No Nuts, No Glory

Can you have it almond?

Photo by Gary Kazanjian/AP

The first time I ate a nut I was 4 years old.?Almost instantly, I felt a tight itchiness in the back of my throat. Eventually, my pediatrician diagnosed it: a tree nut allergy.?With each subsequent exposure, my reaction intensified. Eventually, eating errant nuts prompted trips to the emergency room.?My mom stocked her purses and my backpacks with EpiPens, Benadryl, and bottles of neuroticism. ??

My food allergies aren?t?and weren?t?as severe as those of Tessa Grosso, the young girl profiled by Melanie Thernstrom in this week?s New York Times Magazine. Thernstrom details the struggles of Tessa and her own severely allergic son, Kieran, as they attempt to do normal things like go to birthday parties, swim, and play with friends at school. The kids are miserable. Tessa, at one point, is so shaken from a reaction that she refuses to eat.

Enter Dr. Kari Nadeau, an associate professor of allergies and immunology at Stanford University School of Medicine. A few years ago, she developed a special oral immunotherapy treatment to eradicate reactions like anaphylaxis in allergic patients. How does she do it? Nadeau desensitizes allergic kids to allergens through exposure. They begin her clinical trial by consuming a miniscule amount of the allergen. Gradually, after a couple of years of increasing the allergen dose, they?re chomping on full servings of the once toxic foods. Nadeau has also discovered she can immunize kids suffering from multiple allergens at once?which is what she did for Tessa and Kieran.

But for me, the revelatory moment of the piece came toward the end. Thernstrom relays happy news: Thanks to Nadeau, Tessa can now tolerate her allergens.

And then, in a line that many readers may pass over, Thernstrom exposes a vital truth about those who suffer from allergies. ?Profound change is profoundly unsettling,? she writes. With the successful treatment, ?Tessa lost a defining aspect of her identity.?

That might be a tough concept for someone without food allergies to grasp. Wouldn?t I love, for example, to eat chocolate souffl? at a restaurant without worrying that the cake contains almond extract?and fearing that the waiter has determined the nut content by peering into the cake?s insides? (?It doesn?t look like it has nuts!?) What if I could stroll into a bakery and select any of the beckoning pastries, regardless of whether the chef made it in a clean bowl?

Of course I want those things. But at the same time, I?m grateful for the positive ways my tree nut allergy has defined my identity. It?s shaped my behavior in ways that transcend restaurant encounters and transfer to my everyday noneating hours.

It has taught me to be assertive and persistent. Restaurant waiters and store clerks are often condescending and flippant when I ask about ingredients. ?You?re fine,? they say with a dry sneer. ?I?ve worked here for a while. I know the menu.? At first, I clammed up in response to their dismissiveness; I never wanted to ?make a scene.? Today, I grill them. I don?t care if it?s a fancy restaurant or if I?m dining with people I don?t know well. A few weeks ago, I was out with my boyfriend at one of Washington?s swankier establishments for Restaurant Week. I told the waiter about my allergy and asked that he talk to the chef but got the sense that he didn?t really care. (Blank stares and silence are always so reassuring.) I continued questioning him as each dish arrived. As it turned out, several of the dishes he brought me did contain nuts, and he had to sweep them away at the last minute.

My nut allergy has also taught me to be my own protector and guardian. Family members and friends mean well, but they?re fallible. (They?re also even more frustrated by my interrogations than restaurant waiters because they?rightly?interpret questions as distrust.) The truth is even one?s best friends and closest family members can forget or overlook ingredients: Long-time residents of allergy world have learned, like Dave Navarro, to trust no one. A couple of years ago, my aunt hosted a wake for my grandmother. She?d been offering food at the house for days, and I?d asked her about every morsel. Her exasperation was obvious. At the wake, I once again asked her what I could eat. She told me everything was safe. I grabbed a slice of marble cake from the kitchen; it contained almond flour. Soon, we were zooming to the ER.

It was a typical trip in that she and my family members were far more rattled than me. That?s because I?ve also learned to remain calm in high-stress situations. When I eat a nut, there?s no time to freak out. If I want to live, I must immediately inject myself with epinephrine (a shot of adrenaline which temporarily halts the effects of anaphylaxis) and explain calmly to those around me what they need to do.

But perhaps the most important skill I?ve learned in nut world is the ability to relinquish control. Inevitably, even after I cross-examine family members and waiters, each bite is still a risk. By learning to let go, I?m able to enjoy my meal and the company. I refuse to live in a bubble of phobia and fear.

Of course, I?m still terrified each time I accidentally pop an almond or walnut. So let me be clear, lest the above exaltation paint me as a total nutcase: I?d happily trade in my anaphylaxis today for a life of carefree cupcake consumption. Dr. Nadeau, sign me up for your next clinical trial. I?ve learned all of the lessons I can from a life of food allergies?and I?m more than ready to discover the perks of an allergy-free life.

Source: http://feeds.slate.com/click.phdo?i=ee8393140b38607686c511a81face555

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