Guest Post: His and Hers–Philip and Barbra

romantic walkWe all have different ways to deal with our allergies and to, specifically, deal with the challenges that allergies can create when we are dating or in a long-term relationship. The following story details what has worked for a couple living within this context and has some insights about what works for them and what does not. You, as someone with allergies or dating someone with allergies, must decide what is practical for you and what makes you feel and stay safe.

HIS:

My name is Philip Parry. I’m a schoolteacher, a musician, a marathoner, a boyfriend and, yes, an adult at risk for anaphylaxis to peanuts, peas, lentils, chickpeas, and soy protein. Truth be told, as I child, I never really identified as someone with allergies. I grew up in a household with two other siblings with their own sets of allergies; so all of the food passing through the house was guaranteed to be safe. My school was early to adopt an allergy-safe policy and my two best friends had their own unique food needs (diabetes and lactose intolerance respectively). Surrounded by informed and caring people, I managed to make it to my late teens with minimal participation on my part.

The first real challenge set in when I left home to study music in another city. Suddenly I was responsible for deciding upon all of the food that went into my mouth. My first run-in with allergies happened on my 19th birthday during an impromptu and inebriated game of capture-the-flag on campus. My roommate had just returned from a visit with his grandmother and had brought back some of her secret recipe chocolate chip cookies. After a few catch-up drinks, my roommate was slurring his way through an invitation to try said cookies. Being a well-trained allergy kid, I piped in with the obligatory “are there peanuts in here?” The second he said “I don’t think so” my party-fuelled munchies kicked in and I managed to scarf down an entire cookie while simultaneously thinking about the interesting flavour I wasn’t used to. It only took a few seconds for the two of us to realize that grandma’s cookies, although containing no whole peanuts, might have a certain secret ingredient… peanut butter. After a grueling night spent in the hospital (and a missed capture-the-flag opportunity!) I learned a few things. First, be careful of drinking and snacking! This is one thing they don’t teach you as a kid. Allergies don’t take the night off; so you can’t either. In addition, asking “the question” isn’t always enough. Many people are inexperienced in dealing with food allergies and aren’t used to thinking about food as its component parts or thinking about cross contamination between food items.

The most interesting and complicated issue to arise from being an adult with allergies has without a doubt come from the world of dating and relationships–as if that weren’t complicated enough already! It started out simply. A girlfriend of mine in high school loved peanut butter sandwiches and would have them for lunch more often than not. By this point, I’d already heard that a common cause of reactions was from contact with a significant other. So I got into the habit of asking her every day whether or not she was lethal. If she was, we’d have to wait until the next day before we could kiss.

Taking someone out on a date brings its own set of problems because it leaves you with one of two options. Option A is to go somewhere familiar or well researched. If you’re careful, you can take a date somewhere that has been vetted in advance. This usually works well so long as her favourite food isn’t Thai, Indian, Ethiopian or Mediterranean, and the place isn’t full, overpriced or hard to get to. Option A works if you aren’t concerned about being spontaneous or adventurous when going on dates. Option B is the guess-and-check method. In this scenario, you walk into a restaurant with your date and start asking a long series of food preparation related questions. This option works fine so long as you’re prepared to spend more time talking to the server, chef, and manager than to your date. And this is only if the first restaurant is able to accommodate you. Be prepared to try a few places before someone is willing to risk feeding a ticking time-bomb. In either case, you’ll end up feeling guilty for making a simple meal into a complicated mission.

I was fortunate enough to find someone who was able to tolerate my food allergy shenanigans (and my personality); but being in a long-term relationship as an adult with allergies has also been a rocky road—no pun intended. In our house, peanuts are a straight up ‘no-go’ (I’m particularly sensitive to them). And I constantly feel guilty taking away one of her favourite treats. We keep other legumes (to which I’m allergic) around as a staple protein source because, of course, she’s a vegetarian and, like me, a protein-hungry marathon runner. This generally leads to making separate meals for both of us to get the protein we need. It’s not only difficult. It is extremely time consuming. It takes a careful mix of compromise, advance planning, cautious food preparation, and Tupperware in the freezer to make things work. Even though we somehow always find a way to feed ourselves, it hasn’t been easy. And it hasn’t gone flawlessly. Did I mention that all vegetarian protein powders are basically made with peanuts or peas? Barbra making a Vega smoothie means I have to run and take cover.

The first time I had an allergic reaction while I was with Barbra was agonizing–both physically and emotionally. Having a reaction makes you feel stupid and guilty to begin with because, in retrospect, you can usually figure out the mistake you made to land yourself in the hospital. Now add onto that the fact that you have to make a phone call in the middle of the day to tell someone you love that you put yourself there–a call that you know will make them scared, worried, and stressed-out. In the best-case scenario, they are able to make it to the hospital and sit with you while you turn purple, break out in hives, and gasp for breath right in front of their eyes. This is what happened in my case and I’ve been told it’s a very traumatic experience. If she hadn’t been able to get out of work or class, she would have had to sit and writhe in her seat for hours wondering if I were suffering or recovering. In either case, it’s not a fate I would wish upon anybody.

Despite all of the challenges, I’ve managed to keep a positive attitude and look for the silver lining that comes with being an adult with allergies.  Having discovered early on that food made by other people, no matter how well intentioned, is a potential hazard, I was forced to cook exciting meals for myself and for others–not a bad date idea in itself. For a music student, struggling to pay tuition, this proved to be an invaluable skill. As a person concerned about healthy eating, having allergies has been a very useful status to invoke for both me and Barbra when being offered junk food at a social event that might otherwise be rude to refuse.

When it comes to being in a relationship as an adult with allergies, the best piece of advice that I can offer is to have fun with it. Take some time to look up the best restaurants or specialty food spots in your area and make an adventure date out of it. Look up recipes for foods you love to eat and make a game out of perfecting your own allergen-free versions at home. The more you do things like this, the more you and make your partner feel like allergies are less of an inconvenient problem and more like an interesting quirk.

HERS:

Wow…Philip writes a lot. My name is Barbra Lica and I’m a Jazz singer-songwriter as well as Philip’s frustrated but understanding girlfriend. I must say, I don’t have nearly as much to write as him because food allergies are only a five (six?) year old sport to me. Before Philip, my ultra Eastern-European-pride household consisted of the following people: those who think food allergies are a myth, those who think food allergies are curable with prolonged and consistent exposure, and those who think it’s one of those things that happens if you don’t breastfeed enough. And only North Americans don’t breastfeed enough I’m told. I even had a family friend warn me about the dangers of having children with this boy. “Date him, love him–no babies!” Of course, I don’t take any of that to heart. Philip has a zillion great things to pass on to babies. I mean, we’re still not having any in the foreseeable future; but his allergies certainly aren’t the reason why.

Anyway, I won’t lie, there were many difficulties at first. I love food. I eat every emotion I ever have and, to top it off, I’m a vegetarian with marathon training on the docket. So I basically need the foods that kill Phil as a protein source. It still meant giving certain foods up entirely because they’re too difficult to keep contained (peanut butter) or, alternatively, eating them away from the house followed by a paranoid clothes-removal and wash-down. I’ve gone so far as rinsing my mouth out with soap! Even with all that effort on my part, the Philip I met in University was a very reckless fellow who insisted on eating the free unlabeled intermission food at every music recital the Faculty of Music had to offer. The first time I saw him have an attack, I was horrified. Truthfully, the image is seared into my brain and I cried so hard I think it’s part of the reason he’s more careful now. But you can be as careful as you like and still have accidents. I remember one time we called a restaurant I liked before going there to ask about peanuts; and they said it was no problem. We confirmed this again when we got there. As we rushed out of the restaurant to the hospital, I remember hearing “No peanuts! Peanut butter only!” Safe to say, I no longer like that restaurant. So here I am, several years later, and do I miss Peanut Butter & Jam sandwiches? You betcha! But they’re that much tastier when I go out of town for a gig. We also cook at home together a lot more these days and it always turns into a fun date where we’ll put on nice music and cook up about 5 dishes in one night that are allergen-free and easily freezable. I’ll even put chickpeas in my salad because they’re easy to keep in a jar in the fridge and pour directly on my salad as an add-on without hurting Philip. So yes, I worry about crazy, reckless Philip quite a lot and, sometimes, I’m even the culprit when it comes to feeding his chocolate addiction–he’ll stare in the window of a chocolate shop with big puppy eyes right next to the sign that advertises special edition peanut truffles and I’ll be all “maybe those ones didn’t come in contact with the peanut ones.” But, all in all, we’ve found a routine and I’m just used to it. After all, nobody ever said anything against JAM sandwiches!! JAM!! So…I might have an issue with Jam….don’t look in my fridge…

Check out Barbra’s song and music video at the link below!

https://www.youtube.com/watch?v=QWjygxbQbQY&feature=youtu.be

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Allergies and All-Inclusive Resorts

Beach toys

When thinking about all-inclusive resorts, the first thing that should come to mind is sheer serenity—things like a clear blue ocean, white sandy beaches, and flawless sunny weather.

Even though vacations to all-inclusive destinations do provide many people with a much needed breather from life’s obstacles and challenges, those with allergies actually end-up encountering a host of other potential challenges. These can transform a stress-free getaway into a stressful experience.

Therefore, for all who love to travel, I will offer-up my suggestions in the following two sections. These should help you to prepare for your next trip. I am drawing these from my own experiences.

Choosing a location:

Many all-inclusive destination resorts are located in the Caribbean; so my advice will be focused upon Caribbean destinations. Try choosing an Island where English is the native tongue or at least widely used (ie. Turks and Caicos, Barbados, the U.S. Virgin Islands, etcetera…). When I travelled to Turks and Caicos, I found this to be key in terms of communicating my allergies to the hotel staff. You should also look for Islands that have international-chain grocery stores. Turks and Caicos had an IGA steps away from the hotel, This reduced a lot of the stress when it came to eating and preparing food.  If you want to avoid the islands completely, another excellent option includes US-based destinations: Florida, California or Arizona. All of these states have great weather and high-standards when it comes to food quality and health-care. These factors should not be “be-all and end-all” determinants when it comes to looking for a destination; but keep them in mind.

Choosing your hotel:

When looking for hotels, always try to book a room with a kitchen, even if it is a bit pricier. When travelling to the Dominican Republic, a few years back, I found booking a room with a kitchen to be a big stress-reliever. There were no grocery stores around; so I just asked the chef in the hotel’s restaurant to provide me with a raw piece of veal or chicken that I would grill myself, in my room. Beware, however, that some hotels are not open to doing this. So be sure to call well in advance of your arrival. It is always good practice to call your hotel in advance to ask about the hotel’s allergy policies (if they exist), the nearest medical centre, and the room’s amenities. I can’t tell you how many times I have booked a room with a “fully equipped kitchen,” only to find a broken microwave and circa-1992 mini-bar fridge. ALWAYS call in advance. A lot of people I know “risk it” when on vacation and just eat food from the buffet. I would strongly advise against this. As alluring as the beach and buffet notion is, at all-inclusive resorts, eating at buffets puts you at an increased risk for eating cross-contaminated food. Tongs are not properly cleaned and people use their hands to pick-up food, etcetera. Always try to have as much control over your food as possible.

These are some tips from my experiences. As you travel more, you will begin to carve-out your own routines and form your own rules based upon your own experiences. The key things to keep in mind are to know your destination, know your hotel, and know yourself. You always have to feel comfortable in the situation that you are in; this will guarantee you a stress-free trip.

Saverio M. 

Always Packing: Carrying Your Auto-Injector  

Live_Main Auto Injector

It all started with a fanny-pack. It was a bright blue, yellow zippered, Tigger-themed fanny-pack to be exact. From the time I was five, to about twelve years old, this was the most important accessory I had. Why? It was the vehicle for carrying my auto-injector (my safety net and my security blanket).  Back in the 90’s, my bright blue fanny-pack was my ‘go-to’ item; but I quickly outgrew it and needed to find some other way to carry my auto-injector. Luckily, being a girl, I would eventually grow into carrying a purse with me everywhere. But, during my high school days, I hit those awkward preteen/ teen years. I was too young to carry a purse and too old for a fanny pack. I no longer had a permanent desk to put it in or one specific teacher to hold onto it for me. My locker was too far away and I wasn’t allowed to take a book bag with me everywhere. I needed to find another option to discretely and effectively transport my auto-injector while in school. Lucky for me, I had access to many carriers and tricks to help conceal my auto injector and keep it on me at all times.

I purchased a much smaller, stylish black case that I was able to put in my pencil case. But I also made sure I had one in my book bag in my locker at all times. Getting through those high school years was tough. Most people yearn to fit in. And I was much the same. So I refrained from telling many people about my auto-injector in my pencil case. The people I made aware were my teachers and a few close friends. Now I realize the importance of telling people about the location of my auto-injector and how to use it in case of an emergency.

As I grew up, I became more comfortable with my auto-injector and with my food allergies. I was able to find new ways to carry it around discretely. Being a girl, I was lucky to have the excuse of always having a purse with me. The problem I soon arrived at involved different sized purses and singular-sized auto-injectors. From small little clutches to extremely large purses, I was either fighting to find it or struggling to put it in. Luckily I’ve found a few tricks and discovered, through my male friends, that they also had some unique and creative ways to carry around their auto-injectors.  For me, I’ve always felt it is easier to carry my auto-injector in the side pocket of my purse. It’s easy to grab if there is an emergency and it’s easy to find if I can’t tell someone. There will be no more routing around in the deep caverns of my purse. With the new advancements in auto-injectors, it’s easier to carry them in pant pockets or in those pesky little clutches and purses I mentioned earlier. Some new auto-injectors are as small as a business card with a little width. They can be easily placed in most little bags. As for my male counterparts, carrying an auto-injector can be a little trickier as far as not drawing major attention. One the best ways I’ve seen them carried is in an ankle holster (a lá James Bond) that fits neatly under most pants. Those new auto-injectors I mentioned above are smaller and able to fit in most pockets discretely. There is also many companies offering carrying cases for various activities like belts for outdoor/upbeat activities from Waist Buddy (http://www.omaxcare.com/WaistBuddy.html) or the versatile brand Allergy Pack ( http://www.allergypack.com/) that offer many different styles to carry one or multiple auto-injectors. They even make carrying cases for asthma inhalers.

It doesn’t matter what you’re wearing, what kind of purse you’re sporting or what pants you may be in. It is always important to have your auto-injector with you when you go out.  It can be cumbersome and it can be awkward; but nothing is worse than needing it in an emergency and not having it. So remember to keep it with you. Tell someone you have it with you and where it is located. Think of it as the best and most practical fashion accessory you have; it also just so happens to go with any outfit.

Arianne K.

 

A Food Allergy Camper’s Guide to…Camping!

canoe 2

I wouldn’t call myself a seasoned camper; but I have definitely had my fair share of outdoor adventures and know how to handle my food allergy in the wild. The following is a collection of my best advice and tips for you to consider before setting out on your own big outdoor adventure.

  • Remember to pack extra auto-injectors with your first aid kit. Then, when you have your extra ones, pack another (just in case); and keep them on you at all times.
  • Train your group (if you’re travelling with one) about how to properly administer your auto-injector and make sure they feel confident with it before heading out.
  • FOOD! I would say this is the most important thing to remember to pack (not just because I love food). It is very important to pack food that you can feel safe eating when you go camping. If someone else in your group is in charge of buying the food, make sure they are well aware of the severity of your food allergy. If you are backpack camping in the wild, I would recommend accompanying that person or even volunteering to buy the food yourself. This will improve your safety and comfort when you hit the trails!
  • Wear your medical identification.
  • Pack appropriately. If you are aware that plants carrying your allergen are present in the area, it might be wise to pack long pants and shirts in case you go on a hike. This will help protect your skin from contact with your allergen.
  • Keep contact information with you or with your gear. It may also be useful to add some contact information for nearby establishments to get in contact should an emergency arise.
  • Bio-degradable soap. This is probably a step most people overlook when packing for a camping trip—especially when you have to travel light. Washing your hands with soap is the best way to rid your skin of allergens after contact. So, when the nearest hospital is nowhere close, this is an important item; and you should always wash before meals!
  • Have fun! Always keep safety in the back of your mind while camping; but remember that it is just as important to relax and have some fun!

Hopefully these tips help prepare you for your future adventures. Comment and tell me about your camping experiences. I definitely have a few great stories I’d love to share!

Dylan

 

Food Allergies at Weddings

WhyRiskIt? Teen Allergy Blog

a wedding pic

I get so excited when I receive a wedding invitation in the mail. I love hearing that my friends or families have found that special someone and I love joining in on the celebration!

However, there is usually one slip of paper that comes along with the invitation that brings my thoughts away from the ceremony, the speeches and the party. I’m talking about that slip that asks you to indicate your food selection for the reception.

I love seeing a few options on this slip, as there are usually a couple options I can cross off right away. I am allergic to seafood, and fish is usually one of those options. That typically leaves me analyzing the meat and vegetarian dishes. More information is always better, but sometimes it just says meat with a special sauce, or vegetables with certain fixings. What’s in that special sauce? What on earth…

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Dining with Clients and Cayenne: Guest Post by Patricia J. Pawlak

Pat (dining with cayenne allergy)

 

I have been fortunate enough to have a career where I traveled the world and had to entertain. For me, there is something exhilarating about sitting down with clients for a culinary experience, getting to know them, and knowing you may have to close a deal. In that situation, you want to stay focused and be charming. Nothing zaps the energy out of a dining experience more then having the focus of the evening on your food allergy. I dread the drama of it all and my clients enduring the waiter/ kitchen sprint because of my food allergies.

I have developed such an intolerance to all capsicum, i.e. cayenne, paprika and cumin, that my throat closes up, I start to shake and then, within 10/15 minutes, I actually projectile vomit. It comes on so quickly, violently and unexpectedly that, even during a lunch, I was rushed to the hospital projectiling (as I ruined my new red silk suit).

After several of these rushed trips to the ER, I finally went to an allergy specialist who diagnosed my malaise as the worst possible allergic reaction one can suffer and still survive.

Thanks to Emeril, and the influx of some certain cuisines, most restaurants have infused, charged, and drilled their menus with chili, cayenne, and paprika and made it impossible for me to dine in many restaurants. I have discovered that even the nicest restaurants now marinate all their meat, fish, and chicken dishes with some form of capsicum. That means even a chicken salad is off limits and watch those candied pecans; they have chili on them now.  For some reason, many restaurant salad dressings have cayenne or paprika—even a simple Caesar dressing.  Deserts, from cheesecake to tiramisu, are now spiked with cayenne.  I have even been served strawberries with a “surprise.” Thankfully, I asked what the surprise was or the restaurant would have been surprised! I have gone to restaurants and not been able to have any dish on the menu.

My strategy now is to check out a menu first before I suggest a restaurant for business.  I ignored my own advice last week; I went to a good sushi restaurant thinking that I would not have to bring up my food allergy in front of my clients. To my chagrin, I opened the menu and the first sushi listed was “Jalapeño Sushi” and, along down the line of the menu, most had heat. I had no other choice but to have the proverbial conversation to make sure what dishes I could eat.

The frustration lies not only in its increase of use but in its use in dishes that historically never had any form of heat.  Even when I order a dish that couldn’t possibly have cayenne, Fettuccini Alfredo, I have had it come with cayenne sprinkled all over.  I have asked for plain poached fish (“nothing on it, plain, please”) trying to be discreet. And the fish came covered in chili flakes. When I explained finally that I had an allergy, I was told “You don’t know what good is!” This is not about taste, this is about health and, in my opinion, our taste buds are being hijacked by all this heat!

I am meeting more and more people daily who are developing this allergy due to the proliferation of this spice.  Hopefully, chefs will begin to take notice and will begin to create more interesting dishes instead of just throwing in the heat.
Patricia

Allergy Testing: An Important Part of Your Diagnosis

Doctor writing prescription

Any specific medical information that follows stems from the following article and is not intended to be taken as definitive or wholly sufficient information. Consult your physician or, in this case, an allergist regarding these topics:

James, T. (2002). Allergy testing.  American family physician. 

http://www.aafp.org/afp/2002/0815/p621.html

 

When living with food allergies, the irritable symptoms that certain foods can produce serve as a prominent indicator for identifying what foods need to be avoided.   That being said, also undergoing allergy testing is important to be fully diagnosed with a food allergy and to initiate effective management of food allergies.  An official food allergy diagnosis is described as consisting of a medical history, physical examination, as well as an allergy test.  Allergy testing is also a way to legitimately distinguish between food allergies and food intolerances.  Food allergies and food intolerances can easily be confused.  In basic terms, a food allergy is a reaction that is triggered by the immune system to a food allergen while food intolerance is related to issues with other body systems, such as digestive problems, which also trigger unpleasant symptoms.  Allergy testing works to identify the body’s immune reaction to specific allergens.
While many of us have gone through a variety of allergy testing, we also may have been fortunate to outgrow allergies or, less-fortunately, developed allergies later in life.  Both of these occurrences are good reasons to seek out allergy testing as adults.  Tests available include IgE skin tests, challenge tests, and blood tests. IgE skin tests (or immediate type hypersensitivity skin tests) are the most common form of allergy testing. This test involves exposing the skin to a small amount of allergen through making a small indentation or ‘pricking’ the surface of the skin.  A reaction should occur within 20 minutes and appears as a small red swollen bump on the skin (also known as the ‘wheal and flare’). If a test is negative, and there is still a suspicion of a food allergen, an intradermal injection can be performed injecting a small amount of the allergen just under the surface of the skin. The physician will again observe for a small red bump to form.  Challenge testing for allergies involves eating a small amount of the suspected allergen.  As I’m sure you would agree, this is a form of testing that should ONLY be performed with your allergist present.  Finally, blood tests involve drawing blood and performing an IgE assay to determine the IgE antibody levels present in the blood that correspond for certain allergens.

If preparing to undergo allergy testing, it can be beneficial to know the benefits and drawbacks of each test compared to one another.  Skin tests can be preferable because they give the fastest result and are relatively less expensive than blood tests.  A drawback to these tests includes the obvious annoying itching that is produced with a positive test.  As well, this test may not be appropriate for those on certain medications such as medications with antihistamine properties that include anticholinergic medications, phenothiazine, and tricyclic antidepressants. Skin testing may also be contraindicated in those with certain skin conditions such as atopic dermatitis. The risk of undergoing a severe reaction with skin testing is extremely low with one retrospective study in the USA finding that, out of 18,331 participants whom underwent skin testing over a period of five years, only 6 developed mild systemic reactions (James T.). In terms of the sensitivity and specificity of skin testing, this has been shown to vary with food versus environmental allergens.  Another study conducted found that, when percutaneous skin testing for an allergen was done as part of a two-part allergy test that included a challenge test, the sensitivity of the test ranged from 76-98% with a specificity of 29-57% depending on the food being tested for(James T.). For those unfamiliar with these terms, Sensitivity represents the accuracy the allergy test correctly identifying someone who is in fact allergic. Specificity represents how often someone who doesn’t have an allergy is correctly identified as not having an allergy.  Intradermal tests were found to have a higher sensitivity, but also have a lower specificity.  When comparing this to blood tests, which allow for a laboratory test called an IgE assay to be performed, the IgE has found to be more specific but less sensitive than skin testing(James T.).  It is still more common for skin tests to be performed and blood tests to be more useful only when there is some contraindication to a skin test.  In terms of a challenge test, this is usually performed for one of two reasons: the finding of another allergy test was inconclusive or suspicious OR there is reason to suspect an individual has outgrown a certain allergy.  In some cases, a ‘double blind’ challenge test may occur where the individual eating the food and the medical professional are aware whether the individual is eating the suspected allergen or a placebo.  This is to avoid the possibility of a reaction being triggered based on the idea of eating risky food.  As previously mentioned, this test should only be done under STRICT medical supervision.

Whether you are interested in having an allergy test performed in the near future or not, it never hurts to educate yourself on the ins-and-outs of the testing you may undergo. And it is be better educated on managing as well as understanding your allergies!

 

Caitlyn P.

 

 

 

 

 

 

By Food Allergy Canada