What is risky and what is not

[Hurra]

Hi all

My previous and first thread was about my wife possibly secretly exaggerating her peanut allergy to manipulate factors in our lives and lying about other allergies. I have evidence to question the severity of her allergy and evidence that shows she can eat chocolate which she claims she has not been able to eat since she was a kid. 

Anyway, I had questions on peanut allergies. I read that the smell of peanuts does not cause a reaction; maybe only a mental reaction of fear. One has to intake the protein through their mouth, nose or eyes. So would a bag of peanuts in the same room be a risk? Peanuts that are still in their pods? I can understand and see if the peanuts were broken open, baked,  etc releasing proteins in the air but I'm asking about peanuts in unbroken pods.

If peanuts stored in a kitchen drawer that was moved to an adjacent, sealed attached garage a few days in advance of someone with a peanut allergy visiting, still cause that person to wheeze and have difficulty breathing?  If that drawer was opened during the visit,  could remaining peanut proteins in the air be released and cause a reaction?

I dont have the allergy personally but the above scenario seems unlikely to me but I'd like your opinions. 

Thanks

[guess]

I'm not comfortable with any of the following: the general direction you're going in testing a loved one's threshold or the threshold of others; your motivation which is embedded in lack of mutual trust; your intended actions as a result of gross over generalization thereafter.

This sounds disturbingly like a witchhunt that a school law firm would take in denying 504 eligibility.  People, and even doctors, misappropriate the term "allergy" to mean a variety of things that have nothing to do with medically valid allergy.  However, peanut is associated with the highest mortality rate for a few reasons.

At this point I'm going to directly ask you what your ultimate purpose is.  You use the word "lying" a lot.

[guess]

Tell you what.  Bring your wife here in a show of good faith.  She can talk to other people that live with this, with first hand experience.  We can chat with her about it and share resources.

[Hurra]

I'm not going to test theories that could ultimately threaten her life. I am just trying to get more information and learn about how this allergy can actually affect those who have it before confronting her again.

I do think she is allergic to peanuts,  she would not have been given epipens if she didn't. But the severity is what I am questioning,  and what reactions are possible or not likely.

[CMdeux]

Threshold, routes of exposure, and eliciting doses are questions that are best addressed with two people in the loop (and are probably flatly inappropriate for anyone ELSE to be discussing with them out of it):

1.  The allergic individual-- who, once an adult, is almost certainly THE expert in their own condition, and

2.  That allergic individual's personal physician, preferably an experienced and highly competent FOOD allergy specialist (they don't grow on trees, either-- there are a lot of plain vanilla allergists out there who don't really know a lot about food allergy).

I know that you're reading some responses to your posts as "hostile" but you have to understand that having someone that we trust implicitly "test" our (or our kids') allergies in the way that some of those posts hint at...  well, that is the stuff of our nightmares.  Because there is no way to be mentally prepared for that level of betrayal.  I have no idea whether or not your wife's allergies are fabricated, exaggerated, or anything else.  But if she trusts you with those allergies, "trying" them without her knowledge is a level of betrayal that is so profound that not even infidelity comes close.  I'm not kidding.





Some things that you should be aware of, that said--

a.  The few studies that examine aerosol (smell) reactivity have significant limitations-- making them useless for the most sensitive tail of the food-allergic distribution, IMHO as a scientist (and yes, I really am one, and I'm basing that statement on the statistics and methodology in those studies).

b.  The few studies that attempt to determine what a lowest "eliciting dose" is have ALL had participants which reacted to the lowest levels offered, albeit with "subjective" symptoms that didn't BECOME objective ones until higher doses were reached. What that means is that those allergic people KNEW that they were being dosed before the researchers did. 

c.  One pretty well-designed study demonstrated rather convincingly that those who react to those super-low doses are the ones that have MORE SEVERE reactions, in general.


Add all of that together and what emerges is this:

there are peanut-allergic persons who react to amounts that are so low that they are mind-bogglingly small, and difficult to even measure using the best methodology-- and that those people tend to be at very grave risk from exposures.  They are NOT most people with the allergy, but for obvious reasons they are quite difficult to study.  Once you are in that group of people via reaction history, you are automatically ineligible for most studies that might require you to be exposed to (or react to) peanut-- because the risk of a life-threatening reaction (and possibly death) is too high for Institutional Review Board (IRB) approval to be obtained, if you are designing a study.

So research studies DO NOT INCLUDE people with that kind of sensitivity.  The few early studies that did found some disturbing differences with that group relative to the larger peanut allergic population as a whole-- their thresholds are unstable, and they react severely to low doses-- unpredictably.

Additional research studies have hinted that this population is quite real-- desensitization work has had failure rates (with some pretty spectacular failures, in fact) that indicate that there is something very different about those people.

I'm stating all of that as a caution-- if someone tells you that they have that kind of allergy, you CANNOT afford to go behind their back to prove them wrong.  EVER.  You really could kill them if it turns out that they were not exaggerating or lying.





Please take a look at the events surrounding Chandler Swink's recent death.   This is definitely possible. 

My own DD is fifteen-- and she KNOWS when someone has eaten peanuts-- even hours before they are talking to her.  She knows.  She can sense them on someone's breath-- she truly has a super-human sense for them.  She is one of those super-sensitive people.  A LOT of people have been unwilling to believe her over the years-- and mostly she avoids those people because they are really, really dangerous for her to be around. 

Another example for you-- she had a recent reaction that was pretty spectacular-- vomiting, some disorientation and a few hives that popped up late in the reaction.  The cause was something that we'll never know for sure, probably, but the best we can determine this was caused by her boyfriend TOUCHING her after driving a car-- that another driver had driven after consuming nuts.  Is that too farfetched for you?    We have estimated based on the sum of her life experiences and ours that her reaction threshold fluctuates between 50 micrograms and somewhere close to 1 milligram of peanut.  REALLY not kidding.  Those are invisible amounts.  Any environment where peanut IS regularly consumed poses a dreadful danger to someone like my daughter, and putting them away does little to mitigate the myriad places where the protein has built up or can be stirred up to recontaminate things.

[guess]

Define how hiding a sack of peanuts plays a part in confrontation.

Think carefully, Hurra, before responding.  You said you are suspicious, you state you believe your wife lies, you are very intent about her allergen and now you want to know what it takes to set it off.  Thoughts and communication are one thing.  Actions that can have dire consequences are another.  Think about the difference and conclude what the right thing is to do here to get this resolved with safety, and mutual satisfaction.

[CMdeux]

If peanuts stored in a kitchen drawer that was moved to an adjacent, sealed attached garage a few days in advance of someone with a peanut allergy visiting, still cause that person to wheeze and have difficulty breathing?  If that drawer was opened during the visit,  could remaining peanut proteins in the air be released and cause a reaction?

The answer is that it depends on the individual-- and if it were possible for an individual even, that doesn't guarantee that it WOULD happen.

I cannot possibly tell you whether or not such a series of events is somatic or something else.

What I can very definitely tell you is that my child has experienced just such reactions-- and they were in NO way anything but authentically physiologically derived in her case in particular, given the particulars (her age, the circumstances of the exposure, etc.) -- and that we have a top-notch medical professional who agrees wholeheartedly with that assessment of them.

I can also tell you that she is easily in the most sensitive 1% of patients that this top-notch allergist has seen in his career caring for food-allergic children.    Possibly in the most sensitive 0.1%, actually.    He has mentioned only seeing one or two others like her-- and he did his training at one of the world's CENTERS of research and clinical practice for food allergies.

I'm telling you that yes, this kind of reactivity IS possible, even if it seems to beggar belief. 

I'm also telling you that it is unlikely for MOST people with peanut allergy to need to worry about that kind of exposure.  (But an individual isn't "most people" in the first place; they are themselves as idiosyncratic individuals, not averages.)

[Hurra]

Peanuts were not being hidden. We planned to visit family who kept peanuts in a drawer and removed them days in advance of us being there given her allergy. But apparently leftover peanut protein in the air of the drawer affected my wife days later. That just seems highly unlikely to me especially that she secretly eats chocolate bars that may contain peanuts. 

[guess]

Here is the problem.  For you it begins and ends with peanuts in a bag for a couple of days.

For an allergic individual it begins 6 months prior with all the protein being tracked around.  Roasted peanut is one of the most durable around.  Those proteins do not denature easily, as compared to hen's egg or cow's milk.

All the bag in the Ziploc in the drawer means is that we know for sure it was present in the environment well in advance.  I assume they were not there for ornamental purposes. 

You need to talk to her.  Not confront, talk to her.  Or just drop the whole thing.

[CMdeux]

It sounds-- and I hope this doesn't offend you-- as though you've already DECIDED that you think this was deliberate/manipulative/(something??) and are looking for validation that you're correct.

The problem is that you are unlikely to get that validation from this particular community-- we all know all too well that there are a million tiny inputs that go into EVERY decision re: management.

For example-- in the "just in the drawer" example-- is this bag factory sealed?  No?  Well, then where HAS it been opened in the past?  Is the area carpeted?  Cluttered?  Over a period of how many years has this draw contained peanuts in-the-shell? 

NOT so simple.

[SilverLining]

Anyway, I had questions on peanut allergies. I read that the smell of peanuts does not cause a reaction; maybe only a mental reaction of fear. One has to intake the protein through their mouth, nose or eyes. So would a bag of peanuts in the same room be a risk? Peanuts that are still in their pods? I can understand and see if the peanuts were broken open, baked,  etc releasing proteins in the air but I'm asking about peanuts in unbroken pods.

I breath through my mouth and nose. Does your wife breath a different way?

[CMdeux]

And the act of OPENING that drawer is very definitely a mechanical means of disturbance-- of the drawer, the air IN the drawer, any dust on the glides/runners holding it in place, etc. 

If peanuts have been consumed regularly over a period of years, and stored in that single location (meaning that occasional spills have likely occurred), then yes-- I believe it in someone with a low threshold dose for peanut. 

I also believe that it is nearly impossible to make a peanut-consuming household TRULY safe for a short visit by someone with this kind of sensitivity.  My mother and her spouse tried a few times, but honestly?  It was terribly hard to control my daughter's asthma every time we visited, and I had to spend the first day we were there DECONTAMINATING the kitchen sufficiently that I could use our own utensils and pan to make my DD her own (safe, brought from home) food.

The carpeting and upholstered furnishings were heavily contaminated in my mom's home.  DD suffered terribly while in the house-- and improved when we went somewhere outside of it, often within a few minutes.  Given that this was evident when she was as young as 2 or 3 years old, I'm really thinking that this was not about my daughter's need to control others or misrepresent anything to anyone.  Given that it was STILL a problem when she was 9 and fully aware of what she was touching and was a veritable FREAK about handwashing, going so far as to sit on towels, etc. and not touch non-washable porous surfaces, etc-- I also think that there is only so much that attempts at mitigation can accomplish.

The real question is only whether or not a person with a peanut allergy is among the ultra-sensitive group that my daughter belongs to.   Candy bar wrappers in the trash-- unless the individual has CONFIRMED that s/he is consuming those items-- are not proof that the individual is not that sensitive.  Possible that they belonged to a friend who ate them in the car or something, yes?

This isn't a conversation to be having without involving the allergic individual. 

[Macabre]

Hurra I'm glad you are here asking these questions. As you have no doubt gathered, threshold levels are highly individual.

My son has had an anaphylactic reaction from being around a highly concentrated PB cookie. It's not the smell but the protein. It could have been anxiety but he was in close proximity and his throat tightened  before he knew there was a PB cookie nearby. His doctor says it's by ingestion only but I've seen too many reactions that weren't.

The same doctor (one of the FA gurus) also affirmed that a different anaphylactic reaction happened accidentally. DS picked up peanut protein on the door (cafeteria or bathroom--after he went to the bathroom during lunch at school) and then accidentally ingested it. He head to have an Epi and leave school in an ambulance.

That was the second time a reaction like this happened. The first was at a different school where he picked up peanut protein from sports equipment during PE and didn't wash his hands before having a snack. He had  asthma (that woukdn't respond to his inhaler) and spaciness. Epi and hospital for him--and then he had a biphasic reaction 8 hours later that required an Epi and ambulance ride to the hospital.

He doesn't eat at houses that use peanuts--or at least doesn't eat any food that he can serve himself that hasn't been contaminated. So--individual bags of chips fine but not a big communal bag.

In any case, we also avoid family homes that use our allergens.

After visiting a house with a dog (hardwood floors and I don't sit down, and shower after coming home and wipe down the leather car seats, etc) I am coughing up mucous and having worse asthma symptoms for days. Heck--I can do that for a few hours after. My husband returns from a house with cats and washes clothes immediately and showers.

Peanut protein, as guess said, oeanut protein is not easily cleaned. Clorox wipes aRe effective.  There was a study almost two years ago that showed it doesn't break down on its own--went for at least for 100 days with no significant degradation. It has to be properly cleaned off. A sponge and water won't do the trick.

As we said before, some may contains don't contain but many do and you just don't know. She could be getting lucky. That said, there are foods I am comfortable with for my son or me that work for us. I can't explain why I am comfortable with them. But other brands I have no trust for.

Every single person here goes through a different anxiety journey. And it goes in cycles. It's normal for a person with food allergies to experience this ebbs and flows in anxiety.

However, I would try to stop using the word lying. There may be words for her behaviors, which baffle you. But I would try to stay clear of the L-word. 

[spacecanada]

I can echo most of what was said above, and add that I had an almost EpiPen reaction last night to the walnut oil in the paints my husband was using in the next room.  The proteins from the oil (however minute), were being stirred up in the air, which I breathed in and caused symptoms: itchy/puffy eyes, headache, stomach ache, and other seasonal-type, allergy symptoms.  (I wasn't aware that he was painting at that time.)

Yeah, yeah, multi-symptoms reactions = Epi, and I really should have used it, looking back, despite symptoms being mild overall.    Husband is now re-homing all his paints and art supplies that contain walnut oil.  (He previously only used them when I wasn't home, until yesterday.)

So there's proof enough that incredibly minuscule proteins can be stirred up into the air and cause reactions.  The art studio room has now been quarantined and I'm not allowed in until my husband can scrub everything clean, because traces are now everywhere.

So, yes, the situation you described could be extremely dangerous to a persons with low threshold peanut allergies.  Even with peanuts in their shells, peanut residue is everywhere, and anything in that drawer, around that drawer, or possibly in that room could now be contaminated.  It's not worth the risk.  However, with someone with a much higher threshold, that may not be a problem at all.  Always be conservative; assume the lowest threshold possible when creating a safe environment for someone with allergies.

[SilverLining]

I am so sorry to hear about your reaction.