A Tough Itch To Scratch

Posted on Sep 08 in Latest News, QV Body, QV Face, QV Flare Up, QV Intensive, QV Kids, Skin Conditions, Skincareby QV SkincarePrint

From a runny nose and itchy eyes to a life-threatening anaphylactic reaction, allergies affects one in three New Zealanders. Two Marlborough families cope with severe allergies every day.

Ella Bartholomew bounces around her pink bedroom with little sister Lily and their kitten Bob. It is only her diminutive size that gives any hint of the serious allergies the Picton six-year-old copes with every day.

Ella is severely allergic to nuts, egg and seafood, moderately allergic to strawberries, tomatoes and pipfruit, and mildly allergic to wheat and dairy. She is also allergic to grass, pollen, dust mites, mould, horses and dogs.

Ella has several cats, which her mum Lindsey says she has been desensitised to because she has been around them all her life.

Medical tests have shown that Ella’s tiny body is in a constant state of allergic reaction, which is controlled with daily doses of antihistamine and other medications.

An allergy happens when a person’s immune system over-reacts to a food or environmental allergen.

Antibodies that are meant to protect against viruses, parasites and infections mistake an allergen  for instance, a peanut  as an invader and create antibodies to fight it. Histamine is released from cells in the blood and tissues, and this causes the allergic reaction.

Symptoms can range from a sneeze to the most severe form of allergic reaction, anaphylaxis.

Anaphylaxis can quickly cause swelling, breathing difficulties, a drop in blood pressure and death.

Ella has endured three serious anaphylactic reactions, once after grabbing a plate from the dishwasher that had held fish. Contact with the tiniest trace was enough to land her in hospital.

When she was 14 months old, Ella’s tongue and throat swelled dangerously after she ate a tiny piece of fish. She was rushed to hospital and given adrenalin. It took doctors three days to return her to normal.

Ella carries an Epipen that injects adrenalin if she has a sudden reaction. They cost $150 and last only 12 months, and she knows how to use it.

As well as allergy attacks, Ella has already been to hospital twice this year with asthma. Her mum estimates she has been hospitalised 25 to 30 times in her lifetime.

Ms Bartholomew says the steroids and antibiotics Ella takes have stunted her growth, making her smaller than her peers and even her little sister.

Ella is not alone.

The experts tell us that between 6 and 8 per cent of children and between 2 and 4 per cent of adults have a food allergy.

But more in-depth statistics on allergies in New Zealand seem to be lacking, and it is hard to know whether the number of people with allergies is increasing or if more awareness is simply bringing more out of the woodwork.

Allergy New Zealand has previously pushed for district health boards to put more priority on healthcare for allergy sufferers.

Its chief executive, Penny Jorgensen, says food allergies are affecting a growing number of children, and there is no clear advice on how to prevent them developing.

“About 10 babies born every day in New Zealand will go on to develop food allergy,” Mrs Jorgensen says.

“They are likely to be across all ethnicities and socio-economic situations. Yet very little is known about food allergy and its effect on New Zealand individuals, families and communities.”

She says research is “badly needed” to improve health services for allergy sufferers, education and resources for families, and funding for medicines such as an adrenalin auto-injector (commonly known as an Epipen) for treating anaphylaxis.

The Nelson Marlborough District Health Board has no allergy specialists besides practitioners, like Nelson paediatrician Nick Baker, who take a special interest in the subject.

Experts are divided on what causes allergies and how to treat them. Some advocate exposure to the allergens, which Dr Baker calls the hygiene hypothesis  the idea being that if you raise kids in environments with lots of pets and allergens, that will help.

But this can be dangerous.

A peanut allergy, for instance, is something people don’t generally grow out of.

“The classic reaction is anaphylaxis. Every cell in your body starts to leak, the entire body reacts,” Dr Baker says.

“The flavour is that this is really complicated. There’s no very simple answer.”

But a child with a mild allergy to milk or egg can be re-challenged with that food, he adds.

A recent survey in the Nelson-Marlborough area on how many children have Epipens showed a “surprisingly” large number, Dr Baker says.

“It shows there are a number of families who are living day to day avoiding foods. It’s a big lifestyle issue. It does affect lots of people’s lives.”

Dr Baker’s advice to allergy sufferers is to take practical preventive measures.

“If you know it makes you sick, avoid it. To be honest, there’s not a lot to be gained by extensive skin or blood testing. Often, you’ll come up with things that say you’re allergic to it but you’re not.

“I would come back to very basic principles. People who move bales of hay and get asthma, well, don’t do it.”

There are no Marlborough support groups for allergy sufferers or parents of children with allergies. Ms Bartholomew says she has been, and sometimes still is, on a steep learning curve with Ella that has been mostly self-directed.

“Even parent to parent, there’s nothing. But there’s something for everything else.”

One woman who hopes to change that is Blenheim’s Malia Foliaki. Her daughter Eliza Tapueluelu, nearly 2, is allergic to nuts, eggs, dairy and gluten, and has spent much of her life battling severe eczema.

Ms Foliaki wants to show other parents what she had to learn herself through a process of trial and error: bathing and wet-wrapping Eliza’s entire body several times a day, using a fatty cream and soap substitutes.
Ms Foliaki has already taught some parents but hopes more will come forward, as much for advice as support.
After all, she’s been there.

Eliza was just one-month-old when she suffered her first bout of eczema, which was so extreme that she was admitted to Wairau Hospital for nearly two weeks. The viciously itchy rash remained for nine months.

Eczema, also known as atopic dermatitis, is inflammation of the skin and an inability of the skin to retain enough moisture. It can be caused by many things  clothes, heat, stress, dry air, and allergens like dust mites, pollens, moulds or foods. Like Ella, Eliza suffers from multiple food and environmental allergies.

Nearly two years after Eliza’s first hospitalisation, Ms Foliaki flicks through photos of her baby dressed entirely in bandage-like skin wraps.

She can’t hold back the tears as she remembers endless nights holding her daughter’s hands to stop her from scratching her skin into open wounds.

The itching was so great that when put on the floor to play, Eliza would rub her face against the carpet. Toys were used as scratching devices, and when her hands were covered with socks, she pinched her skin instead.

Desperate to take her daughter’s mind off the relentless itching, Ms Foliaki bought squishy balls, put them in Eliza’s hands to play with, then covered her hands with socks.

Watching her daughter suffer caused Ms Foliaki immense stress, as she worked fulltime to cope with $300 monthly power bills, the result of Eliza’s frequent baths, plus the cost of medicines and formula.

Ms Foliaki was told she was a bad mother and shunned by some of her fellow Tongans, who thought Eliza was cursed.

Doctors feared food allergies, and urged Ms Foliaki to stop breastfeeding, but Eliza refused formula until she became so dehydrated that she was readmitted to hospital. Ms Foliaki had to send her sister to hospital with Eliza so that she could be weaned faster, without the temptation of having mum nearby.

It is now 11 months since Eliza’s eczema subsided, and the toddler’s skin is flawless. But preventive care continues every day. Eliza has bottles of medication, tubes of strong steroid creams and containers of soap substitute.

Ms Foliaki grates goats’ milk soap to wash Eliza’s 100 per cent cotton clothes, which she cannot buy second-hand because previously used detergents may linger.

Wairau Hospital pediatrician David Bond says an outreach nurse is available in Marlborough to educate parents with eczema-affected children, but beyond that there is not much else in Marlborough.

He says there is far more awareness of allergies, which has led to more patient inquiries, but it could be that allergies are actually becoming more common: “It’s hard to say.”

Currently, Dr Bond has about six children in his care who have serious multiple allergies, like Ella and Eliza, and he has about two new referrals a month for eczema, which often indicates an allergy problem.

“That’s quite a lot for a small region.”

His patients include new Pacific Island arrivals, who Dr Bond says have never experienced eczema before, or treated it with traditional medicines they can’t get here. Dr Bond does not know the cause of the onset of their eczema, and can only suggest it could be the change in diet and climate.

He says there appears to be an increase in allergy sufferers the world over. This means that in future, more children will face lifetimes of restricted diets, and avoiding pets and the freshly cut grass on the school field.

ore parents will have to seek out washing powder that won’t aggravate their childrens’ skin, wage a constant war against dust mites, keep the peanut butter out of reach, and cook imaginative allergy-free meals.

Ms Foliaki and Ms Bartholomew say their daughters do not know anything different, so to them, this way of life is normal.

Eliza has already learned not to eat anything that mum has not prepared. Ella has learned to ask what is in food offered to her before eating it, and often carries her own snacks.

“She’s got a good head on her shoulders,” Ms Bartholomew says.

Both mothers hope that more awareness will lead to more education and support for parents like them.

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One Comment

• hansford insurance says:

  September 26, 2010 at 16:56

  I’m glad you said that!!!

  Reply

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