asked how he was doing and my father informed me that after swallowing the cashew, Jax stated “that peanut was hot and put boogers in my throat.” Knowing my son, I figured he did not know how to describe a salty taste and he had been fighting a cold. I told my father not to worry about it, but he should give me a call if anything else took place.
When I left work about 45 minutes later, I called my mother to see how Jaxon was doing. She stated that she was at my house with him, but was going to take him to her house so that she could keep a closer eye on him. I grew a little more concerned and asked what was going on. Jaxon was now getting some redness around his mouth, coughing, and breathing a little bit faster than normal. I agreed with my mother and told her that I would get there as soon as possible. I then hung up, and called one of providers from our clinic to see how long I should keep a close eye on my son since he swallowed and did not vomit the cashew. However, she did not answer.
As soon as I hung up, I was receiving another phone call from my mother. The first words out of her mouth were, “I don’t want you to worry.” I think it was then that I stopped breathing because I was nervous to hear what was going to come next. She informed me that Jaxon was now having a little difficulty breathing, having some swelling around his mouth, and wheezing so she was going to drive him down to the ambulance building since they keep a paramedic on call during the day.
I don’t think I have ever been so scared in all my life. My son was having an allergic reaction, I was not there, and I had ignored all the warning signs that everyone else had noticed. I tried to stay in control since I was driving, but I would be lying if I said my foot did not push harder on the accelerator. I grabbed my phone and called my husband. Through thick tears I asked my husband to get to the ambulance building as quickly as he could because Jax was on his way there, and I was not going to be for about 5 more minutes. All he said was “yes” and then the line was dead.
When I pulled up to the ambulance building, I saw a member of the ambulance crew running into the building, and my husband was standing in the door way. When I opened my car door all I heard was, “Do you want him to have to have epi?” I think my heart froze in my chest. I have no idea if they were talking to me or the man running ahead of me, but I yelled back, “well if he needs it!” When I got into the building, all I wanted to do was see my son. I looked inside from the side door and I could see the side of his face, but that was not good enough. I did not ask or wait for permission to get into the rig with him. I went to the back of the rig and opened both doors. I was greeted by a little boy with a nebulizer pipe in his red and swollen mouth, his hands were swollen, his shirt was off, his face was blank, and his eyes were as big as silver dollars.
His general appearance was hard for a mom to see and it took everything that I had, but I took a deep breath knowing that the last thing he needed was to see how scared I was. I threw a big smile on my face and asked “what’s up buddy?” His response was a muffled “Hi.” At this point, no epinephrine had been given. I was being told that he was not having an anaphylaxis reaction, so epi was not needed, and he was clearing up with the nebulizer treatment. I was hearing what they were saying, but all I could do was watch my son take deep breaths. I questioned their comment of this not being an anaphylaxis reaction in my head, but was not going to argue since he was doing well with their course of treatment. I was asked several times if I wanted him transported by ambulance, but I did not know. I kept hearing the paramedic tell his partner that I was a pediatric nurse, and to let me think things through and decide on my own. In all honesty, I wanted them to make the decision for me; I could not think like a nurse when my child was sitting on an ambulance cot on a continuous nebulizer treatment.
After his second nebulizer, I listened to him again and he was clear, but I knew he was going to need steroids, and possibly nebulizer treatments through the night. I felt the best option was to take him to the clinic where I worked so that we would be able to get steroids and rent a nebulizer, and not have to scare him with everything that would likely take place in an ER setting. I had no question that he was going to be fine driving in our personal vehicle since he was now smiling, pointing this out around the ambulance, and asking what we were going to have for dinner. I also knew that if needed, my husband would find his inner NASCAR driver skills and get us there quickly.
The drive to the clinic was uneventful, but I quickly realized that I had made the wrong choice with his course of treatment. When we got into the exam room, Jaxon lifted his shirt and asked, “what are these balls on my belly mom?” I looked at my son’s abdomen and he was covered neck to toe in hives. At the same time I’m noticing the hives, the doctor walked into the room and all I could do was look at her blankly and say “I messed up… we shouldn’t be here… I made the wrong decision!” The doctor informed me that we were fine, and she began assessing him. After listening to his chest and his throat, she decided that the emergency room would be the best spot. She informed us that his lungs were clear, but she was concerned with his throat being tight and did not want this to become an issue. So, on we went to the emergency room.
When we arrived at Mercy’s ER, we were taken back pretty quick and placed in a room and met with a nurse and doctor. We gave them a rundown of the events of the evening and then the doctor began her assessment. And wouldn’t you know it, his hives were looking better and he was now clear in his lungs and throat. Working with children my entire career, I showed her the pictures that I had taken earlier of his hives so she did not think we were going over the edge on how badly covered he was earlier. She agreed that we should go ahead and start an IV so that he could be treated with steroids and IV fluids. After two hours, we were finally on our way home with a very tired little boy and a set of parents that couldn’t believe this had happened.
The next day, Jaxon stayed home from daycare and I called off from work. I was not ready to have that little boy out of my site even after sleeping in his room with him all night. We were seen in the Mercy Pediatric Clinic for a follow up appointment, and then by an allergist. Both providers recommended that Jax have a blood test done to test for allergies against all tree nuts as well as coconut, and we found out that he is allergic to all tree nuts as well as coconut. An answer I already knew, but not what any parent wants to hear for their child. Unlike other allergies, children do not grow out of or become less sensitive to tree nut allergies. This is something that my son will have to deal with for the rest of his life.
As I stated in the beginning, food allergies are a growing problem in the United States. There does not have to be a family history and just because your child has been fine with a similar food, does not mean they won’t have issues with another. Do not be afraid to use your resources such as on call lines with doctor offices, your pediatrician, and if you are really nervous 9-1-1. No question is a “stupid” question and you are likely not the first person to wonder the same thing. Take it from me, a pediatric nurse and mom!
Special thanks to Stephanie Steffen, one of the amazing nurses at Mercy Pediatric Clinic. We are so grateful to have them as partners with ICMB, and we encourage you to check out their website and Facebook page for more information!