Monday, September 16, 2013

A Food Allergy Close Call

By Kelley Lindberg

“My son is allergic to peanuts and all tree nuts. Can you check with the cook to make sure there are no nuts in this pasta?” I asked the waitress.

“I don’t think there are, but I’ll be sure and tell the cook,” she replied.

We’d eaten at this restaurant before. Many times. And my son had ordered this particular dish before, too, which is part of why he ordered it. But we try to make it a habit to ask every single time we go somewhere. You can never be too safe, you know.

Our food came, and my son speared a shrimp and ate it. Then he spied something different in the sauce on his plate. Something he didn’t recognize. He fished it out with his fork and held it in front of me. “What is this?” he asked.

It looked like a sliced almond. Maybe it was a sliced water chestnut, I told myself. I took it and ate it. Damn. “It’s an almond, honey.”

He immediately spit the remainder of his first bite out, and began rubbing his tongue with his napkin. I tore open four anti-histamine fast-melts and he popped them in as fast as humanly possible. My mom, who was eating with us, flagged down the waitress. “There are almonds in his food!” she told the waitress, who blanched and took away the dish.

Another waitress came out and asked if she could get something else for my son to eat. No, we said, we need to just see what happens now. She brought him some water.

The manager came out, and we explained that we’d asked about allergies, the waitress had told us she’d check, and still she brought him food with almonds in it. He apologized and offered to bring something different for him to eat.

My son didn’t want anything different to eat.

He was panicking.

I’d never seen him like that before. He’s only been accidentally exposed to nuts a couple of times in his life. The last time was maybe 4 or 5 years ago, in Mexico. He had been very calm then, and calmly took his antihistamine when I gave it to him, and calmly ate the rest of his food while I watched him like a hawk, EpiPen in hand.

This time was different. This time, he was 14 and aware. He was 14 and remembering the teen girl in California who died last month after accidentally tasting a treat with peanut butter in it. He was 14 and suddenly afraid of dying from something he had previously worried about more as a mental exercise than as an actual threat, because we’ve been so careful for so many years that it became easy to take things for granted, to assume that because we were careful, he’d be fine.

So he was experiencing this accidental exposure in a whole different way for him. Suddenly it was real, and scary, and new. Even though he’s known he was allergic his whole life. This was new.

I watched him for the tiniest sign of a reaction. For a hint of hives. For a slight hoarseness to his voice. For his coloring, his breathing, his mental alertness. Fortunately, no symptoms came.

But what I wasn’t expecting was his fear. His legs were shaking up and down like pistons. He couldn’t sit still, rubbing his hands on his legs, taking sip after sip of water. I wrapped my arm around his shoulders and talked to him, tried to calm him down, talked him through the first twenty minutes. He showed no symptoms. I told him that was a good sign, but he was still shaking. I talked him through another ten minutes. Still no symptoms. Still shaking. Another ten. Still no symptoms. I reassured him that after 40 minutes, the chances of an anaphylactic reaction were probably minimal, and that we would surely have seen some reaction by then. We sat in the booth at the restaurant the whole time, because I didn’t want to move. I wanted to sit there and talk to him, keep him calm, watch his face for the slightest hint of a reaction.

Finally, after nearly an hour without a single symptom, I told him we could go. When we got home, he sat on the couch beside me for the rest of the evening. His fear had diminished, finally, but nervousness still pulsed at his edges.

As we left, the manager apologized profusely and said he would be doing new training the following weekend for his entire staff about food allergies. He told me he was also an EMT, and that he knew how serious food allergies were, and how dismayed he was that his staff had let this happen. Then he waived our entire bill.

My son and I have talked about this experience, and here are the things we learned:
  1. We were very glad that his first exposure as a teenager was with me. We talked about how lucky we both were that it didn’t happen when he was out with his friends, where maybe no one else would know what to do or how to keep him calm. We talked about what he should do next time if I’m not there. Being prepared is half the battle. Even though we thought he was prepared before, he wasn’t. Not really.
  2. We can never stop being vigilant, even for a second. We asked the waitress about nuts when we placed our order, but we didn’t follow up with her when she brought the food, assuming it had been prepared the same way as the last time he'd ordered it. We made an assumption that she’d talked to the cook, but that was a wrong assumption. We have to remember to ask, and ask again, every single time.
  3. Because of our experience, the entire staff of that restaurant may take food allergies more seriously from now own, making that restaurant a safer place for others with food allergies who may go there. So something good can come from something bad. Nice to remember. 
  4. He relearned how absolutely critical it is that he keep his EpiPens and antihistamine with him at all times. As a teen, it’s easy to get forgetful, or careless, or overconfident. This was a stark reminder of how important that little case of meds was to him right then, and how glad he was that we had it with us. I think he’ll do a better job of keeping it with him now.
  5. Because we’ve been so careful to avoid nuts his entire life, he doesn’t really know what nuts can look like when they’re mixed into food. Sure, he can identify a big ol’ bin of them at the grocery store, and he knows what a peanut shell looks like, but when they’re sliced or chopped or blended into a sauce, he has no idea what they look like. We need to spend some time looking at how nuts are prepared, so that he will recognize them when he sees them. It never occurred to me that he wouldn’t recognize one in his own food.
  6. Fear can undermine everything. If you’re afraid, you forget to think calmly and clearly. You may not make good decisions. You may not remember what to do. We need to work together, he and I, on taking away the fear that made him panic, leaving just enough of the fear that will make him careful. A little is good, a lot is not necessarily so. But we’re a team, and we can work through this together.
We got lucky this time. It was a close call, but fortunately, he must not have come into contact with the almonds in his dish, so he didn’t have a reaction. Or maybe the antihistamine stopped it before it could get started. Whatever it was, we are very grateful. And now we have a renewed determination to be even more careful than before.



.::still blinking::. said...

Oh my goodness! That got my heart racing. Thank you for sharing. My son also doesn't recognize nuts. It's such a strange thing, in my mind, to not know what you are allergic to looks like. And kind of a hard one to teach because they all look different and can be in anything.

Daniella Knell said...

Thank you for sharing this personal story... it puts a huge lump in my throat just knowing it could be my child.. I am so happy it turned out okay for your son and you.

Daniella Knell said...
This comment has been removed by the author.
Anonymous said...

Thank you for sharing - we all have so much to learn and this helps. I am so glad your son is safe!