A Night Owl's Super Productive Morning

I didn't get formula made before bed last night, so I got up early this morning which is NOT an easy feat! I was on a roll and thinking to myself that I should try to get up early every day. (HA!)

44 ounces of unflavored Neocate. Check!
24 ounces of tropical Neocate. Check!
20 ounces of chocolate Neocate. Check!
88 ounces of formula divided into 10 cups. Check!
Lunch bags packed. Check!
Medication measured and laid out. Check!

There's the alarm that tells the boys to get their shoes on so they can take meds and get to the bus. Uh oh...

I FORGOT TO GET THE KIDS UP!!!

For what it's worth, my feet sprouted wings and the boys made their respective buses. I am fairly certain that neither washed faces, combed hair or brushed teeth... But they made it!!!

Peanuts: To Ban or Not To Ban? - Part 2

In Peanuts: To Ban or Not To Ban? - Part 1, I shared my philosophy for managing food allergies at school.  If you read that piece, then you  know that I do not generally support peanut free schools.  But what about specifically?

If my overachievers have taught me anything, it is that there is always an exception.  Always!  And when you are that medically documented exception, it can be incredibly frustrating.  It can take months or even years to convince doctors that your child really is that allergic.  Let's be realistic.  If you had told me 8 years ago that you could not cook anything in your house with peanuts, tree nuts, pork or eggs without causing your child to develop a rash and/or wheezing...  Well I would have probably called you crazy.  And then, after many months, we figured out that was why our baby was fine when he woke up and miserable before breakfast was even served!  With that in mind, now I am going to share what urged me to post my thoughts about peanut bans at school.

There was a recent post on a Facebook page where readers were asked to weigh in on peanut bans at school.  The responses were mixed and downright heated!  My perception - or maybe it is more of a hope - is that those who are so vehemently opposed have limited knowledge about food allergies.  Or perhaps they have a good knowledge of their own food allergies, but they do not recognize that sometimes there are individual situations that are more challenging than their own.  Below is my main response to the discussion - the information that I felt was important enough to share that I needed to bring it over here to my own space.  To be fair, the statement below is as much about allergen free classrooms and the requirement for party food to be allergen free as much as it is about peanut-free schools in general.

1 in 13 school aged children has a food allergy. That works out to 2 students per TN classroom. That is 2 students per class whose lives are potentially endangered by the presence of peanut protein. 

Food proteins are like germs. They are invisible to the naked eye and easily spread from surface to surface by hands, feet, books, bags and just about anything else. Unlike germs, food proteins are not destroyed or removed by hand sanitizer. The only way to remove food proteins is to wash with soap and water. And by wash your hands, I mean lather for at least 20 seconds per the CDC recommendation. Very few people actually observe that full 20 seconds of lathering!

It's not just about what allergic individuals eat. For some patients, ingesting even a minute amount of their allergen can be deadly. Ingestion can mean that the food enters the bloodstream through the mucous membranes of the mouth, nose or eyes. It can also mean entry directly to the bloodstream if the student has a break in their skin. Even a paper cut can introduce allergens to the bloodstream if there is an allergen is introduced into the cut.

The next time you see a group of kids, watch closely. How many have food smeared on their faces or their clothes? What surfaces do they come into contact with? (Door handle, desks, pencil sharpener, white board markers, pencils, walls, etc.) Who touches those surfaces next, and then what surfaces do they touch? How many of those kids do you see wiping (or picking) noses or rubbing their eyes? Don't forget to make note of the thumb suckers and nail biters! Every one of these situations creates risk for students with life threatening food allergies - especially if they are reactive to trace proteins.

Now consider this. If a student in your child's class develops anaphylaxis due to the accidental ingestion of peanut protein, your child is there to see it. Your child will see another child struggle to breathe, the administration of an epinephrine injection, potentially CPR and mouth-to-mouth resuscitation. Your child's classroom will be invaded by adults entering to assist. They will watch their classmate being loaded onto a gurney and wheeled off to be loaded into an ambulance. They will wonder whether their classmate is going to die. And it is very possible that, despite emergency measures taken, that child could die anyway.

Do you really want to explain to your child that their friend experienced a life-threatening, and potentially life-ending, allergic reaction because you didn't think it was necessary to send something other than peanut butter to school for your child to eat?

Again, I do not support blanket bans.  I feel quite strongly that peanut free schools are not necessary for the vast majority of kids with peanut allergies.  Generally speaking, I feel that this is an accommodation that is more about making adults feel better than actually keeping students safe.  But I do support limited bans that are put in place based on physician-documented medical need for avoidance of an allergen.

What it comes down to is this.  If a physician determines a medical need and the school agrees to make an accommodation for that need, it is not my place as the parent of a different child to second-guess the team that made the decision based on medical data.  It is my duty as a member of the school community to support our educators as they are charged with meeting the educational and medical needs of each student in their care.

Peanuts: To Ban or Not To Ban? - Part 1

One of the hottest debates about food allergies is whether or not peanuts should be banned from schools.  Some parents of allergic kids are insistent than schools should not serve or allow peanuts in any form.  Period.  Other parents of allergic kids feel that is overkill.  Parents of non-allergic kids also have varying opinions.  The most vocal seem to feel that a ban on peanuts somehow violates their child's civil liberties.  (I'm still waiting for someone to show me where the right to eat peanuts is listed in the Constitution or any other body of laws!)  

My own opinion is that peanut bans are generally not necessary, and that they tend to create a false sense of security.  (Is there someone checking labels on every bit of food that enters the school to enforce the policy?)  I also tend to get annoyed because my overachievers have life threatening allergies to foods that could never be banned.  Today's example...chicken.  Can you even imagine the uproar that would occur with a ban on chicken fingers?!?!?!  Of course, chicken is really not an apples to apples comparison.  Peanut allergy is more common than chicken allergy, and it also causes anaphylaxis at a greater rate.  But still.  Life would be way easier if we didn't have to look for chicken protein eeeeeverywhere!  (Seriously.  Outside of desserts, chicken broth is ubiquitous.)

My preferred approach is to give allergic students the accommodations that are medically needed, while resisting the temptation to put accommodations in place that are more about making the adults feel comfortable than providing actual safety.  In my ideal world, accommodations will vary based on severity of the allergy plus the student's age, stage of develop, and maturity level.

The youngest students and others who lack the cognitive ability to understand or fully avoid their allergens will need more accommodations than others.  Also in this group would be those that are very reactive to trace proteins, those who are allergic to many foods, and those who are prone to intentionally eating allergens.  These students may require classrooms that are food free, or at least free of specific foods.  It may be necessary to implement some degree of hand washing to ensure that food allergens are not inadvertently introduced to the classroom via cross-contamination.  Depending on the specific allergy, it may be necessary to limit what supplies are used for lessons and art projects.  Think of it like this.  If you can set up a "safe home base" for the allergic student, then you've got an area where the student and the teacher can relax a bit about food allergies and focus instead on learning.  Additional accommodations will likely be needed for whenever these students leave the classroom and are therefore at more risk from their allergens, but for the bulk of the school day the concern for food allergy reactions is pretty low.

My 8 year old falls into the category above for several reasons.  In addition to an allergen free classroom, he requires specialized seating arrangements for lunch and considerations at other times when he is outside of his own classroom.

With time and experience, students can begin to take over little pieces of responsibility from the adults around them.  Those who can be trusted to eat only safe foods may be able to transition to more independence.  (Ex: Move from peanut free table to the main lunch table with an end seat where adults can monitor them for the development of an allergic reaction.)  Once kids can remember to keep their hands away from mucous membranes, they may be able to have limited skin contact with their allergens.  (Translation: They do not to suck thumbs, bite fingernails, pick noses, rub their eyes, create open wounds by picking scabs, etc.)  It may be possible to accommodate these students by substituting safe foods for allergens that are used in classroom activities.  (Ex: counting with Smarties rather than M&Ms)  These students may be able to sit wherever they want for lunch, with friends prepared to signal for a lunch monitor if an allergic reaction begins.

My 6 year old is now able to sit with his peers for lunch.  He doesn't read labels, but he knows to look for the safe symbol that I add to foods that are free of his allergens.  He continues to bite his nails and pick his nose like most boys his age, so he continues to require an allergen free classroom.  He is more independent than big brother partially because none of his allergies are anaphylactic in nature.

As students move from early elementary school and then to junior high and high school, their Allergy Action Plans can and should be adjusted to prepare them for the eventual reality of living on their own with food allergies.  But just as we transition our children from making their bed to cleaning their room to larger household chores, we need to help our kids transition from an adult-led control of food allergies to the self-management that is necessary for teens with food allergies to experience a full life while also attending to their medical needs.

Continued in Part 2

Going "Home" to Visit Eosinophilic Family!

The first time that a physician mentioned eosinophilic esophagitis (EoE) in relation to my little overachievers, I was devastated!  All that I knew of the condition came from observing a friend whose toddler son had it.  This sweet child had only 3 or 4 foods that he could eat, and my friend's stress level was sky high.  She focused nearly all of her energy on keeping her son nourished enough to avoid surgical implantation of a feeding tube.  I saw her battles with the insurance company, and how she scrimped to pay for the formula that cost roughly the same amount as her monthly mortgage payment.  I was not able to observe the effect on her husband because he was always working in an attempt to pay down the medical bills.  This little boy was growing up and meeting milestones that could never be revisited, and his parents were fighting so hard just to survive.  I wanted no part of that world!

My first response was to commune with my keyboard.  In February 2008, a keyword search for eosinophilic esophagitis led me to the American Partnership For Eosinophilic Disorders (APFED) and a relatively small list of research studies.  APFED's website summarized what I was not able to understand of the research.  I was relieved to learn that most kids with EoE are not like my friend's son!  Roughly 3/4 of EoE patients can remove the most common allergens from their diet to get rid of the excess eosinophils and find relief from symptoms.  Those foods are milk, soy, eggs,wheat, nuts (peanuts & tree nuts) and seafood (fish & shellfish).  That's a very tough diet to maintain!  But as long as they don't eat those foods, those EoE patients are healthy.  My little overachievers, of course, fall into the 1/4 of patients that require further food elimination or the use of steroids to manage their condition.  Based on the large number of foods that we knew to be problematic, we went straight to elemental diet which is the removal of all foods.

I expect you're getting a good laugh at my expense about now, but that's okay!  I have come to accept that this is just the way that things tend to work with my bunch.  To give my friend credit, she did not laugh when I complained about how HARD it was to live this life and how LITTLE information there was to guide us!  Instead, she put me in touch with a group of families whose children all had EoE or a similar condition caused by too many eosinophils in other parts of the GI tract.  It is the support of those other families and APFED's educational resources that helped me understand and adjust to what I know refer to as the eos world.

In 2009, I was able to attend APFED's annual patient education conference.  There I met countless other families.  For some, the diagnosis was new and overwhelming.  Others seemed like veterans in the daily fight against the evil eosinophil.  One such father took the podium the first evening.  His son was being successfully treated with elemental diet and a gastronomy tube.  He told us how difficult it was to hand his son a bowl of crushed ice to eat for a snack when the son had first stopped eating all food.  There were silent nods of understanding.  After gaining his composure, the father had gone to sit with his son.  When he rounded the corner, he found all of his children sitting together on the couch, each child with a bowl of ice in unspoken support for their brother.  In that moment, the emotional impact of EoE hit me.  I choked on a sob and bolted to the ladies' room where I could cry with a smaller audience.  And there was an audience, as I was quickly joined by a few moms who had come to offer their own quiet support.  After a splash of water and a few deep breaths, I rushed back my seat...just in time for the father to give reassurance that life with EoE does get easier.  And I knew then that my boys would be okay.  Even if they could never eat full diets and they always needed periodic surgical procedures, they would be okay.  And so would I.

 
Over the next day and a half, I sat through presentations where physician researchers addressed the audience of patients and parents as equals.  They took the time to explain medical terminology as they introduced it, but they otherwise addressed us as equals.  There were break out sessions where we were able to interact with the speakers in small groups to gain more detailed knowledge in areas of special interest.

Since that first conference, I have attended APFED's patient education conference each summer.  The information that I learn exceeds what I can find on the internet.  I meet the people that are changing the world for our growing community of eos families.  I reunite with friends that I see just once each year.  APFED's president, Wendy Book, once said that going to the annual patient conference is like going home.  And I agree!  As I prepare to spend this weekend in Philadelphia, I don't feel like I am preparing for a medical conference.  I feel like I am going home to my eosinophilic family!



While I am in Philadelphia this weekend, I will be participating in APFED's Hope on the Horizon Walk.  All funds raised through this walk will be directed to research on eosinophil associated diseases.  With time, research and continued collaboration between centers, it is my hope that there will one day be a less invasive way to diagnose, treat and monitor EoE.

Please consider sponsoring me for the Hope on the Horizon Walk.  You can view APFED's solicitation disclosure here.  There are 3 ways you can contribute.

1. Donate online through APFED's website with a credit card.
   Payment type = Hope Walk - Philly
   In Honor Of = Overachieving Bunch
2. Mail a check or money order directly to APFED.  Rather than risk an entry error, I ask that you visit APFED's donation page for further details.
3. Spread the word!

Three of my favorite overachievers walking for
APFED's Hope on the Horizon Research Fund.

Xolair: An Overachiever's Miracle Drug

It has been 10 years since Xolair hit the market.  Food allergies weren't even on my radar then, and I couldn't tell you much about asthma in general - let alone severe persistent asthma.  The only reason that I read the article about this new wonder drug is that I was stuck in a tiny room with nothing else to do.  I was annoyed with my doctor because he insisted on treating my shortness of breath and monitoring me for a while even though I had "only" come in with hives from a drug reaction.  Yeah...  I was clueless back then!

Whether it was a whisper from God or just because I'm a science nerd, I was compelled to read that article through to the end even though most of it was beyond my comprehension.  What I did understand is that this new injectable medication, administered once to twice a month, was going to change the allergy world.  One allergist was even quoted as saying that Xolair was going to put him out of a job!

When Overachiever #1 was a baby, we saw many signs of allergy.  His eczema was severe and resistant to standard therapies.  He always had some nasal congestion.  By 5 months, he had a constant wheeze that could be heard from several feet away.  As a "nervous" first time mom, I couldn't get anywhere with his doctor.  Then he stopped breathing during dinner when was he was just 7 months.  The ER doctor got us set up with an allergist.  Skin prick testing revealed multiple allergies.  We left with instructions to eliminate peanut and egg from his diet, and to find a new home for our beloved pets.  There were more medications than I ever would have thought safe for such a tiny child!  A home healthcare company came by the next day to deliver a nebulizer and teach me how to use it for the asthma that had also been diagnosed.
 
Life with an asthmatic baby was chaotic!  Nebulizer treatments were scheduled for twice daily to deliver the inhaled corticosteroids that were supposed to control his asthma.  Oral medications for asthma and allergies were scheduled for twice daily.  Emollients were applied throughout the day, and steroid creams were added in once or twice a day to keep the eczema halfway controlled.  We had to watch the clock to ensure that we were not giving too much albuterol.  We rarely went a day without adding in a dose or two of Benadryl.

Beyond medication, we learned that restricting activity would limit the wheezing.  Contact with furry animals must be restricted.  Airborne pollens and molds are problematic, so time outside has to be limited in spring, summer and fall.  Allergy shots were started at age 3 (or was it 4?) in order to give some relief from seasonal allergies.  Extreme heat and cold are additional asthma triggers.

We eventually became accustomed to this new way of overachieving.  Our sweet boy was just going to pick up whatever bug he encountered.   He would be sicker than the rest of us, and for way longer.  We settled into a pattern that included 5 days of oral steroids every 4 to 6 weeks just to keep him out of the hospital.  Phrases like "respiratory distress" and "intractible wheeze" were added to my vocabulary.

Doctors started suggesting Xolair when Overachiever #1 was 3 or 4.  They would tell me that this drug WOULD give him relief, but that there was no way that we could get insurance to pay for it because it has not been approved for use in children.  We couldn't afford to pay for it out of pocket, so Xolair was nothing more than a carrot just dangled there to taunt us!

When our allergist suggested a few months ago that we should try to get Xolair covered by insurance, I was doubtful that the approval would go through.  But we had letters of medical necessity from 3 board certified allergists, and approval was quickly granted for a 6 month trial.

It will be 2 months tomorrow since the first dose of Xolair was administered.  Two months ago, Overachiever #1 could only play outside for an hour before his asthma was flaring too severely to stay out.  He can now be out (even on high pollen days!) for 3 hours before he is miserable.  Previously, every sinus infection led to an asthma flare and a 5-day course of steroids.  We've weathered 2 sinus infections already.  His asthma did flare, but we were able to manage at home with albuterol.  I can't even giving the last dose of albuterol.  It's been at least 2 weeks since we've had to pull out the inhaler, and I even put away the nebulizer last week because we haven't used it in a month.  A month!!!

Perhaps the most exciting improvement that we've seen has nothing to do with the reason that we started Overachiever #1 on Xolair.  It is the lack of symptoms related to food allergies.  Almost exactly 2 years ago, ingesting a very small amount of apple cause flushing and facial swelling.  It has been almost a month since we started a trial of apple.  So far there has been no flushing and no swelling.  In fact, there has been no sign of any immediate allergic reaction!  There are some symptoms that could indicate an EoE flare, but it's too soon to say.

Xolair may not be putting allergists out of business as was once predicted, but it sure has been a miracle drug for my little overachiever!

How to Eat an Apple

Overachiever #1 has been trialing cooked apples for several weeks now.  He's been doing VERY well, with no signs of an IgE mediated reaction (no hives or breathing difficulties) and minimal symptoms that could be attributed to an eosinophilic response in the GI tract.  We had been reluctant to transition to raw apple because we were afraid to mess up a good thing.  (And by we, what I really mean is me!)  It is so very difficult to begin a new food trial knowing that, if the usual path is followed, we will have to take it away again in a couple of days, weeks or months.  While I would like to be optimistic, I am more of a realist by nature and the odds just really don't seem to be in his favor!

So what's a reluctant mother to do?  Ask the doctor, of course!  But not just any doctor.  I needed to hear from a physician with the knowledge and compassion for our experience who could gently point out that my fear is overblown.  As luck would have it, we were scheduled to see two such doctors!  I often refer to first as the Eternal Optimist.  I can walk into his office filled with anxiety and armed with a miles-long list of questions that I simply MUST have answered.  (Who doesn't need a plan A, B, C...Z?!)  When I leave his office, I am feeling totally calm and comfortable with "let's just see what happens" as the answer to most of my questions.  (How does he DO that?!  I want that calm in a bottle!)  This doctor, of course, told me there was no reason not to proceed with raw apple and that we have a good chance of it going well.  But that's not  a surprise to anyone, is it?

What I really wanted to hear was what the Realist would have to say!  He, too, feels that it is safe to proceed.  And even better, there was not a hint of the "this woman is crazy!" look that I get from most doctors when I indicate apprehension about proceeding with food challenges.  Perhaps I did an awesome job at hiding my fears...or perhaps this doc just "gets" it as no one else does.  Or maybe (just maybe!) I am simply over-analyzing again. It's been known to happen!

So I washed an apple and handed it to Overachiever #1.  Then I tried to keep myself busy in the kitchen so that he wouldn't have to endure me staring at him.  I think I made it about 10 seconds before I just had to look!  And right then, my heart broke.  In just a few months, it will be 5 years since we initiated a strict elemental diet.  During that time, a lot has been lost.  The muscles of the mouth and tongue weaken without the constant workout of chewing and manipulating various foods in the mouth.  (One can only create so many textures with sugar and ice!)  Even something as simple as knowing which teeth to use is tough when you've not had to do it since you were 3!  Realizing this brought tears to my eyes.

Putting on a smile, I noted how tough it is to break through the skin of an apple.  We talked about how some of our teeth are pointed while others are broad and almost flat.  We had spent many hours recently digging dinosaur bones out of plaster with various tools.  He remembered that the sharper tool had a different purpose than the one that looked like a hammer.  He hypothesized that our front teeth are intended for biting off pieces of food, and our back teeth are for chewing it into smaller pieces.  Then we tested that hypothesis.
   

Biting into this apple is hard work!

It was a real workout for those under-utilized jaw muscles, but those front teeth did the job.  And then the back teeth did theirs!

It worked!

And that, my friends, is how you eat an apple - one bite at a time.

Movin' On Up!

Did you just sing the title?  I sure did!  It's been well over 20 years since I last watched George and Weezy Jefferson and their maid in that deluxe apartment in the sky.  What was the maid's name, anyway?  Funny that I don't remember, 'cause I still to quote her when the dishes are piled up and the windows are covered with fingerprints.  Really, any time that there is something around the house that I don't want to do!  Oh, well.  Her name is not the important thing here anyway...
     
When I sat down to write today, it wasn't to tell you about the time that I spent watching television when I was a kid.  It was to share my excitement over one of the little things that makes such a big difference in my adult life.  Okay, maybe it's not a BIG difference, but it is exciting!

[insert drum roll]

Overachiever #1 is moving up from the EpiPen Jr to the adult strength EpiPen!!!  We've been talking about it for quite some time, as his weight has been hovering right around that magical 55 pounds that is the general cut off for up-dosing.  (Up-dosing...  Is that even a word?)  Sometimes he is a pound or two over.  Sometimes he is a pound or two under.  But he is hovering.  So last week we decided to go ahead and make the switch.

You may wonder why this is is so exciting.  Carrying an EpiPen is carrying an EpiPen, right?  WRONG!  With three Epi carrying Overachievers, we have them all over the place.  They are in Overachiever #1's waist pack, the school nurse's office, my waist pack, my purse, The Big Overachiever's waist pack and, of course, on the kitchen counter at home.  While Overachiever #1 and The Big Overachiever just carry a standard twin-pack, I am compelled to carry one twin-pack of the yellow and one twin-pack of the green.  It doesn't matter that Overachiever #1 has forgotten his waist pack maybe 4 or 5 times in as many years.  As the mom, it is my responsibility to plan for that once a year mishap!  Yeah, I've been a bit neurotic about that.

The excitement of up-dosing is that I can now carry just 2 EpiPens with me, because all overachievers in this household are now on the same dose.  This means that I can carry a smaller purse!  Or I can even go back to alternative carriers like the one that I used to have that was a leg holster.  Or maybe I'll just keep carrying my big purse and dedicate that extra space to MY belongings since the rest is taken up by children's books and portable game players and all of the medical notes that I still have not turned into the school secretary.

The little boy that once took away my own breath and all feeling of security in the moment that he stopped breathing during dinner is growing up and turning into a responsible big boy!  The feeling of helplessness that once gripped me has loosened its hold so that I can shake off the fear of group anaphylaxis to a food containing both alligator and peanuts when I'm the only one to remember the EpiPens.  (But it's possible, right?!)  We can now participate in most activities while taking precautions to limit the risk of exposure to allergens unseen.  The transition from the green-capped EpiPen Jr. to the yellow-capped EpiPen is more than just a change in dosing.  It is a tangible sign that we are movin' on up from an allergy family to a family that lives with food allergies.

Well we're movin' on up!  (Sing with me!)

Not "Just" a Cookie

When I think back to the Valentine's Days of my childhood, there are three things that I remember quite vividly.  First is the careful planning and crafting of the shoe box that would collect my valentines.  For some reason, my creations always included purple hearts and ric rac ribbon.  I am quite certain that my art teacher had other supplies available.  But those two features are absolutely required to make a winning Valentine's box!  Next is the heart-shaped box of chocolate candies.  I never did figure out the code that was supposed to tell you what filling to expect, so I had to punch in the bottoms of each one to figure out what was inside.  Just thinking about those chocolates has my mouth watering!  And then there are the cookies...  There were always homemade cookies with a ton of frosting and shaky little conversation heart phrases.

Times have changed.  Or perhaps the Little Overachievers' school just has different priorities.  Either way, transforming shoe boxes into collection boxes for valentines is not in the lesson plan.  Instead, it's a paper bag decorated with stickers.  Somehow, it's just not quite the same.  Multiple food allergies (for all of us!) make the box of chocolates a no go.  But the cookies...  The cookies, I can do!

Overachiever #1 is limited to his medical formula, granulated white sugar, artificial color and artificial flavors. A few years ago, I would have told you there is nothing remotely cookie-like to be created with those ingredients.  Today, however, I know better.  Always the procrastinator, writing out valentines was saved for last night.  So this morning I dropped the Little Overachievers at school and then set out to create memorable "just sugar" cookies in time for the afternoon parties.

Four pounds of granulated sugar, a surprisingly small amount of water, and lots of stirring yields a mixture that feels about like wet sand.

A packed handful of the mixture can be rolled out like cookie dough.

Cookie cutters work just as well for packed sugar as they do for cookie dough.  Sugar doesn't hold together quite the same, so a spatula is required to transfer each cut out.  (Don't ask me how long it took me to figure that out!)  You can also use candy molds or silicone ice cube trays to make "just sugar" candies.

A couple of hours in the dehydrator is enough "cooking" to transform the wet sugar into a solid cookie or bite-sized candy.  Store bought powdered sugar is a no-go in our house due to the inclusion of corn starch to prevent clumping.  So I use a coffee grinder to pulverize granulated sugar.  The resulting powder can be mixed with artificial color and a few drops of water to create a glaze that is easily spread with a small rubber spatula.  Once the glaze has dried, an artificially colored decorating pen can be used for writing messages.  

The end result is not just a cookie.  It is a smile that preempts tears.  It is a single "Yes, please!" in a world of "No thank you - I'm allergics."  Most importantly, it is the start of a new family tradition and, I hope, a memory that the Little Overachievers will recall with fondness when they are adults thinking back on what "makes" Valentine's Day for them.

ARRRRRR, Matey!

When we started talking about birthday plans a few weeks ago, the Little Overachievers were united on just one thing.  They wanted to be pirates.  And once they had made up their minds, they were determined to have a pirate party at one particular place with all of their friends.  And I do mean ALL of their friends!  Or at least all of their classmates.  So I booked a location (no WAY could that many kids would fit into our tiny house!) with lots of space and a cool pirate ship to play on.  Then I started shopping.  I got a Jolly Roger flag, pirate hats, eye patches, plastic swords and all sorts of treasure for the kids to go find.  (Have I ever mentioned that I love online shopping?  No way could we have pulled this off with real world pricing!)

I had great plans!  No.  Scratch that.  I had the grandest of plans!!  We were going to set up a treasure hunt.  I even made a bunch of treasure chests!  I was going to give each kid a list of treasure to collect and then that would be their goody bag to take home.  There would be a staged area for photos with an adult taking pictures of every kid in their pirate gear.  We would have games and lots and lots of fun! Have I mentioned that we were going to do all of this in a time slot of less than 2 hours?  Okay.  Fine.  So my plans were perhaps a little ambitious considering the 5 minutes of time that I was allowed to set up before guests were to arrive.  Plus we were 3 minutes LATE to the party, so we had guests arriving before us!
I reluctantly lined up my treasure chests which suddenly seemed too obviously homemade - and not in a good way - to call treasure chests.  (I am actually rather proud of myself now that I've adjusted to the idea of them being used as party props for a bunch of little kids rather than ready for a movie set as I had envisioned!)  Then I tried to do an assembly line for guests to get their pirate gear and treasure.  That was a very big reminder of why I could never be a teacher.  (How do they handle having so many kids RIGHT on TOP of THEM?!)  I had to resort to sending them all to play and calling them back to me a few at a time.  They were allowed to select a sword while I labeled a hat and goody bag.  Then they each filled their own goody bags from the kid-friendly treasure boxes.  A couple of parents jumped in to help draw on beards, mustaches and tattoos with an eyebrow pencil.  Eventually we got everyone dressed up.  They were having so much fun already that it seemed silly to interrupt them with the games that I had planned.  Their ideas were way better than mine anyway!

You are probably asking yourself why I would put myself through this when I had rented out a play place where they typically run parties while parents sit back and chat with other adults.  Guilt.  Plain and simple guilt.  I have been to a whole lot of birthday parties in my life.  There is one thing they all have: cake and ice cream.  If not cake, then another favorite dessert.  But the Little Overachievers don't eat like other kids...  Knowing that we can't give them something as simple as a beautifully decorated, professional quality cake makes me feel sad.  And feeling sad for my kids not being able to eat like their friends makes me feel guilty because they share their allergic tendencies with me.  So how does a mom allay this overwhelming feeling?  She compensates by throwing the best darned birthday party she can so no one will even notice the lack of cake!

I am not creative by nature, so I thought about all of the birthday parties that I attended as a kid and which ones were the most exciting.  I should be able to duplicate one of those, right?!  But I kept coming back to a party that I did not get to attend.  It was in January of first grade, the Saturday after I had missed an entire week of school due to the chicken pox.  My fever didn't break until Thursday night, so I wasn't allowed to go to school on Friday.  According to my doctor and the school, I would have been allowed to return on Saturday if it had been a school day.  But it wasn't.  It was party day instead.  I was sooooo excited to be well just in time for the big party!  But my mom kept me home because she said if I stayed home sick on a Friday that I shouldn't be attending social events over the weekend because that would look bad.  (Yeah, like anyone was going to think that my scabbed over face was from anything but the chicken pox?!)  When I got to school that Monday, the only thing that anyone talked about was this birthday party.  This was in the early 80s when every business that was worth my quarter had a PAC-MAN machine to play.  The birthday girl's mom had rented out the local community center and put together costumes for all of the guests.  Using the lines for the basketball courts, she reconstructed a PAC-MAN maze.  Guests in ghost costumes chased each other around and even had the little "out" box where the PAC-MAN characters who had been caught had to sit to rejuvenate.  It has been three decades and I am still bummed that I didn't get to go to that party!

So that's why my kids have to have the best birthday parties ever.  Because when their friends leave, I don't want them talking about how awful it was that there was not even any cake or ice cream.  I want them thinking it was THE best party EVER, and not even realizing that we didn't serve them anything more than juice and a lollipop made with Overachiever-safe ingredients.  For what it's worth, I think we may have achieved that.

Our guests greeted their parents with mustaches and tattoos and smiles.  Even the girls!  They immediately started telling tales of sword fights and walking the plank.  I hope that when they see all of their friends on Monday that they are still smiling, even if their parents do refuse to draw on new mustaches.

Lunch Bag Mix-Up

When Overachiever #1 first started school, I was terrified.  How could they possibly keep my helpless preschooler safe with so many kids running around and too many adults in charge?!  For the first few weeks, the ring of the telephone sent chills down my spine.  Was that the phone call that I had been dreading?  The teacher, principal and staff were very understanding of my fears.  For the first few weeks, they started every call with "He's okay!  I just wanted to ask you/let you know..."  With time and a great deal of patience on their part, I learned to extend little bits of trust.

It has been four years since my overachieving, allergic to the world child first entered school.  Somewhere along the way, I learned to relax.  His teacher earned my full trust by consistently following the 504 plan that had been so carefully assembled with input from the pediatrician, allergist, teacher, principal, school nurse and, of course, me.  When we encountered situations that were not adequately addressed by the plan, we worked out a short-term arrangement and then scheduled a meeting to formalize how such a situation would be handled in the future.  By the time Overachiever #2 started preschool, I couldn't wait for each school day to start so that I could have a few hours of kid-free time.  What a transformation from those first few weeks!

When the school's phone number popped up on my caller ID today, my first thought was that head lice had found the boys.  (What an ordinary thing to dread!)  Lucky for me, that was not the case.  The school nurse was simply calling to let me know that Overachiever #1 had Overachiever #2's lunch, and vice versa.  This is an issue because Overachiever #1 can only have unflavored Neocate, granulated white sugar, artificial colors and artificial flavors.  Overachiever #2 is able to drink flavored Neocate, and he also has several safe foods.  This sort of mix up is exactly what we need to keep from happening!  Luckily, Overachiever #1 was not in the mood for an ambulance ride and so he immediately told the adult that supervises the nut free table.  She took him to the nurse who who called me to describe the contents of the lunch bags.  She thought she knew what contents went to each kid, but she wanted to confirm that with me just to be sure.

As I said in an email to the school nurse and assistant principal, today's situation is a perfect example of why I am able to leave my allergic children at school each morning with full confidence that they will greet me with hugs in the afternoon.  I am incredibly proud of my little overachiever for doing the right thing!!!  More than that, I am glad that we were able to establish a good relationship with the school and a 504 plan that helped them to address this issue appropriately.  Each school employee that was involved in correcting today's lunch box mix up may simply have been doing their job.  But they did it well.  They are overachievers in our community, and for them I am thankful.