Monday, June 11, 2012

Food Allergy Incidents & Accidents, Hints and Allegations

A post on one of the chat boards today caught my eye. The writer was recounting a situation we've all been through: her son had experienced a possible allergic reaction after eating. The thing was...she didn't really know if it had been a reaction. He ate the food, he threw up 20 minutes later and life went on.

The writer in this particular case had avoided Burger King ever since "the incident", even though the ingredients of the food in question were safe and there were few chances of cross-contamination. Her child had eaten the food, gotten sick, and an association — whether true or not — was formed.

The post caught my eye because the experience was so familiar. To be blunt, my son was a barfer. The littlest thing could set him off. We were NEVER sure what was really going on. Was it a food reaction from cross contamination where the amount just wasn't enough to tip him over into a big reaction? Was his stomach just sensitive, perhaps as a result of whatever damaged his intestinal wall and caused his food allergies in the first place? (Just a theory...but an interesting one.) Was it perhaps a fever-less virus?

That process is called food aversion. It's one of the strongest responses humans have, thought to be a holdover from the days when something that made us sick was likely to be poisonous. We are trained to avoid like the plague (literally!) foods that make us puke.

The problem with this is that we can back ourselves into a corner with avoidance. To torture the Paul Simon lyric from which this post derives its name, we move from incident (the meal) to accident (the illness) to hint (was it a food allergy?) to allegation (it was! it definitely WAS! We'll never eat THERE again!).

As David Solot notes in his wonderful blog post about food aversion:
To make matters more confusing, sometimes aversions form for the wrong food. Imagine that on the way to work one morning you stop off for your traditional cup of coffee. Later that day, your coworkers all go out for Indian food. You’ve never had Indian food before, but you’re up for something new. You have a delicious meal and try lots of new items. But around 3pm, you start feeling queasy. It gets worse and worse, and by the evening you’re sick to your stomach and not able to hold anything down.
Your brain senses that you’ve been poisoned. Once again, it isn’t sure what did it, but it does remember a lot of strong spices and flavors that it never tasted before. To make sure you don’t poison yourself in the future, your brain decides “better safe than sorry,” and conditions you to feel sick any time you smell, taste or even think about Indian food.
The problem is, it turns out that there was nothing wrong with the Indian food - it was the creamer in your morning coffee that had gone bad! “No way,” says your brain, “we’ve had that coffee every day for a year. We know that it’s safe. It had to be that weird new food we ate.”
Sound familiar? Food allergies are nebulous beasts. When our child is suddenly ill, especially when it involves vomiting, we immediately link the incident to whatever novel food was last eaten. Sometimes, if nothing else will stand up as scapegoat, we'll even knock an old favorite off the safe list. Plus, we have the added reinforcement of knowing that the wrong foods have caused dire illness in the past, so we're primed by the very nature of food allergies to suspect everything going into their mouths as potential poison.

Think about it. How many times has your child been sick? How many (potentially innocent) foods could you, or have you, associated with that sickness? If you ask the food allergy community, they'll tell you to "go with your gut" (a saying no doubt derived from food aversion) and avoid it if it makes you anxious. But the list grows and grows...and the next thing you know, we're avoiding more than we're allowing.

To give you a personal example, when my son was little, he took a gymnastics class. After the class, I bought him Skittles from the candy machine. He had an immediate and serious asthma attack within minutes of eating them. Now, my son a) does not typically have exercise-induced asthma and, b) has reactions without hives.

The label was safe. I gave him an inhaler and shrugged it off, best I could. The next gymnastics class, same thing: exercise, Skittles, asthma. Yikes! I called the manufacturer - they told me no chance of peanut/milk/soy contamination, dedicated plant, no reports of other reactions.

My son has not had Skittles since. It's been 13 years.

Does this make sense? Probably not. But I learned to associate this candy with the fear of dealing with an asthma attack or, possibly, allergic reaction. The rational mother would trot out the probably-totally-innocent Skittles and do a challenge at some point. The human, fallible mother (that's me) is still phobic about those killer candies.

Each of us has episodes like this, and each of us develops a variety of avoidance behavior to deal with them. We all have a touch of "magical thinking" when it comes to allergies and it's natural to want to validate that experience.

While I have not posted on message boards and Facebook about the danger of Skittles, I could see how a scared mom could go that next step. Many moms even see it as their duty to warn others of the danger their kid experienced, even when the cause/effect chain is not absolutely clear. They want to validate their crazy (and I say that with love) by sharing it and hearing that others have experienced the same thing. And the world is big enough that someone, somewhere, will have also gotten sick at the same time they ate that food...

Does it help to know how the food aversion process works and how we FA moms are primed to fall for it because of the food = sickness connection? I don't know. Skittles are still not in our cupboard. But I'm hoping I'll get the guts to put them there sometime soon.

It's time to put them on trial, declare them guilty or innocent and finally close the case.


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