- People with food allergies should be especially careful while traveling
- Know where you would need to go for emergency treatment for an allergic reaction
- Take medications with you in case you get an allergic reaction
- Talk to your doctor about what's right for you when traveling
I'm the annoying person in the restaurant who needs to know specific ingredients in whatever I'm eating. I'm also the one wearing a hooded sweat shirt so pollen won't get in my hair.
Allergies, both to particular foods and pollens, have been bothering me my whole life. Food allergies, which affect a growing number of Americans, can lead to life-threatening reactions. Environmental allergies cause a lot of sinus discomfort.
But I try not to let all of this totally derail my love of travel, and you shouldn't either.
Here are some tips I've gathered from allergy experts for various kinds of allergies when you're away from home:
Food allergies: When you're eating ...
Be extra careful. Dr. William Calhoun of the University of Texas Medical Branch says food allergy sufferers should be more cautious than ever while traveling.
"It's extremely important that they watch their dietary intake, and that can be particularly difficult in foreign countries where you may not know the customs of particular restaurants, and in fact there may be language barriers," he said.
Carry an ID card. Dr. Clifford Bassett, director of Allergy & Asthma Care of New York, recommends having a card in your wallet that lists to what foods you are allergic, the name and phone number of your doctor and a notice that you are carrying an epinephrine autoinjector for emergencies.
In a restaurant, you can present this card to the chef. Make sure you also talk about the possibility of cross-contamination -- if a spoon touches peanut butter before your food, for instance, that could be a problem.
"Call ahead if you're going to a restaurant or a party when it's going to be very busy, and no one's going to be paying attention to food allergies, 24 hours before you go, and go over with them what precautions (they) need to take," Bassett said.
Translate your allergies. Language barriers in foreign countries can be frightening even without allergies. There are services online that offer printed cards that explain your allergies in any language you need, some for a fee. Bassett also recommends Google Translate. In addition, you can recruit a native speaker to help you make your own.
I always feel better when I'm dining abroad with someone who speaks the local language better than I can and who can act as an intermediary in case my accent masks the seriousness of the situation. My boyfriend's family was incredibly kind and thoughtful in helping me eat safely during my 11-day stay in New Delhi in December 2011; I enjoyed a wide variety of South Asian cuisine without getting sick.
Carry backup medications. Epinephrine autoinjectors are the only treatment for anaphylaxis, a life-threatening reaction that can include closure of the throat and difficulty breathing. Make sure you bring multiple doses in case you need to use one; some reactions require two. Once you use an epinephrine autoinjector, proceed to the nearest hospital for follow-up treatment, Calhoun said.
Make sure you have the autoinjector with you in a carry-on bag and not in a checked suitcase, Bassett said. It's a good idea to also carry a doctor's note explaining why you need it in case you get questioned at customs.
Where can you get treated? If you or your allergic child does accidentally ingest an allergen, you should know where locally you can go to get immediate treatment, Calhoun said. Look up which hospitals can treat an anaphylactic reaction in the cities you are going to visit abroad.
Bring your own snacks. Sometimes there are situations where people with food allergies simply do not feel comfortable eating because of the likelihood that allergens are present in food. You should always plan a backup so you don't go hungry. Bassett advises parents to feed allergic children safe foods before they enter situations where everyone else will be eating foods that could cause them to react.
... And when other people are eating:
Think about your comfort with peanuts. The issue of peanuts on planes is dicey. Whether peanut or tree nut dust in the air can cause life-threatening allergic reactions is still controversial.
But people with allergies and parents of allergic children still worry about the potential of reactions from smelling or coming into contact with these snacks in a row of tightly packed travelers. There hasn't been much research on the issue, however.
There is no federal regulation governing peanuts on planes in the United States, but some airlines are peanut-free anyway. Others offer to create a "buffer zone" of a few rows in front and behind a person in which peanuts will not be served.
Some will refrain from serving peanuts if a passenger calls ahead to request that and will even make an announcement requesting that no one eat peanuts. You might also be able to board early to wipe off your seating area.
Ultimately, though, there are no peanut police aboard planes.
"Individual patients need to take into consideration the degree of sensitivity they've got with peanuts, and if they've had overwhelming life-threatening reactions with trivial doses of nuts, then due caution is warranted," Calhoun said.
Dealing with environmental allergies
As Calhoun put it, you can't alter the climate or the pollen count wherever you're traveling, but you can make sure your medications are available.
Know your pollen. An allergist can give you a skin test to determine to which specific pollens you are allergic, Bassett said. If you are visiting a city that displays its pollen counts for different trees or grasses online, you can prepare yourself for what may come.
Get rid of the pollen. If you are in a particularly pollen-heavy place, wear a wide-brimmed hat so that pollen doesn't get into your eyes and hair, Bassett said. Wash your hair before you go to bed and clean off your glasses and change clothes so that you don't allow pollen to linger on your body.
A nasal saline bottle can help remove pollen from your nose and is a handy item for a bag that you carry, Bassett said.
Bring extra defense. No matter what kind of environment you think you're traveling to, Calhoun recommends bringing along extra defenses. Any decongestants and antihistamine medications you would use in an allergic situation should come along for the ride -- the nose sprays, pills, eye drops, and whatever else you would use when the environment is making you sneeze.
"My patients travel from one place to another, and it's not clear what the aeroallergens might be," he said. "If symptoms begin to worsen, they'll have those backstops."
He also recommends keeping all medicines in their original packaging in case security officers question what they are.
When it makes sense, premedicate. There are situations where it may make sense to take allergy medicine ahead of time. For instance, if you are allergic to certain animals, you might find yourself on an airplane with one. People with disabilities, including mental health problems, can bring animals on board for support, and some carriers generally allow small pets.
Calhoun recommends taking a pseudoephedrine decongestant before getting on a plane if there's a chance an animal on board could trigger your allergies or asthma. You might also consider wearing an M95 filter mask, available in drug stores, although there's no hard evidence this will help.
The bottom line
If you have serious allergies, talk to your doctor about what is the best strategy for you when you're away from home. Bon voyage.