“His eyes were so swollen that it looked like he had a golf ball under each eye,” she recalls. Maxime was referred to an Ottawa allergist on Eck’s request, and the doctor advised keeping her son away from legumes, eggs, chicken, and peanuts. “We were shocked,” she says. “I did not know there was such a thing as multiple food allergies.”
Eck and her husband sought a second opinion. Not only was Maxime’s diagnosis confirmed, his list grew. “We thought, ‘How can someone be allergic to so many things?’” By age 3, fish and potato were no-nos. Today, at the age of 8, tree nuts and pumpkin seeds are also on Maxime’s roster of foods to avoid, and he has oral allergy syndrome.
Diagnosing Multiple Allergies
With multiple allergies, a list of must-avoid foods usually grows gradually, as parents watch a child react to different meals. A history of what a person ate and how they reacted is key to pinning down what’s a true allergy, what’s an intolerance, and what foods are safe to eat, says Dr. Tim Vander Leek, an Edmonton allergist and assistant clinical professor at the University of Alberta’s pediatrics department.
One of his “biggest pet peeves” is when he sees family doctors and other allergists perform large screens of skin-prick tests and blood tests when a person hasn’t eaten or reacted to those foods.
“Now this individual is being given this list of foods that they need to avoid that isn’t based on anything that has actually happened to them,” he says. “Many of those foods, they could have tolerated without any problem.” Vadas agrees, noting that a skin-prick test done in the absence of a patient’s history has a false positive rate as high as 50 per cent.
Although the process for diagnosing will be specific to the individual and the circumstances, the experts say it begins with a detailed history of what foods the patient has eaten without reaction; what the person was eating when the reaction happened; and when any new or unexplained symptoms appeared. Based on that information, Vadas says, he’ll perform skin tests for suspected allergens.
Once an allergy is confirmed, Vander Leek said he may also steer patients away from related foods, such as other nuts if a person is reacting to one tree nut. The exception would be a food the person has already eaten and tolerated well in the past.
For some, it’s crucial to narrow down what foods are safe because their list of allergies is so extensive. Eck says her son’s allergist has identified five fish that are safe for Maxime to eat, and four he must stay away from. Having options for protein is important, since Maxime can’t have poultry, tree nuts, peanuts and legumes, and refuses to eat pork and most kinds of beef.
Restaurants and Road Trips
Deciphering that list of “yay” or “nay” foods is just the first of many challenges of living with a bundle of food allergies. Eating out and traveling, for instance, can be daunting. Travel-lover Julie Mototsune didn’t go away on holiday for three years after her son Mark had two of his earliest reactions while on vacation.
The family from Oakville, Ontario, was staying in a cottage on Lake Erie. Mark, who is allergic to eggs, peanuts, tree nuts, fish, shellfish, legumes, pineapple and numerous seeds, was then 17 months old and crawling on the floor. “He had a huge reaction,” Mototsune says. “He was covered in hives. It looked like the hives were going into his eyes. He was just swelling up everywhere.”