Greeting card frustration

I recently tried to buy a greeting card for a friend who was in the hospital. After scanning the row upon row of trite humor and syrupy sympathy I gave up and went home, which is what usually happens when I try to buy a greeting card.

There are whole stores that are devoted to selling greeting cards (and a few other odds and ends associated with giving gifts). They would have you believe that there is a greeting card for every situation: birthday, graduation, wedding, illness or injury, and even death. Cards fall into a few categories: the ones with tasteless or almost tasteless humor, purporting to express something that can only be humorous if it is untrue, and therefore completely irrelevant; the ones with cute animals and fatuous statements; the ones with handsome photos or artistic drawings of the human body; and the ones that are blank. Actually, there are more, but those seem to be the ones I notice.

Each card displays a few key words on the front to make it clear its intent, so a birthday card will start with "This birthday..." and a wedding card will say something like "Congratulations on your wedding" as if to merely say "Congratulations" was not enough for the lucky couple to figure out what it was in regards. This is, of course, because the point of the writing on the front of the card is not so much to express any thoughts to the recipient, but to advertise the purpose of the card to the purchaser. The end result is that the card feels unnatural to the person for whom it is intended.

I inevitably buy the blank cards because, after a sincere effort to find a card that will help me straighten out my thoughts and feelings without actually requiring me to write them myself, I always feel a bit insulted by the simplicity of the commercial cards.

The word greet can mean both to address with some form of salutation and to grieve. This is convenient for the people who manufacture greeting cards, because they create cards not only for happy occasions, like birthdays, but also sad occasions, like the death of a loved one, and disappointing occasions, like injury. Despite the breadth of the occasions, though, there didn't seem to be one card that was appropriate for the one our friend was facing. You see, our friend was in the hospital with the big C. Not the "get well soon" kind, but the kind when the only type of treatment is morphine. The kind when you know the end is coming very soon.

So there I was trying to find a card for when we saw him for what would certainly be the last time. The sympathy cards didn't seem right: I didn't just want to say we were thinking of him. A "Get Well Soon" card would have been insulting. There were cards for when someone has just died, but nothing for someone who was about to die. It was clearly all too immense for the greeting card companies to face. After breaking down in tears, I went home and made a card with a sad face and filled it with my own thoughts about how we were happy we met, that we had become quite accustomed to having him as a friend, and were going to miss him when he was gone. And we do.

Rest in peace Graham.

Land of contrasts

It has been an interesting summer here in Melbourne.  We spent most of the summer trying to keep out of the oven hot temperatures with the hair dryer winds, including three consecutive days in the mid 40s (that's around 110F) with high winds.  In the months of January and February we received only a few mm of rain in Melbourne (normal is about 80-90mm for that period).  At the start of February there was a further windy 40+ day followed by a windy cool change that resulted in the deadliest and most destructive forest fires in Australia's history.

While the drought that started before I moved to Australia 8 years ago wares on, the town of Innisfail, in Queensland, was submerged under flood waters.  Between January 25 and February 25 the tropical town received more rain than Melbourne has for the past four years!  And this week Coffs Harbour, on the North coast of New South Wales, was inundated when some areas near the town received almost 450mm in 24 hours.  Just in case you can't process mms, that's about 1.5 ft of water!  I can't even fathom that much water falling from the sky in such a short period of time.

Finally, to keep us on our toes, we've felt two earthquakes in Melbourne in the past month.

Autumn has come, however, bringing cooler and wetter weather.  The drought is still here, but we've finally had a few good rainfalls, and those fires that were set in February have been contained.  Despite all the sensational news (I mean that in a bad way), we are doing well, as are our friends and family.

Hard to judge how rational the fear is

A recent article in Salon.com about peanut allergy got my goat.  Here's my reaction.

Fear is only irrational if it is out of proportion to the risk. The problem with peanut allergies is that, for many of us, it is difficult to assess the risk of us or our children becoming severely ill or dying from exposure to peanuts. Certainly, for some people, the risk became quite obvious the first time they or their child was rushed to the emergency room, but for many others the allergy is identified in relation to treating less sensational threats, like eczema or asthma. For those people identified through skin prick tests or blood tests as likely to have an allergy, or those who had a reaction to eating peanuts that was not confirmed by a physician, assessing the risk is decidedly more fuzzy.

If the average time from exposure to anaphylactic reaction is 10 minutes, then anyone caring for a potentially allergic person must know how to administer their epipen. Most people have never triggered an epipen and have no specialist training in recognizing an allergic reaction, so for them the best way to control the situation is to prevent exposure to the allergen. This is true not just for parents, but for childcare centers, kindergartens, and schools. For children who are too young to read the ingredients label, or who lack the life experience to know that something called "satay chicken" contains peanuts, it is pivotal that the environment they are in contain as few allergen containing foods as possible. This is why carers of children are increasingly choosing to restrict common allergens from places that are largely populated by children who are too young to protect themselves.

The author implies that many of the children described as allergic to peanuts or other foods are not. Though many people misuse or do not distinguish between the terms "allergy" and "sensitivity", it is not fair to denigrate the experiences of those who suffer serious discomfort from eating certain foods, whether they have been confirmed by a skin prick test or not. Neither skin prick tests nor blood tests are 100% predictive of allergic reaction or lack thereof. The Australasian Society of Clinical Immunology and Allergy states

"When properly conducted, the skin prick test is a highly sensitive and specific test for the presence of allergen-specific IgE antibody. However, the presence of IgE antibody (as defined by a positive skin prick test) does not prove that the patient is clinically reactive to the allergen."

They go on to state that wheal size is not predictive of the severity of symptoms. Controlled food challenges, where the subject eats the food in question in a controlled environment, are considered the gold standard for determining food sensitivity.

My son, who suffered from severe eczema as an infant, has had multiple positive skin prick tests to peanuts (and never negative) but never had a reaction that could be definitively attributed to peanuts. Still, the allergist recommended avoiding all nuts until he was older. After accidentally exposing him to almonds with no negative effect, I foolishly decided to challenge him with cashews, to which he had a severe, but not anaphylactic, reaction consistent with allergy and later confirmed by a skin prick test. We now carry an epipen. As much as I would like to believe we will never need it, it would be irresponsible of me to ignore the recommendations of his allergist, who I must assume knows more on the subject than I.

Though many people with peanut allergies do not have life threatening reactions to eating them, the conclusion I've drawn from countless hours spent trying to determine how serious my son's allergy may be is that the medical studies cannot conclusively say that the severity of one person's reactions will always be consistent. Hence, he may have hives one time he eats peanuts and anaphylaxsis on another occasion. Then again, he may not, but how am I to know. And that's my point. Without more accurate tests to predict the severity of a reaction then one must conclude that a life threatening reaction is possible for anyone who demonstrates some kind of reaction.

I'm all for ridding the world of misinformation, and I appreciate the author exposing the questionable statistics of the FAAN and the motivations of Ms Munoz-Furlong, but I think the author has failed to provide clarity about peanut allergy. Despite any of his efforts to the contrary, he has produced an article that belittles those who express concern for the welfare of the children in their care. If a skin prick test predicted that a child in your care was probably allergic to peanuts, and whose doctor recommended avoiding peanuts and carrying an epipen, you would never forgive yourself if that child died because you did not take the advice seriously.