Dining Out

Dining Out.

Not necessarily an impossible feat.   But one that now requires preparation.

Yes, in advance -- preparation after-the-fact is called an ER visit.

First, find a restaurant that is able to tell you all of the ingredients in each of its dishes.  Fast food  and extremely small restaurants might not be able to disclose all ingredients, or could have compound food components which must further be broken down into subcomponents (that may or may not be available) before you can determine your risk.  Your goal should be places that can a) provide full ingredient disclosure, b) have facilities that enable them to segregate your food for uncontaminated preparation, and c) have service staff who are genuinely interested in accommodating you.

Three simple steps can tip the odds of a safe dining experience in your favor: 

• Call to Arms:  Call the restaurant and speak to the manager in advance of your visit.  
  1. Inform the manager of your restaurant reservation day and time, or the day and time you plan to show up for a meal -- this allows them to identify the chef and staff who will be on duty at that time, so that they can prep the staff prior to your arrival, and make the necessary modifications in their kitchen practices on that day.  In some instances, they will even do the day's shopping with your constraints in mind.
  2. If they believe they can accommodate you, move on to step two.

• Disclose & Review:  Verbally review your list of allergens with the restaurant manager (use your Allergy Flash Card to ensure that you have mentioned everything).  
  1. Offer to email your list of allergens (Allergy Flash Card) and ask for the manager's email address.  In some cases, the manager will offer his/her mobile number.  Start making that Key Connection now, with further intention to strengthen and broaden this connection when you visit the restaurant.
  2. If they put you in touch with the chef, confirm that this chef will be on duty when you plan to be there; then go through the details of your allergens with the chef. 
  3. If there are small things that you could assist with, like bringing your own soy-free butter or organic coconut oil, make the offer in this conversation -- you should be working together to ensure success.
  4. You might wish to ask if they have ever served anyone with a deadly food allergy.  The answer might (or might not) give you a further sense of comfort or discomfort with this restaurant.  
  5.  After the detailed allergen discussion, get verbal confirmation that they will provide a safe dining experience for you.

• Flash & Bon Appetit:  Bring your Allergy Flash Card to the restaurant.  When you enter the restaurant and approach the maitre d'/host/hostess, identify yourself as the person who called in advance to discuss accommodations for a deadly allergy.  If they have assigned staff to accommodate you, the hand-off will be clear.
  1. Once seated, hand your table server your Allergy Flash Card and form that Key Connection with your server -- some of this work may have already been done as part of the staff prep that took place prior to your arrival -- but cementing it always rests with you, so don't forget.  
  2. Chances are that they will already have a printout of your email in the kitchen, and the chef might even come out to have a pre-dinner chat.  
  3. The manager and/or chef will most likely touch base one or more times during your meal to ensure that a medical emergency has been circumvented.  Try not to feel uncomfortable -- they have appreciated the seriousness of your requirements, and have partnered with you to ensure a successful social experience. 
  4. These are the places that deserve repeat patronage... and a tip that shows your appreciation for having honored your specific survival requirements.

Most importantly, as you leave, share your appreciation for their extraordinary service verbally.  Let your body language agree with the verbal gratitude -- a look in the eye and a genuine smile goes a long way.

Now, hit the town with gusto -- Bon Appetit!

Ode to Thriving

Ode to Thriving.

Thankfully, we all have the right to survive... It's what gave Darwin the Warm Fuzzy, and Apple it's Core. But, once past survival, what's next? How could we kick it up a notch? Churn some evolution?

Simply. By thriving.

According to the Free Online Dictionary, to thrive is

1. To make steady progress; prosper.
2. To grow vigorously; flourish.

I must agree with esteemed blogger, Evelyn Chua -- to thrive is as basic to the human condition as is the need to survive. Not a luxuy, but a right.

Let's all take Evelyn's challenge (Thrive)... When they write your epitah, will you merely have survived, or thrived, having been an agent of wonder and change?

Alas, the Environment

Alas, the Environment.

I ventured out for an invigorating walk on Saturday, January 7th.  My destination was one of my usual paths -- a tree-lined area surrounding a river... A very peaceful and beautiful promenade, allowing humans and wildlife to enjoy a bit of natural habitat close to home.  It was a lovely and unusually warm afternoon -- 60 degrees Fahrenheit in January -- and I was looking forward to disappearing into nature, surrounded by the sounds of small animals... looking forward to admiring the crane, geese and ducks that have made the river their home.  As I passed the halfway mark of a mile, I started to notice a nauseous, burny feeling in my stomach that caused just enough discomfort to have created a feeling of dis-ease... that feeling grew as my short walk wore on.

By the time I reached the mile mark, one of my eyes has started itching in a characteristically hive-ish sort of way -- hot and prickly... By the time I had made it to my door, my ear rims had started itching -- I could feel them swelling, and the inside of my right ear had that eery (no pun intended) feeling that I have only ever felt when my internal organs had started swelling... it was a pressure inside my ear, and a corresponding distortion of my hearing coupled with a tinnitus-like ringing.

Think fast, Simran -- think fast... this is clearly a reaction... was it brunch (which was a combination of garden vegetables that did not cause any reaction when I had eaten two days prior)?  Not likely.  My anaphylactic reactions to ingested food usually involve 

• overall hive coverage, 
• profuse, sheet-like sweating, 
• comprehensive internal organ swelling, 
• acutely diminished lung function (similar to a critical asthma attack),
• tongue swelling, 
• intense gastrointestinal distress, and 
• immediate and forceful expulsion of the contents of my digestive tract.  

Minor implosion.  

No... this was different.  It had to have been environmental.  All of a sudden, I had a flash from my past... I had had an unexplained hive reaction to something that had bloomed six years ago, after having walked/jogged the same path into town on a lovely May morning.  This time, the reaction was more rapid and more intense.

After getting home, I noted how quickly the hives were spreading.  It had started around my left eye, to the palms of both hands and the back of my right hand... and to my ear rims and various parts of my neck... then to my right eyelid.  I took off my coat and hiking shoes, as the itching of my neck intensified.  I resisted scratching as much as possible, because the hives would spread like wildfire if scratched.  These hives looked different to food allergy hives -- they were narrower, pointier and taller than the food allergy hives, which were more disc-like, wider and flatter -- covering more area in a shorter amount of time.

An area on the size of my nose started itching... which heralded an onslaught of rapid-fire sneezes producing drown-worthy amounts of mucus... mucus overdrive continued, as i felt itching and irritation at the back of my mouth and palate, and in my throat... the pathway of a breath of air.

Clearly, the first thing I had to do was eliminate the allergens that were causing topical havoc.  As I disrobed, the neck irritation had spread to my shoulder blades and chest... then to the middle of my back... it was then that I realized that the allergen was on my hair, since the areas of hives on my upper body followed the path of my hair.  Hives had started popping up on my groin by the time I stepped into the shower.  I showered, being careful not to further irritatate areas of reaction, thoroughly rinsing, soaping and rinsing again.  The hives continued to spread.

I moisturized the hive areas, since the swelling stretches the skin... then dressed in loose-fitting clothes, since elastic and tight clothing tend to exacerbate and prolong the hives in those areas.  I took an Allegra (antihistamine), hoping that mind-over-matter would kick in immediately.  As the itching and spreading of hives continued, I remembered that I had bought a homeopathic remedy, Hyland's Hives, for use during some future incident of hives -- that time was now... so I took one of the sugar pills and placed it under my tongue.  I did this every fifteen minutes for the first hour -- by then, the itching had diminished 50%, making it tolerable enough to be distracted by a good book or movie.  During that hour, I also called a relative to ensure support in case I could not arrest the reaction on my own and would need to go to the hospital.

Throughout a reaction like this, I find myself treading the fine line between cerebral composure and panic.  The sight of red, swollen, itchy-hot hives making their way across my landscape remind me of times of the most severe reactions... and all of the uncomfortable symptoms.  If I give one moment's notice to the panic, the potential that I feel for the complication of my reaction will be realized... so, while all of this is in flight, the only way I can win the battle is by staying calm.

I made myself comfortable on the couch -- propped up with pillows, and covered with a blanket.  If I wanted to arrest this reaction, I had to shut down activity to let my immune system stop its madness.  One positive -- it would be an opportunity to catch up on rest -- particularly since a reaction like this takes a significant toll on one's energy.

I continued to take the remedy, increasing the intervals of time as the reaction subsided.  The Allegra in conjunction with Hyland's Hives and rest did the trick.  Six hours later, there was very little swelling left, and the itching had completely subsided.

Specifically, what were the allergenic culprits on that fine day?  My Allergy Immunologist told me that many of my fellow respiratory allergy sufferers were also significantly affected, illustrating a tangible example of the detriments of global warming on human health.  Since the temperature soared to 60, the local vegetation mistook it as a sign that Spring had arrived, and that it was time to blossom.  A plethora of pollens and mold spores were released into the air, before the climate was able to support Spring blossoms... before our bodies were ready to handle the seasonal onslaught.

A warm, sunny day makes us want to spend time outdoors, breathing in lung-fulls of clean, fresh air.  It might be prudent to be thoughtful before setting out.  Back to the drawing board....