Food Fights: When Your Insides Turn Against You, In Some Cases It Can Lead to Death
The Debbs family whose 11 year old son Oakley went into anaphylactic shock and died after ingesting walnuts that were mixed into a cake topping back in 2016 started the Red Sneakers for Oakley foundation a year later to alert others to the potential life threatening dangers that food allergies can have. Mount Sinai Hospital is teaming up with other major hospitals in a new clinical study to examine the causes of allergies that afflict an estimated 26 million people in the US.
| 04 Mar 2023 | 02:08
Oakley Debbs was only 11 years old when he went into anaphylactic shock and died from an adverse reaction to ground walnuts that had been mixed with chocolate and sprinkled on a cake. He knew he had a nut allergy but his family had been advised that his food allergies were minor and could be treated with an antihistamine. His parents Robert and Merrill started the Red Sneakers for Oakley foundation to raise awareness about the dangers of food allergies. Photo: Red Sneakers for Oakley
The Debbs family (from left) includes mom Merrill, their daughter Olivia who was a twin to Oakley (who died from anaphylactic shock in 2016) and dad Robert. They all channeled their anguish over the death of Oakley into a foundation Red Sneakers for Oakley, which will stage International Read Sneakers Day on May 20 to raise awareness of food allergies. Photo: Red Sneakers for Oakley
Do some foods fight with you? You’re not alone. The Allergy and Asthma Network says at least 26 million American adults wheeze, sneeze or break out in hives when they eat offending foods, most commonly peanuts, tree nuts and shellfish. And in rare cases, the allergic reaction can trigger anaphylactic shock that the CDC says kills an estimated 150 to 200 people a year. Food allergies are severe enough to send another 30,000 a year to the emergency room each year.
The food allergy problem seems to start in the very first days or months after birth, showing up most commonly as a colicky infant. Mt. Sinai allergists want to know why. Along with cohorts from Johns Hopkins, the University of North Carolina at Chapel Hill, Northwestern, and National Jewish Health, the New York investigators have joined a five-year, 12-site project called The Systems Biology of Early Atopy (SunBEAm) Analysis and Bioinformatics Center supported by the National Institutes of Allergy and Infectious Diseases’ Consortium for Food Allergy Research.
The aim is to enroll and follow parents and children through the child’s third birthday so as to pin down early markers for food allergies and atopic dermatitis (aka eczema) and, better yet, the biological bases for the two conditions that affect nearly 8 percent and 20 percent of children, respectively. The more light SunBEAm shines, the closer medicine may come to controlling and maybe even canceling the condition. That’s an interesting possibility because while allergies that are still with you when you reach adulthood are pretty much with you forever, for some unknown reason children sometimes “outgrow” many of their early allergic reactions. That is more likely to happen with their allergies to milk, eggs, and soy and less so with allergic reactions to peanuts, fish, and shrimp.
By the way, a food allergy is different from a food intolerance. An allergy happens when your immune system reacts to proteins (antigens) in a food that trigger antibodies that swim through your body to make you sneeze, wheeze and in worst cases shut down breathing passageways and other organs. An intolerance, on the other hand, is mostly a digestive problem such as your body’s natural genetic lack of sufficient lactase, the enzyme needed to digest lactose, the sugar in milk. (Interestingly, an allergy but not an intolerance may be exercise related, bouncing up when your body temperature rises, say after that hour on the treadmill or the first fast the mile around the park. Which means you should avoid known offenders for a couple of hours before you start to walk, run, or play.)
Either way, a food allergy is more than a simple itch. As Supinda Bunyavanich, Mount Sinai Professor in Allergy and Systems Biology and Principal Investigator of the Center explains, “Individuals with food allergies are at daily risk for potentially life-threatening conditions, including anaphylaxis following ingestion of a food to which they are sensitized. And those suffering from atopic dermatitis live with chronically inflamed skin that can cover a significant proportion of their bodies.”
Of course, there are several ways to treat a food allergy, primarily with antihistamines for digestive issues, hives, and sneezing and a runny nose. The less-familiar bronchodilators such as Advair and Symbicort are inhaled to widen breathing passages. But the hard and fast rule remains to completely avoid the offending food. That can take some doing as you scroll through multi ingredient food labels or scour a restaurant menu only to find, say, peanuts included as a protein source or eggs smoothing your salad dressing. Nonetheless, it is a vital chore that can make the difference between life and death.
Sometimes, alas, there are simply no guidelines. Seven years ago an 11-year old Florida boy name Oakley Debbs with what the family was told were “minor” nut allergies inadvertently consumed a slice of pie with ground walnuts hidden in the topping during a family Thanksgiving weekend in Maine. From the initial bite and flaver, he worried he had probably consumed some form of nuts and immediately informed his parents who gave him Benadryl, as their doctor had recommended for someone with a “mild” food allergy. Initially he seemed to be fine and as went outside to play with his cousins. As he was getting ready for bed that evening, he complained of a stomach ache then he began vomiting and was having trouble breathing. His last words before he collapsed unconscious into his father Robert’s lap was, “I don’t want to die.” An ambulance arrived within 15 minutes but his heart had stopped and though they gave him CPR, it was too late, he suffered a fatal anaphylactic reaction when his heart stopped. Even though it was revived via CPR, vital organs had gone without oxygen for too long. He died that night. To mourn the loss of their son and protect others from a similar fate, Robert and Merrill Debbs, Oakley’s parents, created the Red Sneakers for Oakley Foundation. “The first time the Debbs family heard the word “anaphylaxis” was in the emergency room on Oakley’s final night. At that point, it was too late,” the web site explains.
As their web site now explains, “Antihistamines (Benadryl), do not stop systemic symptoms, and that epinephrine is the ONLY effective first-line treatment of anaphylaxis.”
The epinephrine, commony called an epi-pen, to treat reactions to severe food allergies or violent reaction to bee stings or other bug bites has to be jabbed immediately into a victim’s thigh. If administered at the outset of an attack, it works quickly to improve breathing, stimulate the heart, raise a dropping blood pressure, reverse hives, and reduce swelling of the face, lips, and throat, according to WebMD, but the site also cautions the patient still should get immediate medical attention as the positive lifesaving effects can wear off.
This year on May 20, the foundation will coordinate International Red Sneakers Day, inviting everyone everywhere to wear red sneakers to raise awareness about the dangers of food allergies and the need to arm schools, sports facilities and caregivers with epinephrine (epi-pen) injectors.
For more info on that go to: www.redsneakers.org
To learn more or register for the clinical study go to SunBEAm: https://clinicaltrials.gov/ct2/show/NCT04798079
“The first time the Debbs family heard the word “anaphylaxis” was in the emergency room on Oakley’s final night. At that point, it was too late.” Red Sneakers for Oakley, a foundation started by the parents of Oakley Debbs who died from a food allergy.