Friday, December 7, 2012

A Nurse Who Wears Many Hats

A Profile of Lisa Stieb

If you are a patient at the Pediatric Food Allergy Center at Massachusetts Center (MGH-FAC) and you haven’t crossed paths with Lisa Stieb, RN yet not to worry, you will.

With nearly 30 years of experience as a pediatric nurse, Lisa has seen it all. Before coming to MGH-FAC, she worked for seven years at the Floating Hospital for Children at Tufts Medical Center. Until two years ago, she simultaneously worked as a part-time school nurse. What makes Lisa even more knowledgeable in her field is that in addition to her 13 years of experience as a pediatric allergy and pulmonary nurse at Mass General, she is also the mother of two children with food allergies.

When asked about her work and home life, she smiles and says, “Food allergies are a passion of mine. And being a mom of kids with food allergies, I just empathize with families --- how difficult it is and how it impacts your daily life.”

This unique perspective has helped Lisa easily step into her roles at MGH-FAC and beyond. Most weeks, Lisa performs six oral food challenges.  (An oral food challenge is the most definitive procedure for testing to determine whether a person can safely tolerate a specific food. Lisa gives increasing amounts of the test food every15 minutes until the child has ingested a predetermined amount. The child is then observed for an observation period of several hours to monitor reactions.) Unlike her sometimes-anxious patients and their parents, Lisa exudes confidence and calm during food challenges. She is always happy when the results show that a child can safely eat one more food and recognizes that patients and parents are disappointed when the child cannot tolerate the food.

When patients do have a reaction during a challenge, the family gains knowledge, she says. “When we have to give epinephrine it is not always a bad thing. Many of these parents and patients leave the office feeling empowered. Emotionally, it is sort of the opposite outcome of what’d you’d expect. Rather than feel anxious about the possibility of a future reaction, families respect the food allergy, understand that the food has caused a reaction, but know that they can give the epinephrine, call 911 and feel confident that, as a caregiver, they have followed the emergency action plan to gain control over the situation.”

Lisa is thrilled about ongoing research at MGH-FAC. She and her sons once felt resigned to their food allergies, but now there is hope. Lisa is a vital part of the peanut oral immunotherapy study and the peanut-patch study — both ongoing research at MGH-FAC.  Participants in the oral immunotherapy study participants ingest increasing amounts of peanut flour to induce desensitization, if not tolerance. In the peanut patch study, participants receive an allergen extract of peanut under the skin, again in an attempt to reduce sensitivity. Both studies are part of the FAC’s overall efforts to find and/or improve future treatments for food allergies.

Aside from working full-time at MGH-FAC, Lisa has found time to become an advocate. She worked on the Massachusetts School Guidelines Taskforce, helping to create legislative guidelines for handling food allergies in schools. She leads a parent support group, trains new nursing staff and makes presentations at schools. She co-authored The Asthma Educators Handbook (a book designed to prepare healthcare professionals for certification as asthma educators.

When asked about MGH-FAC, she says, “The real thing that makes the MGH-FAC so special is the team approach and all of the research. As we know, the testing is not perfect as far as diagnosing the sensitivity, unless a patient has had a reaction. But now we have research studies using component-resolved testing, and that is really exciting for the future of diagnosing food allergies more precisely.” Component-resolved testing is an U.S. Food and Drug Administration- approved blood test which measures specific allergen components to help assess the severity of the allergy.

Lisa’s biggest endorsement of MGH-FAC is her own children’s positive experiences at the hospital.  She tells moms who have children with food allergies: “It’s not your fault. It doesn’t matter if you nursed or didn’t nurse, ate peanut, withheld solids or introduced them early, had a C-section or regular delivery --- the cause has not been determined. Don’t beat yourself up.”  She encourages families to stay connected and informed and use the ever-expanding wealth of information and resources available.

Cookbook Suggestions:

Allergy-Free Desserts: Gluten-free, Dairy-free, Egg-free, Soy-free and Nut-free Delights [Hardcover

Allergy-Friendly Food for Families: 120 Gluten-Free, Dairy-Free, Nut-Free, Egg-Free and Soy-Free Recipes Everyone Will Enjoy [Paperback] Editors of Kiwi Magazine (Author)

Learning to Bake Allergen-Free: A Crash Course for Busy Parents on Baking without Wheat, Gluten, Dairy, Eggs, Soy or Nuts [Paperback] Colette Martin (Author) Dr. Stephen Wangen, ND

Special Diet Solutions: Healthy Cooking Without Wheat, Gluten, Dairy, Eggs, Yeast or Refined Sugar [Paperback] Carol Fenster, PhD. (Author)

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