The Cost of Allergies - Uncle Sam Give Me a Break!

As your mom - I manage most of your health and so I know how expensive all this can be and those costs can add up really quickly, and we have reasonable health insurance. 

From the steep $600+ for an Epi-pen to thousands of dollars each month on food suitable for your long list of allergies and doctor appointment visits to ambulance rides and hospital stays. The costs are high and climbing.  Since I am a CPA, I often get questioned on taxes and credits, etc. The short answer is, I have no idea about taxes! Well I know enough to be dangerous and hold a conversation at a cocktail party. But this got me thinking, are any of the costs related to your allergies deductible?

I did some digging and the answer is Yes! And no.

First, what can we deduct:

• Co-pays
• Transportation costs, including mileage, using the standard mileage rate
• Parking 
• Overnight stays
• FOOD!

Yes, you read that right. The costs of special food can be deductible. The food must meet certain criteria. Those criteria include:

• The food must not be used to satisfy normal nutritional needs;
• The food must alleviate or treat an illness; and
• The need for the food must be substantiated by a physician

"The amount you can deduct as a medical expense is limited to the amount by which the cost of the special food exceeds the cost of a normal diet.  So, for example, if you buy special flour that costs $7/bag because of a wheat allergy and regular flour is $5/bag, you can only include the difference ($2) for purposes of calculating the deduction.  In other words, you cannot deduct the cost of all of your special food; you can only deduct the difference between the cost of your special food and your "normal" food.  If there is no such "normal" equivalent, however, the entire cost of the product is deductible."

Keep records to substantiate the claims. The expenses may be subject to phase outs, eligibility requirements and other limitations and we can only deduct those expenses which exceed 10% of our adjusted gross income (AGI).

What you cannot deduct:

• OTC medicines, even if doctor recommended, example: Motrin
• Non-prescription based personal care products, example: oatmeal bath, creams

The big take-away here is to track all of our expenses all year and if we meet the 10% floor of our AGI, we can start deducting. 

Raisins are the New Candy!

Another trip in the books. This time we went to Seattle for a family wedding. We stayed with Grandma and Grandpa Perry. These sorts of trips where we are staying with someone and have a kitchen on hand are super easy for us to make your food and ensure you are safe. This makes planning really easy.  Except when you have a reaction, which you did.

You and Greyson enjoying juice

It was Friday night and chili and cornbread was on the menu. Cornbread, made of corn right - not so fast, there is in fact wheat in many versions, not all though.  You and your cousin Greyson, who is about six months older than you were eating. He had cornbread and you did not. He even washed his hands. Then you two went about playing like you have known each other for years! Then as I am eating, Daddy was bathing Emrys, I hear that cough you have when you have a reaction. That dreadful, sudden iconic cough. I stop eating and sit by you and watch. I don't think anyone noticed at this point what I was doing. I certainly don't want to draw attention to something if it is nothing because I think many people that don't deal with food allergies are on edge or they think I am over the top and making the situation more intense than they think it needs to be.  Anyway, you did stop coughing after a few minutes, so I went back to eating.   Everyone, including Greyson goes home. You get your bath and then your coveted milk. And then I saw it on your face, projectile vomit. At this point I knew you had come into contact with something, likely wheat, since that was the only thing prepared that you are allergic to.

I clean up the stinky mess with Grandma's help while Daddy bathes you again, much to your displeasure. You already bathed, why again!? Daddy and I watch you for about an hour and nothing else happened. I know you didn't eat any wheat, but came into contact with a very very small amount. You are very sensitive now, which means we all have to be incredibly careful about wheat.

Sharing raisins with Great Grandpa

Fast forward a few days, to the wedding. I cooked your dinner before we went and ensured I had endless amounts of food for you. During the cocktail hour, you noshed on your safe snacks, sharing some with your Great Grandpa Perry all while Emrys was able to eat freely on the sesame chicken, bruschetta and whatever else Auntie Chantel wanted to feed him.  What a feeling to not have to worry. I long for this day for our family. The fear and anxiety is real and it's every damn day, every damn meal, every event, every party, everything. But we still live, fly on airplanes, go on vacation, have dinner dates, attend play dates, laugh, smile and eat.  We will not let food allergies control us, we control them.

Knocking on Death's Door: Anaphylaxis

With you having your first full blown allergic reaction requiring medical intervention to derail the possibly life-threatening symptoms, I am hearing the same questions from friends and family,

• What was it like?
• Did Jahan swell up like Will Smith in Hitch?
• Was he gasping for air?
• Did it happen after one bite? 
• How fast did it happen?
• How did you know you needed to use the Epi-pen?

I want to address all of these. 

I had a conversation with your daddy on Sunday night that took me well past my 10:30pm bedtime when I asked him if he thought your reaction to a mere 281 milligrams of wheat was a wake-up call to him, would he have used the Epi-pen had I not been there? Would he have called 911, gone to the hospital, etc. etc. Daddy did not correlate the symptoms that your were having with having a severe allergic reaction. He didn't want to use the medicine and DID NOT want to go to the hospital.  Scary right? But why didn't he recognize the symptoms, why no Epi? Why skip the hospital? 

Your first symptoms included coughing, nothing crazy, but an obvious sign that there was something going on in your airway. That progressed to you vomiting, which is a great thing.   30 minutes went by and coughing began again, heavier, more frequent. Then itching, then throat itching. This is when I knew we had to intervene. There were clear signs of a systemic response and airway distress. Daddy did not agree with me. I pushed, we called and gave you the Epi-pen. Your symptoms stopped almost instantaneously. Wow - it was that fast. 

Daddy, like many people, including myself, thought that the reaction that would require medical intervention would be really fast, like in the movies, and it certainly can be, but it doesn't have to be. Daddy thought you would swell up, be gasping for air and turning blue. None of that happened, it could have, but it didn't get to that point. The reaction was slow, 45 minutes after ingestion to Epi-pen. Daddy also thought that the Epi-pen administration meant, we are in the clear, that's your parachute to safety, well sort of, but not entirely.  The epinephrine, which is the medicine in the Epi-pen, without getting too technical, helps to stop anaphylactic shock.  The medicine works almost immediately and then can wear off after 20 minutes or so and the reaction can persist. That is exactly what happened to you my love. When you got into the ambulance, about 20 minutes after you were given the Epi-pen, smack dab in your left thigh, the reaction began again. Head to toe hives, huge and small, red and clear. All. Over. YOU.

One of the hives - after Epi, Benadryl, Pepcid and Steroid. The size of my palm

Recovering in the hospital, scared, latching onto daddy

Daddy, like many, thought the hospital was more of a burden then a necessity, that was until he saw the post-Epi reaction begin.  The hospital would monitor your vitals, provide additional medicine (epinephrine, steroids, pepcid) to derail any further reactions. 

Anaphylactic shock can present itself in many ways, but a few take-aways for us, our family and friends:

• Allergies are no joke
• When giving new foods, pay attention for up to four hours for a reaction
• DO NOT WAIT - give the epinephrine before blue, swollen shut and knocking at death's door
• Go to the hospital post Epi
• Every reaction is different than the next and previous

Angel, recovering, you are so resilient Jahan