Galway Advertiser 2006/2006_11_30/GA_3011_E1_020.pdf 

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Galway Advertiser

November 30 2006

NEWS

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FASHION

BEAUTY

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H E A LT H

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LIFE

MARY O'CONNOR Living with anaphylaxis
E
ating out is potentially lethal for Shane Flaherty. The 31 year old Nocknacarra man man suffers from anaphylaxis, a potentially severe and sometimes fatal allergic reaction to food, medication or insect stings. He was four-years-old when he had his first major food reaction. He had just returned home after having some chips at a take-away with his mother when he started vomiting and collapsed. " My family didn't know what caused it. But months later, I had some fish fingers at home and only managed to get from the kitchen to the sitting room before collapsing again. After coming round, I was sick for a day or two." Fish was the problem in Shane's case. His mother soon realised that the chips, which had caused such a violent reaction in her son a few months earlier, must have been cooked in the same oil as that used to fry fish. His frightening experiences have made him very wary of eating out, especially from fast food outlets. " In the past, I used to ask how the chips had been cooked. But I began to sound like a crank or some sort of health fanatic. "Now I don't risk eating them anymore. It's not worth the danger or the trouble. I stick to eating very basic foods. People have died from this condition. When I see fish, I fear for my life." Coming into close contact with cooked fish affects him adversely, too. "If fish is being cooked at home or near me in a restaurant, I come out in a mad pink rash. The very smell of cooked haddock makes me physically sick." Even if utensils used in the preparation of cooked fish, such as a knife, are not washed before being used to prepare other foods, his life could be in danger, he says. He had a violent reaction to food at a previous workplace when her ate a breakfast roll containing white pudding, rashers and sausages. " I thought I got a taste of fish from it but couldn't be sure. I was violently sick for two days afterwards, I couldn't get out of bed. It seems the meat was cooked in oil fish had been cooked in." Shane, who is an emergency medical technical but now runs a florist's with his wife, Laoise in Knocknacarra, says he is constantly vigilant because he knows the risks he faces every time he eats something. "There are only a couple of restaurants I can go to. Even if somebody sits down beside me and eats fish, I have to get up and go or else gobble down my meal as fast as I can. I'm always wary of new foods too and sauces and salad dressings, for example Caesar's salad has fish extracts in it." Galway. In the States, there is no problem. The restaurants are very careful, there is air conditioning too which means I wouldn't be affected by the smell of the food, either from the kitchen or from someone's plate." When he does his grocery shopping, he is equally cautious and examines every label closely before buying any food product. He believes catering staff should be made aware of anaphylaxis and the life threatening dangers it presents to

Shane Flaherty

On the alert
He is constantly on the alert in case he encounters food products that may contain fish. " It's a major issue in Ireland. There are only a couple of restaurants I can go into in

sufferers. Together with an allergy specialist, he spoke to a local catering college in a bid to create a greater awareness about the condition which is becoming increasingly common today. Experts attribute this to the wider availability of potential allergens, including injectable medicines and foods. "We explained about the condition. The chefs were open mouthed. There is a need to heighten awareness at every level."

What is anaphyl-axis?
Anaphylaxis, a rapidly progressive and potentially fatal allergic reaction to food, medication or insect stings is becoming increasingly common today. About 13 per cent of unexpected, unexplained sudden deaths in this country may be due to clinically unrecognised fatal anaphylaxis, according to Dr Joe Fitzgibbon, a Galway based doctor with a clinical interest in allergic and fatigue states and the author of the book Could it be an allergy? Anaphylactic shock occurs because the body's immune system overreacts in response to the presence of a foreign body which it wrongly perceives as a threat. When this happens, blood vessels leak, bronchial tissues swell and blood pressure drops, causing choking and collapse. While allergic reactions are extremely common today, less than one in every 100 are anaphylactic in nature. Only a small number of those would be potentially fatal, he says.

Nettle rash
"The condition is a spectrum of illness which ranges from mild nettle rash with swelling to a very severe reaction in which you can get constriction of the chest and collapse. Usually, subsequent reactions are more severe." Anaphylaxis is not restricted to any age group and can occur at any stage, from infancy onwards. It frequently

occurs in allergic individuals such as asthmatics or those with eczema. But people without allergies develop it, too. There are no genetic indicators to explain why some people are more vulnerable to it than others. Experts believe some cases of sudden infant death (cot death) may be due to anaphylaxis. The condition has been around since pre-Christian times, the Egyptian pharaoh Menes died shortly after being stung by a hornet. It is becoming increasingly common, a fact Dr Fitzgibbon attributes to the wider availability of potential allergens, including injectable medicines and food. The introduction of different foods into people's diets at an earlier age, especially nuts among under-fives, is another factor. Certain foods such as peanuts, cows' milk, fish, shellfish and eggs, can trigger severe allergic reactions in some people. The most common food allergen is peanuts, but other nuts may also cause problems. Virtually any food, including kiwi fruit, banana or sesame seeds, can cause a reaction. It is unclear why some foods should be more likely than others to provoke attacks. In some cases, anaphylaxis only occurs when a particular food is taken in conjunction with exercise. Dr Fitzgibbon stresses that of every 1,000 people with a food allergy, (proven by a blood or skin prick test) only one or fewer, has the potential for anaphylaxis. Early symptoms are often first noted in the mouth, with a sensation of burning or itching in the lips, mouth or throat, he says. Anaphylaxis can also present with sneezing, difficulty swallowing and speaking, warmth and feelings of fear and impending doom (not to be confused with panic attacks). Other reactions can include

abdominal cramps, vomiting, bloodied diarrhoea and convulsions. In severe cases, early symptoms may be quickly (in seconds or minutes) followed by loss of consciousness, obstruction of the upper airway, shock and cardiac collapse. Allergic individuals can be affected by the offending food without even eating it. You can get symptoms from walking past where the food is being cooked in a restaurant or supermarket. Eating just a tiny bite of the trigger food can cause a major reaction. Many sufferers are unaware that certain foods contain allergic agents. They may eat a slice of cheesecake without realising its crushed base contains peanuts. Anaphylactic reactions to food can occur instantly but sometimes it may be 12 hours or more before symptoms occur. Exposure to penicillin, insulin, vaccines, blood transfusions and anaesthetic agents can also pose an immediate threat to susceptible people. Insect stings, bites and occupational dusts are other risk factors as are x-ray dyes, drugs such as aspirin and morphine and foods - seafood, nuts, berries, food additives and drinks. Other triggers are latex in surgical gloves, exposure to the cold, exercise and food dusts. An adrenaline injection is used to treat anaphylaxis. Reactions to allergens can be so dramatic and fast, (they can occur in seconds) people with proven anaphylaxis should carry a pre-loaded adrenaline syringe for self-administration, he advises. "The condition can and does kill. Death is related to two three things, the speed of symptom onset, severity of symptoms and whether or not the sufferer gets adrenaline within the first 30 minutes."

Dr Joe Fitzgibbon

WHERE TO GO FOR HELP
* The Irish Anaphylaxis Campaign, PO Box 4373, Dublin 18. Telephone (01) 2952791.

Clarification
In last week's article about nuisance neighbours which appeared on this page, a photo appeared of a Galway city housing estate. Although the estate was not identified, the Galway Advertiser is happy to state that this was a randomly-chosen photo and its inclusion does not suggest that the problem of nuisance neighbours is any more acute in that area.