Missing out on great restaurant evenings with friends? Learn how you, too, can indulge.

Step 1: Before You Go

Know your condition: Do your homework: learn, in detail, what you can’t eat, where an offending protein hides, the multiple names for it, and names for it in key languages. If you have shellfish allergy, the French bistro menu may refer to fruits de mer. Hint: they aren’t fruits. Nuoc mam pha? Sounds lovely but it’s Vietnamese fish sauce. Sodium caseinate? Dairy. Durum? That’s wheat. (Look up specific allergies and celiac disease at Allergicliving.com, and see left panel links for “hidden peanut”, “hidden milk”, “hidden gluten”, etc.)

Carry your meds: Allergists recommend epinephrine as the first-line medication for a food allergy reaction. Having an auto-injector with you is especially important whenever you plan to eat, since anaphylaxis can come on swiftly after consuming the wrong food. Consider that restaurant reaction horror stories almost always occur because the patron did not have an auto-injector on hand. Also have a food allergy action plan on you: in your purse, backpack or as a pdf on your smartphone. (See American and Canadian plans.)

Restaurant card: I recommend bringing a chef or food allergy card. These explain your allergies and the types of foods they are found in. Top chefs have told me that these can mean the difference between clarity and confusion in the kitchen. Find them at Selectwisely.com or Allergytranslation.com.

The right attitude: Let’s get you psychologically prepared to dine out. Your mental equipment includes: an approachable demeanor, a genuine smile and lots of pleases and thank yous. These will get you far at a restaurant. Conversely, anger or threatening language or behavior will get you nowhere fast. You will be pleasantly surprised by what a positive frame of mind will bring.

Next Page: Step 2 – Deciding where to dine

According to South Carolina-based salon owner Rosanne Kinley, who’s also past president of the National-Interstate Council of State Boards of Cosmetology, sweet almond oil is commonly used by manicurists not only because it’s effective but because “it has an extremely long shelf life.”

But what if you are allergic to almond or other tree nuts? Is it safe?

Allergists told Allergic Living magazine that it’s difficult to know just how much almond protein is in these oils after the manufacturing process. It’s likely there isn’t much, they say. And if that’s the case, and the product is only being applied to the nail surface, “it would be unlikely to be of any significant risk,” says Dr. Scott Sicherer, a New York City allergist.

That said, Sicherer notes that soaking your fingers in the oil could cause skin irritation. And, if you are extremely allergic to almond – meaning that you react even to very small amounts – and if bite your nails or cuticles (meaning that you might ingest the oil), your allergist may counsel complete avoidance.

Discuss the matter with your own doctor. But Allergic Living suggests a simple solution in the meantime: Bring some safe-for-you oil (olive, grape seed, canola, safflower, coconut) to your next manicure to use as an alternative.

Allergic Living asked Dr. Phil Lieberman, clinical professor of medicine and pediatrics at the University of Tennessee’s College of Medicine (and father and grandfather to food-allergic children), for answers to nine food allergy questions you’ve been wondering about but haven’t had a chance to ask.

1. What are the typical hallmarks of severe allergic reaction?

Reactions that involve the respiratory tract system (upper and lower areas) and the cardiovascular system. For example, coughing, wheezing, shortness of breath, inability to breathe because of upper airway swelling, cardiac arrhythmias, fall in blood pressure with shock, and even a heart attack typify a severe allergic reaction.

2. What do the new food allergy guidelines produced by the National Institute of Health/National Institute of Allergy and Infectious Diseases say constitutes an anaphylactic reaction to food?

If any two of the following body organ systems (skin, GI tract, cardiovascular, airway or central nervous) are affected, this automatically requires the use of an auto-injector of epinephrine. If a known allergen is ingested and there is a single manifestation of any reaction in any of those bodily systems, this also automatically requires use epinephrine. For a deeper explanation, the National Institute of Allergy and Infectious Diseases has patient guidelines that can be downloaded for free.

3. What is the best course of action in the event of an anaphylactic reaction?

Immediately inject epinephrine and then call 911.  A second dose should be available and it should be administered in 10 minutes if there has been no improvement and/or if an emergency medical facility has not been reached. To prevent threatening falls in blood pressure, you can lie down and elevate your legs as well, if this posture does not make it difficult to breathe.

4. What exactly is epinephrine and how does it work in the body? What does it do to a severe reaction?

Epinephrine is a hormone the body makes itself: the “fight or flight” hormone. It is designed to increase blood flow to muscles, strengthen contractions of the heart and increase alertness. Its other name is adrenaline because it is manufactured in the adrenal gland.

5. Are there any side effects or risks of using an autoinjector of epinephrine?

In general, there are no severe side effects from the administration of epinephrine. Because it is the “fight or flight” hormone, it can make you jittery, raise your blood pressure and in some patients, cause tremors. In a healthy individual, this is uncomfortable but is not a threat. In some patients who have high blood pressure or heart disease, more severe side effects can occur.  Still, in a case of anaphylaxis, the risk/benefit ratio favors the administration of the drug since anaphylaxis is a life-threatening condition.

Next page: “Is there a difference between different manufacturers of epinephrine?”

In a few short years, there have been huge strides in restaurant awareness of allergies and intolerances. Welcome to the brand new era of dining out safely.

One day in my early 20s, I went to brunch with friends at a new restaurant in a tony section of New York City. I didn’t call ahead to alert the manager to my food allergies, nor did I tell the server of my severe allergies to nuts and fish. My purse held a few antihistamines and my asthma rescue inhaler, but no emergency epinephrine auto-injector. It was the roll of the dice approach to food allergy management – and it didn’t pay off.

I ordered the plain pancakes. An inviting triple stack arrived, dusted with powdered sugar and a sprinkle of something quite unexpected. Pistachios had been artfully arranged on the plate and tucked between each layer. Immediately I flagged down the server, telling him I was allergic to nuts and couldn’t eat the pancakes. He whisked the plate away, returning it seconds later.

How did they remake an order of pancakes that fast? They didn’t. Peering under the top pancake, the pistachios were still there. The server had just scraped off the garnish and top layer. I flagged him down again: “I cannot eat this. No pistachios – anywhere,” I intoned, as my friends happily ate.

The same pancakes arrived a third time; between the second and third pancakes was still a sprinkle of pistachios. It was like the movie Groundhog Day: I kept getting the same wrong order over and over. The scene ended when the server stopped approaching our table. Instead, he glared at me, the “crazy” customer, from the safety of the bar.

I hailed the manager, who halfheartedly offered to make a fresh batch of nut-free pancakes. I declined. By now I didn’t trust the management, staff or kitchen to serve me anything safe. I left feeling demoralized, distrusting, upset with them, upset with myself and hungry. I never went back.

That was then; this is now. Recently, out with friends, we settled on a restaurant that I know takes the needs of the allergic diner seriously. The online menu had at least three dishes that appeared safe; this was easy to confirm by phone with the restaurant manager. The manager assured me the chef would gladly handle my food allergic needs, and they would be happy to welcome me.

Next Page: Changes in the way allergies are approached