Sunday, May 29, 2016

Restauranteur Convicted of Manslaughter in Peanut Allergy Death

As a person with peanut allergy, I am reluctant to eat at restaurants that have any peanut items on the menu.  A kitchen with peanuts is a kitchen that could cross contaminate my food.  My general rule is that I don't eat at any Thai, most Vietnamese, some Indian, and Chinese restaurants.  

Before I go out to eat, I call the restaurant and ask my questions.  I look up the menu online and I scan it for signs of peanut.  Eating at a restaurant is a pain for me and something I don't entirely feel safe doing.  I am as careful as possible.  

When I was around 12, my mom took me out to eat at the Bamboo Garden, a vegan Chinese restaurant.  The waiter assured us that the restaurant would be careful and not use the same cookware to cook my food.  He said that my dinner would have no peanuts.  He lied.  20 minutes later, I was in the Group Health Emergency Room fighting for my life.  My mom complained to the manager,  and I have never eaten there since.  This experience left me with a deep distrust of vegan and Chinese food.  The waiter who lied, and the sloppy kitchen staff who used very cross-contaminated dishes were never punished for hurting me, and causing my violent reaction.  

To my knowledge, historically, restaurants have been dodging responsibility for the suffering, pain, and sometimes death they inflict on people with food allergies.   People with food allergies are usually blamed for their carelessness in eating questionable food.  

Education about food allergies and the dangers of cross contamination should be required Public Health knowledge to obtain a Food Handler's Permit.  Currently it is not, and that needs to change.  And with this landmark court decision, hopefully it will.  

I have been following this trial for a few weeks.  The jury reached a decision, and they convicted the owner of an Indian restaurant  for the death of Paul Wilson, a customer who was allergic to peanuts.  The server wrote 'no nuts' on Mr. Wilson's take out meal.

I am not usually concerned with the proceedings of trials, court hearings, mostly because legal transactions bore me.  However, I followed the news stories about this case with enthusiastic interest.  I had a burning desire to see if the legal system would serve justice.  Would the court find the restaurant responsible?  Would this decision make restaurant food safer for people with severe food allergies like me?  Would restaurants think twice about lying to their customers in the future, if a guilty verdict was reached?  

I was overjoyed when the jury convicted the restaurant owner.  Justice at last!  I hope that this decision makes restaurant food safer for people with deadly food allergies.  

Saturday, May 28, 2016

Recent Reaction!

A couple of weeks ago, I was eating my snack while driving home from work.  My snack was coconut cashews from Trader Joe's.  It was a prepackaged bag of nuts.  The warning on the bag said "Manufactured in a facility that also manufactures other tree nuts."  I have eaten this snack for years.  I like cashews, and I like coconut, and combined they are a great snack!  Creeping along in heavy Seattle traffic, I bit down, and realized that my mouth was no longer tasting the sweet, wonderful taste of cashews, but rather the nutty, roasted, rich taste of peanut!

I was in mid-swallow when I realized what was in my mouth was potentially fatal.  Luckily, I always carry a vomit bag in my car, so I gathered up the bag and spit out the remaining contents of my mouth.  Seattle has awful traffic, and I was stuck!  I had a couple of choices:  pull over and call 911 and use the Epipen, or drive to the hospital using a low traffic route, and use the Epipen if my body started displaying objective signs of anaphylaxis.  I chose option B.  I thought it would probably be safer to just Epipen myself while speeding to the hospital, rather than waiting for an ambulance to take me up to an E. R. on pill hill.

Accidental ingestion is a catastrophic scenario.  If a person dies from a food allergy, accidental ingestion always triggered the fatal reaction.  Accidental ingestion is terrifying to a person with peanut allergies because of 3 things: it's unpredictable, it can occur immediately or within 20 minutes after eating the contaminated food, and finally, once the reaction progresses beyond a certain point, it's impossible to reverse with an Epipen.

So, knowing all of this, I drove myself to the E. R.   I had the Epipen hovered over my right quadriceps.  I didn't use the Epipen.  Probably should have.  Due to the possibility of  accidental ingestion.

The main reason I did not stab myself in the leg with the Epipen is that my body did not show objective signs.  No sudden asthma tightening and wheezing.  No hives.  No swollen lips.  No swollen throat.  I tasted peanut.  That's it.  This whole adventure could have been a false alarm.  Who knows?  But with deadly food allergy, it is always better to be safe than sorry.

The Epipen is painful.  Imagine taking a Philip's head screwdriver and stabbing yourself in the leg with it and holding it there for 10 seconds.  This is what it's like to get Epipened.  If it's between the Epipen or death, give me Epi.  If I am around other people, I usually get someone else to administer the Epipen, because I have a hard time doing that to myself.

I have asked my allergist numerous times to write me a prescription for a small needle kit for epinephrine like the diabetics use, and he claims that epinephrine is not sold to consumers that way.  I am a careful methodical person.  I majored in Biology and Chemistry, -it would be easy for me to pull over, get out my little epi-kit, fill a small injector with the medicine, and then inject it into my arm muscle.  That's more my style.  I could easily handle that.  I struggle with firing what feels like a nail gun into my leg.  No wonder people don't use the Epipen like they should.

In the past, I've noticed that a few weeks after a recent anaphylactic episode, I have nightmares that I Epipened myself, and after I wake up, I discover a large bruise on my leg!  I am most likely punching my leg while dreaming.  This is encouraging because it seems to indicate that my mind and body will hack my brainwaves to survive anaphylactic shock!  I'm sure I could stab myself if I was confronted with objective evidence of anaphylaxis, (sudden wheezing and asthma, hives, face swelling, vomiting, diarrhea).  

There should be an alternative delivery system that is not as violent and doesn't hurt as much as the Epipen.  I received vaccinations in the in the rear when I was a kid, and they didn't hurt as much as the Epipen.  There ought to be another device invented that will inject epinephrine in the arm, or the rear, a little more chill, and non-violent.  I sure hope big pharma manufacturers read my blog, and create this!

Once I got to the Emergency Room, I parked in the 30 minutes or less space right by the automatic sliding glass entrance doors.  I went in and explained my situation to the triage nurse.  I sat down by the aquarium.  I tried to relax and watch the fish.  This was to be my last moment of relaxation and healing for the next 3 hours.  My name was quickly called.  I explained what happened to the next nurse.  My vitals were normal.  My pulse was fast, 100 beats a minute!  I was scared as hell!

I was taken to a small room and a doctor looked over my chart, took my vitals again, and decided I did not need epinephrine.  She noticed that I was getting a red rash and she was concerned about how my asthma sounded, which was slightly worse than baseline.  She ordered IV Benadryl and left.  A nurse hustled me to a new location.  The Emergency Department of UW was getting busy and they needed the room.  My new address was a gurney in the hall.  I changed into a hospital gown and orderlies attached sticky monitors to my chest and back.  A blood oxygen pulse counter was clipped to my finger.  An IV catheter was inserted into my right arm.  The IV was very painful.  My arm ached with dull, throbbing pain.  It hurt so bad I couldn't move it, and after about 20 minutes, my fingers started to tingle.  I was trapped, wired to the hallway heart machine monitor laying on a bed in the E. R. hall, my right arm frozen in agonizing pain.  I was at my most vulnerable.

Despite my physical restrictions, I was able to take a couple of decent selfies...  With my left hand!

I was having a really good hair day that day.

I talked to a couple nurses about the intense pain that the IV in my arm was causing me, and they were unsympathetic.  A terse nurse told me that she could take it out, but she's have to "Stick me again."  I decided to leave the catheter of pain in.  My arm was shot up with diphenhydramine and then I felt dizzy.

Light-headed, helpless, and exposed, I took a look at what was going on in the E. R. and allergies became the least of my worries.  About 15 feet away, the nurses had locked the door to a patient room.  The person inside started to pound the door. 'Bang! Bang! Bang!'  I could see, hear, and feel the door shake.  A nurse called security, and security guards swarmed around the door and the person inside calmed down.  The people who handled the situation started to disperse.  Now I could relax and focus on healing.

That's when I heard the screaming from a room behind me.  The screaming died down.  It was not a full moon that night.  What was going on?

I asked about the screaming, and the nurse explained that the person screaming was now calm because they had ordered his dinner, and he now seemed fine.  I took a deep breath.  Everything was going to be alright.  I was going to be okay.  I heard a loud commotion start behind me: screaming, a struggle, a door being forced open, and a tray full of food whizzed by my head and hit the wall opposite me.  Nurses, orderlies, and security ran past me to subdue the patient who was freaking out.  They seemed to have succeeded because the noise calmed down.

An orderly started to clean up the broccoli and food splattered on the wall.  I looked at him and said, "I guess the food here is terrible and I think he didn't like the broccoli."  The orderly and I laughed.

I was completely terrified.  After 3 hours of observation with no noticeable symptoms of anaphylaxis, the next nurse just who had just arrived to the next shift okay'ed me to be discharged.   I paid whatever it was they charged me, like $300.

What an adventure!  I am very grateful that I didn't get very sick.  This experience had positive aspects that will help me be a better person.  I made some mistakes, and I learned from those mistakes.   I got to practice my skill of being a hospital patient (I am very good at being in the hospital).  Living with deadly allergies may be terrifying at times, but it's not as catastrophic as the fear in my mind sometimes makes it out to be.  Experiences like this have made me extra-ordinarily resilient.  Now, I have a greater appreciation for all the little things in life, and I have noticed I seem to have increased compassion and patience for the people around me.  Thanks for reading my blog.