Panic or Allergies?

Patient Expert

During a dinner out last week something happened that reminded me that I am really taking my life into my hands every time I eat away from home. That panic can exacerbate an allergic reaction (or in my case a non-allergic one) and that, without exception, everyone around me needs to know the allergic action plan in case something goes down.

So I was chomping away on my salad, cautiously, after asking the bartender who was serving me three different times in three different ways (which is totally my modus operandi, I remind servers after each course about my allergies), "Are you sure there are no nuts in this salad?"

He said a firm, "No."

About mid-chomp, some frisée lettuce caught in my throat. Since I can't bread down the frisée, (I'm wheat intolerant) I had some water and forced it to pass. But it left its mark: a scratchy feeling in my throat - just like an allergic reaction. Crap. And then I had a cascade of emotions, all of them panic related. Maybe they made a mistake in the kitchen? Maybe there was a stray nut in the salad? Maybe, maybe.

I started to have that desperate feeling, that pleading feeling, that "Please let it not be anything" feeling. It was then that I realized my dining companion, Shari, with whom I dine often, didn't know the action plan or how to help me if I needed assistance.

I took out my bag of tricks: a very fancy a Ziploc with my two Epi-Pens, scores of tabs of up-to-date Benadryl and my Albuterol inhaler (still the CFC kind). I showed Shari the ICE (in case of emergency) numbers on my celly and how to use an Epi-Pen.

And then I told myself to get a grip and check in with my body. Did I have an itchy throat or was my throat simply friséed? After years and years (and years) of practice at un-panicking myself, I was able to slow my heart rate, and do the check in: was I itchy or hivey? Were there any symptoms?

I drank some water. Throat seemed all clear. I started to relax and I said to myself, "OK. Let's just sit here, have some conversation, stop eating and see what happens."

Nothing. Five minutes went by, then 10. My throat was starting to feel better and I was starting to feel silly. The salad was fine. I was fine. My throat was feeling funny because of the frisée, not anything worse. Whew. I went on with my dinner and the rest of the meal was perfect. No problems.

But here's the odd thing. All you need is the one bad food allergic experience to imagine many more, recreating it in your mind and in your body. I haven't seen any studies on it specifically but I would bet that Post-Traumatic Stress Disorder (PTSD) and chronic illness (in this case, food allergy) have a correlation. PTSD is the name for an emotional cascade that repeats itself after a traumatic event. As defined by "Posttraumatic stress disorder (PTSD) is an emotional illness that develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience. PTSD sufferers re-experience the traumatic event or events in some way, tend to avoid places, people, or other things that remind them of the event (avoidance), and are exquisitely sensitive to normal life experiences (hyperarousal)."

Usually PTSD is associated with survivors of major disastrous events, rape survivors, war survivors. However, I think that lesser forms of PTSD can be found in people with food allergies or those that have experienced traumatic asthma events (like being hospitalized).

Some new studies underscore the correlation between PTSD and asthma: Researchers found that sufferers of PTSD had higher instances of asthma. "No one knows the reason for the association between asthma and mental disorders," lead researcher Renee D. Goodwin, Ph.D., M.P.H., Columbia University, was quoted as saying. "Asthma could increase the risk of anxiety disorders, or anxiety disorders might cause asthma, or there could be common risk factors for both asthma and anxiety disorders. Our study found the association between asthma and PTSD does not appear to be primarily due to a common genetic predisposition." The authors believe it is possible traumatic stress -- which has been associated with compromised immune functioning -- can lead to an increased vulnerability to immune-system-related diseases such as asthma.

As I mentioned, after years of practice, I'm able to recognize when I'm feeling anxious and separate that from when I'm feeling allergic. The trick is to separate the real allergic danger from the perceived danger and to calm the anxiety arising from something historical, rather than what is really happening in the present. I wonder how many of you have felt the same way?