AS ONE OF millions of people around the world with a life-threatening nut allergy I know all too well the trials of eating abroad. I’ve spent an evening in Paris hooked up to an adrenaline ventilator, been in hospital in Peru and starved myself on a Sahara Desert trek thanks to my inability to pronounce ‘cashew nut’ in Arabic.
The risk of travelling with a nut allergy is very real but I’ve learnt the hard way, a few precautions and preventions can make the ride a lot smoother.
1. Know Your Emergency Procedure
Foreign hospitals often do not understand the severity of a reaction or how to treat it so ensure you are aware of what you need. Emphasize that you need to be seen immediately.
Ask your doctor to write down the medication and dosage to be administrated in case of an attack. Note the pharmaceutical names, as brand names can be different abroad.
If you carry an Epi-pen ensure you know when and how to dispense it and are able to do so yourself. Inform your travel partners of their duties should you become unable to help yourself.
2. Remember: You Can Never Carry Enough Drugs!
It goes without saying that you need to carry your prescribed medication, but make sure you have spares and store them in different places in case you lose your luggage.
Modern adrenaline dispensers such as Epi-pens are not available in some parts of the world so take enough for your journey and leave a repeat prescription at home.
Check the use-by dates of all medication if you are on the road for long periods- even recently purchased prescriptions can have short expiration dates.
Keep your prescription on hand when you fly or you’re going anywhere where your luggage might be inspected- taking a syringe into a nightclub can look suspicious to foreign security!
3. Don’t Eat Like A Local
Food trading standards vary drastically between countries and labeling is often done according to different standards. Be extra diligent when trying foreign delicacies as even common foods may contain unlabeled ingredients.
In Brazil, nut traces (especially cashew nuts) are commonly found in chocolate even if it doesn’t state it on the packet. They also serve a cashew nut juice. In France and Italy, almonds and pistachios are common in all cakes and pastries even if staff tell you they are nut-free. Indian and Chinese food is full of peanut oils and kitchens often use the same pans for cooking different dishes so cross-contamination is likely. Mediterranean dishes are often sprinkled with pine nuts.
Exercise caution of ‘home brands’ abroad- Cadbury’s chocolate in South America is actually made in Panama and does not contain the exact ingredients of the British variety.
Be wary of ingredients like sesame, poppy seeds and coconut that can provoke reactions in nut-allergy sufferers. If you’re not sure, this is not the time to find out!
4. Make Yourself Clear
Even if you can’t speak the native language, look up a few words before you go and carry a small dictionary to check food labels. Keep a card with you to show to waiters or shop-owners if you are not sure of pronunciation.
A literal translation may not suffice- in some languages the word ‘nuts’ refers to one type of nut and frequently nuts such as cashews, almonds and pine nuts, as well as items such as peanut butter, are referred to separately. ‘Dried fruits’ is a good catch-all term but try to memorize as many different names as possible.
Sometimes it is best to be dramatic: ‘I will die if I eat this’ avoids the common scenario of the nuts being scraped off and the meal being returned to you. Severe allergies are extremely rare in some parts of the world so the average waiter is likely to put you down as another ‘fussy tourist’ unless you state your case very clearly (and with a smile).
5. Plan Ahead
Problems arise when you entrust your food intake to strangers but it’s difficult to avoid these situations on holiday. Many hotels, hostels and tour operators will accommodate your requests if you explain the situation but always double check. Ask to see the packets wherever possible or to speak to the person preparing the food. Take a packed lunch if you are worried.
Contact airlines and bus companies before traveling with them and confirm that a nut-free option is available. Many airlines (British Airways, American Airlines) have banned nut products on-board but consider buying some sandwiches before you board the plane just in case.
Ensure your allergy is covered by your travel insurance– always declare it and shop around for a company that provides full cover. Many companies will cover you if you haven’t been in the hospital in the past year.
6. Eating Out
Experimenting with local cuisine is a vital part of experiencing a new culture so don’t let your allergies put you off eating out. However, it’s best to accept that you will never be able to have a carefree ‘try-anything’ approach to food.
Ask before you eat, even when pressured by locals to ‘just try it’.
Request to speak to the chef if the waiter seems less than knowledgeable about food content- calmly explain the importance that you know exactly what is in it.
Pass on spicy food as this can mask the tingling sensations of a reaction and it’s a good idea not to drink a lot whilst you are eating too- save the wine till you are safely past dessert!
7. Be Paranoid
Different symptoms to what you have previously experienced can occur so monitor any changes and if you experience any of the following, seek medical attention:
Tingling/ itching in the mouth or lips.
An itchy, blotchy rash
Swelling, particularly around the face and throat.
Wheezing/ difficulty breathing
Stomach aches/ cramps
There’s no reason to let a nut allergy put an end to your travel fantasies. You need to be warier than other travelers, but don’t let that force you into giving up and staying home.
Even if you don’t have to worry about something as serious as a nut allergy, it’s still important to stay healthy on the road. Try these five useful remedies from easily found ingredients when you’re really far out there. And it can’t hurt to pack these medical books for the road, or to brush up on some tips for staying healthy abroad.