Peanut allergy at ten thousand feet

This past Friday Chad and I got on a plane to visit my sister and her family in Alabama. My nephew Michael asked me to be his sponsor for Confirmation. Traveling to Birmingham from New York is often painful because there are few direct flights and the plane is always one of those small jets that has two seats on either side. My sister Josephine calls them “put puts” because you can actually hear the engines put putting as you fly through the air experiencing every bit of turbulence there is to experience. I hate flying as it is. What’s worse, is that I hate to be reminded that I am ten thousand miles above the ground.

Luckily, our flight wasn’t delayed, which it often is, and Chad and I made our way to our seats. We sat second from the last row, near the toilet. So now I had to contend with turbulence outside and malodorous scents coming from inside. Because it is a short flight, less than two and half hours, they never serve food. In fact this flight didn’t serve alcohol, but Chad had the good idea to buy snacks at the gift shop in the airport. He bought a bag of almonds and two peanut butter chocolate protein bars.

Since I hadn’t eaten breakfast because I was too nervous to eat that morning and I was upset because we had to drop Hoffman off at the Puppy Loft to board, I was famished by the time I sat down in my seat. Within seconds of opening my protein bar, the woman behind me leaped over the seat and asked, “Is there peanuts in that bar?”

She had the most hysterical look in her eyes and for a brief second I thought she was going to ask me if she could have a piece. You have to understand this flight to Alabama brings out the worst in people. I looked at her nervously, preparing myself to reject her politely if she indeed asked me to break her off a piece. “Yes,” I replied cautiously. “It’s peanut butter chocolate.”

“You can’t eat that!” she shouted. “My son has a peanut allergy.” That look in her eyes was so scary I thought she was going to lunge forward and grab it out of my hand. “No one on this plane can eat peanuts within three rows of my son,” she then announced to everyone within ear shot. The woman in front of me, who also had a small son, looked back at me from between the seats and cringed. The woman sitting across from Chad, who had two little girls simply hunched her shoulders in despair. But I wasn’t about to give in to this woman. So I said, “Do you think your son is going to have a reaction just from me eating this protein bar?”

“Yes,” she interrupted even before I had a chance to finish me sentence. “Google it. People with peanut allergies can have a severe reaction from the fumes of peanuts. That’s why they don’t serve them on air planes. Look it up.”

“I’m a doctor lady and I’ve never hear that.” (Yes, I played the doctor card but this woman was deranged.)

“You’re a doctor?” she hissed and then laughed mockingly. “What kind of doctor are you? You should know that.” Her head was wedged in between the seats Chad and I were sitting in and that crazy look in her eyes reminded me of Jack Nicholson in The Shinning.

“I’m an internist,” I responded proudly.

“Well Google it,” she added again sounding like Elisabeth Hasselbeck from The View, as though Google is the Holy Bible of medical references. Instead of arguing further, Chad and I placed our protein bars back in their wrappers and reclined in our chairs awaiting take off. But that didn’t stop this peanut nazi. Instead she went on yelling in my ear from behind me. “Peanut allergies are the number one cause of allergic deaths and no one can eat peanuts on a plane. The flight attendant will make an announcement.”

“Who is she talking to?” I asked Chad. He shrugged his shoulders  and opened his magazine. I, of course, was not about to turn a deaf ear to this woman. So I turned around and shouted back, “Listen lady, I put the protein bar away. I did what you asked even though I never heard about aerosolized peanut allergies, but if you are going to harass me for the next two hours then you’re asking for a fight.” I resisted the urge to say, “Look lady the only nut on this plane is the one sitting next to your son.”

“I’m not harassing you,” she argued. “I just want you to know the facts.”

“Thank you for enlightening me.”

The flight attendant never made that announcement and when this woman went to the toilet, Chad turned to her son and said, “Run!” The two mothers sitting near us both confirmed they had never heard about aerosolized peanut allergies and one of them was a doctor. The woman in front of me added that she worked in a psychiatric hospital and suggested that this woman was a psychopath.

After we landed, I was still intrigued, and so I had to investigate whether or not there was some shred of truth in this woman’s statement. The fact is there is a ton of information debating whether or not you can get an allergic response from being around peanuts if you are indeed allergic to peanuts however, I did find an article published in the Journal of Allergy and Immunology which stated, “A variety of flavor and aroma compounds are in foods, including esters, aldehydes, and pyridines (these last are the ones associated with the characteristic peanut odor). None of these flavor compounds, however, are proteins, and proteins are the components of foods that cause allergic reactions. Researchers have isolated the proteins that trigger allergic reactions in those with peanut allergy, and they are entirely distinct from the flavor compounds. So simply smelling peanuts shouldn’t cause a reaction in someone with a peanut allergy. (This has been confirmed experimentally by researchers who exposed peanut allergic subjects with peanut butter and a soy butter placebo for 10 minutes at one-foot range. None of the subjects reacted.) However, a few related phenomena can cause reactions. First, inhalation of peanut dust and small particles of peanuts can cause reactions in those with peanut allergy. So in situations where shelled peanuts can spread dust in the air, that small exposure may be enough to cause a severe reaction. Second, when foods are cooked, they often release oils into the air — oils that can contain allergenic proteins and cause reactions. Finally, trace amounts of peanut products can get onto hands and be ingested by someone with an allergy, causing a reaction.”

So I can understand this woman’s concern. If you have ever witnessed someone experiencing an anaphylactic reaction, you would be a psychopath particularly if it happened to your own child. So I don’t fault this woman however, there were no actual peanuts in our protein bar. So Chad and I secretly ate our protein bars and the bag of almonds despite the peanut nazi sitting behind us. Her son never had a reaction. In fact, he was rather noisy.

Oh and by the way, the pretzels that were served on the plane had a warning on the label that said, “These pretzels were manufactured in a plant that processed peanuts.”

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7 Comments

  1. pognyc
    Posted May 12, 2010 at 10:49 am | Permalink

    Dr. Spinelli, I am surprised you hadn’t heard of this and that two Dr.s on the same plane hadn’t heard this.

    At least one child has died from the inhalation of peanut dust

    That being said, the odds if it happening are probably the same as having a plane crash on your house, but it is possible.

    It is hard to blame a woman who may be frantic over their child’s life…

    I am not a Dr., but I would have snapped back at her:

    “Quick! Show me your epi-pen”

    …and then ripped her a new one for not having her son carry one with him everywhere he went if it were that serious.

    She does sound like she was a nut and over reacting. People can eat peanuts on planes but they were banned from being served on airlines several years ago due to peanut allergies.

    There have been warnings on food labels for at least 15 years. It became a hysteria in the 80’s and it is back again, however the are beginning to realize that many Dr.s have over reacted as well and much misdiagnosis has probably been going on.

    Public schools are often no longer allowed to serve them and many have banned home baked goods for fear of affecting someone’s child.

    That being said, a lot of it is hysteria.

    Anyone with that type of serious allergy should never leave the home without an epi-pen…

    I’m sure a woman protecting a child is an automatic psychopath just by nature…

  2. pognyc
    Posted May 12, 2010 at 10:52 am | Permalink

    please don’t think I am chastising you in anyway because I mean well.

    I often come off that way unintentionally but I just like to spread information for some reason..

    phillip

  3. stephen
    Posted May 12, 2010 at 2:44 pm | Permalink

    welcome to Alabama! I live in Birmingham and i understand what your feeling on the plane!

  4. danh nguyen
    Posted May 15, 2010 at 12:59 am | Permalink

    peanut nazi! love it!

  5. spinellimd
    Posted June 4, 2010 at 9:16 pm | Permalink

    This blog entry has received a lot of comments. Unfortunately, I won’t post comments that use derogatory terminology directed at me. I would be happy to post any criticisms. Just refrain from the name calling.

  6. patti
    Posted June 7, 2010 at 12:32 pm | Permalink

    sure-sure!

  7. patti
    Posted June 7, 2010 at 12:36 pm | Permalink

    “If you have ever witnessed someone experiencing an anaphylactic reaction, you would be a psychopath particularly if it happened to your own child.” EXACTLY!
    if YOU had seen your own nephew react, or someone else you love dearly, you likely wouldn’t be so glib.
    a former co-worker of mine had a niece who simply smelled a peanut butter donut & went into an anaphylactic reaction, so yes, it happens. that same girl later ate something from a chinese restaurant & died from an anaphylactic reaction. i certainly wouldn’t tell her family that they were “peanut nazis”

    by the way, many, many foods have a “cross contamination warning” on them regarding being made in close proximity of peanuts…one of the many reasons us mom’s of peanut allergic children have to be such nazis!

    from your description of the mother’s communication w/you- i could certainly agree that she could go about interaction w/those who appear to be “clueless” about food allergies in an entirely different way…but to think she’s overreacting just shows lack of education on the subject.
    i hope that’s PC enough for you.


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