• Intentional Food Allergy Exposures: Researchers have revealed the reasons that a concerning number of parents are knowingly giving their allergic children food that they are allergic to.
• Pollution Changing Genes: Researchers found that a certain type of air-pollution may be causing a DNA change which results in worsened asthma symptoms, and potentially even new cases of asthma.
• Milk Therapy Lacks Staying Power: Editor Gwen Smith on the study that showed a surprising reversal among patients who had been successfully treated for milk allergy.
• Alcohol, Asthma and Aspirin: A group of people with asthma are experiencing respiratory reactions when drinking alcohol. But how does Aspirin fit into the equation?
• Allergic Children Underweight: Children with multiple food allergies or milk allergy appear to be underweight when compared with their non-allergic peers.
• A New Spot for the Shot: Investigators discovered that there may be a more effective location for an epinephrine shot in obese patients.

Sesame’s reach became more sticky, more apparent, and more extensive. There was no take out sushi, Indian food or Chinese food. There was none of my preferred combo: sesame crackers with peanut butter atop. And, unexpectedly, there were no more of my favourite indulgences: Creme de la Mer skin cream and fancy Gel Express Aux Fleur Sisley face masks. Sesame, the oily seed, also lodged itself in unexpected places: adhesive bandages and pharmaceuticals.

When my son was diagnosed with a potentially life-threatening allergy as a 1-year-old, I was initially glad he didn’t have a peanut allergy. Who had heard of sesame? How bad could that be? Sesame had much less awareness (and the peanut allergy was yet to come). Who knew that — on top of the grinding worry — so much of the world would become denied to us?

Food writers try to describe the taste of sesame, but they always seem to fall short. Sesame is nutty, they say. But not really. It has a spectacular taste unto its own, one that adds spark and refinement to so many foods. Sesame harkens back to Ethiopia and is a central ingredient in many of the world’s great cuisines: Indian, Thai, Chinese, Middle Eastern.

My son’s first birthday invitation came when he was kindergarten. It was to McDonald’s. Of course, sesame’s reach is firmly embedded in that American icon: the McDonald’s hamburger bun. He did not go to the party.

We discovered the allergy on the last hour of a six-hour car ride from Calgary to Jasper. Our one-year-old was fussing, I gave him a Sesame Snap to suck on. You know how the story goes: his face became red and blotchy, then puffy, his eyes began to swell shut. When we checked in at the hotel, the receptionist took one look and said: “Do you need the number of the hospital?”

We called. We could come down and have him assessed, the nurse said lamely. We were tired. We thought we’d wait. It was only sesame, I thought. We waited, his swelling went down. Later, there was a visit to the allergist for skin testing. There would be no more sesame in our house, or peanuts or sunflower seeds.

The joy of sesame is lost. When my husband buys sushi with sesame in error, we wait until the kids are in bed. We eat it in stony silence. There’s little joy to be had from sesame any more. Not in the house, not in a bed, not with a cat, not with a mouse, move over green eggs and ham. There will be no sesame, Sam I am.

At the same time, there was no sesame, of course, there was sesame everywhere. At every friend’s lunch and in every restaurant, sesame was much more in evidence than I’d ever suspected. I would become familiar with the work of a young Spanish scientist, Estibalitz Orruno, at the University of Leeds. Under a grant from the Basque government, she undertook a doctoral degree studying sesame allergy.

And what a spectacular seed sesame was found to be: 42 to 54 per cent oil, 22 to 25 per cent protein, full of folic acid, niacin, calcium, phosphorus. The cost: cheap. In addition to taste, sesame also won’t go rancid. Orruno examined sesame’s proteins and sought to isolate ones that might cause the allergic reaction; she documented sesame’s world dominance in terms of use, and its fast rise as a source of allergic reactions.

The irony of the purpose of the proteins is not lost. Their role is to promote germination and continue the lineage. Yet at the same time, increasing numbers of people have life-threatening reactions to these very same proteins.

Little lingering seeds. There has been an evolution in the seven years since my son’s diagnosis. A pamphlet is now available from Health Canada – “Sesame Seeds: One of the nine most common food allergens,” and every bakery slaps on a “may contain” warning about sesame. Our bread maker does overtime.

We travel within Canada and to the United States, but foreign travel, to the exotic places where sesame is prevalent, is avoided for now. Instead we hope for scientific breakthroughs that will allow the wonderful world that sesame inhabits and represents to open to us again.

Janice Paskey is a writer and editor who lives in Calgary.

Peanut

• Tennis player Serena Williams
• NHL player Tom Poti, defenceman for the Washington Capitals
• Singer Alex Kapranos, Franz Ferdinand
• Freestyle aerials champion Steve Omischl

Tree Nut

• Singer Clay Aiken
• NHL player Tom Poti

But the tenth name on the list may surprise: sulphites. These are the chemical additives used to stop food from browning or spoiling. In 1 per cent of the population, mostly those with asthma, even tiny amounts of sulphites can cause reactions. An estimated 4 per cent of asthmatics are sensitive to them.

In Canada, there have been reports of more than 100 sulphite-related reactions, ranging from nausea and abdominal pain to anaphylactic attacks. At least one Canadian has died.

Although sulphites are known to trigger symptoms in susceptible individuals that appear to be allergic reactions, including anaphylaxis, scientists still don’t know how they do this. Unlike the other food groups on the list, sulphites are chemicals, not proteins.

Researchers don’t yet know whether sulphites cause the immune systems of some people to respond abnormally or whether they set off some other mechanism that causes allergic-like reactions. The researchers also haven’t figured out why sulphites pose a threat to some people and not to others.

One theory is that people sensitive to sulphites have a genetic abnormality that hinders the body’s breakdown of these chemicals. However, Dr. Susan Tarlo, a respiratory physician at Toronto’s University Health Network and a specialist in lung disease and allergic response, says her extensive research does not confirm that theory. Another theory links sulphite sensitivity to a lack of B12 vitamins, but that research is still riot conclusive.

If you develop hives or have trouble breathing after a restaurant dinner and a glass of wine and suspect you may have this sensitivity, the first step is to see an allergist and confirm what is causing your reaction.

The only way to be sure that it is a sulphite sensitivity is to undergo an oral challenge in a hospital setting. In such a test, doctors will give you a glass of juice with sulphites to see whether you respond. (For sulphites, Tarlo says a skin test is riot reliable enough.)

The food inspection agency has added sulphites to its top 10 allergens list because they cause allergic-like reactions in such a significant number of people. (One per cent of the Canadian population equates to about 320,000 individuals.) But there is no scientific evidence that the prevalence of sulphite sensitivity has actually increased over the past years.

In her experience, airlines had stopped serving nuts years ago – pretzels were the norm now – so she didn’t think to contact Air Canada in advance.

But 10 minutes after takeoff, Humphreys’ tropical vacation became an allergy nightmare: Thousands of feet in the air and locked in the thin metal tube with nothing but hours of ocean ahead, the flight attendants began handing out packages of cashews – by far Humphreys’ worst allergy.

The 43-year-old knew she had to speak up, so she tapped one of the flight attendants on the elbow and explained that she was extremely concerned about the possibility of a serious reaction.

“The flight attendant was nasty. She said, ‘Well, we just can’t take care of everybody,’” recounts Humphreys. The crew continued to dole out the nuts. “So I had to bide my time and hope that nothing happened.”

Luckily, nothing did. But Humphreys and her husband spent much of their vacation trying to figure out how to get Paige home safely. Air Canada told them, as they do all allergic travelers, that it would be “unfair to other passengers” to withhold nuts, and that it was the couple’s responsibility to “bring the proper medication and to have the proper protection.”

Problem was, the “proper protection” included not being surrounded by people eating cashews. Humphreys began looking into other options. “But the other airlines serve nuts, too,” she says. So I thought, ‘I’m no better there – and I would be alone, too.’”

When it comes to nerve-wracking and sometimes dangerous experiences of flying with food or environmental allergies, Humphreys is definitely not alone. In the past decade, allergies themselves have taken off: roughly one million Canadians and 11 million Americans now have food allergies, and approximately 23 million North Americans have asthma.

Still, airlines have not adapted to this new reality. Few have clearly defined policies and procedures in place for allergic passengers, and they continue to serve some of the most highly allergenic foods, including nuts, sesame, fish and shellfish. Some even still hand out peanuts, the most prevalent trigger of serious reactions.

But many allergy sufferers and parents of allergic kids think it’s high time airlines made the skies safer for the millions of travelers with allergies. Dozens have filed formal complaints with airline regulators such as the U.S. Department of Transportation and the Canadian Transportation Agency.

In 2002, we took our first summer vacation in Europe with two children. Kieryn was not yet 3 years old and Taya had just turned one. We flew into Toulouse in the south of France and rented a car for what should have been a simple two-hour drive on the motorway to our villa near Perpignan.

We were barely onto the motorway when Kieryn called out: “I have to go pee!” Fortunately the French have a lot of rest stops, and we pulled over briefly. Back on the motorway, we’d only driven 15 minutes more when Kieryn again had to go.

She was toilet training, and we were trying to encourage that, so I pulled over at the next rest stop. Back under way and, you guessed it, 15 minutes later, Kieryn “had to pee”. I was a bit frustrated, but once more pulled over.

While my wife Keely and Kieryn were in the bathroom, Taya, our younger daughter, woke up crying; she’d soiled her diaper and it had leaked right up her back. I got her out and began cleaning up the mess. Keely returned to help, first giving Kieryn some bread with cream cheese to keep her occupied. We had Taya cleaned up and dressed when I noticed Kieryn had just spread the cream cheese all over the front seat.

At this point I lost it, asking Keely, whose bright idea was it to go on vacation to Europe with two small children. She calmly pointed out that it was all mine, to which I replied, “That’s why I married you, so you’d talk me out of these crazy ideas.”

Traveling with children, even without food allergies can be challenging, but it is also highly rewarding. Despite that rough start, we had a great first trip with two kids, and we find that enjoying new experiences as a family can be uplifting.

It does, however, take careful planning to travel with children with life-threatening food allergies. The good news is that our food requirements are complicated – so if we can do it, you can, too. Taya has multiple allergies, including peanuts, nuts, sesame and kiwi. Keely and I are vegetarians, and Keely is allergic to eggs. As well, I have allergies to dust and cats.

Our fundamental approach explains the “Have Kitchen” title of this series: we always stay in places with a kitchen, and prepare as many of our own meals as humanly possible. Not only does this keep us safe, it also saves money, especially in Europe where eating out can be expensive.

City or Countryside?

Europe has a wonderful selection of self-catered villas and apartments for rent, usually for a minimum of one week. While many people think villa vacations are for the wealthy, in fact, there are villas in every price range. Sharing these acommodations with family or friends makes them even more affordable.

If you want to spend your time sightseeing at museums, churches and landmarks, then look for an apartment in a city. If you want to spend it relaxing in the country or at the seaside, then there are lots of villas to choose from as well. For the best of both worlds, consider one week in a city and one in the country. (Remember that if you are renting outside a city, you will need to rent a car to get around for sightseeing day trips and for groceries.)

The Internet is a great source for finding villas. If you can travel outside of high season, you’ll find the best selection and prices. It’s possible to rent directly from an owner, but I recommend that first-time renters book through an agent. Check that the agent has seen the properties recently, and have a list of questions ready to ensure you get a villa that suits your family.

Our European Trips

England/Ireland – England is the most accessible of the European countries for English speakers, and what better way to experience it than to stay in an historic building. The Landmark Trust is a charity that rescues heritage buildings and gives them new life as places to stay. There are 185 “Landmarks,” including forts, manor houses, mills, cottages, castles, follies, gatehouses and towers (www.landmarktrust.org.uk).

We stayed in a 17th century house called Shelwick Court near Hereford, with beautiful countryside. The Irish Landmark Trust is a similar organization with properties throughout Ireland (www.irishlandmark.com/home/self-catering-ireland.html). You can also rent apartments in London and other major cities in the U.K.

Next: France, Spain, Italy

IN 1993, BEFORE having children, my wife Keely and I went trekking in Nepal. We felt so adventurous, traveling with just a guidebook. We walked from village to village, staying in huts without electricity or running water, and eating at local restaurants.

Keely and I knew when we had children that our days of backpacking through Asia, Africa and South America were over, but we still wanted to travel and to instill the love of travel in our children.

When Taya, our second child, was diagnosed with multiple food allergies, including peanuts, nuts, dairy, eggs, barley and kiwi, it seemed like travel was going to be impossible.

Our food requirements were already complicated since Keely and I are vegetarians and she is allergic to egg yolks. As well, I have environmental allergies to dust and cats to consider.

However, we have discovered that you can travel safely with anaphylaxis and allergies. With careful planning, by always staying in places that have a kitchen, and by bringing our special foods with us, we have been able to continue to travel, albeit in a different style.

So far Taya (who’s now 6) has been to Jamaica, Grenada, England, France, Spain, and even Morocco.

Next Page: Villa Vacations in the Sun

Owl’s Head – For more than 20 years now a large group of 50 family and friends has gone skiing every spring at Owl’s Head (www.owlshead.com) in the Quebec Eastern Townships, about 1.5 hours east of Montreal. Owl’s Head is one of the last family-owned ski resorts in Canada and also one of the best values. The resort offers one- to three-bedroom condos with full kitchens with excellent ski-in, ski-out access. It is rarely crowded, has a good mix of runs for all levels, but après ski activities are limited. Views of Lac Memphremagog are stunning.

Mont Tremblant – We have been to Mont Tremblant (www.tremblant.ca) in both winter and summer. It’s located 132 kms north of Montreal and consistently rated the Number One ski resort in eastern North America. It is pretty much the opposite of Owl’s Head, and is a full fledged four-season resort with shopping, swimming and lots of restaurants. It also has golfing, swimming, boating and biking in the summer. Tremblant has studio to four-bedroom condos with good ski-in, ski-out access. There is a good mix of runs and lots of après ski activities. But it can be crowded, and sometimes very cold.

Smugglers Notch – Smugglers Notch, Vermont (www.smuggs.com) is about 165 kms south of Montreal and is consistently rated the Number One ski resort for family programs in North America. Accommodations range from studio to five-bedroom condos with full kitchens and good ski-in, ski-out access. There is an excellent learn to ski program for children as young as 2½ years old, as well as more non-skiing activities for children than any resort I have been to. These include: a fun zone with inflatable slides, bouncy house, pools, basketball and mini-golf. Resort has a good mix of ski runs for all levels, but can be crowded on weekends because there are no high-speed chairlifts.

Sugarbush – My favourite ski area in the east is Sugarbush, Vermont (www.sugarbush.com), 235 kms south of Montreal. It has studio to five-bedroom ski-in, ski out condos with an outdoor, heated swimming pool and hot tub. There is a great variety of skiing, with lots of easy and intermediate runs as well as among the best expert terrain in the east. The luxurious new Claybrook Residences have a valet to park your car, a ski valet to stow your skis and a boot valet to dry and warm your boots.

Silver Star – My daughters’ favourite ski trip was to Silver Star Resort (www.skisilverstar.com) in British Columbia’s Okanagan Valley, about an hour from Kelowna. There are reasonably priced studio to six-bedroom condos and chalets with excellent ski-in, ski-out access. The chalet we stayed in was so close to the run at Silver Star that the kids could ski right onto the back porch. It has a good mix of runs for all levels, lots of après ski activities and rarely gets crowded.

Big Sky – My wife Keely’s favorite ski area is Big Sky (www.bigskyresort.com) in Montana, 70 kms from Bozeman. The village has ski-in, ski-out studio condos to five-bedroom homes. It features lots of groomed, intermediate cruising runs as well as easy and hard runs and never has crowds. There are swimming pools, restaurants, a spa, shops and it’s also near Yellowstone National Park.

Whistler Blackcomb – The largest resort in North America is Whistler Blackcomb (www.whistlerblackcomb.com) in British Columbia. This is a huge resort, 125 kms from Vancouver, which will host the alpine skiing event of the 2010 Winter Olympics. It features over 200 trails for every level of skiing. There are three villages at the base of two mountains with studio to six-bedroom units. Some of the accommodations are ski-in, ski-out, but others require you to walk or shuttle to the lifts. There lots of activities to keep you busy, regardless of whether you ski or not, but it is not cheap.

Next Page: More ski resorts.

Before you fly:

• Call the airline and ask about their allergy policy before you book your ticket. You don’t want to find out by surprise that peanut satay is being served on your flight to Hong Kong.
• Look at the airline’s website or call customer service to find out what foods are served or sold on board.
• When you book, make sure to tell the reservations or travel agent about your allergies, and what specific accommodations you need.
• Book a flight that’s earlier in the day, because the planes get cleaned overnight, and there is less likelihood nut snacks will be consumed in the morning. This means less chance of encountering the allergen on seats and in seat pockets, etc.
• Book direct flights if possible, so you’re not dealing with multiple planes and flight crews.
• Bring your auto-injectors and/or asthma medications with you onto the plane (do not check them). Security may require that these medications show a prescription label in the name of the patient/traveler.
• It’s wise to carry an official doctor’s note stating that the medication is required for severe allergies or asthma. See sample notes here.

When you fly:

• Tell everyone you deal with – the check-in agent, the staff at the gate, the flight attendants – about your child’s or your allergies. Even if the booking agent said you will be accommodated, play it safe and make sure everyone knows.
• Arrive at the gate early and talk to the staff before they’re too busy. Be clear, calm and polite.
• If concerned about contact with allergen residue from previous passengers, ask to pre-board and wipe down the seats, tray tables and armrests. You can also cover the seat with a blanket or a seat cover. Bring wipes to wash your hands.
• Bring your own food. Don’t eat meals prepared by the airline’s caterers, even if a flight attendant tells you there are no nuts or other allergens. You don’t know if there has been cross-contamination in the preparation. Bring extra food in case of delays.
• Keep medication with you; do not store it in the overhead bin.
• If someone near you is eating a food that is dangerous to you, politely explain your situation and ask if they would be willing to stop. If they are, say thanks and offer to buy them some food that is safe.
• Keep your hands out of your eyes and mouth.
• Have a plan for what happens if you react.
• If you are reacting to something, tell the flight crew. It is important that they know about your condition.

After you fly:

• If you had a good experience, make sure to thank the flight crew for their efforts, and tell them you’ll definitely fly with the airline again. Write a letter to the airline (copying the company president), expressing your appreciation, and noting that you will certainly travel with the company again and will encourage others to do so.
• If you have an unpleasant experience, write to the airline and politely explain what happened. Tell them that you and your family will think twice before flying with the carrier again. Also include information about what could have made your flight better.
• You can also lodge a complaint with the U.S. Department of Transportation or the Canadian Transportation Agency.
  

First published in Allergic Living magazine.
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See Also:

• Flying Allergic by Jennifer Van Evra
• Scott McKenzie’s Rules for traveling with food allergies
• Travel Guide 1 -Have Kitchen, Will Travel
• Travel Guide 2 - Off to Europe
• Flying With Food Allergies – Allergic Living’s Essential Tips

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