Be prepared ... nut allergies can be a problem in Thailand. Photo: iStock
'Gin tua mai dai!" These words have saved my life more times than I know. I suffer from an anaphylactic allergy to nuts, which means my body cannot process the protein in nuts. If I ingest nuts, the effect is illness and, potentially, death.
On my first trip to Thailand many years ago, I asked a Thai woman sitting beside me on the plane to write the phrase in Thai for "if I eat nuts I'll die". I still have that piece of paper in my wallet and it's a phrase I utter before every meal in Thailand.
I have mistakenly eaten nuts, prompting hours of Exorcist-like vomiting. My face swells like Will Smith's in Hitch. Anaphylactic reactions can result in death, though it's not a reason to abandon travelling. Developing your own methods for ensuring nut exposure is kept to a minimum while overseas is crucial, so when planning a trip, learn the relevant phrase explaining your condition in the required language(s) and write it down.
The website selectwisely.com has taken this idea a step further. The people behind it create laminated cards with the relevant allergy information written in whatever language you need.
Another useful tip is to read about food habits in the countries you're travelling to. India, for example, can be a daunting place for allergy sufferers. Even though many curries and desserts are loaded with cashews and other nuts, if you know what you can safely eat it can be fantastic – masala dosa (lentil pancakes) in southern India are always a reliable option and in the north I always look for aloo gobi (potato-cauliflower curry) and palak paneer (spinach and cottage cheese curry) as their base ingredients don't contain nuts.
The national medical adviser for The Travel Doctor, Dr Tony Gherardin, says there are several ways travellers can minimise risks. "Do some research about a destination, check eating and food-shopping options, and plan if food is able to be taken to the destination," he says. "Choose destinations where simple foods are available or clear choices about content of foods is known."
The president of Anaphylaxis Australia, Maria Said, goes a step further and suggests contacting your airline beforehand to be advised of its nut-free policy, as well as filling out a travel plan with allergy and medication information for foreign doctors and authorities. "Take time to plan your trip," she says. "It is better to have good memories rather than regrets about not having planned ahead."
Many travellers with allergies will know the precautions and required medications, though it can be just as important to make sure someone you're travelling with knows where your antihistamine (to reduce severity of symptoms) and EpiPen (a concentrated adrenaline shot to open airways and blood vessels) are kept. Another good idea is to wear a MedicAlert (medicalert.org.au) tag that identifies your allergy. Being conservative is key. Don't eat or drink foods you are unsure about. Choose simple foods where possible, and eat peelable fruits and safe, packaged foods where available.
Despite such precautions, sometimes things go wrong. "Make sure you have travel insurance, as any medical costs overseas can be very high and medical repatriation in an emergency is extremely expensive," Gherardin says.
Sometimes waiters don't understand, sometimes you relax your vigilance and that is where travel insurance is a must.
I have had several allergic reactions while travelling: a sneaky walnut in a Buenos Aires ice-cream, a bite of an Afghani paratha and a dodgy salad in Paraguay all gave me severe reactions requiring action.
The director of World Nomads travel insurance, Michael McAuliffe, says the option for specialist medical treatment and evacuation is important. "All food allergies are covered within our policies and there is no need for a traveller to apply separately," he says.
The travel safety specialist for World Nomads, Phil Sylvester, says: "Travel insurance is not a license to take risks. As long as people declare their pre-existing allergy and then continue to do everything reasonable to reduce their risk, they should be covered."
As well as disclosing allergies when you purchase travel insurance, it's a good idea to register with Smart Traveller so that if there is an emergency it can be dealt with efficiently.
As the Smart Traveller website says: "If you can't afford travel insurance, you can't afford to travel."
Should people with severe nut allergies avoid international travel? The answer is a qualified "no". With planning and preparation, most people should be able to enjoy a holiday with confidence.
Useful websites include: selectwisely.com, tmvc.com.au, allergyfacts.org.au, medicalert.org.au, smarttraveller.gov.au, worldnomads.com.au.