How hospice became big business. A new investigation in The New Yorker reveals an industry that at times puts profits before patients.
Twelve million Americans suffer from food allergies, with reactions ranging from annoying itch to death. The incidence of multiple food allergies is on the rise. We all know someone with a food allergy, but misunderstandings abound. New mothers get conflicting advice on when to feed children peanuts. Someone who thinks he is allergic to milk, might just be missing the enzyme to digest lactose. It’s easy to feel overwhelmed. But one woman with more than a dozen food allergies says those who suffer don’t have to be victims. Diane and her guest discuss how to live and thrive with food allergies.
- Sandra Beasley Author and poet
Read an Excerpt
Excerpt from “Please Don’t Kill the Birthday Girl” by Sandra Beasley. Copyright 2011 by Sandra Beasley. Excerpted here by kind permission of Crown:
MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Throat swelling, trouble breathing, rashes, hives, vomiting, those are just some of the things that can happen to Sandra Beasley when she eats. In a new book, the award-winning poet describes growing up with more than a dozen food allergies. She examines the ways in which food shapes not only our bodies, but our relationships and our sense of self.
MS. DIANE REHMHer new book is titled "Don't Kill the Birthday Girl" and Sandra Beasley joins me in the studio. I know that food allergies are very much around all of us, whether it's within us or our children so do join us, 800-433-8850. Send us your e-mail to email@example.com Join us on Facebook or Twitter. Sandra, it's good to meet you.
MS. SANDRA BEASLEYHi, happy to be here.
REHMYou've got lots of food allergies. Tell us what you're allergic to.
BEASLEYOh, goodness. Well, some of the most significant allergies are dairy, egg, soy, beef, shrimp, some tree nuts, such as cashews, macadamia, pistachio, some forms of melon, like honeydew and cantaloupe, all the way down to mustard and swordfish.
REHMMustard and swordfish. Now, all of this must have come slowly, gradually as your mother learned about you as a baby.
BEASLEYWell, in my first month, I had quite a bit of difficulty feeding. I rejected my mother's breast milk, which we realized, in hindsight, might have been because she was eating so many things I was allergic to. But when they tried to use any of the usual supplements, cow milk, soy milk, goat's milk, I rejected them all. So I went back to the doctor after the first month very underweight and that was when they realized something was wrong.
REHMAnd what did they begin doing when they realized something was wrong?
BEASLEYWell, the thing is, in the first year, a child's body isn't developed enough to exhibit some of the responses that we use to diagnose food allergy later in children so I was put on a very, very simplified diet, really pineapple juice, a supplement called Calglucon, a lot of water and a lot of rice. And then it was only as I grew older and they attempted to gradually introduce other foods into my diet that they realized how broad the spectrum of my allergies was.
REHMHas anyone tried to figure out why all these allergies have come to you? Are there people who have such broad allergies in your family?
BEASLEYWell, it's demonstrable that you can inherit a predisposition to have food allergies, but you don't inherit specific allergies. And I certainly won the jackpot in terms of picking up allergic traits from both sides of the family. You know, I think that one of the things that is so frustrating is we don't know what causes food allergies to develop.
BEASLEYFive years ago, we were telling mothers to avoid eating common allergens while they were pregnant or giving them to children in the first year of their life. We've now reversed that advice. We tell mothers to not hesitate to feed on common allergens and we say that beyond the first four to six months, you can feed a child anything. There's no point in restricting arbitrarily. So the science is just very much in flux.
REHMThe rules keep changing and that leaves people confused.
BEASLEYConfused and concerned. I think so many parents see this as a prohibitive element for their child's young years, that it leaves them feeling very helpless to not know how to protect against it.
REHMI understand that in many elementary schools or even upper schools, for example, peanuts are not allowed, cupcakes not allowed, chocolate not allowed. Did you go through that?
BEASLEYNo. In that sense, we're really seeing a cultural shift. When I was a child, food allergies were not nearly as common and peanut allergy, in particular, was not as prevalent as it is now. So I never had a peanut-free zone or a table at the cafeteria reserved for me and I think that these efforts are, in many ways, beneficial to, particularly young children who might not know how to keep themselves protected. But it's a shift. We need to recognize that it is a cultural shift.
REHMDid you go through a series of injections to try to help you with your allergies?
BEASLEYMy first visit to my allergist was on my very first birthday.
BEASLEYHe was a local physician who actually oversaw my allergies for a full 30 years. He just retired this summer. And for the first 14 of those years I did receive weekly allergy injections, in part because I had so many other environmental allergens which is very common, asthma and hay fever, ragweed allergy, pollen allergy, dust allergy, very, very concurrent with these allergens.
REHMSandra Beasley, you could have spent your whole life in bed.
BEASLEYIf I had that option now, I might choose it, but at the time I had to get out in the real world and do some living.
REHMSo you went to school. You were with other children. What happened when those kinds of potential disasters were right there in the classroom?
BEASLEYWell, there are many casual ways in which we're exposed to food not through the cafeteria. For example, it used to be that the tempera paints that they would use for holiday decorations would have egg in them and that's still the case in some schools.
BEASLEYSo my mother remembers me coming home from one Thanksgiving celebration all dressed up like a Native-American and just my face covered in hives, but I had no idea from handling it. Things like we used to make peanut butter pinecone bird feeders. We don't do that anymore, you know, and I had -- for the most part, my classmates tried to be kind. There was definitely some bullying. I can remember people threatening me with milk cartons in the lunchroom, which is a little silly.
BEASLEYI can remember kids tackling me at PE and saying, you know, it seems like you have it so easy. You don't have to clean the cafeteria tables. I want to catch food allergies. They'd rub up against me hoping to contract whatever mysterious thing it was I had.
REHMBut now it does seem as though many of these allergies are potentially life-threatening?
BEASLEYYes. And my allergies always had the potential to shut down my breathing, to induce what's known as anaphylactic shock or an anaphylactic reaction. My parents recalled driving me to Nashville for a work trip when I was only three, feeding me a crumb of buttermilk biscuit off my father's plate not realizing yet how bad my allergies were. And just the horror of being far from home, just off the road and watching as your child's face swells and her breathing grows hoarse...
REHMWhat happened then?
BEASLEYWell, we were -- now what would have happened was probably I would have been administered Epinephrine and rushed to the hospital, which is probably the best and appropriate response. We were of a generation where we -- you know, I took Benadryl, I waited it out. And the next morning we had to go right back to that same hotel restaurant and try again.
REHMSo your purpose in writing this book is surely not just to tell the world about your allergies.
BEASLEYAbsolutely, yeah. I mean, on one hand, I did want to tell the story of someone who was not only a child with food allergies, but a teenager, a young adult, a grown woman with food allergies. However, in "Don't Kill the Birthday Girl," I wanted to really get out there and look at the latest science, the cultural histories of food allergies and really meditate on the ways in which food is not just sustenance, but something that is a social fabric.
BEASLEYAnd looking at the rituals and the ways in which something as simple as taking communion in church becomes very complicated if you have a wheat allergy. And just be very honest about some of the issues and see if we could tie some of the threads together.
REHMActually, I gathered that particular issue had been taken up with the Roman Catholic Church?
BEASLEYIt has, yes. And you will hear anecdotally that some individual churches have decided to relax their dictate, but the official Vatican stance is that you must have some gluten present in a communion wafer in order for it to be valid. They recommend a particular low-gluten wafer that's made out of, I believe, Missouri, by a, you know, a convent. And for any parent of a child with food allergy who has seen the severity, that's a completely unacceptable option.
REHMTell me why you chose "Don't Kill the Birthday Girl" for your title?
BEASLEYWell, when I had birthday parties as a kid, and I think that this is a theme for many kids with food allergies, I didn't want to be different. I wanted my friends to enjoy the birthday treat and that meant that in addition to whatever was safe for me, whether it be some special apple sauce cake my mother made, I would want ice cream and cookies and the Duncan Hines mix, what everybody else craved.
BEASLEYHowever, once all the other kids had eaten that treat, I had to be careful because a casual touch, a kiss on the cheek, a moment where somebody accidentally drank out of my water glass could eventually cause an allergic reaction that would shut down the party. So my mother or myself or some member of the family would say, don't kill the birthday girl, and it would be that gentle reminder to everybody that we had to be careful.
REHMBut Sandra, it almost sounds as though you'd have to live in a bubble to protect yourself from that casual touch, that kiss on the cheek, that glass somehow picked up by someone else.
BEASLEYWell, one way in which I am slightly different from a lot of younger children with food allergies is that I grew up in a reality where I was going to have casual reactions. My allergies were too multiple and too severe to completely keep myself safe, so to speak. And so even if we tried to have a bubble, the world would have burst it lickety-split and the thing became finding a balance where I could recognize the importance of protecting myself, but not always presume or rely on the rest of the world being as focused on that as I was.
REHMSo how do you make sure you protect yourself?
BEASLEYIt's the little things. If I'm going on a first date, I'll try to pick a restaurant where I know the cuisine is friendly. I won't pick an Italian place where there's a lot of cheese. I'll pick sushi or something like that, lots of little things we can do.
REHMSandra Beasley, her new book is titled "Don't Kill the Birthday Girl: Tales from an Allergic Life." Short break and right back.
REHMWelcome back. Everywhere we look, we find food allergies. Some people would say they are indeed on the rise. My guest today, Sandra Beasley, is one who has multiple allergies. She's written a new book. It's titled "Don't Kill the Birthday Girl" which has a cupcake with M&Ms on the icing, but a skull on the cupcake. So you gotta be careful don't you, Sandra?
REHMVery careful. What about -- a number of people want to know, what about peanuts?
BEASLEYWell, peanuts are actually not one of my allergies. And so one of the things that I've tried to connect with, with the current generation of these younger children where peanuts is, in fact, the number one allergy, followed closely behind by milk and shellfish, two allergies I do have, is how peanuts are different. And one of the concerns is that the peanut protein is particularly versatile in its ability to cause reactions. And that's why there's this concern over -- on airlines and such is that the community force of every seated passenger opening a small packet of peanuts at once, that protein is released into the air that's then re-circulated because it's an airplane.
BEASLEYAnd so in this way, the threat of peanut allergy and inhalation reactions is slightly different, slightly more intense, although in some ways comparable to the experience I'd have as a kid in movie theaters where if somebody sat next to me with a thing of buttered popcorn in their lap...
BEASLEY...I would often have to get up and move or deal with itchy eyes throughout the movie.
REHMYou had an experience on a plane once with the -- with a child who was the child of a member of congress.
BEASLEYWell, it was not my experience, but, yes, there was a wife of a Senator who was accompanying their -- her small child on an airplane and experienced what, in her judgment, was a secondary reaction to some type of contamination, not in her row, not -- you know, maybe a few seats back. And that resulted in an anaphylactic reaction. Now, the difficulty is you hear about these stories and you're protective of the children and you're not doubting...
BEASLEY...that particular reaction. But at the same time, if we have a minimum of 12 million Americans flying -- well, 12 million Americans with food allergies, certainly more than that flying, the proportion of those handful of cases, as terrifying as they are, still is not a compelling reason to have a government mandated policy necessarily about how to handle food allergens on planes.
REHMSo you would be against the banning of peanuts on planes?
BEASLEYUntil we have more data. The reality is we don't have a lot of, you know, scientific studies of airborne anaphylaxis, if that's a proper phrase. Now the food allergy initiative, and there's some other groups that are pushing for us to get the information we need.
REHMHere's an e-mail from Karen who says, "My daughter was like your guest, allergic from day one. She's thrived after eliminating milk, wheat and all nuts. But a good diagnosis took more than seven months to get. Any recommendations for getting a diagnosis?"
BEASLEYYes. It's important to understand that there are three primary diagnostic tools used to identify food allergies. One is the gold standard of an oral food challenge, which ideally is administered in a doctor's office with a blind where it's just that simple. You take a bite of the food and you wait to see what happens. There's also what's often referred to as a prick test, a skin test where you have a little bit of pin pricks and a little bit of the allergen applied and they wait to see what the skin reaction is, and a blood test, a RAST test.
BEASLEYNow, the thing about the blood tests are parents are often drawn to them because they're the least scary for the child. They're non-invasive. The unfortunate thing is that they tend to return a lot of false positives. My blood RAST test claimed I was allergic to rice and pineapple, two of my staple foods. And so it's -- the importance with diagnosing food allergies is to understand that you have to have proof on at least two and ideally three of these different diagnostic tools.
REHMI see. And Rona in Gaithersburg wants to know why you think these allergies are on the rise.
BEASLEYWell, it's difficult because the simple answer is we do not know. And there are patterns of incidents of food allergy. For example, African-Americans and those in the Asian population are currently showing more rise than whites in America and, in particular, Hispanics, which have a relatively low incidents of food allergy. We don't know why.
BEASLEYThere's one common hypothesis you'll hear called the hygiene hypothesis. It's the idea that nowadays our bodies are freed of all these enemies of dirt and bacteria that we used to have when we lived in dirtier environments. And so the body has run out of things to do and turned against food. One of the experimental treatments they're looking at for this is the helminth treatment, which would actually release a harmless pig worm in the body to see if the immune system's refocusing on that freed up the energy that had been distributed (unintelligible).
REHMDid I hear you right, a pig worm?
BEASLEYA pig worm. And, you know, I -- as I joke in the book, even if we do find this is successful, what's the mainstream going to be of that? Is it going to be Tropicana now with added pig worm?
REHMIsn't there another theory that -- about folic acid?
BEASLEYYes. Well, that is not so much a theory as an observation that the rise of food allergies on a generational level coincided with the rise of heavy prescription of folic acid supplements in pregnant women.
REHMAnd yet, that is still prescribed, is it not, that women who are in certain stages of pregnancy take folic acid?
BEASLEYSure. I mean, the reality is that we don't have a theory of a mechanism for how those two are linked. And so for now, we're -- you know, as we saw with the advice about either giving or withholding food allergens, better to not give advice until we actually have a function in mind that we're basing that on.
REHMAll right. And we're going to open the phones because lots of folks have questions. Let's go first to Shirley in Durham, N.C. Good morning, you're on the air.
SHIRLEYGood morning, Diane.
SHIRLEYHi. Number one, I'm definitely going to buy this book because I'm a personal chef in the Raleigh-Durham area of North Carolina. I have become, in the nine years I've been doing this, a specialist in food allergies now because so many people contact me with various allergies, most of them being celiac. So it's just amazing to me that so many people, especially adults, you know, have lived their lives being sick and then come to realize they have this issue. And, you know, I wanted to state also that people with food allergies, I found that if they just go back to eating whole foods, unprocessed as much as possible, that you can exist quite well and eat really well. You know, the people that I cook for, this is what I do for them.
REHMIs that something you would adhere to?
BEASLEYYeah, the simple reality is I do have a mostly whole foods diet. My breakfast most mornings is almonds and a banana. And I think that it's interesting that when people are asking me, oh, what can we do for you in terms of dessert, they go through all of these -- jump through all these hoops to come up with...
REHMAnd you say, I'll have a banana.
BEASLEYYeah, or strawberries or blueberries. You know, it doesn't need to be that complicated. But the point that our caller is making, which I do want to say, is that there's no reason why people with food allergies can't love food, can't in fact be foody, so to speak, because in a way we're designed for it. We pay really close attention to ingredients. We're extremely loyal to brands when we find that we like them and they're safe for us. We -- there's no reason why we can't embrace the act of eating.
REHMAnd surely, you eliminate, for the most part, processed foods.
BEASLEYYeah, although I certainly recognize, particularly for children, I'm appreciative of this flood of safe cupcakes and some of these things that have come onto the market now that let kids have an experience that, frankly, I just never had.
REHMInteresting. All right. To Derby, Kansas. Good morning, Leeann.
LEEANNWell, good morning, Diane. I was going to comment that I am allergic to corn and apples. And it's just fairly amazing how much corn is in everything. It's even in table salt. And now they're making citric acid out of corn.
REHMCorn in table salt.
REHMNow, that, I had never heard of.
LEEANNWell, I didn't know about it either until I went to a site about corn allergies and I was just amazed that it's even in table salt. I don't use salt very much.
BEASLEYIt is a -- it's a real problem, this issue of these major crops that have become present in derivative forms in so many things. You know, I talk about -- in "Don't Kill the Birthday Girl," I talk about the history of soy in America. And one of the things is, is that soy is actually a very common allergy. The reason why we don't hear more about it is that the reactions tend to not be as severe as those to peanut. Now, if that changes all of a sudden, and we don't really understand why it would or wouldn't, we're going to be absolutely hamstrung because we're going to have all these people with soy allergy and it is everywhere.
REHMIt's everywhere. Do you stick pretty much to a vegetarian and a fruit diet?
BEASLEYI sometimes have that. Days will go by and I'll have adhered to that and I won't have even noticed. But, you know, again, one of the funny things is for those with certain allergies, the cuisines can kind of work against each other. For me, going to a vegetarian restaurant means dodging soy left and right. You know, the tofu won't work for me. I've spoken with people with celiac who are making products that use nut flour, which means all of a sudden nuts are showing up in baked goods in a way that people with nut allergy would've never worried about before. I think the important thing is we have to focus on food allergy as the enemy and not any one food allergen.
REHMTalk about celiac disease for a moment because a number of folks have asked us to devote an entire program to it. I have wondered whether celiac is a combination of allergies or whether it is one specific food allergy.
BEASLEYIt's actually slightly different on a systemic level. A food allergy is when the mast cells in your body respond to recognizing a food protein by releasing histamines that wreak havoc. Celiac disease is more similar to an intolerance of sorts in that your body just doesn’t know how to process the food properly. However, I'm always quick to clarify that I'm not suggesting that celiac is in any way less serious. It can have absolutely severe medical consequences for those who have it, but I think only now we're beginning to really realize.
BEASLEYI think those with celiac face many of the same issues in terms of navigating everyday culture. I was speaking with a friend just the other week whose niece had been training to be a chef and had only been diagnosed with celiac a year short of going into that fulltime profession and is not sure what to do now.
REHMWhat foods are completely off the table with celiac?
BEASLEYWell, you really have to avoid anything with gluten in it. And that is -- what people don't realize is that it's not as simple as thinking in terms of wheat or whole -- you know, soy sauce has gluten in it. It's the inability to process that basic starch. And so it -- again, it's slightly different from food allergy. I don't think they're looking at the same desensitization treatments, the oral immunotherapy that they're looking at with food allergy. But in many ways the two populations have a lot in common, in terms of fighting to have safe environments.
REHMSandra Beasley. Her new book is titled "Don't Kill the Birthday Girl: Tales from an Allergic Life." And you're listening to "The Diane Rehm Show." Let's go now to Silver Spring, Md. Good morning, Laura. Thanks for joining us.
LAURAGood morning. I'd like to make a comment about my son. When he was a very small baby, he went into daycare at 12 weeks 'cause I went back to work right away. He was breaking out all the time in hives and I would get these calls and I would have to pick him up and take him to my pediatrician. And they were like, oh, contact dermatitis because he had a lot of sensitive skin issues. But it turned out when he was four, I gave him a sesame seed bagel and he had a major reaction. And even my pediatrician, at that point, said, oh, I think he just has a sore throat.
LAURAAnd then -- so I kept it in the back of my head -- and I gave him one of these Kashi crackers which has sesame flour in it and again he was panicked, felt like he couldn't breathe. And after that, I turned to allergists and he had this very severe reaction to sesame. So it's just interesting how long it took to get this diagnosed. And I wonder who -- what other little babies are out there breaking out that their pediatrician says, oh, contact dermatitis.
BEASLEYWell, and it is difficult because eczema is a common -- much like asthma, it's a common concurrent condition with food allergy in small children. Some pediatricians would look at it as a marker. You know, it's interesting with sesame. Sesame in the United States is not one of the big eight allergies, which is what we call those top eight allergens. However, in Canada, it is considered one of the primary allergens. And I suspect that in five years, we're going to be talking about a lot more sesame allergy.
BEASLEYNow, you can track that back to changes in mainstream diet. Hummus is now a standard party food. Mediterranean cuisine has gone mainstream in the United States and I think it raises a really interesting question of -- as these foods become introduced more heavily, we're seeing a rise in...
BEASLEY...reactive food allergy.
REHMThanks for calling, Laura. I hope your child is fine now.
LAURAYes. He -- in fact, we've done a really good job of eliminating sesame since then. He also has a shellfish allergy, which is a lot easier 'cause it's labeled better. And sesame is number nine right now in the U.S. And I think in Israel, it's number three.
BEASLEYWell, and be glad that -- it sounds like your child is a son. Now, sesame is one of those sneaky things that also shows up in cosmetics, in bath products, sesame oil in soap, you know. And so that'll be another generation of things to watch out for when your child gets a little older.
REHMGood luck, Laura. Thanks for calling. And to Boston, Mass. Hi there, Erin.
ERINHi, how are you guys doing?
ERINGood. I was calling about the changes in allergies over someone's lifespan. Because my boyfriend actually -- funny the last caller called about that -- he had this shellfish and sesame allergy, as well as bees. But the shellfish and the sesame didn't show up until he was about in his late teens and 20's. He just had a severe reaction one time to a sesame dish and he had never had a problem before.
ERINAnd then a few months ago, we kinda tested out the fish thing and he had some shrimp and we kinda watched him and he was okay. So we're thinking he might've kind of lost the allergy. And I was just wondering if the caller experienced that or had heard of those allergies kind of changing. I don't know if it has to do with hormones or (unintelligible) interested in.
REHMAll right. Okay. Well, Sandra, hold on to that thought. We've got to take a break here. And when we come back, we'll talk about how these allergies may or may not change over a lifetime. Stay with us.
REHMAnd what about that question, Sandra Beasley? In your book, "Don't kill the Birthday Girl," have you looked at the how allergies change over the years?
BEASLEYSure. I think for any individual food allergies, your reactions and their severity can change. For me, a trio of my worst allergies, shrimp -- when I was very young, I was able to eat shrimp tempura. It was only after a couple of years' exposure that I began reacting. And now it's actually one of my most severe allergies. Cashews similarly, when I was very young, I can remember times where I picked another nut that was safe out of a bowl where cashews were mixed in.
BEASLEYI would never do that now. Now, just being on a New York street corner by a man roasting cashews is enough to make my eyes tear up.
BEASLEYYeah. And, I think, that -- and mango, which used to not be a mainstream food product, is now very trendy. Mango salsa, mango cocktails, mango on sushi and so that allergy has become quite severe. And one of the things that my body does now, which it not -- didn't used to, is I have biphasic reactions. Biphasic reactions are when your body releases one set of histamines on a slower schedule.
BEASLEYSo you might not realize you're having a reaction or you might think you're reaction has calmed down. You might go to sleep and wake up four hours later in the full grip of anaphylaxis. It's terrifying. It happened to me when I was on an Amtrak quiet car and right in the middle of a medical emergency, I had the conductor yelling at me to be quiet and to turn off my cell phone.
REHMWhew. What happened?
BEASLEYI, literally, hunkered down, teared up, did what drugs I could and then the moment that I felt safe to creep into the next car where I could use my cell phone, called my boyfriend for help.
REHMHas your body ever reacted to something because you panicked?
BEASLEYI think that with any child with severe food allergies who knows the trauma of losing the ability to breathe, of projectile vomiting, we always need to find ways to calm them, to make sure that they're emotional state is not complicating their reaction. I do have incidence where I realized, in hindsight, that my level of exposure was probably not proportionately realistic to what, at the time, I felt, in terms of the reaction.
BEASLEYAnd I think that's very important when we're dealing with parents of small children is, you know, creating that message of be calm, let your calmness -- child -- affect your child positively.
REHMHere's an e-mail from Peter in Tarrytown, N.Y., "Is there a correlation to the increase in allergies and the increased use of chemicals used in growing and processing food?"
BEASLEYWell, again, we have cases of correlation, but we don't have a mechanism for causation. However, one thing that's really interesting to note is that there is concern that the ways in which we're processing these allergens is contributing to the rise in their allergenisity. A perfect example is peanuts. Now, peanuts is a very -- that's a very widespread food in China, but the incidence of peanut allergy in China is relatively low.
BEASLEYWell, in China, they're usually served in boiled form. In America, they're served in roasted form. And that is a different manipulation of the protein. There's a belief among some scientists that part of the problem is that we -- in trying to make peanut butter stable to be on the shelf, we've manipulated it so much that our body no longer recognizes it as peanuts even.
REHMAnd here's an e-mail from Matthew, pardon me, who says, "The National Institute of Allergy and Infectious Diseases recently released clinical guidelines for the diagnosis and management of food allergy as a tool to assist physicians across various medical guidelines specialties." And these are available online. You can link to our website at drshow.org and you will be linked to that website.
REHMLet's take another call from Martha in Indian Mound, Tenn., good morning to you.
MARTHAGood morning and thank you. What I wonder is whether there is a correlation between the increase in allergies and the introduction of genetically modified food. For instance, I am allergic to eggs, dairy, corn and soy, but I have not had any problems with organic eggs, dairy or corn. And I haven't been exposed to soy because I really try to avoid it.
MARTHAI just try to avoid all GMO foods and re-labels because it has been shown that the genetically modified organisms can exchange DNA with our gut bacteria.
BEASLEYAnd we've known about this possible issue of cross contamination for a long time, way back in the early '90s when genetically modified crops first began entering the marketplace. There was a study that showed that a Brazil nut gene that had been supposedly harmlessly inserted into a genetically modified crop was eliciting food reactions in those allergic to Brazil nuts.
BEASLEYSo I think that it is an issue. We, again, we don't quite know the -- the function or the mechanism, but, I think, there's a lot of concern about this casual introduction of muddying the genetic background of crops.
REHMBut even with something like tomatoes, apples, aren't you doing genetic modification even there?
BEASLEYRight. And, you know, I mean, anytime that something is grown organic versus with pesticides to assist, but these are also -- there's -- some of these are going to be issues of intolerance versus true food allergy. There's also an interesting phenomenon called oral allergy syndrome in which sometimes those with what seems to be a food allergy, they're actually not responding to the food.
BEASLEYWhat they're responding to is the skin of the food or the flesh of it doing an impersonation of the protein, such as ragweed or another alder birch pollen. And the body is actually mistaking the fruit -- this is very common of apples -- and producing almost like a hay fever reaction in the mouth, so to speak. So we really -- there's a lot still to be learned.
REHMThanks for calling, Martha. You're going to be amused at this, Sandra. It's an e-mail from Alex in Salisbury, N.H. who says, "I have several severe food allergies, shellfish, tree nuts, bananas, kiwis. And your guest's book titled, "Don't Kill the Birthday Girl," reminds me of what my husband does when I go out of town for at least a couple of days."
REHM"He has what he jokingly calls a fiesta del muerte, which means he has Nutella sandwiches for breakfast, banana smoothies at lunch and copious amounts of shellfish for dinner. He often has friends over, hence the fiesta to share in all of his favorite foods that are forbidden when I'm in the house. I come home to a spotless kitchen and house and a very happy husband."
BEASLEYWell, I'm glad you trust his dishwashing skills because that last part about the house being -- and the kitchen being clean when you come home is critical if that type of thing will happen. Anytime you share a household with someone who doesn't have your food allergies, those everyday bickerings over dirty dishes and such become greatly intensified when that unclean glass might kill you.
REHMWow, all right. And I hope you'll keep that in mind. Let's go to David in San Antonio, Texas, good morning to you.
DAVIDGood morning, Diane. Thank you for taking my call.
DAVIDI have also kind of an amusing situation. I am 53 and I have had a sudden onset of a food allergy late in life and it happens to be beer. And it happened in December and, you know, your guest had mentioned, you know, the diagnostic -- you know, the process of diagnostics. I went through a full battery of just about everything. And, I think, with the blood test, just about everything I had consumed in the prior week came up positive.
DAVIDAnd the diagnosis was really based upon my reporting of when the occurrence happened. My question is with the sudden onset late in life allergies, is it possible that it could suddenly disappear, as well? Because in south Texas, not being able to drink a beer is pretty distressing.
BEASLEYI'm very sympathetic. I was recently speaking with an author who had just developed an allergy to alcohol, particularly wine. And she -- we were joking about one's first sober book tour. It's, you know, it is distressing. I think it would be important, if at all possible, to figure out whether the issue is the gluten within the beer or the beer -- the alcohol itself. It sounds like it's probably the later and I'm certainly sympathetic to your experience with so many false positives on the blood test that it was hard to tell what was causing the reaction.
BEASLEYIt is entirely possible that this reaction will, at some point, recede. However, for now, you probably need to really get into liking ginger ale.
REHMGive it a rest, David.
DAVIDWell, at least it did -- it doesn't -- wine doesn't bother me so I'm okay with that. It must have been the malt, barley or hops or something of that nature.
BEASLEYYou know, those things do happen. I've had problems with chocolate stouts, so to speak, or milk stouts where the small amount of the food that's processed within the alcohol...
BEASLEY...triggers a reaction.
REHMThanks for calling, David. We've had several e-mails, Sandra, saying that celiac disease is an autoimmune disorder and not an allergy. It's not a lack of an enzyme to digest gluten. It has been mischaracterized by you.
BEASLEYOkay. I will -- you know, it wasn't something that I was necessarily going to try to define in the medical sense. My -- my main goal was to point out that it was not a food reaction, in terms of the mass reaction, but it certainly is characterized as an immune disorder so I have no issue with that.
REHMAll right. To Portsmouth, N.H. Hi there, David, you're on the air.
DAVIDHi, thank you for taking my call.
DAVIDI just wanted to briefly relate a story of my wife. She -- she had some intense food allergies similar to your guest, probably 20 plus allergies, including corn and gluten and tomato and egg and dairy and vinegar and I could go on and on. And it severely impacted her life. About a year ago, she went to an alternative treatment, completely non-invasive, and she is right now completely healed.
DAVIDShe's able to eat anything she wants and it's just an amazing -- amazing story of transformation and renewal. And the treatment is based on Pavlov's principal so that an allergy is no more than a negative reaction to an otherwise benign substance where the benign substance gets paired with a stress response in the body.
DAVIDSo if you unpair that stress response, then you remove the allergy. And the treatment's called AAT, advanced allergy therapeutics, and I'm just wondering if your guest has heard of that.
BEASLEYYes. I was actually contacted by someone soon after the book came out who was interested in sharing more information about that program with me. In addition, I've had discussions with people about acupressure and some of the other focusing on biofeedback and on training the body to not respond. You know, I can't tell you that I've had any successful first-hand experience with that.
BEASLEYI would hesitate to recommend it as the primary and sole response to food allergy. I think it's really important, though, to understand that with a lot of desensitization or other treatments on the table, I think it will be unrealistic for a lot of people to be cured in the sense of eating all of these things that used to have the potential to kill them.
BEASLEYWhat a lot of people are seeking is a level of security that minor exposures, cross contamination, you know, casual reactions will not have the potential to kill them. And so it's not so much about being able to eat a peanut butter sandwich after having been allergic to peanuts, it's about not worrying about being seated on an airplane when the person next to you opens up their peanut butter sandwich.
REHMAnd you're listening to "The Diane Rehm Show." Good for you, David, and good for your wife. I think that's just really great news. Here's an e-mail from Laura in Ann Arbor, Mich. She says, "Have you done much research into the history of allergies? I often wonder what happened to children born with severe allergies in the past. Did they all simply die?"
BEASLEYWell, there has been some recording of something that was approximated food allergies going all the way back to the days of Hippocrates so, you know, the awareness of food allergies has been in the body of medicine for a long time, however, the term was not coined until 1906. And, in fact, right around that time, there was a little bit of a turf war or branding war about whether allergy or anaphylaxes was going to be the dominant term. You know, it is a relatively new body of medicine.
BEASLEYAnd understanding and for many, many years, injections were considered the primary mode of treatment. We're now only getting back to what, in fact, was some very early on successful use of oral immuno therapy returning to that as the possibility for the future.
REHMYou know, you speak as a totally rational young woman taking into account what you've learned, what you've experienced, putting it into practice, but like so many others, you did go through a rather rebellious adolescence where you probably wanted to forget that you had anything like an allergy.
BEASLEYSure. And one of the things I try to do in "Don't Kill the Birthday Girl," which is a memoir, is I try to be really honest about some of my less flattering, less responsible moments of handling my food allergies.
BEASLEYOh, well, I don't think any parent wants to envision their child resisting going into the hospital when they should, but I'll be honest with you, there were times where the young 20-something on health insurance where I wasn't sure it would be covered. The idea of taking the EpiPen and going in and possibly having a $500 bill fall on me was prohibitive and so I tried to control my reaction through Benadryl.
BEASLEYNow, I'm not recommending others do this. What I'm trying to do is be honest about how some of us do end up handling it. And I hear this -- I heard this from a taxi driver coming home from Union Station a few weeks ago. He said, oh, yeah, I have an anaphylactic shrimp allergy. I carry Benadryl. He made no mention of EpiPen, you know, and I think that we have to be honest about the full spectrum of how people are handling these food allergies if we're going to move the conversation forward.
REHMSo you always carry an EpiPen?
BEASLEYAlways. I was the only kid in my elementary school who carried a purse and that was so I could have my EpiPen, my inhaler and my Benadryl on me at all times.
REHMKids must have taunted you a little about that.
BEASLEYWell, I think that they -- they did sense that it was -- you know, I like to say that if there's a silver lining, it's that children with food allergies grow up very diligent, very responsible, very attentive to the world around them.
REHMSandra Beasley, her new book, "Don't Kill the Birthday Girl: Tales from an Allergic Life." Thanks for being here. Thanks for sharing.
REHMAnd thanks for listening all. I'm Diane Rehm.
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