When Cason Taylor was 18 months old, he grabbed a single cashew off the kitchen counter, popped it into his mouth and spit it out. Yet within 60 to 90 seconds, his face and mouth were swollen. Now 5 years old, the memory of his first anaphylactic allergic reaction lingers.
“He is very careful, cautious and fearful,” says his mom Katie Taylor, who is a registered nurse. “He won’t eat anything unless I or someone he trusts has read the label to ensure it’s safe for him.”
Cason and his older sister, 13-year-old Kyra, both have severe anaphylactic food allergies, including tree nuts, peanuts, eggs, dairy and seafood. Kyra also has skin, seasonal and environmental allergies.
The Taylors never eat out because of the risks. “You just don’t know,” Katie says. “Did they fry fish in the same oil as the French fries? I’m always thinking about cross-contamination. What if someone ate peanut butter and touched something near him? We have to constantly be mindful.”
The Taylors never leave the house without EpiPens, inhalers, oral steroids, Benadryl, Zyrtec and Zantac. This is life with severe allergies.
How and why do people develop allergies?
Allergies are a type of modified immune response to something that is not part of the body. “How this happens is very complex and not entirely worked out yet,” explains Dr. Timothy Nickel with Allergy Clinic of Tulsa.
Nickel further explains the phenomenon using the analogy of a home and family as the body and a guard dog as the immune system. “Normally, the guard dog will fight off any intruder to our home, which is good,” Nickel says. “However, sometimes the guard dog will also bark and get agitated with the mailman, who is actually not a threat. This is like an allergy to inhalant pollens and environmental allergens. If the guard dog goes crazy and starts attacking the family, this is like autoimmune disease.”
Tests and treatment
Although allergies can develop at any age from infancy through adulthood, Dr. Jane Purser of Allergy Clinic of Tulsa says she often sees a pattern to development. “Three to seven years after moving to a new state or even in daily environmental (changes) such as retirement, one can see new or worsening allergies. Retirees often start doing their own yard work … or cleaning out closets,” she says.
The type of test used to confirm allergies is dependent up symptoms, according to Dr. James T. Love with Allergy Clinic of Tulsa. A skin test using pinpricks or injections is often used for nasal allergy, asthma, food or insect sting reactions. Blood tests are another option but may be less sensitive than skin testing. Patch tests are used for unexplained rashes and may also be used to test chemicals and metals.
Once an allergic trigger is identified, the first obvious treatment is avoidance. For allergens of the eye and nose, a saline (salt water) wash is beneficial. Topical and oral medications are also commonly used. “Some patients may be good candidates for immunotherapy to help the allergies go into remission,” Purser says. “This can modify the inflammation in the body caused by allergies.”
In addition to these options, for families like the Taylors facing multiple life-threatening allergies, 24/7 vigilance is the optimum strategy.