jasmom

We had a scare earlier this year when my husband received a call from one of my s's friends/classmates alerting us that s was in route via ambulance to the ER from an apparent serious allergic reaction to a tree nut. I will always be grateful to the faculty, TA, EMS folks, ER crew for their quick action. (And thank you, Danielle, the TA who accompanied my s to the ER and assured me over the phone that he was breathing and conscious.) This allergy was a new discovery for my s, who left the ER with an epipen and instuctions to avoid all nuts. My mind has replayed the scenerio numerous times and can't believe he had the good fortune to collapse in a very visible place, near faculty he knew and trusted, who accurately assessed the danger and sought medical help promptly. And thankfully, he was very near an ER.
Now, the question. This same s is planning to spend the Fall semester studying in Shanghai. He does not know Mandarin (but will get an intro lesson). Have any of you dealt with something similar? What protections have you (or would you) take?

binx

Haven't dealt with it, but it would be a huge concern to me. In Germany the labeling of products is much less controlled than here, and it seems they put hazelnuts in everything! I often thought that I was glad we had no nut allergies, because they showed up in the most unlikely places.

I think the first Mandarin phrase he should learn is "I am allergic to nuts," and be prepared to use it at every meal.

unregistered

I have a friend with many serious allergies who only takes vacations in English speaking countries. I'd consider that, but I am also a worrier. Especially with Mandarin, where even after a semester there he will likely not speak the language adequately, I would be concerned. I believe there are bracelets that people with allergies can wear (perhaps one with Chinese symbols?)

Does the instruction to avoid "all nuts" include peanuts, which are technically legumes, or can he eat those?

jasmom

Unreg, Although this reaction occurred after ingestion of a brazilnut and a hazelnut, I believe he is to avoid peanuts as well, given the apparent likelihood ofboth allergies.
binx, I, too, am especially worried about the food-labeling issue. I wonder what it will be safe for him to eat!

unregistered

I've never been to China, but I think it is often heavy on peanuts. My best friend went to China and said that nobody ever had a clue what they were eating, they just went for it.

It might sound alarmist, and other people may have better plans, but I would seriously consider studying abroad elsewhere if that were a possibility. The UK has good food-labeling procedures, and of course communication wouldn't be a problem. Australia or New Zealand if he wants to go further from home? I assume he isn't focusing on China in his studies as he has never taken Mandarin, is that wrong?

Maybe I'm just being nutty, and I hope other people have better suggestions which would enable him to go, but I know that if I were in his shoes, I wouldn't want to spend a semester in China - though I may plan a shorter tour to China at a different date with a guide who spoke Mandarin fluently.

How set is he on going?

jasmom

He's pretty resolute. He picked this program for some very specific academic reasons, so I think I'm stuck with trying to help him figure out how to do it as safely as possible.

reflectivemom

I would advise consultation with an allergist and allergy testing. They will test for nuts and may be able to pinpoint the actual nut causing the problem. If he has never had a problem before, while I'm not an expert in this area, I think it is doubtful that he is allergic to all nuts. I "think" he would have reacted to peanuts earlier in his life. Has he identified where/what he had eaten when the reaction took place? Hopefully, there was some "uncommon" nut in his food.

I would be very concerned about his travel with such severe reactions to all nuts. The epipen does not solve the problem - it is only emergency first aid - buying time to get to an emergency room. There are so many ways nuts can be incorporated into products - even when speaking the language, it's often difficult to ascertain the possibility of inclusion.

I'm sure there are those on CC who are more experienced with this issue, than I. But, please seek the guidance of an allergist before making your decision on this. Best of Luck to you and your son!

Biohelpmom

Wow, I can actually be helful to someone else! We have been through this exact same scenario (anaphylactic shock to nuts, revived in the ER, study abroad the following summer.) A good allergist can do skin tests in the office to pinpoint the exact nut. There is also a blood test called the RAST that can measure the amount of sensitivity to a substance. There is a great organization called the Food Allergy Network with books and helpful hints on how to travel with food allergies. The MedicAlert Foundation will log your information in to their database, and provide an internationally recognized bracelet engraved in the language of your host country. The bracelet will also have an international toll free number that can be called in the case of an emergency. All this for about $50. You might want to get a letter from a doctor with permission to carry the EpiPen or TwinJet on the airplane. Finally, have cards printed in Chines that he can give to a waiter in a restaurant if he can't make himself clear in the language. PM me for more information! Good Luck!

jasmom

Thanks, bio! It's great to know that you survived the worrying re: that semester abroad.

Biohelpmom

No problem jasmom. I have always enjoyed your posts. One thing that surprised us about the Epipen was that it didn't reverse the reaction the way that we expected it to. It just stopped it from getting worse. It was the IV Benadryl and steroids that provided the "cure."

"just"aMom

I spent nearly a month in various parts of China, and never saw any type of nut. I am allergic to walnuts, and I never had a concern while there. It IS true, however, we had NO IDEA what we were eating, but nuts was never part of it.

I'll never (NEVER) forget asking at one meal what the tasty, tender, flat meat was we were eating (and it was good). "Beef" we were told. Later we learned it was cow's ears. Yes, we ate parts of animals that in a million years I wouldn't consider eating at home, but when prepared by someone who has eaten them all their life, it's amazing how good something can taste. Even an ear.

snowball

I also have a child with an anaphylaxis allergy to peanuts. We have had a few scares in the United States with cross contamination. I have a fear for when she goes abroad next year-she has picked a program in Spain. We are checking with all the organizations associated with food allergies and found one in Spain. I hadn't though about getting her another Medicalert bracelet printed in Spanish, but that is a great idea. She is still wearing her cheap bracelet from 10 year ago that she can not remove as the catch is stuck. We just ordered her a nice silver one the other day as the silver was 20% off.

A big concern with an allergy to nuts is the cross contamination. I would make sure you son has all the allergy test done, both skin and blood. Then make sure he wears some bracelet or necklace at all times. Check out www.medicalert.com

Here are a few other websites that may be of help:
www.foodallergy.org
www.foodallergyconnection.org
www.foodallergyinitiative.org/
www.aafa.org
http://www.aaaai.org/members/resourc...laxis_toolkit/

NYMomof2

My 14-year-old son is allergic to several tree nuts, although he is one of the rare people who has outgrown a documented allergy to peanuts. He has had an anaphylactic reaction only once, when I served him butternut squash ravioli without reading the label. As it turned out, there was a small amount of ground walnuts in the filling. We have been carrying the Epi-pens for his whole life, so we knew what to do.

Reflectivemom makes an important point about the Epi-pens - they only stop the reaction for about 15 minutes. For this reason, they are usually prescribed in pairs. It is also important that after the Epi-pen is administered, the person be taken to the hospital in an ambulance, in case the reaction starts again.

I would be very worried about traveling in China, if their food is like Chinese food here (it may well not be). We do not go to Chinese or Thai restaurants. Even if we order dishes that do not contain walnuts (or other nuts), the cooking oil is re-used and traces of nuts can remain from a previously cooked dish.

I would see the best allergist in your area. If you are near NYC, PM me for recommendations.

interesteddad

I'm not an expert in Chinese cooking, but I know a little and I stayed at a Holiday Inn Express last night....

I think a much bigger problem in China would be a mushroom or soybean allergy. That would be insurmountably tough.

The main thing that you are going to need to find out from an allergist is whether there is a peanut and/or peanut oil allergy. Peanut oil is used for stir frying in Chinese cooking. You can buy it in gallon cans at Chinese markets.

I don't know as much about cashews. They are prevalent in US "Chinese" cooking, but most of those recipes don't have much to do with actual Chinese recipes. For example, there's no "General Tsao's Chicken" in China. It's an American recipe.

If you can get clearance on the peanut issue and prepare a little index card to show waiters about the other nuts, I think you could probably do just fine. The other one I might get the allergist to test is water chestnuts.

Almost all food in China is served as an array of dishes. As long as peanut oil isn't a problem, then it should be pretty easy to see which, if any, dishes on the table have nuts. I can't think of any recipes off hand that would have hidden nuts.

mathmom

Unlike the Germans, I don't think the Chinese are prone to grinding up nuts. But I agree peanut oil is a potential problem. Definitely get tested!