Tag Archives: Anxiety

Generalized Anxiety Disorder and Life-Threatening Allergies

Having a life-threatening food allergy can be scary, but what happens when you also suffer from a diagnosed anxiety disorder? How do you cope with having a sensitive food allergy, without having anxiety attacks every time you go out to eat, or go to a party?

About five years ago, I was diagnosed with a form of Generalized Anxiety Disorder but had been noticing symptoms for far longer than that. For me, Generalized Anxiety Disorder symptoms come in the form of constant worrying, with certain situations making those worries feel even more intense. Prior to this diagnosis, I experienced two anaphylactic reactions, both of which required me to administer my EpiPen®. One of these anaphylactic reactions occurred at a Christmas party I was at, and another was at a casual fast food restaurant, where there was a miscommunication between myself and the cashier. Both instances caused my anxiety levels to rise and made me feel intensely worried anytime I ate away from home.

Overcoming the obstacles of being able to eat food that I didn’t prepare myself was a challenge, but with time and preparation, eating out became a manageable task, which didn’t cause me to feel severe anxiety.

The first step I took in managing my food allergy anxiety was making a promise to myself to be far more diligent than I had been in the past. One area of my life that I recognized I needed to take more control over in order to help manage my anxiety was going to events with baked goods. Typically, if I went to this kind of event , I felt confident enough to eat it if the baker assured me that they were tree nut and peanut safe. However, this still left the possibility of “what if?” As a healthier alternative for my mental health, I started bringing my own baked goods, or potluck items to parties in two separate containers – one container for myself, to ensure that my items didn’t get cross contaminated with other items, and another container for the rest of the party-goers to enjoy. If I wanted to enjoy food that I didn’t bring, I started to make sure that it was pre-packaged from a store and had ingredient labels on it that I could read. I would also ensure I was the first one to grab food out of the package before any other cross-contamination could occur.

The second step I took in managing my food allergy anxiety, was being more careful and inquisitive at restaurants – even fast food ones. Typically, when going to a fast food restaurant, I had a bad habit of not mentioning my food allergies at all. When ordering a sandwich, which was supposed to be allergy safe, it mistakenly had a sauce on it which included tree-nuts. This bad experience caused me to have severe anxiety whenever I visited any type of restaurant or fast food establishment. After this incident, I started being more diligent to ensure that every restaurant I visited – from fast food to fine dining – was aware that I had life-threatening allergies to tree nuts and peanuts. I also started to make sure that I asked about the food making and cooking procedures at the restaurant, and whether or not the kitchen used tree nuts and peanuts in their dishes. Doing my research and asking lots of questions helps to minimize my anxiety and helps to ensure I feel safer when eating out in public.

The third and final step that I took in conquering my food allergy anxiety was being more confident. Not only did I feel anxious about my food allergies, but I also constantly worried about whether I was being a burden to the people around me when asking lots of questions about allergy safe items or holding up the server at a restaurant to ensure my dish was safe for me to eat. Since being diagnosed with Generalized Anxiety Disorder, I’ve come across a lot of resources which have helped me deal with my constant worries. Over time, I’ve learned that I’m not being bothersome when asking about allergy safe food, because without doing that, my life could be at risk.

Having life-threatening food allergies, and managing anxiety can be tough, but with the right tools and confidence, it’s extremely possible.

– Rachel MacCarl

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To Epi or not to Epi? Why I Stupidly Delayed Giving Myself Epinephrine

At the Library

I grew into several life-threatening food allergies when I was 19 years old, and learning to manage these allergies has been challenging. Let me tell you a story. I was spending an afternoon in a local library studying for an upcoming university exam and I decided to refuel at the library café. I ordered an iced cappuccino and after drinking a few sips, I could feel something was wrong. I could feel my throat beginning to swell and I began to feel dizzy. I looked to the café and realized that the same blender that was used to make my cappuccino was also being used to make fruit smoothies. Among the long list of allergies that I grew into are raw fruits and raw vegetables.

I was having another reaction. My throat continued to close, I felt more faint, and I was starting to have trouble breathing.

I grabbed my backpack and took out the medications I bring everywhere with me: antihistamines and my EpiPen®. I took the antihistamines, but I was hesitant to take my EpiPen®. I gathered my things, quickly got to my car, and drove to a nearby hospital. I parked my car in the emergency department (ED) parking lot and waited.

I couldn’t swallow, I was having trouble breathing, and I felt really nauseous. I made a deal with myself: if at any time this reaction gets worse, I’ll take my EpiPen®, and go into the ED.
My symptoms remained unchanged for the next half hour, and
then began to resolve over the next few hours.

Looking back, I was extremely lucky.

Double-dose

Now, another story. I was helping move some furniture at a friend’s house two summers ago. After we finished lifting the last bookcase, his father brought us both a glass of wine. After one sip I felt strange. My typical symptoms occurred (throat swelling, difficulty breathing, dizziness, and extreme nausea) but this time they came on like a freight train. I ran to get my EpiPen® and immediately administered it to the outside of my right thigh. Then I took an antihistamine. We alerted 911 and sat on the couch. Minutes after my first EpiPen®, my throat completely closed off. Even as I write this right now, I become very emotional. Those were some very tense minutes that felt like an eternity. My friend’s father was calmly instructing 911 what was happening, and my friend administered a second EpiPen® to my left leg. I was still gasping for air and my swollen throat would not let any air in. The fire fighters burst through the door. I felt a little air pass into my lungs – the second EpiPen® was working. I am so thankful that I did what I did, and that my friend and his family knew what to do too. They saved my life.

In my first story I didn’t take my EpiPen® and I am well aware how lucky I was in that situation. I have had 12 anaphylactic reactions in the past seven years, and in some circumstances, I chose not to take my EpiPen®. In retrospect, I wish I had used it every time. So, why didn’t I? Here are some common themes that I’ve noticed about my decisions:

  • This one won’t be serious, right?

I have had 12 allergic reactions in the past and most of the time I use my EpiPen®. I have never had what’s called a “biphasic” reaction, I have never needed a breathing tube in the emergency department, I have never been admitted to the hospital for my allergies, and before the reaction at my friend’s house, I have never stopped breathing completely. So, why would I have serious complications during this allergic reaction?

  • Guilt

When I administer my EpiPen®, I call 911, go to the hospital, and receive care from nurses and doctors. Usually, by the time I get to the hospital I am stabilizing, I am able to breathe without difficulty, and the swelling in my throat decreases. In the emergency department I look around and see some really sick patients – elderly patients, infants, and those who are not as fortunate as I to be recovering. I feel very guilty that I am taking up a bed. I don’t deserve this.

  • Costly

The ambulance in Ontario will cost a patient under 65 years-of-age $45, and replacement EpiPens® can cost over $100 if you do not have insurance.

  • Waste of time

After using an EpiPen® and calling 911, patients are routinely kept in the ED for 4 hours to see if they will have a biphasic reaction. This is how long it takes the epinephrine to wear off. So after the reaction, the ride to the hospital, and the ride home, at least 6 hours have gone by and it’s often more time than I can afford to give up.

It’s important to understand the difference between the medications that can help us during an allergic reaction. An EpiPen® contains the medication epinephrine (also called adrenaline). Benadryl® and other over the counter allergy medications are commonly referred to as antihistamines. The medication in Benadryl® is called diphenhydramine. It’s not necessarily useful to remember these long names, but it can be important to understand how these medications work in order to avoid making the mistake that I have made – choosing not to take my EpiPen®. Epinephrine does the job of an antihistamine but it helps in more ways, and it works much faster with stronger effects. It is always the medication of choice for life-threatening allergic reactions.

I have to be honest, there is one important reason why I chose not to take my EpiPen® that I haven’t told you yet. Whether we’ve had one happen to us, watched a friend have one, or heard the story of a friend’s reaction, anaphylactic reactions are terrifying.

A man is reacting to something he didn't expect

It’s actually happening…

Sometimes, in the early stages of an allergic reaction, it may be tricky to discern if what is happening actually is a reaction. In a situation where I may not be sure whether I am having a reaction, I used to feel that by administering my EpiPen®, I was confirming that this was, in-fact, a reaction. When people are presented with bad news, a well-known coping mechanism involves going through the Kubler-Ross stages of grieving (https://en.wikipedia.org/wiki/K%C3%BCbler-Ross_model):

Denial, anger, bargaining, depression, and acceptance.

The bad news I was presented with was, “Fraser, you’re having an anaphylactic reaction.” By not administering myself my EpiPen® I was dealing with this bad news by denying it. I have coped with the news of an allergic reaction with other stages in the past as well. When I drove myself from the library and waited in the emergency room parking lot, I was bargaining with myself: “Okay, I’ll wait here and take an antihistamine deal?”. I know it can be difficult to do, but the safest and most effective way to deal with an allergic reaction is to skip right to acceptance.

If my body had reacted more rapidly while I was in the library, I may not have made it to the hospital safely due to the way I handled the reaction. In short, in the future, I will always use my EpiPen®. Unsure? EpiPen®. Scared? EpiPen®. It is impossible to predict how one’s body will react to the same allergen an additional time, so basing what might happen based on my history of reactions is not a good idea. Financial cost and a short stay in the emergency department should never influence my decision to take care of myself. Allergies, whether we like them or not, may be part of our lives and they are of no fault of our own. Accepting them as a part of what makes us special can be difficult, but once this is done, it makes the challenge of having allergies much more manageable.

– Fraser K.

The Anxiety of Never Having an Allergic Reaction

As someone who has been immersed in the food allergy world for most my life, I’ve read and heard a lot about anxiety with food allergies. However, most of the attention has always been on anxiety after experiencing an allergic reaction. As an example, my brother has had three major reactions to peanuts or tree nuts where he had to use his epinephrine auto-injector. After each of these reactions, he was very hesitant to eat out or try any new foods for fear that they might trigger another reaction. One of my best friends grew into his food allergies after the age of 20 and has since experienced at least 11 severe allergic reactions, some of which required the use of multiple epinephrine auto-injectors and very close calls in getting to the hospital. Needless to say, his anxiety when eating in a social setting is quite high!

My own anxiety about my food allergy to peanuts and tree nuts feels quite different. I’m technically at-risk for anaphylaxis. I’ve been tested every other year for as long as I can remember and the result is always the same. The peanut bump always swells up like a balloon. That being said, I’ve been extremely fortunate and never experienced an allergic reaction. I know the signs and symptoms only through what I’ve read, heard, or seen. I’ve never physically or mentally experienced what a reaction actually feels like but I still get anxious at times.

man with stressed face expression brain melting into linesI’ll give you an example. Around the holiday season, people like to share baked goods with me at the physiotherapy clinic I work for. I know baked goods are potentially risky for someone with a peanut/tree nut allergy so I always triple check ingredients and ask about the risk for cross-contamination. Only when I feel 100% confident that the treat is allergen-safe, will I take a bite. Well on one particular instance, a patient brought in brownies. I asked about each and every ingredient, was taken through the steps required to make them, and was assured they were “nut-free” because she had a nephew who had the same allergy. From the protocol I made for myself, the brownies passed every test. So I took a bite. It was delicious! I thought about how I could easily eat the entire batch and not think twice about it.

Then, I heard the patient chatting with another patient about Belgian chocolate that she bought from a bulk food store. Bulk food? Belgian chocolate? One red flag went up. She continued to talk about how that chocolate was so good that she put it in the brownies. Another red flag went up. As she turned to me, she asked if I could taste that chocolate. All I could think about was the risk of cross-contamination from the bulk food store. As a rule, I never eat “may contain peanuts or tree nuts” products because any risk is too much risk for me. So in the moment, I simply nodded my reply, set down the rest of my brownie and left the clinic to go on my lunch. As I drove, I checked my signs and symptoms a hundred times thinking that I was likely to react. I was shaking and had put myself into an anxious fit! An hour passed, then two, then three, and I realized I must have been lucky this time.

It may have been an over reaction on my part but I still think I had reason to feel anxious. The unknown, especially when it comes to food, can be quite nerve-wracking. I also think that maybe my own anxiety stems from the fact that I’ve had to administer an epinephrine auto-injector on both my brother and my best friend. Maybe it stems from the fact that I have seen the fear in my friend’s face when he was experiencing his most severe allergic reaction. Whatever the case, I’ve learned to slow my breathing, calm my thoughts, and focus on what is actually happening, not what I think could happen. This strategy has helped me conquer food-related anxiety multiple times and I consider myself very lucky to be 17 years without an allergic reaction (knock on wood!!)

– Dylan B.

Checking it Twice: Adventures in Dining

It was a beautiful Saturday in July. The sun was shining, there was a breeze in the air, and Ottawa was looking particularly beautiful.

It had started off as a great day, and when a group of friends and I decided to venture down the street to one of my favourite restaurants in the city, I thought nothing of it. I usually call ahead to most places to ensure its safety, but this particular restaurant was consistently safe, I had even had discussions with the owner about allergens, so I felt confident just showing up on a lazy Saturday to have drinks and appetizers.

Business Celebrate Cheerful Enjoyment Festive ConceptAs we were seated I immediately noticed new menus and the twinge of anxiety chimed in; maybe I should have called ahead. As our server took our drink orders my heart sank and my stomach lunged into my throat. Staring me in the face was a burger compiled of pure nuts, cashews, almonds, and pecans encrusted with sesame seeds. Literally a burger constructed of all my worst, most severe allergens. I almost dropped my drink in shock. This was a safe place, my favourite place to eat in the city, literally down the street from my home! it had always been safe and now without warning it all changed. I had several emotions stirring inside me: Guilt because I choose this place. My friends had just ordered their drinks and barely had a second to enjoy them. Fear because of cross-contamination and the idea that those allergens were lurking around so openly. Anger because a place I trusted and felt confident in had let me down. It took my trust and broke it. And lastly, disappointed, not in the restaurant but in myself. I allowed myself to be lulled into a sense of security and familiarity and let my guard down.

Luckily, I was with people I trusted and who knew my food allergies well and noticed the burger a few seconds after me. I asked the server about the food preparation and she informed me that it wasn’t prepped in a special area and cross-contamination was a very real possibility. My friends asked me what I wanted to do, and we collectively paid our bills and left.

I could have let that experience ruin my attitude towards restaurants and new experiences, letting myself become bitter or scared of new things, or even places I felt safe. Instead, I let it be a very stern reminder that it’s okay to have trust, but you constantly have to be vigilant and aware of your surroundings. Even though I may have eaten there a million times or been there before, you always have to ensure it’s still safe. I now try to always call ahead or check their website before going out. It may be tedious but it’s a small task to do to ensure a safe meal.

– Arianne K.

Anxiety and Your Allergies

Stop me if you’ve heard this one before, you’re sitting in a restaurant or at a friend’s, or even on a plane. You’re minding your own business, when you see your allergen walk by in the hands of someone you’ve already made aware of your food allergy. You also made sure that any food around you was be allergen-free. But, there it is, walking around within smelling distance or maybe, scarily enough, within touching distance. You start to panic; you watch the food as it travels around the room, it looms closer and closer. You wonder, is that my allergen? Is it coming over here? Am I just imagining it? Do I say something? A million thoughts swirl around your head, you wonder if you should say something or just leave, but you’re stuck, the words form in your mind but can’t seem to make the journey to your mouth. And then it starts, the panic sets in as the food is placed near you, or you watch the same person handle your food with the unwashed hands that touched your allergen. You shrink into your chair, and try to fold into yourself, you can’t make a noise, your breath becomes short, and you’re frozen in that moment.

Portrait of young man suffering for depression

I’ve been in this situation one too many times, and sometimes the feeling of panic still creeps up on me unsuspectingly. You so badly want to speak up for yourself but you feel deflated and beat since they didn’t listen the first time. It’s enough to make you want to never venture out for food again. It can be hard to put into words the panicky feeling you get when your allergen pops up un-expectantly or in a situation you can’t remove yourself from, and even more so to voice that feeling and ask for help. It seems like anxiety and food allergies can sometimes go hand-in-hand, but that doesn’t mean we have to go it alone. It took me a long time to find my voice, and express my concern in risky situations, and yes sometimes its uncomfortable or even awkward but I’ve discovered it’s a fleeting feeling compared to the anxiety and dread of not saying anything or feeling trapped. It takes time and practice but expressing your concerns out loud and making an effort to rectify the situation will leave you with a little more confidence each and every time.

Trust the people around you and the people you care about, practice the situation with them, or have a statement prepared.
Now stop me if you’ve heard this one before, you’re in the same situation, you see your allergen coming close to you. Instead of backing down, you find your voice, confidently express your concerns and instead of dread, you feel happy and satisfied with not only the situation but also yourself.

– Arianne K.

The Dangers of Complacency with a Food Allergy: The Black Bear Tale

This past spring, two friends and I went interior camping near Gravenhurst. We found a really cool map online of an unmaintained provincial park that is essentially a big playground waiting to be explored by camping geeks like us. We prepared for weeks, slowly purchasing new gear, mapping out potential routes, acquiring additional auto-injectors, and discussing all the great trails waiting for us. As the big day grew closer, we began planning out our menu. This is where things can get tricky. I am at-risk for anaphylaxis for peanuts and tree nuts and my other friend, let’s call him Ted, is at-risk for anaphylaxis for peanuts, tree nuts, raw fruits and vegetables, and salmon. Luckily some of our allergens cross-over so we went with some of our staple foods that were easy to carry: Noodles, rice, oatmeal, chips, etc. Before long, we had our menu completed, our food purchased, and our bags packed. We didn’t think twice about the food since we ate them all the time and felt confident that what we had was safe to eat.

Entering the park was quite the experience. The road in starts as pavement, then turns to gravel, then abruptly turns into pot-holed, uneven dirt for several kilometers. Once we parked our car and took off down a trail, we soon realized we had missed the trail we wanted and had to double back. Whenever we stopped moving, the black fly army would swarm us and leave itchy reminders that this was their land. Clearly, we were off to a great start… The actual trail we wanted started as hardly more than a half foot of compact grass but regardless, we were finally on the trail and making up ground.

DSCN1407The scenery was beautiful! The trails meandered up and down, left and right, and popped us out on some really nice ridges overlooking forest and marsh below. This park was like a dream come true for us! We couldn’t believe we hadn’t discovered it earlier.

Anyway, that night we found a great little campsite beside a lake and stayed there for the night. The next day, we made some oatmeal and Ted had a packet of noodles and off we went down the trail to continue our exploration.

DSCN1410Flash forward about an hour later. We had been hiking through a dense forest that took us over a little stream and up a steep ridge. At the top of this ridge, we took a break to take in the incredible view of a marsh below and drink some water. Andy, the second friend, points down to the marsh and says, “Whoa! Look! A bear!” Lo and behold, there was a massive black bear trudging along the marsh in a line away from us where we had been hiking not even twenty minutes prior! We marvelled at catching this sight and probably got a little too loud because the bear turned and looked up the ridge towards us.

Bear in the morning on the loop in Cades Cove in the Great Smoky Mountains in East Tennessee.

We all paused, not knowing what to do next.

The bear seemed uninterested in climbing the steep ridge and continued to the other side of the marsh while we picked up our bags and continued to hike the ridge, still excited that we saw a bear!

About ten minutes later, Ted started to breathe heavily. He took out his puffer and took a couple puffs thinking it was just his asthma that sometimes flares up.

We continued our hike.

A few minutes later, Ted took a few more puffs which raised a few red flags in my head. We took another break near a split in the trail and he told us that his chest felt very heavy and his breathing felt oddly similar to one of his past anaphylactic reactions. Now all red flags were up!

We quickly looked at the map. Luckily there was a fork in the trail right beside us that led a kilometer straight back to our car. There was a river to the left and the marsh to the right. There was only one way to go.

Oh, I forgot to mention…the bear was last seen at the end of that trail. So now we had quite the scenario. Ted needed to get to the hospital and the only way to get there was down a trail blocked by a bear! …Are you kidding me?!

There was really no choice. We took out some pots, I had my hatchet, and we made as much noise as possible while we walked down the trail. The bush was so thick that we had no idea where the bear might be hiding so we kept our eyes peeled and kept moving.

No sign of the bear.

The car was now in sight and Ted’s breathing had gotten worse, so he took his auto-injector.

We loaded the car as fast as we could and I sped down the pot-hole road. I had only one thing on my mind: Drive Fast! The hospital was 45 minutes away and I wasn’t going to be the reason Ted didn’t make it there.

After he took the auto-injector, Ted’s symptoms didn’t get better but they weren’t worse either which was a good sign. After 35 minutes of winding roads, we made it to the hospital and everything turned out great. Ted was fine and we ended up going to a friend’s cottage nearby instead of braving the trails again.

We looked back at our food and meticulously read every ingredient twice. It turns out that the noodles that Ted insisted he ate daily may contain peanuts, tree nuts, AND fish. A triple threat for Ted!

The moral of the story is that it is easy to become complacent with food allergies. Reading the label can become so routine that we just trust that the ingredients of our favourite brands won’t change. Ted and I learned a very scary lesson that food ingredients should always be read multiple times no matter how often you buy a certain brand. Companies can change ingredients at any time. All it takes is you eating one package of “may contain” out of a thousand other times to trigger an anaphylactic reaction. It is never worth the risk. Do yourself a favour and always stay sharp with your food allergy. Be alert and stay safe.

– Dylan B.

We’re going to need a bigger bracelet!

Closeup portrait nervous stressed young woman girl in glasses student biting fingernails looking anxiously craving something isolated on grey wall background. Human emotion face expression feeling

My foot was tapping the floor faster than the scarlet speedster, and my arms were crossed so tightly across my chest I could hardly breathe; but I barely noticed. Even the nervous glances my mother was giving me went unaddressed as we patiently waited in the doctor’s office.  This was my first food allergy test since I had a severe allergic reaction three days previously to perch, a type of fish. It was a reaction that came out of left field and required two doses of epinephrine, and a 24-hour hospital stay. Since my reaction was from a food that had never been identified as one of my allergens, I was too terrified to eat anything but mashed potatoes. I was paralyzed in fear of what else might cause me to react randomly, so I refrained from eating even foods I knew to be safe.

So there I sat, stomach growling in hunger, arms red and itchy from testing, and yet I barely felt a thing because my mind was too busy racing with scary scenarios. Time felt like it was at a stand still between the testing and results, when finally my doctor stepped into the room. He started with the basics; for my known allergies (peanuts and tree-nuts), the levels remained the same. He then asked me to recount what exactly happened three days previous.

I sat up a little straighter, tightened my arms around my chest and tried my best to remember:

I never liked the smell of perch, it was “gross” in my opinion so when I was told it was for dinner I was disappointed, and the rest was blurry. I reluctantly ate a small piece and immediately felt the symptoms of an allergic reaction. My father administered an auto-injector and shortly after I was taken in an ambulance where they gave me another shot and 24 hours later I left the hospital. The whole event was a blur of strong emotions and even though I should look at it as a learning event, I would rather forget it altogether.

I leaned back in my chair, close to tears and after a long pause and a lot of writing, my doctor looked up from his notes. He handed me a paper with a list of fresh water fish, and proceeded to tell me my levels on each, and simplified his explanation by saying I was at-risk for anaphylaxis to most of them.  After a long silence the first words out of my mouth were something along the lines of: “this not fitting on my medical alert bracelet.” My mother and I went through the motions after the appointment, both of us defeated by this news. After years of coming to terms with my peanut and tree nut allergies and getting a handle and level of comfort we were just thrown a curve ball late in the game. I wanted to cover my head and forget the whole ordeal; I jumped between wishing I never ate the fish and stayed blatantly oblivious to these new allergens and being thankful that the reaction happened in my home around people who knew what to do.

It took me a long time to come to terms with trying to eat new foods. Over time, I’ve come to terms with these new allergens thanks to the information my doctor gave me on that day. At the time, I wasn’t appreciative of the information but now, I think of it as a blessing.

I never truly respected and understood the importance of the semantics from allergen testing until I was thrown a fork in the road with these new allergens. Moving forward with allergy testing instead of paying more attention to my itchy arms, I listen more to my doctor and have him explain more in-depth regarding new allergens and what my levels mean.  Allergy testing has been and will always be important, and no matter what emotional events may surround your visit or why you’re there, its always better to be informed and prepared than ignorant to something new.

– Arianne.