Great topic!!
There are many real reasons to vigilantly practice avoidance of anaphylaxis triggers, many of which have hard numbers in terms of total cost and additional risk. Even if one is as comfortable as one can get with managing a life-threatening allergic reaction, it's more than injecting yourself (or a loved one) and surviving.
Reducing concerns to a model based only on fear is overly simplistic.
I agree.
Though I also agree that the fear itself has to be a rational (not catastrophized) one. This is, I think, what Boo is also getting at.
It's one thing to be fearful of air travel if you're
my family. Our
allergist encouraged us to have DD wear a mask on any flight where cashews will be served on board. Just FWIW, I mean.
But it is quite another to be fearful of air travel when you have
no history that supports the relative rationality of that fear.
Someone who has a child with severe reaction history to non-ingestion exposures is being "cautious" and someone who is fearful on the basis of a positive SPT to peanuts... probably not.
So I do see both sides of this.
I practice this kind of avoidance with shellfish. I do not with citrus (my other food allergy).
My DH does not practice this level of avoidance with any of his allergens, all of which seem to be fairly high threshold. The only one of his that we've NEVER kept in the house for fear of accidental exposure is walnut.
I'd also like to add, though, that
some people with anaphylaxis history have more reason to be wary than others... just because while deaths are somewhat rare, studying them can give clues. Allergists often privately believe that the people who are at greatest risk of death are those that anaphylax without typical symptoms (hives, vomiting) and
to tiny quantities... and those who anaphylax particularly RAPIDLY.
This is why our level of avoidance for our DD is
far more scrupulous than it is for us. She has
never taken more than ten minutes to reach "peak" anaphylaxis... and hasn't had hives with a major reaction since she was about 7 years old. She even lacks airway involvement sometimes, and at others, she presents with mostly/only asthma. Many of her reactions take weeks to 'figure out' in terms of what transpired. Only a handful have been traceable to ingestion-- and that, of seemingly trustworthy food that was later determined to have been on shared lines. Many have been from casual contact or inhalation.
Her allergist has expressed a belief (which I also believe, having read the same studies) that this particular cocktail means that even ONE additional instance of anaphylaxis which
can be humanly avoided-- SHOULD. Every spin on this particular roulette wheel seems like a monumentally BAD idea. Epinephrine aside, I mean.
The psychological burden imposed by episodes of anaphylaxis is also difficult to overstate. For people who have anaphylaxis history, that alone is a significant factor in aggressive avoidance. Particularly for the type of person that TT and I (and many others here!) tend to be-- we're gnawers, basically. Anaphylaxis is an excursion from normalcy that we (mentally) MUST frame in logical, cause-and-effect terms, and we will continue to struggle in 'processing' the event until/unless we can do that. I have vivid recall of each of my DD's most severe reactions-- and I have adequate explanations (even years later) for only ONE of those five incidents. Every so often, I take them out and go over them again, hoping that I will have finally picked up "the key" to understanding them... as unlikely as that is now.