Diagnosed with almond, walnut allergies today...feeling a bit overwhelmed!

Started by SwayGirl, June 11, 2012, 04:59:43 PM

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SwayGirl

Hi! I'm new here, and new to the world of food allergies. I spent pretty much all day today at a first visit to an allergist, and I was diagnosed with allergies to almonds, strawberries, walnuts, feathers, two different molds, and some other seasonal stuff, plus a strongly suspected egg allergy. I left with a prescription for an epipen, and about a million questions. My head is swimming! I was overwhelmed, to say the least. Plus, after all the skin testing I felt so awful, I could hardly think straight.

It was eggs that sent me to the doctor in the first place, so I was shocked that I didn't react as strongly to egg as to almond, which I had no idea about. And strawberries, well, that's just sad since it's been my favorite fresh fruit all my life, and I look so forward to strawberry season every year! Ah well, if I feel better I will happily give it up.

According to the doctor, apparently I had an anaphylactic reaction (grade 4?) on May 27 after eating a few bites of angel food cake (with strawberries!). I'd had several instances, in the months prior, of feeling ill after eating scrambled eggs, and had just sort of stopped eating them, without really realizing it. Certainly food allergy never crossed my mind. I'm 43 and had never had a food allergy (that I knew of), nor does anyone in my family have food allergies. So it seems out of nowhere. I had just about convinced myself I imagined it all, except I had a lesser reaction just a few days ago while making oatmeal cookies. (Never occured to me I couldn't make things with eggs, even if I couldn't eat them!) With the first reaction (to the angel food cake) it started after just two bites with sudden massive head congestion, followed very quickly by tickly/itchy feeling in back of throat, lump in thoat, intense pressure from rapidly swelling lymph nodes in throat/jaw (and arms as well), then throat closing, pressure/weight on chest, inability to get a good breath, wheezing, dizzyness... I was by myself at the time, because my husband and son were out of town for the weekend. I didn't feel panicked, but I did think, Okaaay...something is happening here. Something not good... Hah. Bit of an understatement, I guess. Luckily, it resolved itself eventually. I stopped eating the cake  immediately, of course, and lay on the couch trying to will these sensations away. Guess I had an angel on my shoulder (no pun inteneded!), because although nausea followed after a bit, plus more intenstinal symptoms later, the breathing issues did resolve after half an hour or so.

Somehow in the middle of all that, I had the thought: Oh my gosh, I think I'm allergic to eggs! It was kind of a shock, and I'm not even sure where that thought came from. And perhaps I still am allergic, but the results definitely me, and the dr too. Will have to wait for blood tests to confirm, I guess. Despite the lack of a strong positive for eggs on the skin test, the dr seemed to strongly suspect that eggs were the cause of the reactions. However, he said it would really have to be the nuts if egg is not the cause.

Sorry for how long this post has gotten. What I'm wondering is, if I'm allergic to almonds (and walnuts, but it was not as strong a positive as almonds), does that mean I should avoid all nuts? I can't believe I forgot to ask the dr, but after the epipen demo and the mounds of papers I was handed, I just didn't even think of it!

After that first reaction to the cake led me to your boards here, I've been reading them with interest, educating myself a bit.  This is my first post, though. Thanks to all the info members have shared, I already feel more on top of it than at first, but still there's so much to learn. Any tips for a nut-allergic newbie would be most gratefully received. Thanks so much! (And sorry again for the epic length of this post!)

Swaygirl

Brand spanking new diagnoses: allergies to almonds, walnuts, strawberries, feathers, indoor & outdoors molds, severe ragweed, severe grass pollen
Previously dx allergies to penicillin and sulfa drugs

GoingNuts

Welcome Swaygirl!  Sorry you had to find us, but glad that you did.  ;)

A couple of questions first - from what you've written, it does sound as though eggs are the culprit.  As far as the others, were they diagnosed via skin test, blood test, or both?  Have you ever reacted to almonds, walnuts or strawberries at any other time?

I guess the next step is to tease out what you test positive to, as opposed to what you are truly allergic to.  Some people test positive to things they aren't truly allergic to.

As far as whether or not to avoid all nuts, I would say for the time being - yes.  That is because it can be tricky to find nuts that aren't all processed together and you don't really have a handle on the situation yet.  As things become clearer, you may be able to find nuts that aren't processed with other nuts that are safe for you to eat.

I hope that has helped somewhat.  Seems like you still have a ways to go before you have all the answers.

Deep breaths.  This is tremendously overwhelming at first, especially to have your first reaction as an adult.  :console:  Hopefully some of the other adults will chime in here and give you some words of wisdom.
"Speak out against the madness" - David Crosby
N.E. US

YouKnowWho

We joke and say that my older son tests positive to everything but is allergic to only a few things (wheat, rye, barley and egg) and my younger son at one point reacted to everything and tested negative to most of them (though he seems to have outgrown everything but peanut at this point).

Have you eaten strawberries, almonds or walnuts without reaction?  Regardless of the size of the wheal, in your case I would think common denominator of probable egg reactions lean me more towards of the thoughts of being egg allergic than to the others.  Granted I am doing so from a single post.

Another question - is this an allergist who specializes in food allergies or more of the environmental allergist that dabbles in food allergies.  I ask because we have seen both - the environmental allergists were a disaster for us personally.  They had little working knowledge of food allergies and thought my son would chunk up if he avoided wheat, rye, barley, oats, rice, corn, eggs, dairy, soy, peanuts and tree nuts.  You know because air has so many calories LOL 

Honestly, if almonds, walnuts and strawberries come back as positive and you haven't noticed any reactions to them - I would ask for an in office food challenge.  Eggs honestly are pretty easy to work around at home and while a little more difficult out, can be done.  But for each allergen you add, it makes life tougher (not to say it cannot be done, just a little tougher).

Welcome to the group btw!
DS1 - Wheat, rye, barley and egg
DS2 - peanuts
DD -  tree nuts, soy and sunflower
Me - bananas, eggplant, many drugs
Southeast USA

SwayGirl

Thanks for the welcome, and for taking the time to help. It's really appreciated. I do, of course, have questions and confusions, and I'm trying not to overreact. Any information that helps me feel like I've got a better handle on all this is valuable to me!

Quote from: GoingNuts on June 11, 2012, 05:31:28 PM

A couple of questions first - from what you've written, it does sound as though eggs are the culprit.  As far as the others, were they diagnosed via skin test, blood test, or both?  Have you ever reacted to almonds, walnuts or strawberries at any other time?


Well, so far the strawberry, almond, and walnut allergies were diagnosed with skin tests, but I have had reactions, at least to almonds and strawberries. Not sure about walnuts. Just a few days after my first big reaction (to the angel food cake) I had a bowl of Honey Bunches of Oats with Almonds cereal topped with, of course, a big pile of fresh strawberries!!! I immediately felt strange after taking a few bites. (I do not normally eat this cereal anymore, although it used to be a favorite. For some reason, I just stopped eating it over a year ago, and pretty much stick with Rice Chex, because I feel better--any other cereal didn't seem to sit well with me, although I never knew why or really gave it much thought at all.) It wasn't as big a reaction as to the cake, but I immediately got very congested, and nauseaus, a bit dizzy, heart racing, itchy, a little short of breath.

The thing is, I really thought I was just being paranoid after the cake incident. I convinced myself I was just imagining it, getting overly anxious and neurotic about food. So although I was stunned about the almonds and strawberries, I wasn't completely shocked--strawberries especially I had thought I was reacting to, although very differently than eggs. It was kind of validating actually, because I realized maybe I can trust my instincts about what I'm feeling. It just seemed so crazy, like suddenly I was reacting to all kinds of things, and that seemed impossible. It seemed more likely it was just anxiety.

I am not normally one to doubt myself so quickly, but I am amazed at how I've been able to rationalize away some of these reactions lately. It is kind of scary, because I've had many lesser, but uncomfortable, reactions that I suppose now I have to take more seriously. I guess it's not all in my head!

Thanks again for the help. It's truly appreciated!
Swaygirl

SwayGirl

Quote from: YouKnowWho on June 11, 2012, 11:37:05 PM

Another question - is this an allergist who specializes in food allergies or more of the environmental allergist that dabbles in food allergies.  I ask because we have seen both - the environmental allergists were a disaster for us personally.  They had little working knowledge of food allergies and thought my son would chunk up if he avoided wheat, rye, barley, oats, rice, corn, eggs, dairy, soy, peanuts and tree nuts.  You know because air has so many calories LOL 

Honestly, if almonds, walnuts and strawberries come back as positive and you haven't noticed any reactions to them - I would ask for an in office food challenge.  Eggs honestly are pretty easy to work around at home and while a little more difficult out, can be done.  But for each allergen you add, it makes life tougher (not to say it cannot be done, just a little tougher).

Welcome to the group btw!

Hi! Thanks for the welcome, and for the comments and info. As for the doctor, I'm not actually sure if he specializes in food allergies. I think not. I was a bit concerned at first, because so much of the paperwork/history questions seemed focused on seasonal stuff. But when I met him, he seemed knowledgeable. I'm a pretty tough judge of doctors, partly because I've had some bad experiences in the last couple of years. I tend to go in a bit skeptical. I am still not 100% sold on him, but he listened, took me seriously, and was responsive to questions. He took plenty of time with my questions, and I didn't feel brushed off. That's not so common these days. I appreciated that he didn't blow off the egg issue because of the questionable skin test, because so much evidence points to egg based on the circumstances of some of my reactions.

On the downside, he never mentioned an action plan or other document indicating exactly what to do in a severe reaction. I've read about those here on the boards, so I was surprised. Perhaps it's something more commonly given to parents with allergic children?

I'm giving him the benefit of the doubt right now, I guess. Do you think an action/emergency plan is a deal breaker? Is this something all food allergy specialists would do?

Thanks again!

Swaygirl

CMdeux

Swaygirl, a warm welcome!

It sounds to me as though you definitely have a life-threatening food allergy... but whether you've got more than one... hmmm... maybe, though to develop MORE than one food allergy like that as an adult would be pretty unusual in such a short period of time.

Something to be aware of is that if your very serious reaction (and wow-- are you ever LUCKY to have had that self-resolve) was not that long ago, skin testing may show artificially elevated responses to a TON of things becaues of your entire immune system being on a hair trigger right now (and for the next few weeks, probably).

Once you eliminate all sources of egg (because it does sound as though that is truly the culprit) then you may find that strawberries/nuts aren't really an allergen in the first place. 

Many adults find that they react to MANY more things than they are actually allergic to by virtue of having their immune system so amped up all the time from exposure to a true allergen.  It's a little hard to explain how that works, but it's basically like filling up a coffee cup-- once you get VERY close to the rim, even a few drops can cause an overflow (a reaction).  If the cup were more empty, then that would never in a million years have happened.  KWIM?

If your response to strawberries has typically been hives, it may be due to the exceptionally high histamine level in the berries.  That's one possibility.

Nuts are a tricky one... because they so readily produce anaphylaxis in people who are truly allergic to them, I'd have expected that a truly exceptional allergic might have suggested "avoid for now" and looked at re-evaluating you once you are avoiding eggs for some period of time (6 mo or so) in order to try to tease apart what the real situation is there.  Probably it would involve a food challenge, with the logic that it is almost certainly much, much better to KNOW whether or not you're allergic to a tree nut.

Is your allergist a good one?  Well, he knew enough to recognize food anaphylaxis and he treated you with respect.  That's an very very good sign.  On the other hand, he didn't mention anything about food challenges or false positive rates with blood and skin testing... so I'm guessing that you might have a good clinician that doesn't keep super current on best-practices derived from major researchers in FA.  That's not a bad doc, all in all.   :thumbsup:

Be sure to get familiar with the anaphylaxis grading chart (I'll pull up the link in a moment here) so that you have a clear understanding of when to use your epinephrine!
Resistance isn't futile.  It's voltage divided by current. 


Western U.S.

YouKnowWho

I don't think going over the action plan is a dealbreaker.  I will have to find the link in a minute to add it here.  I would suggest going over it at home and being ready to have questions the next time you see your allergist.  I think many allergists discount adults needing to know this for themselves because they assume we just know when enough is a enough, kwim.  I think it's gone over more often with parents of kids with food allergies because they have to know what to watch for in regards to a reaction - does that make sense.

You may also want to go over the action plan those around you - and especially how to administer the epi pen because even sometimes when you know you need it, you can't do it.  Mid-reaction is never a good time to conquer fears.

Thank you for clarifying the other reactions - it does sound like you are reacting to them.  And yes, environmental allergies can be a part of the big picture.  But I wouldn't discount egg because it had a smaller wheal or even if the numbers come back smaller on the blood test than the other foods.  My son's numbers and size of his wheal for egg is so minor that a few times he has fooled us into thinking he outgrew it but he failed in office food challenges and still continues to react to it.

Just out of curiousity - do you normally eat wheat/gluten products?  I ask because the two items that you reacted to contain wheat but you also mentioned being fine with the rice chex.  (Keep in mind that my brain goes there since I have a gluten allergic child).

And it looks like CM beat me to adding the chart :)

DS1 - Wheat, rye, barley and egg
DS2 - peanuts
DD -  tree nuts, soy and sunflower
Me - bananas, eggplant, many drugs
Southeast USA

SwayGirl

YouKnowWho & CMDeux, thanks yet again for taking the time to eductate and support--it's so appreciated, especially because I don't really have anyone in RL who gets this at all. DH sort of talks a good game, but is generally slow to adapt to change and this is no exception--I can tell he thinks I'm being paranoid, and no one seems to get that it's not quite as simple as avoiding scrambled eggs or a big handful of almonds.

Every day I seem to be adding more experiences to the "allergy file" in my brain, trying to sort through what is really happening. Not sure if it's making the picture clearer or more murky! Monday evening (about 7+hours after all the tests at the allergist), I was coaxed into a quick dinner with DH at a favorite restaurant down the street. It's a brewpub. After a bit of thought and many questions to the waitress, I ordered something that seemed safe, and a glass of white wine. Before our food even came, I began to feel funny. It started almost immediately after taking my first sip of the wine, but I think that might have been a coincidence. I stayed, and made it through dinner (once again thinking I was imagining it), until finally I was feeling so droopy and lightheaded, I told DH we needed to go. As soon as I got outside, I began to perk up and felt much better by the time we got home. Only then did DH mention that we were sitting right next to the door to the room where they actually brew...stuff. Not sure what they were brewing at the time, but he said people were coming and going through the door the whole time we were there, and it was often just left open (it was right behind me). They make all sorts of spirits as well as microbrew beer, and who knows what's in it, with all the crazy flavors of beer and liquor these days. Anyway, I was just stunned that once again I could possibly have reacted to something in the air. I said something to DH very similar to this:

Quote from: CMdeux on June 12, 2012, 11:06:22 AM
Something to be aware of is that if your very serious reaction (and wow-- are you ever LUCKY to have had that self-resolve) was not that long ago, skin testing may show artificially elevated responses to a TON of things becaues of your entire immune system being on a hair trigger right now (and for the next few weeks, probably).

Many adults find that they react to MANY more things than they are actually allergic to by virtue of having their immune system so amped up all the time from exposure to a true allergen.  It's a little hard to explain how that works, but it's basically like filling up a coffee cup-- once you get VERY close to the rim, even a few drops can cause an overflow (a reaction).  If the cup were more empty, then that would never in a million years have happened.  KWIM?

It's so interesting that you bring this up. I said the same thing after the restaurant debacle--that maybe because of the skin tests--so many of them, and I felt fairly sick at the dr's office just from the testing--that maybe I was all full of histamine and more reactive, and it wouldn't take much to push my immune system into overdrive. Sounds like maybe that really was the case, and hopefully that's partly the reason for the other milder reactions I've had since the first big one. I hope so. It's heartening to hear that things might calm down in the near future, because right now I feel like I'm going crazy, constantly feeling "off" and reactive in situations I wouldn't expect.

But I've come across some info that may (or not?!) shed light on WHAT I'm anaphylactic to. First of all, in trying to track down the ingredients in the angel food cake that was culprit #1, I found that many recipes contain almond extract. Hmm, interesting, I thought. Maybe it really isn't eggs!

Then, when talking to a staff member in Bakery at the store where I bought it, she read the label to me, saying it didn't list almond extract, but "the label says it is made on shared equipment with products containing nuts." Didn't say which kind, though, just "nuts."

She gave me the contact info for the supplier who makes the cake, and the person there was very helpful, seeming to go out of her way to track down info that was confusing. She called me back within the hour to say that despite the statement on the package, that cake is made in a facility that does not process anything with nuts. (They have two plants; the other plant does handle breads and cakes with nuts.) Ugh. Don't know what to believe. And to further confuse the issue, she added this: "That plant DOES process buns with sesame seed toppings, but according to my manager sesame's not really considered an allergen."  ??? I said that actually it definitely IS an allergen for some people; it's just not one of the top 8 and doesn't have to legally be listed as such. (Putting to good use the knowledge I've gained from these boards!) She quickly said, "Oh, yes, that's what I meant!"

Anyway, now I'm stumped. I wasn't tested for sesame. There really isn't anything else in the cake that it could be, I don't think, but eggs or possible cross-contamination with nuts or sesame. Right now my plan is to wait for the RAST to come back, probably negative I guess, for eggs (seems like the odds are against positive if the skin test is negative, right?), and ask him to test for sesame.

This is all just...confusing. I do really want to know what is actually dangerous for me, and what is not. I suppose it's like the dr said, that if the egg is negative on the blood test, he will be much more worried about the nuts than if the egg is positive.

Swaygirl

CMdeux

Tests are just.... tests.

Seriously-- Angel Food cake is, like, once of the most amazingly concentrated sources of egg allergens that I can envision, short of meringue.  <shudder>

It would completely make sense that if you have an egg allergy, that would have elicited an anaphylactic reaction, leaving you WAY more sensitive to any and all other stuff for the time being.

One other thing worthy of note-- most "almond flavoring" isn't almond-derived.  It's cheaper, apparently, to extract it from apricot/peach pits using some industrial process.  That's why so many almond flavorings do NOT list "tree nut" on the label.  Of course, you'll have to call to verify that this is so, but a lot of the time it's the case.  "Almond" scent/flavor isn't always. 

Keeping my fingers crossed that you'll start feeling better (and safer!!) soon.  :crossed:
Resistance isn't futile.  It's voltage divided by current. 


Western U.S.

YouKnowWho

Wine when I am on histamine overdrive, stressed or post antihistamines will make me feel like I am on another planet. 

If eggs come back negative on the bloodwork, I would ask for an in office food challenge before declaring them a non-issue.  I say this for two reasons.  One, you might be second guessing yourself at this point - I'm guessing this whole situation is overwhelming at this point.  (Again keep in mind that size of wheals really has little coorelation of "how allergic" you might be, so just because it was smaller than almond doesn't mean that almond would be more of a reaction for you.  The same goes for the RAST test).  Two - challenging them in the office with a possible reaction may give you a chance to speak with your dr about action plans, etc. 

Hang in there - I know it's a roller coaster but so far you are rocking it!
DS1 - Wheat, rye, barley and egg
DS2 - peanuts
DD -  tree nuts, soy and sunflower
Me - bananas, eggplant, many drugs
Southeast USA

SwayGirl

Quote from: CMdeux on June 14, 2012, 12:29:38 PM

most "almond flavoring" isn't almond-derived.  It's cheaper, apparently, to extract it from apricot/peach pits using some industrial process.  That's why so many almond flavorings do NOT list "tree nut" on the label.  Of course, you'll have to call to verify that this is so, but a lot of the time it's the case.  "Almond" scent/flavor isn't always.

Oh, this is interesting. I'm sure you're right, it's an artificial additive.

Quote from: CMdeux on June 14, 2012, 12:29:38 PM
Tests are just.... tests.

Seriously-- Angel Food cake is, like, once of the most amazingly concentrated sources of egg allergens that I can envision, short of meringue.  <shudder>

Yes, I agree. I'm certainly going to follow what my body is telling me, as opposed to a test. I'm definitely avoiding all egg, reading ingrediant lists and everything. I've been doing that ever since the angel food cake incident. Actually, I was wondering if that affects the blood test? Because I've been pretty darn vigilent, so the only egg in my system when I had the blood test would be the bit from the skin test an hour or so before. Not really sure how the blood test works, I guess.

But I think the nut thing is real, unfortunately, not just a false positive. I had a scary situation yesterday after eating a sandwich made on a bun I thought was safe (and maybe was...), but unthinkingly I toasted it in the toaster oven, which had not been cleaned out since the nut diagnosis, and definitely had residue and crumbs from the normal bread we have eaten for years--chock full of nuts, seeds, all manner of suspect bits. I absolutely, positively should have Epi'd, and I'm so upset I didn't. Strangely, by coincidence I was alone again, and when the reaction started I thought, Oh, no...I better get the Epi from my purse (which was across the room). But then I got so sleepy, and I couldn't get up off the couch to get it. Just sort of fell asleep...it really didn't seem like "passing out" but like drifting off to sleep, then woke up soon after (seconds, minutes...not sure). I was really freaked out--thankfully DH came home very soon after.

But STILL I didn't use the Epi. Kept saying I would wait and see. I don't think I was thinking clearly. But I was supposed to take my son and 3 friends to see a movie, and it was kind of a big deal, they'd been looking forward to it all week, and I didn't want to let the kids down. This seems, in retrospect, really idiotic. I am so mad at myself for not taking more care. If it were my son, I would not have hesitated to use the Epi. I don't know why I keep taking risks with myself when I absolutely know better.

I do think part of it is that I am, I realize now, kind of scared of the Epi. Not so much the needle, just...I guess the effects of the medication, the chain reaction that follows, with ER, etc. Maybe it will make it real? I don't know, but I am not normally a fearful person--fairly action oriented, really. Perhaps that's the whole deal with the food allergies:  It is a big smack-in-the-face reminder that I have no control over it. Can't wish it away, or pretend this isn't happening. Better put on my big girl panties and deal with it, as they say. I realize I need to be as vigilant with me as I would be with my son. I would NEVER gamble with his health and life the way I realize I have been with mine.

Once again, I am grateful for this forum and the awesome support and answers I've found here. Thanks!

Quote from: CMdeux on June 14, 2012, 12:29:38 PM
Keeping my fingers crossed that you'll start feeling better (and safer!!) soon.

Thank you. Me too!

Swaygirl

SwayGirl

Quote from: YouKnowWho on June 15, 2012, 07:19:06 AM
Wine when I am on histamine overdrive, stressed or post antihistamines will make me feel like I am on another planet. 

Really?! This is very interesting. I've had some funny reactions to wine in the last few years--flushing, suddenly very hot, after one a sip or two. I had been speculating (since the cake reaction) that egg whites used in "fining" might be the culprit, but maybe it's something related to histamine levels. This seemed even faster than those other reactions, though--almost instantaneous--which is why I thought it might be a coincidence. Also, it was way more intense than the "flushing" type stuff I've had before. It's that darned "allergy cup" I keep hearing about, I guess. I was suspicious of the brewing room because I do seem rather susceptible to airborne sort of contact, and seem to have respiratory symptoms more than other body systems. Oddly, I don't often get hives. I do get itching, sometimes very intense, but not usually hives. (When I have had hives, it's been on my palms or the soles of my feet.)

Quote from: YouKnowWho on June 15, 2012, 07:19:06 AM
If eggs come back negative on the bloodwork, I would ask for an in office food challenge before declaring them a non-issue.  I say this for two reasons.  One, you might be second guessing yourself at this point - I'm guessing this whole situation is overwhelming at this point.  (Again keep in mind that size of wheals really has little coorelation of "how allergic" you might be, so just because it was smaller than almond doesn't mean that almond would be more of a reaction for you.  The same goes for the RAST test).  Two - challenging them in the office with a possible reaction may give you a chance to speak with your dr about action plans, etc. 

Hang in there - I know it's a roller coaster but so far you are rocking it!

Thanks for this guidance. I will do that. I'll talk to him about it when I get the bloodwork back. And thanks for the words of encouragement. I'm not so sure I'm rocking it yet--more like it's rocking me!--but I'm working on it!

Oh, by the way, you asked about gluten earlier. I can see that this would seem really suggestive of a gluten issue. I know I don't have Celiac, at least, because I have to have yearly colonoscopies after an upper/lower GI found, rather by accident, a scary polyp close to becoming cancerous (and apparently it's a type that is nearly always fatal when it happens in people in their 30s). I'd been having gastro issues, including major pain when I ate, which made my doctors think Celiac or Crohn's since I was a woman in my 30s, but testing showed no evidence of Celiac (on bloodwork or on the colonoscopies), so I think I'm clear on that front. Skin test was negative this week, also, for wheat. I wonder now if that gastro pain & symptoms were the first signs of the FA. That was the start of many physical symptoms for me but no one recognized them as possibly FA related.

lakeswimr

You go so many good replies already and you are asking really good questions.

A few things that stood out to me.  The reaction you described as 'not that big' where you have various parts of your body reacting and some minor breathing difficulty is considered very serious and all plans i have ever seen would call for giving the epi pen for those symptoms. What you should know is that most anaphylaxis self-resolves but for the times it isn't going to self-resolve the epi is the only thing that is going to be able to save someone's life.  The sooner it is given the more effective it is.  Most fatalities happen in people who delay the epi beyond 20 or 30 min and giving it much sooner than that is optimal.  We divide reactions based on whether they are local or systemic.  A local reaction would be if my son got an allergen on his arm and some hives where it touched him.  A systemic reaction would be anything that affects multiple parts of my son's body.  Also, anything that involves any itchiness or swelling of the mouth, throat or for many, the fact will get the epi pen because swelling in that area can continue and block breathing. 

Once a reaction is systemic no one knows how far it will progress.  It is likely going to self resolve as your serious reactions have so far but you can't count on that.  If it isn't going to self resolve the epi is what you need and you need it asap.  Waiting and seeing is very dangerous.

Your allergist should give you a clear, written plan and the fact that it seems you don't have one is a red flag.  I'd call asap Monday and ask for one.  You can use this plan for now and have a doctor sign it.

http://www.foodallergy.org/files/FAAP.pdf

I'm wondering if you have been eating wheat with no problems.

I recommend you stop going out to eat until you know what you are allergic to so you can avoid it. Also, when you do know you can make up chef's cards that list your allergen(s) and also explain that your food needs to be prepared on a clean surface with all clean utensils that have been washed in hot, soapy water and haven't touched any allergens.  I'd be very picky about where and what I eat.  It stinks because you are not used to the restrictions and you are an adult but you will find a lot of places out there that should work for you once you know what to avoid.

I also wondered about sulfites because of the wine.   People can be allergic to them and they are in bread, wine, maybe angel food cake, etc. 

I would want to do an in office food challenge for anything you are not 100% certain is an allergen. From what you wrote I wasn't clear why you are so sure about nuts.  Egg does seem very likely but there is a small chance it wasn't egg and was something else from what I can see.

YOu are doing a great job investigating this and learning a lot very quickly!

Macabre

Yes to everything folks have said. I will add this:

I have sulfite issues with wine. I only drink wine not made in the US (All wines naturally have sulfites but US makers add more) and only red wines with the occasional champagne. Whites have more sulfites than reds. I have had anaphylactoid reactions from wine. And maybe one anaphylactic one, though those are rare, as this type of allergy is not a true food allergy. It's a chemical one. But the flushing and feeling like I was going to pass out--wow.

I have adult onset allergies. And while CM may have a point about so many developing at one being rare, it happened with me. Shellfish and sesame the same year.

My son is allergic to peanut btw. And I had a chamomile allergy prior. Also sage.

You may have an almond allergy. You may have a strawberry allergy, though it is rare.

But you will need to start thinking about where food is processed and the ingredients that you don't see on the label. The cereal: is it processed on the same equipment as egg-containing cereals?  Post makes that cereal. I don't know about their labeling. I do k ow General Mills labels for shared equipment. The same with that bun you ate. I would think easy cross contamination. (I use "cross contact" in restaurants--it makes them less defensive.)

With my sesame allergy I pretty much do not eat bread in restaurants. Because by law sesame doesn't have to be listed as an ingredient (it's not a top 8 allergen). But cross contanination tends to make me react.

For you this is important:  by law shared equipment doesn't have to be listed for even the top 8, including egg and treenuts.


We don't deal with egg, but the people here who do have to have a whole different set of criteria for asking questions than those dealing with just peanuts or just treenuts.

Also--let it sink in that no one can determine something is safe for you other than you.

One more thing--alcohol can make a reaction bigger and worse.

Oh one more freaky kind of thing--there are wines that are fined with egg or dairy. I don't know much about that and we used to have info at our old place.  don't know if we have it here.

I would hAve (on separate days) in office food challenges to almonds and strawberries before too long.


Welcome! 
DS: 🥜, 🍤

Penny

Many adults find that they react to MANY more things than they are actually allergic to by virtue of having their immune system so amped up all the time from exposure to a true allergen.  It's a little hard to explain how that works, but it's basically like filling up a coffee cup-- once you get VERY close to the rim, even a few drops can cause an overflow (a reaction).  If the cup were more empty, then that would never in a million years have happened.  KWIM?

I had lots of GI reactions to peanuts over the past 15 years or thereabouts, finally diagnosed when I had an ana reaction about 7 years ago.  My skin tests showed me to be allergic to lots of things besides peanuts, though I only reacted to peanuts and cumin. 

I avoided these foods, including trace amounts, then a couple of years ago, I tested negative to peanuts and also was neg to most other foods.   My allergist told me that with adult onset, if you scrupulously avoid your allergen, your immune system can forget that your allergen is the enemy....and as my allergy cup wasn't full, my other allergies were so much better, even environmental!   

He told me to assume I'm still allergic until I have a peanut challenge.  Because of lousy health insurance, I just avoid peanuts (but I do eat 'may contain) and have not had a challenge.  However last November, I had a reaction from a food in an Asian restaurant (a bite of a friend's appetizer - I didn't check ingredients).  I'm guessing I'm still allergic to peanuts - but def much better than in the past.  There is hope!


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