Peanuts, walnuts, cashews, soya, apple, strawberry, cherry, carrot, peas, celery – these are just some of the foods that 29-year-old Canadian Kortney has to avoid. She writes about her experiences with food allergies and shares tips and recipe alternatives on her website, www.allergygirleats.com.
As a baby, she was diagnosed with several allergies. She had her first allergic shock at the age of 12, and the second one eight years later. There is a long list of foods that she must avoid. Some of her food restrictions are based on her paediatrician’s advice. But she also knows from experience that she must avoid certain other foods.
She has accepted that allergies are a part of life since she was a child. But lately she has been wondering whether she could now to tolerate some of those ‘forbidden’ foods. An allergy check-up will provide new information. After a preliminary consultation at Allergie-Centrum-Charité (ACC) in Berlin, Germany, she has been booked for a skin test and a blood test.
Memories of the allergic shock
It is a cold winter’s day when Kortney arrives at ACC at eight in the morning. She hasn’t slept well. She has been feeling uneasy thinking about the peanut allergens being applied to her skin. After all, she has already had an extreme allergic reaction to them and would rather not repeat the experience. But the risk that the skin test will trigger such a reaction is very low. For added safety, intravenous access has been set up so that medication can be delivered quickly in case of emergency. She also has to stay for a few hours after the test for observation in the day ward. Given Kortney’s history, the doctors don’t want to take any chances.
In the treatment room, nurse Susanne asks Kortney to lie down on the reclining chair and put her forearm on the armrest. She is performing a prick test. First she applies nine small drops with various test solutions on the skin. Seven of them contain food allergens and two are for the control: histamine, an allergy messenger substance that will trigger a reaction regardless, and a saline solution, which normally causes no skin reaction. These substances are used to determine whether the test can be evaluated.
The nurse then uses a lancet to lightly scratch the skin under the drops. She marks the areas with a pen and sets a timer. After making sure that Kortney is comfortable, she leaves the room.
Carrot, crab and red hives
The nurse checks in on Kortney. Her arm has started to itch severely in several places and red hives are appearing, but the nurse is not worried. “This is a sign of allergic sensitisation, but no cause for concern,” she explains. After around 20 minutes, the intermediate results are read. The nurse measures the diameter of the red hives with a ruler and writes everything down. Then the next test solutions are applied. The procedure is repeated a total of 26 times: apply the drops, scratch the skin, wait and measure. After one and a half hours, the standard allergens from all kinds of foods – cow’s milk, carrot, crab, and many more – have been test. Kortney’s arm looks as if it has been scribbled on. There are pen marks all over it and a lot of red hives, but she doesn’t mind. If anything, she is relieved that nothing bad has happened. It’s nearly over. All that’s left now is to be tested for foods that are not in the standard solution.
Shopping for the allergy test
In the preliminary consultation, Kortney told her doctor that she suspects she might also be allergic to certain other foods. She was instructed to buy some of them and bring them to the appointment for the test. Now she puts packages of beans, pumpkin and sunflower seeds, poppy seeds, red pepper and pine nuts on the table. Nurse Susanne can begin the “prick-to-prick” test. She puts small amounts of the foods into different bowls and pricks them with a lancet. Then she finds some free space on Kortney’s forearm and pricks the surface with the same lancet. She notes the reactions after around 20 minutes. Kortney has a peek at the test results – she would like to know what the outcome is, but she will have to wait a bit longer. They will go over the results once the blood test has been analysed. And that will take some time.