While many allergic adults are laissez-faire about the risks they face, Muñoz-Furlong is not. “I am scared for the adults,” she says. “It is heartbreaking when I have had to speak to a family and someone in that family has died [from a reaction]. And when I’m talking about an adult, it’s somebody’s mother or father or brother – there’s the impact on the entire family.
“These deaths can be prevented with some education and preparation, and I just wish the adults would really value their lives as much as they do their children’s.”
McGarr agrees better education is important. But he thinks the need goes even beyond it, and that this community would benefit from behavioral psychology studies about the sense of denial, and the need to feel in control and minimize risks.
For every cavalier allergic person, he notes, there is also another non-compliant adult who diminishes the condition because he or she finds it difficult to face up to the unpredictability of anaphylaxis. “Raising the alarm bell isn’t the only answer because you’re going to have a large proportion of people who just feel overwhelmed.”
He says there has got to be better communication with these patients, so that they understand the precautions – from food label reading to owning an auto-injector – are the life jackets, the providers of control. This begins on the front lines in the family doctor’s office, where many allergies are diagnosed.
From research with primary care physicians, McGarr has seen both the time constraints and the pressure doctors feel to assure patients that their allergies can be controlled.
“In an effort to assuage a patient’s upset and anxiety, the well-intentioned doctor may inadvertently send out signals that suggest ‘this isn’t too serious; you have a mild allergy,’” he says. In the patient’s mind this gets picked up as: “I don’t need to worry – or take protective action.”
If there’s one place McGarr would start with the adult risk-takers, it’s with the severity question. Until tests can reliably predict a person’s anaphylactic risk, “it would really be helpful if everybody would strike the concept of severity out of their minds. It’s counter-productive in inspiring the right behavior.”
As for Koentges and Ahluwalia, we don’t know if they’ll ever accept the condition is life-threatening or become reliable carriers of auto-injectors. But perhaps reading this will at least make them pause, and consider the volcano that gurgles underfoot.
First published in Allergic Living magazine.
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