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Life With a Peanut Allergy

This is only meant to be a personal account of what it is like to live with a peanut allergy. Obviously others that suffer from the same condition will live their lives very differently from my own, and I do not intend anything discussed herein to be construed as advice on the proper way to deal with such an allergy.

Few things have as profoundly shaped my life as my constant cosmically imposed compulsion to avoid peanuts at all costs. The allergy has always been somewhere between a nuisance and a threat, but at times it has also been a source of identity, a convenient excuse, and perhaps even a force that has unconsciously driven my decisions in life. I've found that the constant vigilance mandated by this condition can be very trying at times, but even so I can't imagine living without it.

Days of My Youth

As far as anyone can say, my allergy first appeared when I was just one year old and I was given some peanut butter on a cracker. That was the last time in my life to my knowledge that I've ever consumed that mixture of mashed legumes. No one can really say why I developed the allergy; atopy isn't common in my family. It could be that I had didn't run into many germs in my first year in this world, or maybe I simply ran across the wrong bacteria. Maybe I lost the genetic lottery, or maybe, like so many things that science would desperately like to explain, it was simply a streak of bad luck. Whatever the reason (or lack thereof), that well meaning cracker covered with its nutritive bounty caused my face to swell to several times its original size, and it no doubt made me incredibly itchy. Fortunately, I had medically savvy parents and the reaction wasn't too severe, so it was readily quelled with a quick dose of liquid Benadryl and I was out like a light as chemicals rapidly rid my body of its histamine efflux.

A trip to an allergist confirmed what we already knew; that I had developed an allergy to peanuts, and that that allergy was likely to extent to many other kinds of legumes - lentils, beans, and chickpeas especially. It's worth mentioning to those that aren't familiar with plant classifications that peanuts are in fact not nuts. Nuts grow on trees and bushes and are seeds for the plants that bear them, whereas legumes such as peanuts grow under or near the surface of the ground and are genetically fairly distinct despite the similar name. Of course, for reasons that aren't well understood considering the genetic distance between them, people that are allergic to peanuts are also often allergic to tree nuts which really makes the whole point fairly moot.

Anyhow, at some point the allergist equipped my family with all the tools they would need to both protect and educate me about the dangers that lay before me in life owing to my newfound weakness. We were given a “Jr.” version of the standard Epi Pen autoinjector familiar to paramedics and allergy sufferers the world over in order to stave off death should a peanut convince my body to try out a precipitous drop in blood pressure. We also got a nice VHS tape containing a cartoon video about an elephant at the zoo that couldn't eat peanuts. I honestly couldn't say what the point of the video was since it certainly didn't feature any scenes of elephantine anaphylaxis, but I can only assume it was aimed at making sure I didn't feel alone in the world. And I never did feel alone; it didn't hurt that I grew up amidst a peanut allergy boom - up to 1% of people have suffered from this unfortunate affliction in my generation, and while some have outgrown it the majority haven't.

My parents were very good about protecting me from peanuts in my daily life. When I started daycare and preschool, they made sure all the snacks provided were peanut free and that the other students wouldn't try to share their PB&J sandwiches with me. Nowadays schools are more willing to ban peanuts altogether for fear of the wrath of wronged and litigious parents, but such extreme reactions were far less common when I was a youngling. I was taught to refuse food unless a grown up checked the package for me to make sure I would survive my snack. Evidently I took this to heart remarkably well, since I had the wisdom to refuse circus peanuts from a wayward child when I was sitting in my front yard as a three or four year old (About a decade later I learned that circus peanuts do not, in fact, contain peanuts, but that is really neither here nor there).

I did have one more run in with an allergic reaction in my youth, but it didn't come in the form of peanut butter or contaminated snacks. No, my parents opted to serve split pea soup for dinner without considering that the soup had a leguminous base. To be fair, I have to this date never figured out why I can eat peas, but I cannot eat them in their dried and split form that is readily creamed into soup. Regardless, as my eyes began to swell shut it became quite clear that my persistent claims that this soup tasted “funny” were more perceptive than they at first appeared. I had even gone so far as to pour milk into the soup in order to try to avoid eating more before its insidious nature became apparent, but I was still told to continue eating if I hoped to enjoy dessert. Fortunately, my legume allergy was far less severe than my peanut allergy had become, so Benadryl was once again able to save the day, and I have never since had a reaction so bad that it caused anything more severe than hives.

Friendships

As I entered into the lower echelons of grade school and I began to integrate into the hustle and bustle of school life, it became clear that my allergy was going to pose certain problems for me going forward. The most salient source of misery for me at the time was that I couldn't partake of the cupcake feasts that accompanied by classmates' birthdays just in case a wayward molecule of peanut might lurk within one of the provided pastries. As an aside, I just learned this week that many schools are taking to outright bans on bringing in baked goods for birthdays in an ill-calibrated overreach undoubtedly meant to protect children like me from the dangers implicit in such provisions. Whenever someone snacked on something in school, I had to find solace in my graham crackers or potato sticks, and it time I came to terms with the fact that this was just the way of the world. My classmates never seemed to notice or care that I couldn't have their cupcakes, or perhaps they did notice but if so their reactions were so uninteresting that I have long since forgotten their content.

When I moved to a new town in the first grade, my allergy suddenly went from being an inconvenient facet of my personality to a defining trait of me as a person. In my first school, I knew I couldn't have peanuts, and I was allowed to sit with my friends at lunch without incident. At my new elementary school, I was deemed “allergic” and I was mandated to eat lunch at a special nut-free table with others that shared my allergy or any host of other allergies. While there was a unique camaraderie in knowing that we were all similarly restricted, the notion that people who suffer from food allergies need to be grouped together and separated is patently absurd. I understand the thought process - that children eating peanut butter might offer some potentially allergenic food item to a friend who unknowingly consumes it, for which the school might be responsible. This fear, however, does not justify isolating atopic children from their friends in the lunch room.

Of course, at the time I thought nothing of this mandatory segregation. Only in retrospect did the unreasonable nature of this policy become self evident. Now when I tell people that my school took this approach to handling food allergies I get horrified expressions, and I can only hope that my alma mater has found a more reasonable way to handle the problem. Regardless, at the time the five of us at my nut free table formed a clique that others were literally forbidden from joining - no one without an allergy could sit at the nut free table, even if they didn't have nuts in their lunch. We traded Pokemon cards and discussed the latest fads, and we became friends outside of lunch in time, and to this day I'm still Facebook friendly with at least two of them. Unfortunately, as I moved into the fourth and fifth grade I started to make new friends in class, and yet I was excluded from their conversations at lunch by virtue of my allergy. It never prevented my friendships from thriving, but it did nothing to improve them and I always felt left out due to my inherent absence from the conversation.

Close Calls & Growing Up

I never again had an allergic reaction as severe as that to split pea soup. Occasionally I developed sporadic hives, likely from some minute contaminating peanut particle although this is of course quite impossible to prove definitively. I did have friends that came a bit closer to death, however, as one of them evidently ate some tomato soup at school lunch that was laced with trace peanuts and had to be rushed to the ER as a consequence. Even the school had no idea that the tomato soup was suspect, and it was only by the grace of the fact that I had taken to bringing my own lunches to school that I managed to avoid a similar fate. A legend developed that was used to justify the existence of the nut free table in my school. Specifically, it was said that once at recess a peanut allergic student sat on a tire swing that had some small amount of peanut butter on it from a previous occupant. They then immediately began to swell up and went into anaphylactic shock, only just escaping from the incident with their life. Whether this ever actually happened is unclear, and how this justified segregating the lunchroom was even less so considering it happened at the desegregated recess, but even so it was always mentioned whenever the topic of nut allergies came up.

After fifth grade I moved on to middle school where I enjoyed previously unimagined levels of freedom - I could eat with whoever I wanted and no one would tell me otherwise. Just like that, my allergy clique all but dissolved and was largely forgotten. For this time in my life, my peanut allergy moved into the background and was often a flaw that many people were largely ignorant of - without constant reminders in the form of lunch table rules or class time cupcakes, there was little to indicate to anyone that I was anything other than average. In high school this remained true, and the pressures of puberty and teenage angst overtook any concerns about my dietary limitations. Occasionally I would discover that something I had once eaten had since been reclassified as something outside my range of acceptable foods, but otherwise things continued as normal.

At this point perhaps I should mention the range of things someone with a peanut allergy can and cannot eat. Obviously any food that has peanuts in it is out of the question, as that would inevitably cause a reaction. This is not true of peanut oil necessarily, though, as refined peanut oil contains no protein and protein is what is recognized during allergic reactions. That being said, there is also unrefined peanut oil that does contain protein, and I avoid all peanut oil as a precautionary measure, which can be something of a challenge when visiting family in the depths of the Bible Belt. Many other foods receive the less clear classifications of “May contain peanuts” or the more unsettling “Processed in a facility that also processes peanuts”. Despite what I thought for most of my life, these two phrases are in no way federally regulated or mandated, and are used by companies as legal armor to prevent attempts at lawsuits following allergic incidents. I believe one study found that roughly 10% of items that may contain peanuts actually contain measurable amounts of these legumes, and the number of products processed in a facility that actually contain peanuts is likely negligible. Whether someone with a peanut allergy eats these products is often a matter of personal comfort and reaction severity/history. I for example will not eat anything with either label, as I feel that it simply isn't worth the risk however small.

When I reached college, my peanut allergy entered into the spotlight once again. Not in a mean way, nor in a sudden way. I don't even know how it first entered into the lexicon of my college days, but inevitably every one of my friends knew that I was the kid with the peanut allergy. And I didn't mind that. Indeed, I've tended to embrace this identity since it makes me reasonably unique (of course, 1% of the US population shares my uniqueness), and this probably only encourages more people to make more jokes that tend to involve me dying in a peanut related incident. This never bothers me as it has never been malicious, and is only ever meant as a convenient point of reference for humor. Indeed, when I needed to indicate that a particular grave was my grave in a pictionary-style drawing game, I drew a tombstone with a big peanut on it as it seems like the easiest way to demonstrate that it belongs to me. I have a stuffed peanut sitting in my room, and I have realistic looking peanut erasers as well for gag potential. In effect, I chose to let peanuts once again become an integral facet of my life, and this time they weren't the negative and isolating influence that they had been in my youth.

In college I chose to study biology after I discovered how interesting it was in my high school days, and in time I began to apply for various biology scholarships. One premise I used in many of these scholarship essays was that I had chosen to study biology because of my allergy, and that I hoped to gain knowledge on the sub-field of immunology in order to research and treat or cure allergies in others. At the time I told myself that this was just something I was saying because it was compelling, and indeed it helped me get a number of small scholarships, but as I approached graduation I began to reconsider that perspective. I joined an immunology laboratory and began to do research there, and as a consequence discovered that I loved immunology, leading me to pursue a graduate degree therein. While I can't honestly say that my allergy drove me to research immunology, I do believe that it likely subconsciously drove me in the direction of my current vocation, and for that I can't fault it.

Limitations & Silver Linings

As I mentioned earlier, there are a lot of things that I cannot or will not eat out of an abundance of caution, if their labels mention peanuts in any context (other than peanut free, of course). The majority of foods excluded by this restriction are pre-packaged candies and dessert items, as well as store-brand products, as these often seem to be made in giant food plants somewhere in the world where they process peanuts among hundreds of other types of food. I also have a tendency to avoid literally all baked goods that I did not make myself. No matter how many times someone promises me that they did not put any peanuts in their cookies or cakes, I will not eat them. This isn't because I don't trust my friends, but rather because it is a risk I just don't view as being worthwhile. For example, people will often make chocolate chip cookies and offer them to me by declaring that they didn't use any nuts in them. They rarely think, however, to inspect the allergy statement on the bag of chocolate chips that they used, which almost always have a peanut warning on them.

This paranoia about baked goods was somewhat reinforced for me at a recent dinner party when I was interviewing for graduate school programs. The topics of allergies came up, and it was made clear that another interviewee also had a severe peanut allergy at the same party. Later in the evening, one of the interviewing faculty ran up to me flush with fear and asked me if I had eaten any of the cupcakes at the party. Naturally, I hadn't, but my allergy ally had not been so risk averse, and had eaten a cupcake, causing her face to begin to swell. As she didn't have her Epi-pen with her she had to be taken to the ER as a precautionary measure. In the end she avoided anaphylaxis and recovered without incident, but the clear risks of eating baked goods of well intentioned origins was made quite clear to me that night.

Perhaps the greatest drawback to having a severe peanut allergy is the fact that it limits what you can eat at restaurants or other people's houses. A large number of cultures heavily use peanuts, lentils, and chickpeas in their cooking, meaning that I cannot go to a Thai, or Ethiopian, or Indian restaurant and feel safe eating anything there. This isn't to say that I wouldn't be safe with certain meal options in these places, but I simply won’t ever feel comfortable enough to try the food as I know that the risk is more substantial than in say a French or Italian restaurant. This risk also extends throughout the Southern United States where peanut oil is as popular as EVOO in Italy, although if I am able to directly ask the chef whether or not they use peanut oil I am usually willing to overcome my hesitation. While no restaurant owner wants their customers to have an allergic reaction, I usually find the wait staff at high end expensive restaurants to be far more accommodating to my allergy needs. They will often prepare special areas of the kitchen for my meal or have chefs come to talk to me to ensure my comfort and enjoyment of their restaurant.

While these restrictions are probably viewed by many of you as being quite debilitating to normal enjoyment of culinary traditions, whether by cognitive dissonance or otherwise I view them as a minor inconvenience (most of the time). Indeed, sometimes I enjoy the fact that I can supplement allergy fears for self control. For example, when I first reached college and was delighted to discover the unlimited amounts of food awaiting me in the dining halls I was able to avoid the dreaded “freshman fifteen” weight gain problem. This was largely due to the fact that I couldn't eat any of the dessert items that were offered, and I thus had to have cereal or fruit in lieu of baked goods. Similarly, I have never gotten dessert at any but the highest of high end restaurants for fear of contamination in the kitchen, and I do not miss this dessert availability. Likewise I am able to avoid most foods in the candy aisle of the grocery store (although Skittles are always a weakness, and if they ever produce peanut skittles I will be incensed with rage).

As an aside story, this ignorance of most candy types has led me to bewilder my friends with my thoughts on candy composition. Specifically, I always assumed that M&Ms were fruit flavored candies, much like their similarly colored Skittles counterparts. While I admit I'm not sure that M&Ms would taste very good if they had blue raspberry chocolate pieces, I had never really given it much thought (and who doesn't enjoy chocolate orange flavor combinations, after all?). I didn't discover this fault in my logic until I had reached college, and it proved to be good for several laughs. It also made my friends trek to a nut free candy store specifically to buy me pseudo M&Ms so that I could taste them in all their disappointingly fruit free glory.

The biggest benefit of my allergy has, to me, been its effect on my cooking. While I suspect some with such an allergy would avoid offending restaurants and consequently never get to taste food from these different cultures, for me it was an impetus to learn to cook facsimiles for foods I would otherwise miss out on. While I obviously cannot make a Pad Thai or the like, I can now make Thai curry and lawb (chicken salad with mint, cilantro, shallots, and other spices), thus allowing me to gain a window into a culture that I wouldn't otherwise have experienced. This motivation has expanded my cooking repertoire and has improved my skills as a chef in general to the point that I feel comfortable following almost any recipe (although I have yet to master the fine art of improvisation which I hear improves with time). Obviously anyone can become a great cook without the drawback of an allergy, but I know that for me it was the desire to find out what I was missing that pushed me into this beneficial realm of culinary expertise.

Going Forward

Every few years, I go to an allergist's office and have my blood drawn. They test it in an immunological assay that determines the levels of anti-peanut and anti-legume antibody (IgE, for anyone else who may be inclined to study the immune system) circulating in my blood. While these levels in the blood don't always correlate with risk of anaphylaxis, they are a good indicator, and my peanut risk is always off the scale. Some people lose childhood allergies as they grow older, and while this is mostly true for egg, wheat, and milk allergies it can on occasion happen for peanut allergic individuals as well. At this point, however, it seems quite unlikely that I will ever be so lucky, and even with I were I'm not sure what I would do with that. I would still never feel entirely comfortable eating any product that I once had to avoid due to years of learned aversion.

Even today, there are studies that systematically desensitize children to their peanut allergy by giving the successively higher doses of peanut that their bodies learn to tolerate, and I have no desire to participate in one of these studies. This is in part because of the risk inherent in eating peanuts, even in a medically controlled study, but more and more I think that it is because I wouldn't know what to do without the allergy. It has become integral to my identity. It isn't all that defines me, and it doesn't conciously drive my decision making with regard to my goals in life, but it has an undeniable effect on the way others view me and I view myself in the world. I have embraced my peanut allergy as much as is possible, and as such I can't imagine what it would be like without it.


Non-Fiction


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