Medications for Allergy

While spending the day with her grandmother, one-year-old Natalie Kalitsi suddenly began acting strangely. First the little girl grew very sleepy; then red blotches broke out all over her body. She seemed to struggle to breathe. An ambulance rushed her to the hospital, where doctors questioned her grandmother: What had Natalie eaten that day?

Nothing unusual — but Natalie did have her first bite of fish. That small bite of fish was enough to almost kill her.

Today Natalie is an active, happy three-year-old with big brown eyes. Like other toddlers, she loves going to preschool, playgrounds, and birthday parties. But wherever Natalie goes, a special shot that contains powerful medicine always follows. If Natalie accidentally eats seafood, peanuts, or dairy products — all of which give her allergic reactions — the shot will help her breathe until she can be taken to a hospital.

“At first it was hard getting used to, but it’s routine now,” says Gale Kalitsi, Natalie’s mother. “Everywhere Natalie goes, I pack a special lunch box for her — it’s like a game. We even do it at birthday parties — or when she goes to her cousin’s house.”

All parents try to look out for their child‘s safety, but being the mother of a severely allergic child means that Gale must be extra careful. Before Natalie began to attend a preschool near her home in Bethesda, Maryland, Gale called meetings with her teachers and the school’s director to make sure that they understood how serious allergies can be.

“Until you have an experience with food allergies, you don’t know how deadly allergies can be,” says Gale. “In Natalie’s case, it can close down her air passages and kill her. Everyone who comes in contact with her needs to be able to read food labels. And because children like to share food, or they may kiss her and have peanuts on their lips, we need to be especially careful.”

So a special rule was set for Natalie’s classroom: No students could bring in peanut-butter sandwiches for lunch.

By now. Gale is an expert at reading the labels of everything Natalie eats, but in the beginning food labels were filled with confusing words. For example, Natalie is allergic to milk, but how could Gale know that many unfamiliar-sounding ingredients such as “casein” or “whey” contained milk? Gale says that an organization called the Food Allergy and Anaphylaxis Network (1-800-929-4040) has been an enormous help and has even provided her with special note cards listing ingredients that aren’t safe for Natalie.

Gale and her husband have learned so much about food allergies that when their second daughter was diagnosed with an allergy to wheat, they felt confident of their ability to handle her special needs. “You really need to become an educator and a campaigner for your child,” says Gale.

But Gale and her husband recently learned they’re not the only ones watching Natalie’s diet. Now that Natalie is growing up, she can speak up for herself.

“At the age of three, Natalie can tell you what foods make her sick, and she can tell you what she can have,” says Gale proudly.

Every day when Erminia Cardenas goes to work, she performs a simple test that can change the lives of her patients.

Cardenas, who is a licensed vocational nurse in Houston, uses tiny prongs to prick the skin on her patients’ backs. There are 80 prongs in all, and each contains something different — from grass pollen to mold to cat dander.

The procedure is often the first step in unlocking the mystery of what is causing her patients’ unexplained sneezing fits, watery eyes, and even difficulty in breathing — all symptoms of allergies. For Cardenas’s patients, the test is fascinating: Could the cause of all their problems be something as simple as the goose-feather-stuffed comforter on their bed, or could the culprit be a type of tree that lines the streets in their neighborhood?

If one or more of the pricks begin to itch, swell, or turn red, Cardenas has the answer. Even though the prong pricks cause a bit of discomfort, finally learning the cause of their difficulties can be a huge relief to patients.

“We have one patient, a young man who works on the golf course at a country club, who came to us because he had started sneezing every time he went out on the course,” says Cardenas. “When we tested him, he was allergic to all the grasses and tree pollens that surrounded him on the golf course — he was a mess, poor thing! He said, ‘I can’t give up my job,’ so we put him on shots and he’s doing very well.”

Cardenas, whose ancestors are Mexican, considers herself lucky because she doesn’t have any allergies. Neither did her parents, which was fortunate, since they were migrant workers who spent a lot of time outdoors in the cotton fields. As a baby, Cardenas traveled with her parents to the fields. “If they ever had allergies, it wasn’t severe — not like what the patients I see have,” she says.

But her son suffers from watery eyes and sneezing when the season changes every year from summer to fall. The good news is that, with treatment, even people who suffer from severe allergies can control their symptoms.

“Some of our patients can even give themselves shots at home, if their symptoms are milder,” says Cardenas.

Cardenas, a mother of three who returned to nursing after taking time off to raise her children, sounds positively maternal when she talks about her patients. She worries that many of the patients she sees — who range from airline pilots to lawyers to fellow nurses — have such demanding jobs that their symptoms can worsen because of the pressure. “Sometimes because they’re so stressed at work, they don’t take care of themselves,” she says. “I think stress can aggravate allergies.”

So can the change of seasons — and Cardenas, who talked about her job on a beautiful March day when the spring’s first flowers were pushing through the ground, knew she would be in for a busy time at work.

That’s just fine for Cardenas. After all, she knows that after patients come to her office and receive a proper diagnosis and treatment, they might actually be able to sit outside and take in nature’s beauty — without suffering from a sneezing fit.