Feel the fear and do it anyway?

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Harper Leary

“Feel the fear and do it anyway”, that has been my motto my entire adult life, ever since I began having allergic reactions and anxiety attacks. The co-existence of allergies and anxiety have been studied and found to be a linked. Which came first the chicken or the egg, for me in this regard, I am still unsure. Having either of those issues is a continual source of embarrassment for me. I know it shouldn’t be and I would tell any other person with those issues that they have nothing at all to be embarrassed about! But me, I have a superhero complex and like to think myself invincible. But my immune system states otherwise. I have many allergies to many things including nature, food, medications etc. — I am seriously like that boy in the damn bubble at times.

My kryptonite, however, comes in the form of shellfish (shrimp, lobster, crab etc). It has become so severe over the years that I literally can’t be in a room where it is being cooked, served, or eaten without having a life-threatening reaction. Once I walked into a Whole Foods, my eyes started to burn, my throat started to tingle, and my entire physiological system sent out warning shots. However, me being me, I dismissed it and continued onward, until minutes later an announcement was made overhead that folks shopping should come on over to the seafood aisle and get a sample of the shrimp they were cooking up! Well, I made my way over to the local ER and spent a few hours enjoying the allergy medications they cooked up instead! Needless to say, I am eternally on high alert, and therefore eternally anxious!

This is hard enough on my mental health (I see shellfish everywhere…), but it also disrupts my personal life (my wife, my kid, my friends LOVE shellfish) and my work life (its hard to go out to work dinners or receptions — everyone LOVES shellfish) on the daily! This disruption is heightened and made significantly more difficult when it comes to traveling. Lets forget for the moment the complete pain in the ass it is to try and find a restaurant that does not serve shellfish in every, single, solitary city I travel to for work or pleasure — and I travel a fair amount. Lets focus for the moment on air travel, because that is the biggest source of anxiety and complexity in my life currently.

And well, as one of my Twitter followers commented:

So true! At least someone understands my plight!

Yet airlines in general do not seem to take concerns around allergies seriously, or at least my concerns. Which considering the numbers of folks in the US who have an allergy to food, estimated at up to 15 million people, this dismissiveness is astounding. Allergies in children have increased 50% in the last 15 years and are rising steadily in the general populous overall. Not all allergies to food are life-threatening, but every 3 minutes an allergic reaction sends an individual to the emergency department, accounting for over 200,000 visits annually. Life-threatening allergies, know as an anaphylactic reaction, can cause among other things: throat swelling, diarrhea, dizziness, low blood pressure, rapid heart beat and cardiac arrest (also known as death!).

The Food Allergy and Education organization estimates that 6.5 million adults have an allergy to shellfish and other finned fish. Of all the food allergens that are listed, shellfish is the third most common food allergy overall.

In general, it really is no fun to have an anaphylactic reaction (I don’t recommend it), it is uncomfortable and scary. So when an airline dismisses concerns around it outright, I take note! I have struggled for years trying to get airlines to understand my concerns. As a public health practitioner I am all about prevention! “Why wouldn’t the airlines want to make a simple announcement letting my fellow passengers know I have a severe food allergy before boarding?”, I wonder to myself. “Surely the passengers — and airlines — would prefer that to an emergent landing?”, I say to no one in particular and anyone who will listen. But alas, the airlines are “not allowed” to do much of anything when it comes to prevention, other than assure passengers that they clean their planes.

Which brings me to my current quandary, my family is traveling to Ireland in July for a family vacation. I love Europe, before my sensitivity to shellfish increased I traveled to countries around the world, no problem. But over the past 8 years or so I have become more and more sensitive. Therefore, to prepare for this upcoming trip, and to make an educated decision about how much I want to play the game of chance with my life over the atlantic ocean, I decided to be proactive.

I went to the airlines’ websites to determine if shellfish was being served onboard their international flights and also what their food allergy statements and policies stated.

American Airlines does not list any food options on their website. They only tell you that you can reserve a meal 30 days in advance of a flight, though what you can pre-order is a mystery until then. I also went to their link for “Special meals and nut allergies” and they merely ask the question, “Nut allergy?”, stating:

“American recognizes that some passengers are allergic to peanut and other tree nuts. Although we do not serve peanuts, we do serve other nut products (such as warmed nuts) and there may be trace elements of unspecified nut ingredient, including peanut oils, in meals and snacks. Requests that we not serve any particular foods, including tree nuts, on our flights cannot be granted. We are not able to provide nut “buffer zones,” nor are we able to allow passengers to pre-board to wipe down seats and tray tables. Our planes are cleaned regularly, but these cleanings are not designed to ensure the removal of nut allergens, nor are our air filtration systems designed to remove nut allergens. Additionally, other customers may choose to bring peanuts or other tree nuts on board. Therefore, we are unable to guarantee that customers will not be exposed to peanuts or other tree nuts during flight, and we strongly encourage customers to take all necessary medical precautions to prepare for the possibility of exposure.”

Next I went to British Airways; on their long-haul website page, they state that they offer meals which can be ordered in advance of an international flight, unfortunately for me, many of those options are shellfish. Not wanting to give up quite yet, I thought I would investigate their website further, and it gave me a glimmer of hope:

“If you have a food allergy, we can offer special meals that exclude a variety of potential allergens, e.g. seafood, dairy and gluten. You can find out more about food allergens in our meals. You can also check the label on the packaging, or ask a member of your cabin crew.”

Challenge accepted. I went to find out more, this is what it said on their food allergen page:

“We’re passionate about food, our meals are made with high quality ingredients and we do our best to cater for people with food allergies. However, we cannot guarantee an environment completely free from allergens so traces of some ingredients may still be present in our meals.”

They even had a nice chart:

And while I appreciate British Airways’ transparency with their food choice options and thoroughness with listing the most common potential food allergens, not just nuts, the suggestions do nothing to help my situation.

So once again, I say to no one in particular and anyone who will listen, “I can’t possibly be the only one in this position, surely one of the other 15 million people with food allergies need to fly around the globe every now and then?”

Cue the Allergy Safety Travel website. The Allergy Safety Travel website was set up by a journalist who has two children with allergies and asthma, and clearly understands the stressors and struggles of traveling with those conditions. The website links to airline policies on allergies all in one convenient location. And again, though I appreciate this website exists (though it does not seem to have been updated since 2014), it only lists nut allergies.

Since British Airways seemed to be the most transparent and comprehensive in regards to their take on allergy prevention, I emailed them. It took a little while but I did get a reply from two different representatives in two different departments. They both passed my concerns onto their Corporate Safety Catering Team and stated that they confirmed that details regarding menus for my flight would not be finalized until March. One of the representatives went a step further and forwarded my concerns to the Head of Catering to determine if it would be possible to meet my request. Both told me to check back in March. Whether they can meet my request or not, the amount of appreciation I have toward those two individuals, and British Airways in general, for taking my concerns seriously, it beyond measure! Thank you British Airways for top notch customer service! Note: I also emailed American Airlines twice, and received no reply.

In parallel to those emails with the airlines, I also reached out to my old faithful, social media. Surely one of my thousands of “friends” would have a reliable contact with the airlines and/or a travel agent. Three people responded to my plea, though everyone came back with the same answers:

  • Call the airline so they know about your allergy and they can make a note on your reservation: I assure you I have done this in the past and the airline representatives couldn’t actually care any less. But sure why not, wouldn’t hurt to try again right?
  • Carry medications such as an epinephrine pen and others: well duh!
  • Check with the gate agent to find out what meals are being offered; if it includes shellfish request to change your flight: I assure you I have also done this repeatedly in the past, and most of the time the gate attendants either conveniently forget, outright ignore me, or flat out say no. Only once on a Southwest flight was the gate attendant receptive to my concerns and that is because she had a family member with severe food allergies and knew how scary it was for them.
  • Even if an airline does not serve shellfish people are allowed to bring whatever food they want onto the plane: i.e. “don’t make your problem, our problem.’
  • Airlines don’t know in advance what meals are going to be served on what flights: This last point boggles my mind to no end. How could you possibly run a business and not know what meals you will be serving? Don’t you need to order and plan in advance? Is there no tracking of what is generally served on which flights? It is no wonder the airlines continually lose money!

With all hope almost lost (fingers crossed for a British Airways shellfish free menu in March ), I contacted Adelman Travel Group. Adelman Travel Group handles a lot of the arrangements when I travel for work. I am specifically mentioning them here because their customer service representatives are hands down the most helpful, understanding people I have ever had the pleasure to interact with! They have helped me in the past with travel issues related to my allergies, and I highly recommend them for your travel needs! The representative I contacted regarding this current situation went above and beyond to reach out to her airline contacts in multiple departments, over multiple weeks. Unfortunately though, she ended up with the same answer as everyone else — two different airline representatives stated to her that “…there is nothing that can be done”, they won’t know if shellfish will be served, and they have no control over what other passengers bring on board.

I go back and forth gaming out the Ireland flight — if I take a really late red-eye, more than likely most people will be sleeping, so the likelihood that anyone in first class would be served shellfish for a meal is low (though no guarantees). If I am asleep and it is served and I take enough pre-medications (benadryl and prednisone) and sit as far back as possible, I might just be lucky. The bigger problem is getting home. There are no red-eye flights back to the US from Europe. The early morning flights still provide lunchtime meals, and while most people I talked with didn’t think the airlines could afford shellfish in general anymore, let alone at lunch, again, they can make no guarantees.

So do I feel the fear and do it anyway? Do I follow the motto that has gotten me this far in my adult life? Pushing me to the limit of what my anxious brain thinks possible on a daily basis. I honestly don’t know. Just recently my wife and I met with a financial planner who informed us that in order to reach financial stability for retirement, I need to stay alive until I am 59 years old, which seems like a reasonable request, no? Though for a person who is as sensitive to her environment as I am, in a family that does not come from very hardy stock to begin with, and who do not live very long, that is a lot of pressure. Compound that with the possibility of an allergic reaction somewhere over the Atlantic ocean, and well, it seems like an unnecessary risk; though my wife did just up my life insurance, so maybe its worth it?