Monday, January 30, 2012

My Allergic/Atopic Valentine

Chocolate, flowers, stuffed animals, perfume and jewellery - that pretty much sums up most Valentine's Day presents. Not that there's anything wrong with them, though I'm not sure what to do with the stuffed animals, except give them to my niece.

So, I think we can do better. And, if you have an allergic/atopic girlfriend or boyfriend, I know we can do better.

1. Massage - You have two choices here. DIY or book a single or couples massage at a spa. If DIY, look for a basic massage oil that does not contain your beloved's allergens. A massage oil with a grapeseed base is usually pretty safe. Common allergens found in some massage oils are sweet almond oil, soybean oil and other nut oils. If in doubt, buy a pure, food-grade grapeseed or avocado oil from your local health food store. To make it a little bit more aromatherapeutic, add a couple of drops of lavender or rose. Stay away from essential oils like peppermint since it's an irritant. Remember that many essential oils can irritate if applied directly to the skin, undiluted. Just a couple of drops pre-mixed with the massage oil will do. A note about fragrance, just because it's pure, doesn't mean it's problem-free. Even natural scents can cause respiratory, nasal and/or skin reactions, like contact dermatitis . If in doubt, skip the scent entirely. Focus on creating an inviting atmosphere with heated towels, relaxing music and unscented candles.

If you've decided to go all out and book a massage with a registered massage therapist, do your research and pick a reputable place like spas in hotels or salons that carry your favourite vegan brands. When making the booking, make sure they are aware of your girlfriend's/boyfriend's allergies and can accommodate. If you get the sense that they don't "get it" over the phone, find another place or find another gift.

2. Chocolate - Good quality chocolate that is free of dairy and nuts is a difficult thing to find. Cross-contamination is a common thing in chocolate processing. There are some allergy-free chocolates available, but sadly they're not always great quality. Pacari is a great chocolate since it's pretty much dairy-free. However, there are nuts in some of its products. However, chocolate availability is different from city to city. So, find your nearest and best chocolate boutique and have a face-to-face conversation. When chocolate wrappers say "may contain", it usually does contain. This year, Ange Gardien (located in Boucherville, Quebec) is offering lovely, boutique-style chocolates which are egg-free, nut-free and dairy-free. Any guy who did his research and bought me these, would definitely be in my good books!

3. Jewellery/Watches - You really can't go wrong here, as long as you're buying something of quality. Be aware of nickel allergies. If you're buying that stunning, diamond solitaire in a platinum band, you're probably okay. Local artisans are very aware of what they use in their jewellery; so, email or talk to a designer your beloved admires in order to find something that works. Something else to consider this year is MedicAlert's line of beautiful and casual bracelets - leather, beads, crystals and silver. These might not be worn everyday; so, a special and thoughtful gift for that special someone is appreciated. Make a gift certificate for them and participate in the ordering process.

4. Flowers -With flowers, unless you know for certain that your Valentine is okay with them, it's best to avoid this entire gift giving category. If you decide to go ahead because of experience, stick with low-pollen flowers, like orchids, hydrangeas and pansies. CasaSugar has a great list of Low-Pollen Flowers. What's available will depend on where you live; so, ask your florist for advice.

5. Dinner - Those of us with food allergies can get a little tired of always having to interrogate the restaurant staff about everything before we put it in our mouth. So, once again, you have two choices, DIY or find a safe place. In the case of DIY, it's more than okay to discuss with your girl or boy ahead of time if you don't know everything he or she is allergic to. Ask questions and be interested. It shows a level of dedication that is certainly romantic.

If you're going to take your sweetheart out to a restaurant, try to stick to either a cuisine or restaurant with which they're comfortable. Valentine's Day is about being romantic and showing you care, not having an adventure (a.k.a. trip to the ER). Talk to your significant other and make sure they're comfortable and call the restaurant ahead of time to book and discuss allergies with them. Valentine's Day is busy; so, make time a few days in advance to speak to the chef and advise him or her of the allergens to be avoided. On the day of, tell your server of the allergies and that you've spoken to the chef. A written card with the allergies on it is a great way to make sure no miscommunication happens on a busy night. Review my previous post "Eating Out With Allergies" for more tips.

6. Perfume/Cologne - Skip it. With the countless chemicals and scents contained in any vial of perfume, you're doomed before you begin with this present. From contact dermatitis - allergic and irritant - to asthma and nasal reactions, you can't win. So, unless your darling has requested something specific, keep shopping.

7. Movie Night - This can be as simple as agreeing to see something at the theatre (that you wouldn't otherwise agree to) or spending a wonderful night in with a few movies, wine and allergy-free snacks. This can be as fancy or as casual as your relationship calls for.

The real advice here is to think differently. Valentine's Day is a day to go out of your way to show that special someone you love them. It's not about the amount you spend, but how you spend it. For anyone with atopic conditions or allergic conditions, there are things that are difficult to arrange or obtain. Really think about it. Is it an allergy-free dessert that they didn't have to bake themselves? Perhaps a nice dining experience in which you've already briefed the chef ahead of time so they don't have to. Maybe it's their favourite moisturizer that they have to mail-order to get or a set of bamboo sheets in a beautiful colour so they can have a good night's sleep.

In the end, maybe it has nothing to do with allergies or atopic conditions at all. A visit to a great art gallery exhibit followed by drinks at a nice wine bar can be a great way to spend an evening. Romance is in the eye of beholder.

Saturday, January 21, 2012

Improvement or Cure?

I used to work in a ophthalmology clinic. When I first started, part of my duties included talking to patients about their treatment options and what they could expect after treatment. The big word was "improvement" - one we've all heard, but one that means so many different things. In a medical setting, the word "improvement" is not synonymous with the word "cure". In an ophthalmology clinic, improvement could mean better contrast or reading an extra line on an eye chart. It is almost never perfect vision. Improvement, especially in cases of allergy and atopy, can mean a partial or temporary alleviation of symptoms.

The reason why this is important to understand is because thinking about allergies and atopic conditions in these terms can help one cope throughout life. It's optimism tempered with reality. There may one day come a cure (hopefully, soon), but until then, there isn't. So, instead of chasing non-existent cures or expecting miracles from any kind of treatment, what parents and patients should be looking for is the treatment option that leads to the best improvement.

I'll use my atopic dermatitis as an example of improvement. My skin has been visibly affected by over three decades of trauma. At present, I do not have any major flare-ups. Everything is under-control. So, at this moment, it's a question of maintenance. To maintain this level of improvement, I have to ensure that I continue my skin care regimen. It's not romantic or miraculous. I never found a cure and no one thing has lead me to this level that I am at currently.

Still, it's improvement. I don't lay awake itching like I did as a child. I don't have to put socks over my hands, but I do keep my nails short. I don't have to use corticosteroids every day, but I always have some on hand in case I need it.

I like to brag that my immunologist gushes about my skin whenever I see him. Not because it's flawless, but because the texture has improved. It's not something I could have imagined when I was young. I also couldn't have imagined that I would wear t-shirts, despite the areas of depigmentation on my elbows. More importantly, I never guessed that I would genuinely like the way I look when I see myself in a mirror.

All of that is improvement. It's not a cure, but it's pretty spectacular nonetheless.

Wednesday, January 4, 2012

Travelling With Food Allergies on VIA Business Class

To know me is to know I love travelling by train, specifically VIA. It's one of those "proud-to-be-Canadian" things. I've been travelling on VIA for about 15 years and I've always looked forward to my trips. For every bad experience (screaming children, chatty university kids who don't use headphones for their music and chatty people on mobile phones), I have at least three good experiences.

So, it is no wonder that I was looking forward to my first Business Class trip on January 2nd. I got to the station earlier than usual just to hang out in the Panorama Lounge. Totally worth it. And, while I ordered the strict vegetarian meal (a.k.a. vegan) for my on-board meal, I knew there was a chance that I might not be able to eat it since nuts could be involved. VIA states on their website: "VIA cannot guarantee that its meals are free of all products that could cause allergies."

It was with absolute glee that I found out I could eat the meal since there were no nuts. The attendant was kind enough to get my permission to check the meal itself before she served it. The nature of my allergy to selected nuts is such that I have to worry about certain nuts in food more than cross-contamination. I certainly wouldn't recommend this course of action for anyone else.

So, in the end, the entree itself was not the problem - in terms of allergies. Sadly, it wasn't at all appetizing. I couldn't bear to finish what only looked like a delicious rice and chickpea dish. What did shock me was what was included as part of the meal - CoffeeMate and Canola Harvest margarine. While I know first hand that CoffeeMate has dairy (that was my first sign that my dairy allergy was worsening way back when and it says it contains dairy on the package), I could only suspect that Canola Harvest margarine likely contained whey as most margarines do. I only know of a few exceptions amongst typically non-vegan brand names - Fleischmann's and Becel Vegan. A quick email to the company confirmed that there is whey (and soy) in the margarine. So, a meal that is considered vegan, which is of concern to those with allergies and ethical considerations, includes items which contain milk.

Of course, I did what any food allergy blogger would do, I emailed VIA next. I've submitted complaints and praise on a couple of previous occasions and I've always been more than pleased with their response. Not so in this case.

I received a very generic form letter, complete with spelling errors and, quite humorously, it was even addressed to Mr. Tristan Joseph, even though my gender was clearly chosen in the email form I sent them. There was no mention of my specific complaint. I received an apology and a promise that it would be sent to the relevant manager.

An apology is appreciated, but it's not what I want to see happen. What I proposed and what I would like to see is the following:

1. Do not include items with dairy or egg in the strict vegetarian meal. If a special meal is not supposed to contain certain food items/ingredients, do due diligence and ensure all products meet those criteria.

2. Include ingredient listings for food items like bread, chocolate, margarine and salad dressing (which do not come with ingredients) on-line and on-board. I will happily go without if it contains my allergies, but it would be a small and welcome change.

3. Basic food allergy training for attendants who deal with meals. Lactose intolerance is not a dairy allergy, but I cannot expect an attendant to know that if that attendant hasn't been given the tools or knowledge. This would help them from making claims out of ignorance which has happened in restaurants on too many occasions.

In short, if you are a vegan or have a food allergy and are travelling in VIA Business Class, be prepared to not eat parts of the meal. Since you can't walk out the way you would in a restaurant you didn't trust, politely and kindly tell the attendant why the meal isn't safe for you. Remember that they have nothing to do with the preparation which is all done off-site. Send an email to VIA via their Contact Us page. Plus, always have some allergy-friendly snacks as a backup.

NOTE: Somehow I cut this part out, but it's worth including. Most VIA snacks which could potentially contain peanuts (pretzels, snack mixes) seem to be peanut-free. On that note, I'm not advocating for any food bans on-board. Business Class is predominantly booked by adults who have a greater ability to analyze potentially allergic situations than children.

UPDATE 05Dec12 - @VIA_Rail read this post and replied within 24 hours. I have to say their Twitter team is always on the ball. Obviously, they're not in a position to make promises or changes, but I hope that the management teams in charge of meal services and service delivery (as noted in @VIA_Rails' tweet) do take this seriously.