Monday, May 12, 2014

FeNO Testing - Asthma Management Tool

Disclaimer: I am not a doctor, nor a medical professional. I am merely sharing information on a test that I had done for my daughter, to assess her asthma management protocol.  Please consult a doctor with any medical questions or concerns, thank you!

As I wrote about in my post about Qvar, I have been pleased with its effects.  I had heard about FeNO testing, and asked our allergist about having it done for my daughter, as a way to gauge her progress.

What is FeNO testing?  FeNO is short for "Fractional Exhaled Nitric Oxide."  According to Wikipedia, "Nitric oxide (NO) is a gaseous molecule produced by certain cell types in an inflammatory response."  It can be used to determine whether symptoms shared by other conditions can be attributed to asthma, and can also give an indication of whether the patient would benefit from Inhaled Corticosteroid (ICS) treatment.  Another use of FeNO testing is to gauge how well a course of treatment is going.

We pursued it for the latter reason, since my daughter had been on Qvar for over a year.  The device used was the Niox Mino.

The Niox Mino
At our appointment, they had my daughter, who is 5 1/2 years old, sit in front of the machine, which was placed on a desk.  They attached a disposable mouthpiece and instructed her to place her lips on it and take a deep breath in from the machine, until an indicator told them it was good and then she was told to breathe out for about 10 seconds.  It took us a few tries, but she got it and they were able to get a good reading.

This process was different and not as "exciting" as the Lung Function Test she had done, previously, where she was able to blow out birthday candles and make a balloon float across a waterway.  There isn't really a "kids' version" for the FeNO test, but it was over and done with rather quickly, so that was not an issue.

We waited in the room for a bit and the allergist came back and said that her results were just fine.  Her reading was 6 ppb. (Yay!)

Here's what is listed on the literature available on their site, for a reading below 20 ppb, for a child under 12 years of age, who is asymptomatic:
  • Implies patient is adherent to treatment 
  • Consider dose reduction, or in case of current low ICS dose, consider ICS withdrawal altogether (repeat FeNO 4 weeks later to confirm this judgement; if it remains low, relapse is unlikely)
We are definitely adherent to the treatment plan.  I can't say we never miss a dose, but it is a rare occurrence.  She is currently on two 40mcg puffs, twice daily.  Though the allergist did not bring it up, we could consider lowering her dose and/or tapering off, but I am not going to pursue that, just yet, and we will discuss it at her next appointment.  

My only minor concern with taking the test is that my daughter sprouted two very small pink spots on her face after the test and the thought occurred to me that she had to take in a deep breath from the machine.  I was concerned about "shared air", so I called the makers of the Niox Mino.  They said that the internal chamber has an "NO scrubber" that removes NO particles from the previous test (for up to 100 uses, I believe) and the mouthpiece has a filter on it, so they didn't think allergenic particles would be an issue.  My daughter's spots may have been unrelated and nothing more came of it, but I thought I would mention it, since it was part of our experience.  

In any case, I am glad that I had the test done and it was comforting to receive a value only one tick above the minimum detectable level.  Whether this proves to be because the Qvar is doing its job, or because she has improved to the point of no longer needing the Qvar, remains to be seen.

Has anyone else had FeNO testing done?  Did you find it helpful?  

Saturday, April 19, 2014

Freedom Foods - Allergy-Friendly Cereals for Multiple Food Allergies

The path to trying Freedom Foods cereals started with a friend's craft idea that involved "Cheerio"-type cereal.  I remember having read about Freedom Foods' "TropicOs" a long time ago and went on the hunt.  They were not available at either Whole Foods location, but I was able to find them at another local store - H-E-B Central Market!  I did my due diligence, contacting the company to inquire about the various cereals to see which ones my daughter could try.  They sent me some coupons and off I went in search of safe cereals!

After getting to the cereal aisle and seeing so many options, I actually got a little teary.  It isn't often that we, parents of multiple food allergic children, are presented with a bevy of options!

I couldn't get all the options in frame!
I loaded up my cart like I was at Costco!  Here is a closeup of one of the boxes and an informational image from one of their emails:

I don't think I've ever seen a cereal free from so many different allergens (it's free from more, but they don't fit on the front of the box!)  I also love that they use non-GMO ingredients.  This company is based in Australia, where the incidence of food allergies is even higher than here in U.S.  I wish I could see these products on every grocery shelf in the U.S.  They are on the higher-priced end, for cereal, but I feel that it's worth it for the higher-quality ingredients and the fact that they test every batch for certain allergens, every time!  They are serious about this stuff, and I appreciate it.

These cereals would also be great for anyone - not just those with allergies.  Why save $2 buying junk cereal, when it's going to "cost" your child's health and wellness, down the road?  There are no artificial colors or flavors, which is another added bonus.  (Though I consider it a requirement...)  

They have more varieties, but these are the ones carried locally.
Of the course of several days, my daughter tried out the various cereals.  One of the ingredients in some of the cereal varieties is sorghum flour, which is new to her diet.  I think that ingredient made her a little itchy, but it was not a major issue.  As fun and flavorful as the TropicO's and Maple Crunch cereals are, my daughter actually prefers the Rice Flakes the most!  She will eat the Corn Flakes, too, but she has a definitely preference for the Rice Flakes.  So, it's up to me to finish off the others. ;)

So, if you're looking for an allergy-friendly cereal option, consider checking out the Freedom Foods' line.  As always, please be sure to contact them, directly, to check if their products are safe for your child's particular needs.  I am just so happy to have another item to add to the "CAN HAVE" list!

Note:  I received coupons after I asked about cross-contact possibilities, but I did not receive any compensation for this post.
All opinions are purely my own, as always!

Sunday, March 9, 2014

Food Allergies: Traditional Chinese Medicine, Western Science, and the Search for a Cure

by Henry Ehrlich

Before covering this enlightening book, I'd like to take a moment to thank the author, Henry Ehrlich, whom I am lucky and honored to call a friend, for writing it. I think the author is worthy of discussion, along with the subject. I hope I am not overstating, but I believe Henry Ehrlich was born to write this book. Son of an "English teacher turned lexicographer," and cousin to the perennially top-rated New York allergist, Dr. Paul Ehrlich, whose father was a pediatrician, Henry is genetically predisposed to be the ideal storyteller and information liaison for our allergic community. He is able to distill information in a way that is engaging and accessible, while not failing to deliver the technical specifics of the complicated landscape, which is the human immune system.  
Henry displays the markers of his "gene expression" as the editor of and co-author of the book by the same name. He works tirelessly, providing top-notch content through his website, and acting as a guide, assisting us in our quest for reasoned wisdom from seasoned professionals. He is active in our community and shows a genuine, passionate interest in this most intriguing and perplexing of fields. I could not imagine anyone that would be better-suited to cover this subject, that is so personally and vitally important to our allergic children's futures.  (Even if we find that this particular treatment does not work for everyone, the lessons-learned will contribute to future scientific endeavors.)

Now for my discussion of the book, itself...

The cover imagery for the book is based on the concept of yin and yang, which Wikipedia describes, as follows: (emphasis mine)
In Chinese philosophy, the concept of yin-yang, which is often called "yin and yang", is used to describe how opposite or contrary forces are interconnected and interdependent in the natural world; and, how they give rise to each other as they interrelate to one another.
Yin and yang can be thought of as complementary (instead of opposing) forces interacting to form a dynamic system in which the whole is greater than the parts. Everything has both yin and yang aspects, (for instance shadow cannot exist without light). Either of the two major aspects may manifest more strongly in a particular object, depending on the criterion of the observation.
I cannot think of a more fitting characterization of the path that Dr. Xiu-Min Li has taken with her work at Mount Sinai. The book takes the reader through Dr. Li's history as a physician and researcher, the basics of food allergy, and a description of how Dr. Li came to focus her efforts on retraining the sometimes savage beast that is a misbehaving immune system. It chronicles the early trials on mice (murine models), and the initial human safety trials. The process for human efficacy trials is discussed, but the results of said studies have yet to be published. There are even case studies from patients that have seen Dr. Li in private practice and an account of participation in a clinical trial for FAHF-2. (Those who see Dr. Li in private practice are not taking FAHF-2, but an individualized dietary supplement treatment protocol, based on their particular needs.  FAHF-2 an investigational drug undergoing clinical trials and is not yet available for dispensation to the population, at large.)

I find this book to be an excellent reference for the skeptics, who might tilt a suspicious eye at anything "Eastern" or involving "herbs." Set any preconceived notions aside. This book may be about soft plants, but it involves hard science, and should satisfy even the most exacting scientific researcher.  It will help quiet the qualms of the nervous naysayer.

As I read through this book, I felt a renewed sense of hope. I know my graphic below may seem over-the-top, but it genuinely reflects the emotions I felt while reading. We do not often get to feel lucky, in this situation (though I try and take stock of the silver linings), but reading this book made me realize that we are extremely lucky to have such an amazingly brilliant, dedicated, caring, conscientious scientist working on our children's plight.

Original book image: "HOPE" added by Selena Bluntzer.

Henry Ehrlich's book, 
is now available for purchase from the following sources: - Kindle Edition (coming soon) - eBook Edition
Barnes & Noble - Paperback and Nook editions

Please also check out my review of one of Henry Ehrlich's other publications:

Disclaimer: I have not received any financial compensation for this book review. I received an advance book draft, but have since purchased multiple copies, with my own funds. links are affiliate links, but as always, all opinions are my own.