A little while ago, I blogged about how nickel allergies from ingesting foods high in nickel can cause dermatitis. The responses were overwhelming so I figured I'd add two more posts, one about the only nickel allergy cookbook I could find and one about skin barrier creams that protect from topical contact. The second one will be coming soon. For now, though, more on food! Charity Bratz has a severe nickel allergy - as in, she will die if she consumes too much. Pretty intense stuff. She and her mom co-wrote what might be the world's only comprehensive cookbook for nickel allergy sufferers. I have a copy and, although it is for meat eaters, I was able to modify it for a vegan and vegetarian diet by substituting applesauce for eggs in the baking; vegetable oil for butter; and mushrooms and/or eggplant where the recipes called for meat (chicken, etc.). It actually cooks up really well like that! I thought it would be neat to interview Charity about her experiences with the allergy and her diet and how the cookbook came about. To my delight, she obliged, so here is her story:
Q. Can you tell readers a little about your background and what inspired you to write a cookbook for those who suffer from nickel allergies?
To start with, I’ve moved a lot over the years. I lived in Canada when I was little, in a town that had a nickel mine. We moved to Wisconsin when I started elementary school and I was your typical kid. I had my ears pierced when I was old enough, and that’s when we found out for sure I had a nickel allergy. I had to wear jewelry that was nickel free so I wouldn’t rash. I had other issues that didn’t come out until we were researching nickel foods and reactions to them. I thought it was normal for everyone since it was normal to me. For instance, my mouth would get ripped apart whenever I’d eat chips. I would get blisters that would burst as I ate, and I’d have skin hanging down in my mouth. We lived in Pennsylvania and a few more places in Wisconsin, where I got my degree in teaching. It was during my college years when things started going horribly wrong. I reacted to my tetanus booster, finding out it was the suspension I had a problem with. I can’t have another one of those or I could die. I had my first severe allergic reaction. My throat was swelling up and my mom had to hold my head back to get an airway while the ambulance came. It took two hours to stabilize me, and about a month before I could walk without getting winded and tired. I had two more severe allergic reactions after that, to what seemed like completely different food items. The allergist couldn’t figure it out, but required me to carry two epipens because the reaction was so severe. When I graduated from college, I went to Japan to teach English and French to high schoolers for a year. I had a reaction the second night I was there in Tokyo. They debated whether they should send me home or not, but I made it through the reaction and stayed. I had two more severe reactions while in Japan, which led to my decision to leave when the year was up. We still couldn’t figure out my allergy and I was risking death every time. I had several more before moving to Alaska to teach in a remote village along the Alaskan Highway. I taught a multigrade classroom for four years, and it seemed like I would always get very sick. I didn’t have another severe allergic reaction until the last year I was there, but it was a bad one. I was in Fairbanks when it happened and had to drive myself to the hospital (about 5 minutes away, luckily). I went for allergy testing again, and this time the allergist suggested that I look into a nickel allergy since all the foods I reacted to were high in nickel. For the first time, I had answers, and was tested for a nickel allergy. The patch test showed a severe reaction to nickel, leeching over to the ones around it. I also found out I’m allergic to gold at the same time. The allergist gave me a list of forty foods, both good and bad, to follow. With my reaction being so severe, I wanted to avoid high nickel foods and be safe, but a small list like that doesn’t give you a whole lot of options. After days of poking around the internet and finding contradictory lists, I decided to go research-based. I went to the FDA website, which had tested 300 foods and their nickel levels. When I cross referenced it to what the allergist had given me and found the range to look at, I started compiling a list of foods to eat, moderate, and avoid. I had to eliminate quite a few foods from my diet, and it wasn’t perfect. I had another severe allergic reaction that year, and I was not close to a hospital. My tongue was so swollen I was choking. I had to stab myself with an epipen, then a few more times along the 56 mile drive to the hospital. Apparently Jelly Beans are out. The main problem with my type of allergy is that it’s continuous, meaning when the medication wears off, I go back into it until what is setting it off (the nickel in my system) goes back to normal. This can take days, and makes it trickier to treat. I moved to North Dakota to teach second grade in the oil fields. I researched as much as I could on my allergy to live normally, and discovered there is very little out there in way of recipes. My mom and I started creating recipes so I could figure out how to use things like rice flour without it becoming a disaster. The gluten free recipes didn’t help much because a lot of ingredients used in gluten free products are high in nickel. Through my trial and error with the list, I had more severe allergic reactions, one of which to artificial almond flavoring that swelled my tongue up. I had been given some emergency prednisone pills (they help with swelling) and Benadryl from my allergist to stop these reactions faster so I don’t die. I took them, but didn’t realize how high a dose the pills were. I started swelling again the next day when they wore off, so I took another one, and another half pill the day after. Well, it was too much, and they had to catch me at the ER as I collapsed from a tachycardia. What a lot of people don’t realize is that some of the medications you take for these reactions can be just as serious as the reaction themselves, and you have to be careful when taking them. After a year in North Dakota, I decided to move back to Wisconsin to be closer to family and to seriously start work on The Nickel Allergy Cookbook. We had enough recipes that we were coming up with to make a cookbook, and since there is nothing out there for nickel sufferers, decided to publish it so there was. It took two years to kitchen test all the recipes and to put together the cookbook. We took our own pictures for each of the 188 recipes, and had the books printed locally. What kept us going was hearing from people we met that they suffered from nickel allergies and would love to have a cookbook to use. It’s their stories that motivate us to continue with the business we created called Low Nickel Enterprises and pursue selling the cookbook to those that need it.
Q. In your opinion, what is the biggest challenge (and way to overcome it) for those who suffer from a nickel food allergy?
Personally, I think the biggest challenge today for those who suffer from a nickel food allergy is figuring out what information is helpful and what is misinformation. Just because someone types something on the internet doesn’t mean it was based on research, and those false assumptions can kill someone with a reaction as severe as mine. The main question is how do you sift through it all to find the facts that will help you? Really, the best way to do this is to research, find credible sources, look at the studies, and see if there are multiple studies saying the same thing. Approach any topic with a bit of skepticism, and make sure if it is a food you want to try that’s supposedly low in nickel, that you take a small dose during a low nickel week (a time when you haven’t been eating moderation foods). Nickel allergies need more research, and if we can spread the word that there is such a thing, maybe more people will take the initiative to do that research.
Q. What tips do you have for dining out with a nickel allergy or going to friend's homes for meals and other social gatherings?
The biggest issue with dining out is that you don’t know everything that is in your food. That can be dangerous for someone with a nickel food allergy, and that meal you thought was low nickel could be your last. Nickel allergies are so tricky that it is not safe to eat out or to eat meals at social gatherings. The safest thing you can do is to make your own food and bring it with you. Only eat from what you brought, and watch that it doesn’t get cross contaminated. Even the most well meaning relative can still get the cooking process wrong and raise the nickel level, and it’s the person with the nickel allergy that will suffer.
Q. When faced with an unfamiliar (yet delicious looking) food and unable to determine any easy resource regarding its nickel content, are there any safe ways to "test" the food to see if it can be safely consumed?
The problem with nickel food allergies is that some people can have a low tolerance and others a high tolerance, making it easier for someone with a high tolerance to do what I’m proposing. If you have a high tolerance, and you’ve been eating low nickel foods (so the level in your body is low), then it would be fine to take a small nibble of the food and wait about 10 minutes to see if you react. You need to know your body and how you react so you know when you’re reacting. For me, my first sign when it’s a less severe reaction is that my sinuses on my face start to swell and fill. So, if I start to get the sniffles, I know it’s too high in nickel. If you’re fine after the 10 minutes, you can proceed to take a little more and wait. Then try a little more, and wait. Of course, with nickel allergies, you need to remember the motto “Everything in moderation.” Eventually there is a point where it will be too much, and your body will react. This is the same process they use sometimes at the allergist’s office, and seems to be safer. Of course, for someone like me with a low tolerance, it’s a gamble whenever you do this. When I had the imitation almond flavoring, I only had a couple of drops in the batter mixture for four waffles, and after two bites, my tongue swelled up. You just have to debate whether the food you’re trying to add into your diet is worth the risk. For me, it’s safest to just pass it up.
Q. The no/low nickel diet creates some serious challenges when trying to get complete nutrition - especially for vegans and vegetarians. For those who don't consume animal meat or milk, especially those who do so for moral and ethical reasons, making animal products completely not an option for them, do you have any nutritional tips?
The thing to remember about nickel allergies is that it is a restrictive diet to begin with. I have trouble myself with getting the proper amount of nutrition into my diet. Protein tends to be an issue since it’s almost entirely restricted to animal products and byproducts. Iron is hard to get since most leafy greens are out, and even taking nutritional supplements like I’ve had to, are not always enough. You need to balance in your diet different vitamins and minerals, and some of the vegan and vegetarian options are too high in nickel to do. I would highly recommend talking to a nutritionist to find out which foods you could go heavier with that are also a low nickel food. For vegetarians, I would suggest going heavy on the milk and egg products, since those are some of the only foods that have a nickel level of 0. They are freebies, which means you can eat as much as you like without having your nickel level go up. The only other foods that we found are like this are beer and wine, not exactly the healthiest of foods. There are some foods that I’ve personally added because they are vitamin superfoods, such as a kiwi a day. It gives me so much extra vitamin a, c, and potassium that they’re worth eating often. Make sure you don’t ignore your nutrition when going on a restrictive diet.
**Note from interviewer: eggplant and mushroom can be substituted for meat in the recipes and also have a nickel score of 0. For more on the health benefits of eggplant, click here. For more on the health benefits of mushrooms, click here. You can also substitute vegetable oil for butter, rice milk for dairy milk, and applesauce for the eggs when baking. Apples also have a nickel score of 0.**
Q. Do you have any positive or funny stories to share relating to the making of cookbook and/or its publication?
Well, my mom would always get on my case about taking a picture and writing down the recipe whenever I’d make something new. This would happen frequently, and my answer would always be, “Well, I didn’t do that yet because I was hungry. I ate it!” I’d always have to remake the recipe a second time to make it so we had SOMETHING to put into the cookbook. The funny thing was that I would purposely not do this with a few I really liked, so I’d have the excuse of making it over and over and over again so I could eat more of it. Let’s just say the custard recipe is now a complete perfection. The other funny one was when we were doing multiple recipes in the same day, and would have to take a hard look at the pictures afterwards to figure out which recipe it was from. I know my mom will never let me live it down, but some of our recipes came about by accident. I tried to make some scones, not realizing they should be thicker than how I was making them. After baking, we realized my mistake and ended up with a cookie instead. Tasty, but a complete accident. Sometimes things turn out different from what you expect, but it tastes just as good.
Q. We know you're a nickel allergy sufferer, however, we also know you're a lot more than just your allergy! You're a daughter, a self-taught cook, and the co-author with your mom of perhaps the world's only cookbook for those who suffer from nickel allergies. Can you tell us a little more about you, Charity, aside from your nickel allergy?
To start with, I love to travel. I lived in Japan for a year, the best time of my life, and saw so many unique and extraordinary things. I went to France during my college years for a month with a family from Germany. Since I was studying French, it was great to really experience the culture first hand and see things like the stones of Carnac, the palace of Versailles, and the Eiffel Tower. After I was in Alaska, I went on a vacation by myself for a month and a week in Europe, spending time in Ireland, Scotland, England, and Wales. It was a great time, and easy enough to cook in youth hostels. You meet a lot of different travelers in those places. I’m an avid reader and love my home library of over 1,000 books, especially when I get to read my picture books to kids. I also like to write and am slowly putting together a fiction ebook novel based in disaster and suspense that I hope to eventually publish. I’m an aunt to my newly born nephew this past year, and have enjoyed spending time with him. I like to draw and paint, and have dabbled in gardening (trying to overcome my black thumb). I’m hopelessly addicted to tv shows, but find the time to get out and go for a walk or bike ride around town. I’m in the process of taking the leap into home ownership for the first time, and should be in my new home by the end of May. And, most importantly, I love strawberries. ;)
Q. Last but not least, what does the phrase "Ethical Is Beautiful. Be Beautiful" mean to you?
A person with a nickel allergy should focus on being healthy for them. If you feel better, then you look better, and you will be better.
Q. Can you tell readers a little about your background and what inspired you to write a cookbook for those who suffer from nickel allergies?
To start with, I’ve moved a lot over the years. I lived in Canada when I was little, in a town that had a nickel mine. We moved to Wisconsin when I started elementary school and I was your typical kid. I had my ears pierced when I was old enough, and that’s when we found out for sure I had a nickel allergy. I had to wear jewelry that was nickel free so I wouldn’t rash. I had other issues that didn’t come out until we were researching nickel foods and reactions to them. I thought it was normal for everyone since it was normal to me. For instance, my mouth would get ripped apart whenever I’d eat chips. I would get blisters that would burst as I ate, and I’d have skin hanging down in my mouth. We lived in Pennsylvania and a few more places in Wisconsin, where I got my degree in teaching. It was during my college years when things started going horribly wrong. I reacted to my tetanus booster, finding out it was the suspension I had a problem with. I can’t have another one of those or I could die. I had my first severe allergic reaction. My throat was swelling up and my mom had to hold my head back to get an airway while the ambulance came. It took two hours to stabilize me, and about a month before I could walk without getting winded and tired. I had two more severe allergic reactions after that, to what seemed like completely different food items. The allergist couldn’t figure it out, but required me to carry two epipens because the reaction was so severe. When I graduated from college, I went to Japan to teach English and French to high schoolers for a year. I had a reaction the second night I was there in Tokyo. They debated whether they should send me home or not, but I made it through the reaction and stayed. I had two more severe reactions while in Japan, which led to my decision to leave when the year was up. We still couldn’t figure out my allergy and I was risking death every time. I had several more before moving to Alaska to teach in a remote village along the Alaskan Highway. I taught a multigrade classroom for four years, and it seemed like I would always get very sick. I didn’t have another severe allergic reaction until the last year I was there, but it was a bad one. I was in Fairbanks when it happened and had to drive myself to the hospital (about 5 minutes away, luckily). I went for allergy testing again, and this time the allergist suggested that I look into a nickel allergy since all the foods I reacted to were high in nickel. For the first time, I had answers, and was tested for a nickel allergy. The patch test showed a severe reaction to nickel, leeching over to the ones around it. I also found out I’m allergic to gold at the same time. The allergist gave me a list of forty foods, both good and bad, to follow. With my reaction being so severe, I wanted to avoid high nickel foods and be safe, but a small list like that doesn’t give you a whole lot of options. After days of poking around the internet and finding contradictory lists, I decided to go research-based. I went to the FDA website, which had tested 300 foods and their nickel levels. When I cross referenced it to what the allergist had given me and found the range to look at, I started compiling a list of foods to eat, moderate, and avoid. I had to eliminate quite a few foods from my diet, and it wasn’t perfect. I had another severe allergic reaction that year, and I was not close to a hospital. My tongue was so swollen I was choking. I had to stab myself with an epipen, then a few more times along the 56 mile drive to the hospital. Apparently Jelly Beans are out. The main problem with my type of allergy is that it’s continuous, meaning when the medication wears off, I go back into it until what is setting it off (the nickel in my system) goes back to normal. This can take days, and makes it trickier to treat. I moved to North Dakota to teach second grade in the oil fields. I researched as much as I could on my allergy to live normally, and discovered there is very little out there in way of recipes. My mom and I started creating recipes so I could figure out how to use things like rice flour without it becoming a disaster. The gluten free recipes didn’t help much because a lot of ingredients used in gluten free products are high in nickel. Through my trial and error with the list, I had more severe allergic reactions, one of which to artificial almond flavoring that swelled my tongue up. I had been given some emergency prednisone pills (they help with swelling) and Benadryl from my allergist to stop these reactions faster so I don’t die. I took them, but didn’t realize how high a dose the pills were. I started swelling again the next day when they wore off, so I took another one, and another half pill the day after. Well, it was too much, and they had to catch me at the ER as I collapsed from a tachycardia. What a lot of people don’t realize is that some of the medications you take for these reactions can be just as serious as the reaction themselves, and you have to be careful when taking them. After a year in North Dakota, I decided to move back to Wisconsin to be closer to family and to seriously start work on The Nickel Allergy Cookbook. We had enough recipes that we were coming up with to make a cookbook, and since there is nothing out there for nickel sufferers, decided to publish it so there was. It took two years to kitchen test all the recipes and to put together the cookbook. We took our own pictures for each of the 188 recipes, and had the books printed locally. What kept us going was hearing from people we met that they suffered from nickel allergies and would love to have a cookbook to use. It’s their stories that motivate us to continue with the business we created called Low Nickel Enterprises and pursue selling the cookbook to those that need it.
Q. In your opinion, what is the biggest challenge (and way to overcome it) for those who suffer from a nickel food allergy?
Personally, I think the biggest challenge today for those who suffer from a nickel food allergy is figuring out what information is helpful and what is misinformation. Just because someone types something on the internet doesn’t mean it was based on research, and those false assumptions can kill someone with a reaction as severe as mine. The main question is how do you sift through it all to find the facts that will help you? Really, the best way to do this is to research, find credible sources, look at the studies, and see if there are multiple studies saying the same thing. Approach any topic with a bit of skepticism, and make sure if it is a food you want to try that’s supposedly low in nickel, that you take a small dose during a low nickel week (a time when you haven’t been eating moderation foods). Nickel allergies need more research, and if we can spread the word that there is such a thing, maybe more people will take the initiative to do that research.
Q. What tips do you have for dining out with a nickel allergy or going to friend's homes for meals and other social gatherings?
The biggest issue with dining out is that you don’t know everything that is in your food. That can be dangerous for someone with a nickel food allergy, and that meal you thought was low nickel could be your last. Nickel allergies are so tricky that it is not safe to eat out or to eat meals at social gatherings. The safest thing you can do is to make your own food and bring it with you. Only eat from what you brought, and watch that it doesn’t get cross contaminated. Even the most well meaning relative can still get the cooking process wrong and raise the nickel level, and it’s the person with the nickel allergy that will suffer.
Q. When faced with an unfamiliar (yet delicious looking) food and unable to determine any easy resource regarding its nickel content, are there any safe ways to "test" the food to see if it can be safely consumed?
The problem with nickel food allergies is that some people can have a low tolerance and others a high tolerance, making it easier for someone with a high tolerance to do what I’m proposing. If you have a high tolerance, and you’ve been eating low nickel foods (so the level in your body is low), then it would be fine to take a small nibble of the food and wait about 10 minutes to see if you react. You need to know your body and how you react so you know when you’re reacting. For me, my first sign when it’s a less severe reaction is that my sinuses on my face start to swell and fill. So, if I start to get the sniffles, I know it’s too high in nickel. If you’re fine after the 10 minutes, you can proceed to take a little more and wait. Then try a little more, and wait. Of course, with nickel allergies, you need to remember the motto “Everything in moderation.” Eventually there is a point where it will be too much, and your body will react. This is the same process they use sometimes at the allergist’s office, and seems to be safer. Of course, for someone like me with a low tolerance, it’s a gamble whenever you do this. When I had the imitation almond flavoring, I only had a couple of drops in the batter mixture for four waffles, and after two bites, my tongue swelled up. You just have to debate whether the food you’re trying to add into your diet is worth the risk. For me, it’s safest to just pass it up.
Q. The no/low nickel diet creates some serious challenges when trying to get complete nutrition - especially for vegans and vegetarians. For those who don't consume animal meat or milk, especially those who do so for moral and ethical reasons, making animal products completely not an option for them, do you have any nutritional tips?
The thing to remember about nickel allergies is that it is a restrictive diet to begin with. I have trouble myself with getting the proper amount of nutrition into my diet. Protein tends to be an issue since it’s almost entirely restricted to animal products and byproducts. Iron is hard to get since most leafy greens are out, and even taking nutritional supplements like I’ve had to, are not always enough. You need to balance in your diet different vitamins and minerals, and some of the vegan and vegetarian options are too high in nickel to do. I would highly recommend talking to a nutritionist to find out which foods you could go heavier with that are also a low nickel food. For vegetarians, I would suggest going heavy on the milk and egg products, since those are some of the only foods that have a nickel level of 0. They are freebies, which means you can eat as much as you like without having your nickel level go up. The only other foods that we found are like this are beer and wine, not exactly the healthiest of foods. There are some foods that I’ve personally added because they are vitamin superfoods, such as a kiwi a day. It gives me so much extra vitamin a, c, and potassium that they’re worth eating often. Make sure you don’t ignore your nutrition when going on a restrictive diet.
**Note from interviewer: eggplant and mushroom can be substituted for meat in the recipes and also have a nickel score of 0. For more on the health benefits of eggplant, click here. For more on the health benefits of mushrooms, click here. You can also substitute vegetable oil for butter, rice milk for dairy milk, and applesauce for the eggs when baking. Apples also have a nickel score of 0.**
Q. Do you have any positive or funny stories to share relating to the making of cookbook and/or its publication?
Well, my mom would always get on my case about taking a picture and writing down the recipe whenever I’d make something new. This would happen frequently, and my answer would always be, “Well, I didn’t do that yet because I was hungry. I ate it!” I’d always have to remake the recipe a second time to make it so we had SOMETHING to put into the cookbook. The funny thing was that I would purposely not do this with a few I really liked, so I’d have the excuse of making it over and over and over again so I could eat more of it. Let’s just say the custard recipe is now a complete perfection. The other funny one was when we were doing multiple recipes in the same day, and would have to take a hard look at the pictures afterwards to figure out which recipe it was from. I know my mom will never let me live it down, but some of our recipes came about by accident. I tried to make some scones, not realizing they should be thicker than how I was making them. After baking, we realized my mistake and ended up with a cookie instead. Tasty, but a complete accident. Sometimes things turn out different from what you expect, but it tastes just as good.
Q. We know you're a nickel allergy sufferer, however, we also know you're a lot more than just your allergy! You're a daughter, a self-taught cook, and the co-author with your mom of perhaps the world's only cookbook for those who suffer from nickel allergies. Can you tell us a little more about you, Charity, aside from your nickel allergy?
To start with, I love to travel. I lived in Japan for a year, the best time of my life, and saw so many unique and extraordinary things. I went to France during my college years for a month with a family from Germany. Since I was studying French, it was great to really experience the culture first hand and see things like the stones of Carnac, the palace of Versailles, and the Eiffel Tower. After I was in Alaska, I went on a vacation by myself for a month and a week in Europe, spending time in Ireland, Scotland, England, and Wales. It was a great time, and easy enough to cook in youth hostels. You meet a lot of different travelers in those places. I’m an avid reader and love my home library of over 1,000 books, especially when I get to read my picture books to kids. I also like to write and am slowly putting together a fiction ebook novel based in disaster and suspense that I hope to eventually publish. I’m an aunt to my newly born nephew this past year, and have enjoyed spending time with him. I like to draw and paint, and have dabbled in gardening (trying to overcome my black thumb). I’m hopelessly addicted to tv shows, but find the time to get out and go for a walk or bike ride around town. I’m in the process of taking the leap into home ownership for the first time, and should be in my new home by the end of May. And, most importantly, I love strawberries. ;)
Q. Last but not least, what does the phrase "Ethical Is Beautiful. Be Beautiful" mean to you?
A person with a nickel allergy should focus on being healthy for them. If you feel better, then you look better, and you will be better.
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