Evidence vs. Experience
I have what can best be described as a crapload of allergies. Some of them have been around since I was a kid — if I ate too many grapes or apples, I’d get hives — but others are new additions. First came kiwi, then 15 years ago certain kinds of nuts arrived, taking with them all other kinds of nuts due to the risk of cross-contamination (I miss nuts…). Then came Enbrel, which made me allergic to what seemed like the entire world. Since I started Humira, I’ve gradually added back foods, but still have a number of interesting limitations, what between cross allergies — did you know that if you're allergic to kiwi, you probably have a cross allergy to melon? I found out the hard way — aggravated histamine levels thanks to Humira and my body’s just plain persnicketyness.
Living with a crapload of allergies is a pain in the arse, particularly nut allergies. Because of the cross contamination issue, having a nut allergy means being pretty paranoid about other kinds of foods. You can't buy bread in a bakery, because the baking sheet upon which the bread has reposed may also have been used to bake something containing nuts. You can’t buy chocolate bars without nuts because they’re usually made in a factory that also makes chocolate bars with nuts, so there might be cross-contamination. Same goes for cookies, ice cream and anything else you can think of. Thankfully, the last couple of years, I've seen more products being made in nutfree environments and the labeling laws in Ontario do help tremendously. But I still miss chocolate. Good chocolate. Nestlé makes four different kinds of chocolate that's nutfree, but it's made for children. It's not really good chocolate.
But I digress. Lately I've been in the mood to expand my food options, but thought it best to verify my own assessments of allergies. I'd seen an allergist and had some blood tests that came up negative, but let's make sure. This meant a return visit to said allergist for a skin test to confirm — or perchance, I hoped, to deny — the long list of what I shouldn’t eat.
A very nice woman from an Eastern European country was entrusted with performing the skin test. This is that test where they smear concentrated allergen on a double row of small needles and then press them hard into the underside of your lower arm, followed by a few notations in pen to differentiate them from each other. I winced my way through the right arm, but as she prepared the contraption for a second imprint on my left arm, I started thinking about Eastern Europeans and their reputation for brusqueness. Somehow, she didn't seem nearly apologetic enough.
And then I went into the waiting room to join the line of other
victims patients sitting with their bare arms outstretched, afraid
to move in case it might mess up the test. Deeply fascinated, I kept an eagle
eye on each tiny hole in my arm with its accompanying marker in blue pen,
waiting for red bumps to appear.
None did. I looked closer. Nothing. Cooked some more, then looked again. Still nothing.
And this is when I started fantasizing. Because I knew that several perforations on my left arm represented nut proteins and there clearly was no reaction, so maybe I wasn't allergic after all? Maybe it had been some fluke reaction? Maybe I could start eating nuts again?! And this was the point where visions of not sugarplums, but two particular items after which I have been lusting for years started dancing in my head. I imagined stopping by the grocery store on my way home to buy one of those wonderful deep, dark Lindt chocolate bars that are all over the place now, but which I have never tasted (with the exception of a few experiences, I haven't had really good dark chocolate in decades). Right after that, I’d swing by the bakery on the bottom level of the Market and get a freshly baked croissant and carry it home, still warm in the bag. I'd eat the croissant and chocolate together.
I love croissants. So much so that back in the 1980s when we visited Paris for five days, I lived on cappuccino and croissants. Once, we stood outside a bakery not too far from the Eiffel Tower for 25 minutes waiting for them to finish baking. It was a really good vacation.
But I digress. My allergist came out, took a look at my arms and then sent me back in for another round to doublecheck the nuts and kiwi. For the latter, we had to go to the cafeteria, get a fresh kiwi and the love Eastern European woman mashed some of it up and put the juice on a couple of the holes in my skin. I haven't been that close to a kiwi in 15 years. All I remember is being nervous and that it smelled really green. The result? Again, nothing.
The chocolate and croissant were so close I could taste them.
And then I went to have a chat with my allergist, who told me that the only tests that came up positive were for dust and dust mites. So, I asked, with a significant amount of excitement in my voice, did that mean…?
No, it did not. As my chocolate bar and croissants fluttered away with the inside me yelling noooooooooooooo, I listened to my doctor tell me that there are studies showing that you can show negative in both blood and skin tests and still have an anaphylactic allergy. In particular, a large French study of people with sesame allergies demonstrated this conclusively (at which point, I wondered whether they had deliberately induced anaphylactic reactions and then decided I didn't want to know). He told me to trust my experience of "interesting" reactions to a crapload of different foods, snacks and other substances. And then I went home. I did not stop by the grocery store for a chocolate bar and I did not stop by the bakery on the bottom level in the Market for a freshly baked croissant.
As I was nearing home, I considered the irony of a doctor trusting my experience, rather than the evidence, the one time I didn't want that to happen.