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Traveling in Nicaragua with Food Allergies

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Quite simply put: when food can kill you, travel can be terrifying.

Thanks to my friend, Linda, a fellow food allergy mom (whose daughter was desensitized to milk through treatment at John’s Hopkins!  Yay!) for succinctly articulating this thought.  Linda has also traveled extensively with her daughter, and was a good resource for me before we left, and in the decompressing that needed to happen once we were home.

The short story:  8 nights in Nicaragua, brought our own food, had one troubling incident, made it home in one piece with no more than a couple of doses of Benadryl. Glad we went.  Slight modifications if I were to do it again.

The long story: [deep breath] I knew that trying to navigate food in a country where I don’t speak the language, or know the cultural issues around food allergies would be difficult. So we planned and planned and planned some more.  Here is what we planned:

1. We packed a suitcase full of packaged food to keep my son full for the week.  Shelf stable soy milk, dry cereal, crackers, cookies, Daiya “cheese” spread, bagels, margarine, dry pasta and so on….  It helped that we froze much of what we took, and then defrosted things as needed, so that kept the bagels going all week (though by the end, I didn’t think my son would eat another bagel for a year.)

2. We rented places that had full kitchens, so we could prepare hot meals for our son and feel safe.  It also meant we could refreeze our ice packs and store our cold items for the week.  This worked great, and allowed us  to make him his favorite “mac n cheese” (dairy free of course!), baked chicken and warmed bagels.

3. We brought along a lot of emergency medication.  Like 8 epi pens, tons of Benadryl and even filled a script of liquid prednisone (the steroid) after I had read that not all counties readily treat with that.

4. We had all of his allergy information, and key phrases like “he’s having a serious life threatening reaction to milk” translated into Spanish.  If something happened, we needed to be able to communicate it!

5. We bought emergency travel insurance.  I wanted the peace of mind that if we needed to get out fast for a medical issue, we’d have help.  The travel clinic where we got our typhoid shots before the trip told me that the travel insurance carriers were great resources for local medical help, too.  So we didn’t just buy the insurance, we printed out all the contact information and coverage instructions so we could be prepared.

6. We brought tons of antibacterial hand wipes, to clean hands plus surfaces on the airplane or in restaurants.  (Remember, antibacterial gel doesn’t remove food allergens!)

7. Most importantly, we were really careful.  We planned to be really careful.  At home, we eat out and we let our son eat restaurant food, once we’ve done the song and dance about cross contamination and all that.  But we decided that we would take no chances while we were traveling, and unless we cooked it, he wasn’t eating it.  This really bummed him out, but we stuck to our plan — except for the fruit smoothie we got him at the American-owned hotel Mango Rosa, where we were able to have the food allergy song and dance conversation with the American owner, and we went for it.  But then we felt stupid and remembered our plan and didn’t deviate again.

But like many well planned events, we failed to foresee every possible issue, and found ourselves in a bit of a pickle (I mean panic) while on an aging ferry on Lake Nicaragua on our way to the most remote place on our trip.

IMG_3752No sooner than we lifted anchor and found ourselves leaving land did my son start to show signs of an allergic reaction.  We were seated in the passenger area of the cramped ferry — broken seats everywhere, lots of holiday tourists on board, and vendors had been on board selling sunglasses and roasted nuts.  Yes, roasted nuts.  We hadn’t let my son sit down, for fear of the seats being contaminated, but he got hives on his face and neck and started to complain of an itchy throat.  He was scared.  We were terrified.  This all happened within minutes of leaving the port.  I had him outside in fresh air immediately, washing him down with those handy wipes, dosing him with benadryl and counting epis in my head while I imagined having to ask them to turn the ferry around.

For all the adrenaline and fear I experienced, the whole thing resolved itself almost as fast as it came on.  But from that moment on, I was berating myself for putting us in this position.  I mean, what was I thinking taking my FAMILY to this remote place?  How could I bring my allergic son to someplace SO FAR AWAY?  And even though we had identified before our trip that there was a hospital on Ometepe Island, I was sick about the might-ofs that were running through my head.

My darling husband was calm once we were off the ferry (under an hour on the ferry) but I wasn’t calm until we had finished our three night stay on the island and were safely back in the more developed, modern city of Granada.  On the return ferry, we never took our son inside, and found a quiet spot on the deck to ride out the trip back to the mainland, and it was a blissfully uneventful trip.

IMG_3795The only other point of nervousness for his safety came, ironically, when we visited the active volcano outside of Granada.  Now, we weren’t nervous about the VOLCANO erupting (though in hindsight, I seriously brought my family to an active volcano!?!?) But, the air is thin and the sulfur from the volcano can make it hard to breathe.  I had trouble as we ascended the volcano (by car), and only then, in that moment, did I realize that I had failed to pack my own inhaler AND MY SON’S inhaler!  Oops.  Asthma is not a chronic problem for him (it is more an issue for me) but I really had thought that it was in our bag, but it wasn’t.  Luckily, there was a great breeze at the top and we all had good clean air to breathe.  Problem averted.  But next time I would definitely pack the inhalers!

Next time?  Well, we’ve been home a few weeks, and I’ve had time to reflect on our trip, and have asked myself many times, “would I go again?”

Yes.  I am glad we went. I would go to Nicaragua again with my food allergic son.  I would still do all the planning we did, but I would not go on the ferry.  It was too remote.  It was too “developing” and I was so unprepared for airborne tree nut particles causing a reaction!  I know that the unexpected can happen anywhere, but if it is to happen, I don’t want to be on a remote ferry in the middle of Lake Nicaragua!

Ask my son, and he’ll say he loved Nicaragua, but he has asked “next time can we please go to an English speaking country so I can eat in a restaurant?”  And that just breaks my heart.  Should we have brought food for all 6 of us? Should we have totally avoided eating out (where we’d bring his food that we’d prepared?)  It just isn’t practical, especially when part of our purpose of travel was to expose our kids to the food of Nicaragua.  But I do wish that he could have been more free to get more smoothies, or to get allergy safe pancakes or other special “restaurant food” that the other boys got.  We made sure he got plenty of treats, but they grew less and less special as the trip wore on, and he was sad that he couldn’t eat like everyone else.

What my darling son doesn’t know is that even if we went to an English speaking country, it doesn’t mean we’d be any less vigilant; and it doesn’t mean we’d even let him eat in a restaurant (unless we could understand the cultural issues around food allergies.)  We are seriously talking about traveling to India next time (English speaking yes, but I would not be comfortable with food prep/handling/cross contamination in the kitchens there.)

I would love to hear from other food allergy parents about their experiences traveling abroad!  Happy travels.