Living with food allergies and understanding risks...

by Amanda Painter, South Chapter Coordinator 

Living with food allergies comes with risk. Those managing food allergies must work to reduce risk with the understanding that all risk cannot fully be removed, but it can be managed.  While high risks need to be avoided, other risks can be minimalized and controlled. Reducing risk is key for successful food allergy management. 
 
There is a fine line between appropriate precaution and being overly cautious.  How do we strike a balance that leads to a well-adjusted life?
 
First, recognize that different factors and components contribute to risk.  Some of these factors are associated with higher risk. Recognizing high risk situations is crucial to avoiding potential life-threatening reactions. 
 
Individual 
The age and diagnosis of the individual is the first factor that should be looked at in each situation.
For example, toddlers and teenagers have different risks associated with their age.  Crumbs on the floor can be an immediate risk to a crawling toddler, but not necessarily for a teenager.  It’s important to understand that risks change as a child grows.  Address these changes and communicate with the child on how they can help recognize and manage the risks. 
 
Teens and young adults are the age group at highest risk of anaphylaxis.  Teens have less adult supervision and may take risks in an attempt to fit in and avoid social issues. 
 
Those with asthma are at a higher risk of anaphylaxis due to reactive airways being prone to respond with narrowing.
 
Food Choices
Depending on what allergens need to be are avoided, different foods are of high risk. Familiarize yourself with the top type of foods to avoid.  For example, desserts are high risk for those with peanut and tree nut allergies.  Those managing a mustard allergy should be cautious of sauces, condiments and marinades.
 
Complex dishes with several ingredients and sauces are also high risk.  Allergens are harder to be seen in this type of dish.  Order simple dishes with few ingredients to reduce the potential for hidden allergens.
 
Choosing a restaurant where there is a language barrier adds additional risk.  Be sure you are able to clearly and effectively communicate with those preparing your food.
 
Understand that alcohol can affect judgment and increase risk-taking behaviors.   
 
Situations
Lack of adult supervision can increase risks depending on the age and self-management skill level of a child with food allergies. If a child is not capable of self-management be sure they are supervised by an adult that understands prevention steps and is trained to recognize and treat a reaction. 
 
For teens and young adults capable of self-management, it is still important that they be surrounded by those that encourage them to make healthy choices.
 
Choices/behaviors
Managing food allergies and the associated risks confidently largely comes down to communicating with those around you about your allergies. Choosing to not communicate your needs regarding food allergies with others, especially those preparing food for you, is a risk that is not worth taking. 
 
Ultimately, the most dangerous situation is choosing to not be prepared for a reaction.  Not having epinephrine available is not a risk that should be taken.
 
Now that we’ve looked at the different factors that contribute to risk we can analyze and prepare for risk better.
 
Identify the risks
Sometimes this is easier than others; for example, a birthday party.  It’s fairly easy to identify that the cake or other food to be served, and possibly messy hands from other kids, is the risk.
Other situations may create a long list of potential hazards.  Summer camp for example.  Who is providing the food? Will my child always be under the supervision of someone who is trained to recognize and treat a reaction?  Is there a communication system in place to call 911?  How far away is the nearest hospital?  For more complex situations, make a list of concerns so nothing is over-looked.
 
Assess and evaluate to understand the level of risk
Prioritize what is high risk and urgent and address those concerns first. Educate yourself, your children and those who care for your children about high-risk factors and situations. 
 
Acknowledge what should be avoided
Some situations are nonnegotiable.  Removing yourself or your child from or avoiding a dangerous situation at times may be necessary. 
 
Don’t avoid a situation simply because it CAN be avoided. Avoid if it SHOULD be avoided.  It’s important to acknowledge if there is a true risk or if something is being avoided due to anxiety. Avoidant coping isn’t a healthy solution.  If you are uncertain if a situation is safe or not, consult your allergist.
 
Implement strategies to control situations where you can minimize impact
Plan ahead and be in control.  Make safe choices and be confident in your choices. Teach self-management skills to children at a young age and add to the responsibility as they mature. 
 
If diagnosed with asthma, work to keep it under control and avoid your triggers.
 
Follow reaction prevention steps.  Be vigilant about label reading and ensuring your food is safe from allergens. Never assume a food is allergen-free.  Communicate with those preparing and cooking food for you.
 
Always be prepared for a reaction. Know that anaphylaxis is unpredictable.  Previous reactions cannot predict how severe a reaction may be in the future.  If you have been prescribed epinephrine, you are at risk of anaphylaxis. Always carry 2 auto-injectors with you at all times, and follow your emergency care plan on when to use it.  Be confident on when and how to use an auto-injector.
 
Living a balanced life is possible while managing allergies.  It does take effort though.  Confident food allergy management happens through making smart choices every day to avoid or minimize risks.  Keep a positive outlook that you are in control of what you eat and always prepared if a mistake does happen.  Do not let your food allergies define who you are or restrict you from living the life you want.  
 
***While talking about the risks that come with food allergies, I must mention that some individuals are more risk adverse than others. Accepting different levels of risk can be dependent on many factors including education level and doctor recommendation.
One way that many with food allergies take risks is by consuming foods with cautionary labeling, such as “May Contain…”.  I urge everyone managing food allergies to educate yourself on this topic.  Understand the limitations of food labels and what “may contain” truly means.  Allergic Living covered this topic well in May Contain Confusion.  Also, please read the story of how complacency and not taking cautionary statements seriously resulted in one young man’s death here.