Dealing with allergies in the restaurant kitchen
October 25, 2015 8:40 AM   Subscribe

"In a stunningly short slice of history, we’ve gone from food allergies being met with ignorance or indifference in the restaurant world to their domination of the discussion between server and diner, starting with the greeting and continuing all the way to dessert. ... After witnessing enough diners who make a big fuss about how their bodies can’t tolerate gluten and then proceed to order a beer or dig into their date’s brownie dessert, fatigued chefs and managers are beginning to adopt a less accommodating approach. But the people who may ultimately pay the price for this pushback won’t be the “free-from” fabulists. They’ll be those with serious conditions."
posted by Johnny Assay (142 comments total) 29 users marked this as a favorite
 
Where does that dominate discussions? I eat out a lot and there may be some boilerplate about allergies in small type on the bottom of the menu, but I don't hear it discussed at all. I ate at 3-Michelin-star restaurant in New York this week and the most animated discussions I had with any of the staff were about how much they were expanding their gluten-non-free offerings: their big new beer list with all kinds of cool choices and their pastry chef's new bread and dessert directions.
posted by MattD at 8:47 AM on October 25, 2015 [1 favorite]


I've had servers ask diners to mention allergies in their introduction.

And whether the server asks or not in my experience if one mentions what they're avoiding, an allergy, or intolerance there are often a lot of questions to clarify what is meant.
posted by mountmccabe at 9:00 AM on October 25, 2015 [1 favorite]


To some extent, the restaurants brought this on themselves in the "no substitutions" era when they wouldn't accommodate preferences unless someone mentioned allergies.

The best approach I've seen recently is servers who ask questions to clarify whether it's a 'leave it out' or a 'biohazard level 1, cross contamination protocol 3' kind of scenario. It gives the fake allergy people a chance to express that they don't need the cross contamination protocols, just no green peppers in their dish, please, without forcing them into admitting they lied about the allergy itself.
posted by jacquilynne at 9:23 AM on October 25, 2015 [17 favorites]


I'm lactose intolerant, which is truly not a big deal as food issues go and is never going to endanger my life or long-term health, but accidentally eating lactose can ruin my night, and I don't think it's unreasonable to ask servers to tell me if there's hidden lactose in something. I don't need anyone to alter recipes for me, but I will order something else if you're making the french fries crispy by dumping lactose on them. It annoys me a little bit that some restaurants seem to think this is unreasonable. Chances are that your food is not so delicious that it's worth 8 hours of gas and diarrhea. I mean, very occasionally it is, but I think that should be my choice to make. Also, lactose intolerance is extremely common among people of African, Asian and Native American descent, so if your restaurant isn't accommodating people who can't eat lactose, then I think it's worth asking who is welcome there and who you're unintentionally excluding.

But yeah, lying about food allergies is scummy.
posted by ArbitraryAndCapricious at 9:26 AM on October 25, 2015 [54 favorites]


We eat out fairly often and I've never once had a server mention anything about food allergies. What kind of restaurants do this?
posted by octothorpe at 9:26 AM on October 25, 2015 [1 favorite]


so many Americans believe they have a food allergy and act on it without ever going to the doctor to confirm the hunch.

This is me, because my allergy is to kiwi. I don't intend to waste anyone's time with testing for a very, very easily avoided food (but I have the weird tingling in my mouth and throat and slight swelling). Mostly it's an issue in smoothies or breakfasts, occasionally a dessert is served with kiwi. I admit I forget to ask occasionally because it's rarely served, and really all I need is "no food that has touched kiwi on my plate" (because honestly what kind of cross-contamination does kiwi get? I'm not lying if I say I don't actually need biohazard-level concern) so it's solvable if there was kiwi on the plate.

I do wish servers wouldn't look so disdainful when I mention kiwi, though. I know it's rare and a weird question, but it's not that vanishingly rare.
posted by jeather at 9:31 AM on October 25, 2015 [8 favorites]


We eat out fairly often and I've never once had a server mention anything about food allergies. What kind of restaurants do this?

My wife and just moved to the Bay Area and we've been dining out a lot, as one does, and the staff at about half of the trendier, featured on Eater spots have asked about allergies. ("Nope, none. What's the best thing here?")
posted by notyou at 9:47 AM on October 25, 2015


One of the kids in my family is severely allergic to anything dairy, eggs, gluten, and a laundry list of other things --- heck, I didn't even know you could be allergic to apples, of all things! --- but oddly enough he's perfectly fine with ground nuts like peanuts. Yes, he's been tested every which way from Sunday by actual allergists; so if we tell a restaurant "no, he absolutely cannot have x" we ain't kidding..... apples just give him eczema rashes, gluten is diarrhea-level bad, but dairy is damn near a 'where's the nearest hospital?!?' situation. Poor kid.
posted by easily confused at 9:50 AM on October 25, 2015 [1 favorite]


This is one reason that I really like Disney. If someone in your party has any allergies at all, the chef will either come out and talk to you, or even call you before your reservation. Don't tell me that restaurants can't accommodate these things. Disney is HUGE, and they do this all the time.
posted by roomthreeseventeen at 9:53 AM on October 25, 2015 [14 favorites]


I get the annoyance with diners who claim an allergy, then order dessert with the allergen. But people are going to be fussy about their food, and the restaurants that accommodate those diners will profit.

I'm also lactose-intolerant, and the lactase enzyme doesn't help much. Over time, I've learned that dairy aggravates my inflammatory arthritis. If there's dairy in my food, I'll be uncomfortable in the short-term, and in pain in the long term. So I do appreciate honesty from restaurants, and I'm not going to sample my tablemate's pizza, no matter how much I miss gooey, delicious cheeeese.
posted by theora55 at 9:58 AM on October 25, 2015 [2 favorites]


It gives the fake allergy people a chance to express that they don't need the cross contamination protocols, just no green peppers in their dish, please, without forcing them into admitting they lied about the allergy itself.

It's a good protocol not just for "fakers," but for people who have more mild allergies as well. My husband can't have avocados and certain tropical fruits. A small exposure (a bite of something) will just cause some itchiness. When ordering, he doesn't like to say that it's an allergy, because he's seen them break out separate equipment just for his dish when for him it just needs to be left out. He obviously appreciated the effort, but felt bad that he'd created extra work.

So now he just asks for it to be left out, if possible (and orders something else if it can't). But one time he asked for the avocado in a dish to be left off without realizing that avocado oil had been used in the dish as well. He had welts all over his back and his breathing was slightly impacted.

And he still doesn't like saying it's an allergy, because he still feels bad about generating extra work. Most places are very accommodating, so it's only been the one time that he's had a real problem. But yeah, encouraging an open dialogue and recognizing that theres varying levels of food intolerance/allergies would be beneficial for both patrons and restaurants.
posted by ghost phoneme at 10:01 AM on October 25, 2015 [17 favorites]


Don't tell me that restaurants can't accommodate these things. Disney is HUGE, and they do this all the time.

Wouldn't being huge give them an enormous advantage in their level of flexibility? You say this like it's more impressive because they're huge, but of course Disney is more able to spare a chef to come out and chat with customers and then spend the time making something tailored to a specific allergy profile than a normal non-chain restaurant would be.
posted by showbiz_liz at 10:05 AM on October 25, 2015 [32 favorites]


Yeah. My shrimp thing doesn't rise to the level of an allergy, but even the smallest amount of it will give me a miserable stomach ache and associated digestive problems that can drag on for a couple of days. So I do ask, and given that a shellfish allergy is something that seems to be universally taken seriously, I've been OK so far, but no server has to worry about me making a big deal about hidden shrimp paste or something like that in any given dish, and then blithely chowing down on the prawn crackers .
posted by skybluepink at 10:06 AM on October 25, 2015 [2 favorites]


Wouldn't being huge give them an enormous advantage in their level of flexibility? You say this like it's more impressive because they're huge, but of course Disney is more able to spare a chef to come out and chat with customers and then spend the time making something tailored to a specific allergy profile than a normal non-chain restaurant would be.

I guess there are two sides to it. Maybe more staff, but also a much higher turnover rate of tables, and seeing hundreds/thousands more people every day.
posted by roomthreeseventeen at 10:11 AM on October 25, 2015


UK Filter: It is now law in the UK that restaurants/food outlets must label things and train staff. The last place I worked had signs up about this.
posted by marienbad at 10:15 AM on October 25, 2015 [3 favorites]


I deal with this at work all the time, and most people are reasonable about their allergies, but there are some who are clearly using it to go way, way off menu so they can feel special. These people also ask for "half a glass of wine," for example. We don't sell half a glass of anything. They insist on changing things around, then complain when it doesn't turn out how they expected. Restaurants make menus for a reason, in order to produce yummy, quality food quickly and uniformly. A good place will alter that to keep people happy, within reason. One chef I worked with has a policy, a good guide line I think: If your allergy is so severe that you'll end up in the ER, don't risk it. I always triple check that a particular dish is safe, but that takes time, and if we are busy, it can disrupt everyone, guests, BOH, and FOH.

Don't get me started on the "experts" who question our ingredients, like the ass who insisted lump crab meant fake crab, or the young lady who was shocked that we had Chilean sea bass because it was an endangered species. It isn't.

Sometimes it gets this bad.
posted by vrakatar at 10:28 AM on October 25, 2015 [13 favorites]


One chef I worked with has a policy, a good guide line I think: If your allergy is so severe that you'll end up in the ER, don't risk it.
Don't risk ever eating out? I'm not sure that seems reasonable, especially if the allergy is to something reasonably easily avoided, rather than to something ubiquitous.
posted by ArbitraryAndCapricious at 10:36 AM on October 25, 2015 [8 favorites]


No, don't risk eating a thing that can make you that sick. Shellfish could kill you? Don't order the seafood pasta and make me and chef ensure there is no risk. Have the chicken.
posted by vrakatar at 10:38 AM on October 25, 2015 [14 favorites]


vrakatar, did you read the article? The problem is that you don't always know what rando ingredients are being put in things that you would not expect.
posted by roomthreeseventeen at 10:40 AM on October 25, 2015 [5 favorites]


Please, please take mild allergies seriously. I have treated a lot of people in anaphylaxis who only had mild reactions up to that point.
posted by poe at 10:40 AM on October 25, 2015 [35 favorites]


The best approach I've seen recently is servers who ask questions to clarify whether it's a 'leave it out' or a 'biohazard level 1, cross contamination protocol 3' kind of scenario. It gives the fake allergy people a chance to express that they don't need the cross contamination protocols, just no green peppers in their dish, please, without forcing them into admitting they lied about the allergy itself.

This.

Where I work we do fried chicken in a rice flour dredge (so gluten free, right?) but fryers are shared so there's cross contamination. Finding out if this is going to kill them or not is priority #1. And I confess, I ask in a way that slants a little toward "If you're really serious about how serious your allergy is, then this isn't the place for you to dine." I'd rather loose a couple of covers then call 911.

Aside: it's remarkable how many people think there's gluten in distilled spirits and ask for gluten free options. I am always happy to point this out though I also point out, again, since there's a possibility of cross contamination ("Hey, I just handed a plate of hushpuppies before pouring your whiskey.") that if we're talking about life threatening, maybe this isn't the best place for you.
posted by Insert Clever Name Here at 10:41 AM on October 25, 2015 [3 favorites]


Disney is HUGE, and they do this all the time.
Wouldn't being huge give them an enormous advantage in their level of flexibility?

Disney is able to survive the ramifications of a lawsuit if they fail and someone sues. Taking that food allergy liability for them translates to tons of good will and business across all their properties (cruise line, Aulani, parks, etc). The more reassurance a restaurant gives when they attempt to feed someone, the more risk they run of a lawsuit when they fail (example). As much as a restaurant may talk about wanting to provide the best food and best service possible, their food allergy policy or lack thereof is based on their attitude towards handling potential legal ramifications.

My son has multiple anaphylactic allergies and the only consistent place we eat out at is Chipotle where I know exactly what ingredients are in the kitchen and the staff happily changes their gloves. I plan our vacations around Chipotle, Disney, and accommodations w/kitchens.
posted by girlhacker at 10:43 AM on October 25, 2015 [6 favorites]


you don't always know what rando ingredients are being put in things that you would not expect.

But you know what you are allergic to. So ask about it, and if I tell you it is in the dish do not insist it be made safe. If you are allergic to shallots we'll take those off, but we are not there to be re-working dishes from the ground up, especially if the worst that might happen is a mild reaction. On preview Insert Clever Name has it. The responsibility for saftey, for what one puts in one's body, rests ultimately with the diner.
posted by vrakatar at 10:46 AM on October 25, 2015 [6 favorites]


the restaurant I work at has taken a hard stance on the gluten allergy request. I'm sorry, you'll just have to skip those courses. about 99% end up eating those courses anyway. I feel bad for the 1% who have to miss the courses, but the gluten-free fadists have ruined it for everyone.
posted by [tk] at 10:54 AM on October 25, 2015 [15 favorites]


My son has a life-threatening peanut allergy and I can tell you that "So don't order the stir fry with peanut sauce then" doesn't nearly cover it when it comes to keeping him safe at restaurants. Secret peanuts show up all over the place. Peanut butter is used to thicken chili or mole sauce, or to seal egg rolls. Peanut flour is used to boost the protein content in granola or crackers or bread. And of course all manner of things are fried in peanut oil (which is not always refined enough to remove all the allergenic protein despite what some restaurants will tell you). And those are just cases where peanuts are an intentional ingredient-- then you have to think about how most ice cream and chocolate and cookies and pastries are made on shared equipment with peanut-flavored versions, and that equipment might not always be cleaned between flavors. And that sort of contamination doesn't just happen at restaurants-- it also happens at food factories. So even if a restaurant takes precautions its own kitchen to prevent cross contamination, some of their ingredients might have been contaminated before they ever arrived. And where we live in the midwestern United States, there is very little general public awareness about the seriousness of food allergies and restaurant staff are often very uneducated.

So yeah, we DON'T eat out much. For my son's own safety. But let me explain to you just what that choice means:

We miss birthday parties. All the time. Not just the birthday parties of my son's school friends, but the birthday parties of family members. Oh, Uncle Frank, you want to have your birthday at the Chinese restaurant down the street where literally everything is fried in peanut oil? Sorry, we are unable to attend. Or, we go to a birthday party, but we only order drinks, and my 11-year-old sits for three hours at dinner time nursing a cup of water, watching everyone else eat, and then we dodge out early because none of our relatives can ever seem to remember not to hug and kiss him after they've just eaten a Snickers Delight Double Peanut Butter ice cream sundae for dessert and he doesn't want to break out in hives.

We miss Easter Brunch with the grandparents. We miss ice cream after swim practice. We leave early from the field trip, before all the other kids have lunch at the Dairy Queen.

Restaurants aren't just places where people eat. They're places where people socialize. If you avoid restaurants, you lose out on an amazing amount of time with friends and family. If you don't live with the reality of managing a food allergy yourself it sounds so easy to tell someone with a severe allergy "Well don't go to restaurants then." But when you tell someone that what you are really telling them is "Don't meet up with your friends after school. Don't go to your cousin's fifth birthday party. Don't go on any dates where eating out happens. Don't go to the office holiday party."

That's what restaurant staff are telling my son when they say, "If you have a life-threatening allergy, don't eat at our restaurant." Hey, if you really can't make accommodations because of what you serve or how your kitchen is structured, then thanks for telling us-- I appreciate the honesty. Like, Five Guys, I get that barrels full of peanuts are your thing; I am totally down with those DO NOT ENTER IF YOU HAVE A PEANUT ALLERGY signs on your door. But if you have the ability to accommodate, and you just don't WANT to make accommodations because you think it's a pain in the ass to put some clean foil over your griddle or wash out a pan, or because you that my family is crazy to ever take the risk of eating out in the first place, please realize that we're not coming into your restaurant and taking that risk just to annoy you personally, or to experience your amazing macaroni-and-cheese production skills: we are taking that risk because if we don't occasionally take a risk on eating out with other people, my really kind, funny, sociable 11-year-old boy has to basically live like a hermit.

(And yeah, allergy fakers make it much worse for us because they make everyone without allergies suspect that everyone with a real allergy is faking, too. So please stop.)
posted by BlueJae at 11:10 AM on October 25, 2015 [103 favorites]


Also FYI, servers: real food allergy sufferers are often loyal repeat customers AND amazing tippers when you are kind to them, actually take their concerns seriously, and make them feel welcome at your place. I have tipped 50% for really good service. And why not? It's a literal lifesaver.
posted by BlueJae at 11:15 AM on October 25, 2015 [27 favorites]


BlueJae has it. We have a lot of family members with celiac and others who cannot tolerate gluten but don't have celiac. The GF fad is a mixed bag - more options on places to eat but people are often cavalier about it because so many people are avoiding gluten for the hell of it and servers are often justifiable skeptical. It's not pleasant to have a server's eyes roll when ordering and asking about GF and I don't always want to have a detailed conversation about my and other family members' health and diet when going out. Places where we know we can order safely without it being a big thing are wonderful and yes - we're regulars there and tip well.
posted by leslies at 11:29 AM on October 25, 2015 [3 favorites]


Yeah, don't misunderstand me- 80% of the time allergy folks have a concern, and there is a simple fix, and i have certainly had guests show big appreciation for making it happen. But there are people who fake it or overdo it and seem to feel great joy in making it a problem.
posted by vrakatar at 11:31 AM on October 25, 2015 [2 favorites]


Oh and another thing: have you ever tried taking a road trip without eating out at a single restaurant along the way? Oh, you think my peanut-allergic child should just fly then? No wait: heavens forfend he should want to fly, because then for his safety some small group of people might have to just once give up a ten cent packet of peanuts and eat pretzels or crackers instead and that would be TERRIBLE AND TRAGIC AND TOTALLY UNFAAAAAAAAAIR.
posted by BlueJae at 11:31 AM on October 25, 2015 [10 favorites]


t bluejae: It's not just "put foil over a griddle or clean out a pan" The problem is that kitchens are crowded busy places that are geared by having everything prepared in advance. Asking to make a change like that in the middle of dinner can bring the whole system to a grinding halt. For example, lots of places cook meat on flat grills, if you want a modified item and it can't touch that griddle without being cleaned you'd have to wait until everything else was off, then clean it, then cook it alone, then proceed. That sort of thing can break your workflow (which really does matter! Slow kitchen=bad tips for servers and bad yelp reviews which can be brutal). Whenever I get people who have severe allergies like that at busy times I tell the servers to let them know we can't safely accommodate them. It sucks but it's a lot better than causing anaphylaxis.

That said, if you do want to try and get accommodations made, come at a very late lunch or a very early dinner hour. That way the kitchen probably isn't very busy and has much more flexibility to work with you.
posted by Ferreous at 11:36 AM on October 25, 2015 [16 favorites]


I used to host a huge Thanksgiving dinner every year, multiple courses, up to about 30 people. I'd have someone else donate the space because my house was always too small, but I'd buy all the ingredients and do all the cooking, and I'd always provide a vegetarian option for the main dish and ensure that non-meat eaters could have a nice Thanksgivingey meal with lots of things to choose from. And then, one year, a woman I didn't really know invited herself, which was totally cool with me, and informed me that she was vegetarian and allergic to tomatoes. The main vegetarian option I'd always make, and which people really looked forward to, was heavily tomato-based, so my whole planning process went SCREEEECH. And I'm desperately trying to figure out how to handle this. Do I try some new main vegetarian option and disappoint everyone who was looking forward to my usual one, or do I come up with a third, meat AND tomato free main dish?

I'm still trying to figure this out maybe a couple of days later, when it comes up in conversation and her boyfriend says, "But you put ketchup on everything," and she replies, "Oh, ketchup is fine. I don't like the little seeds."

And some time after that, I discover she's not actually vegetarian, either. She just liked to think of herself as vegetarian, but she ate meat pretty much every day.

On the other hand, I currently have a friend who comes to other, smaller group dinners I host regularly, who has reactions to a whole bunch of different things. She currently has shitty health insurance, which is better than the none she had pre-ACA. She does have some known autoimmune disorder, and she also clearly has various food sensitivities that she's pretty much on her own with. She is gluten, soy, and dairy free right now, but the specifics change a lot because she honestly doesn't know what's making her sick. I've seen it, though. I've seen her bust out in a rash after eating something and have no idea what did it. I've been fortunate not to see the gastro effects firsthand. So she is self-diagnosing, but it's not just recreational. She's not just looking for attention or buying into some silly trend. She just can't afford the multiple doctor visits she needs to get someone to take her seriously and then do the extensive testing and such to get official diagnoses.

It does complicate my meal planning, especially when I try to figure out something that will accommodate her diet as well as all the others', but I can't imagine begrudging her or trying to trick her or dismissing whatever she's trying to cut out at any given time. It really sucks for her. She's also single and very very social, so just staying home and totally controlling her own diet would be an enormous lifestyle hit for her.

Obviously, I'm just a home cook, and I would be very uncomfortable trying to accommodate a potentially fatal allergy, but a lot of people are on elimination diets of various types, and not always for stupid reasons.

It really would be ideal if there were some commonly understood social proscription where lying about serious allergies were on par with lying about terminal illnesses or military service, but there would also need to be some commonly understood social convention where less-serious sensitivities and dietary limitations were taken seriously. The dangers may be less imminent and less likely to require ambulances, but they're real.

Picky eaters, though, just need to cop to being picky eaters. I mean, I feel bad for them and all, and I even accommodate certain limited pickinesses in people I cook for, but be a fucking grownup about it. Don't lie.
posted by ernielundquist at 11:39 AM on October 25, 2015 [33 favorites]


Please, please take mild allergies seriously. I have treated a lot of people in anaphylaxis who only had mild reactions up to that point.

Poe, does this mean that cross-contamination protocols should be used even for mild allergies, or just that people with mild allergies shouldn't gamble (i.e. just have one bite of the allergen)? I know repeated exposure isn't good, but if, for example, my husband doesn't react as long as you don't directly touch his food with an avocado, would he really need to have sterilized utensils etc.

If you are allergic to shallots we'll take those off, but we are not there to be re-working dishes from the ground up, especially if the worst that might happen is a mild reaction

That's another reason why my husband doesn't want to say allergy: he'd rather be told, no, it's integral to the dish if it is. He's afraid that if he says allergy, people would be more likely to try to work around it, resulting in more work for them with less payoff. Usually if he sees avocado listed he'll just order something else anyways. But sometimes he really wants tacos, and if the guacamole can just be left off with no fuss, cool. If not, he'll just order something else.
posted by ghost phoneme at 11:42 AM on October 25, 2015


BlueJae, I hope I'm not peanutsplaining here, but since you mentioned you don't go out to eat much, you may not realize that most if not all restaurants will allow a person with special dietary needs to bring in their own outside food, and will often even re-heat it for you. I know that doesn't solve all your problems (people touching your son after eating allergenic food and so on), but I thought I would mention it in case you weren't aware.
posted by Rock Steady at 11:43 AM on October 25, 2015 [9 favorites]


I got just one more then I will lay off. I was busy as hell at lunch recently and a lady called to order takeout but wanted to know what brand of gf bread we use because some of them are "just awful!" I had people at my bar and a small but nearly full dining room, let's say 4 2 tops a 4 top and 6 bar guests, all at various points of service. I had to delay the thousand things that needed doing ever so slightly to go bug chef about it. When she called back and i told her she ordered two sandviches on plain white bread because our brand was "the worst." So she did not have an allergy after all? WTF? She just wants to feel like a special snowflake?
posted by vrakatar at 11:47 AM on October 25, 2015 [6 favorites]


Here's a fact though, Ferreous: 1 in 13 American children has a food allergy.

That means something like 1 in 6 families with children may have a child with a food allergy.

That is not even counting adults with food allergies, or people who have celiac disease or lactose intolerance (which are not technically allergies and are therefore not included in allergy stats).

That means you are turning away a LOT of customers.

There are a number of restaurants that have realized this and have made a deliberate choice to structure their business in such a way that they can accommodate people with food allergies and intolerances, even during busy times. Chipotle, Red Robin, and P.F. Chang's are some good examples. It is possible to provide a lot of people with food allergies and intolerances good options in a fast-paced restaurant environment, even if you can't reasonably offer to modify everything on your menu. Most people with real food allergies and intolerances (not the fakers) understand that they can't have everything on offer at a restaurant and will be grateful and happy if you can even just give them a list of four or five things you know you can safely make for them.
posted by BlueJae at 11:48 AM on October 25, 2015 [5 favorites]


I had to delay the thousand things that needed doing ever so slightly to go bug chef about it.

Uh, not really. I mean, the woman on the phone was your potential customer, too. It was part of your job to ask.
posted by roomthreeseventeen at 11:53 AM on October 25, 2015 [3 favorites]


Rock Steady in an ideal world that would work, but in the real world we have been harassed and asked to leave restaurants over bringing in outside food, even after telling the staff about the allergy. (That probably has to do with our living in Missouri aka the last refuge of 20th century thinking.) And as far as reheating goes . . . well, think about it: if the kitchen can't safely cook my son a plain steak or some white rice or even offer him a bowl of fruit, then can I trust them to safely reheat the pasta I brought with us in that same unsafe kitchen space? Um, no.

We do sometimes bring nonperishable or cold foods in to restaurants but it's not always a solution.
posted by BlueJae at 11:53 AM on October 25, 2015 [2 favorites]


I'm curious how Chipotle handles people with allergies, since they've been name-checked a couple of times as being a good example. I have no allergies, but I don't think I have ever once got a meal at Chipotle that wasn't cross-contaminated with at least a little bit of something I didn't order. I would trust literally nothing that came off of Chipotle's standard serving line to be allergen free.
posted by jacquilynne at 11:54 AM on October 25, 2015 [1 favorite]


I think that Chipotle never uses any of the most common allergens (peanuts, tree nuts, shellfish, fish, etc.) in any of their food, so there's no danger of cross-contamination.
posted by ArbitraryAndCapricious at 11:57 AM on October 25, 2015 [4 favorites]


I think you should be more forgiving of behind-the-times diners who aren't up on the reversal of fortune lately enjoyed by the Patagonian toothfish; when the fisheries-dying-out controversy became common knowledge, Chilean seabass were like the main ones we were all told to avoid. On the other hand, what do I care, rip 'em a new one. I support server rage because it inspires stuff like The Restaurant. (Thanks, for real. That was hilair.)
posted by Don Pepino at 12:00 PM on October 25, 2015 [2 favorites]


Jaquilynne, Chipotle's entire menu is peanut-free, tree-nut-free, egg-free, fish-free and shellfish-free. As in they have none of those things anywhere in their store, and none of the ingredients in their store are cross-contaminated with any of those foods, either. That knocks out 5 of the top 8 food allergens (The top 8 are the food allergens that cause 90% of reactions in the U.S.). They also have excellent, detailed allergen information available online so you can easily find out exactly what is in each dish. On top of that, if you are allergic to say, dairy or wheat, if you ask, Chipotle staff will change their gloves and get your food out of a new unopened container with clean utensils, etc., to avoid cross-contamination. And since their kitchen is open you can literally watch them do it. That said, I'm not sure if I'd let my son eat there if he had a very severe dairy allergy since they do have a lot of dairy sitting around. But as fast food places go Chipotle is probably about the allergy-friendliest place out there. It's certainly our go-to place for eating out with a peanut allergy, and the only place I ever eat out with my son and feel basically zero anxiety.
posted by BlueJae at 12:02 PM on October 25, 2015 [8 favorites]


Those are also large chains with much more standardized structures. They have a lot more ability to implement these sorts of protections. Smaller local restaurants often don't have the space, time or staff to do so.
posted by Ferreous at 12:04 PM on October 25, 2015 [3 favorites]


in the real world we have been harassed and asked to leave restaurants over bringing in outside food, even after telling the staff about the allergy.

Ugh. Sorry.
posted by Rock Steady at 12:05 PM on October 25, 2015 [1 favorite]


I have a class three peanut allergy, which I like to explain as a mildly deadly peanut allergy. I am unlikely to go into sudden anaphylactic shock and die at the table before the ambulance shows up, but it is within the realm of possibilities. Perhaps the best analogy for what a true food allergy is like is to think about playing russian roulette where the number of bullets and cylinders is determined mostly at random, but the more severe the allergy the more bullets and fewer cylinders. Some unfortunate souls don't have any empty cylinders at all, just some stage blanks mixed in with the bullets (and right next to your temple can still kill you). I am not that unlucky but I've often wondered if some of the times I've felt sick weren't actually mild reactions. But this is why the fakers are so terrible, as I and people like me are putting our lives in your hands when you feed us, and the fakers are making it even harder for us to trust you.
posted by Meeks Ormand at 12:12 PM on October 25, 2015 [14 favorites]


Ferreous, in St. Louis, Pi, Modesto Tapas and Pastaria are all locally-owned restaurants that are well-known for being allergy friendly and are also generally quite successful. I understand that it's not possible for every restaurant to accommodate every intolerance or allergy for every customer. But many restaurants successfully serve a lot of food allergic customers. Maybe you could call the managers at some of these places that are pulling this off, and ask them how they do it?
posted by BlueJae at 12:14 PM on October 25, 2015


> my allergy is to kiwi. I don't intend to waste anyone's time with testing for a very, very easily avoided food (but I have the weird tingling in my mouth and throat and slight swelling

I am not alone! Also mango peel but not the good part, as far as I can tell. I haven't bothered to test for them, either.

> This is one reason that I really like Disney. If someone in your party has any allergies at all, the chef will either come out and talk to you, or even call you before your reservation. Don't tell me that restaurants can't accommodate these things. Disney is HUGE, and they do this all the time

A friend took her daughter to Disney lately (the one in California, I believe). They'd called ahead and everything, but her daughter was still given a meal that had one of the items she's allergic to in it -- which resulted in her having an embarrassing accident in the hotel lobby while they raced back to the hotel room.

This friend of mine is super-duper on top of allergies, because her son has the most serious ones I've ever seen. He's had a reaction to the school bus, because the driver didn't clean the seat off sufficiently before the boy sat there. Her son can't drink from water fountains.

That my "ooh my mouth is tingly" reaction to kiwi and that kid's "off to the hospital because you shared pencils with a classmate" thing are both called allergies is part of the problem.
posted by The corpse in the library at 12:45 PM on October 25, 2015 [3 favorites]


Disney is HUGE, and they do this all the time.

Well, sure, but Disney's brand is making children/parents happy, not haute cuisine. At best, you're getting food that is "basically just as good" as what you would get in a typical nice restaurant, generally aimed at people who don't eat in nice restaurants often and are somewhat a captive audience. Nobody doesn't go back to Disney World because the risotto was a little bit al dente.

Not that it isn't good for restaurants to cater to people with (actual) allergies, but citing Disney seems like a non sequitur here.

(Also, if you have an allergy, it is somewhat on you to figure out what that means for you, what ingredients are in food, etc. and choose restaurants and cuisines accordingly. The vast majority of haute cuisine restaurants have their entire menu online. Sure, there could be a weird food additive you weren't anticipating -- this can be especially hard for soy allergies -- but by and large, if you're allergic to something, just don't order it/don't go to a restaurant where every item on the menu has that.)
posted by Sara C. at 1:44 PM on October 25, 2015 [3 favorites]


Remember, more and more people are becoming allergic, and while no one really knows why, one reason could be pollution: it seems that more people have allergies in urban and suburban environments than in the countryside, and more and more people grow up and live in cities.

I have had hay fever since I was 12, but a terrible unexplained rash from I was an infant (terrible in the sense that I have several times been close to hospitalization). Theories abounded, including that it was somehow psychological, because it always went away when I was at my gran's house.

Then one day I ate something and had my first asthma-attack. My then boyfriend identified the culprit: MSG; I went to the allergist, and lo-behold that was it. At the time, doctors didn't test for MSG because they didn't think it could be an allergen because it is a salt, and they found the people who claimed to get head-aches annoying. Today, it is well-known that hay fever can have cross-allergies with sun-dried tomatoes and soy-sauce, natural sources of MSG. And the diagnosis explained the granny-cure: she was too conservative and country-style a cook to use stock-cubes or other forms of artificial flavoring, she made everything from scratch and had no interest in Asian food or pasta with tomato and parmesan.

While I might understand the resentment towards the people who have pretend allergies, the widespread anti-MSG sentiment has led to far more available products without MSG, and far more restaurants who serve dishes with no MSG content. So even though I completely understand the irritation of some restaurant staff towards picky eaters, their effort has meant that I have far more choices today than I did when I was first diagnosed, 27 years ago. There are even several Chinese restaurants who offer MSG-free food, so I can still eat out with the stubborn uncle who thinks I'm picky. I can't really hate that.

I can see the same is happening with gluten-free products and lactose-free products now. Already some interesting new tastes have come out of it.

And cutting off all natural and artificial MSG for something like a decade means that today I can eat a teaspoonful of thin soy sauce and a sprinkling of parmesan cheese with no problems. Such a luxury.
posted by mumimor at 1:45 PM on October 25, 2015 [3 favorites]


So would it be crazy for people with real allergies and serious sensitivities (like celiac) to get some sort of ID card, kind of like a handicap sticker on your car? I suppose there would still be the problem of tourists with allergies (who come from places without said ID cards, but still don't want to die in a restaurant), but I would think it would really cut down on the fakers. And I expect anyone with a serious allergy who knows they have a serious allergy would have had contact a doctor from whence they could obtain such certification, right?
posted by If only I had a penguin... at 1:47 PM on October 25, 2015 [1 favorite]


I've suffered from severe debilitating stomach problems, what was originally called IBS, however once I made a range of dietary changes including restricting gluten, and learning I have reactions to corn (pain, diarrhea and weird feverish sore throaty symptoms) and also mild reactions to dairy, especially straight milk I have not had such problems. I can eat cheese and cream ok without problems, the big issue is really drinking a full glass of straight milk. So maybe I will order something with soy and also something with cheese. People might think I'm an asshole, but I also don't give servers a hard time about understanding my condition and needs. I might ask for flour rather than corn because corn is the one thing I have a pretty bad reaction do but I won't freak them out about how it's an allergy and they need to do it perfectly. The same if I am trying not to eat much gluten I might order something gluten free if it's on the menu, or ask for an item without the bread but I won't tell them it's an allergy or make a big deal of it.

I don't expect servers to get this. I've worked in food service a lot, and we never made an offering that food would be safe for people. Requests can be made, they can also be refused. That should be ok.

A server should be able to say "We can not accommodate that"

Food service is hard and if you have a request that is not on the menu and you're drilling the server over it it sucks. I feel like when restaurants offer gluten free or allergen free options they are going to deal with a range of people who have severe to mild allergies- and also assholes who just want to make servers lives miserable (or at least don't give a shit if they do.)

I feel like there is not reason to assume all people who are lessening certain food allergens but sometimes eat them are fakers. My grandmother (we are all allergic and have a lot of health problems) was told after doing extensive testing on what foods she was allergic to, that she could do a rotation diet where she mostly eliminated all the allergen foods, but occasionally ate one or two of them here and there.

Another relative has a severe auto-immune problem where they recommend her avoided many common allergens especially gluten but they actually tell her to eat a little bit sometimes so she won't entirely loose the ability to digest it.

This is advice some people are getting from doctors, so it's not just fakey fakers.
posted by xarnop at 1:52 PM on October 25, 2015 [12 favorites]


I don't know. I sort of feel that if someone says they want/need a menu item to be made in a sort of way, they should be accommodated if at all possible, allergy or not. As a picky eater, I return food all the time that has ingredients that I simply won't eat, if I wasn't aware (see: it wasn't on the menu) that they were included. It shouldn't matter if I have an allergy or not. If you serve something I'm not going to eat, I'm not going to pay for it. If you can't accommodate requests, you need to say so.
posted by roomthreeseventeen at 1:56 PM on October 25, 2015


If you are picky:

1. Order something on the menu that you actually like/doesn't have items you specifically dislike.

2. Learn a little bit about food and try to use some logic about what is likely to be in a particular dish (garlic will turn up in pasta sauces, curries often are garnished with cilantro, etc) so that you can ask informed questions. Example, I really dislike raisins, and will always ask if the carrot cake has raisins before ordering it. Because I know from experience that a lot of carrot cake recipes include raisins.

3. Frame special requests as preferences, not allergies.

4. If all else fails, pick it out.
posted by Sara C. at 2:03 PM on October 25, 2015 [13 favorites]


I don't know. I sort of feel that if someone says they want/need a menu item to be made in a sort of way, they should be accommodated if at all possible, allergy or not. As a picky eater, I return food all the time that has ingredients that I simply won't eat, if I wasn't aware (see: it wasn't on the menu) that they were included. It shouldn't matter if I have an allergy or not. If you serve something I'm not going to eat, I'm not going to pay for it. If you can't accommodate requests, you need to say so.

But the article is making the point that the "allergy or not" is a huge difference. It's one thing to leave out an ingredient or two but otherwise proceed with the recipe. It's another to do this:
That means with every allergy, the action must stop in this kitchen jammed with cooks and dishwashers. The cooks consult a printed breakdown of ingredients in each dish to make sure the allergen isn’t hiding out in a component. They either grab new cutting boards, knives, and tongs or put theirs through the sanitizing dishwasher. And when the plate is done, they use disposable wipes to hold it by the edge.
In other words, the accommodation for a preference is far less difficult than the accommodation of a life-threatening allergy. So the preference-people are creating an enormous amount of extra work by claiming an allergy, to the detriment of people with actual allergies.

One chef in the article calls diners' bluff by offering a substitution for a higher price. That weeds out a lot of people who are faking, and probably compensates the restaurant somewhat for the extra effort of avoiding contamination. But it sucks for the actually allergic who now need to pay extra because others are dishonest.
posted by mama casserole at 2:08 PM on October 25, 2015 [21 favorites]


Many places I eat, they list every single ingredient, which can be confusing. I'll ask where the carrot went, and the staff will say it was only in the vegetable stock. But it is really helpful for people with allergies and they can fairly easily do it as soon as they get into the routine.
posted by mumimor at 2:10 PM on October 25, 2015


(Also, if you have an allergy, it is somewhat on you to figure out what that means for you, what ingredients are in food, etc. and choose restaurants and cuisines accordingly. The vast majority of haute cuisine restaurants have their entire menu online. Sure, there could be a weird food additive you weren't anticipating -- this can be especially hard for soy allergies -- but by and large, if you're allergic to something, just don't order it/don't go to a restaurant where every item on the menu has that.)
Sure, and I think that most people do that if they can. This isn't a huge issue for people who have allergies to something that is easily avoided. My dad has a very serious allergy to one particular kind of fish, and it doesn't stop him from eating out. I actually wish he were a little more careful about it, but he seems to have figured out how to work around it. I think this is primarily a problem for people who have issues with hard-to-avoid food like gluten or peanuts. Plus there are issues with cross-contamination, although I don't think my dad has ever run into that.
posted by ArbitraryAndCapricious at 2:10 PM on October 25, 2015 [1 favorite]


If I Only Had A Penguin, that's a nice idea, but given that we don't have universal health care and that most doctors won't definitively say 'yes, it's an allergy to [x]' without having you actually do the tests, that would go...not well?

I'm a person with multiple fatal allergies. There's not a year in my life that I've not come close to dying because of an unmentioned ingredient or cross contamination or someone's thoughtlessness about not putting their mouth on me after eating things that could kill me. But I also haven't had health insurance consistently--of the last fifteen years, I've had insurance for maybe six of them. I was diagnosed with the first couple allergies as an infant, but some of them have developed as I've gotten older. For example, pineapples used to be my favorite fruit, right until I was about twenty-three. Now, pineapple is the kind of allergy where I can take an epipen literally a minute after exposure, and still end up needing another epipen fifteen minutes later because I'm slumped against a wall and gasping for air. But I've never seen a doctor about it, because going in and paying with money I don't have to get someone to run a test to tell me that I'm allergic to something that's nearly killed me, multiple times, is not a thing I can afford to do in my life.

You're meant to go to the emergency room after every allergic reaction, and I've never been able to do that, because I'm not a millionaire who goes to see doctors. When I'm lucky, I have someone who can hang out with me for eight or twelve hours after a reaction to make sure that it doesn't recur; when I'm not, I try to stay up for that time, just in case. When I do end up in the ER, I get someone to write me a scrip for epipens, and hope that I can find one of those free epipen coupons; when I don't end up in the ER, I ask friends in Australia, where you can buy epipens over the counter, buy them and mail them to me. This is how people without adequate health care deal with their allergies--with our fingers crossed, and an intimate knowledge of exactly how much diphenhydramine you can take and still wake up for work the next day, and the constant awareness that it's likely that our deaths will by both premature and preventable, if only we had the resources to prevent it.

I completely understand the irritation of some restaurant staff towards picky eaters, their effort has meant that I have far more choices today than I did when I was first diagnosed [...] I can see the same is happening with gluten-free products and lactose-free products now. Already some interesting new tastes have come out of it.

I feel like the gluten-free thing is an especially touchy thing, though, because often making things gluten free means that they're now unsafe for people with, say, nut allergies, or egg allergies. For many of us, it's not an improvement.
posted by MeghanC at 2:12 PM on October 25, 2015 [22 favorites]


often making things gluten free means that they're now unsafe for people with, say, nut allergies, or egg allergies.

MeghanC, I wasn't aware of this, thanks for the information. I always try to anticipate allergies when I entertain, and while I can easily work around it, I needed to be more aware of cross-contamination.
posted by mumimor at 2:19 PM on October 25, 2015 [1 favorite]


Gluten is weird. I know people with genuine doctor-diagnosed celiacs that will sometimes eat gluten either because it is not severe for them yet, or they want the trade off of something now with the agony coming later. Both cases don't eat it often, but sometimes they make exceptions. Evidence for gluten intolerance is less certain, but as someone who has a crab intolerance - I'm sure some of it is at least genuine. And some of it seems to be people thriving in the low carb diet that a gluten intolerance inevitably pushes them into.

Then there are intolerances like my weird ass crab intolerance. I vomit when I eat crab. About 1-2 hours after eating it. Sometimes a little longer if I make a conscious effort not to, take some benedryl and rub my neck. It's usually easier to just let myself vomit because that's the inevitable outcome. But I could eat it as a kid, and a brief while as an adult. And then one day, I couldn't. I thought maybe I had a bad crab. Nope, happened the next time. And then I tried some at home, and like clockwork, my body noped it out of me. (- I really like crab, so I wanted to try anything.) I tried it in Seattle, hoping the issue was something like maybe being in the Midwest it is just not as good. Nope, Seattle crab came back up.

But! I can eat dishes with a small amount of crab. I don't know where the line is. Sometimes it's fine, sometime there is a little bit of nausea that passes, and sometimes it's a hard no. To a server or acquaintance, if I said I had a crab allergy; I'm not lying, but I might look like it if I have a bite of that cheesy crab biscuit.

I think you should be more forgiving of behind-the-times diners who aren't up on the reversal of fortune lately enjoyed by the Patagonian toothfish; when the fisheries-dying-out controversy became common knowledge, Chilean seabass were like the main ones we were all told to avoid.

Yes. This. And people frequently miss use the term "endangered" to mean anything that they are aware has a conservation-based concerned. People often claim seahorses are endangered because their trade is regulated and populations at risk in some places. Only one species actually is *grumble grumble grumble*

Remember, more and more people are becoming allergic . . .
And yes this! If allergies keep increasing, as they seem likely to do, we've only guesses to the cause, then somehow restaurants are going to have to accommodate to. While some, like peanut allergies, seem to be pretty extensive, and might do with a blanket ban, there also seems to be more variety in food allergies.
posted by [insert clever name here] at 2:24 PM on October 25, 2015 [1 favorite]


It's actually really not obvious at all what foods contain what allergens. People who think that only think that because they've never tried that particular guessing game.

Oh yes, this. I had a food allergy I couldn't pin down. It lasted for a couple years and went away (also kind of what the fuck). Fortunately it wasn't severe, but my mouth would get tingly, and my neck itchy. But itchy inside. I thought it was peanuts, because it seemed to occur when I ate food containing peanuts. Then I at a candy bar that didn't have peanuts. The label indicated it was peanut and soy free. It happened a few more times with non-peanut foods. I tried all sorts of single ingredients to trigger. And weirdly, sometimes straight peanuts would, sometimes they would not.

Then it just went away. No kids or pregnancy scares, so I can't even blame the major hormone shift that are known for changing allergies.

And that was a mild allergy, unlike the "you're going to die from this" ones many people face.
posted by [insert clever name here] at 2:38 PM on October 25, 2015


But! I can eat dishes with a small amount of crab.

The restaurant probably used imitation crab.

Also, yeah, dude, you have a crab allergy and you should proceed as if you have a crab allergy going forward. A lot of allergies can be adult-onset or become more severe over time. Just because sometimes it's maybe OK, for values of OK meaning "I just get nauseous but don't go into full on anaphylaxis", that doesn't mean it's not an allergy.

Shellfish allergies aren't a joke. Stop ordering stuff with crab in it! I'd also probably avoid mixed-seafood stuff, while you're at it, and clarify with servers things like what's in the stock, etc. when you eat fish or seafood adjacent dishes.
posted by Sara C. at 2:38 PM on October 25, 2015 [5 favorites]


We struggle with this for my daughter, who is peanut-allergic. Her allergy isn't mild by any means, but we have always allowed her the "may contain traces" and "manufactured in a facility" labels with no issue. But when you try to talk to a server or the staff at, say, a catering hall for a family wedding, their allergy training often means they just say "oh you can't have any dessert" because *all* of the desserts have a CYA "may contain" label on them. It's a struggle to navigate the nuance required to get to an educated assessment of genuine safety. And it's a sad, sad thing for a child to be the only one out of two hundred guests who isn't eating dessert.
posted by Andrhia at 2:44 PM on October 25, 2015 [4 favorites]


I have food allergies, to peanuts, walnuts, and strawberries. I also have food intolerances, to lactose and sulfites.

The sulfites I'll refer to as an 'allergy', because I cannot have any added sulfites at all in my food. At all. While technically my reaction isn't a histamine-induced allergic one, it is potentially deadly, as i have persistent asthma, and sulfites cause a severe asthma attack. In my history, if I say 'intolerance' to servers and restaurant staff, they think it's something not life threatening - like my lactose intolerance. I drink milk, I squirt out the poops for a couple of days and have incredible gas - but it won't endanger my life. If I say 'allergy', though, they get it.

My pet peeve is also places that have 'secret ingredients' in their food, and they can't/won't tell me if there's any sort of baddie I may hit in it. I've walked out of places like that. I'm not trying to reverse engineer your chili recipe here, I want to make sure it won't kill me.
posted by spinifex23 at 2:45 PM on October 25, 2015 [4 favorites]


Honestly I think that part of the deal of getting your needs taken seriously is that you don't indulge in the one bite even if you can. It just confuses the issue.

You are right for the issue of a server. Mine was just an example and perhaps a poor one- I don't think I've ever had the need to tell a server, I just avoid those dishes. But what about the acquaintance who saw you pass on one meal due to an allergy or intolerance, and then some time down the road eat food with ingredient? Say a coworker at a company with food events? Only close friends who I have lamented about the awfulness of one of your favorite foods being a non-option know the whole story of my crab intolerance. And who doesn't know someone who is lactose intolerant that may be willing to have a bit, but they're doing the careful math of what the rest of their day is? To the casual observer, those people look like liars. Yet this is frequently what informs people's decision about the falseness of allergies.

Or do we only draw the line at life threatening allergies and intolerances?

I also, perhaps incorrectly, refer to my crab intolerance on the rare occasion I need to convey it to someone outside my circle of close friends*. I started doing this when intolerance confused people and drew more questions. This was back before people were talking about gluten intolerances, and has just been a habit. So perhaps I can rethink and go back to the other way.

*A surprisingly large number of friends and acquaintances have bonded over our mutual love of crab and going to dinner just for crab, down to silly I jokes, so there is a surprising number of times I've had to explain something that I'm not sure would be the case for most people.

I miss you, crab legs!
posted by [insert clever name here] at 2:56 PM on October 25, 2015 [3 favorites]


Um, mild allergies can and will kill you. One of the weird things that we don't understand about allergies is that the amount required to trigger a response does not appear to have anything to do with the severity of the response. Once the allergic reaction gets triggered, how bad it gets is for practical purposes random (though the more severe the allergy the more likely a bad allergic reaction is), so a person with a mild allergy usually won't go into anaphylaxis, but the possibility exists and there is no way to know if that tiny amount you can normally get away with is going to be the one the says 'nope" and kill you. Poe is right in saying that even a mild allergy needs to be taken seriously because previous reactions are not reliable indicators of what future reactions can be.
posted by Meeks Ormand at 2:58 PM on October 25, 2015 [4 favorites]


Shellfish allergies aren't a joke. Stop ordering stuff with crab in it.

I don't disagree with you in theory. But in practice, you can pry crab from my cold, dead, puffy, hive-covered hands.

(Also, I carry an epipen.)
posted by [insert clever name here] at 3:02 PM on October 25, 2015


Food allergies are increasing because there's a lot more local variety of foods, and the people that used to have food allergies would just die young from them, or never had them in their local cuisine anyway. (Anyone in the Midwest with a seafood allergy in 1850, for example)
posted by Xyanthilous P. Harrierstick at 3:07 PM on October 25, 2015 [1 favorite]


Yeah, that's not true.
posted by [insert clever name here] at 3:11 PM on October 25, 2015 [4 favorites]


[insert clever name here]: Then there are intolerances like my weird ass crab intolerance.

I don't think that's weird at all. Nobody should be expected to just put up with ass crabs.
posted by Anticipation Of A New Lover's Arrival, The at 3:15 PM on October 25, 2015 [21 favorites]


Thanks, Meghan. I did not understand most of that (meaning I didn't know it before and hadn't taken it into account, not that I didn't understand what you said). I would have thought that every anaphalactic episode would result in an ER visit and no idea it was even possible to skip that and survive, nevermind that there might be people forced to do that. Also, I thought even in the US the ER had to treat you if it was something life threatening. Isn't that the law conservatives are always using to imply poor people never suffer from lack of healthcare?
posted by If only I had a penguin... at 3:15 PM on October 25, 2015


I feel so bad for people with allergies. I was listening to this podcast earlier today and they were talking to an industrial spice supplier who talked about problems with peanut contamination appearing in things like ground cumin.
posted by XMLicious at 3:16 PM on October 25, 2015


Also, I thought even in the US the ER had to treat you if it was something life threatening. Isn't that the law conservatives are always using to imply poor people never suffer from lack of healthcare?

They generally do have to treat you, but they will also bill you, and ER care is expensive. (Unless you're officially below the Federal Poverty Level, in which case you might qualify for either no-cost-to-you medical insurance or discounted care.) Not being able to pay medical bills are a huge reason for people declaring bankruptcy in the US.
posted by jaguar at 3:25 PM on October 25, 2015 [2 favorites]


I feel so bad for people with allergies. I was listening to this podcast earlier today and they were talking to an industrial spice supplier who talked about problems with peanut contamination appearing in things like ground cumin.

I googled that, and look: it's horrific. I know it from my own allergy - you end up having to make everything from scratch. In a way it's OK, when you get into the habit. But easy it is not
posted by mumimor at 3:29 PM on October 25, 2015 [2 favorites]


I would have thought that every anaphalactic episode would result in an ER visit and no idea it was even possible to skip that and survive, nevermind that there might be people forced to do that.

In theory, they should. In practice--or, at least, in my personal experience--jabbing yourself with an epipen and taking a megadose of diphenhydramine will usually arrest the reaction. In the event that it doesn't, you can take a second epipen fifteen minutes after the first. It's not pleasant, and you have to be very aware of what you're doing, and alert for signs that the reaction is recurring (which some do, a secondary flare of whatever in the 8-12 hours after the initial reaction) and also able to track that the reaction is subsiding. The epipen is often not enough to make you normal again, but it's enough to stabilize so you're not going to lose your ability to breathe, even if it means you spend a few hours wheezing. Reactions will abate over time, if you can keep yourself alive long enough to let your body chill out.

As a datapoint, the over the counter price for epipens (as I buy them, anyhow) is about $100 each. Last time I had health insurance, my ER copay was $200, plus the deductible, plus the co-insurance.

Also, I thought even in the US the ER had to treat you if it was something life threatening. Isn't that the law conservatives are always using to imply poor people never suffer from lack of healthcare?

That's the law, yes. But the bills as astronomical and can be life ruining, and besides that, for many people, if you use an epipen, you reach the hospital and you're no longer in active crisis. Maybe you're wheezing, but you're not about to die, and you're showing up for what amounts to observation as a safety/preventative thing. It's not really life threatening, at that point...unless your reaction recurs, which may or may not happen. Best practice is definitely being observed in case of crisis, but...well, ER bills are a lot to shoulder for something that's just a best practice and not a matter of life and death.
posted by MeghanC at 3:51 PM on October 25, 2015 [2 favorites]


I've had a peanut "allergy" (or whatever) since kindergarten as I remember but have never gone to the hospital so I don't actually know how serious it is, or if it was serious but I've outgrown the potential for anaphylaxis. It has remained the most disgusting, repulsive, gut-triggering food I know of for my entire life. For most of four decades in order to successfully avoid peanuts I've had to create an extreme fuss - yes I'm allergic, no not even a bite, yes even those brownies gross gross gross, because it was never taken seriously. It's only in the past five years or so that I've needed to append, but don't worry I won't die from it - just don't put it on my plate, in order to not have hosts and restaurateurs look perplexed. I really don't appreciate people calling whatever I have a "fake allergy" just because I managed to survive childhood without eating peanut butter sandwiches. Intolerances are just as valid as allergies. It is still a problem for me if I eat peanuts or things cooked in peanut oil (Thai food, so sad), so until there is a good in-between word that is just as effective as "allergy" at getting peanut ingredients omitted or at least revealed, I will continue to use it. Besides, at the last conference I went to my peanut allergy got Nanaimo bars added to the dessert bar and that was a win for everyone.
posted by dness2 at 4:37 PM on October 25, 2015 [2 favorites]


It's actually really not obvious at all what foods contain what allergens.

In all of those AskMe can-I-eat-this posts, I think, "give it to me I'll eat it." I'll eat anything, and I don't know if it makes me stronger , but it's never killed me, nor even made me sick.

But I had a guy sit in my office for about ten minutes, and he turned red and stated wheezing. It turned out to be that it was due to an open can of peanuts on the top shelf of a cabinet in the room. The same guy had to be hospitalized when he ate a chicken satay that the server told him had no peanuts.
posted by StickyCarpet at 4:39 PM on October 25, 2015 [1 favorite]


I have a Class 2 peanut allergy, which is pretty mild. I know it can still be dangerous, so I inform and never eat (also because allergies can get worse). I don't seem to be impacted by inhalation or small traces (I can eat somewhere which serves peanuts in other form). Most restaurants are pretty good about peanut allergies.

One of my good friends regularly lies about allergies-- claims an allergy to peppers and garlic. Really, she's never been diagnosed with anything, but she claims that both make her feel bloated.

I asked her why she didn't just tell the restaurant she doesn't want any garlic or peppers, and what she said was "then they often tell me they can't make the dish without the garlic or pepper, but when I say I'm allergic, they usually do it. Besides, I think I probably am allergic, just never diagnosed."

I won't eat out with her anymore because she doesn't seem to understand that she's really making it much harder for those of us with real allergies to go to restaurants, especially small restaurants. These little places are on very thin margins and are very tightly staffed-- they really can't cater to every preference. They really don't want to punish those of us with allergies, but if everyone claims an allergy or an intolerance then they can't handle any of it in a cost effective way. So then they just tell people they can't accommodate anyone. Which I get. And it means my friend eats out and grumbles, but for me it means I honestly can't eat there anymore.

There's nothing wrong with telling a restaurant-- "I don't like xxx. Can you make it without it?" or "xxx makes me feel a little sick when I eat it-- what do you serve which doesn't have it?". But please please please don't call it an allergy.

(btw to the poster with the Kiwi allergy-- this is totally a thing and can be really severe. I'd get it tested.)
posted by frumiousb at 4:43 PM on October 25, 2015 [9 favorites]


dness2 -- why do you think that isn't a real allergy? I would be wary, if I were you. My peanut allergy appeared at 40 as a surprise birthday gift, and what the doctor told me is that I most likely always had it, but outgrew the reactions only to have the reactions return with fangs later in life.
posted by frumiousb at 4:47 PM on October 25, 2015


I have one of the highly unusual allergies and it is one reason that I very rarely go out to eat.

I grew up eating onions. Never liked them, but my family was one where you were not permitted to nope out of things you did not like. As a young adult, I got tired of 'sounding like a child' in restaurants, asking for onions to be left out of my food, and so decided to train myself to like them. I started adding more and more onion to the food I ate, hoping to learn to at least not hate the taste anymore.

Welp - that ended with me in the hospital with anaphylaxis. Until that point, I had never heard of anyone being allergic to onions of all things, and even twenty years later I have only met one other person with a true onion allergy.

But when I go to restaurants, it is clear that the servers hear about onion allergies way more often than is statistically likely to be true. And then I have to make the judgement call - is the kitchen going to roll their eyes at another lying picky eater? I never ever order anything that has onions integral to the dish, but so many places garnish with onions, or slice all their vegetables on the same surface with the onions, with the same unwashed knives...

Usually, I just don't bother. I take a cooler with sandwich fixins on road trips, I make dishes I can fill myself up on easily for potlucks, and I am the boring one who just doesn't go out to eat with the group.
posted by Vigilant at 4:53 PM on October 25, 2015 [2 favorites]


onion allergy perfectly reasonable in my book, but beware anything with meat stock. It is strange, sometimes I decry this era of food network and chopped and smartphones and the well informed customer. However all that info helps the allergic person know what to avoid, what to ask about, etc. And really grok it when I tell them the truth about a foodstuff.
posted by vrakatar at 5:05 PM on October 25, 2015 [1 favorite]


I had people who I repeatedly told about my dairy allergy (like about 900 times) make me cookies with butter in them as a gift. Knowingly and on purpose. And then when I lied and told them I didn't react so they didn't feel guilty (I had hives and asthma) they told me that see, I actually could eat dairy!

That's some serious commitment to being an asshole, right there.
posted by jaguar at 5:28 PM on October 25, 2015 [22 favorites]


The converse of don't like that you have an allergy really is "Tell people you have allergies and call them allergies." though. It's just as important.

I attended a pot-luck dinner party once where I was bringing the soup. the invitation, sent out weeks before the event said "Don't bring fish." Which I promptly forgot because I was bringing the soup, not a main dish, and I would think fish is a main dish. So fast forward several weeks to the day of the party and my soup recipe has the option to add some fish sauce, and I happen to have some fish sauce, and I think umami-licious and add it. The soup was a big hit. So much so in fact that one guest asked what was in it, and when I got to "fish sauce" another guest dropped her spoon and said "That's why my throat is itching!"

So yeah, she has a fish allergy of the real anaphylaxis variety. Fortunately, it was 2 tbs of fish sauce in two gallons of soup and she only had a little of the soup before realizing, so she guzzled as much water as she could and was fine.

But the invitation didn't say "Someone is deathly allergic to fish. Don't bring anything with any fish-containing ingredients in it." it just said "Don't bring fish." I assumed it meant literally, don't bring any actual fish. I had no idea it was an allergy issue. And since there was no risk I was going to bring actual fish, I didn't even file it away as a thing to remember. I just forgot all about it.

So yeah, please don't keep allergies to yourself if people are cooking for you. Please use the words "allergy" and "anaphylaxis." Please.
posted by If only I had a penguin... at 5:38 PM on October 25, 2015 [9 favorites]


Really, she's never been diagnosed with anything, but she claims that both make her feel bloated.

Not to nitpick your example (I trust your judgement, your description just got me thinking), but at what point is it OK to say you have an allergy/intolerance? How severe do your symptoms need to be before it's okay to ask for an accommodation? Someone who feels bloated, and can be accommodated by just leaving out the offending ingredient can more easily and more safely be accommodated than someone who can't have any cross-contamination without a trip to the ER.

I'm also sort of bothered by the attitude that "fakers" are ruining it. As a lot people have mentioned here and in the article, they have to emphasize their allergy in order to be taken seriously (and sometimes not even then). Even sticking to "safe food" can be risky when a well-meaning chef tries to be nice (adding something to rice to make it interesting for the kid). This problem has been around longer than gluten free has been front and center, so it's not like everything was running smoothly for everyone.

And how are we determining who is a faker? If someone has a milder allergy or intolerance decides one dish isn't worth the discomfort, but another is, they haven't betrayed or lied to anyone, they're just an adult who has made a personal cost benefit analysis and not told everyone in the world about it in detail (because who really wants to hear about it?).

And what about the people who have a reaction short of death and then don't make a huge fuss about it after and accidental exposure because they don't want people to feel bad (on preview internet fraud detective squad, station number 9, you are a saint), they now look like "fakers."

It's why I like the idea of having an open (judgement free) conversation: it lets kitchens know when extreme measures need to be taken vs just don't throw X in at the end. The staff can steer clients towards other dishes when appropriate (X really makes the dish), or direct them to another restaurant if they can't be safely accommodated. It's giving everyone the benefit of the doubt and treating them like competent adults.
posted by ghost phoneme at 5:52 PM on October 25, 2015 [12 favorites]


Yeah, and I think that was the main point of the article, that saying "allergy" triggers extreme measures in the kitchen and so is overkill for people who don't need to worry about cross-contamination.
posted by jaguar at 6:06 PM on October 25, 2015 [1 favorite]


Not to nitpick your example (I trust your judgement, your description just got me thinking), but at what point is it OK to say you have an allergy/intolerance? How severe do your symptoms need to be before it's okay to ask for an accommodation?

I think it's always okay to ask for an accommodation, but I think that allergy is a really specific word with a medical meaning and triggers an appropriately extreme response. I think it's not okay to claim an allergy because of discomfort because you think the people hearing it won't take it seriously enough otherwise (which I view as lying, not faking). Which I think is the point of the article.

(I also think restaurants can decide they won't handle special requests if it isn't potentially serious in consequence. My friend in question would expect them to (for instance) make a stir fry for her without peppers-- not just order something without it. Given that usually they prep all that stuff before the evening starts, it's a big ask. Steering, however (dish xx has yy) is not doing anything special-- that's just the restaurant's job.)
posted by frumiousb at 6:38 PM on October 25, 2015 [3 favorites]


The thing is even for mild allergies, anaphylactic shock and death are possibilities, they just aren't likely possibilities. Which is why I likened it to Russian Roulette, play often enough and long enough and they will be taking that {insert allergen here} from your cold, dead, puffy, hive-covered hands. I understand being free to make your own choices and take your own risks (after all I don't carry an epipen), but insisting on an accommodation for your main course, but not for your dessert makes it much less likely that anyone who asks for the same accommodation later will be taken seriously.
posted by Meeks Ormand at 6:44 PM on October 25, 2015 [1 favorite]


I have been eating at alot of fancy NYC restaurants with tasting menus over the past 6 months and almost every one asked about allergies immediately when we sat down, sometimes when they called to confirm our reservation
posted by elvissa at 6:59 PM on October 25, 2015


you don't always know what rando ingredients are being put in things that you would not expect.

But you know what you are allergic to. So ask about it, and if I tell you it is in the dish do not insist it be made safe.


Unfortunately my experience is that servers are really hit and miss on knowing ingredients and preparations. I'm not allergic to anything, but if I'm with someone who is we will usually ask someone in the kitchen, not the server. I've seen too many times where a server is trying hard to be helpful but just doesn't understand, or doesn't know.

This is also why we will almost always eat at small places where the person in charge of the kitchen is present and controls every stage of the food prep, rather than chains or large, popular places. The menu will usually say something like "modifications politely declined" which is fine -- it's being able to find out the trace ingredients that matters, not making the kitchen modify their dishes.

4. If all else fails, pick it out.

This is extremely useless advice for allergies, though great for things someone just doesn't like eating.
posted by Dip Flash at 7:17 PM on October 25, 2015


"faker" here, complete with confusion over which words to choose when describing it, mild guilt over where to place myself on an imaginary "scale" with other people's problems, etc.

Like [insert clever name here]'s cheesy crab biscuit, I can sometimes tolerate small amounts, and will sometimes risk it (and then some of those times suffer) if I'm tempted enough by something special, or just wanting to not create a big deal or make people feel awkward (including in a group at a restaurant).
posted by spbmp at 7:32 PM on October 25, 2015 [1 favorite]


Don't tell me that restaurants can't accommodate these things. Disney is HUGE, and they do this all the time.

The reason Disney can and does do this is because they're huge. Disney restaurants tend to have very high usage rates, which means very high backline staffing, which means they can afford to have a line cook redo a dish from scratch to avoid X without making everybody else wait. That's the can. The does part is that by doing that, they get more guests.

But yes, my standard answer is "Just mention allergies when you make the res. There's even a checkbox on the form. Disney can work with it." Seriously, if it'll kill you, if it bothers you, or if you just don't want it, let them know, the chef *who will be working on your food* will come out and talk to you about it, and will either be able to make X without Y, or tell you to try Z, A or B instead.

(Aside: Disney restaurants tend to have more limited menus -- even the very top ones -- than typical restaurants. This is the land/world of the one page menu. By making a few things, they can do them better than making a lot. Also, all Disney menus at the higher end have the Emergency Steak Option if you've found yourself in a place that has all that foreign füd. Disney wants you to be happy because lots of reasons, but money is a big one.)

Disney, BTW, has also pretty much set the standard on food preparation hygine, because they don't want to deal with things like camphobacter or norovirus outbresk on the scale of a couple of thousand cases.

The truly life-threating allergic people tend to be easy to spot -- if they or their parents have an epi-pen on them, you simply do not fuck around will the allergy question. Matter of fact, if you want to make sure the servers and chefs are paying attention, just have the epi-pen out when you're talking to them about the allergy.
posted by eriko at 7:34 PM on October 25, 2015 [4 favorites]


This has been an interesting discussion and I'm wondering if anyone knows of a X-Things-Everyone-Should-Know-About-Food-Allergies. If not, I'd be happy to write and share on Buzzfeed Community or something if folks can offer some citations and such. I thought it could include things like food allergies can vary in intensity (didn't know that) and that people can grow out of food allergies or develop them as adults. And that the most common allergens are problematic for 90% of those with food allergies and the differences between being truly allergic to something versus a food intolerance or something similar. Just an idea, let me know.
posted by kat518 at 7:51 PM on October 25, 2015


This is extremely useless advice for allergies

It was not advice for allergies. It was advice for picky eaters who defend lying about having allergies.

When I was a picky child, my parents made me pick out or eat around the stuff I didn't like in restaurant dishes. If a seven year old can do it, you can too.

(I think there's space for people who didn't like a particular food as children realizing as adults that they have a minor allergy to same, and telling waitstaff in restaurants about that allergy.)
posted by Sara C. at 8:22 PM on October 25, 2015 [3 favorites]


kat518, you can find a lot of good basic information on food allergies at Food Allergy Research and Education (FARE) and the Food Allergy and Anaphylaxis Connection Team (FAACT).
posted by BlueJae at 8:50 PM on October 25, 2015 [1 favorite]


It really would be ideal if there were some commonly understood social proscription where lying about serious allergies were on par with lying about terminal illnesses or military service, but there would also need to be some commonly understood social convention where less-serious sensitivities and dietary limitations were taken seriously.

The reason why they're not always taken seriously is because of the utter assholes who fucking lie and lie and lie and lie and lie and lie about having allergies.

I have anaphylactic allergies to all tree nuts. Every single one. And I am a chef. When I see an allergy alert, or the server tells me there's an allergy, I treat it every single time as though the guest will die right there at the table if they get a molecule of their allergen in their bloodstream.

And you know what? Most of them are fucking lying because they're picky special snowflakes who want to be special and they make life harder for me, both professionally as a chef and personally as someone who really needs kitchen staff to understand that yeah, you can't guarantee, and you really need to make sure there are no nuts in what I eat because I'd like to keep my unbroken streak of unused epi-pens, thanks.

my allergy is to kiwi. I don't intend to waste anyone's time with testing for a very, very easily avoided food (but I have the weird tingling in my mouth and throat and slight swelling

Actually it's a really good idea to go get tested. Two reasons:

1) Kiwi allergies often come bundled with other allergies (strawberries e.g., if memory serves), so a good idea to know what else might cause you problems.

2) Prescription for an epi-pen, just in case.

I sort of feel that if someone says they want/need a menu item to be made in a sort of way, they should be accommodated if at all possible, allergy or not

Yeah, no. Any restaurant above roughly the level of Olive Garden is trying to do something specific, trying to do a Thing. Sometimes accommodations are reasonable and fit within the general idea of what we do, and sometimes they are not. If you want a trained professional to make you something exactly the way you want it, pay the cost of hiring a private chef.

At the end of the day, as someone with actual allergies, if you (that is the general 'you' of anyone reading this) do not have such allergies--STOP fucking lying about it. You are making the world more dangerous for me because of your special snowflake selfish stupidity.
posted by feckless fecal fear mongering at 9:42 PM on October 25, 2015 [19 favorites]


FWIW, my daughter has unusual carbohydrate intolerances (fructose malabsorption disorder), and the language I use when telling people about it is "My daughter can't eat X, Y, or Z. It is an intolerance, not an allergy; cross-contamination isn't an issue, and a tiny exposure means a tiny reaction, to the point where incidental amounts are fine. It will never kill her. However, the digestive effects are serious enough that she usually has to miss school for a few days, so it is definitely worth avoiding." This has always resulted in people taking us seriously, thank goodness. I don't know if it's because she's a kid or because my Don't Fuck With Me face is well developed, but nobody's ever blown us off on account of it not being a Real Allergy.
posted by KathrynT at 9:46 PM on October 25, 2015 [17 favorites]


And many thanks to fffm for helping me develop that language, it occurs to me belatedly to say.
posted by KathrynT at 9:48 PM on October 25, 2015 [5 favorites]


Oh wow, thanks. I don't think I ever told you anything you hadn't already figured out though.
posted by feckless fecal fear mongering at 9:50 PM on October 25, 2015


Well you told me what was important to stress, and how to phrase things so that they'd believe it wasn't just me being a weird hippie.
posted by KathrynT at 9:51 PM on October 25, 2015 [1 favorite]


I used to have dinner parties all the time, but in the last ten or so years, so many people have developed allergies or intolerances, that I don't feel safe doing them any more. My traditions are middle eastern, so there is wheat and nuts everywhere in my pantry and kitchen. One of my friends is has become deathly allergic to even smelling cinnamon, and I have enough weapons grade spices, that she gets an itchy throat just walking in the door.

I have tried, but the most people I can seem to accommodate has become about 5, instead of twelve, because any more than that and the menu requirements become more than I could manage without a sous chef and a walk-in.

Which is not to bitch about people's dietary needs, but more to wonder what has changed so much in such a short amount of time that we are seeing these reactions to common foods?
posted by SecretAgentSockpuppet at 10:03 PM on October 25, 2015 [2 favorites]


One thing I have found confusing and irritating, is when people who claim to be allergic or intolerant order foods where the thing they can't eat is a major ingredient. Like chicken satay with no peanuts or risotto with no onions. But then I found out that many people have no idea what food is made of.
This is why I like the practice of listing all ingredients of a dish on the menu. And to be honest: if you really think it's a problem that someone might figure out your "secret ingredient", you are not a cook but a snake oil salesman.
posted by mumimor at 12:16 AM on October 26, 2015


This is an all sorts of tough subject in my house.

See, on one hand, my husband has a life threatening peanut allergy. And he's been treated with eye rolls and "well will it REALLY hurt you"s and "yeah there's no peanuts in that! Oh wait yes there is!" More times than I can count. One whole foods type place had unlabeled local bakery items. He grabbed one under the caramel label and it turned out to be peanut butter. I marched over there to complain because they could have killed my husband and I was met with, "well we encourage them to label them but they are made offsite." Uh. Right. In the same place where everything must be labeled as vegan or not you can't be bothered to put a "contains nuts" sticker on something. I mean a kid with an allergy could literally die that way. We now have a hard rule that he won't eat anything that's not individually labed.

On the other hand, I don't eat gluten or milk. I don't have celiac but I can tell you that the last times I had a large amount of gluten was complete hell. And now there's research linking gluten problems with a syndrome I have. So fries made in a shared frier or soy sauce seems ok but anything past that I'm not willing to chance.

But... I order things without gluten already or don't get cheese on a salad and ask about the dressing. Truth is I just end up not eating out at a variety of places because they don't have good substitutions. I think at a bare minimum there should be some options that don't include those so-called fad items already.

I get that people abuse this but I would really not want to rush to an ER or end up on horrible pain because someone doesn't take it seriously. People who are assholes will be assholes no matter what but that shouldn't mean you take allergens or intolerances lightly because of it.
posted by Crystalinne at 1:41 AM on October 26, 2015 [4 favorites]


SecretAgentSockPuppet, that's a really interesting question, and I don't think anybody knows the answer. But there is some evidence that the rise in allergies may be linked to the growing use of antibiotics. The theory is that, in addition to killing off the bad bacteria, the antibiotics are also killing off beneficial bacteria. Perhaps these good bacteria help the body fight off molds that might cause allergen sensitivity, or perhaps there is some other mechanism.

Another theory is that increased hygiene has resulted in fewer intestinal worms, and those worms may have had beneficial side effects we are only now beginning to understand.

On a hopeful note: a very promising study at Cambridge University showed that feeding people very small doses of peanut, and then gradually increasing that amount over the course of months, cured peanut allergies in 84 to 91 per cent of participants.

IMPORTANT: DO NOT TRY THIS AT HOME. The treatment involved giving very carefully controlled doses, in the presence of medical experts who were qualified to intervene if anything went wrong. (I know you all know that, but I'm worried that one of the assholes that Internet Fraud Detective mentioned is going to see this study and think it's a licence to sneak allergens into food they give to allergy sufferers.)

My young son has a number of allergies (including peanut and kiwi). I'm pretty hopeful that by the time he's a teenager, they'll have figured out a cure-- whether it's the Cambridge protocol or something else.
posted by yankeefog at 2:13 AM on October 26, 2015 [4 favorites]


PS: "The Cambridge Protocol" would be a great title for a thriller in which James Bond discovers he has severe food allergies.

BOND: I don't care how many guns you point at me. Bullets don't frighten me.
BAD GUY: But Mr. Bond. These guns aren't loaded with bullets.
[He flips open the chamber, revealing it is filled with peanuts. Bond turns pale.]
posted by yankeefog at 2:16 AM on October 26, 2015 [19 favorites]


I have a very serious allergy to tree nuts though thankfully can eat almonds and cashews which makes life easier and I'm generally quite pleased at how much more knowledgable restaurants in the UK and US have become in recent years. It's gone from 'no idea' to let me check' in basic places which is a start.

Not eating out is not an option for me - I travel extensively for my job all over the world. And, I like food. Of course information in some countries varies greatly so I have to be extremely careful on the road. On the few times I have eaten something containing nuts, it's usually been the most innocuous seeming thing where I forgot to ask - some lettuce leaves in Ukraine, a shortbread in Prague, waffle in Chicago. And most recently, a beer that neglected to mention it has pecans added at the last stage.

Despite this my usual strategy, if in a country with questionable healthcare, or at home, is to never ever ask for a dish that has nuts to have the nuts taken off (to avoid inconveniencing the kitchen). I choose something else. I avoid nut heavy cuisines like Georgian and Persian altogether, and to skew towards Japanese, Chinese, Thai where there are few dishes I must avoid. No desert at a restaurant, ever. Non-ethnic, gastropub type meals tend to be more problematic. Fearing your food may kill you does kind of suck.
posted by wingless_angel at 2:52 AM on October 26, 2015


"Sometimes accommodations are reasonable and fit within the general idea of what we do, and sometimes they are not. If you want a trained professional to make you something exactly the way you want it, pay the cost of hiring a private chef."

As someone who has worked food service for most of my jobs I completely agree with this. However I feel like it's a little confusing if it's assumed that the word allergy is and can only be something with life threatening risks. I have been allergic to so many things my whole life, the most obvious being pollens, molds and dusts, and dogs... there has never been a risk of death from these reactions but they are very much real allergies and I was the kid who had to sit in class with a box of tissues and a trash can next to me for months, I would get sinus infection after sinus infection, take shots for years at a time with no improvement, take all the pills you can take with no improvement.

Dietary changes actually helped a LOT with my seasonal allergies. And I'm not sure there AREN'T a lot of mild allergies people are having to food that do result in symptoms that will not be life threatening but that people will feel better overall if they understand. My food allergies tests have always been very mild and they said other than corn I shouldn't have to worry too much about them. I used to try to eat corn sometimes because I thought maybe I would stop being allergic, I have found that if it's a trace amount it seems to be ok, but if I eat a bunch of popcorn or corn chips or a big plate of corn tortilla enchiladas I will be sick within the day, now I know why I always got sick after Mexican food, I thought it was just the spices!

I do feel like we NEED to develop sane language and practice around this because most restaurants that are not very high end are not paying staff enough to make personalized meals for every person or have essentially a medical grade knowledge and quality of food that meets every mild or severe allergy, intolerance or preference.

I NEVER mention allergy, but I will ask if they can do a burrito without the tortilla or something of this nature, and I assume they can say yes or no to that request. And if they say no and I order with the tortilla and eat around it, it's fine. And yes on some occasions I will eat a tortilla and I will be ok. A lot of restaurants are doing gluten free menu's now and if I order off that menu I have had some ask "is it a preference or an allergy"

This would be a useful way to clarify, I will say preference since I do not want them to take extreme measures and I will be ok. But if it's on the menu I don't think you even need to have an allergy to order it, or to assume that people who don't have a life threatening allergy are therefore beings fakes ordering off it. I eat out very rarely and since I eat pretty carefully at home I usually assume going out will mean some variation from my diet. But yeah that does mean deciding how much discomfort I will deal with and sometimes I'm fine with that. Sometimes as I deal with chronic pain and regular sickness at some times more than others, I'm already in a lot of pain and I'd like to avoid things that might add to that if I can.

I also specifically avoid using the term allergy in restaurants not because I don't think there are allergies there, I am a seriously allergic person, but because the real, not fake, term allergy means a lot of things and in a restaurant context it should largely be brought up when the accommodations do need to be taken seriously.
posted by xarnop at 4:49 AM on October 26, 2015 [1 favorite]


Also, we really need to pay food service people far higher for the valuable and difficult and needed work they do, hire enough staff that they can do the work of making these accommodations without falling behind on other duties, and that needs to be part of this expanded consciousness of dietary needs/wants and expectations of restaurant staff as well.
posted by xarnop at 4:54 AM on October 26, 2015 [5 favorites]


I'm both lactose intolerant and gluten intolerant. No real food allergies to speak of. I did like this one burger joint that would let me order just the patty. I occasionally had mild gut troubles afters, but I didn't think much of it... until I went in at a different time and got a different server who told me that they use bread as a bonding agent (can't think of the word) in the meat.

Nowadays, I flat-out don't go to restaurants unless they are specifically gluten-free places. Sucks that socialising with folk at a restaurant isn't an option, but the 24 hours of dire gut misery is worse.
posted by XtinaS at 5:18 AM on October 26, 2015


Although I appreciate everyone's concern for me, in 20 years I have never accidentally eaten kiwi, and in 40 years my mother has never accidentally eaten kiwi, so I am unconcerned about this. I am not allergic to strawberries, birch, latex, or indeed anything I have ever been exposed to except kiwi.
posted by jeather at 6:00 AM on October 26, 2015


Just a factual note: recent barrage of misleading media headlines to the contrary, there is unfortunately no major "cure" in the works for peanut allergies. Even though the "Cambridge protocol" yankeefog mentions above does exist-- it's more commonly called oral immunotherapy, or OIT for short, and there have been several promising studies on it over the past few years-- that process is a treatment, not a cure.

OIT has been shown to be successful in about 80% of patients. However, what qualifies as "success" in OIT is not a cure of the allergy, as in bye bye EpiPen, hello giant pile of Reese's, but increased tolerance to the allergen, as in, someone who formerly reacted with anaphylaxis to 1/10th of one peanut can now eat four peanuts before experiencing an anaphylactic reaction. And hey, that's actually hugely helpful-- it makes you what my friends who've successfully put their children through it call "bite-proof"-- as in if your child accidentally takes one bite of a peanut butter cookie instead of a sugar cookie, he or she will probably not go into full anaphylaxis over that single wrong bite. Which opens up a lot of options at restaurants, because it seriously reduces the need to worry about trace amounts of peanuts in your food. But it's not a cure. It's a treatment

When you see those "80% of kids in this OIT trial were CURED!" headlines, if you click through or Google to read the actual study abstract you'll find that maybe 20% of kids in the study seem to have lost their allergy completely, and another 60% developed the ability to eat a few peanuts before reacting, and another 20% dropped out because they couldn't handle the regimen or the side effects or were kicked out by the researchers for their own safety because they reacted with allergic symptoms to every updose. I know a mom whose daughter experienced anaphylaxis repeatedly during an OIT study and it was pretty rough. Remember: to do this treatment you literally have to eat the thing that's trying to kill you. It's dangerous to try this at home. It should only be done under strict medical supervision by experts who actually know what they're doing. And it's definitely not a walk in the park.

About 20% of kids will outgrow a peanut allergy at some point even with no intervention, so it's not even entirely clear whether the kids who are "cured" in OIT trials, in the sense that they can actually eat peanut butter sandwiches every day, rather than just have a better chance of surviving an accidental bite of the wrong cookie, were actually cured our just outgrew their allergy.

Also, since OIT is a new treatment there has not been time to do long-term trials yet, so no one knows for certain whether the tolerance people build during OIT lasts, or how long you have to keep up with the treatment to make it "permanent." Right now the generally recommended protocol to maintain tolerance is to keep taking small doses of your allergen daily for the rest of your life. If you miss a few doses for a week because you're sick or stuck in a natural disaster or camping in the jungle doing field work on endangered monkeys or something, your tolerance level could drop back to traces-can-hurt level (and this has actually happened to the kids of a couple of people I know who got sick during treatment, and had to start it over from scratch). Also, some people undergoing OIT with seeming initial success have developed a really nasty side effect called eosinophilic esophagitis, which is a chronic allergic inflammation of the espophagus that makes it very hard to eat anything at all because your esophagus is constantly swollen. People who develop EoE have to stop OIT and lose their tolerance.

tl:dr, OIT is not a food allergy cure that makes your allergy go away; it's a treatment designed to increase allergen tolerance. It does not work for every patient; it involves a lifelong commitment to taking your meds every day, and it is risky and may have side effects and should only be done with the supervision of a competent doctor.

A similar treatment in the works that may prove to be a bit less risky (but sadly also in trials so far seems somewhat less effective than OIT) is the Viaskin peanut patch, which delivers microdoses of peanut through the skin.
posted by BlueJae at 6:03 AM on October 26, 2015 [8 favorites]


Also there are no allergy shots for peanut allergy and also NAET is a quack treatment with no proven efficacy, don't do it, and also the headlines that say "PROBIOTICS CURE PEANUT ALLERGIES!!!" are really about an Australian OIT study that paired a probiotic with regular OIT treatment and found . . . the same "80%" "Success! You can now eat four peanuts before dying!" rate as regular OIT so no I can't cure my kid with yogurt.
posted by BlueJae at 6:16 AM on October 26, 2015


And, LISTEN TO THIS FOOD ALLERGY MOTHER: all of you who have weird symptoms when you eat things but have never been tested, if you can possibly afford it, please, go get tested, and not by a regular doctor, either, but by a board-certified allergist with a good reputation. If you have a true food allergy, you should know it and carry an EpiPen, so you don't die if that one food that always makes you throw up decides to make your throat swell shut next time. If you have Oral Allergy Syndrome, treating your seasonal allergies to pollen with meds or allergy shots, or even just avoiding certain foods during the specific times of year when your seasonal allergies are at their worst, could wind up helping a lot with your food related symptoms. If you have celiac disease you need to find that out so you can stop destroying your intestines. If you're lactose intolerant you need to know that, too-- because it turns out there are some dairy foods that are low in lactose that you might be able to eat without trouble, and that can help you sort out which foods with dairy will upset your stomach and which won't. (I developed lactose intolerance a couple of years ago myself so I do actually know what I'm talking about here.) The more you know about what's really going on with your body, the better you will be at communicating with the people who make food for you about what will and won't make you sick.
posted by BlueJae at 6:48 AM on October 26, 2015 [5 favorites]


Oral Allergy Syndrome

I have this. I actually have a huge list of raw fruits, vegetables and nuts I can't eat because of it and this combined with my wheat allergies causes frustration in restaurants, but more for me than any one else. "Yes, cooked is fine though, yeah really, no, not gluten free, just allergic to wheat..."

And yeah I don't usually ask for things cooked separately (But it's better when it is) but that doesn't mean it's not an allergy.

Also, most people who get tingly mouths from kiwi or blueberries or apples or carrots (or or or) probably have Oral Allergy Syndrome. I know so many people who are like "I don't have allergies, but get weird tingly mouth when I eat x" and it's so puzzling they want to insist it's not an allergy. You have Oral Allergy Syndrome! Probably! Go to an allergist and confirm!

(this is not addressed to any person here)
posted by zutalors! at 7:33 AM on October 26, 2015 [1 favorite]


I was headed out on a work-related road trip and my coworker, knowing that we had a long stretch of gas stations-only highway in front of us, suggested stopping at Panera in the morning to pick up salads for lunch.

I asked for a salad minus the almonds because of my nut allergies. STOP the presses! The cashier asked me more about it, noted it on my order ticket, and called the manager over to talk to me. The manager asked me some more questions, then walked my ticket over to the food preparers and told them "this one is a nut allergy, as you can see on the ticket."

Wow. I was seriously impressed.

Got about 4 hours into the trip and opened the salad. Out in the middle of no-man's land.

It was covered in almonds.
posted by vitabellosi at 10:40 AM on October 26, 2015 [10 favorites]


Wow, vitabellosi, that takes work.

Did you call them back and say "hey you assholes, wtf"?
posted by KathrynT at 11:07 AM on October 26, 2015 [4 favorites]


vitabellosi, that's amazing. (I mean it's also terrible, and as someone with the same allergies I'd be pretty annoyed.)
posted by feckless fecal fear mongering at 11:12 AM on October 26, 2015 [1 favorite]


until I went in at a different time and got a different server who told me that they use bread as a bonding agent (can't think of the word) in the meat.

This is why understanding food and what ingredients are usually in what is pretty valuable. I don't know that bread crumbs are typical for burgers, but almost all meatball and meatloaf recipes use them, and it's not crazy to think of a burger place doing so. Especially if their burgers are particularly large or the texture seems meatloaf/meatball-adjacent.
posted by Sara C. at 11:13 AM on October 26, 2015


The word you're probably looking for is panade. It's bread/crumbs soaked in milk then squeezed out and used as a binding agent in some forcemeats. (That is, ground or emulsified meats as you'd find in sausages, meatloaf, hamburgers, meatballs.)
posted by feckless fecal fear mongering at 11:15 AM on October 26, 2015 [1 favorite]


I was just looking at prepared turkey burgers in the store the other day, and they had a whole list of ingredients that didn't include bread crumbs. I only found out by asking, because I knew they were likely in there.
posted by zutalors! at 11:16 AM on October 26, 2015


Also, I have to say I find it hard to understand why people want to draw all these lines around who gets to claim food allergies and who doesn't. The whole idea that you must be deathly allergic to any small amount of the food to ever speak up goes against anything any allergist has ever told me, as well as the idea that if you ever eat the thing voluntarily you must not be allergic, or allergic enough or something.

To me it's a level of anxiety inducing food scrutiny that I equate with "do you really NEED that dessert?" (pointed eyes on stomach).
posted by zutalors! at 11:20 AM on October 26, 2015 [1 favorite]


To those of you who are allergic to kiwi (jeather and The corpse in the library): please consider you might have cross-reactivity with and might should avoid eating a fairly big list of things that contain the same (birch pollen) proteins including avocado, banana, rye, hazelnuts, and a big list of others.

I bring this up because kiwi is how I started about 13 years ago, out of nowhere. I ate two (TWO. WHY DID I EAT TWO) while stranded on a small island off the coast of nowhere and was probably borderline needing to go to a hospital, but you know. 13 years later I start feeling generally terrible and itching when eating things ranging from avacado, apples, pears, carrots... . The thing is, these range in severity from mild discomfort to hives to my throat swelling and major gastrointestinal issues. But I haven't always brought them up in restaurants because, like others have said, I don't want to bother people. And I never know just how sick it's gonna make me. Like the roulette Meeks Ormand talked about, I'm class 3 with peanuts and other things are just a question of how bad am I gonna feel rather than how dangerous is it. I haven't given restaurants the red alert (I make sure they're not directly in the food but I don't talk about cross contamination) on so many of them because my reactions haven't been that worrying so far and honestly I don't want to inconvenience people, like the attitude prevalent in most of this thread. But I'm worried one day it's going to be made abundantly clear to me that that is A Bad Choice.

Also, as someone else mentioned, this can be incredibly expensive to test for. I don't regret it because I was miserable all the time but it's money I didn't have to spend.

Allergies are a weird, weird thing that we still don't really have a sufficient understanding of. So yeah the 'fakers' suck but like... please don't let the possibility of fakers jade you against people's food choices because they may very well not be technically diagnosed, but still completely legitimate.

all this being said I ate a cookie this morning with icing that may have been made with almond powder because I'm itching all over my mouth and face. I'm still getting used to a huge list of foods I can't eat, and like some people have mentioned, there are 'hidden allergies' all over the place where I wouldn't have even thought about before
posted by nogoodverybad at 11:20 AM on October 26, 2015 [3 favorites]


Also, as someone else mentioned, this can be incredibly expensive to test for. I don't regret it because I was miserable all the time but it's money I didn't have to spend.

I didn't have a special test, I went to an allergist and got a prick test that was like YES YOU ARE ALLERGIC TO TREES AND GRASS with the redness and itchy and swelling and then I asked the allergist "oh also I have an itchiness in my mouth when I eat certain things, especially carrots and kiwi" and she started smiling and I started smiling and I was like "why are we smiling" and she gave me a paper on Oral Allergy Syndrome with the tree pollens mapped to related to foods and nearly every single fruit nut vegetable thing mapped to birch pollen.
posted by zutalors! at 11:24 AM on October 26, 2015 [3 favorites]


nearly every single fruit nut vegetable thing* mapped to birch pollen.

*nearly every single fruit nut vegetable thing that I have had issues with. And that I had had issues with as long as I could remember - my mom had always thought I was being difficult as a child about fruits and vegetables because I would complain about eating most raw.
posted by zutalors! at 11:34 AM on October 26, 2015


It's also worth noting (and this is not to cast aspersions IN ANY WAY on people with food allergies) that getting a test, or even just talking to your regular doctor and/or learning more about this stuff, is useful to rule out allergies as well.

For a long time I thought I might have Oral Allergy Syndrome because pre-cut fruit, especially pineapple, makes my mouth itch. I recently found out that pineapple has a chemical in it that is known to irritate the mouth (not just for people who are allergic), and that a lot of pre-cut fruit is sprayed down with citric acid to keep it from going brown.
posted by Sara C. at 11:39 AM on October 26, 2015 [1 favorite]


I didn't have a special test, I went to an allergist and got a prick test

They ran the whole gamut of that on me and at best it's come out to something like ~210 bucks because it was 30 some pricks at $7 a pop if you have good insurance... which I couldn't get an answer on whether or not I had..... The bill is apparently still in the mail.

My insurance had already ruled my peanut allergy testing (blood and prick test) wasn't a 'necessary' test even though my doc tried to vouch for me. Thanks, insurance.

On the plus side tho it elucidated a lot of things. It took up the entirety of both of my forearms. They were a mess.
posted by nogoodverybad at 11:41 AM on October 26, 2015


The worst is when they make you sit in the waiting room and you're watching ITCHY UNTO DEATH hives popping up all over your arm and you're not allowed to scratch so you end up sitting on your other hand making whimpering noises
posted by feckless fecal fear mongering at 11:45 AM on October 26, 2015 [5 favorites]


This is why understanding food and what ingredients are usually in what is pretty valuable.

Yeah... we have a place downstairs from my office that's pretty good about allergens - they even have gluten free bread for sandwiches, which is heaven.

But I will be forever thankful for the 16-year-old server from whom I ordered a tuna sandwich on gluten free bread. She thought about it, walked away, then turned around and came back and said, "Did you know we make the tuna salad with breadcrumbs?"

I have a tendency to be a tiny bit cavalier about my gluten intolerance, because it just causes causes digestive issues... not rashes or you know, instant death. A little bit of gluten isn't going to kill me, so I don't worry much about cross-contamination; I just don't eat foods where gluten is an actual ingredient.

Gluten will make my life severely annoying for the next little while after I eat it. I had a meeting scheduled for right after lunch, and switched to chicken salad (no crumbs!) right on the spot, and the meeting was saved.

But it had never once in my life occurred to me that anyone would put bread crumbs in tuna salad on purpose, as an ingredient....
posted by kythuen at 11:54 AM on October 26, 2015


please consider you might have cross-reactivity with and might should avoid eating a fairly big list of things that contain the same (birch pollen) proteins including avocado, banana, rye, hazelnuts, and a big list of others.

I have considered it, but I do not. I eat rye and carrots and apples and bananas and hazelnuts regularly, I do not have a response to anything at all in the world (that I have eaten) except for kiwi. I have seen the OAS lists and I have exactly zero reaction to everything on the list with kiwi. I don't have asthma. I don't have hayfever. I am fine around birch trees. I am just allergic to kiwi. Among the time I don't want to waste is my own. If I start reacting to other things I will reconsider this stance.

If I die of an allergic reaction you're all welcome to say I told you so in my obit thread, though.
posted by jeather at 1:09 PM on October 26, 2015 [3 favorites]


Having cooked in restaurants, who the fuck cares why someone doesn't want something in their dish, make it without it. I've had people - a fellow chef's own brother - who were allergic to garlic before. If you can walk into a restaurant and order something, then it can be made to at least that portion of your specifications. Now, with that said, it may taste like crap - but you'd better believe, if I were cooking for you - as the chef, I'd be transplanting my palate from normally tasting with the executive chef's taste buds, to tasting with the executive chef's taste buds as if he were making the dish without garlic (or whatever).

You are a chef. You bust your ass. Drop your ego at the door, pick up a knife and cook.
posted by Nanukthedog at 1:56 PM on October 26, 2015 [2 favorites]


I have a shellfish allergy. While restaurants are more aware of cross-contamination and ingredients than they once were, not all of them are. And I suspect wait staff are not always aware of kitchen handling practices.

I no longer eat tempura in a restaurant that serves any kind of shellfish anymore. Even if the servers assure me that the oil/batter would never be used, (perish the thought!) as a batter for shrimp, etc. I'm also incredibly picky about sushi and fish restaurants.

Throwing up violently while praying for death more than one time in one's life is enough of a deterrent to be super cautious.

Please don't mess with potential shellfish allergies, [insert clever name here]. Get tested if you can. Most insurance plans will cover it. Or hey, just swear off the stuff. It ain't worth it.
posted by zarq at 2:26 PM on October 26, 2015 [2 favorites]


Hell, one of my instructors in school had an allergy to scallops that was so bad she couldn't even touch shellfish. During a demo on scallops she mistakenly touched one and her whole hand started swelling up, in the 0.0003 seconds between touching it and sprinting for the sink to scrub.

So yeah, definitely not something to fuck around with.
posted by feckless fecal fear mongering at 2:52 PM on October 26, 2015 [1 favorite]


My kid's preschool is nut-free, which is totally fine and great. She has one kid in her class (of 16) who, according to her mother, has allergies that are very, very hard to deal with and understand:

- she's allergic to sesame seeds but not sesame oil (?)
- she's allergic to pumpkin seed but not pumpkin (?)
- she's allergic to sunflower oil but not sunflower seeds (?!?!)

They carry an epi-pen but they cost $400 each (!) and luckily they've never had to bust it out b/c the worst reaction the kid has had to anything listed was itchy skin or rash.

Also, she can't eat dairy or eggs because she gets a rash. So, ALL the kids basically snack on veg and fruit and whatever snack we can find that doesn't have the above but is filling and caloric, which is tough.

What is my point? I guess (besides that I am just venting), I appreciate the lot of you who have allergies/intolerances who are just cool and straightforward and tell people exactly what you can deal with, and I am *highly* annoyed at this kid's mom for not just bringing this ONE kid her own, tolerable snack, but makes 15 other families scramble for snack food that's filling and not gonna kill anyone. (Sorry, maybe I'm also just an asshole. Actually, yeah, I'm an asshole.)
posted by tristeza at 4:02 PM on October 26, 2015 [1 favorite]


No, tristeza, you are the one hitting the mark here.
No one on this site or at your kid's school or anywhere in the civilized universe would not want to accommodate special needs. But some people make us all want to cry revolution.
At the other day at lunch, one of the fake-celiac people started pontificating (while having a brownie from our cafeteria which I can guarantee you contains both wheat protein and milk protein, and probably nuts, too). Luckily, the majority of my colleagues are wise and strong, and just ignored her. Which is the thing to do. She is a nice person in many ways, and her phony food phobias are just best left unattended.
However, she is also the type of person who might provoke our cafeteria staff to ignore all necessary requests.
posted by mumimor at 4:17 PM on October 26, 2015 [3 favorites]


tristeza, that just makes no sense. Also, $400 for an epipen is utter nonsense. Here they're like... $140ish.
posted by feckless fecal fear mongering at 4:23 PM on October 26, 2015


- she's allergic to sesame seeds but not sesame oil (?)
- she's allergic to pumpkin seed but not pumpkin (?)
- she's allergic to sunflower oil but not sunflower seeds (?!?!)


Totally can work this way. My son loves peanut butter. Loves it. Leave it on his skin and he breaks out in hives; his allergy is only contact and only the oils. It doesn't affect his breathing. As long as he washes his hands and face real well - he's fine. We did all the nutty (ha!) stuff required by his alergist and GP, and finally they greenlit us for Peanut butter again - which we were ecstatic for because he hated sunflower butter.

In kindergarten though, one of his best friends hated peanut butter. So, while he was allowed to bring it, he had to sit at the 'Peanut Butter Table' which meant he couldn't sit with his friend... so... goodbye peanut butter.
posted by Nanukthedog at 4:27 PM on October 26, 2015


ps there's a product called Wowbutter that's derived from soy, and it's close enough to peanut that even this hardcore PBJ person loves it on toast.
posted by feckless fecal fear mongering at 4:30 PM on October 26, 2015 [2 favorites]


Allergies are weird. My father has a serious allergy to fresh tuna, but canned tuna is fine. I think that's actually pretty typical of people with fish allergies, but it sounds like the kind of thing that someone would make up. And I promise you that he's not making up the fish allergy: he went into anaphylaxis the last time he ate fresh tuna.
posted by ArbitraryAndCapricious at 4:49 PM on October 26, 2015


I think EpiPens now just come in pairs in the US, ~$400 for the package ($200 a pen). My understanding (from NPR a few weeks ago) is you generally want 2 on hand just in case it's a bad reaction, but frequently you only need to use one at a time. So when you use one you have to either gamble one will be enough, or buy a package of 2 at $400 and have 3 on hand. It's not just creating bigger out of pocket costs (and increasing the number of people gambling that one will be enough), but it's also increasing the chance that an EpiPen will expire, again increasing waste/and cost.

I think one patient they interviewed couldn't pay for a replacement package, so only had an expired one on hand until she could drive to Canada to get a fresh one (and kept the expired one as backup).

I was in traffic, so my recollection may be off, but I think there was talk of having an unbundled option again, but the drug company wasn't saying when that would happen.
posted by ghost phoneme at 4:53 PM on October 26, 2015 [1 favorite]


Canned tuna gets a pretty high heat treatment for pasteurization/sterilization. That might denature the specific protein he's allergic to.
posted by feckless fecal fear mongering at 4:53 PM on October 26, 2015


Most peanut allergy sufferers don't react to refined peanut oil, since it is the peanut protein that triggers the allergies. That explains the oil/seed difference for other seeds and nuts, I guess.

ps there's a product called Wowbutter that's derived from soy, and it's close enough to peanut that even this hardcore PBJ person loves it on toast.

feckless fecal fear mongering, if this turns out to be anywhere close to true I will love you forever. I miss peanut butter more than I can tell you.
posted by frumiousb at 5:03 PM on October 26, 2015


And Wowbutter is available in Hong Kong! *happy dance*
posted by frumiousb at 5:05 PM on October 26, 2015 [1 favorite]


I have several food allergies, none of which are super severe, but restaurants that take allergies seriously make me want to cry happy tears. I love to go to Hibachi restaurants, but it never occurred to me until recently that I got so sick afterwards because of cross-contamination. My old favorite Japanese restaurant had great-tasting food, but I would be running for the restroom immediately afterwards. My new favorite Japanese restaurant keeps egg completely away from my food or cleans the grill immediately after cooking egg, lo and behold, I have no problem!

But it's a weird allergy, so I worry sometimes that people don't take it seriously (like one babysitter I had as a kid, who decided I was "too picky" and made me eat eggs anyway). I can eat dried egg pastas and most breads, but not cakes/cookies, sauces, etc. So I may be asking to not have that eggy sauce, but still eat the bread. (This link has more detail on egg allergies)

TL;DR - Even the person who seems to be contradicting themselves can have a legitimate allergy. Best to err on the side of caution for the benefit of the actually allergic, even if some people are jerks who abuse the system.
posted by jet_pack_in_a_can at 6:04 PM on October 26, 2015 [2 favorites]


I am just allergic to kiwi. Among the time I don't want to waste is my own. If I start reacting to other things I will reconsider this stance.

ok... sorry if suggesting it was out of line, I just had no idea when I encountered allergy issues related to it so I wanted to just call attention to it as a possibility?

if it was already addressed in the thread sorry... it's a huge thread
posted by nogoodverybad at 8:09 AM on October 27, 2015


I have several food allergies, none of which are super severe, but restaurants that take allergies seriously make me want to cry happy tears. I love to go to Hibachi restaurants, but it never occurred to me until recently that I got so sick afterwards because of cross-contamination.

Yes! Our local hibachi place is fantastic at prevent cross contamination with shellfish. They cook the non-shellfish stuff first, use a cooktop screen if needed and even swap out for clean knives whenever necessary. They're hyper-aware, and it's awesome.

I ate a plain salmon filet at a Red Lobster once and became deathly ill, despite their assurances that there was no danger of cross contamination. It happens. I imagine that dealing with a shellfish allergy can't be easy in a seafood restaurant kitchen. Still... no more Red Lobster for me!
posted by zarq at 12:47 PM on October 27, 2015


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