World No Tobacco Day - May 31, 2011

The original title for this post was "Your Right to Smoke Ends at My Lungs". I took inspiration from my high school law teacher whose favourite refrain was "Your right to swing a golf club ends at my nose". It's a simple statement which applies to so many things in life. At its heart, it's a statement about being considerate of those around you.

I'm generally not a preachy sort of person and I definitely don't feel comfortable telling people what they can or cannot do. However, when it comes to my health and safety or that of people who cannot defend themselves, it's really difficult for me to keep quiet. 

So, I'll make this simple and try to lay out why I think smoking should be completely banned. I came to this decision after years of considering the matter and I didn't always feel this way. But, here it is:

1. No level of cigarette/cigar/pipe/hookah smoke is safe (World Health Organization, WHO).

2. Tobacco smoke and all of its inherent chemicals can remain on fabrics and in homes for seven days (Canadian Lung Association). This is referred to as third-hand smoke.

3. I can have (and have had) asthma attacks from sitting beside people who have recently smoked - third-hand smoke - or from walking by a smoker on the sidewalk - second-hand smoke.

4. Of all the things we need to do with the limited arable land in the world, why on earth are we wasting it on a product that can only cause harm and even kill?

5. Smoking can lead to cancer, heart and lung disease and a host of other health problems.

6. The economic costs of smoking (health-related and lost productivity) were over $11 billion in 1993. Even if that has decreased, it's a ridiculous waste of money.1

7. Approximately half of children are exposed to second-hand smoke on a regular basis. In children it can cause respiratory diseases and in young infants, death. "In 2004, children accounted for 28% of the deaths attributable to second-hand smoke." 2

8. "Tobacco caused 100 million deaths in the 20th century. If current trends continue, it will cause up to one billion deaths in the 21st century." 3

9. "Second-hand smoke has over 4,000 chemicals; many of them cause cancer. Two thirds of the smoke from a cigarette is not inhaled by the smoker, but enters the air around the smoker." 4 


10. My final argument is once again from the WHO:

"The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”

So, all of that being true, I cannot fathom why smoking of all kinds - cigarettes, cigars, pipes, hookahs - is not banned. Since it's not likely to happen in my lifetime, I'd settle for a comprehensive smoking ban in any public area or private environment where children under 18 are present at any given time. Children don't choose to become asthmatics and they shouldn't be forced into it.

I think it's pretty clear that I could come up with more reasons, but I'll leave it at that. For more information, I've included the references below and more links about tobacco and smoking.


References
1 http://www.cbc.ca/news/background/smoking/cost.html
2 http://www.who.int/mediacentre/factsheets/fs339/en/index.html
3 http://www.who.int/mediacentre/factsheets/fs339/en/index.html
4 http://www.lung.ca/protect-protegez/tobacco-tabagisme/second-secondaire/index_e.php

Links
Canadian Lung Association: Smoking & Tobacco
Canadian Lung Association: Second-hand smoke
World Health Organization: Tobacco Fact Sheet
World Health Organization: No Tobacco Day
Hookah smoking lounges face curbs

Atopic Girl on the Rails

As an atopic girl I have several issues when traveling.

1. I can rarely eat a lot (if anything) while traveling by any method of transportation. This requires bringing food (extra baggage). I cannot do this while traveling by air, but it's not a problem when I take VIA Rail.

2. While airlines seem to be decent about nuts (for the most part), my severe egg allergy is unavoidable. Save for cashews, egg contamination is much more of a worry for me than peanuts.

3. For some silly reason, some airlines in Canada have recently decided to allow pets to travel within cabins. There is no need for this and it's annoying to have to call airlines in advance to make sure I'm not seated anywhere near any animal should one be on board.

4. Smokers - I am very allergic to smoke. I can't sit near someone who has recently been smoking or someone who is a regular smoker. Walking into a building entrance covered with smokers or walking by a smoker on the street requires me to hold my breath. It's all enough to cause an asthma attack.

5. I also have to take every single medication I could possibly need...again, extra baggage. If I'm traveling outside of Canada, this also means ensuring that I bring the original containers with the name of the medication, pharmacy, dosage and doctor - not conducive to traveling lightly.

6. Finally, while there is "free" health care across Canada, a lot of people don't seem to clue in that health care is provincially-regulated. So, while I can get health care for free in Ontario, it is possible to incur costs in other provinces and not have all of those costs covered by one's home province. So, whether I'm traveling to Montreal or Texas, I have to get out-of-province health coverage, just to be safe. Air Canada makes this easy during the ticket purchase process through a partnership with RBC. Even if you don't want to buy RBC's coverage, it's still a good reminder.

I tend to travel by either Air Canada, who seem to be fairly decent with allergies (though not perfect yet), and VIA Rail. I have to admit an addiction to the latter. It's less expensive, relaxing and more environmentally-friendly. Plus, including the time required to travel to an airport and check in, the travel time is often comparable to taking the VIA. I also get VIA Préférence points which are invaluable and the Express Deals are phenomenally-priced.

Regarding my allergies, there aren't a ton of options from the cart, but I do appreciate the availability of Summerfresh Hummus and Crackers (dairy, egg, nut-free), decent wine, good tea/coffee and regular-flavoured chips (dairy, egg and nut-free). On my last trip, I noticed that VIA has a Vegetarian Salad. I stuck to my usual hummus and crackers, but I will have to check this out on my way back  home tomorrow to see if it's a new option. While VIA doesn't seem to offer peanuts, they do offer cashews. For people with specific allergies to peanuts this is great. Of course, if you have a severe allergy to cashews (like me), it keeps me vigilant (lots of hand washing). That said, I've never had a problem.

So, my trip to Montreal (a trip I've made a few times, though this will be my last for a while) was easy and uneventful. The WiFi connection (which is currently in a beta testing phase) was much more reliable and faster than before on both legs of my trip; so, I'm suitably impressed with that. I like having the choice to be productive or just relaxing with a book, music or movie.

VIA is also offering more opportunities to check baggage and given the amount  of health-related stuff I have to take along with me, I take advantage of this at every opportunity. I couldn't check my baggage the entire way this time, but on the whole, porters often help me when I have a heavier bag.

Since I've started this blog, I've also started to pay a lot more attention to how various organizations deal with allergens. So, I checked out VIA. As a current Privilège member, I have a coupon for 50 per cent off a Business class ticket, something I've always wanted to try. The benefits of Business Class aren't just the seats or the setting, but the meal. All the meals look wonderful and the vegan meals sound delicious. However, I can't escape the potential allergens (cross-contamination) in the food I would eat according to VIA Rail's website.

Obviously, there are difficulties and liabilities in promising meals that are free from allergens, not to mention the financial aspects of doing so on a large scale. Since I don't necessarily think VIA should take this upon themselves (though I'd appreciate it if they would), I would love to see a partnership between VIA and a restaurant like Zero8 or an allergy-friendly company to offer pre-packaged (and sealed) selections for their Business Class meals. I can't imagine a more perfect travel experience than sitting in a VIA rail car in the evening with a glass of wine and a delicious allergy-free meal.

As things stand, I'm a devoted VIA Rail traveller. It's easily the least stressful travel experience one can have - no traffic, no body scans and I can bring my own food. I appreciate the level of customer service and the pleasant staff. On the couple of occasions there has been a strong odour of cigarette smoke from another passenger, the car attendant has always let me switch seats without a problem.

I always look forward to my VIA trips and as an Atopic Girl, what else can one ask for?

Maybe I Should Wear A Sign

Well, not really, but after a while having the allergy/asthma/eczema talk with friends can get annoying. I thought about this recently after Anaphylaxis Canada's great PSA "First Kiss". While the kids are in their early teens, this is a process that I go through every single time I meet someone new.

So, when should you bring it up? Honestly, I'd rather not and in the past I've underplayed my allergies to the point of not mentioning them until I'm being fed oxygen by some really buff firefighters. So, I've realized that's not the best way to go about it and I try to be honest with people.

Boyfriends/Girlfriends
With the whole dating experience, it isn't the first thing I bring up. I've never had a meal with a guy I just met; so, I figure I'm allowed to decide if I like him before sharing. However, before a meal occurs, I do have a discussion. I let them know that I have severe food allergies, but I don't go into detail unless they ask, which they usually do. At this point, I let them know that they don't have to worry, but any nice girl or guy will. I let them know I have a MedicAlert bracelet which lists my allergies, an EpiPen/Twinject which I know how to use and an easily-accessible makeup bag with medications. I don't ask them to become familiar with using my EpiPen/Twinject unless the relationship progresses. I have the luxury of doing so due to the nature of my reactions. If you don't have the luxury, this might be part of your discussion. It might weed out the jerks too.

Don't be afraid of recommending or vetoing a restaurant (in the nicest way possible). First dates are not times to have reactions. Sure, they might happen, but you have every right to minimize the possibility. That said, I've made my fair share of concessions over the years and ended up eating my fair share of green salads and french fries.

I've also had to have the "kissing" discussion. Past boyfriends may have just had a coffee with milk before coming over and a simple kiss at the door results in hives all over my face. So, brushing teeth after that coffee and waiting at least a half hour before kissing becomes the norm. And sometimes, if the situation doesn't allow it, we just don't kiss. To the credit of the guys I've dated, I've never suggested the brushing thing. They've done that by themselves.

As for the eczema and asthma, those are conversations which I leave until the relationship is going somewhere. I've never met a guy who was turned off by either. I've been involved with a couple of amazing guys who could have cared less. Still, especially with eczema, the proof is visible but it's still personal and I think it's fair to keep that to yourself until you decide you're ready.

I don't date guys who smoke (I'm very anti-smoking anyway) or guys with pets since I'm far too allergic to pet dander/fur/whatever. I've told past boyfriends that if they've been around pets that I can't go near them since it can result in skin breakouts and asthma attacks. So, same as the brushing, they change their clothes before coming to see me.

Friends

I don't over think this. I tell them when I tell them. Usually if we're going out to eat. If they ask questions, I answer. When I trust them, I'll show them my kit. In the past, I've heard some stupid, insensitive jokes and I've let them go. Now, I have no problem letting people know what's appropriate and what's not. Most friends don't purposely try to hurt other friends and it's up to you to let them know when they're crossing a line, especially when it's unintentional. People often use humour when they're uncomfortable or unsure of what to do or say.

When I was younger, kids were a lot more vocal and cruel about the visible signs of my eczema. Since I've gotten older the comments are usually absent or at least voiced out of concern. Same thing goes with romantic relationships though - I don't discuss it unless I want to. It simply doesn't define me.

Employers
Employers are trickier than the rest. Once you're hired (and not a moment before), speak confidentially with the HR manager. To be cautious, it's best to document all interactions you have regarding this issue. While the majority of employers are accommodating, be wary of those who do not want to get involved.

I worked for a company which was understanding regarding my food allergies but I ran into constant issues regarding chemical exposure. I'm not generally overly-sensitive (I can handle some fragrances and room sprays), but there were constant lapses in how chemicals were being used on the premises. In my opinion, I was far too accommodating. So, my advice is not to be. Know your rights. In Ontario, employment standards are very specific and you can seek government compensation for days missed due to reactions from chemical exposure. Cleaning solvents, improperly ventilated shafts and insecticides are big deals when you have asthma and you shouldn't have to suffer or lose days of work (and pay) for your employer's misdeeds. Speak up. It's not an easy thing to do, but unfortunately employers need to realize that they can do real damage by being casually negligent.

The messages here are that it's your body and you need to feel comfortable disclosing information in a safe fashion. However, don't be afraid. Don't feel like you're inconveniencing someone. It's your life and your well-being that are at stake. I've had to remind myself of that a lot of times over the years and still do.

Eating Out with Allergies

Eating out can suck or be wonderful. You can have an allergic reaction because your server was a dork and didn't listen (or didn't think of cream cheese as dairy) or discover new and wonderful foods you've never had before. I thank the Japanese for sushi every time I have it.

So, if you want to eat out, doing the following can help a bit.This is a bit of a long post, but it's based on decades of experience; so, I hope it helps.

1. Check out the restaurant's website to see if you can find something that might work.
2. Call ahead to find out if they can accommodate you. At the very least, give them a head's up. It's just a nice thing to do. Plus, you can often get a sense of how allergy-aware the restaurant is before walking in.
3. Take a physician-approved anti-histamine 30 minutes before you leave, especially if you haven't been there before.
4. Have a printed list of what you're allergic to, including derivatives, to give to your server. (i.e.: egg: albumen, lecithin, etc.) They're busy and again, it's just a nice thing to do. Here's the link to my template or you can order a personalized card from Allergy Translation. They offer translations and free chef sheets; so, it's wonderful for travelling.
5. If your server doesn't repeat it back to you, repeat it back to them. Ask them to write it down if you don't have a card.
6. If you're still not comfortable with the server, ask to speak with the manager. Some restaurants are great with this and their policy is to have the manager come out to speak with you. Some restaurants have recipe books - ask to see it.
7. Check the food out before eating. I always ask whoever is actually putting the food in front of me if the dish is free of my allergens. If they don't know, they usually do a double-check with the kitchen. This little trick has saved me on a couple of occasions.
8. Try the food slowly. No sense digging in only to find someone put butter all over everything.
9. Always, always have your MedicAlert bracelet, EpiPen, anti-histamines and any other approved medications.
10. Let the restaurant know they've done a good job (assuming they have). I always fill out a comment card or speak to a manager regarding a great server, great chef and great experience. Sending a thank you card is also a nice thing to do.

I've been to restaurants and done everything right, but before ordering decided the server and manager weren't taking my allergies seriously. So, I've walked out. Be prepared to do so. It can be embarrassing and uncomfortable when you're with friends, but I've never been with anyone who didn't understand. Usually, they're more upset than I am.

If all your hard work hasn't worked out and you do have an allergic reaction:

1. Obviously, take your medication as directed by your physician. Inquire about EpiPen/Twinject, standard anti-histamines (liquid forms may be faster) and medications such as Losec (acid inhibitors).
2. Take your injector and always go to a hospital or call an ambulance. Ignore anyone (including doctors) who tell you that you don't need to go to the hospital. Do not throw up the food. Simply take medications as directed and seek emergency assistance.
3. Ask your companion to speak with the restaurant to find out what you may have reacted to, especially in cases where you have multiple allergies.
4. Once your reaction is under control, inquire about post-reaction follow-up. This usually includes diphenhydramine (commonly known as Benadryl), but I've found that a low-dose, short course of Prednisone can assist greatly with the after effects. Speak to your doctor about the risks of low-dose Prednisone first and if it's right for you. If your ER doctor doesn't prescribe it, feel free to ask if it's a good option for you.
5. Complain. Call the restaurant and let them know you were displeased with their service. Write a review on AllergyTrails. Consider contacting the Canadian Food Inspection Agency (depending on the circumstance) or the Canadian Restaurant and Foodservices Association (CRFA). The latter is an organization for restaurants, not customers, but they have a voluntary food allergy awareness program. In the past, I've contacted the CRFA and they have contacted the restaurant to remind them of this program.

Whew! If you have any tips or tricks that have literally saved you or someone else, let me know!

Food Allergy Awareness Week (In Canada) Part 2

So, I had no luck with Twitter. Lots of stuff going on in the U.S., but the EpiPen/AAIA Take Action event is all I can find in Canada! Next year, that's going to have to change. I hate waiting.

But, Allergic Living's handy newsletter arrived in my email inbox this morning. (It's not possible to express how much I love that mag and website.) According to them, it is Food Allergy Awareness Month. So, I'm very slightly vindicated.

There seems to be so much stuff going on in the U.S. and I hope we can get up to that level. Since I'm new to the allergy community in general (strange considering my background) I'd love to hear about anything going on anywhere. If I'm missing something in Canada, please let me know, too.

On a vaguely related note, thank you to Bell Canada for your $10 million donation to Toronto's Centre for Addiction and Mental Health (CAMH)! That's community involvement! To read one of the many articles, click here. Everyone benefits from that kind of contribution whether they use CAMH's services or not.

On that note, I'm going to try and enjoy the sunny (and "pollinated") day! Apparently we only have about 90 days of summer; so, I have to take all the sunshine I can get. Technically, it's still spring...

Food Allergy Awareness Week (In Canada)

Created by The Food Allergy & Anaphylaxis Network (FAAN) in 1997, this is the 14th Annual Food Allergy Awareness Week (FAAW). The posts on Twitter and FB are plentiful and helpful. The Allergy-Free Boston Cream Pie recipe posted by Cybele Pascale, award-winning author of two allergy-free cookbooks, looks amazing.

So, what's going on in Canada? FAAN is well-known up here, but it is primarily American. While the information is useful, the programs don't apply to allergic and atopic Canadians. FAAN is a member of the Food Allergy and Anaphylaxis Alliance (FAAA). Here in Canada, we have two organizations which are also members - Anaphylaxis Canada (AC) and the Quebec Food Allergy Association (AQAA).

So, I searched on Google (apparently they don't want their name to be used as a verb anymore) for events. For Canadians, FAAW was actually last week, May 1-7, according to the Allergy Foundation of Canada, which doesn't really exist anymore. Last year, May was Food Allergy Awareness Month (FAAM) according to Anaphylaxis Canada. But, this year...no mention of it. Even the link on Health Canada's website has generic info. AC hosted their Spring Conference at the Ontario Science Centre on May 7th, which I missed, unfortunately (Next year!).

EpiPen and AAIA have food allergy walks planned across Canada, but other than that I'm stumped!
There's no mention of FAAW or FAAM on either site.
At this point, I'll admit my confusion. So, I'm taking this to Twitter to see what I can find. Feel free to comment, too.

I Lied...But I've Made Amends

I promised I'd put up some more reviews on restaurants and the like. However, since that post, so long ago, I've found someone else who's doing a far better job than I could ever do.

AllergyTrails (check out the link on the right side of the page), founded by Robert Kania, is an international review website for restaurants and airlines. So, I've started putting up my restaurant reviews on his site.

I encourage everyone who reads this (there's got to be a couple of you) to visit the site and review a restaurant, any restaurant. This is an invaluable resource for all allergic people in the world. I'd also like to hope that it will bring attention to a serious issue and hopefully force delinquent restaurants into changing their practices and recognize great restaurants for their dedication and care.

In future, if I've had an amazing experience (like Zero8), I will post here and there, but other than that, I'll focus on the million other things related to being atopic in Canada. I'm trying out a bunch of new creams and cleansers right now as a result of my visit to AvantDerm (see the post "Toronto in the Spring") and trying to manage the lovely blooms with a combination of topical and systemic meds. So, those two things alone are worthy of a couple of blog posts.

And, I've finally figured out how to get the allergy-card template up for download; so, that will be posted shortly! In the event any Americans are reading, Happy Food Allergy Awareness Week!

EpiPen® TAKE ACTION Event

EpiPen, in support of the Allergy/Asthma Information Association (AAIA), is holding a series of Canadian food allergy walks to raise money for anaphylaxis research and education.

For more information, to register or donate, please visit http://aaia.raiseapp.ca

The EpiPen® TAKE ACTION Event Locations and Dates are:

• Kelowna – City Park - Saturday May 7
• Ottawa – Ottawa River Parkway Trail at Tunney’s Pasture - Saturday May 7
• Whitby – Heydenshore Pavilion, adjacent to Whitby Waterfront Trail - Saturday May 14
• Vancouver – Stanley Park (Ceperley Park by Second Beach) - Saturday May 14
• Winnipeg – Assiniboine Park - Saturday May 14
• Windsor – Riverfront Trail (Dieppe Gardens) - Saturday May 28
• Mississauga – Erindale Park - Sunday May 29

Mental Health Week - May 1-7, 2011

I've posted about depression and its connection to allergies, asthma and eczema, especially for those who have all three conditions. It's the fourth disease that is often included for people with multiple atopic conditions. Discussing mental health is becoming more mainstream, finally, and this week is Mental Health Week. While it seems to be starting off small, it's a great start for a crippling condition that affects people across Canada, regardless of other underlying conditions.

Check out the website and find out how you can participate in your area.