SURVEY
CONDUCTED BY
CORN ALLERGY ADVOCACY/RESOURCES
December 4, 2019
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I would also
like to extend my deepest gratitude to members of corn
allergy support groups for their contributions in the preparation of this survey.
allergy support groups for their contributions in the preparation of this survey.
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This survey is to be completed by adults diagnosed with an allergy to corn. Your responses will be kept strictly confidential. Please copy the survey to a Word® document, and submit your replies to cornallergyinitiative@gmail.com.
_______________________________________________________________
This survey is to be completed by adults diagnosed with an allergy to corn. Your responses will be kept strictly confidential. Please copy the survey to a Word® document, and submit your replies to cornallergyinitiative@gmail.com.
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1. Do you have a physician-diagnosed allergy to corn?
2. In what year was your allergy to corn diagnosed?
3. Did your allergist include corn allergy as part of a
standard panel of testing?
4. Did you have to request that your allergist test you
for a suspected corn allergy?
5.
Did your
allergist ever refuse to test you for a suspected allergy to corn? If yes, what was the allergist’s reason for
refusing the test?
6. Did you ever seek a second opinion for a suspected
corn allergy because your allergist refused to test for an allergy to corn? If
so, was your allergy to corn confirmed after seeking a second opinion?
7.
Did your
allergist prescribe an epinephrine auto-injector pen for you as a direct result
of your anaphylactic reaction to corn/corn-derived ingredients?
8. How many times in the last year was an epinephrine
auto-injector pen required due to your anaphylactic reaction to corn?
9. Did your allergist or any other medical professional advise
you that even though you have a confirmed allergy to corn, it would be safe to
continue consuming corn or corn derivatives?
10.
Has your allergist
been helpful in recommending corn-free foods, fluids, supplements, or
medications?
11.
Do you find it
difficult to obtain adequate nutrition as a result of your allergy to corn? If
yes, please explain; e.g., are you unable to take vitamins or nutritional
supplements due to corn-derived ingredients in these products?
12. Did your physician or hospital prescribe medications
for you that contained corn-derived ingredients, even though your allergy to
corn was clearly indicated in your medical records? If yes, how was this issue resolved?
13. Are you aware if your physician or hospital declared
you as “non-compliant” for refusing physician-prescribed medications due to
corn-derived ingredients in the prescribed medications, even though your
allergy to corn was clearly indicated in your medical records?
14.
Do you require
compounded medications to exclude corn?
If yes, does your insurance cover the cost of compounded medications?
15.
If you require
compounded drugs to exclude corn-derived ingredients, was the pharmacy able to
fill the prescription to exclude corn?
Were there any drugs prescribed by your physician that could not be
compounded to exclude corn-derived ingredients?
Please explain.
16.
If you were
hospitalized, was the hospital fully equipped to treat/nourish you? If no, please explain. .
17.
If you were hospitalized,
did you ever have to advise the hospital against administering dextrose IV
fluid, or was the staff already aware of the warning on the product information
sheet accompanying dextrose IV fluids that it should not be administered to
corn-allergic patients?
18. Did any medical professional ever administer dextrose
IV fluid to you, even though your allergy to corn was clearly indicated in your
medical records? If yes, did you suffer
an allergic reaction to the dextrose IV fluid?
If yes, how was this situation resolved; e.g., did you file a report
with The Joint Commission?
19.
Do you have ready-access
to corn-free antihistamines? If no,
please explain.
20.
Do you have
difficulty finding corn-free foods, fluids, and/or medications? If yes, please explain.
21.
Are you ingestion-reactive
to corn?
22.
Are you contact-reactive
to corn?
23.
Are you inhalation-reactive
to corn?
24.
What are your
symptoms after exposure to corn?
25.
Have you
consulted with a nutritionist as a direct result of your corn allergy
diagnosis?
26.
Was your
nutritionist able to recommend safe sources of corn-free foods?
27.
Do you feel that
your nutritionist was trained to address a corn allergy diagnosis?
28.
Has a food
manufacturer ever refused to disclose if their product(s) contain corn/corn-derived
ingredients upon your request?
29.
Has a food
manufacturer ever told you that their products are safe to consume since the
corn “protein" has been removed? Did
you then suffer an allergic reaction to this product as a result of your corn
allergy? If yes, how was this issue
resolved; e.g., did you file an adverse reaction report with the manufacturer,
the FDA, or the applicable health department?
30. Does your allergy to corn restrict your social
activities? If yes, please explain.
31. Does your allergy to corn restrict your travel? If yes, please explain.
32. Please explain how your allergy to corn has impacted
your life (emotionally, financially, etc.).
33. Does the fact that corn allergen warnings are voluntary on product labels hinder your ability to find corn-free
foods, fluids, and/or medications? If
yes, please explain.
34. Due to corn-derived purification chemicals in some tap
water, can you safely consume tap water in your home; or have you been required
to purchase corn-free water from another source, or install a corn-free water
filtration system in your home?
35. Has any medical or academic professional ever implied
to you that “There is no such thing as an allergy to corn,” or that “Corn is
hypoallergenic?” As a result, did you
feel that you were demeaned in any manner?
If yes, please explain.
36. Please add any additional information about your
allergy to corn that is not addressed in this survey.
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Thank you for your
participation is this survey.
Diane H., Corn
Allergy Advocate
Founder, Corn
Allergy Advocacy/Resources
