Food Allergy Counseling

Food Allergy Counseling
Sloane Miller, MFA, MSW, LMSW, Psychotherapist; Specialist in Food Allergy Management, Speaking At Mylan Specialty / EpiPen Event (© Noel Malcolm 2013)

Tuesday, February 25, 2014

Food Allergy Counseling: Food Allergy Mortality Discussion for Healthcare Professionals, AllergyHome.Org

I had a version of this conversation with D. a few weeks after the kissing conversion, about food allergy risk: 

The bottom line is there is a risk I could die from accidentally ingesting one of my allergens (tree nuts or fish). I do everything I can to manage that risk, including carrying emergency medication. It probably won’t happen but it is possible and I live with that risk every time I eat, dine out and travel.  

We were talking about risk generally and I felt it important to help him understand that this is a deep truth of my life. It has probably helped to shape who I am, how I view the world, how I interact with the world and how I move through the world. (This is among the many, many, many other factors that shape who any of us are.) I accept my food allergies and I do not let that one aspect of my life define the rest of my life. However, I am aware that the risk is very real. My job is to manage that risk while having a life.

When did I know that truth? At an early age. How did I find out? That's hazy. Back then, there were no support groups or national non-profits dedicated to education and awareness; no other kids for me to talk to, no parents for my parents to connect with. I imagine my awareness came after years of doctor’s appointments and overhearing bits of conversations and putting it together. Not ideal and definitely scary and anxiety-producing.

But how do families and adults these days address the possibility of a fatality from food allergies? At what age does one have that conversation? With what language? It is a complex question with a complex answer. And it’s not only about the children: many parents cannot handle this information (a possibility of a fatality from food allergies) and choose to remain in denial about the real risks of food allergy exposure, thus potentially endangering their child’s health and well-being. Truly, it’s an issue that must be tackled from a multi-viewpoint perspective. Not so easy to do in a 20 minute consult with a doctor. OK, near impossible.

Dr Mike Pistiner in a recent post on his website begins to tackle the over-arching concerns from a Healthcare Professional perspective (as in the professionals who dispense information to you about disease management).

It is a conversation to have with your pediatrician and allergist about real risks, and how to engage your feelings as a parent first and then your child about this very serious issue in order to integrate the information in a helpful, useful, un-fearful way.

This is something I’ve talked about directly with my teenaged food allergy counseling clients and with parents within a food allergy counseling relationship. 

f you have concerns about how to engage either your medical team or you family about, the possibility of a fatality from food allergies, contact me about a short term counseling program, today.

Friday, February 21, 2014

Food Allergy Counseling: Kids With Food Allergies: Epinephrine Free Seminar

Our friends at Kids With Food Allergies (KFA) are hosting a free seminar about epinephrine with my colleague, allergist and food allergy dad, Dr Mike Pistiner.  Here’s more from a press release from KFA:

Everything You Want to Know About Epinephrine and More SIGN UP NOW

Angela Nace, PharmD, and Michael Pistiner, MD, MMSc, will answer your questions about epinephrine. Submit your questions in advance on the registration form. We're very excited to continue to bring physicians and experts to you in a free format that is easily accessible. Space is limited, so be sure to register early. We thank Mylan Specialty for sponsoring this event.

Date: Wednesday, February 26, 2014
Time: 7 pm Eastern | 4 pm Pacific
Where: Your computer or mobile device 

They will review what epinephrine is and how it is used to treat anaphylaxis (severe allergic reactions), the different brands of auto-injectors available and topics such as:   

-What body systems does epinephrine work on and what does it do to each of them? How does it work differently than antihistamines? 
-Is epinephrine dangerous? 
-Can the effectiveness of epinephrine wear off if used too much? 
-Why does it need to be kept at a certain temperature? 
-Does epinephrine not work sometimes? Why? 
- Is it okay if my baby/child weighs less than what is recommended on our dose?  Is it safe to give that dose? 

Tuesday, February 18, 2014

Allergic Girl: Interview,

A much beloved Kips Bay / Murray Hill neighborhood restaurant that was on the forefront of gluten-free dining and allergen-awareness here in New York City, Bistango, is opening a second location on the Upper East Side (1420 Third Ave at 77th street.)

I’ve been going to
Bistango for a few years now. I’ve consistently had safe and yummy dinners that were prepared by an allergen-aware staff.  If you’ve been there you may recognize it as the setting for the last scene of my Allergic Girl: Adventures in Living Well with Food Allergies (Wiley, 2011) book trailer.

Last week, I was interviewed by to reflect on the news that
Bistango is opening a second location. A quote:

“[Owner] Anthony is a true restaurateur in that the customer comes first,” she said. “He focuses on what each customer needs and then tailors a menu to that.”

Read the full story here on

I can’t wait to try it out. 

Best of luck to Anthony and the whole Bistango team!

Friday, February 14, 2014

Food Allergy Counseling: Kissing & Food Allergies: Valentine’s Day Edition

Picture it. A cold, January Friday night. Date Two with D.. Metropolitan Museum.

D. and I have strolled into the Temple of Dendur, a separate building that houses an ancient Egyptian stone temple. The museum is practically empty. The lighting near the Temple is low and there are ripples of light on the wall opposite us: reflections of a pool below. The conversation slows to a halt as D. looks at me, his eyes softening and intensifying.

In that moment I had two thoughts: he’s going to kiss me (yay) and he probably ate chocolate with nuts recently (uh oh). He had told me a few days prior that he loved high quality chocolate, often with nuts and ate it every day.

He leaned in, and kissed me softly on the mouth.  I pulled back and placed my hand on his.

“I totally want to kiss you back. But did you have chocolate today?”


“What kind?”


And in two blinks, his expression changed.

“Nuts,” he said. “I didn’t think it could transfer. And it was a while ago. Would that matter?”

Thus, began a conversation about my food allergies and kissing.

It’s a conversation I’ve had often over the last few years: a combination of being single and dating, and, I suspect, dating healthy eaters who enjoy diets rich in seafood and tree nuts e.g. every man I’ve dated in the last three years loves almond milk. Seriously. 

The conversation I have about food allergies and kissing ranges from highly nuanced to short and sweet, depending upon a variety of factors. In the beginning of a dating relationship, certainly on date one or two, I usually stick to the facts: I can't kiss you if you've eaten my allergen recently. This is what we need to do. 

On this date, even though it was date two, D. expressed some interest to know everything I could tell him in order to keep me safe (and to satisfy his curiosity about what I was telling him). I offered to email him my food allergy list as well as the only major salvia study that talks about how to rid one’s salvia of peanut protein (a study often extrapolated for other allergens). D. read the information and said that it helped him to understand better my medical needs and how to keep me safe. The next time we met, I brought him some safe chocolate (both Divvies & Enjoy Life Foods) and we had big kisses, which were totally lovely.


Seems easy, right? Straight forward? An easy exchange of information?

Not exactly. Stories, press releases and interviews on the Internet from large news organizations and national non-profits (many in which I am quoted) state that you have to tell your partner about your allergies and not kiss them if they have eaten your allergens. Totally true.

But how does that play out in the real, offline world?

If you are the one explaining your needs, it can feel awkward. Or weird. It can feel confrontational or feel unromantic and informational. For your potential kissee (and I just asked D. what he thought), it can be frustrating in the moment because this person wants to kiss you and can’t. He added that he felt curious about the information I was telling him but also wondered how kissing me would work down the line?

So, then, not so straightforward. Not such a clean, exchange of simple information.

I’m not saying don’t have the conversation. You have to. I have to. And there are a thousand ways to get it done, in your own way and time. And with every person you kiss, the conversation will change, be differently great or differently awkward or a combination of both (which, I find, is usually the case).

My point is: if you are anticipating feeling all of these uncomfortable feelings (and/or more/different ones) and thinking maybe I’ll skip the conversation this kissing holiday or any kissing opportunity, don’t. You and your partner will probably feel all of these feelings and ones I haven’t even described here. It’s normal. It’s natural. Feel the feelings and have the conversation anyway. You may get kissed, you may get someone who isn’t interested in knowing more; that’s the risk.

But that is a way easier risk to handle than the risk of a severe food allergic reaction or anaphylaxis.

Go out there this holiday and get your kiss on, safely!


Generally speaking my food allergy and kissing conversation contains a version of these basics:

I have food allergies and this is what food allergies are
This is what I’m allergic to
This is what can happen during a severe allergic reaction
For me to kiss you safely, these factors are vital

Want more? My book Allergic Girl: Adventures in Living Well with Food Allergies (Wiley, 2011) has a whole chapter on dating and food allergies and you can get it here.

Wednesday, February 12, 2014

Food Allergy Counseling: Myths & Facts About Food Allergy & Valentine’s Day: Mylan Specialty

Mylan Specialty, marketers and distributers of EpiPen® (epinephrine) Auto-Injector, gathered some fun stats about VDay and food allergies and put it together in the below graphic. Feel free to visit for more information about severe allergies and anaphylaxis.

For me, t
he most interesting and pertinent myth from Mylan Specialty is the below:

Myth or Fact: You can experience a life-threatening allergic reaction (anaphylaxis) from a kiss

Fact! It is possible to experience a life-threatening allergic reaction if you kiss someone who has eaten something to which you are allergic. Your best bet is to ask your loved one to stay away from your allergens before you pucker up.

This is the one that you have to explain to your potential kisser (or is it kiss-y?) and therein lies the trick. I’ve talked about kissing and food allergies often. Like here. And here. And here

In my next post, I’ll explore how to I accomplished that conversation most recently. 

For a deeper exploration, see my best selling lifestyle guide, Allergic Girl: Adventures in Living Well with Food Allergies (Wiley, 2011)

Monday, February 10, 2014

Food Allergy Counseling: FARE: Food Allergy Field Guide

Food Allergy Research & Education (FARE) has just launched “Your Food Allergy Field Guide,” an excellent  FREE downloadable resource for newly diagnosed individuals and families with food allergies.  

The guide can also serve as an easy read for families, friends, loved ones and partners to help them better understand the basics of food allergies, specifically that they are real, serious and can be life threatening.

From a Food Allergy Research & Education (FARE)  press release: 

“Your Food Allergy Field Guide,”  was designed to help individuals and families who are new to food allergies have the information they need to stay safe, avoid reactions, shop smartly and live well with food allergies. 

To download a free copy of the Field Guide, visit

Saturday, February 08, 2014

Allergic Girl Book Giveway: Canyon Bakehouse Month of Love Giveaways

Canyon Bakehouse is doing a fun February Facebook promotion with some of their favorite gluten free brands/products and books for a “Month of LOVE Gluten Free Giveaways”. 

My book, Allergic Girl: Adventures in Living Well with Food Allergies (Wiley, 2011) is THE giveaway today February 8. 

To participate, go to @CanyonGlutenFreeBakehouse on Facebook and follow the instruction on the @CanyonGlutenFreeBakehouse on Facebook page

Please note: in order to participate, you must go @CanyonGlutenFreeBakehouse on Facebook page and like, comment, or share the post to enter.

Here’s more about Canyon Bakehouse. They are gluten-free and nut-free and here are their FAQ

Please check with Canyon Bakehouse directly about your individual needs.

Good Luck!

Wednesday, February 05, 2014

Food Allergy Counseling: Doctor Radio: Food Allergy & Valentine’s Day

I know you have questions about living your best life with food allergies, food intolerances or celiac disease. 

I have answers. 

Tomorrow, February 6, 2014 at 10:00 until 11:00am EST you can hear me on Dr. Nieca Goldberg’s show on Doctor Radio on Sirius XM where I’ll be there the whole hour talking food allergies, lifestyle issues, dating, kissing, holidays, traveling and more. 

Call in to 877-698-3627 
Email your questions to 

Remember: Just because you have a restricted diet, doesn't mean you have a restricted life.

*A Special Offer for Sirius listeners and social media followers: Contact me for a 3-session sliding scale food allergy counseling program tailored just for you for the month of love!*