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Burnout 

1/25/2016

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As promised, I am going to keep you all updated on my journey (which started here) though therapy as I attempt to get over my anxiety around anaphylaxis and using my epipen. After talking with multiple teenagers with severe food allergies I have learned that this is a problem faced by many and unfortunately there isn't a lot being done to address it. Here are my reflections from this week's session with my therapist: 

I remember my first day of EMT class when we talked about two things. The first, the provider always comes first to the patient and the second, how to recognize burnout in yourself and your coworkers. Being in EMS is stressful. When you go into work, you never know what you might see. On one call, you might help a kind old lady and on the next call, you might be shot at by a drunk. EMS is unpredictable and dangerous and can eventually lead to what is referred to as "burnout" in providers. So there we were, sitting in EMT class, on our first day, learning about what could maybe, possibly happen to us 10 or 15 years down the road. I glanced at the potential list of burnout symptoms--sleep disturbances, lack of care and motivation, anxiety--just to name a few. Honestly, I sort of dismissed it and assumed it would never happen to me. And while thankfully, it hasn't yet, burnout is starting to happen in other aspects of my life.

Today, my therapist pointed out to my friend (who attended with me) and I that I am probably experiencing some form of food allergy burnout. I am so tired and done with dealing with my food allergies that I have probably, perhaps unconsciously started to let my food allergy management slip. I have put other things before my food allergy management like social events and recreational activities that in years prior would have come secondary to my safety. And when I have reactions, part of my resistance to using my epipen most likely comes from the fact that I don't want to be having another reaction because I am just so done. I am so done with struggling to breathe. I am so done with checking every ingredient in every thing I eat. I am so tired of having to cook every meal I eat and navigate social situations where I have to be hyper-vigilant about what everyone else is eating and touching. I just need a chance to completely let my guard down which unfortunately with food allergies is extremely risky. 

In EMS so many measures are put in place to prevent provider burnout. Things like Facebook pages dedicated to EMS humor, support groups, talking with partners who "get it" and debriefing stressful events with critical incident stress management (CISM) teams. Perhaps the last one is most important though. After particularly stressful calls or incidents, crews have the opportunity to meet with CISM teams. CISM teams are put in place to help reduce the emotional trauma EMS crews experience. Unfortunately with food allergy management, there is no such thing as a CISM team for after a reaction.

For me, the trauma of an anaphylactic reaction is just as much physical as it is mental. Sure my body is not itself for days after an anaphylaxis, but neither is my mind. After you have a reaction, which for me feels like confirmation that I am not doing everything I can to manage my food allergies, instead of taking a vacation we go back to food allergy management. There is no break.

For teenagers with food allergies, while at this point food allergies have become as second nature as tying our shoes, it is important to recognize that it isn't. It is important to remind ourselves that managing food allergies are a lot of work. They eat up our time and energy and can make us miss the things we love. And while it is important to remain hopeful of the treatments on the horizon, it also stinks to know that there is a potential we could be managing this condition for the rest of our lives.

I am happy I am addressing this issue now before it had a chance to negatively effect my everyday life and the relationships I have with my family in friends. If you are reading this, and this seems like you, don't be afraid to get help. Please talk to a friend, a family member or even a licensed therapist and get help. While food allergies may be chronic, there is no reason that the feelings of burnout need to be chronic too.

So now, the golden question remains, how exactly do we prevent burnout and treat it if it is already manifesting? Comment below with ideas, we love to hear your voices!
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The Worst Advice I've Ever Been Given In Regards To My Food Allergies

1/20/2016

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Here are some of the worst pieces of advice I have received over the years in regards to my food allergies. While I believe that all of these people were giving me their "advice" with the best of intentions, I can't help but think about how comical the advice really is. Just goes to show we still have a lot of community education to do.

Disclaimer: Before reading these pieces of "advice", please note that none of this "advice" should be attempted without consulting your doctor.
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  1. "You should try eating little bits of your allergens every day and build up a tolerance."  ~PreMed Student who thinks they are a doctor​
  2. "Next time you have an anaphylactic reaction, give yourself your epipen in your heart like on TV and see what happens." ~Fellow leadership conference attendee
  3. "When you are ready to die, go buy foods you are allergic to and just eat them, but don't use your epipen. That way you can die happy and on your own terms." ~High school classmate 
  4. "Do online college, you won't be able to handle regular college with your food allergies." ~ER Nurse
  5. "Don't get vaccines--they cause food allergies" ~Facebook "Friend"
  6. "Have you tried probiotics? They fixed my friend's gut health and got rid of her food allergies." ~Whole Food's Cashier
  7. "You should have tried your inhaler first, even if your lips were swelling." ~Paramedic after my school nurse gave me my epipen for an anaphylactic reaction 
  8. "If I were you, I would just stay in my house. That way I could never be exposed to allergens and never have an allergic reaction." ~College Classmate
  9. "What if you took Benadryl every day before eating what you are allergic to. Kind of like a Lactaid pill." ~Pharmacy Student
  10. "Perhaps you need to get rid of your sins and then you will stop having allergic reactions." ~Religious group leader
  11. "Hold food you aren't sure if you are allergic to in one hand and hold out your other arm so that it is perpendicular with your body. Hold your arm ridged. Then have someone try and push down your arm while you resist. If they can push your arm down, you are allergic to the food you are holding. If they can't push your arm down, you aren't allergic to it. ~Food Allergy Mom 
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If You Have Food Allergy Fears, You Aren't Alone 

1/6/2016

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I am a pretty free spirited person. I love smiling, laughing and having fun with the people I love. On a day to day basis, food allergies don't really cross my mind and I am lucky enough that I don't live with day to day anxiety as a result of them. Sure, they are a huge part of my life, but in general, managing them has become as normal and routine as tying my shoes. 

Going off to college, the one thing I didn't want to show anyone was fear--especially my parents. I didn't want my parents to see that I was afraid of using my epipen, or that I was afraid of going to the doctor's by myself or calling 911. I worried that if they knew I was afraid, I would loose their trust that I could handle my allergies six hours away from home.

Unfortunately, in 2015, I had more anaphylactic reactions that I had ever had before. Not all of them were my fault and I attribute most of them to the fact that this past semester in particular, I had been more involved and social activities than I have ever been which put me at a higher risk for allergic reactions. Unfortunately, the more reactions I had, the greater my fears of having a reaction and using the epipen. My fears of having a reaction primarily revolved around knowing what was coming after the epipen--the ambulance ride, the ER visit, all of the meds that make me feel awful, feeling like a disappointment to my parents, days of feeling like I have been run over by a bus, the fear of loosing my parent's trust, not wanting to inconvieneince my friends or interrupt plans, etc. 

When I am healthy, things make sense logically. As an EMT and someone who has experienced plenty of anaphylactic reactions, I know that I need to use my epipen when I start reacting, call 911 and go to the hospital. In the moment though, when I am having a reaction, I want nothing to do with the epipen, or the ambulance or the hospital. I don't think straight and end up putting myself in great danger.

A few months ago, I had a reaction in my friend's apartment. As my lips and tongue started to swell, my friends (an EMT and paramedic) told me I needed my epipen. I wanted to wait it out, hoping it would go down on its own and not require further treatment. Of course though, my friends know that that isn't how reactions work (and I do to when I am thinking clearly and not reacting). According to my friends, they had to hold me down to give me the epipen since I insisted I just wanted to wait. Of course, the epipen (and some benadryl and a breathing treatment) reversed the reaction and I was cunningly able to convince them that I didn't need to go to the hospital (always go to the hospital after using the epipen, no matter how much you don't want to go). 

That night, my friend stayed with me in my apartment. After I fell asleep, she told me I was having night terrors where I would scream in my sleep. At one point, she told me she woke me up and asked me what I was screaming about and I told her that I was dreaming she was chasing me with my epipen. Clearly the fear is real and needs to be taken care of which is why my friends and I are going to talk to a therapist in the near future about how I can control my fears in the moment of me having a reaction.

I guess what I am trying to say is, when I went off to college, I was so afraid of telling my parents about my fears in fear they wouldn't let me go away. As a result, I ended up stuffing and ignoring the fears to the point where I am now having night terrors about my epipen (luckily I don't remember them). 

As a food allergy community, I think we often avoid the discussion of the impact of food allergies and allergic reactions on our mental health. While I don't know the exact reason, I would imagine there are some socially constructed factors that play into it. One, in our society, everyone battling any kind of illness/condition/disability is expected to be a superhero. When we look on the news we don't see stories about those living with illnesses/conditions/disabilities who are wallowing in their sorrows--we only see stories about those living with illnesses/conditions/disabilities who are overcoming the odds. While they are nice to see, it paints this false picture that if you aren't strong through it all, you are doing something wrong. 

The second is the stigma behind mental health and food allergies. In our society, as much as we want to deny it, mental health is still not viewed the same as physical health. Living with food allergies unfortunately can also have the stigma as being weak or attention seeking when looking for accommodations. Whether or not it is conscious or not, I think that the food allergy community doesn't talk about mental health as much as they should because they are afraid it will make them seem weaker and they are afraid people will start to think food allergies are created from fears of certain foods. Which could result in others not taking them as seriously as the are. 

The reality is though, fears can kill. If a fear is so strong 
that you don't use your epipen or you isolate yourself in an effort to stay safe, it is important to seek help and it is important that collectively as a food allergy community we are more open about talking about fears and how to address them so they don't consume our lives.

I am fortunate enough that my fear only really manifests itself in the moment of a reaction and isn't present on a daily basis. Unfortunately though, that isn't true for everyone. In fact, I have talked to many teens who are crippled by their food allergy fears.

While I haven't figured out yet how to manage my fears, hopefully, after speaking with the therapist I will. If you are dealing with fears around food allergies, I ask that you seek help too. If you are too afraid to speak to a therapist or aren't sure where to start, please at least talk to a friend or a parent--someone you trust. In fact, if you don't know who to talk to, email us at  [email protected] and we will be more than happy to lend an ear. 

If you have dealt with fears surrounding food allergies and have some good strategies, please comment below. You never know who it may help!
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    Lily Roth Is a college student with food allergies and Nancy Popkin is her mother.

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