WEST ORANGE, NJ — West Orange resident and food allergy advocate Nicole Ruffo spoke out at Monday’s West Orange Board of Education (WOBOE) meeting on the need to train teachers to recognize the signs of a student going into anaphylactic shock.
Three of Ruffo’s four children, all of whom attend West Orange schools, suffer from food allergies. After recently addressing the WOBOE about the need to formulate a food allergy awareness committee, Ruffo returned on Monday to share the recently publicized story of fellow parent Julie Ferrier Berghaus in order to show as many people as possible “how complicated food allergies are and how many different ways an allergic reaction can present itself.”
Berghaus’ daughter was undergoing a controlled tree nut challenge at her allergist, which Ruffo mentioned took place in a hospital setting so that the child could try to outgrow the allergy. Five minutes after being fed “approximately one-tenth of a cashew for her challenge,” the daughter’s ears began to itch.
“She was perfectly happy and playing still,” Berghaus wrote, but said that her daughter later complained of a stomachache and was scratching all over her body without a rash present. At this point, the health professionals decided to administer her first epinephrine (EpiPen) shot, because “she was exhibiting two symptoms, belly pain and itching,” then they gave her a dosage of oral Zyrtec, Ruffo explained.
Ruffo continued that for about ten minutes everything was calm, until the daughter started itching again.
Reading from her fellow mother’s story, Ruffo said, ‘“Upon inspection, her entire body was quickly breaking out in severe hives before our very eyes,”’ and then explained that the daughter was given a steroid called Prednisolone. ‘“She was still playing, and not showing signs of real distress. About five minutes later, there was a big coughing fit. We couldn’t hear her breathing really hard or wheezing at all, so when they called the nurse, she came in, she checked, she listened with a stethoscope.”’
Ruffo interjected the story at this point to reiterate that this occurred at “a controlled place with nurses and doctors.” Ruffo continued that Berghaus’ daughter, who was still alert and playing, started complaining of tightness in her chest and it was not long after that she ‘“started blacking out.”’
According to Ruffo, the child was given an albuterol treatment along with another shot of epinephrine, and was then given ‘“a dose of Solu Medrol,’” which is another hormone steroid.
After this, the daughter was coming in and out of consciousness and as a result had to be watched for several hours because ‘“the anaphylaxis can return in a second round, just as severe as the first.”’ This, according to Ruffo, “is the super scary part for many allergy parents.”
‘“It was nothing like we expected to see,”’ Ruffo continued to read. “It snuck on so unexpectedly and quietly. I [Berghaus] expected to see choking, gasping, hear wheezing, and see her grabbing at her check and neck…I expected the entire ordeal to be very fast and obvious and dramatic, and actually it was very silent”’
As she finished reading the story, Ruffo said, “Imagine if this was field trip, on a bus, outside during recess, which always happens after they eat, or during an assembly or a special where they’re being transferred between teachers.”
“To me,” she said, “I just feel that every staff member needs to be trained on all of these different ways to see [an allergic reaction].”
The board collectively appreciated Ruffo’s comments and Acting Superintendent Eveny de Mendez assured Ruffo that, although it might take some time, the board will be “reaching out to the different parents shortly to say who would like to participate” by joining the upcoming committees.
WOBOE member Mark Robertson commented that Ruffo’s struggle resonates with him because he grew up as “sickly asthmatic child,” whose “big goal every day [was to] be able to go out, play ball and act like [he] can actually breathe.” He suggested that the board try to get an “analysis from [the] nursing staff and from [a] PE/health teacher.”
“Those are two areas where we’re addressing health and wellness on a daily basis, both through education and through actual interventions,” said Robertson, who added that he believes this could help guide the board and the committee as well.
Ruffo stressed the importance of having a plan for the upcoming allergy committee and updating the allergy management plan. Ruffo concluded by saying that “there is no time to waste and we have to start now.”