Dr. Manny: Little boy's death can teach us a lot about food allergies

Oakley Debbs ate a cake containing walnuts. (Red Sneakers for Oakley)

When I read about 11-year-old Oakley Debbs’ tragic peanut allergy death, and the horror that his family has had to endure since his untimely passing in November, it struck me that for many parents who do not deal with allergies in their own children, the seriousness of the issue may not hit home. According to his family, Oakley was like any other growing child who loved sports and hanging out with friends, but he was also one of the estimated 3 million Americans living with a peanut or tree nut allergy.

During a family trip to Vermont and Maine this Thanksgiving, Oakley ate a piece of cake that contained walnuts, and never recovered. As a physician and as a father of children who have their own food allergies, I can tell you that this is one of my greatest fears. What is even more frightening, is that the Debbs family followed their typical protocol when it came to dealing with Oakley’s allergic reactions, but that this time it was not enough to save him.

When a child or person of any age is exposed to a food allergen, things can go from mild to worse in a matter of minutes. Oakley’s reaction began as a small blister, according to reports, which went away after he was given Benadryl, and escalated to vomiting and anaphylactic shock with seizures and cardiac arrest to follow. The Debbs administered an EpiPen three times but it didn’t help.

When severe allergic reactions like anaphylactic shock occur, it may take a hospital setting to counteract the effects of the allergen. Often during anaphylactic shock, patients suffer from laryngeal spasms, which is when the vocal chords constrict or close meaning there is no air flowing from the mouth into the lungs. Such a state requires trained professionals to break the spasm and administer a breathing tube in order to maintain oxygen flow to the brain. If air flow is not restored quickly, there is a risk of brain damage or even brain death. The same risks apply with systemic swelling, which involves swollen mucosa that interferes with oxygen flowing to the tissues. In this circumstance, large doses of intravenous steroids are required to be given quickly.

With food allergens carrying such high risks, I am amazed that food labeling is still not as clear as it could or should be. While it’s not clear in this case whether the cake Oakley ate was homemade or store bought, labeling is one of our greatest tools in preventing severe allergic reactions. It also shocks me that airlines continue to serve peanuts knowing that at 35,000 feet in the air, emergency medical attention is limited. Even worse, many school systems are not well-suited in identifying food allergies, or have an organized plan in place for dealing with an anaphylactic shock, should one occur in the cafeteria or classroom.

My heart goes out to the Debbs family and I applaud them in their latest efforts to raise awareness. They have chosen to honor Oakley by speaking out about food allergies and spreading valuable information so that other families do not have to endure their same tragic fate. With more than 15 million Americans living with some type of food allergy, chances are, you know at least one of them, or your future children  may join that population. Take time to educate yourself about the importance of cross-contamination and safety precautions when bringing homemade goods into public places, because worried parents everywhere will thank you.