January 20, 2013

• Moving

     Sometimes I forget to trust that what my body is showing me is accurate. Several years ago, I had an incident after eating a lot of shellfish, when my tongue was so swollen it was sticking out of my mouth and I started to wheeze. Epinephrine from my nurse's bag took care of the symptoms and the presumption was made that I had a shellfish allergy. I only tried clams once after that. My tongue started to itch, I started to wheeze, and once again epinephrine was employed. I did not knowingly eat shellfish again. 

  Until yesterday.

     My doctor had suspected I had an allergy to cats, as my new cat ,Jack, tends to inspire wheezing and itching when I pet him too close to my face. My doctor  decided to check my IgE level for an allergy to cat epithelium. At the time, I asked him if we could also test varieties of shellfish to see if I could eat any of them. The orders were entered for ten different types of shellfish. All results came back as negative. My doctor gave me the go-ahead to eat shellfish. I was puzzled but excited at the possibility of once again eating the seafood I had enjoyed when I was younger. 

     Vermont is not especially well known for his superior seafood, having land to the North, East and South. Most of the Western boundary is adjacent to Lake Champlain. No seafood to be had there. So off to the local supermarket we went. 

    For my first foray into shellfish consumption, I chose a can of crab meat and two bags of frozen Maine shrimp. I knew it would be less satisfactory than the fresh shrimp and crab meat I had enjoyed living in Maine, but with my diet being so restricted due to the Lyme, I decided it was worth exploring. I mixed the canned crab meat with a little mayonnaise and placed it on mesclun with one of the Ezekiel tortillas. The texture was what I expected from a canned product. It was ok. I was most interested to see what, if any reactions I would have to my little experiment. 

    After a little while, my tongue started to itch. In the mirror, it looked slightly swollen, but not as grossly swollen as it had been years ago. Two hours later, my face was flushed with redness. My tongue itched for a few hours, then it went away. I was perplexed.  No wheezing occurred.

     For dinner last night, I thawed the Maine shrimp and composed a salad with mesclun, arugula,cucumber, garlic olives and hard boiled egg.  At the last, I placed about four ounces of shrimp in the center.   It was delicious! The shrimp were not as sweet and flavorful as the one's I used to buy during shrimping season on the side of the road in Maine and New Hampshire, but tasty nonetheless. About one half hour later, my tongue was itchy. It stayed that way through the night.

     A little later in the evening, I was speaking with my sister. I was perplexed. Why was I having this reaction when my IgE levels indicated there were no antibodies in my blood indicating allergy to seafood? Sandy, my sister, observed that my antibody levels may have been too low too detect as I had not consumed shell fish in almost twenty years. She also pointed out that her middle daughter, my niece, Kate, is allergic to shellfish containing iodine-that is, shellfish that turn pink-but not to mollusks such as scallops, clams and mussels. My next experiment will be with one of those bi-valves. Perhaps I am destined to have a life where shellfish is ok once in a while, or only of certain types. 

     This reminds me of something I learned early in nursing, especially when I worked in the Special Care Unit:

  "Treat the patient, not the numbers.'

    In other words, no matter what their numbers look like, observe the person for whom you are providing care and see how they are tolerating the state the numbers indicate. I am reminded that medicine is not a set of absolutes, as one sees in algorithms for conditions. It is also an art of observation and balance.  Another of my teacher's had taught me,"whatever the body shows you is accurate.'  It occurs to me that I have to trust what my body is showing me and avoid foods that make my tongue itch and my face flush.  Even after all this time, I am still learning to trust my body an what it reveals to me.

  Blessings abound

   

  • 9:20 am
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