I had two airborne reactions to apple this summer when there was a large amount (institutional quantity) of apples cooking in the camp kitchen.  I wouldn't have believed it myself, except that it happened twice, and I didn't even know that there was allergen being cooked at the time.  Both times it resolved with getting out of the environment and neb treatments.

Hoping things go well today.

Thank you so much.  Very helpful, as always.

It did not resolve until she left the room and then calmed down quickly when she did.

I forgot to mention that last year a child was chewing egg next to her, started laughing and spit some on her face.  The entire side of her face swelled up and started itching.  That incident understandably caused her to be even more cautious with where she sits.  Unfortunately, she has so many allergens, (and a very low reaction threshold to all of them) that it's nearly impossible to avoid sitting next to someone eating at least one of them.  She sits at the end of the table, but they are so crammed in that it's just hard.  I used to go be a helicopter mom every day for years, but decided a few years ago to land my chopper and let her use the skills we've been teaching her since she was two.  She did a great job yesterday. 

She is at lunch right now and I'm just hoping she's feeling okay.

Thanks again for your thoughts.  It's a tremendous help.

I also agree with Guess here-- on some level it doesn't even matter whether this was subjective or objective, somatic or organic, or something in between.

If she has a history that supports contact alone being dangerous...  um--

this is a "get the hell away from the allergen" situation any way you slice it.  It's simply NOT worth the risk of your friend sneezing and getting you in the eye or mouth.  KWIM? 

And yeah, we doubted DD for a long time, too-- but her accuracy is superb to the point that I seriously cannot doubt it.  She always knows.  Well-- her body does, anyway.

   Glad DD is okay!

My experience has been similar to what CM said. 

I have airborne reactions to PN, but so far I haven't to TN.  I've had obvious symptoms like lip swelling and hives - those are easy to confirm, but the more ambiguous symptoms can be challenging. 

Did your DD react before she "smelled" the cashew?  In my experience, I'll usually react before I can actually smell the PN.  Would it help her to know that smelling it doesn't really affect whether you react or not (allergic-react that is - the smell makes my chest feel tight and causes some anxiety, but I think that's a protective mechanism rather than an allergic response)?  I also have early warning signs that are easy to dismiss.  My first sign is usually my face and then throat will get a bit itchy.  Once I notice my face itching, I go on alert and look for the source.  I was older before I noticed and learned to pay attention to the early signs.  When I was little and up through about age 14 or 15, the airborne reactions would progress to swollen eyes, lips, hives, etc. before I realized a reaction was happening.

Also, when did DD's reaction go away - only after she left the area?  If I stay in the area the reaction doesn't go away - sometimes it gets worse, but sometimes it doesn't.  It almost always goes away if I leave the area.  How sensitive I am to airborne exposure tends to fluctuate as well.  At one point in high school, I could tell if my mother had a PB sandwich for lunch when I came home after school because my throat would begin to itch the second I walked through the door even though it was several hours later.  At first she didn't believe me, but I was 100% accurate - that finally convinced her.  I don't think I'm that sensitive, now, but I do always know if someone nearby is eating PN because I do start to react. 

I totally hear you on the friends, school and inroads.  Paddling with you in that white water rapids. 

My feelings as a mom first so I don't seem robotic or too detached this being a support group and all.  It's too risky in that seating arrangement so many brain cycles go towards constant threat assessment it doesn't really facilitate socializing with expected back and forth turn taking, reading body language, engaged conversations all the good stuff mine have to work on as social communication goals.  Bobbing and weaving like in you're in the fight of your life ('cuz, you are) while the other person is munching nonchalantly is more of an advanced level relationship and avoidance for like work or something unavoidable.  If at all possible I'd say have them sit opposite of one another and push for playdates on more even terms.

The more detached clinical version is while I personally need more proof to say yes, it was a reaction I'm not sure that matters.  If the individual is feeling it how exactly are you supposed to sort that stuff out second by second with so much on the line?  It violates most rational choice models in human behavior.  The stimulus remains and whether it's affect alone (psychological) or risk assessment (cognitive) the response will remain true until the stimulus is removed.  Keeping with it for the hope of further socialization during the 20-30 minute lunch allows neither fight or flight.  Despite the mantra about keeping calm, washing hands there's a point where choices need to be made based on credible and imminent threat.  Socializing needs some progression, interaction and I don't see in a lunch room situation with two biggie potent allergens how that can be facilitated without some oversight or refereeing.

Having said all that maybe she is having reactions because of mastication of that much nut product.  My nut allergic child flies a lot, always had.  I'm not sure he could do that next to someone chomping down on his super potent allergens.  At that point what is the contact? Is it just aerosol or is it sitting next to a human nut grinder exhaling and sending a good number of PPM your way as you eat.

 



Really glad that she is okay.

So her symptoms resolved... when, exactly?

Because all of DD's aerosol-triggered reactions have resolved upon leaving the area-- not before, no matter how she "calms down" about some perceived level of non-contact risk.  Does that make sense?

So we've run this kind of experiment a few times, honestly-- not because I don't think these reactions are dangerous, precisely, but because from a logical and research-backed place, it's just so hard to not chalk them up as psychosomatic.  KWIM?

So we went through a period where we pushed back on them significantly when DD was 3-8yo.  We'd calm her down, wash her hands, and put her right back.  Well, we soon learned that "right back" led right back to a recurrence of the exact same symptoms, regardless of how "calmed" she was, regardless of how much we all believed that "not contacting" the allergen should be fine-fine-fine.

People eating right next to her is sometimes fine-- and sometimes not.   Sometimes REALLY not fine.

DD had a very similar reaction which she treated with inhalers and benadryl in late Nov/early Dec when a classmate began eating pb from a jar of the stuff in her chemistry lecture course.  Was it psychosomatic?  Well, I simply cannot know, really.  I do believe that it's plausible that it wasn't, however, which elevates this to the same category as a made-on-shared-lines food that is MOSTLY not contaminated, but sometimes is.

Does that make sense?

I have no idea what to say re: treatment of such symptoms.  As you no doubt know, (at least we do, as it reflects our particular experience) mostly they'll resolve on their own within minutes if one leaves the area for fresher air. 

On the other hand, it certainly seems clear to me that if exposure to the allergen is causing those symptoms, there is probably in theory some tipping point beyond which a more serious systemic reaction is triggered-- like an avalanche, without additional ongoing exposure being needed to sustain the cascade.

It's just hard to know which is which.  We tend to go with "wait a few minutes and see" but we've also been burned by that a few times, I think.  Maybe one of these reactions out of...  well, I don't really know, but my estimate off the cuff is that about one in twenty or thirty of them goes south in spite of evacuation for a better location.  It's too high for comfort, for sure-- but not quite high enough to warrant epinephrine administration during them, since 95% or more of them turn out to be self-resolving without any additional intervention at all.  They're also very common if you happen to be in the low end of the sensitivity distribution, and there's quality of life and normalcy at stake here, too.



Not sure any of that helps.  Just know that you aren't alone.  This kind of thing is SO beastly.

I received The Call from school yesterday.  I was initially told that dd was having an allergic reaction to nuts.  My heart stopped and then I fleetingly wondered how that was possible since we are so careful as I ran out the door while on the phone with the "health aid".  As I was driving to school, the aid explained that dd had smelled the peanut butter and cashews that the girl next to her was eating and then felt like she was having trouble breathing, a feeling of impending doom and had a very flushed face.  DD quickly decided that she was fine and seemed fine when I saw her a few minutes later.  No Epi or Benadryl administered.

I'm mostly writing this to work through it in my head to determine if this was an actual airborne reaction (she had one two years ago so I dont dismiss that possibility) or anxiety due to the proximity to cashews (to which she had a severe contact reaction when she was 3.

Yesterday was the first time she had ever sat next to anyone who was eating nuts.  She has a lot of trouble socially and has finally made a friend.  She made the decision to sit with her friend even though she had both pb and cashews in her lunch (friend has asked mother not to pack nuts due to dd's allergies).  It is probable that dd simply panicked and thought the anxiety was a reaction.  However, it started when she smelled the cashews so perhaps it was more than anxiety.

She had an airborne reaction at a baseball game two years ago.  She was in long sleeves, seated with her back against a wall and me and dh on either side of her. And seats thoroughly wiped.  Within minutes of sitting down, she mucous streaming out of her eyes and nose and her face was very flushed.  Stopped as soon as we got in the car and turned on the air conditioner.

I'm very worried about the possibility of future airborne reactions and am terrified to fly.  I'm also worried about her in the lunchroom.  She has been working so hard at making a friend and at her social skills and I'm worried that this will be a setback.  We talked it through and discussed some ways to handle it.  I think it will take a few days for both of us to feel okay.

Thanks for reading my long post.  I would certain welcome any thoughts.