I can tell you exactly where I was when the field of allergy and immunology first stole my heart. I was in my first year of medical school sitting in an overly cool classroom taking notes as fast as any human hand could. My pathology lecture was just ending and immunology was up next. I rubbed my sore fingers and prepared to write down, verbatim, the next lecture.

But shortly after my professor started to speak, I realized that I had completely stopped taking notes. I had allowed myself to be drawn into the story that she was weaving, a story of T cells and B cells and their physical and chemical conversations with each other. It was amazing.

Little did I know that she was introducing me to a cast of cellular characters that would soon become not only important for me to pass my next immunology test, but also to complete my subsequent fellowship training and to my understanding of the mechanism of food allergy, an immunological disease that would affect three of my four children.

In 2005, after completing a pediatric residency, I started my fellowship in the field of allergy and immunology at the Children’s Memorial Hospital in Chicago. I had a 7-week-old baby boy at home so I was knee-deep in motherhood, but I was ready. I was excited to finally be seeing patients with the allergic and immunological disorders that I had been so interested in during medical school.

These diseases, including chronic sinusitis, seasonal allergies, and immune deficiencies, were all challenging and interesting, but what drew me in the most was food allergy. There was something so cruel and senseless about a disease that denies a child a bakery cookie – it made me want to break its code.

Patient Emotions
As fellows, we were taught to take a detailed history of the allergic reaction from the patient and the parent, paying exquisite attention to what food was ingested, the timing of the ingestion in relationship to the symptoms and what symptoms occurred.

Patient histories would often become complicated, a fusion of facts and feelings. We would then perform skin-prick testing with the suspected food protein and draw blood for the same allergen. Combining the history and the results of the testing, a diagnosis was made.

We would review an allergen avoidance sheet with the family, explaining the importance of reading food labels, and discuss an emergency health-care plan, teaching the families how to recognize and treat an allergic reaction. We provided them with a short list of support services and asked them to follow up in one year. It was a good system, at least as far as I knew.

By the end of my first year of fellowship, we had twin boys (yes, we had three boys in 13 months!) and one of them, Gino, literally had hives on his skin only a few days after he was born. He would soon be covered in itchy, bleeding eczema and more often than not, vomit, so I made an appointment with an allergist.

Next page: The diagnosis: a powerful blow

But I’ve also learned how to stay healthy, and I want to help others with my story. So here it is.

My parents found out that I was allergic to nuts at the age of 2. I was still always feeling sick, so more tests were done when I was 8 years old. I was positive for fish, but my salmon allergy level was low. So later, at Toronto’s Sick Kids Hospital, I did an oral challenge for salmon, which is when you eat the food to see if you react. I felt fine afterward, and we went home.

In bed that night, I woke up feeling very itchy. Then suddenly I was burning on the inside. I walked into my parents’ room and as they switched on the lights, they saw large hives and swelling all over my body. It was a reaction to the salmon.

Ambulance Ride and Secondary Reaction

My mom ran for my EpiPen. I so was scared of the needle, but she told me it was important to have it. She gave me the shot while my dad held me. She called 911, and told me, “you are going to be OK, you’re very brave.” Soon we heard the sirens. The firemen got there first and gave me oxygen – and a teddy bear to keep me calm.

At the hospital, after the ambulance ride, I felt a blanket of relief fall over me. But soon I was feeling bad again. I was going back into anaphylactic shock, called a biphasic reaction. The doctor gave me another shot of epinephrine. Over the next days, I took a lot of prednisone and Benadryl. I didn’t feel great, but I was alive.

Mine was not a typical case. It’s unusual to have anaphylaxis so long after trying a food. After that reaction, it was hard for me to sleep. I’d have flashbacks, hearing the sirens and feeling like I couldn’t breathe. I’ve been told this is post-traumatic stress. I learned to try things to help me relax, like reading a funny book, listening to music or saying a prayer. I’d tell myself I would get through it.

Today, life comes with restrictions. My family doesn’t eat in restaurants – with so many allergies it’s hard to find a safe place. My mom does the cooking, and we eat a lot of fresh foods and nut-free products. And I can’t do everything other kids do because I have to be careful.

Avoiding all my allergy triggers can be challenging. In June of last year, I had another reaction – we don’t know to what. I was at school, and got hot and itchy and my face became covered in hives. Yet I was not positive it was anaphylaxis. I called my mom to take me home.

On the drive, I felt worse and told her I needed the auto-injector. I tried to stay calm and took deep breaths. By the time the ambulance got there, I was already starting to feel better. I learned from that day: I need to trust my instincts. I didn’t give myself the auto- injector at school. I should have – it makes you feel better right away.

Severe allergies can be scary at times, but by now I know what to do to keep safe. I always carry an auto-injector, wash my hands a lot, let other people know about my allergies, and I don’t take chances.

I used to think my allergies were a curse, but now I believe I have them for a reason: to help educate others. Some students make nasty remarks about my allergies. These bullies just do not understand that allergies can be deadly. I want to spend my life educating people about anaphylactic allergies, and I hope that I can help other allergic kids not to feel scared.

I’m working on a book about allergies and post-traumatic stress. I think the more we tell people about allergies, the more understanding will grow, and the stronger those of us with allergies will feel.

They are scary at times, but allergies don’t have to stop us from living and having fun. We just have to be careful.

Erika DaCunha lives in Brampton, Ont. To comment, write to: editor@allergicliving.com

First published in Allergic Living magazine, Winter 2009.
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