What you read here could save someone’s life
By Rebecca Peterson, Humour Editor
“Oh, just as a note for the kitchen, I have a severe peanut allergy. It shouldn’t be a problem, but I wanted to give you a head’s up just in case.”
It’s a line of patter that I have memorized, something I’ve said so many times to so many servers and cooks in hundreds of different restaurants that the words don’t ever sound like words anymore. The reactions vary depending on the establishment. Usually it’s a quick head nod from the server and a little note jotted alongside my order. Other times, the manager will show up to my table to assure me that they’re going to do everything they possibly can to make sure I don’t die in their restaurant. It can be a bit of a hassle, but I’ve been dealing with this for so long I can’t think of what life would be like without it. The idea of being able to walk into any restaurant, any grocery store, and eat anything I want without checking labels and double-checking my bag to make sure I have my EpiPen on me is utterly foreign to me.
I’m one of about 2.5 million Canadians with a severe food allergy. I also have a bunch of less deadly allergies as well: Legumes, corn, sprouts, carrots, celery, egg yolks, kiwi, pumpkin, and strangely enough, chamomile. I’m a little leery of trying new foods in case I discover a new allergen the hard way, but hey, at least I’m not allergic to wheat anymore.
Last year, I experienced my first severe anaphylactic reaction in about 20 years. Thanks to the quick actions of some incredible friends, I came away completely fine. Since then, I’ve been trying to educate as many people as I can on allergies in general, but especially on how to help someone in crisis.
According to the Canadian Anaphylaxis Initiative, around 3,500 Canadians experience anaphylactic shock each year from food allergens, and of that number, about 12 will die as a result. Twelve a year may not sound like a huge number, but considering that allergies are becoming progressively more common and death from anaphylaxis can be avoided if the proper treatment is administered in time, it’s a number we should absolutely pay attention to.
What are the signs and symptoms of anaphylaxis?
The symptoms of anaphylaxis are widely varied, and it may show differently in some people over others. With that in mind, the most common symptoms are:
Skin: Hives, swelling, itching, skin warmth, and redness.
Breathing: Coughing, wheezing, shortness of breath, chest pain, congestion, and trouble swallowing.
Stomach: Nausea, cramps, vomiting, and diarrhea.
Heart: Skin paleness/blueness, weak pulse, disorientation, shock, and unconsciousness.
Other: Anxiety, feeling of “impending doom,” headache, and a metallic taste in mouth.
What to do in case of an anaphylactic reaction:
If you suspect someone is suffering from anaphylaxis, it is important that you work quickly and calmly. You might not have a lot of time to help them.
- Have someone call an ambulance. Make sure they stress that anaphylaxis is suspected; the patient will need to get to a hospital right away.
- Retrieve the victim’s EpiPen. If they’re still conscious, they should be able to find it for you, but they will likely not be able to administer it themselves.
- It’s a corny saying, but important to remember: BLUE to the sky, ORANGE to the thigh. You need to pull the blue safety cap off the end of the EpiPen to activate it. Then, stab the orange part into the patient’s thigh. (yes, stab. The EpiPen needs force and momentum for the spring-release to work. The official packaging says “swing and press,” but I think that’s a little confusing quite honestly.) Hold the EpiPen in place for 10 seconds.
- GO TO THE HOSPITAL. The EpiPen does not “cure” the anaphylaxis; it only buys time. In fact, if possible, have another EpiPen ready to go if the effects of the first dose wear off before help arrives (which can happen!). If liquid Benadryl is available, it doesn’t hurt to give the patient some of that as well.
- Keep a close eye on the patient for the next 48 hours, even after they are released from the hospital. It’s entirely possible for them to slip back into anaphylactic shock, and they will need someone there to help them if it happens.
A few notes on anaphylaxis from someone who’s experienced it:
- After having the EpiPen administered, your leg is probably going to do its own little solo Irish jig. This is a normal response to having a whole bunch of adrenalin shot into your system. Don’t worry about it.
- It will take longer than you expect to recover from anaphylactic shock. Take it easy for the first couple of days afterwards; having your body jump-started multiple times with shots of adrenalin makes you feel like you’ve been hit by a truck for a little while afterwards. Get plenty of rest and keep wild partying to a minimum.
- Unfortunately, after an anaphylactic reaction, your tolerance to that allergen will lower significantly. The doctors warned me that my next attack is likely to be much more severe as a result of my exposure. It pays to be paranoid; if you’re not sure if something you’re about to eat has come in contact with something you’re allergic to or not, don’t risk it.
Frequently asked questions:
In case of an emergency, can I use someone else’s EpiPen to help another person who is suffering from anaphylaxis?
There is some confusion about the nature of prescribed EpiPens. With most medications, doses are measured out for an individual’s needs. This is not true of EpiPens, however, and if the victim does not have an EpiPen or needs another dose, using someone else’s EpiPen could save their life.
Can I administer the EpiPen through someone’s clothing?
Yes you can, and please do! You will lose time fussing around trying to get someone’s pants off before using the EpiPen, and it’s entirely unnecessary. The EpiPen will work through cotton, denim, polyester, what have you. Short of wearing plate armour and chainmail, it’s unlikely that the victim will be wearing something sturdy enough to block the needle.
Does someone with a severe food allergy need to ingest the allergen to have a reaction?
Not necessarily. Some allergens can affect the victim by touch, or by airborne properties. Peanuts especially are notorious for causing airborne reactions; it’s rare that they will cause full-blown anaphylaxis, but it can cause milder symptoms such as wheezing, hives, and discomfort. As well, for those with anxieties tied to their allergies, the smell can cause anxiety and panic attacks.
If I cook the allergen, will it neutralize the proteins that cause the reaction?
I once had someone tell me that roasted peanuts should be safe for me because they’re cooked. It seems like a stupid question, but there are some allergens that only cause reactions when they’re raw (for example, I can eat celery and carrots if they’re cooked, but not if they’re raw). Ultimately, you should ask the person in question if you’re concerned, but the safest bet is to assume the allergen is dangerous to them either way, and to avoid using it if you know the allergic person is going to be present.
Can allergic people eat food items with a “may contain” label?
This really depends on the person and the item in question. A “may contain” label is often incredibly vague; it’s mostly there to protect the company in question from liability if equipment isn’t cleaned correctly or a mix-up in products occur, and someone has an allergic reaction as a result. It could mean anything from “the factory where this product is made does not have a peanut-free policy” to “there were peanut products directly on the equipment used to make this food item.” For some allergic people, even minute traces of an allergen can cause a severe reaction. Despite having a severe allergy, I’ve never had a problem with items that have a “may contain” label. However, I tend to avoid products with other nuts in them, because the likelihood of a mix-up or cross-contamination is much higher than products where nuts are not involved at all.
Can you grow out of a food allergy?
Yes, you can! Allergies in general are more prevalent in children than they are in adults. I used to be allergic to wheat as a child, and I was far more allergic to egg yolks than I am now. Unfortunately, some allergies only get more severe the older the person gets, and it is possible to develop food allergies later on in life. A friend of mine didn’t develop her severe shellfish allergy until her early thirties. It isn’t clear why this happens, but it’s theorized that changes in hormone balances can cause allergies to crop up.
I don’t believe allergies are real, and I think kids are just too gosh-darn sensitive these days.
Yes, I’ve heard this said. As someone who has spent eight hours on a steroid drip after taking two epinephrine shots to both legs, I can attest that they’re very real, and they suck. If that’s not enough, I’m sure there’s about a million doctors out there to back me up. If that’s not enough, you’re an asshole, and I really can’t help you.
The top nine most common food allergies are:
- Tree nuts
About 2 in every 100 children in Canada have peanut allergies.
Food allergies are becoming increasingly common. All the more reason to become informed!
Only 1 in 5 Canadians at risk of anaphylaxis carry epinephrine auto-injectors on them at all times, according to a 2014 survey by King Pharmaceuticals and Anaphylaxis Canada.
EpiPens can pose a risk for people with pre-existing heart conditions; however, in cases of emergency, it is still better to use one than to risk not using one.
Many people with allergies will wear a Medic Alert bracelet or necklace. If you come across someone who is in distress and unable to speak and you are unsure as to why, check if they’re wearing one! It will tell you the nature of their condition and how best to help them.