Teens and Anaphylaxis

by Lois King, AAIA Volunteer, Ottawa, ON

Relying on Awareness, Avoidance and Action to achieve independence safely

Parents of anaphylactic children have greatly benefited from the work of many AAIA volunteers over the years in raising awareness in schools and daycares, at camps and recreation facilities, and with groups providing activities for children. Our children are now much safer than they used to be in these types of environments. But as the child grows up, it is less and less possible to protect him from allergens and other hazards. A teen wants and indeed needs to hang out with peers, go on group expeditions to the movies, parties, school dances, camping trips, school trips, and so on. Teens must learn to recognize and avoid dangerous practices and situations for themselves and become capable of anticipating and preparing for the challenges these activities may present. We as parents must teach him how to do this, despite any misgivings we may have.

In the same way that some provinces now issue graduated driver's licenses to teens as they master and prove their ability to operate a car safely, we must gradually turn over responsibility for their health and safety. After all, by age 18 they may very well be leaving home for an out-of-town job or education. In addition to knowing how to do laundry, clean a bathroom, manage money, drive safely, go to bed on time, know about safe sex, and eat a healthy diet, our teens must be ready to assume the responsibility of managing their allergies.

This is a lot for our children to learn but much of it can be done gradually from very early on. For most teen issues, there is lots of advice in books, in the media, and from society in general. We are still feeling our way with anaphylaxis, and the teens of today are in some sense pioneers. What follows is by no means the last word on how we should proceed, but it is a start.

AWARENESS

As with any chronic condition, it is the responsibility of the parents to provide relevant INFORMATION to the teen. Remember, however, that this should be started long before parents begin to lose their credibility - from the time of diagnosis and continuing as the child's understanding develops.

Parents and teens should make a special effort to COMMUNICATE with each other about how they will treat each new challenge. Plans should be worked out jointly and assessed afterwards. Every new situation is a learning experience for both parties. Encourage feedback from your teen to raise your own awareness about the world he/she lives in. It's probably very different from the world you remember as an adolescent.

Parents can help a teen have a POSITIVE ATTITUDE in dealing with restrictions. A private, matter-of-fact comment about how well a situation was handled will give the teen a boost without seeming to make an issue of it.

Parents should be aware of, and acknowledge, some of the STRESSES which the teen may face:

• having to be responsible beyond her/his years;
• having to curb spontaneity and impulsiveness (a big one for teens!);
• feelings of resentment due to repeated questions, teasing, dares, or charges of being "spoiled";
• fear or resentment of being conspicuous;
• fear of being defined by the allergy;
• issues related to dating/romance - being accepted, having the allergy treated seriously, "how can I kiss him/her?", other limitations imposed on a serious boy/girlfriend;
• worry about being able to cope on his/her own upon leaving home;
• fear of having an accident;
• fear of death.

AVOIDANCE

• Teach the teen to read food labels and assess the safety of a product.
• Give the teen practice in shopping for and preparing appropriate foods which are as close as possible to "regular" dishes that other teens eat. Serve these when his/her guests come to the house. Some teens enjoy hosting complete dinners for their friends and it's a great way to get them interested in learning to cook.
• Encourage the habit of carrying an extra snack and drink along. Hunger may strike unexpectedly, or plans may change, and a hungry teen is more likely to take a risk.
• Identify some "safe" snacks that are readily available at a corner store even if their nutritional value is zero. Do the same for items which might be found at friends' homes: fruits, vegetables, chips or pretzels, etc.
• Discuss cross-contamination and how it can happen in an unprotected environment. Discuss how to minimize this problem so that the teen can confidently enjoy outings with his/her friends.

MOST ACCIDENTS HAPPEN WHEN THE USUAL ROUTINE IS UPSET!

Parties and special events are always more risky than an ordinary day at home or at school. Inform your teen of the special danger of alcohol in reducing inhibitions and in enhancing allergic reactions.

ACTION

It is the responsibility of the teen and his/her parents to ensure that emergency medication is always available. At this age, it should be automatic to the teen and discretely monitored by the parents. For excursions and trips without parents, Mom can (if she feels she must) include it in the "nag list" - "Do you have your hat, sunscreen, snack, money, Epi-pens, puffers, health card, extra sweater?"

Parents and teens should occasionally check to see that they still agree upon what the emergency plan is, and determine if any changes are advisable.

Teens should be involved as much as possible in informing their school and their individual teachers of their allergies, and in obtaining any forms to be completed by parents. No teen does this willingly, so parents must still check every year that it has been done, especially in a large high school.

Negotiating with a teenager

Try not to say "no" to a proposed activity on the basis of the allergy, but instead encourage the teen to identify any difficulties. You can ask: "How could you work around this problem?" "Where do you think you might need help?" and "How important is this activity to you? Is it worth the effort required?" The principle is the same whether it is a trip to the movies or a school trip to Europe.

from Allergy & Asthma News, Issue 3 2005