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Airborne Food Allergies in the Hospital

I will be hospitalized soon in Germany, where I live, and have noticed that German hospitals don't seem to have a protocol for handling patients with airborne food allergies in rooms with more than one patient. I have an airborne allergy to apples and it's a common food. How do American hospitals handle the problem? Do they put the patient in a private room? Do they control what the roommates eat? I'm curious because I'd like to make some suggestions to the hospital staff. The last time I was hospitalized, the staff left it up to me to discuss it with my roommates and all the visitors and ask them not to eat any apples in the room. But given that I might have to undergo surgery soon, I might not be in the condition to be so vigilant.

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  • K8sMom2002

    Ann Marie, on the airborne reactions to apples! My DD is allergic to corn and apples, but her apple allergy is far less of a bother to her than the corn — her doctors have said she is cleared to eat "baked" apple, which means as long as the apple is baked at 350 degrees for 30 minutes, it should be safe. 

    It sounds like there is no safe amount of exposure of apple for you! Apples are also tricky because they have that "healthy" reputation and an allergy to apples is not a common one.

    A few questions:

    • Will you have family with you who will be able to communicate with the staff at the hospital and other patients?
    • How long will you be in the hospital? Just over night, or longer?
    • Does the hospital have a social worker or patient advocate that you could speak with in advance? 
    • Will your doctor write an order that says you are not to be exposed to apples and that for safety reasons you need a private room?
    • Do you know what floor you'll be admitted to after your surgery?

    Off the top of my head, you could try these things:

    • Talk to your insurance company (not sure how it works in Germany, but this is what I would do in America) and get pre-approval for a private room.
    • Make sure your file is up to date and labeled/flagged clearly that you have a life-threatening allergy to apples.
    • Talk in advance to hospital staff — a social worker/patient advocate AND the staff/head charge nurse on the floor where you'll be admitted or the German equivalent of the Director of Nurses  – about the seriousness of your allergy.
    • Talk in advance to the director of the hospital's dietary services and ask that no dishes containing apples be sent to your room and that all menu items containing apples be left off any "choices" for that room while you are admitted.
    • Have a family member or friend with you who can advocate for you while you are coming out of anesthesia or medicated with pain relievers.
    • Have that same family member or friend post a note on the door of your room saying: Life-threatening allergy to apples! No apples or outside food, please!
    • On the date of your surgery, when you FIRST get there, ask to be red-banded (or whatever the German equivalent is) to clearly show that you are allergic to apples. In American hospitals, patients with allergies get a red wrist band that shows they have a drug or food or latex allergy. 

    Another tip from a food allergy mom on our sister community, , is to use a washable marker to write a warning on directly on your sheet.

     

    In all of the hospitals I've ever been in or had family in (and that's a LOT!), it's been rare for us to see a semi-private room (where two patients are in the same room.) I can think of only two occasions from the time I was a teen to now — and I'm in my 40s. One was because an uncle's insurance wouldn't cover the entire amount of a private room, and the other was because the hospital was slammed with patients and needed to find space wherever they could — that one was NOT a good situation.

    Keep us posted! Sending good (non-apple) and prayers — when is the surgery?

  • Jen

    Cynthia gave you some great ideas.  I think everything would be much easier if you were able to get a private room.  I would start by calling the hospital to see if that's possible and/or if you need some sort of documentation.  Good luck!

  • Kathy P

    How do they normally handle your food allergies in the hospital? It sounds like you've dealt with it before and they left it up to you to deal manage the situation. How did that go? Were there issues? Is there a specific circumstance that you are concerned about?

  • Anne P

    My daughters and I are airborne anaphylactic to peanut and tree nuts, so we have had to deal with this situation before.  There are hospitals around us that still have semi-private rooms, though they prefer to not double up except when they're crowded.  They try to leave 1 bed vacant in each room.  Still, I anticipate that the hospital will be crowded; and we will have to share a room.

    I did a quick Google and came up with a couple of articles about .  It sounds like you could be in a room with 2 – 4 patients but semi-private and private rooms are available depending on your insurance. talks about patient advocates in German hospitals.  

    I would contact the patient advocate and request a private room and also talk about the food that will be served during your stay.  Request to speak to a dietician about how your food will be prepared and stress that your food must be prepared separately from any other food to prevent cross contact with apples.  You could also ask the patient advocate to provide a small refrigerator or kitchen space on the hospital ward to store your own food.

    Praying everything goes well!

  • Ann Marie

    Thanks, everybody, for all your tips. I'm going to follow up on all of them. My surgery won't be for another couple of months and that gives me lead time to work on these issues in advance.

    The other time I was hospitalized it was in a different hospital, a smaller one, and it had no protocol whatsoever for airborne food allergies. This time I'm going to bring it up in advance and ask the hospital to develop a protocol if it doesn't have one already.

    My allergist already wrote a letter to the hospital detailing my allergy and emphasizing the need to keep me away from apples. That should help. It's always better when the information is coming from another doctor.

    I will check into the possibility of a private room. And I love the idea of talking to a patient advocate!

    Thanks many times over.

  • K8sMom2002

    Yay! I'm glad you have plenty of lead time to work things out in advance, and I'm especially glad your allergist is already smoothing the way for you! Do you have a copy of the letter to share with the patient advocate?

    Keep us posted on how things go!

  • Kathy P

    Let us know how things are going with making accommodations. Hopefully it will be easy to get what you need to stay safe.

  • Shea

    I think they should definitely NOT put it on the patient to make sure they are not exposed to their allergens when they are sick in a hospital! I am thinking they note it on the nursing board in the front of the room (in all my hospital stay they have a place the nurse write their names, maybe they could write "Airborne food allergy– Apples" so each nurse/staff member is made aware, as well as on your medical bracelet, and in your chart, and noted in "special diet/dietary restrictions" in your chart, which is often shared with the cafeteria here so people cannot order stuff they are not approved to eat, maybe they can note it on both your restrictions and your roommates restrictions, so that you know it is not getting in there, and you have it in multiple places.

     

    I am actually allergic to apples, I cannot touch them or eat them in any form, but I never noticed or thought it could effect me airborne–I will have to keep an eye on that. I am also allergic to grapes, peaches, pears, plums, and nuts.

  • K8sMom2002

    Shea, it would be great if the patient didn't have to double-check on all of that.

    But unfortunately with a "non-Top 8" food allergy, a food allergy that doesn't require plain-language labeling by the FDA, I've found that even when people genuinely want to help you avoid that food, it's harder for them to figure out what's safe for you.

    For instance, people have routinely not seen the danger in DD eating popcorn, although she has a life-threatening food allergy to corn. It's only when she says, "No, it's popCORN," that they blush and apologize profusely. 

    Apples are the same way — we've had people tell us that their fruit leather roll-ups are okay because it contains "fruit" and not apples. 

    It's frustrating, but they don't live this everyday, and we do, so I don't take it personally. I'm sure there's something equally critical for them that I don't fully "get," either. 

  • Jen

    @Ann Marie - Do you know if the hospital has received your letter yet?

  • Shea

    Yes, K8SMOM, I agree it is hard for others to be responsible for your food allergy normally… and with s child it is SO hard because you cant always be there as a parent, I am already teaching my 4 year old to self-advocate….., but in a hospital? There, you are a patient, and the focus of the hospital staff is on health and giving you the right medications and the right foods per your chart when you, the patient, are out of it from being really sick or on strong meds or just out of surgery. Mistakes can happen, sure, but a system of checks, written measures, and record keeping can help prevent that. Whether it is, " have ingredient labels read and checked for allergens by nurse before bringing food in", or a sign on the door and a note on a bracelet.. food allergies are common enough now they really should have a system in place in a hospital to protect people. If they dont, if requests like those above cannot be accomplished, then.. they should give someone their own room, or get sued, in my opinion.

  • K8sMom2002

    @Ann Marie, hope you're having success with all the preparations. I'm always surprised at how time flies leading up to a deadline. I'm really hoping to hear good and positive things from your doctor's letter to the hospital and your reaching out to the patient advocate.