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School and Allergies, Asthma

Food Allergy, Teens: The Danger Years

Recent medical studies have confirmed what many parents long suspected: teenagers’ brains are wired differently. In fact, the prefrontal cortex of the brain, the decision-making nerve center, is the last part of the brain to develop, usually not fully mature until 25.

Ham Pong says it’s a potent combination: a developing brain, raging hormones (also affecting the brain), and that unforgiving force known as peer pressure. This confluence of factors can lead to irrational behavior in a child who used to be so predictable and reliable.

“There is a feeling of invulnerability that teenagers tend to have,” says the doctor. In teens with serious allergies, “if you ask them what the risks are, they know. But are they concerned? Not so much. It doesn’t register with them.”

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KATHLEEN BLAKE is exquisitely sensitive to peanut and is also allergic to nuts, wasp stings and eggs. She also has asthma, triggered by grass and pollen. At a mature 17, she confines her risks these days to her moves on the soccer field and basketball court. The sports-obsessed student is in Grade 12 at Bishop Smith Catholic High School, the same school Trevor attends. She is one teen who is vigilant about avoiding her allergens and keeping her epinephrine at the ready in her pencil case. But she concedes that in the early grades of high school, she too, had lapses.

“I wasn’t always that serious about my allergies. Sometimes the EpiPen would be locked in my locker.” Kathleen’s attitude changed overnight in September 2003; she and all the students at Bishop Smith got a tragic wakeup call.

A Grade 8 student at their shool anaphylaxed from food that was accidentally exposed to one of her allergens in the cafeteria. She died a day later. The student was Sabrina Shannon, the teenager for whom the new anaphylaxis law in Ontario is named.

Sabrina’s death had a powerful impact on most of her fellow students, especially those who had also experienced anaphylactic reactions. “It freaked me out,” says Kathleen. “I’d never had anyone I know die of it [anaphylaxis].”

Clint Young, who recently transferred from his job as vice principal at the school, says, “the silver lining in the tragedy is that all you have to say to kids at Bishop Smith is ‘Sabrina,’ and their heads go down. It is the most powerful tool that staff there have. It’s a shame to say that it took a tragedy for us to really focus our students, but that is the same in any tragedy – whether it’s a drinking and driving tragedy or a workplace tragedy. It is a powerful thing to reflect on.”

Tragedy also led the school officials to reassess the food allergy policy. Bishop Smith has since instituted one of the most rigorous anaphylaxis plans in the country. At-risk students have a designated “buddy” – a friend who is fully versed on the symptoms of anaphylaxis and how to use an EpiPen, and who knows to get help at the hint of a reaction. Posters of the students and are in the staff room, the prep room and in the cafeteria’s kitchen.

All staff -from teachers to coaches and bus drivers – are trained on the use of the auto-injector (both the EpiPen and Twinject brands), students bring in spare auto-injectors for the office and all teachers of each at-risk student are directed to ask that student where he or she is carrying an auto-injector – whether it’s in a purse compartment, a jeans pocket or a pencil case. Trevor may have managed to evade Young’s system of spotchecking allergic students for their epinephrine “pens”, but he was still highly identified among staff as a student at risk. Kathleen’s mother, Alice Blake, finds the procedures a big improvement. “I don’t think there’s much more they could do to make it safer. Anything else would be drastic.”

Besides Sabrina’s death, Kathleen has another motivation for vigilance about her allergies. She clearly remembers what a reaction feels like – her last anaphylactic episode was at the age of 12. The reaction also made a profound impression on her good friend, Tessa Cotnam, 19, who had invited Kathleen and other friends over to her house on the day Kathleen ate a peanut-filled candy by mistake. As Alice rushed her daughter to hospital, a crying Tessa ran “to tell my parents that I thought I had killed Kathleen.”

Next: The Power of Peers

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