A guide to improving quality of life for food allergy sufferers

If food allergy patients want to improve their quality of life, they should never live their lives as "walking allergen insulators." Instead, they should establish a "personal risk-graded response system" on the premise of completing accurate allergen screening and clarifying individual tolerance thresholds. They will not have to turn away all friends for dinner out of fear of allergies, nor will they send themselves to the emergency room just because of luck.

I met a 12-year-old boy with a wheat allergy a while ago. He only had a serum specific IgE test before, and the value was several times higher than the reference value. The local doctor directly told him to ban all wheat products. He has not eaten a bite of steamed buns and noodles for three years. He even dared not go to the school's spring and autumn outings for fear of accidentally touching his classmates while sharing snacks. Later, his parents took him to Xiehe Union Medical College for a double-blind placebo-controlled food challenge test, and found that it was perfectly fine for him to eat 1/4 of ordinary bread. He would only develop urticaria if he ate more than 200g of wheat flour food at one time. He had been starving for three years before.

Oh, by the way, there are actually different judgment standards in the allergen testing industry: some doctors believe that the combination of skin pricking + serum IgE testing is enough to determine allergies, which is convenient, fast and low-cost.； Some insist that double-blind food challenge is the gold standard, especially for children. Many of them only have staged immune intolerance, and rash fasting will affect growth and development. I would like to mention that the "food intolerance test" that checks for IgG has been stopped by many regular hospitals. Don't waste your money because the results cannot be used as a basis for allergy fasting.

There is no unified recommendation for food desensitization treatment that many people are asking about now: the top domestic allergist team recommends that children over 4 years old who meet the indications should undergo it as early as possible. The effective rate of desensitization to common allergens such as milk, eggs, and peanuts can be about 70%, which can greatly reduce the risk of severe allergies in the long term.； Many grassroots doctors will also remind you that the desensitization cycle lasts for 2-3 years, and you have to go to the hospital every week to adjust the dosage. If it is stopped midway, the effect will be greatly reduced, and it may even induce severe allergic reactions. Whether you should do it or not depends entirely on your own time cost and tolerance. There is no standard answer.

After getting the accurate determination of allergens, the most troublesome thing is actually the scene of dining out. I have seen many people either repeatedly emphasize that they are allergic in public right from the beginning, causing everyone at the table to eat cautiously, or they are afraid of trouble and insist on taking a few bites, then go to the hospital for emergency treatment. In fact, there is no need to go to extremes. A girl I know who is severely allergic to nuts will call the restaurant 10 minutes in advance before every dinner party to ask if there are any hidden nut ingredients in the dishes that day. If she goes to a buffet with small ingredients such as hot pot and barbecue, she will She brought a small bottle of her usual dipping sauce, and when she arrived at the venue, she would not yell at everyone to stop touching nuts. She would just quietly mention to the people at the table, "I'm allergic to nuts. It's okay for you to eat, just don't give it to me." No one ever thought she was in trouble, and she was able to enjoy eating herself.

There is actually no uniform template for how to handle a dinner party: if you have severe allergies that can cause laryngeal edema when exposed to trace amounts of allergens, you should make it clear to the organizer in advance, or even bring an edible lunch to go. A true friend will not think you are too busy.； If you have a mild allergy that only causes mild urticaria after eating it, just ask about the ingredients of the ingredients in advance to avoid minefields. There is no need to be overly nervous and spoil everyone's fun.

Don’t believe what is said online that “all allergic patients should carry an epinephrine pen with them”. This is also a misunderstanding. Only patients who have had a history of anaphylactic shock or laryngeal edema need to prepare an epinephrine pen as directed by the doctor, and they must pay attention to the shelf life. I met a girl in the emergency department a while ago. The pen she took out after she was allergic had expired for almost half a year. Fortunately, it was just hives that time, otherwise something serious would have happened. For ordinary patients with mild allergies, it is enough to carry a second-generation antihistamine with them, but remember: if you have difficulty breathing, a tight throat, or dizziness or difficulty standing after eating the food you are allergic to, don't take medicine first, call 120 first. It takes at least 20 minutes for antihistamines to take effect. If you can't save the emergency, don't hesitate to use epinephrine.

Many people ignore the emotional problems caused by allergies, especially young children. All the children in the class eat cakes but he cannot eat them, and it is easy for him to feel that he is an outlier. I have seen two types of parents who handle it very well: one is to communicate with the teacher in advance, put a drawer of special non-allergenic snacks for the children at school, and prepare edible cakes and snacks for the children in advance during group activities to prevent the children from falling behind. ； The other is to teach children from an early age to speak openly about their allergies without having to hide them. Many kindergartens and elementary schools now have special accounts for children with allergies. Teachers and classmates will take the initiative to pay attention, and no one will find it strange at all.

There is also a boy in college who is allergic to peanuts. He printed a small palm-sized card with a cute crossed-out peanut pattern on the front, which says, "I have a severe peanut allergy. Please don't feed me anything if you eat peanuts~". On the back is the emergency contact number and the emergency number of a nearby hospital. Every time I meet new friends or go out to dinner, I take it out and show it to everyone. It has become his social card. Everyone thinks he is very interesting and will take the initiative to help him check whether there are peanuts in the dishes.

In fact, to put it bluntly, allergies are just your body's "little temper" towards certain foods. It is neither your fault nor a problem that needs to be concealed. There is no need to eat unsuitable things to accommodate others, and there is no need to trap yourself in the shackles of "you can't eat anything." Try it a few times and slowly figure out your own safety boundaries, eat when you should eat and play when you should, and calmly respond to situations when you encounter them. After all, your life is your own, and you can't miss out on so many interesting moments just because of a few incompatible foods, right?