Tag Archives: Fraser K

Magic words to get anyone to take your allergies seriously

In relation to my peanut and tree nut allergy

I am a 27-year-old adult with life threatening allergies and I carry my epinephrine auto-injector everywhere I go. When I’m out with friends or family at restaurants it is very important that I communicate the severity of my allergies to servers and to the chef(s) or management. It is more and more common that restaurants and pubs ask about food allergies before patrons need to mention them, which is accommodating and proactive. Still, it is vital to impress upon the wait staff the severity of the allergies, so the chef can comment on whether or not various meals or parts of the kitchen are allergen friendly. As well, it is not only when I am out on the town when I find the need to mention the seriousness of my allergies; it can also be when I am at a friend’s house for dinner, or even at my own house with my family.

It was not easy learning how to broach the subject of my allergies. I recall visiting a friend who had put out a vegetable platter to which I had to politely refuse. She asked why, and I explained my allergy. Following up, she asked what happens when I eat raw fruits and vegetables, to which I said “I die”. The whole room fell silent, and I realized that everyone either thought I was being over dramatic or that my allergy was so severe that I couldn’t even be in the same area code as an allergen. I then explained that my body may go into what is called “anaphylactic shock”, and helped them understand the severity of my allergy better. This was when I learned that there is a fine line between over-dramatizing allergies and downplaying them. At a restaurant or a friend’s house it is important not to scare people with the thought of a life-threatening allergy, but it could even be less effective to undercut their severity.

I have learned that there are two or three phrases, which I commonly use now, that portray the quality of my allergies without creating a panicked environment: “life-threatening”, “anaphylactic”, and “serious” allergies.

Surprisingly, another method that has worked effectively to communicate the danger of my allergies is simply having my auto-injector visible on the table. It is nearly a habit of mine that when I sit down at a desk or at a restaurant table, I empty my pockets of my wallet, cell phone, keys, and auto-injector. I do this for comfort and to avoid losing one of these valuable items in the crack of a seat or onto the floor. One time at a restaurant a server noticed this ritual, and immediately asked me what I was allergic to. They seemed concerned to obtain accurate information too. This method worked unusually well, but personally I don’t like being the centre of attention, so I have stopped doing this as often.

In relation to my other allergies

I have found different experiences with my common allergies compared to my uncommon allergies. I have a severe form of what’s called “Oral Allergy Syndrome”, where my body confuses fruits and vegetables with tree pollen. Many people have an allergy to one or two fruits or vegetables and when they eat these, they experience a mild throat irritation or scratching. I have a severe form of oral allergy syndrome and when my mouth and throat are exposed to any raw fruit and any raw vegetables, there is profound swelling which can lead to airway compromise. Peanut, tree nut, gluten, and milk allergies are fairly well publicized in the media, and I find restaurants usually understand that these are serious. Raw fruits and vegetables on the other hand are less commonly life-threatening allergies, so it always comes as a surprise to my server. I usually avoid fruit and vegetables in a restaurant because servers invariably mention, “How cooked do they have to be.” Since this is so often subjectively interpreted, I don’t risk it. It is not always known whether or not they understand the severity of these more uncommon allergies. I’m sure this is not limited to my allergies, but other adults with other less common allergies as well. It is important to approach these allergens as you would any common allergens when communicating them to others and understand that there may be some surprise and discussion about these allergens.

Overall, a useful method to ensure the severity of an allergen is communicated effectively, I remember to use a calm demeanor, language such as “serious” or “life-threatening”, and avoid dramatizing or underplaying an allergy.

– Fraser K.

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(Backcountry) Camping with Allergies

Route planning

I recently returned from a ten-day, 85-km hiking and backcountry camping trip in the Canadian Rockies, about 90 minutes southwest of Calgary. It was so enjoyable and the views were so magnificent! I went with three friends, one of which like myself, has life-threatening food allergies. We camped in the Peter Lougheed Provincial Park, about 30 minutes from any cell phone service so needless to say, the trip took a lot of preparation. We had to select our routes, campsites, gear, and safe food. I found that meal planning was surprisingly the most time-consuming part of the trip, especially for an adult with allergies. I have life-threatening allergies to peanuts, tree nuts, and all raw fruits and vegetables, so here’s a glimpse into my camping preparations:

Exit strategy

I am a very pragmatic individual, and since I have food allergies, I planned for the worst-case scenario. If I had an allergic reaction in the wilderness, I need to know how far I was from the nearest ambulance and hospital. This was important for our trip because we were so secluded, but I think it’s an important part of weekend camping as well. With appropriate meal planning and proper meal preparation hygiene, it is unlikely that an adult with an allergy will experience a reaction while camping, but knowing the closest healthcare facility is important because it can put one’s mind at ease. Before leaving on the trip we found that our furthest point from the trail head was 21-km and from the trail head we were 95-km from the Canmore General Hospital. We were also able to determine how many epinephrine auto-injectors to bring. Since we were quite far from healthcare services, we chose to bring a satellite phone as well, which gave us the flexibility to call for emergency services if the worst-case scenario occurred.

Overcoming previous fears

Mental preparation for this camping trip was especially difficult for myself because of a previous camping experience. In the summer of 2016, I was camping with two friends in Northern Ontario when we encountered a very large black bear. It was moving away from us into the woods, but was directly between us and the trail head. Minutes later I realized that I was having an allergic reaction. We had to get to the trail head to get to the car, but there was a bear in between us and our goal. I administered my auto-injector and we proceeded with caution towards the car, making as much noise as we possibly could to deter the bear. We made it to the car and arrived at the hospital nearly 45 minutes after my initial reaction, but not without tremendous anxiety. So the thoughts going through my head leading up to this big trip was…what if something like this happened in the Rockies?

New food exploration

I discovered my allergies in my early 20’s. I have a severe form of what’s called Oral Allergy Syndrome (OAS) and with this type of allergy, skin testing is not effective at elucidating allergens. I kept having allergic reactions to food I previously ate without concern. This method of uncovering allergens can be stressful because I felt that nothing was safe. Since discovering my allergies, exploring new foods has always been difficult. I used to avoid new foods altogether, but honestly that’s quite a boring way to live. So, I began incorporating new foods into my diet, trying them in safe places (in a doctor’s office, or at a hospital, or if you have easy access, at the allergist’s office), and now I try them at home with my epinephrine auto-injector in-hand. I felt that in the wilderness camping, I would be alright with my prepared food as long as I had my emergency plans in place (auto injector, satellite phone, and an escape route) since I only brought food that I was comfortable eating and 100% sure about.

Medication preparation

So, now that I had my escape route planned and the information about the closest healthcare facilities noted, I knew that the furthest I would be away from medical services at minimum was 12 hours hiking and 90 minutes driving. To be safe, I doubled this estimate, and I brought enough allergy medication for just over 24 hours. As well, we made sure that not only was each member of the group aware of my allergies, but each member knew what to do in case of an emergency.

Having fun

Once all the preparation had been complete, it was time to explore the Canadian Rockies. This trip was one of the most enjoyable experiences of my life! I swam in glacier waters, I saw many different kinds of wildlife including a grizzly bear and a large buck, I experienced some of the most glorious views from mountain tops, and really learned what it takes to hike and camp in the mountains. I spent 10 days with my closest friends, experienced highs and lows (literally and figuratively), and learned to work together. With the right preparation, weekend camping and backcountry camping can be very, very enjoyable experiences, even as an adult with allergies.

– Fraser K.

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.

Wine-ing about my Unusual Allergies – Lessons Learned from an Anaphylactic Reaction

Camping tent in the nice yellow dandelion field with mountains on background

My name is Fraser and I am a 26-year-old medical student. Last spring some friends and I planned to go camping in Gravenhurst, Ontario. While my friend Darryl and I were organizing our tents and sleeping bags, his mother offered us each a glass of wine. Our friend Pozz was picking us up so since we weren’t driving, we each indulged in a glass of wine.

I have life-threatening allergies to a long list of unusual allergens. I am allergic to all raw fruits, all raw vegetables, peanuts, tree nuts, raw salmon, and scallops. I grew into these allergies when I was about 18 or 19. I have had 10 anaphylactic reactions and each time, I have had to use my EpiPen®. I went to the hospital each time and on four occasions I needed another injection of epinephrine at the hospital. Thankfully, I have not stopped breathing during any of these reactions.

Darryl’s father handed us a small glass of white wine and we began pretending we were wine aficionados. I have enjoyed wine in the past, having a glass here and there. We swirled the wine around, spoke in British accents about the fruitful bouquet and the sparkling colours, pretending we knew the subtle differences between French and Italian wines. But, when I had a sip I could feel something wasn’t right. My throat was rapidly swelling up, I felt nauseous, and I began to feel dizzy. I had mistakenly left my EpiPen® in my car, so I ran out into the driveway, grabbed it, and administered it myself. Darryl came to the front door, saw what was happening, called for his father to dial 911, and came to help me. Within minutes, we had to administer another EpiPen® because the first had not yet provided effect. This was the first reaction that caused so much swelling in my throat that I was unable to breathe. The second EpiPen® took effect quickly. I was only unable to breathe for a few seconds. Soon, firemen and paramedics flooded the house and I was taken to the hospital.

I began breathing shortly after the second EpiPen® was administered, and my breathing stabilized in the ambulance. By the time I arrived to the hospital my symptoms were beginning to gradually recede. I was set up in a bed in the emergency department and was assessed by medical staff. My friend Darryl had accompanied me in the ambulance and my friend Pozz was on his way to meet us at the hospital. It was there that I began to feel something much different.

I felt guilty. I was going to be in the emergency department for a few hours to receive other medications and to ensure that I didn’t have a ‘bounce-back’ or “biphasic” allergic reaction. This is another reaction that can sometimes occur a few hours after the epinephrine wears off. By having to wait to make sure my symptoms were gone, I had delayed our camping trip. We were going to have to leave later in the evening, it was going to be dark by the time we arrived, we were going to have to set up our island camp site in the dark, my friends had to pay for parking at the hospital, my mother was called and she had to come down to the emergency department to see me, and I was taking up a valuable bed in the hospital. These were all thoughts going through my head. I don’t like being the centre of attention and having an anaphylactic reaction in the suburbs north of Toronto had brought several neighbours onto their porches to watch the commotion of firetrucks rushing with lights and sirens. I felt guilty that Darryl had to use his EpiPen® because mine hadn’t taken effect. I just felt guilty.

I spent four hours in the emergency room, and on the bright side, felt well enough to continue on the camping trip, and had a great weekend in Gravenhurst.

I think it’s very important for me to understand that having food allergies isn’t my fault. I don’t have food allergies because of poor lifestyle choices or because I didn’t study in school. I had enjoyed wine many times in the past and had no reason to believe that it would cause a life-threatening allergic reaction. Feeling guilty might cause people to shy away from help when they think they might be having an anaphylactic reaction. While studying medicine I was chatting with an emergency room physician who has a life-threatening allergy to walnuts. He had a reaction at a social dinner and instead of signalling for help, he ran down to the washroom. Thankfully, someone found him, administered his EpiPen®, and averted what could have been a terrible allergic reaction. I am not weak or defective because I have food allergies and this is important for me to realize. I am not bound by my food allergies and after this scary reaction, I did not let my food allergies define me. They are just one of the aspects of my life that make me unique. For readers who feel guilty about your food allergies and your reactions, I want to assure you that this is a totally normal way to feel. You might feel like a hassle when you and a partner are making a special dinner and they have to remove several ingredients from the meal because of your food allergies. Or, you may not be able to accompany your friends to a restaurant or pub where peanut shells cover the floors. It is normal to feel this way. But, overcoming these feelings is important, because if you don’t, you will experience much more distress than you need.

Thank you for letting me share.

– Fraser K.