Tag Archives: Caitlyn P.

Nepal, Austria, Greece & Keeping on Track with Food Allergies

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This spring was quite busy to say the least. As I prepared to finish my Bachelor of Nursing Science degree, write my nursing licensing exam, and begin the search to find a “real person” job, I also found myself in the midst of planning a volunteer trip to Nepal for the beginning of June. I’ve volunteered abroad before and am quite interested in global health so I was very committed to the idea of taking some time to go on a volunteer trip before taking on ‘adult responsibilities’ in the ‘adult world’. Before I knew it, after I organized my trip to Nepal, I also tacked on a week of visiting relatives in Austria and then arranged a one week tour of the Greek Islands. Could you say that I had a bit of a panic attack thinking that after I got my first nursing job I wouldn’t have any free time to travel again? Absolutely. Was this a slight overreaction? Perhaps…but no regrets, right? Anyway, along with the challenges of organizing three very different trips there is always the challenge of taking appropriate precautions with regards to food allergies.

In the weeks leading up to my trip departure I did basic research on the cultures I would be visiting and what sorts of food I would likely encounter. In Nepal, their cuisine takes influence from India as well as China with their main meal being Dhaal Bhat (rice &lentils). With my allergies being to wheat, eggs, and nuts I was a-ok with that. I was familiar with Austrian cuisine since my grandparents would always cook Austrian meals growing up. That being said, before even booking my trip I knew their love of schnitzel doesn’t work with my wheat allergy and sausage would also pose a challenge. What I did have going my way was the fact that, when in Austria, I would be meeting with my cousins who luckily could speak German and would be able to help me find suitable food options.

Finally, the mediterranean diet would for the most part agree with my food limitations of wheat, eggs, and nuts. But it would still pose some risks in terms of cross contamination. After getting an idea of what foods I would encounter while travelling, I also did the routine task of contacting airlines and informing them of my food allergies. I will admit I did not pick my airline based on which ones were allergy friendly. Instead I looked at which ones offered the best deal. I then had to find out that some airlines such as Turkish Airlines did not accommodate allergies in anyway such as even offering a gluten free meal option to passengers. This at least tipped me off to be well prepared with snacks for my air travels.

Other preparations before I left for my trip included making sure that I had not only one auto-injector to take with me but in fact several stored in different bags so I had backup options in case one needed to be used or perhaps accidentally got lost. I also packed anti-histamine medication which I use for less severe allergic reactions and a few inhalers in case I had one of my in-frequent asthma attacks. Having travelled by myself to other countries before, something that I always like to bring is allergy cards. You can order these online through companies like Select Wisely.

These allergy cards are neat because you can have these pocket- sized laminate cards made to state your allergies as well as other phrases such as ‘I am having an allergic reaction please get me to an English speaking hospital’ in virtually any language. I naturally ordered a fresh batch of these allergy cards in Nepali, German and Greek. But the roadblock I encountered was that, although I ordered these cards five weeks before my departure date, because they were coming from the USA they didn’t actually arrive before I left. The real kicker is I flew out on a Saturday and my allergy cards arrived the Monday after! Oh well, c’est la vie! I found that a useful and convenient alternative for communicating my allergies was downloading the google translate app on my smartphone. By downloading this app I could use very simple language to communicate my food allergies and inability to eat certain foods and type this into the app. I then saved the phrases that were produced so I could easily bring them up when ordering food.

So after months of planning and prepping for my trip it was finally time for departure. For my time In Nepal, I was living in Kathmandu and the work I was doing involved volunteering with the largest women’s health NGO in Nepal. I got connected with this group through a volunteer liaison organization that provided room and board for those coming to the country to volunteer. This provided some obvious perks such as not having to find my own accommodations as well we had all of our meals provided for us by an in-house cook. I knew in Nepal it was customary to eat rice at most meals (usually at least two meals a day), but when I had my food allergies explained to the cook I could see her eyes bulge as I am sure she began to ask herself ‘what else can I make for this girl besides rice, rice, and more rice!?’

I will admit.. I ate ALOT of rice when I was in Nepal. Breakfast usually contained of fruit and some form of rice, rice donuts, fried potatoes or even fried rice noodles (I believe the cook was trying to get creative as I could not eat things like toast or egg). Lunch typically involved fried rice prepared with some fried vegetables and potatoes or beaten rice (another form of rice quite popular in nepal…usually fried). Dinner again usually consisted of dhal bhat (rice and lentils) with curried vegetables. If you want a true picture of Nepali cuisine don’t just use my blog as a source they DO eat food beyond rice including their famous stuffed dumplings called Mo-Mos as well as various noodle dishes but as I definitely experienced rice is their main staple grain.

While my day-to-day meals were always allergy friendly I did eat out from time to time and had to be careful with ordering my meals. It was tempting not to eat out in Nepal since for $3-4 american could get you a LARGE meal of your choosing. In terms of ordering safe, I always try to stick to foods I can identify as likely being allergen free and then reconfirming when placing my order. In Nepal this involved ordering a lot of curries and traditional plates of dhal bhat that came with curried vegetables, pickled vegetables, your choice of meat as well as potatoes. It was here that I would bring out my phone and show waiters my pre-typed allergy message. The organization I worked for was stationed in Kathmandu (the capital of Nepal) and I was surprised how many people in Nepal could speak or understand some English. That being said, allergies are next to non-existent in Nepal so while some educated Nepali people know of allergies this is not something they encounter regularly like we do in North America. Therefore it was important to always re-evaluate the waiters understanding while placing my order and even confirming again when the order arrived.

While I found it easy to avoid food allergens when eating out, I actually found it harder to avoid allergens at my place of work. The volunteer organization that I worked for had its main branch located in Kathmandu. However, due to the recent earthquakes that struck Nepal, we were going out to areas around the Kathmandu valley and working in health camps. Regardless of whether we were at the main branch or out in the field, lunch was always provided for the staff (something commonly done in many places of work in Nepal). These would be simple lunches of Mo-Mos (dumplings) or packets of dried noodles which are extremely popular in Nepal (yes, exactly like the ones you ate in grade school). That being said most days I could not eat any of these lunches and instead brought my own.

Some of the staff did not speak English so, when I politely declined their offer to have some of their food, it was hard not to feel completely rude. After a couple of these offers, during which I received strange looks for not wanting their food, I brought my phone with me to work so I could communicate to everyone that it wasn’t that I didn’t like their food but literally could not eat it. They definitely understood and even on my last day of work made me a special lunch with only foods I could eat— just one small example of the incredible kindness and hospitality of the Nepali people. I am thankful to say I did not have an allergic reaction while in Nepal and in fact was more successful at avoiding my food allergens than avoiding drinking untreated well water…but that is an accident and a story for another time!

After the trip of a lifetime to Nepal, I flew to Austria for a week. Here I will admit I was fortunate that, for about 2/3 of my travels, I was with cousins who could help with translating food allergies when ordering or helped with reading ingredient lists. While on my own I still didn’t find it too difficult to order food and communicate my allergies. I attribute most of this to the fact that I was in tourist centres like Vienna and Salzburg where it wasn’t hard to find those who spoke English. When it came to buying food at stores, when in doubt, I simply would look for a friendly stranger who spoke English and could help me translate what the package said. I had the google translate app ready to go but found I didn’t need to use it often at all. Again I was fortunate that Austria proved to be a trip that was reaction free!

For my final stop in Greece, I found it slightly more difficult to order food than in Austria. I obviously didn’t have family right there to translate, as well I found English wasn’t quite as commonly spoken here. That being said, while travelling the Greek islands, many of the cities are tourist hot beds so you will find someone working in a restaurant that does speak some English.

Another thing I found was that sometimes the personality of servers in Greece were such that, depending their mood or how busy they were or maybe just how they were feeling that day, this would dictate their promptness for allowing you to order with a ‘special request’ (i.e. a allergy safe meal). Despite this I did appreciate that they always did pay attention to my actual concerns and were very good about making alterations as necessary so I could eat safely wherever I was.

Even on my last night in Greece I was dining with some people in Athens and after having one of the best dinners of my trip the waiter/owner of the restaurant brought everyone at our table a piece of a pastry. I graciously thanked the man but explained that this was also something I could not eat. He of course understood and then came back a few minutes later asking if I could eat watermelon. After I said I could, he came back with an entire chopped up watermelon for our entire group! One of the greatest experiences of my travels had to be seeing the generosity and thoughtfulness of people are all across the world!

Yes, it can definitely be extra work and an added responsibility when travelling with food allergies. But I am a firm believer that it is not something that should hold you back from allowing you to gain life- changing experiences and travelling around the world! There are so many other things to consider and precautions to take when travelling with food allergies. While I tried to take precautions that made sense to me, feel free to comment below with tips and tricks you use to stay safe while travelling!

Caitlyn P.

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Expectations when Eating Out with Allergies

Waitress

When talking to other people about my allergies, a common topic that comes up is how hard it must be to eat out at restaurants.  For the most part, however, I have had nothing but positive experiences when it comes to eating out. I will admit that there have been some less than positive incidents, for example where it was not detected that the menu item I ordered contained food allergens. And only once did a restaurant refuse to serve me because of my allergies. While these are not positive events, they for the most part are preventable by having my own routine for how I inform servers about my allergies along with the responsibility I expect to see from the restaurant for serving someone with allergies.

The expectations I have when eating at a restaurant include always making sure I get confirmation that the chef is going to be informed about my allergies and that whatever I ordered is going to be prepared in an area where no cross-contamination will occur.  When I order food, I also expect waiters or waitresses to be investigative to ensure that the meal I am ordering is actually free of any possible allergens. One of the incidents where I had an allergic reaction in a restaurant occurred because the waitress misread the ingredient label for a veggie burger, which actually contained egg.  Therefore, I always prefer when a restaurant has a binder that contains a list of what ingredients are in what menu items. Since this is not always possible at every restaurant, I also find that it is a good sign when a waiter/waitress comes back to the table to verify ingredients with me— as this signals they actually have been looking into the food I have ordered.

Overall it is my hope that restaurants will be very accommodating when serving someone with allergies since they want to encourage business but also don’t want to trigger an allergic reaction in one of their patrons.  The incident where a restaurant refused to serve me occurred at a restaurant in Toronto. This restaurant had all of their food shipped in from an outside supplier and could not verify all the ingredients in their food and then could not guarantee any food items were definitely allergen free.  This was obviously a frustrating incident. But it was the right call since no food item could fully assured to be safe. Some incidents where restaurants get ‘brownie’ points for their service in regards to managing food allergies include when the chef comes out and personally talks to me about menu options and what is safe for me.

This exceeds my expectations for eating out and completely reassures me that my meal will be safe. Furthermore, the more flexible a restaurant is with altering their menu options to make safe meal choices also puts a restaurant in my good books.  This gesture is obviously much more work for a restaurant kitchen but is a testament to their commitment to providing an allergy- safe restaurant experience for their guests. It is a shared partnership between myself and the restaurant I eat out at to ensure that the food I eat is allergy friendly. For the most part, however, I must commend restaurants for the steps they take to make my experiences eating out safe and enjoyable. What have your experiences been like eating out at restaurants with allergies?

Caitlyn P. 

Managing My Allergies: Then and Now

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When I take time to look back at how I’ve learned to manage my allergies, it’s amazing to see the differences from when I was growing up versus now as a young adult.  Obviously, when I was very young, it was my parents’ responsibility to ensure that I stayed safe avoiding allergens. It’s easy to see now that they were training me from a young age to eventually take on this responsibility.  This started out with ensuring that I was able to identify what foods I couldn’t eat and only eating foods I knew were safe.  Going to school, my parents really emphasized the importance of not eating anything that was from someone else and always carrying my auto-injector with me (and knowing how to use it). When I was starting school, my parents took on the responsibility of contacting my school and my teachers to ensure that they were also knowledgeable about my allergies along with informing them of where my auto-injector was kept. They would also make sure a plan was in place for storing my medicine in the school’s office and they established a protocol for field trips. My parents also made sure my medications were always up to date and that I frequently saw my allergist. I have now been able to assume these responsibilities myself—but this change was not something that suddenly took place; it came gradually over time.

As I got older, and progressed through elementary school and then high school, I was able to become more and more active managing my allergies. My first big shift in responsibility between my parents and I came when I entered high school.  Having gone to the same school from kindergarten to grade 8, starting high school meant it was now my turn to meet with my new teachers and principal to introduce myself and discuss how we would ensure I was safe at school with my allergies.  While I took on a bigger role in this, I have to admit my mom was still present and was the one who double (and triple) checked that I had taken all the appropriate measures to ensure that I would be safe entering high school. It would not be until I started university that I truly began to feel fully independent when it came to managing my allergies.

When I moved out, all of a sudden there was no one asking if I had my medicine with me when I left to go out. Initially, everyone I met was a stranger who didn’t know about my allergies; and it was my responsibility to educate them. I never fully realized all the things my parents did to help manage my allergies until they were longer there to help with this. That being said, as I mentioned earlier on, I felt like my parents were training me to manage my allergies from a young age. And this definitely has paid off.  Going to university and living on my own have marked two of the biggest changes in terms of having total responsibility when it comes to managing my allergies; but I have never felt unprepared.  Living on my own, I have lived a far distance from my parents and old friends who are already very knowledgeable about my allergies.  I’ve also had various living arrangements that involved living with roommates who weren’t used to having a roommate with allergies.  Along with this I’ve also travelled independently to other countries where I’ve had to manage staying safe with my allergies in a foreign nation.  These are all new experiences I never encountered as a child.  That being said, with every new experience I’ve had as a young adult, I’ve felt competent to ensure that I stayed safe by using the common sense my parents taught me about managing my allergies.  I’ll admit that my parents still like to check in now and again to make sure I am staying safe with my allergies; but what is different now is that I am the one with the responsibility to manage this.  One of the positive things that has not changed in this situation, though, is trust. When I was young, I trusted my parents to make sure I was safe with my allergies and, now having watched me grow up with allergies, my parents can trust me to do the same.

Caitlyn P.

Instructing Others About How to Read Food Labels

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Having grown up with food allergies, I found that a special skill I acquired from a very young age was the ability to carefully read food ingredient labels.  I sometimes joked that, as a child, I read more labels than I did books (which when I think about it is very true!).  That being said, for people who don’t have food allergies, reading ingredient labels to make sure they don’t contain specific food allergens can be a complicated task to navigate.

There are helpful tips that can be given to those less experienced with reading ingredient labels; these  can help them successfully identify what foods are or are not allergen free.  The first important step is to identify what allergens need to be avoided. Canada has new labelling guidelines that require manufacturers to use simple language when referring to priority allergens. Become familiar with these new guidelines at http://www.hc-sc.gc.ca/fn-an/label-etiquet/allergen/index-eng.php

It can also be useful to have knowledge about what types of foods typically contain what allergens.  For example, some ice creams, while typically a no–go for people with dairy allergies, may also pose a problem for some people with egg or nut allergies.  Being able to identify what allergens are commonly found in what foods comes over time  along with a general knowledge about what purpose different food allergens serve in different food products (i.e. egg as a binder or wheat flour as a thickener).  That being said, the ingredient label is always the best way to verify what is in your food.

When instructing someone about how to read an ingredient label, after making sure they know what allergens they are looking for, ensure that the label is read VERY carefully.  This includes ensuring that the person who is reading the label is able to identify EACH ingredient listed.  If they are ever unsure, it is always a good idea to consult the person with the allergy to determine if listed ingredients are safe.  It also is never a bad idea to re-read (or re- re-read!) the label so one can confidently say that the ingredient list doesn’t contain any allergens.

Another thing to look out for when reading food labels is to identify if the label lists any allergens that MIGHT be found in the food product.  These food allergen warnings are most commonly listed directly below the ingredient list and commonly say something along the lines of “This product MAY CONTAIN” or is produced in the “SAME FACILITY” or on the “SAME MACHINE” as certain allergens.   While it is not definite that these foods contain these allergens, eating these items still poses a huge risk (and why risk it, right?).  It is also important to make sure that whoever is reading the ingredient label understands that any food that ‘May Contain’ an allergen should best be treated as if it still contains that allergen (and therefore avoided).

Last, but not least, while it’s important for those around to be educated about reading ingredient labels, you are still the primary person responsible for ensuring that you are staying safe and avoiding food allergens. Always personally ensure that you are able to eat questionable foods before taking a risk.

 Caitlyn P. 

 

 

 

 

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.

 

 

 

 

 

 

Food Substitutes for Common Allergies

Cake Temptation

One of the most common responses I get from people when I tell them about my allergies is typically: “What do you even eat!?” I always find this funny to respond to; but I always reply with something along the lines of: “oh trust me, I eat.” I will admit that being allergic to wheat, eggs, and nuts can pose some limitations; though I realize not necessarily as many as others encounter with other allergies. There are, however, numerous food substitutions for allergens that allow you to not have a diet that is lacking important nutrients or yummy food options.

When trying to find replacements, in your cooking and baking, for common allergens, there are some commonly used options that are growing in popularity and can be found at many grocery and health food stores. Wheat flour is a very common in cooking and baking. This poses a challenge to those who have wheat allergies or gluten intolerances.  Numerous wheat-free flours are commonly available now for use. The challenge is getting an appropriate consistency with wheat free flour that best resembles regular wheat flour.  A combination of wheat- free flours is usually recommended to produce the best results when baking.  Different varieties of wheat-free flours include: white rice and brown rice flour, oat flour, potato flour, tapioca flour, and garbanzo (chick pea) flour.  Along with replacing wheat flour in cooking, there are many wheat-free products available in grocery stores and health food stores that include: breads, pastas, cookies, cakes, pizza doughs, etcetera. It is even more common to find gluten-free restaurant options and, with a little more searching, to find even restaurants and bakeries dedicated to being gluten free.

Dairy is another common allergen that is in many different foods. There are various possibilities for substitutions. For milk, there are a variety of dairy-free milks that are available. These include: soy, rice, hemp, almond, and coconut milk.  That being said, someone with nut allergies should exercise caution with almond and coconut milks depending upon their specific allergies.  For substituting butter, margarine may be an option for some; but many other foods are being used for butter in recipes which are considered to be ‘healthier options’.  This includes using coconut oil, applesauce, avocado, and canola oil in your baking in lieu of butter.  For substituting items such as yogurt, sour cream, and cream cheese, dairy-free versions can be found at many health food stores and will often be made from a soy base.  Along with this, soy cheese and other vegan dairy-free cheeses are commonly sold; but these do not melt the same as regular cheese and, therefore, do not work in recipes where this is required.  Nutritional yeast is an item found in health food stores and it is a popular ingredient used in recipes requiring melted cheese (such as ‘mac and cheese’).

In terms of ice cream replacements, sorbet is a chilled dessert that doesn’t contain dairy. However, other dairy-free ice cream options are available—such as ice cream made with rice or coconut milk.

Egg can be a tricky allergen to replace in foods where it is the core ingredient; this is in dishes such as omelets and scrambled eggs.  Eggs are, however, key in baking either as a binder or leavening agent. But you can have various substitutes available that can also serve this purpose.  It is very common to find, in health food stores and some grocery stores, packaged egg replacer. This is a powder that, when mixed with milk, can be used specifically as a replacement for eggs in baking. Other egg substitutes that serve the ‘binding’ purpose in baking include: a half cup of mashed banana, ¼ cup of applesauce, 3-1/2 tablespoon gelatin blend or a ‘flax seed egg’ (1 tablespoon flaxseed mixed with 3 tablespoons water, set for one minute).  For using eggs as a leavening agent, a good substitute can be combining 1- ½ table spoons of vegetable oil with 1-1/2 table spoons water and 1 teaspoon of baking powder. Also see a blog post by Arianne which specifically talks about focusing on replacing eggs!

Peanut and nut allergies are extremely common and can make eating some Asian foods such as Thai a ‘no-go’. These allergies also get rid of the possibility of having that classic ‘go-to peanut butter-jelly sandwich’.  Some alternatives include a variety of ‘seed butters’ available that are made out of seeds such as sunflower, sesame, and pumpkin seeds. Soynut butter and peabutter are also common items now also found in grocery and health food stores.  Seeds can also be a great ingredient to use in salads and other dishes for a ‘nutty-like’ addition.

Soy is a tricky allergen to avoid. As you might have noticed, it is commonly used as a ‘go-to’ for other allergen substitutes.  That being said, more and more soy-free options are becoming available.  With items such as vegan cheese gaining in popularity, it is possible to find a soy-free version for those also allergic to dairy.  Soy-free margarines are also sold; but it does take some time to find what stores are the most soy-free friendly.  Butter is also an option for this if you are not also allergic to dairy.  For replacing soy oil, canola oil as well as olive oil are good options.  Some foods such as soy sauce are inevitably hard to replace; but there is always the option of searching out recipes to create your own version.   There are also chickpea versions of miso available (which is traditionally made from fermented soybeans).

This just highlights some common allergens that have different food substitutes available.  I always like to look at avoiding my allergies as a way to find exciting new ways to prepare food and get creative!  Feel free to share and comment below with other foods you struggle to find substitutes for or ways you have been creative with your food allergies!!

Caitlyn P.

 

Food Dependent, Exercise-Induced Anaphylaxis 

biking

Being a young adult with allergies, I have grown up learning all the ins-and- outs of my allergies and how to manage them.  Since the age of one, I have been identified as being allergic to wheat, eggs, nuts, and have also had other allergies that I’ve been fortunate enough to grow out of. Like others who have grown up with allergies, I became proficient in knowing what each of my allergic reactions were like, the severity of each reaction, and what works for managing and staying safe with my allergies.  Over the years, I have become quite comfortable with my abilities to manage avoiding food allergens. And, while I’ve had the occasional reaction to wheat or eggs, I have been fortunate never to come in contact with nuts—which put me at risk for anaphylaxis. That being said, I recently had a different kind of allergic reaction which I was unprepared for, and knew very little about.  This allergic reaction is something known as ‘food dependent, exercise induced anaphylaxis’ or FDEIA.    Some of us may be aware of the ability of exercise to exacerbate medical conditions such as asthma; but this can also be true for food allergens or foods we are not even normally allergic to.  FDEIA is defined as a rare, unpredictable syndrome characterized by anaphylaxis associated with the ingestion of a food and the occurrence of exercise.

I won’t go too in depth. But I want to share part of my experiences with an exacerbated allergic reaction related to exercise.  Currently I go to school and live in Kingston.  My living arrangements involve housing with a great group of girls who have all been extremely accommodating towards my allergies.  My one housemate had done some baking one afternoon and was kind enough to make her baking ‘allergy friendly’ for me.  She had finished making her goods before I was about to go for a run. And, being assured it was free of my allergens, I indulged in her baking before starting my exercise.  Briefly into my run, I noticed a slight ‘tickle in my throat’ and the idea crossed my mind that my body could be mildly reacting to something.  I then made the poor decision to keep going (thinking that the tickle in my throat couldn’t really be a reaction).  I then noticed my breathing was becoming a bit more labored and uncomfortable.  I again made a poor judgment call and attributed this to just being a normal shortness of breath from the progression of my run.  I can’t stress enough how things quickly escalated from there.  My breathing became extremely labored, my eyes started swelling, and my body became extremely itchy on its extremities.  I also began experiencing a variety of uncomfortable GI symptoms and started to become progressively light headed—which was,  likely, from my blood pressure dropping.  This was an extremely dangerous situation to be in.  I had always been a very confident and regular runner and, in this situation, had no medicine or phone with me. I will admit that, at that point, carrying an auto-injector was never part of my usual running routine.   In this case, I still marvel at how fortunate I was that, while this was occurring, I was able to get help and receive medical attention.

What was extremely eye opening to me in this situation, and what I really want to share, was how long it took me to fully recognize that I was actually experiencing a severe life threatening allergic reaction.  With my allergies, on a day-to-day basis, I felt quite confident in my ability to identify allergy risks and when a reaction was starting. In this situation, however, I didn’t identify the progression of this reaction early enough.  It never crossed my mind that I was at risk for experiencing a severe allergy attack until it had progressed to such that level.  It was only after I was treated for this reaction that I was told about Food Dependent, Exercise Induced Anaphylaxis that things really became clear.  It was found my personal reaction was triggered by spelt (as species of wheat which my housemate thought was gluten free but in fact was not).  While having spelt would cause me to have an allergic reaction, it normally would never have caused such the severe reaction I subsequently experienced that day.  Exercise itself has also been found to be capable of inducing anaphylaxis (known as Exercise-induced Anaphylaxis) or ,with FDEIA, it can be related to a combination of food consumption and exercising.  As mentioned earlier, with FDEA, it has been found that both foods someone is aware they are allergic to, and sometimes even foods that don’t normally cause an allergic reaction, can trigger FDEA.  Research has been done on these topics and, while there is still a need for more, it is an interesting subject to look into and educate yourself about. It is important, as individuals who have managed our allergies for some time, to still be aware of different reactions and risks with allergies that can occur, and to always work to stay educated and safe.

Caitlyn