FAAN Teen Summit kicked off on clinical trials. Dr. Hugh Sampson, the famous allergist and researcher from the Mount Sinai School of Medicine, explained in a video how clinical trials for food allergy desensitization work and why they’ve so far proven very effective.

For those unaware, the continuing clinical trials are studies being done to see how individuals can be cured of food allergies. Currently, they use the process of a food challenge, in which someone eats a very minuscule amount of what they are allergic to, and then gradually eats more and more of the food until they can eat a full serving of what they’re allergic to. With severe food allergies, this desensitizing process can take between two and three years.

While some students expressed nervousness about trying such a trial, Kendall Hollinger, 14, said she would definitely go for it. “If I would be eligible, I would totally do it, even though it’s really, really scary. It would be great to grow out of an allergy,” said the student from California. “I would want to be the person who’s brave enough to go against everything they’ve gone against their whole life and grow out of an allergy.”

Friday night was a fun casino evening. And then on Saturday, it was down to food allergy business. The teens and the 99 parents in attendance split into two separate groups, then among the teens there were breakout sessions for: Middle School, High School & College, and Siblings.

Kendall, 14 on clinical trials: “I would totally do it,
even though it’s really, really scary.”

There was a famous face in the crowd at the High School & College session: Kenton Duty, the 16-year-old star of the Disney show “Shake it Up”. Yes, even the famous aren’t immune: he is allergic to cocoa (chocolate). Kenton says: “My favorite topic was the psychiatrist because it was interesting to hear the discoveries of how anxiety and reactions were influencing the teens. He wrapped it up well.”

The Teen Summit provided a Saturday Night Social for the teens only, featuring good and loud music – and dancing. On November 20, the last day of the summit, the teens and adults came together for a Q&A session. Questions were directed alternately to the teens and the adults, and various audience members offered answers.

Next: Peer Pressure

Their second date was supposed to be a lovely evening in, complete with takeout vegetarian sushi that he was to buy at a place she trusted with her life. The first time they ever met, Lori Medoff, a Montreal optometrist and divorced mother of two, told Kenny Webber, the new man in her life, about her severe allergy to fish. The entrepreneur accepted it as just another facet in what he hoped would become a relationship.

Only when Webber arrived that evening in November 2007 with the food, Medoff noticed to her horror that the sushi wasn’t vegetarian, salmon roe had been sprinkled on top. And she explained all over again that if even a hint of the tainted sushi passed her lips, her throat would close and she wouldn’t be able to breathe, never mind kiss him.

“The restaurant thought salmon eggs weren’t fish,” Webber, now 45, said at the time. “Fish is fish,” Medoff, 41, recalls replying. So what did these two lovebirds do? Simple: they skipped the food and went straight to kissing.

Ah, the kiss. You know: that warm, flushed feeling as your lips part and lock with another’s, that flutter in your stomach and your heart beating a mile a – hey, wait a minute! Because if you have food allergies or celiac disease, some of these sensations may indicate a less than romantic physical response.

Consider this story from Sloane Miller, who last August brought a new guy and an allergy-safe restaurant dinner to her New York apartment. After dinner, as the pair held and kissed, Miller got itchy.

When she looked in the mirror, she was alarmed to see hives on her skin, like a red, bumpy map of where his lips had been, around her mouth, on her cheeks, and along her neck, clavicle and right shoulder. She couldn’t believe what was happening, and for a few frightening minutes, she blanked on what to do to stop the reaction.

Now Miller is no novice when it comes to dating and food allergies. She is allergic to salmon, tree nuts, eggplant, melons, most tropical fruits and lemongrass.

Her interest in her condition, combined with her background as a psycho-therapeutic social worker, have led to a career as a food allergy coach and the basis for her popular blog, “Please Don’t Pass the Nuts.” But no matter the extent of her knowledge, she and her date couldn’t pinpoint the cause of her reaction. It had to be something. But what?

Next: Residue and Being Upfront

These are prime dating years for 16-year-old Lisa Gordon, an outgoing Grade 11 student from a northern suburb of Toronto. But long before Lisa gets to the first kiss, she has to ask a few questions that are not likely to be written into any romantic plot: Did you eat any peanuts today? Or shellfish? Or coconuts? What about pecans or walnuts? “If we haven’t talked about it, there’s no kiss,” says Lisa. “I wouldn’t want him not to know, and then something terrible happens.”

No longer can those first few fumbled kisses just happen by chance or circumstance. It is a new world for Lisa and other teenagers with food allergies who are entering the dating arena, and that world can be dangerous. A kiss, even a careful peck on the cheek, can cause an allergic reaction or even a potentially fatal anaphylactic attack.

It was long believed that allergic reactions from kissing were exceedingly rare. But then, in 2002, Dr. Rosemary Hallett and her colleagues at the University of California at Davis discovered that kissing was far more hazardous for people allergic to nuts and seeds than doctors had thought.

Hallett and her fellow researchers sent out a general questionnaire to 379 individuals with allergies to nuts and seeds, or parents of children with those allergies. Twenty people who completed the survey, or 5.3 per cent, volunteered reports of reactions after kissing.

When Hallett tracked down 17 of them, she found they all had symptoms of itching and swelling in the area kissed within a minute after the contact. Four of them had also started wheezing.

There was one child who nearly died. He was, Hallett wrote, “kissed on the cheek by his mother right after she tasted pea soup on the stove, and a large wheal immediately developed at the exact site of the kiss.” The child then flushed and started wheezing, and he was whisked to a hospital emergency department, where he was given a shot of epinephrine.

In the findings, published in The New England Journal of Medicine, the researchers noted that four people suffered reactions even though their partners had brushed their teeth. What’s more, Hallett suspected the percentage of people suffering post-kiss reactions might be far higher than 5 per cent, because the 20 people in the survey volunteered their information as opposed to being asked directly.

Her conclusion: “Since one-third of our subjects had reactions while dating, teenagers and young adults in particular need to be informed about this mode of exposure to allergens; patients of dating age who have severe food allergies may need extra encouragement to tell friends about it.”

Next: Learning to Speak Up About Allergies

DATE GEAR

• Always carry emergency medications in a purse or a ‘man bag,’ including at least one auto-injector (the brands EpiPen or Auvi-Q, Allerject) and some Benadryl or  Zyrtec [Reactine].

• Always wear a MedicAlert bracelet. There are now attractive ones in 14K gold or silver and even with Swarvoski crystals and pearls for women.

• Carry your doctor’s phone number.

• Have a written emergency action plan that’s kept in an accessible place. Forms are available online from the Food Allergy & Anaphylaxis Network http://foodallergy.org/downloads.html and the American Academy of Allergy, Asthma & Immunology at http://www.aaaai.org/patients/resources.

• For longer outings, have safe snacks in your bag.

TALKING “THE TALK”

• Be upfront from the start with a new date, explaining your allergies or intolerance. Make it clear that you have some dietary restrictions that have to be followed – either food allergies or celiac disease are serious conditions. Handled carelessly, the former could lead to a trip to the ER. Stress that, when you abide by your avoidance practices, your condition is completely manageable.
  Social Factor [SF]: Don’t put the dating partner in the position of reserving at a great restaurant, and then you have to turn down the invitation.

• Suggest early dating ideas without food: a concert, movie, sports event, art exhibit or going hiking, skating, skiing or indoor rock climbing. Or meet some place that you know for drinks.
  SF: Dates outside of the standard dinner date can be unique, memorable. You’ll get to make the point that you can have a great time, you simply have to be careful with food.

• Let the person know, early on, what to do in an allergic emergency. Make it clear that if you seem to be reacting, you’ve got to have the auto-injector; then 911 needs to be called. Show the auto-injector, demonstrate how it is used, stress that it needs to be used promptly.
  SF: People can be initially concerned by the “big needle”. Assure the person that it’s a great relief from a reaction, that the discomfort is minimal.

• If looking for a companion on a dating site, why not mention food allergies or celiac?
  SF: Could be intriguing to a foodie who likes to cook.

EATING OUT

• In the early going, if you’re eating out, be the one to suggest the restaurant. Have a list of safe spots that you like and whose kitchens you know to be vigilant about food safety and avoiding cross-contact. It’s good to be aware of a few restaurants in different areas of town. Then if you’re out for a walk and he (or she) suggests stopping for dinner, you have a name.
  SF: Allergy-aware kitchens tend to have progressive kitchens, and that usually means good food.

• For later dates, when he or she suggests a new eatery, phone ahead and question the chef or manager about the menu, making sure there are dishes safe for you, and that the kitchen is mindful of cross-contamination.
  SF: By checking, there will be no embarrassing “we can’t eat here” scenes.

• Be judicious with wine and alcohol, so you don’t drop your own guard around food. If you’re a teen, avoid wine, liquor and drugs, period. While anaphylaxis is not something you want to encounter, even worse would be encountering it in a compromised state.

• For a subsequent date, preparing a meal at your place is a great way to have a romantic evening and be safe all at the same time. Learn how to cook a few easy dishes.

HOTTER OF COOLER?

• Go out with people who aren’t nervous around your allergies or intolerance. On the flipside, avoid people who constantly make jokes about your condition. You won’t find it funny at all.

• Be willing to say “no”.
  SF: If someone is cavalier about your food needs at the wooing stage, the outlook isn’t good.

• The mood is getting flirty and relaxed? Great, but if you haven’t already, now’s the time to sashay into the topic of kissing precautions – and that it can be risky to kiss someone who has been eating nuts (if you’re nut allergic). So you ask: anything you’ve eaten today that contains nuts?
  SF: If you handle it right and he hasn’t eaten anything nut-laden foods, you could boost the romantic tension.

• SF: If he (or she) really is “that into you,” he’ll probably gladly give up a food – not just for a day – to please you.

Originally published in Allergic Living magazine.
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See Also:

• Main Article: Dating with Allergies, Celiac
• Kissing Reactions and Teens
  

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