Study abroad in Italy

[Andiamo]

My daughter, a freshman in college, wants to do a summer abroad in Italy this summer.  It is four weeks.  They go to class four days a week and then go traveling each weekend.  She is allergic to milk and peanuts.  She is very responsible, but I worry about her being given wrong information in a restaurant.  Italian culture is very laid back and not at all precise.  She wants to go now and not when she is older, because she took four years of Italian in high school, including AP, and figures she should go while her Italian skills are good.  She would not know anyone there, although she makes friends easily.  We would purchase foreign travel insurance so if she ended up in the hospital or needed to be medi-vacced out, they would make all of the arrangements.  They would also give us the names of allergists in the area.  She would go with three or four epi two packs, so she would not have to find epis if she had to use hers.  She has self administered one time.  She has only had two reactions requiring epi in her life.  One was due to a restaurant mistake.  I have several concerns, especially her arriving and being jet lagged and tired, not the best time for making important decisions about what is safe to eat in a foreign country.  Has anyone ever let their food allergy college student study abroad?  We have been told there is not a lot of peanuts in Italy, but there is a lot of milk.  She is fine with milk x contamination, but not peanut x contamination.  She tested negative to tree nuts, but avoids.  She would be fine with tree nut x contamination.  Thanks!

[CMdeux]

I know of one member whose son spent a year abroad in Scotland during college, but that (obviously) didn't present the language and quite the cultural barrier re: food that Italy would present.

Can you give any idea what PART of Italy she's interested in spending time in?  That might help.  I know that several members here have spent time studying and traveling in Italy.

[Macabre]

I've studied in Italy--pre FA. Most of my time was spent in Rome and Florence. I can't help with FAs much but can with general info.

[CMdeux]

I can say, having recently done an international trip with FA's (I accompanied my teen-- she was significantly younger than your DD) that I think this concern:

I have several concerns, especially her arriving and being jet lagged and tired, not the best time for making important decisions about what is safe to eat in a foreign country.

is a really astute observation.  When we're tired or off-balance, it's easy to let your guard slip.  We carried prepackaged snacks and meal replacements-- which turned out to be a lifesaver in a lot of circumstances where it just wasn't SAFE to eat something-- or when the rest of the group would get their food in a restaurant, by my DD would wait-and-wait-and-wait for her "special" order.  Sometimes the wait was so long (an hour or more) that it just didn't make any sense to wait for the food at that point.  DD ate about 2 dozen Enjoy Life bars over a period of 3 weeks, but then again, we weren't in one place long enough to find much that was actually safe (other than McDonald's).  That brings me to another tip-- investigate international fast food options.  Some things were safe in Ireland, some in England, and some in Paris-- at McDonald's, I mean.  Check the country's particular website for allergen and nutrition info.

I will also add that with the language barrier in place, it really helped to have a handful of safe brands in mind while we were in Paris.  We were able to get my DD baguette (yes, it was a risk-- but one that we felt was culturally worth it, and-- IN Paris proper-- reasonably low since volume means that boulangeries tend to do only breads), fresh cheeses, and fruit preserves without nut/egg contamination at almost any tiny market.  I don't know what the equivalent might be where your DD is headed, but it's something to think about.  Consider what is culturally so ubiquitous that it is likely to be available everywhere, and relatively 'single-sourced' in terms of not being contaminated with a lot of other food prep.  Bread was like that in Paris.  Crepes would have been, too, for someone with, say, a shellfish allergy (like me).

I also carried an immersion heater with a small metal cup to heat water in, a pair of collapsible bowls and some instant Ramen noodles (Maruchan is peanut-free), oatmeal packets, and freezer-dried vegetables and fruit from Just Tomatoes.   It didn't take up a LOT of room in a suitcase and made it so that neither my daughter (with peanut and egg allergies-- both very severe, and both with low reaction thresholds) nor myself (shellfish allergy)  ever felt that we were in a position where we HAD to eat food served to us.  The peace of mind of that is tremendous-- and it means that you can continue to just make-- well, good decisions, not pressured ones.

If she were to be in one location for a while, you could probably SUPPLY her with some safe emergency rations at regular intervals.  International flat-rate or UPS global shipping would be ideal. 

[CMdeux]

Other things that I did--

MedicAlert in French language-- this was not as straightforward as it sounds, by the way-- it had to go through MedicAlert's translation people before they'd approve it for engraving, and they wanted to put the international line on the engraving, too.

FULL documentation of all prescription medications and fresh handwritten scripts for them from our US allergist.  No, they won't be good in Italy, but an Italian physician will know what they are and can maybe use them for some quick guidance if she needed a local script.    I also kept scans of the same in a flashdrive that I wore against my skin under my clothing-- just as important as scans of my passport.

Take extra meds-- about double what she thinks she could even remotely need.  (For why-- see Hedgehog's DD's story right now in Havana-- she is without epinephrine because she can't get a refill there because there aren't any available.)

Chef cards-- I had them printed in BRILLIANT pink cardstock in French, and another color (for English).  Take a lot of extras, because you don't always get them back.


Get a REALLY good under-clothing waist-pack to carry extra epinephrine in.  Pickpocketing is surreal now in Spain and in Italy, particularly in Rome, Venice, and Florence-- so the wisest thing is to basically plan to lose your bag, even though you do all that you can to guard against it.  My anxiety would have been SO much higher if I'd not known every minute that the worst still wouldn't leave me without epinephrine.   That and my passport were pretty much all that I guarded like that.

[yelloww]

Where will she be when she's not traveling on the weekends? In a city? Does she have a dorm room or will she live with a host family?

[Andiamo]

Thanks.  These are all really good suggestions.  She would be in Rimini which is near Bologna.  When I go to Europe it takes me a week to get over jet lag.  I feel spacey for the first week.  I never would have thought of pickpockets.  I would imagine bread would be fine there and possibly deli meats, although I am trying to figure out if cheese cross contamination from the slicer would be enough that she could react, or if there is any chance of peanut cross contamination from the slicer.  They will be staying in a hotel.  Breakfast is included and they are on their own for lunch and dinner.  There will be a fridge in the room, but no microwave.  There will be a microwave downstairs in some common area.  I do have some concerns about that as far as how clean it might be or if there would be food residue, although peanut seems unlikely.

I really wonder what the standard of medical care is in Italy, though.  They have socialized medicine.  We have great insurance here and have managed to stay away from Obamacare and all of its restrictions.

I read the post about the girl in Cuba, same age as my daughter, right before I posted yesterday.  I was cringing as I was reading it, since I can completely imagine being the mom in that situation.  I wonder if epis are easily obtained in Italy.

[CMdeux]

We took a total of 18 autoinjectors with us to Dublin-- and we were only staying for three weeks.  Now, granted, my DD's history made that prudent and there were two of us, so technically she had 5 refills with us and I had 4; still, we planned for it to be difficult to impossible to obtain a refill in an urgent situation-- meaning that we assumed that it might take as long as a week to refill one if it were used.

That took some planning because our insurance company will only pay their portion of 1 pair every 30 days-- period.    So in the five months before we went, I refilled them at 31 day intervals.


A zippered/secure snapping cross-body day bag just large enough to carry your essentials (a couple of energy bars of some sort, camera, phone, and a pair of epis), a wallet that you wear on a wrist (that zips), and that under-clothing carrier for extra cash (cab-fare), passport, and an epi...

Taking just those kinds of fairly reasonable precautions, we had no trouble at all-- and we rode the Metro/Tube everywhere and visited pickpocketing hotspots galore, like Montmartre, Notre Dame, the Louvre, d'Orsay, Versailles, etc.   We saw bag snatchings and pickpocketing activity, all right. 

We did okay with jet lag both directions--  but we were coming from the west coast, so a complete "reset" of the body clock, while vicious on the outbound, was the key.  We left the west coast at 6 AM, flew to east, had a long layover and flew to Europe on the overnight flight.  While neither of us slept much on the flight, we caffeinated upon landing and hit the ground running.   That night, we crashed (after what was effectively 40 hours awake with only an airplane catnap).  DD did fine.  Me, I'm over 45, and well, I won't lie-- I was pretty beat that first couple of days.

Flying home, same deal-- left mid-morning and landed back on the west coast (after ~16 hr of flights) at night.  Travel being as exhausting as it is now, that worked fine, too, though I had more trouble with jet lag on the return... more just still being on Paris time, though.

The biggest thing for us was making sure that we had enough food to allow for flight delays/etc. and a reasonable supply of stuff upon landing.  The TSA went through my (very carefully packed) bag and ruptured one of my bags of dehydrated fruit... and I wound up throwing it out.  (and, er--  washing all the stuff that smelled very strongly of strawberries)  Luckily I had planned on a margin of error.

I recommend freeze dried over merely dehydrated because of the weight and volume difference.

About 30% of our suitcases was emergency foodstuffs.  Yes, this meant that we took less clothing than most people in a standard suitcase, but it was lightweight, and our bags were LIGHTER and had more room for mementos coming home.     Doing laundry in a hotel sink was really no big deal. 


Rick Steves has some of the best travel advice ever.  IMO.    That and Just Tomatoes were my two favorite links.

I'll dig up my planning thread for you.  This is really something that she can do, in my experience.  My DD could do it on her own at 20, I think.  She was only 13, but made no truly stupid moves that I could see-- she enjoyed herself enormously, but was very aware of her surroundings and the food safety issues.  One problem that I had not anticipated is that even chefs who read and understood DD's chef card... still... sometimes... didn't get it.  Like the restaurant in Paris where "no egg" apparently meant "skip the overt one put on TOP of the savory crepe" rather than "batter can't contain egg either."  Luckily I know enough to recognize that what they initially sent out very definitely had egg in the crepe batter-- dd wouldn't have.  Of course, her tolerance for cooked egg is high enough now that she probably would have taken a cautious sampling bit and sent it back anyway.  Or at least quit eating.

She DID have a pretty significant reaction after one restaurant meal-- in Paris.  No idea what it was from, honestly, because they made her a special meal, even.  Had to have been cross-contamination.  Had it not been the end of our first night in Paris, we probably would have opted to go to the emergency room.   But air quality was SO bad that it wasn't clear at the time that it wasn't just a major asthma flare. 

[Macabre]

Oh, you can absolutely count on pickpockets on busses in Rome. Rick Steves has some great tips. What I've seem is group of pickpocketers crowd around the victim.

When I was in Florence one of our group had appendicitis or something else that required emergency surgery.  It was a very good experience all around.

Here's a tip--it will be important to not appear to be an arrogant American. What I have found while living in Switzerland in an international community and traveling in France, Italy and Switzerland is that Americans have a reputation. I have also been in Italy when our contrary committed an atrocity toward another country. It was NOT a fun few days to be an American. Your might not talk about socialized medicine (and other things) like you do, but I would urge her not to compare US and Italian systems disparagingly in a public way. Ever.

[twinturbo]

What is her cow's milk tolerance in specific terms? Can she eat small amounts of high-heat treated milk in baked goods like cake or breads? Just to get a sense for planning purposes.

[Macabre]

There are Pharmacias widely available in Italy (green signs). I personally found an incredibly helpful pharmacist when I was trying to buy hydrogen peroxide for a nasty canker sore. And fwiw the socialized medicine served me beautifully in Switzerland when I had bronchitis. It was no different than the US except that I wasn't deterred from going to the doctor by a worry about how I was going to pay for it on my tight student budget. So I actually went. 

[CMdeux]

Oh-- pre-program her cellular phone (and make sure that it's a global phone) with contact numbers for local assistance as well as home (N. American) numbers.  Make sure that at least a couple of other people in her party can access the information via a password-locked cell phone.  I kept mine unlocked just in case, though I knew it was a risk with a pickpocket (I just kept the "deactivate" emergency provider number with my passport and on my magic flashdrive just in case).

[CMdeux]

This thread

International Travel

has many, many details of how I went to Europe with an MFA teen (and my spouse met us there).

[Macabre]

My locked screen for my cellphone has my ICE info there.  I basically just added the text I wanted to an image/background, took a screenshot of it, and selected that as my locked screen.

[yelloww]

Is she even going to be able to eat the breakfast? If it's a hard roll and cheese or butter, is she going to be ok just eating bread plain for a month for breakfast?

This sounds like a lot of work where she doesn't even have a kitchen for a month. It is doable, but she's going to have to find and negotiate three meals a day for herself and that's a lot of work.

Have you found out how far the grocery store is to her home? When we travel with my milk allergy son, we always try to find foods that we can stock up on for breakfast so we aren't scrounging for food while we are still bleary eyed. It is more complicated for us since ds is allergic to dairy, pn, and eggs.

Beef jerky is our travel staple. Giant costco sized bags of it.