Allergy testing in 2019; what to expect and what not to do

I must start my post by apologising. I know I haven’t posted for quite a while as I’ve been busy studying for an exam and writing assignments. I’m still mid-study, but something happened to me yesterday that I want to write about, so I’m typing this while sat on the train home from an all day seminar.

Over the summer of 2018 I had two allergic reactions to unknown foods. They were pretty bad reactions, one of which left me with a swollen, puffy face and eyes for approximately 24 hours. It wasn’t a good look:

I’d not had a reaction like that for more than 10 years, so I decided it was time to see my GP about being re-tested.

My appointment day finally arrived yesterday. Mr Allergy battled his way through the rush hour traffic to get us to Southampton General Hospital for 9am. The traffic tried its best to thwart us, but at 8:58am he chucked me out of the car towards the West Wing entrance while he disappeared to find the elusive hospital parking space.

The night before the test I thought I’d better check the appointment letter to see where I had to go and find out how long it would take to get there. I also thought I ought to find out whether or not I needed to avoid any particular foods in advance of the test. What I hadn’t realised (and if I’d actually read the letter when it arrived, I would have known) is that you’re supposed to stop taking antihistamines 3-5 days before a skin test. I didn’t do this, so upon arrival at my appointment I had to own up and say I’d taken a tablet the day before.

I’ve had skin testing done before, over 10 years ago. I also would have been tested as a child, but I don’t remember this as I was too young. The test I remember was where the specialist tested different allergens on my skin. The results showed a very severe peanut allergy as well as allergies to dairy, egg, other types of nuts, fish, pollens and animal fur.

I couldn’t have a skin test this time because of the presence of antihistamine in my system. However, my specialist told me this wasn’t actually a problem. Apparently skin tests on people who had bad eczema as a child can give a false positive result, as the skin is naturally more sensitive. For results to be accurate they need to be read in conjunction with blood tests. Thus, I lost around 7-8 ampules of the red stuff to a friendly looking vampire in the phlebotomy department.

It was a fascinating appointment. Things have moved on considerably in the space of only a few years. I’m due to go back for some skin testing once my blood test results are in. I’ve also been referred to a nutritionist who can make sure I’m not missing anything vital in my diet. Once all of the tests are complete I may be put on a programme of introducing different foods, which both excites and scares the bejeezus out of me.

I also learnt that it is possible for a person to have an allergy to locusts (for the record I don’t think I’m allergic to them). Apparently it’s similar to a shellfish allergy and brings on hay fever-type symptoms. This came up in conversation as, in my bid to be allergen free, I have pet geckos; little did I know my pets’ food could cause allergic reactions. For clarification, it’s an airborne allergen, the allergy isn’t from eating the locusts, although I’m sure if you did feel a bit partial to a ‘hopper’ it might give your mouth a tingle. It does make me wonder what happens if/when insects become a main part of the human diet; will new food allergies appear?

The key thing I learnt is that the method of treating allergies now is very different from the methods in the early eighties when I was first diagnosed. The medical opinion back then was to avoid the allergens altogether with the hope you would grow out of it. Unfortunately for me, this means that I have never had the opportunity to desensitise from these allergens and I’ve grown into more allergies as I’ve got older. If I was diagnosed as a child now, they would expose me to the allergens to help build up an immunity. Hindsight is a wonderful thing, so I’ve got to work with how things are now, in the hope it might get a little bit better.

That’s all from me for now. Hopefully I’ll have some good news over the next 6-12 months, but I’ll keep you posted on how things go.

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What happens during an allergic reaction?

I was unlucky enough to have an allergic reaction yesterday. I have no idea what caused it. I ordered take away from the usual Indian restaurant and had the same dishes as usual. I realised something was wrong about five minutes after finishing my meal, which got me thinking…….

No two allergic reactions are ever the same, and they vary based on the severity of the allergy and the amount of allergen the person is exposed to. I guess they also vary from person to person as everybody’s allergy will be different. For example my brother, Allergy Boy, tends to have bad eczema after eating something he’s allergic to, whereas I tend to have a more anaphylactic style reaction (although once when he was a baby he touched a raw egg and swelled up like a red ballon. Not good).

Dust and pollen allergies usually affect the eyes and nose, and anyone that has suffered from hay fever will recognise the symptoms. Asthmatics may also get wheezy with these allergens, and may need to use their ventolin (blue) inhaler.

Allergies to animal fur and feathers can present themselves in a similar way to dust and pollen allergies, but they can also cause anaphylaxis. One of the most serious reactions I ever had was to dog fur one Halloween. I was at a house party when someone knocked a bowl of crisps onto the rug, where a very hairy dog had been sitting. I helped clean up, and almost immediately my throat started swelling, my nose began to run and I couldn’t breathe properly. My friends (still dressed in their Halloween costumes) took me to A&E where I was put on a trolley in the corridor and left there for four hours. By the time I finally saw somebody, most of the symptoms had died down. I think I finally got home at about 6am, and slept for the rest of the day.

Nearly every food allergy I’ve ever experienced has started with what I can only describe as a funny taste in my mouth. It’s like a tingling sensation that also tastes weird. As soon as I get this taste, I take an antihistamine tablet. Sometimes this will knock it on the head early and the taste will disappear with no other symptoms. If I haven’t got to it early enough or I’ve consumed too much of the allergen, the following will often happen:

  • Swelling/lumps in the throat
  • Runny nose and sneezing
  • Swelling of lips
  • Lumps under the skin, starting at the hairline and gradually spreading around my head. Sometimes I’ll also get these on my arms, back, stomach and chest.
  • Sore throat
  • Swollen face and eyes on very severe occasions.

Last night I had everything apart from the swollen face, although I did have lumps under my nose, which was fairly unpleasant.

When I have an allergic reaction I generally use cetirizine hydrochloride to treat it. I don’t know how many tablets should be taken as a recommended dose, but I ended up taking four yesterday. In addition I have Fexofenadine, a daily antihistamine, which can be taken at the same time as the cetirizine hydrochloride. I also carry an Epipen for very severe reactions. Luckily I’ve never had to take my Epipen, as usually the combination of antihistamines does the trick (which is good news, as all four of the Epipens I found in my handbags were out of date!). Apparently I should have taken the Epipen the night I ended up at A&E, but I was only told this when I finally got to see a doctor.

In addition to medication, drinking lots of water can help flush it through. Sucking on ice lollies or ice cream can also help to soothe the soreness of the throat and reduce the swelling.

The day after an allergic reaction I often feel extremely wiped out. The allergic reaction attacks the body, so I sometimes have flu like aches and shivers and am drowsy from the antihistamine. If my throat has swollen during the reaction I will have a sore throat that sometimes lasts a couple of days.

Allergic reactions aren’t always visible to other people, so if someone tells you they’re having an allergic reaction, ask them what medication they have in their bag, find it for them if they need to you to and get them a glass of water. If they are having trouble breathing and they have an Epipen, use it. The instructions will be on the packaging, but it should be noted that once an Epipen has been administered to a person they should attend A&E. Allergic reactions can be deadly and can come on very quickly, so the most important thing is to act quickly and keep calm.

So, that’s what happens when I have a reaction, hopefully this might be of some use, but fingers crossed you’re never in the situation where you’re either having a reaction or with somebody that is.

Warning: Contains Nuts

I had a very narrow escape yesterday. Following a training seminar near Fleet Street (where an Allergy Girl friendly lunch of ham salad with balsamic vinegar was provided), I decided to detour back to Waterloo via Le Pain Quotidien near the Royal Festival Hall on the South Bank. Le Pain do a very nice Cocoa and Pear cake, and I thought I’d treat myself to a slice to indulge in during my commute home. On entering Le Pain, the conversation went like this:

Me: Do you have any of your vegan cocoa and pear cake?

Server: No, the only vegan cakes we have are the salted caramel and passion fruit cakes.

Me: Do they have nuts in them? I’m allergic to nuts.

Server: I don’t think so, let me just check.

She gets a typed piece of paper out of the folder, looks at it.

Server: There’s no nuts.

Me: Can I check?

I look at the typed list of ingredients in the salted caramel cake, and 2nd or 3rd on the list is cashews (not in bold type).

Me: There are cashews in it.

Server: Oh sorry, yes I didn’t see that. What about this one? (Pointing at the passion fruit and beetroot one)

At this point we both read through the list of ingredients, which seemed to be mostly coconut based. I purchased a slice of this for a whopping £5.95, and carefully carried it to the station for fear that a hurrying commuter might knock it out of my hand.

It got there in one piece.

On the train I opened the little box. The cake looked pretty and inviting and I was looking forward to trying something new.

I stuck my fork on the pointy end, and as soon as it reached my mouth my spidey senses were telling me that something was not right. I’m lucky that when I eat something I shouldn’t I get strange taste in my mouth, usually accompanied by a tingling feeling. My alarm bells were now ringing.

I quickly went onto Le Pain’s website to find their allergen information, but there wasn’t any. I then did an internet search for “Le Pain Quotidien Allergen Menu.” This came up with allergy menus from January and March 2017. I searched the menu and there were no passion fruit and beetroot cakes listed.

I then did a more general search for “Le Pain Quotidien passion fruit cake recipe.” This took me back to their website, and the menu, but no ingredients. The only passion fruit and beetroot cake I could see was a Passion fruit and Beetroot raw nut cake. Uh oh! The clue’s in the name. Interestingly the menu doesn’t say that this item contains nuts and there is no allergen information present at all. I thought by law they had to inform people if there are allergens present?

Anyway, just to be on the safe side I called them (from the Quiet Zone, I must add. I wouldn’t usually do this and I’m the first to tut and roll my eyes but at this point I was getting concerned that I might have a full blown allergic reaction on a train that was an hour away from home).

The lady I spoke to was very nice. She started reading the recipe; passion fruit, coconut cream, cashews…. Hang on!! Cashews?

You haven’t eaten any have you? Yes!

She offered a refund next time I’m in. I was less bothered about the refund than why both the server and I had missed the crucial piece of information that the recipe contains nuts. I’ll probably never know the answer, and can only assume it was missed off the recipe when it was typed up, or somehow we both missed it as it wasn’t in bold type. Had I known the name of the cake before purchasing it, I wouldn’t even have considered purchasing it, but unfortunately I didn’t see a menu and the full name of the item was never mentioned in the conversation I had with the server.

In a mild panic, I promptly swallowed three antihistamines and guzzled an entire bottle of water (the idea is to flush the allergen out). I then located the train guard and told him I was having an allergic reaction and where my epipen was kept just in case.

It turns it that apart from being extremely dozy from the antihistamines I was ok. It’s great that my body warns me that something isn’t right, and I’m able to catch it early. Had I eaten the whole thing it could have been a very different story. Le Pain Quotidien really need to sort out their allergen information. It needs to be clear and readily available, and I will be writing to them to this effect.

I think the moral of the story is check the ingredients. Then check again. Or just don’t buy the cake in the first place. It’s better for the wallet and the waistline!

Update

I saw the manager this morning. She was very apologetic and gave me a refund. She will raise the issues of training and allergen information with their food standards people.

She also pointed out that it’s called a “Nut Cake” for a reason!! Lesson learnt, I will always look at the menu in the future!