Q. My son has tree nut allergy and asthma. He’s 16, starting to date and getting confrontational about not wanting to carry his auto-injector. He also no longer believes he’s that allergic – his only major reaction to cashews was back when he was 3 years old. The allergist doesn’t think his IgE levels are low enough to try an oral challenge. How can I get through to my son?
Dr. Waserman: This type of behavior is not uncommon among food-allergic teens. He may relate more to real-life stories from other teens who have had food-related reactions. Their stories can be found on www.whyriskit.ca , a site for teens with food allergies, and on Allergicliving.com  and in Allergic Living magazine.
Ask his allergist to speak with him one on one to advise him of the risks as well as encourage him in understanding his condition. Having him involved in interpreting allergy skin-test results with the allergist, as well as being introduced to current allergy research, may help him feel more in charge of his own health through knowledge and understanding.
It sounds as if he may be concerned about his image; like many teens, your son probably does not want to stand out. Because teen life has so much social focus, it may help to pose questions highlighting the allergy’s social implications.
For example, “How would your friends feel if you had a severe reaction and they weren’t able to help because you didn’t have your auto-injector?
Lastly, I think empathy is key. It’s obviously not fun to have allergies, but carrying an epinephrine auto-injector is a small price to pay for staying safe. Go back to the seatbelt analogy: “You may never need it, but it’s there to protect you.”
Dr. Susan Waserman is an allergist and Professor of Medicine in the Division of Allergy and Clinical Immunology at McMaster University in Hamilton, Ont. She is also a past president of the Canadian Society of Allergy and Clinical Immunology.