How to use Epipen, Jext Pens and Emerade

No one wants to be in the situation where they need to use an adrenaline auto-injector but it's a good idea to know exactly how to use one if the situation were to unfortunately arise. Currently, in the UK, 3 different types of adrenaline auto-injectors are available, these are Epipen, Emerade and Jext pens. Each pen is different so I will be discussing how each of the pens are used as well as my experiences with both epipen and emerade pens as I have used both of these after suffering anaphylactic reactions. I hope this blog proves to be useful in helping people newly diagnosed, help the general public become more aware and more educated and also help provide experience and reassurance to people who are at risk of anaphylaxis but have never suffered a reaction before.

Epipen

Epipen is available in 2 different medication strengths, 0.15mg (the green pen for children weighing between 7.5kg-25kg) and 0.3mg (the yellow pen for children and adults weighing more than 25kg). Both pens are supplied in a sturdy outer case which protects the pen. The 2 different pens work in the exact same way which makes moving from the lower dose to the higher dose stress-free. The orange end is a shield which covers the needle and the blue cap when not removed means the needle end is not active. Here's a step-by-step guide on how to use an Epipen:

1. Remove the Epipen from it's carry case
2. Hold the Epipen in your dominant hand in a fist, the orange end (needle end) facing down to the ground and the blue cap end facing up to the sky (a way to remember this is "orange to the thigh, blue to the sky")
3. Remove the blue safety cap using your other hand, keep all fingers away from the orange end as the removal of this cap means that the needle is now active 
4. Move your hand with the epipen approximately 10cm away from your thigh
5. Swing your hand and jab the pen against your thigh at approximately a 90 degree angle and keep it there for 3 seconds 
6. Remove the Epipen from your thigh (the orange shield over the needle end extends fully to cover the needle so there will be no exposed needle) 
7. Dial 999 and seek medical attention stating you've suffered an anaphylactic reaction and have used your Epipen 

From my personal experiences with administering Epipen I found it easy to use. The one thing a lot of people ask about it is "does it hurt?" and I personally found on administering it it didn't hurt much, afterwards I'd have a sore leg for a few days but it wasn't extremely painful, I'd describe the initial pain similar to getting stung by a bee/wasp. 

It can be really helpful before you end up in the situation of having to use your Epipen to order a trainer epipen (you can get one via this link: https://www.epipenshop.co.uk/), sometimes the person who looks after your allergy and who issued the prescription for an Epipen is able to supply you with a trainer pen so it's worthwhile asking if they have any, if you can't get a trainer pen another good way of learning how to properly administer an epipen is by watching a video which shows the correct way to administer it (an example of a video such as this can be found here: https://www.youtube.com/watch?v=isyth9yqlKI). 

For more information on Epipens please visit: http://www.epipen.co.uk/

Jext

Jext pens are available in 2 different medication strengths, 150mcg (the yellow pen for children 15kg-30kg) and 300mcg (the red pen for children and adults over 30kg). The 2 pens work in identical ways which makes switching from the lower to the higher dosage as stress-free as possible. The black end is a shield which covers the needle and is inactive until the yellow cap is removed. Here is a step-by-step guide on how to use a Jext pen:

1. Take the Jext pen out of the container it's in
2. Hold your Jext pen in your dominant hand and keep the black end (needle end) facing downwards to the ground and the yellow cap end facing upwards to the sky
3. Remove the yellow cap, keep all fingers away from the black end as the removal of this cap means the needle end is now active 
4. Place the tip of the black end against your thigh at approximately a 90 degree angle 
5. Push hard against the thigh, you will hear a clicking noise when the needle has activated, keep the Jext pen in this position for 10 seconds 
6. Remove the Jext pen from your thigh and massage your thigh for 10 seconds (the black shield extends down the needle-length to fully cover it once activated)
7. Dial 999 and seek medical attention stating you've suffered an anaphylactic reaction and have used your Jext pen

I personally have never used Jext pens so cannot comment on how I find using them or how painful they are however I imagine it'll be similar to the pain of an Epipen which, as I'd mentioned above, isn't too painful, it just left me with a painful leg for a few days.

It can be really helpful before you end up in the situation of having to use your Jext pen to order a trainer Jext pen (you can get one via this link: http://www.jext.co.uk/), sometimes the person who looks after your allergy and who issued the prescription for an Jext pen is able to supply you with a trainer pen so it's worthwhile asking if they have any, if you can't get a trainer pen another good way of learning how to properly administer an Jext pen is by watching a video which shows the correct way to administer it (an example of a video such as this can be found here: https://www.youtube.com/watch?v=jJNrIBksvWk).

To find out more about Jext pens please check out http://www.jext.co.uk/.

Emerade

Emerade pens are available in 3 different medication strengths, 150mcg (the pen with yellow writing for children 15kg-30kg), 300mcg (the pen with the green writing for children and adults over 30kg but under 60kg) and 500mcg (the pen with the green writing for adults over 60kg) (please note that these are just recommended dosages, the individual prescriber may decide that the 500mcg dose is more suitable for you in spite of you being under 60kg). The end of the Emerade pen you remove is also the end where the needle is unlike both the Epipen and Jext pen where you remove the opposite end to the needle end. The needle end of the Emerade is clearly marked as such on the pen itself. Here is a step-by-step guide on how to use an Emerade pen: 

1. Remove the Emerade pen from it's outer casing 
2. Remove the cap from the needle end, keep all fingers clear of this end once the cap is removed
3. Place the now activated needle end against the thigh at a 90 degree angle 
4. Press down against the thigh and hold for 5 seconds
5. Remove the Emerade pen from the thigh and massage for 10 seconds 
6. Phone 999 and seek medical attention stating you've had an anaphylactic reaction and have used your Emerade 

I personally am prescribed the 500mcg version of Emerade due to being over 60kg in weight. I have found the Emerade pens are very easy to use, they tend to have a longer shelf-life than both Epipens and Jext pens. In terms of how painful they are to administer the Emerade pens have a longer needle than other adrenaline auto-injectors and also the 500mcg dose is a higher dose of adrenaline so I have found that Emerades are slightly more painful to use than Epipens, they don't hurt too much to administer initially but I found afterwards I had quite a stiff leg and also my leg was more painful for a few days afterwards. 

It can be really helpful before you end up in the situation of having to use your Emerade pen to order a trainer Emerade pen (you can get one via this link: http://www.emerade.com/order/), sometimes the person who looks after your allergy and who issued the prescription for an Emerade is able to supply you with a trainer pen so it's worthwhile asking if they have any, if you can't get a trainer pen another good way of learning how to properly administer an Emerade is by watching a video which shows the correct way to administer it (an example of a video such as this can be found here: https://www.youtube.com/watch?v=G7PUsftg9ls). 

For more information on Emerade please visit: http://www.emerade.com/

Drinking alcohol whilst living with allergies (and) anaphylaxis

I have lived with anaphylaxis since the age of 16. I very much spent the later part of my teenage years, like a lot of other teenagers, experimenting with alcohol in different settings whether it be house parties, parties, night clubs, pubs etc. I found I faced new challenges surrounding this, challenges which people without allergies wouldn't even think twice about. I've decided to put together some tips surrounding staying safe whilst enjoying alcohol and having a good time with allergies.

1. Ensure that you take all of your medication with you
This is really important to do in any situation but particularly where alcohol is concerned. It's been found that alcohol can increase your risk of reacting if you're exposed to something you are allergic to. Young people can find it difficult being different to their peers and want to fit in so may decide not to carry their adrenaline with them, this is a big no no particularly where alcohol is concerned.

2. Make sure you know where you are

This may seem like common sense but knowing the exact location for the place you are in whether it be a home address or the address for a bar/nightclub. I myself have been in the situation where help was delayed as we couldn't give an exact address for the place I was at, thankfully this situation didn't prove fatal. Help being delayed could potentially result in a fatality so it's vital to have a mental note of your exact location so the emergency services can be given it straight away.

3. Be aware of what your drink contains 
Many people with allergies don't realise that drinks can pose issues and could have your allergen within them, even though it seems like they are completely safe. For example amaretto can be made with almonds and would be unsafe for a person with an allergy to almonds, wine can contain sulphites so would be an issue for someone with a sulphite allergy, wine can even contain milk which could be problematic for someone allergic to milk. Drinks such as cocktails are definitely worth asking about what exactly is in them as sometimes the name doesn't fully give it away. If in any doubt it's best to avoid it entirely and select something you've had before and know is safe. I found this list to be really helpful in terms of steering me in the right direction as to what is best avoided and what I should ask about: http://www.bestallergysites.com/alcoholic-beverages-that-contain-top-allergens/


4. Have a medic alert  

This can be a life-saver if you, for example, fall unconscious (whether that be due to too much alcohol or the result of your reaction). It's not only important to help alert someone that you do have allergies but also is good for medical staff to know what to avoid giving you if you are in a situation where you may be inebriated. Where young people are concerned some people don't want to wear a medic alert as they feel they will stick out but many medic alert items are rather stylish and to and most people wouldn't notice it. There are even items that are suitable for males such as dog tags or plain bracelets. Some examples of companies which do medic alert pieces are:
Medic Alert:
https://www.medicalert.org.uk/ This is personally where I got my medic alert bracelet. Their items are a great price and there's such a wide variety, there will be something to suit most people. The good thing about this company is they create a file with your information in it, you have a membership number and medical professionals can phone up Medic Alert's number quoting your membership number and get information about you, and they also supply you with a card to keep in your wallet with more information than is on your item of jewellery.
ICE Card:
http://www.icecard.co.uk/ ICE Card supplies a range of different in case of emergency cards for a host of different medical conditions. They have wallet sized cards as well as cards which go on your keys. The cards are plain and give you space to write your personal details as well as your emergency contacts and your GP practice etc. You can also get cards which allow you to write extra information on them so you can document as much as you like. Their products are greatly priced with the allergy pack costing only £4.99 (http://www.icecard.co.uk/allergy-icecard-pack/)
The ID Band Company:
http://www.theidbandco.com/ They have a range of different styles of medical ID ranging from silicone bands, bracelets to charms and watches. They're ID's range in price and are a great value for money. There's something for anyone and they're suitable for any gender and any age.
Make your own: 
If you don't wish to purchase a medic alert an idea is to make your own. I personally have wallet cards made with with: my name, date of birth, address, GP surgery, my next of kin, medical conditions, allergies (and the reactions they cause i.e. anaphylaxis, rash etc.) and medication I take. This has proved so helpful when I've been in situations where I have had to have an ambulance phoned or I've ended up in hospital. This can be a real time saver when you have a lot of medical conditions or lots of allergies or take multiple medications. It can also really help speak for you when you can't (i.e. you're unconscious or you're struggling to breathe) it can also help in the situation where you've been drinking as sometimes when you're drunk you may struggle to make lots of sense.

5. Letting who you're with know about your allergies and what to do in an emergency
This is rather important when it comes to going out drinking. It can feel awkward in the sense some people don't like telling others that they have allergies but it can truly be a life-saver in this situation. If you were to, for example, fall unconscious as the result of an allergic reaction who your with is more likely to phone for medical help than if they aren't aware of your allergies as they may just assume it's alcohol related if they cannot rouse you. I've personally been in the situation where I was faced with a friend having to phone an ambulance on a night out, I'd become unwell in the toilets and when I was found they automatically phoned an ambulance whereas if they weren't aware of my health issues they may have just got me to go home instead, in this situation it was an anaphylactic reaction I was having so I'm very thankful they did phone for help. It can also be a good idea to let them know where you keep your medication so if you are in the situation where you are unwell they can easily find it which really speeds things up. Also let them know who you'd want contacted in the event you became unwell and needed to be taken to hospital. It can be an idea also ensuring they know certain things about you so they can tell medical staff, things like: full name, date of birth, address, next of kin contact, medical conditions, allergies, medications currently taking, GP surgery (to make this easier for them it's an idea to have it written down in some form of medic alert (see number 4 above for more information) Another idea could be to train them on how to use your adrenaline auto-injector, an easy way to do this is by ordering a trainer pen for your particular type of auto-injector, these can be found at:
Epi-pen: https://www.epipenshop.co.uk/ (free, you just pay postage)
Emerade: http://www.emerade-bausch.co.uk/patient/order-trainer-pens (free)
Jext: http://www.jext.co.uk/ (free)

6. Don't kiss someone unless you know what they've been eating
If you have any doubts as to what someone has consumed do not risk kissing them. It is a common misconception that the person has to eat the allergen to have a reaction but in a lot of patients this is not the case as the protein, the thing that causes the allergen, can be transferred from mouth to mouth contact. When people get older and start going on night's out to clubs and pubs and such, often they will kiss someone whom they have never met before and know nothing about. This is best avoided if you suffer from a life-threatening allergy, or an allergy of any sort, as you have absolutely no idea what the person has come into contact with. It is not worth risking your health over!

Carry Two Adrenaline Auto-injectors

When I think about living with allergies and anaphylaxis one thing that really resonates with me is just how vital having access to adrenaline pens are if you're at risk of anaphylaxis. Adrenaline is the life-saving drug that helps to reverse the effects of anaphylaxis within the body. I am very fortunate to live within the UK where thanks to the NHS we have access to free healthcare and do not have to pay the cost of the medication itself, whilst in England many people need to pay a prescription charge I am very fortunate to live in Scotland where prescribed medication is entirely free. I find myself thinking about those living at risk of anaphylaxis and requiring an adrenaline pen in the USA where unfortunately people are charged for the medication itself and whilst some insurance companies do cover part or all of the cost of adrenaline pens lots of people affected by anaphylaxis in some way are subjected to having to pay hundreds of dollars for adrenaline pens. Whilst we do not face this battle in the UK many people are facing their own issues.

Most guidance available suggests that a person at risk of anaphylaxis should be prescribed, have access to and carry with them 2 adrenaline auto-injectors:

MHRA (Medicines and Healthcare products Regulatory Agency):
"It is recommended that 2 adrenaline auto-injectors are prescribed, which patients should carry at all times" (Medicines and Healthcare products Regulatory Agency cited in Gov.uk, 2017)
"If you do not start to feel better, use the second auto-injector 5-15 minutes after the first one" (Medicines and Healthcare products Regulatory Agency cited in Gov.uk, 2017)

European Medicines Agency:
"It is likely that your doctor will recommend that you carry 2 injectors, in case a second dose is needed while you wait for emergency treatment" (European Medicines Agency, 2015)
"It is recommended that healthcare professionals prescribe 2 auto-injectors, which patients should carry at all times" (European Medicines Agency, 2015)

Epi Pen UK:
"Anyone at risk of an anaphylactic reaction should carry an adrenaline auto-injector with them at all times, as an immediate injection of adrenaline could be the difference between life and death" (Resuscitation Council (UK) Guidelines, 2008 cited in Epipen UK, 2017)
"People who have been prescribed an adrenaline auto-injector because of the risk of anaphylaxis should carry two with them at all times for emergency, on-the-spot use" (Drug Safety Update Volume 7 Issue 10, 2013 cited in Epipen UK, 2017)
"35% of patients may require more than one adrenaline dose" (Korenblat P et al. Allergy Asthma Proceedings, 1999 cited in Epipen UK 2017)
"It is vital that at risk patients carry 2 Epipen at all times. A second dose can be given after about 5 to 15 minutes if necessary" (Drug Safety Update Volume 7 Issue 10, 2013 cited in Epipen 2017)

However, guidance from the BSACI (British Society for Allergy and Clinical Immunology) only recommends one unless: the person is obese, the person lives in a rural location, the person has had a prior reaction which proved life-threatening or if the person required more than one lot of adrenaline in a short timespan:

"A recent MHRA drug safety update (2014) recommended that people who have been prescribed an AAI should carry two; however, normally only one auto-injector is required for self-administration during a reaction. For children, two should usually be prescribed one each for school and for home. Exceptions, when two pens may be required in one kit, that is giving the option of administering two doses, include obesity, remoteness from medical help, a previous life-threatening reaction or if two doses were required (as distinct from given) in a short time period for previous reactions, or other assessment of risk." (British Society for Allergy and Clinical Immunology, 2016)

This guidance means that a lot of people would fit into the category of not requiring having more than one pen at hand. This guidance not only means that people who have never had a reaction before but are at risk for an anaphylactic reaction would most likely only be supplied one adrenaline auto-injector but people who have suffered anaphylaxis before would also only be supplied with one if they don't fit into the categories mentioned above. 

As a result of these new guidelines many people throughout the UK are facing issues with only being prescribed one adrenaline auto-injector. This reduction in access to adrenaline auto-injectors has a high probability of allergies and the potential of anaphylaxis resulting in an increased level of anxiety, a reduction of independence and added stress. What happens if the only adrenaline auto-injector a person has is faulty? What happens if the auto-injector is used incorrectly? What happens if an ambulance doesn't reach the person within 5-15 minutes when a second pen is usually recommended to be used? Many reasons exist past obesity, rural location and severity of reaction where a second pen should be supplied to people. Adrenaline is a life-saving medication and reducing people's access to this life-saving drug could potentially result in fatalities that could otherwise have been avoided.

The Campaign For The Right To Carry 2 Adrenaline Auto-injectors was founded to try ensure that everyone has access to at least 2 auto-injectors no matter their weight, their location, the severity of a previous reaction or having a previous anaphylactic reaction. They set up a petition 3 years ago in response to the BSACI guidelines. The aim of the petition to encourage the BSACI to alter their guidelines surrounding access to adrenaline auto-injectors. This campaign has received immense support in the past 3 years from all over the UK and has even had celebrity support too. In the 3 years since the petition was set up it has gained over a whopping 49,300 signatures! This is a fantastic result thus far and it continues to be shared far and wide with new signatures being added on a regular basis. They are working extremely hard behind the scenes to promote their campaign to not only those living with anaphylaxis but members of the general public too. Many may not understand why the BSACI's guidelines are so anxiety-provoking however many people who's lives are influenced by allergies and anaphylaxis state that the guidelines are causing added stress and anxiety that doesn't exist as much as when 2 adrenaline auto-injectors are accessible. Many people live in fear of when they're next adrenaline auto-injector prescription is due that their GP/consultant will only prescribe one pen to have to hand.

For more information on the Campaign For The Right To Carry 2 Adrenaline Auto-injectors please visit:
Facebook: https://www.facebook.com/campaign42AAI/

Please also considering signing the petition to encourage the BSACI to alter their guidelines:
https://www.change.org/p/this-petition-supports-the-alwayscarrytwo-campaign-we-ask-the-bsaci-to-reverse-its-recommendation-that-the-majority-of-patients-require-one-aai-back-to-two

References

BSCAI (2016) Adrenaline Auto-injector (Accessed on: 6th December 2017) Available at <http://www.bsaci.org/Guidelines/adrenaline-auto-injector>
Epipen UK (2017) Epipen (Accessed on: 6th December 2017) Available at <http://www.epipen.co.uk/hcp/epipen/>
European Medicines Agency (2015) Adrenaline auto-injectors (Accessed on: 6th December 2017) Available at <http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/referrals/Adrenaline_auto_injectors/human_referral_000367.jsp&mid=WC0b01ac05805c516f>
Gov. UK (2017) Adrenaline auto-injectors: updated after European review (Accessed on: 6th December 2017) Available at: <https://www.gov.uk/drug-safety-update/adrenaline-auto-injectors-updated-advice-after-european-review>

Anaphylactic reaction whilst flying

Anaphylaxis is scary no matter what the circumstances are surrounding it however when you're 32,000ft up in the air...it reaches a whole new level of terrifying.

I had an amazing trip away to the Harry Potter Studio's in Watford, UK. I flew from Edinburgh to London Luton and returned via flight the next day. Everything went according to plan until the return journey. I got on the plane and talked to the cabin crew about my nut allergy. They made a special announcement stating they would not be selling nuts on-board the aircraft and asked if people could please refrain from eating their own nutty products they may have brought with them. One of the flight attendants even passed down the aisle a few times to check if people were eating anything nutty.

Within half an hour I found myself starting to become unwell. I began to feel horrendously itchy. My reaction turned from itching to coughing into difficulty breathing. I cannot begin to describe how it felt to be unwell whilst flying. You try to prepare yourself for anything happening. You ensure you have your medication with you, request a doctor's letter stating you're allowed to carry your medicines including epi-pens. You tell the flight crew about your allergy to nuts which in turn means they can stop the sale of nuts. Yet you never actually think anything is going to happen. Unfortunately this is not always the case. Even the best precautions can often amount to nothing.

I am unsure what caused my reaction. I cannot say for certain but I feel that it was down to peanuts being eaten on a previous flight, someone touching something which I in turn touched which resulted in a contact reaction to peanuts. This is the problem with the seriousness of allergies. People do not for the most part realise that ingestion is not the only thing that can result in anaphylaxis, simply touching something that has peanut protein on it or even breathing in the protein can spark a life-threatening reaction.

I am lucky that this reaction was quickly resolved and did not result in anything more than having to use an epi-pen and paramedics checking me over. I am very thankful to the airline for their help throughout the whole incident as well as the airport.

How to make Peanut free Reece's peanut cups (wow butter cups)

I don't know about anyone else but whenever I walk into a supermarket I always seem to come across "Reece's peanut butter cups". As my nut allergy started later in life I have tasted these and thought they were really nice. Peanut allergies really do make everything so much more difficult! Today I decided to trial making my own version of them however the difference being they are completely peanut free :)

Things you will need: 

• Chocolate (I decided on Tesco baking chocolate however you could use any type you like)
• Wow Butter (I used crunchy however smooth would work just as well)
• Icing sugar 
• Muffin cases (I used 6 big ones however you could use more or less and just adjust the amounts of things used)

Method:

Melt half of the chocolate. Place 2-3 spoonfuls into the base of each muffin case. Once completed place the muffin cases into the fridge and leave for 5-10 minutes until it is solid

Mix together the same amount of icing sugar as wow butter. Depending on how much wow butter you want inside the cups depends on how much you would use (I personally used enough to fill each muffin case with 1 teaspoonful).

Bring the now solid chocolate muffin cases out of the fridge and spoon the mixture of icing sugar and wow butter on top of the solid chocolate. Place these back in the fridge for another 5-10 minutes.

Bring the muffin cases back out of the fridge and melt the remaining half of the chocolate. Share it out evenly between each muffin case spreading it over over the wow butter so there is none showing. Place it back in the fridge for another 5-10 minutes and enjoy!

Source: http://wowbutter.com/recipe-viewer.php?recipe=22

I may have allergies but they don't have me!

I thought I would post a blog post that is a little different. Here's a few photos from the past few months to show what I have been up to. I think it's a great way to show that allergies and anaphylaxis do not define you as a person and do not have to stop you doing things that you want to do and enjoy

Doing warm-up exercises at singing and
performing class

On a night out in a night club
with two of my friends

After completing a 5k race
where I raised over
£331 for the
Anaphylaxis Campaign

Enjoying a dessert
at a restaurant

Another night out with my best friend

Spending time with others

My up to date warrior beads

Warrior Beads (my medical journey in one picture)

I came across something called "Warrior Beads" last month after 2 of my facebook friends posted pictures with theirs. Warrior Beads is very similar to Beads of Courage. For anyone unsure on what this is, it's mainly based in America (however is also available in the UK for children with cancer). It's a way of helping a child tell their medical journey in a fun, positive and colourful way. They receive a glass bead for going through things medically. Unlike Beads of Courage, Warrior Beads has no age limit, no limit on which countries can apply and no medical conditions are excluded (both mental and physical).

I choose to back date mine to the start of my medical journey (2008 with essential tremor/2009 with asthma) however you can choose the date in which to start yours. I guessed a great deal of the things as some of the categories were too challenging to give a proper answer on. There's a colour of bead for basically everything!

These are my Warrior Beads:

In this picture I have 2,814 beads. Each bead represents something I have gone through medically. You also receive special beads for reaching 50 and 100 within any colour of bead as well as special beads of medical milestones and everyday accomplishments. 

Illness is something that is so negative. It causes you to go through a great deal of both emotional and physical pain and hurts those closest to you. Warrior Beads brings a positive out of every negative experience I have been through. Some may not understand how a mass quantity of beads can mean so much to me but they mean more than words can say. They show me how strong a person I have been and continue to be. I have been through a great deal medically, and it's shown visually using warrior beads, however it helps me to see just how brave and strong I truly have been. I've gotten through so much and will continue to fight :)

292 doctor/clinic visits (dark blue bead)
221 inpatient days in hospital (yellow bead)
24 HDU/ICU stays (gold bead)
43 isolation stays (tan bead)
234 A&E visits (red bead)
206 ambulance rides (white bead)
423 needle pokes (black bead)
219 IV medications (orange bead)
1 hair loss (dark brown bead)
32 no food/drink before a procedure (light blue bead)
303 x-ray's/CT Scans/MRI Scans/Ultrasounds (olive bead)
163 ECG's (copper bead)
6 procedures (star bead)
206 oxygen required (pink bead)
8 catheter's (lime green bead)
9 days with a feeding tube (when applied for) (green bead)
2 respiratory therapy's (khaki bead)
1 EEG (clear purple bead)
4 seizures (purple bead)
1 glasses, 1 contacts (clear bead)
394 days of school/uni/work missed (clear yellow bead)

If anyone would be interested in finding out more about Warrior Beads check out these links:

Application form: http://www.1boy4change.org/warrior-beads-application.html

Facebook page: https://www.facebook.com/1Boy4Change?fref=ts

Website: http://www.1boy4change.org/