quality of life studies with peanut allergy

[eragon]

http://www.ncbi.nlm.nih.gov/pubmed/?term=Avery+N+%2C+King+R%2C+Knight+S%2C+O%E2%80%99B+Hourihane+J.+%282003%29+Assessment+of+quality+of+life+in+children+with+peanut+allergy.+Paed+Allergy+Immunol+14+%285%29+378-382

http://www.ncbi.nlm.nih.gov/pubmed/21708202

[CMdeux]

Wow-- pretty small sample size, there.

I'm also wondering about two additional factors that I know from experience play a HUGE role in determining QOL:

a) nature of the food allergen

b) reaction history-- especially as it pertains to threshold dose and past reaction severity.

When you take a ubiquitous allergen in a, and combine it with low threshold and severe reactions in b, you get MAJOR impairment in quality of life.

I was amazed at how much less stressful Europe was as compared to daily navigation of north America with a peanut allergy.  It was sobering.  VERY sobering. 

So I don't think that a European study probably has a ton (or maybe a tonne) of bearing on life in North America, necessarily.

Paris would be a complete nightmare for a person with a hazelnut or dairy allergy, for example, but we didn't find it stressful at all. 

[jschwab]

Wow-- pretty small sample size, there.

I'm also wondering about two additional factors that I know from experience play a HUGE role in determining QOL:

a) nature of the food allergen

b) reaction history-- especially as it pertains to threshold dose and past reaction severity.

When you take a ubiquitous allergen in a, and combine it with low threshold and severe reactions in b, you get MAJOR impairment in quality of life.

I was amazed at how much less stressful Europe was as compared to daily navigation of north America with a peanut allergy.  It was sobering.  VERY sobering. 

So I don't think that a European study probably has a ton (or maybe a tonne) of bearing on life in North America, necessarily.

Paris would be a complete nightmare for a person with a hazelnut or dairy allergy, for example, but we didn't find it stressful at all.

Yes, I know tons of food-allergic kids and adults where it barely affects their quality of life even if they have had a previous anaphylactic reaction.  They just avoid the allergen and never think about cross-contamination, eat at any restaurant they want, etc. It's not very adult of me to resent these kids, especially  but I will admit to being jealous of that allergy lifestyle. Not that I want them to have worse allergies, just very jealous.

[twinturbo]

They probably have larger thresholds. It doesn't mean they don't have big reactions just that it takes a decent amount compared to those of us with virtually no threshold. And let's face it: we all know anaphylaxis is dangerous but the quality of life for someone who has to eat a peanut (and only peanut) or two before reacting is going to have a totally different risk calculus than LTFA with multiple allergens who have a history of contact-to-ingestion or aerosol trigger.

[jschwab]

They probably have larger thresholds. It doesn't mean they don't have big reactions just that it takes a decent amount compared to those of us with virtually no threshold. And let's face it: we all know anaphylaxis is dangerous but the quality of life for someone who has to eat a peanut (and only peanut) or two before reacting is going to have a totally different risk calculus than LTFA with multiple allergens who have a history of contact-to-ingestion or aerosol trigger.

Of course and I know that. I seem to know a lot of people who were one and done with their reactions. They had one reaction years ago, maybe as a child, maybe only eczema or hives, and they avoid the trigger but never worry about it more than that and never had a reaction again. Part of me thinks if you don't even need to think about the allergen except to remember to not knowingly ingest it, say, as a main course, maybe it's weird to keep saying you are allergic? Because then everyone assumes that all food allergies are no big deal. But I think I am just in a dark, bitter place right now.

[CMdeux]

Oh, I think that it's FINE to say that you're allergic to whatever you please, really.

What isn't okay is to treat others like they are being "way over-sensitive about it" when they have a different set of management needs.  You know, like-- er-- not eating anything at potlucks.

Just for example. 

[jschwab]

Oh, I think that it's FINE to say that you're allergic to whatever you please, really.

What isn't okay is to treat others like they are being "way over-sensitive about it" when they have a different set of management needs.  You know, like-- er-- not eating anything at potlucks.

Just for example.

Yes, of course. I have not even really encountered much of that kind of attitude at all and most people I have had to deal with have been just swell about that kind of thing. One thing we do is to always bring a huge fabulous meat dish to a potluck (like a smoked brisket). We take first dibs and everyone oos and aahs over the fancy meat they likely don't usually have time to prepare. Occasionally I have had it implied by people I don't know well (in one instance, a boss) that if I were starving I would find a way to eat my allergy foods but that is inevitable that a few people will come along who have little to no understanding.

[twinturbo]

Yeah, in the same way they'd eventually drink sea water if lost on the open ocean. It'll go about as well.

[jschwab]

Yeah, in the same way they'd eventually drink sea water if lost on the open ocean. It'll go about as well.

It's just a myopic attitude about the world. It's like people who assume that in developing and poor countries no one has food allergies - it's a "first world problem". Well, they do. They are probably just more likely to not receive proper care. Long before I developed food allergies, I met a homeless man while I was waiting in front of a theater for an event to start. I had quite a while to wait and we got to talking and I went and bought him a plate of food without asking him about it when I went to get my lunch. It turned out he was allergic to shellfish and could not eat most of it . I was so embarrassed and annoyed with myself for not just talking to him and assuming he would take whatever was offered. Of course, I'd probably have no empathy now since I can't eat anything that has been on a plate with shellfish or anything with mystery ingredients  .