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In the book Don’t Kill the Birthday Girl: Tales from an Allergic Life, Sandra Beasley, 31, writes about her life growing up with severe allergies to a wide range of foods—including dairy, soy, beef, shrimp, cucumbers, cantaloupe, mango, cashews, swordfish and mustard, among others.  Simply coming into contact with someone who had eaten dairy products could cause her throat to swell shut, prompting her family and friends to joke at parties, “Don’t kill the birthday girl!”

Check out Beasley’s book for a detailed, humorous account on how to navigate the world of allergies and deal with social situations where food is present – and can be a major threat.

What are some of the biggest misconceptions about food allergies?

A lot of people think that the word ‘allergy’ is used to disguise dietary preferences or mild intolerances. For a lot of people, it’s life and death, and tiny amounts can trigger severe reactions.  Also, people think allergy issues are just about one food and if that person can avoid that food, they’ll be safe.  But so many people have multiple allergies that go beyond peanuts or tree nuts.  For example, for people with milk allergies, it can be frustrating when you go to a baseball game that’s advertised as “allergy-free” just because they’re not serving roasted peanuts.  People don’t realize that within the allergy world, there are different concerns and issues.  It’s not just one big group.

What is the hardest aspect for you in dealing with allergies?

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What’s frustrating for me is I’ve had allergies since birth, and I’m still discovering new allergies. Obviously, I took a conservative attitude to trying new foods because of my allergies. I had never tried passion fruit before, and just two weeks ago I discovered I was allergic to it.  It was in a drink.  Before that, I recently discovered I was allergic to mangoes and cucumbers.  So it’s be a long unfolding of understanding what my allergies are – and also, the fact that they can change.  Some have gotten worse, some a little better and some I seem okay at the time, but then I wake up at night and I can’t breathe.  The hardest part is the lack of control.  I don’t mind going without foods – I can live without ice cream or cashew or steak – but what’s hard is going to a wedding party, and despite all pre-cautions, just a tiny amount of contamination, like a waiter who handled cheese then handling my plate, can cause a reaction, and I have to miss my friend getting married.  It’s hard not being able to control being safe in those kinds of environments.

How do your allergies affect your relationships?

It’s an issue because unfortunately, casual contact like shaking hands or a kiss on the cheek or mouth can cause a reaction.  I’ve had evenings at the end of a great party where everybody’s getting ready to go home, and someone who’s been eating nachos kisses me on the cheek. My eyes get puffy, and I look like I’m crying – that’s the effect of casual contact with people who have oils from cheese on their skin.  In the dating world, you know, every new couple has trust issues – and with allergies, those issues are quickly put to the test.  If someone moves in for a kiss after drinking coffee, I have to trust they didn’t have cream with it or they washed up afterward.  If they did, then we’re both dealing with the evidence – puffy lips.  It can be a mood killer.  Nobody wants to ask their boyfriend to wash up after eating.

Some of the larger issues can come up when I’m out to dinner or traveling with friends because when I do have a reaction, I have no choice but to ask people around me to play a role in taking care of me – whether it’s waiting for the doctors with me, or taking my car home if I have to go to the hospital or getting servers to tell them exactly what was in the foods I ate.  Nobody wants to be a burden.  The awareness that someone seated to my left or right might have to shoot me with an EPI pen before the end of the night is not something you want to think about on a night out.

In your book, you mention how some parents get upset when they can’t bring in peanut butter or other foods because it could put an allergic child in danger.  What do you have to say about this issue?

We’re seeing a severity and intensity of reactions in small children that is new.  Allergies weren’t always this common and severe.  For really small kids, I understand the need to take caution.  But for older kids in middle school or high school, we have to ask the hard question of whether in trying to protect these kids on one level is holding them back on another by creating an artificially safe environment for them that doesn’t exist in the real world.  Parents will say they won’t take their (allergic) kids to restaurants, and I say, I understand you’re trying to protect your child, but that child will turn 18.  They’ll want to go on dates or out with their friends.  You don’t want their first time at a restaurant to be at a party on prom night.  You have to teach them real world skills, how to navigate.

Also, I think it’s very important, especially in smaller or rural schools, when there are those sudden changes in policies like no peanuts or no birthday treats, it’s often because of a single child.  A great deal of care needs to be taken not to make the child feel blamed because kids, they want their cupcakes.  It’s an unfair social stigma that can be avoided, but parents and teachers must work together so the policy is cast in the right way.

What are your tips for people dealing with severe allergies?

Learn about the science of foods.  Learn which foods are related to each other.  For example, I’m allergic to cucumbers, which are related to melons, which are related to tree nuts.  If you have an allergy to one of those foods, be on the lookout because you may be allergic to one of the other ones.  Also, be aware that some meats are treated with pistachios or milk powder, like sausages, while others are totally fine, like Spanish ham.  By knowing the science, you can look at a menu and anticipate which foods may cause problem.

Also, loyalty is important.  Know which restaurants and cuisines are safe for you.  You don’t want to go to the same restaurant every week but develop a list of a half dozen restaurants for different cuisines.  That why, if your friend wants to eats sushi, you know the place you can go where the sushi counter keeps the shrimp well away from everything else.

Finally, have a community of people around you who know about your condition, where you keep your medications, and who you can trust and be honest with.  Have a trusted person who you can tell, “There might be problems with this meal,” so if it turns into an emergency, everybody isn’t blind-sided.  Have a core group of people who aren’t freaked out by your allergies and don’t make you feel weird.

What are your tips for loved ones of people who have severe allergies?

With parents, I try to remind them that during certain periods of childhood and being a teenager, their child is going to feel left out and wonder, “What’s wrong with me?” or “Maybe I’m just not meant to be here.” But it’s also important to realize all kids go through moods and periods where they feel left out.  So on one hand, you have to honor kids’ fears but keep it in perspective.  In the long run, the minor crises at the time – like oh my God, someone brought a peanut butter sandwich to school one day – these things are relatively small incidents in the lifetime of someone with allergies.

Also, it’s important to strongly encourage that kids who are carrying around an EPI pen and medications look at the situation through a lens of empowerment rather than fear.  Kids can be scared of needles or intimidated by the need to go to the hospital after getting the shot, but it really empowering.  By carrying an EPI pen, they’re carrying around the number one medication that addresses an allergic reaction.  Doctors can’t even do much more.  So it’s a great thing to give us bravery in stepping out in the world and exploring it – even with food allergies.

Parents also need to understand kids will become teenagers and then 20-somethings.  Certain complications will arise such as kissing people or going out and drinking, and their inhibitions are lowered, so they eat something they’re allergic to, or they may encounter allergies in the drinks themselves.  Parents need to be forthright; not say, “My kid would never do a shot at a party, so I don’t need to warn them about nut liquors.” They need to address those issues.