Allergy Message in English and Spanish for Restaurants

I recently had another allergic reaction due to butter being in a sauce that was not mentioned on a menu.  I was at a business dinner and didn't want to make a big deal about my allergies, so I rolled the dice on a Salmon entree with a lemon white wine sauce.  Big mistake.  I am done playing Russian Roulette at restaurants.

This morning, I created a 2-sided business card on VistaPrint - English on one side, Spanish on the other side.  From now on - I am going to give the waiter this card with every order.

Readers:  Please feel free to use the following to either print or create your own business cards.

Cross Contact - Food Allergies

Yesterday, my husband and I were traveling and I didn't have too many viable choices for a lunch spot.  We ended up going to Jersey Mike's so he could get a sandwich and I figured I could find something there to eat.  Most sub places have tuna fish salad which has become a regular staple in my diet this summer.

So I am watching the guy at the front of the line, slicing meat for each sandwich order.  He is also the order taker, and is wearing gloves.  All the meat off the slicer is being handled by his gloved hands.

I order the tuna salad "bowl" versus a sub.  Before I get a chance to ask him to change his gloves for me, he reaches into the lettuce to start the preparation of my Tuna Salad Bowl.  Immediately, I told him I only wanted the tuna salad - no veggies.  I am highly allergic, so I am not willing to risk the cross contact between things I can eat, and those that I cannot.

Here's some interesting information about how to avoid cross contact ...

https://www.foodallergy.org/cross-contact

News Links - Alpha Gal Allergy

Recent:

NPR News - 6/25/18

TODAY News: 6/26/18



Older:

RadioLab Podcast Story & Interview

http://www.nbcnews.com/health/allergies/tick-bite-linked-rise-red-meat-allergies-why-now-n559346

CNN Article from 2012 - Alpha Gal Allergy

Interview - UVA Research

Wall Street Journal Article

Preventing The Next Tick Bite

As most allergists and scientists will tell you, your Alpha Gal testing numbers will come down over time .... provided you don't get another tick bite.

I'm an outdoor person, so naturally I said I couldn't make any promises on avoiding another tick bite.  I live in the woods, have an outdoor dog, have 2 horses that are in pastures previously occupied by cattle, and live in North Carolina where ticks are prevalent.

My allergy physician team (at Duke) suggested that I check into Permethrin Clothing that is used by forest rangers.  So far, I have purchased a polo shirt, socks and a hat.  The chemical treatment on the clothing lasts for about 70 washings.   The clothing has a distinct chemical odor, but I can live with it.

Here's a couple of resources

http://www.insectshield.com/

https://www.rei.com/s/permethrin-insect-repellent-and-clothing?ir=collection%3Apermethrin-insect-repellent-and-clothing&page=1

Salmon Cakes / Salmon Burgers

Quick and Easy Recipe for either Salmon Cakes or Salmon Burgers

Ingredients:

Canned Salmon - 2 cans (7.5 ounce each) - I use Royal Red brand

2 Eggs

1/2 Green Pepper - chopped

1/2 Red Pepper - chopped

1/2 sleeve - Saltine Crackers (or other Gluten Free crackers) - crushed

Salt & Pepper

Olive Oil

Directions:

Preheat oven to 275 degrees - place foil-lined pan in oven to also preheat.

Mix together in a bowl (hands work best):  Salmon, Eggs, Chopped Green and Red Peppers, Crushed Crackers, and Salt & Pepper to taste.

Pat out salmon patties or burgers - no more than 3/4" thick.

In a non-stick pan, add 1 Tbs of Olive Oil - brown salmon patties on both sides.  After browning, place in pre-heated pan, cover with foil and bake for 15 minutes to ensure thorough cooking of egg ingredient.

Serve on buns or with a salad.
Suggested sauces or drizzles:  Lemon Juice, Apple Cider Vinegar, Hot Sauce or Mayonnaise-based Dill Dip (no dairy).

Shrimp / Chicken / Anduille Gumbo Recipe - Red Meat Free, Dairy Free, Gluten Free

Ingredients:

3 Tablespoons vegetable oil or olive oil
I package Chicken / Turkey Anduille Sausage (chopped) - no pork casing
4-6 boneless chicken thighs
1 pound raw, peeled and de-veined shrimp
Cajun Seasoning (I use Tony Chachere's Creole Seasoning) 
6 Tablespoons gluten-free flour
1 green bell pepper, chopped 
2 small celery stalks, chopped 
1 small onion, chopped 
2 cloves garlic, minced 
1 35 oz can of Stewed / Can Tomatoes (I use Cento Italian Style)
32 oz low-sodium chicken broth 
2 bay leaves 
1/4 teaspoon smoked paprika 
1/4 teaspoon cayenne pepper (or more if you like it hot) 
Optional:  Sprinkle of Filing Powder (Cajun Seasoning: Sassafras)
Cooked White Rice

Directions:
Heat 1 Tbs oil in a 6+ quart Dutch oven or soup pot over medium-high heat. Add chopped sausage then saute until browned. Transfer to a plate then set aside. 

Lightly season both sides of chicken thighs with Cajun Seasoning then place skin side down in dutch oven or pot. Sear on both sides until golden brown, 3-4 minutes a side (does not need to be cooked through,) then transfer to plate with sausage and set aside. 

Remove pot from heat for a few minutes to cool slightly then place back over medium heat. Add remaining 2 Tbs oil then sprinkle in flour and whisk constantly until mixture is the color of caramel, this is your roux.)  It gets quite gooey. 

Add bell pepper, celery, garlic and onion then saute until vegetables are slightly tender - do not overcook - scraping the bottom of the pot to make sure roux doesn't burn. Add tomatoes - pulling them apart and crushing them with your hands as you add them.  Pour in the rest of the tomato sauce from the can.  Stir in chicken broth and continue to scrape the bottom of the pot.

Pull apart chicken into small pieces and add to the pot.  Also add back the chopped sausage.  Add 1 Tbs of Cajun Seasoning, 1/4 tsp paprika, 2 bay leaves and 1/4 tsp cayenne pepper (or more if you like it hot).

Turn heat up to bring gumbo to a low boil, then turn heat down to medium-low and simmer uncovered for 1-1/2 hours.

Add raw shrimp and turn up heat to Medium High for 3-5 minutes until the shrimp are pink.  Optional:  Sprinkle with Filing Powder and stir in after the shrimp is cooked.  Remove Bay Leaves before serving.  Serve over or under cooked white rice 

Chocolate Cake!

Okay, I'm not a big sweets person, so I surprised myself that with all the food items I have to give up that Chocolate Cake is what I have been craving all week - not steak, not cheddar cheese, not any of the things that you would guess.

So - I decided I would figure out how to make a yellow cake with chocolate icing that contains No Gluten and No Dairy.  I was surprised how easy it was and what was available in your everyday grocery store.

Betty Crocker - Gluten Free Yellow Cake Mix

• Make according to directions, but substitute a lactose free, gluten free butter substitute - I used Blue Bonnet Lactose Free (which comes in sticks).

Pillsbury Chocolate Fudge Frosting (in a can) - gluten and dairy free (made with soy).

Simple.  Craving Satisfied.

Living Dairy Free - Nutrient Replacement

Essential nutrients found in dairy products that will need to be replaced in your Alpha-Gal Diet:  

• Calcium
• Vitamin D
• Riboflavin
• Phosphorus
• Vitamin B12
• Protein

Here are some non-dairy alternatives for obtaining these nutrients without taking supplements.

CALCIUM

• Almond milk
• Soy milk
• Breakfast cereals
• Some fruit juices
• Leafy greens
• Legumes
• Tofu
• Some fish
• Almonds

VITAMIN D

• 15 minutes of sun exposure each day
• Eggs
• Fish
• Fortified cereals
• Cod liver
• Fortified almond and soy milks

RIBOFLAVIN - VITAMIN B2

• Fortified cereals
• Sweet potatoes
• Asparagus
• Spinach\
• Mushrooms
• Rasberries

PHOSPHORUS

• Eggs
• Poultry
• Fish
• Legumes
• Whole grain breads

VITAMIN B12

• Eggs
• Poultry
• Fish
• Fortified cereals
• Fermented foods, such as tempeh, and tofu.

PROTEIN

• Eggs
• Fish
• Poultry
• Edamame (fresh soy beans)
• Tofu
• Soy milk
• Legumes
• Quinoa
• Whole grain breads
• Nuts, such as almonds

Goofed up - Cross Contact

So, last night we were doing the pizza thing - ordering family style (cheese and pepperoni) and also ordered my "special" pizza - no gluten, no red meat, no cheese.  These are take and bake pizzas from Papa Murphy's.

Order of operations matters not only with math, but also with shared utensils.  I cooked everyone else's pizza first and sliced their pizza.  Then I cooked my pizza and didn't even think about the pizza cutter.  I cut my pizza and 6 hours later, woke up itchy .... and stayed itchy for the next 12 hours.  I have been trying to avoid antihistamines use as I am approaching my appointment at the Duke Allergy Center.  It's been a long day with little sleep.

New rule:  2 pizza cutters .... perhaps a whole new set of kitchen tools that are deemed "clean".

Where in the World is Alpha Gal?

Here's an interactive map for people who are self-reporting that they have the Alpha Gal Allergy.  I was amazed to see all the pin-dots knowing that these numbers are most likely just a drop in bucket for the number of actual cases.

I added my pin, and hope that others will too.  Here's the link:  Where in the World is Alpha Gal?

Day 11 - Blood Test Results Are In

I've always been driven to achieve good grades & high scores - I guess that is my "Alpha" personality.  In reality, the blood test for Alpha Gal is a Pass / Fail scenario.  While I was hoping to fail, I have been anticipating that my test results would be positive.  Since I adopted the Alpha Gal Allergy Diet, I have had no further allergic reactions - therefore the elimination method is just being verified by the blood test.

Today, I received my results, and the test result number is 77.5 which is a Class 5 (Very High Positive).    In-Range results (as a "Negative") would be a value less than 0.35.

In reality, any number over 0.34 is a disappointment and I would have liked for my number to be lower, yet it is also a relief to know for sure that I do have Alpha Gal Allergy.  I'd rather have a label on my condition and have a diet plan than to live through the daily terror of wondering if an unknown food item is going to kill me 6 hours later while I sleep.

Information from The Mayo Clinic's Website regarding Alpha Gal testing values are shown below.  I am not a medical professional, so I don't want to speculate as how severe an allergic reaction could be based on a number.  I've read other blogs & websites that indicate the testing values do not directly correlate to an individual's condition, list of foods that should be avoided (such as dairy), or severity of allergic reaction.  I have also read that the numbers may reduce over time provided there are no further tick bites.   This topic is certainly on my list of questions for my upcoming appointment at Duke.

Class	IgE (kU/L)	Comment
0	<0.10	Negative
0/1	0.10-0.34	Equivocal
1	0.35-0.69	Low Positive
2	0.70-3.4	Moderate Positive
3	3.5-17.4	High Positive
4	17.5-49.9	Very High Positive
5	50.0-99.9	Very High Positive

6          > or = 100    Very High Positive

Day 10 - Pizza? Really?

Here's a take out idea from Papa Murphy's Pizza .... Papa Murphy's is a "Take & Bake" pizzeria - they make it and then you take it home and bake it in your oven.  I called them earlier to make sure there was no dairy or red meat by-products in the Olive Oil and Garlic Sauce.

The good news - you can pick up this pizza for yourself, and also pick up a pizza for the rest of the family at the same time.  Easy mid-week meal.

https://www.papamurphys.com

Here's the pizza I had tonight - No Red Meat, No Cheese, No Dairy - and Gluten Free.  There are plenty of other veggie ingredients to choose from.  I added a little bit of vegan provolone cheese (dairy free) before I baked it.   Quite delicious!  It it encouraging to make some new combinations.  Also to mention, you bake it on the paper pizza tray it was prepared on, so little chance of cross contact with allergens.

• MEDIUM GLUTEN FREE CRUST

• 

  Olive Oil & Garlic
• 

  Chicken
• 

  Mushrooms
• 

  Tomatoes
• 

  Artichoke Hearts
• 

  Spinach

Day 9 - Back to work, and seeking out resources

It is the Tuesday after Memorial Weekend .... back to work!

Although not mentioned in my blog bio, my primary industry is Commercial Real Estate.  It just so happens that I currently head up Real Estate and Facilities for Veritas Collaborative, which is specialty hospital for patients with eating disorders.

As I am struggling with this diet, my shopping lists, menu ordering, etc - It occurs to me that I have some great resources at my disposal that I am friends with at the office - Chefs, Dietary Specialists, Medical Doctors, Psychiatrists, Psychologists.  Hmmm .... so I started off with our Director of Culinary Services.

Since we have many patients with food allergies that must be accommodated, I asked our Culinary Director if she had ever had to meal plan for a patient diagnosed with "Alpha Gal".  First of all, she laughed because I am known to be an "Alpha" personality within the office.  She had never heard the term "Alpha Gal", but when I described it, she immediately knew what I was talking about.  Her hairdresser has this allergy.

She followed up later today with a suggested card that can be printed at home and taken to restaurants to inform the chef of the allergy and how best to prepare your meal.  Please feel free to cut and paste this message into a printable format for your use at restaurants.

Printable message for restaurant use:

I am highly allergic to all red meats, dairy and byproducts.  I can eat:

-NO beef, pork, lamb, venison or bison

-NO dairy products—butter, milk or cheese

-NO food with ingredients that include the byproducts of red meat, red meat fat or dairy products—this includes gravy, sauces, marinades and the like

-NO food cooked using pots, pans, grills or utensils that were used to cook red meat, red meat byproducts or dairy products

If I eat any of these foods, I may suffer a fatal allergic reaction.  Thank you for preparing my food using these guidelines.

Day 8 - Asking for Help & Getting Settled In

After yesterday's outing to Whole Foods, I came to grips that I am not handing this well.  I have been experiencing a lot of anxiety every time I have been to the grocery store in the last week - even at Trader Joe's and Whole Foods where there are numerous options to choose from that suit the Alpha Gal Allergy Diet.

I spoke with my husband about it last night ... and told him that I needed some support.  I need a shopping buddy.  Someone who can make food decisions for the rest of the family, along with being there for me in case I start feeling "sketchy".  Also - I am scared to touch meat packaging for items being purchased for the rest of the family.

This is the new normal and I need to rely on my family for support and encouragement.

Day 8:  Challenge #1
(Glass Half Empty)
Our teenage girls are having a massive cookie bake-off this morning.  Toll House Chocolate Chip Cookies - one of my favorites.  I haven't had even a bite.  It's just not worth having a reaction.  I opted for a piece of my dairy free chocolate bar instead.  It was good, but not the same.

Day 8:  Challenge #2
(Glass Half Full)
Decided to research all the long term health benefits for cutting red meat out of my diet.  There's no time like your 50's to start a new healthy lifestyle, right?

The Benefits of Cutting Red Meat Out of Your Diet

• Meat consumption raises your estrogen levels.
• Women who eat red meat have a greater risk of breast cancer.
• High red meat consumption increases your risk of colorectal cancer.
• Just the act of cooking red meat may increase your risk of cancer.
• Many women lose weight when they switch to fish.
• Meats are high in certain endocrine disruptors and persistent organic pollutants (POPs).
• People who eat more fish (and less meat) have lower rates of breast and prostate cancer.
• Red meat is associated with an increased risk of diabetes.
• Red meat increases uric acid and creatinine which increases risk of gout and kidney problems
• Meat can be contaminated with superbugs, which can trigger food-borne illness.

Day 7 - Compiling Food Lists

I am one week in .... and have had my blood drawn at Any Lab Test Now (see Prelude Blog).  Test Results should be in within 3-4 days.

So, what is the next step?    I really need to develop a better grocery list, so I headed off to Whole Foods for a sight seeing tour ... adding some new items to others I have already found.

Here's where I am so far:

Shopping List for Alpha Gal Allergy (that is also Gluten Free)

Meats
No Meats from Mammals 
No Beef, Pork, Lamb,Veal 
No Venison, Bison, Squirrel Rabbit
All meats can be prepared any way you like, just beware of cross contamination with beef/pork and no dairy can be included in your recipe - meaning NO butter, NO cream, No milk.  Olive Oil is your best bet for a cooking oil.
Chicken - any cut.
Chicken Sausages - read the labels carefully. Some use pork casings
Turkey - any cut, or ground turkey
Turkey Bacon - I preferred uncured, peppered from Trader Joe's
Emu
Ostrich
Alligator
Eggs - hard boiled, poached or scrambled
Fish - Fresh or Frozen -
(Tilapia, Salmon, Tuna, Mahi, Wahoo, Shrimp, Scallops, Lobster)
Tuna Fish Salad (mayo, celery, salt and pepper)

Dairy Substitutes
Look for labels that indicate "Vegan" and "Gluten Free"
Almond Milk - I prefer the vanilla flavored unsweetened
Rice Milk - which I have heard works well for baking
Vegan Cheese - not my favorite, but the provolone cheese melted is ok
Earth Balance Spread - Organic / Vegan
Coconut Milk
Ice Cream made with Coconut Milk

Veggies / Fruits / Salads / Dressings
Eat all you want - just no added cheese, no milk based dressings
Coleslaw with Mango Salsa (try the Island Salsa from Trader Joe's)
Mayonnaise is okay
Dipping Sauces /Dressings - avoid milk, cheese & whey ingredients

Snacks
White or Yellow Corn Tortilla Chips - I like the $2 Santitos
Salsa - all sorts
Trader Joe's Savory Thin Cracker (Gluten free)
Plain Potato Chips (no flavorings that contain whey)
Plantain Chips
Newman's Fig Bars (dairy & wheat free)
Enjoy Life Chocolate Bars - dairy, nut & soy free

Breakfast Foods
Cheerios (regular and frosted) with Almond Milk
Corn Flakes (regular and frosted) with Almond Milk
Rice Krispies
Chex Cereal - Corn or Rice
Gluten free Oatmeal
Grits
Gluten Free / Dairy Free Frozen Donuts