I live, which makes me very lucky

Yesterday I was standing over a mall toilet, trying to throw up this demon nut (legume, really) before it gets too deep in my bloodstream. This happens to me maybe once a year.

I’m very lucky.

Peanuts cause one of the most dangerous allergic reactions in the world. Some human bodies read it as an all out attack and unleash the full inflammatory response of the immune system, to the point of killing the host. I have felt this itchy symphony of chemical panic, and it sucks.

When I was a teenager I had some peanut at lunch and was walking back to school when I passed out in some leaves. Luckily my friend was home and I could ring the bell and pass out inside his door while he called an ambulance. I made it to the bathroom but things were constantly going black around the edges, because my blood pressure was dropping. I had to vomit and then I just had to lie there, suffering. The itchiness was on my skin but also, seemingly, inside my lungs and it was hard to breathe. At the hospital I think they just gave me anti-histamines and observed me. I remember sitting there, leaves in my hair, and how horribly itchy my sweater felt.

I was lucky. For some people if they don’t get an epinephrine shot quickly, they’ll die. Their throat will close up, their blood pressure will get precipitously low, they’ll die. Thankfully, deaths from peanut allergy are very rare, I think mostly because people are careful, and the treatment does work. Over the counter anti-histamines give a lot of relief, and Epi-Pens are effective in emergencies, though they seem to cost hundreds of dollars in America now.

Living With Food

As someone with a peanut allergy you mainly have to have a heightened awareness of food, depending on how severe your allergy is. I am not very good at this. I like to eat and I don’t like to be rude, so I have actually finished an entire meal which contained peanut, which made me terribly ill. I’m embarassed to ask what’s in a food and I will still go to Thai restaurants, which is effectively gastrointestinal roulette.

This is, I think, because my peanut allergy is mild. My worst case is that I spend a miserable night throwing up and sleeping on the bathroom floor. I have never had to find and inject myself with adrenaline to keep my throat from closing.

At the extreme end, some people have to eat at separate tables at food, or even tell other children to not bring anything with peanuts. They can’t eat birthday cake or sample things while travelling.

It’s a completely different attitude towards food that you may not understand if your food has never tried to kill you.

A Typical Reaction

Let me walk you through a typical reaction, for me. Yesterday I got an ordinary order (salted caramel) from a place I’ve eaten before. As I’m walking along something feels off, and this is what drives me crazy, I keep eating. The risk to reward is so off, but I often find myself still eating something which may hurt me. Sometimes I don’t want to be rude, sometimes I think about how much I paid for it, sometimes I’m just hungry. It’s insane but I can watch my brain being stupid and it just happens.

Then I bite into something which is definitely a chunk of peanut and I’m like, ‘oh shit’. I’m with my wife, thankfully, so I make a quick decision — either go home before my blood pressure drops or try to throw up now. Luckily I choose the latter. At this point I feel that itchiness and awfulness around my mouth. If the thing hits my bloodstream I’ll be itchy everywhere, seemingly itchy inside, and then of course the edges of reality will go dark.

I rush to the bathroom and stick a finger down my throat. Luckily it’s a nice bathroom. I hate puking (who doesn’t) but everything must go. I hate puking so much that I sometimes avoid this until my body compels me, but the sooner the peanut is out of me, the better I fell. Note that this is not medical advice, for some people vomiting may make it worse.

After slobbering all over my hand I final get through dessert and back to dinner and I feel better. Much better actually. I step back out and my wife has got me two Piriton, and over the counter anti-histamine. I pop these and then generally feel fine.

My wife said she was torn between caring for me and wanting to eat the offending ice cream, so she was running down the escalator eating two ice cream cones as fast as she could. She mercifully got rid of them before coming back.

This actually isn’t a typical reaction. I typically take Door A and go home, by which point my immune system has already gone crazy. For me, at least, immediate expulsion seems to work better.

Growing Out Of It

My particular allergy has gotten better as I age, as it does for around 20% of people. Perhaps through exposure, but largely through ‘who knows?’. Scientists don’t seem to quite understand where this allergy comes from, why it is reported more now, and how it works.

One thing that seems to work in children is starting with microscopic does and eventually working up to a full peanut. That is, you can develop a tolerance. For adults, there is a new drug which sells small doses of peanut flour for $4,200 a year. This has significant risk, however, as you are really just giving peanut to someone with a peanut allergy. Sometimes they have a reaction.

Getting Help

Right now, there is no cure. This is just the way my body is wired, and to survive in the world I need help. This is the main fact of living with a peanut allergy: you need support.

Allergies require parents, schools and also restaurants and strangers to help. They require the labeling for everyone to change (which it has) and restaurants to keep binders with ingredients and allergens. This, of course, doesn’t always happen, and varies significantly across cultures.

Peanut allergies have doubled in America recently and people there are aware. When I was in the UK if I mentioned my allergy we immediately we served by the manager, who had brought out these impressive binders with ingredients and allergens. In my home of Sri Lanka, however, people do not give a shit.

It’s not a common allergy here and you sometimes have to explain the entire concept of allergies from scratch. Presumably the weak just die here. In Thailand, for example, I doubt anyone with a peanut allergy has reached reproductive age. This could be partly due to early exposure, or some effect of too-hygenic an environment, but this makes no difference to me when I’m trying to order lunch.

Unfortunately in Sri Lanka, if I mention my allergy they can get confused and try to add extra peanuts.

Hence travelling with an allergy can be a very stressful experience, especially when there’s a language barrier. When I was in China I would often eat at Subway or KFC because I felt safer.

Living With It

For me living with a peanut allergy is annoying, inconvenient, but ultimately survivable. For some people it’s this constant threat in their lives, lurking in every cookie and buffet. It makes the social sharing of food difficult or impossible for some people, leaving them on the outside of every birthday party or lunch room.

For me it’s just the daily minesweeper of life. I just have to be aware, and quick to respond if it happens. For some reason this demon nut makes my body short circuit, and I just have to live with this traitor in my bloodstream. But, again, I’m very lucky, because I get to live to tell the vomitous tale.