27 October 2016Last updated

Real Life

‘I had visions of my son going into cardiac arrest’

One moment Victoria Algate’s 18-month-old son Joe was fine; the next, after munching on a cashew, his face flushed red, his eyes swelled up and he began vomiting

As told to Catherine Harper
17 Jun 2016 | 12:00 am
  • Source:Aiza Castillo-Domingo/ANM Image 1 of 3
  • Joe is terrified of a reaction, but the fear makes him wary of what he can and can’t have, and if he’s not sure of a food he always just refuses.

    Source:Supplied Image 2 of 3
  • Source:Aiza Castillo-Domingo/ANM Image 3 of 3

My youngest child Joe had eaten Nutella before, and had little in the way of any signs or symptoms of a serious allergy, so I had no reason to suspect he might be severely allergic to nuts. We were relaxing at a hotel in Fujairah when Joe, who was 18 months old at the time, decided to help himself to a cashew from a bowl casually left on a table.

Within seconds he went from a bright, happy, energetic little boy to one literally paralysed with fear in sheer panic at what was happening to him; his face flushed bright red, he began vomiting, his eyes swelled up and started watering, and he began dribbling from his mouth and his nose.

Panic-stricken, I scooped him up, placed him in the back of the car, and made for the nearest hospital. Driving with him in his car seat in the back and me unable to do anything while we were on our way was simply agonising. Visions of him going into cardiac arrest flashed through my mind, no matter how hard I tried to stop myself from fearing the worst.

I’m a first-aid trainer so I’m well used to describing the signs and symptoms of anaphylactic shock, but there’s a world of difference between teaching strangers theory and seeing your tiny, helpless child actually experiencing it.

I haphazardly parked the car in the nearest available space at the hospital, grabbed Joe and rushed him into the emergency room, frantically telling anyone who would listen that my son desperately needed help. Doctors quickly took him from me, but I refused to allow him out of my sight, so they let me go with him into the treatment room.

In what seemed like hours, but was in fact only a matter of minutes, the medical staff managed to stabilise him and he began to return to something resembling normal. Slowly, the panic started to subside and I began to wonder why staff didn’t have epinephrine to give him when he’d clearly been having an anaphylactic reaction. Luckily, they’d been able to stabilise Joe without it, but what if they hadn’t? It didn’t bear thinking about.

Surprisingly, given how seriously ill Joe had been and how long anaphylaxis patients are usually kept in hospital, to watch for something called a biphasic reaction where the reaction lasts longer and has more than one stage, we were allowed to go home a few hours later.

Following Joe’s hospitalisation, I took him for a full allergy test to establish exactly what he was allergic to, and I began to realise what having a child with such a serious nut allergy would mean. On a scale of one to 100, Joe’s allergy to cashews was 35, to pistachios 38 and to peanuts a phenomenal 87. I’d have to watch everything he put in his mouth, worry endlessly about leaving him on play dates or sleepovers, and be on my guard constantly in case he unknowingly ate something he wasn’t supposed to.

When Joe had his first reaction it was all a bit overwhelming, but I’ve managed to calm myself and look at the situation rationally. He’s now seven years old and I worry far less because pretty much everyone he interacts with on a daily basis is well used to him having a serious nut allergy, and knows what to do if it happens, including how to use an Epipen. Thankfully my other kids Danni, 21, and Jaimie, 11, don’t have the allergy.

I draw strength from Joe’s own attitude to his condition; obviously he’s petrified each time he has a reaction – petrified enough to say no to cupcakes – but he’s incredibly sensible about what he can and can’t eat and always just refuses if he’s not sure. His fear isn’t nice to see, but it does reassure me that he won’t take any risks.

One of the ways our lives are affected is that we don’t take Joe out to eat at many restaurants, as you simply can’t rely on anyone but yourselves to make sure food really is nut-free. And although it seems trivial in comparison to what could happen if he eats nuts, I then worry about him becoming a picky eater! We’ve also had some stressful situations on flights over the years; once it took me hours to get an airline to agree to swap the nuts offered as part of the beverage service with crackers, and another time we ended up experiencing several hours of sheer panic and covering Joe’s face with a mask as an airline’s ‘no nuts’ confirmation turned out to mean ‘no peanuts’, which I only discovered after more than half of the economy cabin had opened their packet of nuts.

Since the first reaction, we’ve had four further occurrences, one of which was just two weeks after the first. My mother inadvertently gave Joe a praline chocolate; he had the same reaction and we had the same dash to the hospital. I couldn’t believe we were in that situation again, so soon after the first, and I was devastated. Another reaction was caused by a home delivery pizza, where the dough must have been prepared on a surface previously contaminated with nuts, and another was when Joe’s sister touched him after eating pistachios and must have had nut dust left on her hands. Then he once rubbed his eyes after playing at a friend’s house and his eyelids swelled up so much they almost looked like they were inside out.

Of the four major occurrences, we’ve had to use the Epipen three times. It is a horrific experience but I go into survival mode; it simply has to be done, even if I have to hold him down. Thankfully you don’t see the needle go in and I hope he’s too sidetracked by the reaction he’s having to notice it.

If you’re in two minds about whether or not to inject, though, you just have to do it; with anaphylaxis you don’t get much time to halt the progress of the reaction, and the longer you leave it the less chance you have of stopping it. There’s also a risk of a secondary reaction, even if you think the primary reaction is subsiding, and there are no major side effects caused by using the Epipen, so it’s far safer just to do it. We have an emergency pack with the Epipen at home and there’s another one at school, and I carry one when we’re out.

While I did feel rather isolated when Joe was first diagnosed with his nut allergy, these days there’s a lot more support out there. One of the main resources is the Allergy Network Dubai group on Facebook, which is growing steadily and offers a network of support to parents and those suffering from nut and other allergies, so they know they’re not alone.

One of the main problems is awareness and understanding, though. I get that ‘no nuts’ policies can be frustrating and tedious, especially when it comes to school lunches, but all I can say is please try to consider the consequences of someone with a severe nut allergy coming into contact with a nut – or, for people like Joe, even a tiny bit of nut dust. Is it really worth risking someone’s life?

Victoria Algate, from the UK, lives in Jebel Ali, Dubai

What is a nut allergy?

Food allergies happen when the body’s immune system identifies proteins found in food as a threat and releases chemicals to combat this perceived threat. These chemicals cause an allergic reaction, or a number of signs and symptoms involving various body parts and ranging from mild to severe.


Initial signs of an allergic reaction can include symptoms similar to hay fever, such as itchy, watery eyes and sneezing, and sufferers may experience an itching or tingling sensation inside the mouth as well as a red rash – either smooth or raised – known as urticaria or hives. Swelling can occur around the eyes, lips, tongue and roof of the mouth, as can abdominal pain, vomiting and/or diarrhoea. A person suffering an allergic reaction can find it difficult to swallow, and may experience wheezing, difficulty breathing and/or shortness of breath. Some patients also report dizziness or feeling light-headed.


A severe allergic reaction is known 
as anaphylaxis, or anaphylactic shock, and requires immediate medical attention to avoid proving fatal. Signs 
of anaphylactic shock are exactly the same as those of a less severe allergic reaction, but also include collapse and unconsciousness, a rapid heartbeat and a sudden drop in blood pressure leading to feeling light-headed and confused. If the patient is able to speak, they may report feeling a sense of fear or intense anxiety. Treatment for anaphylactic shock is an injection of adrenaline, often from an auto-injector carried by the patient themselves if they are already aware of their allergy.


Read Priyanka Talwar’s You Can’t Always Tell


Indian mum-of-two Priyanka Talwar discovered her son Jaiveer, seven, had a severe nut allergy when he was hospitalised with an acute allergic reaction at 18 months old. Despite doing her best to ensure Jaiveer was involved in the management of his condition, she found little in the way of resources suitable for a primary school child, and so resorted to writing her own book. You Can’t Always Tell is a story aimed at helping children of all ages understand what it means to have a nut allergy, in particular making it clear why allergy sufferers can’t afford to take any chances with the food they eat. Not just for children with a nut allergy, it can also be used as a classroom resource for those who have friends with nut allergies and as a general educational resource.

As told to Catherine Harper

As told to Catherine Harper