Anaphylaxis: Who Gets It?

When I was a kid, I yearned to reach that the mark that, in my family, would make me a "big kid."  That mark was my grandmother's height.  Short with bent shoulders, a face lined with the years, and white hair that looked like cotton candy.  Grandma was the yardstick that my cousins and I used.  Every time we went for a visit, a crowd would gather 'round as Grandma took off her heels to stand next to me for a measurement.  I don't recall how old I was when I finally hit the mark, but I do remember feeling an odd sense of pride, as though I had somehow willed myself to reach the her height.  And every time I saw her after that, she would remind me of a time when she had to look down to see me rather than up.

Every family has its measuring stick.  In my father's family, that was Grandma.

For a long time, my younger son seemed to think that having food allergies was typical.  While he has a ton of food allergies related to his EoE, he has never personally experienced anaphylaxis.  For a long time, I tried to convince him that he never wanted to!  But to the little brother that always had to be quiet at the allergist's office;  the one that didn't get to ride in the ambulance;  the one that didn't get to carry an EpiPen, not having life-threatening food allergies was almost like a punishment.  As the only member of our family not to have a need for epinephrine, he felt left out.  He used to ask me all the time when he was going to get to carry his own EpiPen, as though it was some kind of measuring stick.

He thought that carrying an EpiPen was a goal to achieve. 

So I was a little surprised at his recent response to a commercial for EpiPen.

 A soothing voice says, "Avoid allergens first.  Carry EpiPen always."  

We know. (Said without emotion, as though he was really saying blah blah.)

"EpiPen auto-injectors are for the emergency treatment of life-threatening allergic reactions, anaphylaxis, and for people who are at increased risk for these reactions."

We know...  (Mildly annoyed, as though wondering who wouldn't know this.)

"EpiPen is injected into the outer thigh..."   

We KNOW that already!

And in that moment, I was assured that he is well on his way to being a big kid.  He GETS it!  Epinephrine is used to treat anaphylaxis...a life-threatening allergic reaction that requires immediate medical intervention.  Epinephrine is not a license to eat allergens, and it's not a replacement for seeking medical assistance.  He's got it!

No.  He doesn't need to carry an EpiPen.  Epinephrine is not a measuring stick.  It is a life-saving medical device that is used to treat anaphylaxis to keep someone alive so they can receive intervention from medical professionals.

Now when are we - the adults charged with keeping so many little lives going...  When are we going to get it?

Why Schools Need Stock Epinephrine

You probably know by now that I support the availability of epinephrine auto-injectors in all Tennessee schools for use during unanticipated anaphylactic emergencies.  I write an Op Ed recently on the subject.  It was published The Tennessean on July 31.  Below is a link to the piece.

http://www.tennessean.com/article/20130731/OPINION03/307310093/Tennessee-Voices-New-law-cuts-risks-students-serious-allergic-reactions 

Stock Epinephrine for Tennessee Schools (VIDEO)

8-year-old demonstrates how to use an EpiPen in the video below

New law allows schools to keep EpiPens in cases of emergency: The law authorizes all Tennessee schools to voluntarily stock epinephrine auto-injectors, better known as EpiPens.

Bill Signing Ceremony - Epi in TN Schools

Governor Bill Haslam will be signing legislation soon to authorize TN schools to stock epinephrine autoinjectors for use on any student suspected of experiencing anaphylaxis.  Your phone calls, emails, letters and photos are what brought this legislation through!

Please consider joining Governor Haslam and other bill supporters for bill signing ceremony at 1:30 pm Central time on Tuesday, June 4, 2013 at the War Memorial building in downtown Nashville!  If you cannot attend, please consider sending a quick note to tell the Governor what this means to your family.

As I am totally bummed at being unable to attend myself, please direct all RSVPs, questions and letters to Andrea at afanta@kvbpr.com.  That way she can pull everything together and send out any last minute details that you'll need.


5/29/13 UPDATE:
Due to overwhelming response, no further guests can be accommodated in the space allotted for the bill signing ceremony.  Andrea is continuing to collect letters and thank you notes.  She will print these and present them to Governor Haslam at the ceremony.  Please email letters and questions to afanta@kvbpr.com.

Onto the Next Vote!

GREAT news!  Not really breaking news because I was on Spring Break with my Little Overachievers when it happened, but great news nonetheless!!


HB0866 was passed by the TN House Education Committee last week with a great deal of support.   The Senate version of the bill, SB1146, was also passed by the Education Committee.  I have not heard when the bills will be voted upon by the full House and Senate, but I will be sure to share the date when I have it!


Many thanks to those who spread the word about this bill, and those provided direct support through letters and phone calls to committee members!  I would like to give a special thanks to those who were able to represent our community at Legislative Plaza.  I so wish that I could have been there with you!

• Jill Connell, Memphis  
• Alyssa Tucker, Memphis
• Becky Basalone, Knoxville
• Jenine Ward, Murfreesboro
• Connor Ward, Murfreesboro
• Amanda Hargett, Murfreesboro

UPDATE: The bill that would allow TN schools to stock epinephrine autoinjectors for all students perceived to be in experiencing anaphylaxis was passed by the House and Senate of the TN General Assembly on 4/15/13.  Many thanks to all who lent their support to this process!!



LAST UPDATE:
There is a bill signing ceremony for this legislation on 6/4/13.  See this post for more info!  

TN Legislative Update

I received an update late this afternoon regarding the pending legislation that I have been talking about all week.  The original phrasing of Amendment 4828 to HB0866 would have required all schools in Tennessee to stock epinephrine auto-injectors that are basically prescribed to the school rather than a particular student.  The new phrasing authorizes schools to stock this life-saving medication which can be used on any student believed to be experiencing anaphylaxis.  This is still an important change from current law which restricts the use of epinephrine to those students who have a prescription and their own auto-injector on campus.  I have not received confirmation as to whether SB1146 (the TN Senate version of the bill) has received the same modification.  I hope that you will all continue to lend your support to this important legislation!


If you live in Tennessee and you have not already done so, please write letters of support this weekend.  These should be emailed directly to members of the TN House Education Committee and TN Senate Education Committee.  Please include the following details.

• Your first and last name
• Your city and state
• Briefly state why you support authorizing schools to stock epinephrine auto-injectors for use on any student experiencing anaphylaxis
• Ask committee members for their support
• Thank them for their time and service

Questions can be posted below in comments or directed to afanta@kvbpr.com.

UPDATE: The bill that would allow TN schools to stock epinephrine autoinjectors for all students perceived to be in experiencing anaphylaxis was passed by the House and Senate of the TN General Assembly on 4/15/13.  Many thanks to all who lent their support to this process!!


LAST UPDATE:
There is a bill signing ceremony for this legislation on 6/4/13.  See this post for more info!  

Letters to Support Auto-injectors in TN Schools

If you've read my blog within the last few days, then you probably know that there is pending legislation that would require authorize schools in Tennessee to stock epinephrine auto-injectors.  I feel like going into detail about the bill now would be silly because I'm already preaching to the choir.  If you don't know what I am talking about, take a look at my previous entry and you'll catch up quick!

My request tonight is for Tennessee residents to write a letter to the TN House and Senate Education Committee members to indicate their support for the bills that would require stocking of epinephrine auto-injections in all Tennessee schools.  Our legislators need to hear our stories if they are to understand the importance of this legislation!  Below are some suggestions to consider as you write.

1. Start now!  Letters need to be emailed to afanta@kvbpr.com by the end of business on Thursday, March 21.
2. Address one letter to the TN House Education Committee, and another to the TN Senate Education Committee.
3. Introduce yourself!  Include your full name and city/state.
4. Briefly state that you support legislation to require epinephrine auto-injectors in Tennessee schools.
5. Ask committee members for their support.
6. Thank them for their time!
    
7. Consider including a picture or two of your allergic family member.  I plan to include one picture of my 8 year old having fun at his birthday party, and another of him in the hospital receiving treatment for anaphylaxis.

Thank you so much for your support of this legislative process!!!  Please post any questions to the comments below.  I will answer them as quickly as I can get to them.


3/22/2013 Update
HB0866, Amendment 4828 was passed by the TN House Education Subcommittee on 03/19/2013.  The wording of the amendment has been changed from "requiring" schools to stock epinephrine auto-injectors that could be used on any student thought to be experiencing anaphylaxis to "authorizing" them to do so.

UPDATE: 
The bill that would allow TN schools to stock epinephrine autoinjectors for all students perceived to be in experiencing anaphylaxis was passed by the House and Senate of the TN General Assembly on 4/15/13.  Many thanks to all who lent their support to this process!!


LAST UPDATE:
There is a bill signing ceremony for this legislation on 6/4/13.  See this post for more info!  

HB0866 Passes TN House Education Subcommittee

Many thanks to all who shared yesterday's entry about pending legislation!  Passage of HB0866 would require authorize all schools in TN to stock epinephrine auto-injectors for use on students experiencing a life-threatening allergic reaction.  Epinephrine is a life-saving medication for patients experiencing anaphylaxis and must be utilized soon after symptoms begin to ensure maximum efficacy.  The TN House Education Subcommittee agreed after hearing testimony today that our schools need should be authorized to be prepared to address life-threatening allergic reactions when our children are in their care and agreed to pass this bill to the entire committee.

Below are the steps that Tennessee residents can take right now to help our TN House Education Committee members recognize the importance of this bill.

• Write a letter addressed to the House Education Committee - TN State Legislature.  Tell them why it is important to you that they pass this bill.  Please include your first and last name, as well as your address (city/state) so they will know you are a resident of Tennessee.  Letters that are emailed to afanta@kvbpr.com by the end of business on Thursday, March 21, 2013 will be assembled and presented together to Committee members.
    
• Consider having your allergic child write their own letter asking the Committee to pass the bill.
   
• Spread the word!  Share this information with your family and friends, your medical team and your social media contacts.
   
• Show your support for the bill by appearing in Legislative Plaza when the bill is presented Tuesday, March 26 at noon.  Please email Andrea at afanta@kvbpr.com if  you are able to attend.
   
• Watch for updates on this legislation.  I will continue to post information here as it comes to me from those working directly with the bill's sponsors.
• UPDATE, 3/20/13 AT 11:00 AM - A similarly worded bill is just starting through the TN Senate.  Please also send letters addressed to the TN Senate Education Committee to Andrea so she can compile those and present them all together for more impact.  I will post again when I have additional information on the Senate bill.

3/22/2013 Update

HB0866, Amendment 4828 was passed by the TN House Education Subcommittee on 03/19/2013.  The wording of the amendment has been changed from "requiring" schools to stock epinephrine auto-injectors that could be used on any student thought to be experiencing anaphylaxis to "authorizing" them to do so.

UPDATE: 

The bill that would allow TN schools to stock epinephrine autoinjectors for all students perceived to be in experiencing anaphylaxis was passed by the House and Senate of the TN General Assembly on 4/15/13.  Many thanks to all who lent their support to this process!!


LAST UPDATE:
There is a bill signing ceremony for this legislation on 6/4/13.  See this post for more info!  

Pending Legislation for Epinephrine Auto-Injectors in TN Schools

The TN House Education Subcommittee will be meeting tomorrow at 3 pm.  On the agenda is HB0866 which would require authorize all public and private schools to stock epinephrine auto-injectors to treat students in the event that their own auto-injector is unavailable or they are having an anaphylactic reaction for the first time while at school.  The bill stipulates that every school shall stock auto-injectors in at least 2 secured but unlocked locations such as the school office and cafeteria.

The bill is written in such a way that a school nurse or other trained personnel may utilize the auto-injectors for anaphylaxis under a standing protocol from a physician.  The prescribing doctor would be exempted from liability "unless the physician issued the prescription or standing protocol with intentional disregard for safety."  The school nurse or school employee administering the epinephrine would also be exempted from liability with the same phrasing.    

Assuming that HB0866 is passed by the Subcommittee, it will be presented to the full House Education Committee at noon on Tuesday, March 26.


You may wonder why this bill is important.  The following are statistics pulled from FARE's website.

• Researchers estimate that up to 15 million Americans have food allergies, including 1 in 13 children.  That works out to roughly 2 children per classroom.
• Failure to administer epinephrine promptly after an allergic reaction begins is a significant risk factor for fatal anaphylaxis.
• Teens are among the group of patients with the highest rates of fatality due to food-induced anaphylaxis.
• Food allergies can begin at any time, even to foods that have previously been consumed with no ill effects.
• 20 - 25% of anaphylactic reactions in a school setting occur when there was no previously known food allergy

Now for the most pressing question.  What can we do to help our House Committee members understand the importance of this bill?

• Show your support for the bill by appearing in Legislative Plaza when the bill is presented Tuesday, March 19 at 3 pm and/or on Tuesday, March 26 at noon.  (You do not have to speak!)  Please email Andrea at afanta@kvbpr.com if you are able to attend in order to work out the logistics.
• Write a letter addressed to the House Education Committee - TN State Legislature stating why you support the bill.  Please include your name (first/last) and address (city/state, at minimum) so the committee members will know that they are hearing from TN residents.  Letters can be emailed to afanta@kvbpr.com no later than Thursday, March 21, 2013.
• Consider having your allergic children write their own letter to the Committee saying what the bill would mean to them.
• Spread the word!  Share this information with your friends, family, physicians and blog readers.

3/22/2013 Update

HB0866, Amendment 4828 was passed by the TN House Education Subcommittee on 03/19/2013.  The wording of the amendment has been changed from "requiring" schools to stock epinephrine auto-injectors that could be used on any student thought to be experiencing anaphylaxis to "authorizing" them to do so.


UPDATE: 
The bill that would allow TN schools to stock epinephrine autoinjectors for all students perceived to be in experiencing anaphylaxis was passed by the House and Senate of the TN General Assembly on 4/15/13.  Many thanks to all who lent their support to this process!!


LAST UPDATE:
There is a bill signing ceremony for this legislation on 6/4/13.  See this post for more info!