You've likely heard the term "oral food challenge" mentioned by your allergist or in online food allergy support groups. But if you haven't, here's a quick primer from the American Academy of Allergy, Asthma and Immunology on oral food challenges:
What is an oral food challenge?
An oral food challenge (OFC), or feeding test, is a medical procedure in which a food is eaten slowly, in gradually increasing amounts, under medical supervision, to accurately diagnose or rule out a true food allergy.
What are the reasons to perform an OFC?
OFCs are usually done when a careful medical history and allergy tests, such as skin and blood tests, are inconclusive. The OFC is a more definitive test because it will show whether the food ingested produces no symptoms or triggers a reaction.
Oral Food Challenge (OFC) Anxiety and Worry:
Given that during oral food challenges you are eating a food that you may potentially be allergic to or have previously been allergic to, it's no surprise that you may feel anxious and worried in anticipation of that appointment - many do. Our mind wants to keep us safe, so an oral food challenge can feel like a potential threat to our mind when we think about it. Therefore, it's normal and appropriate to experience anxiety about oral food challenges. However, it's important to remember that you don't need to interpret that anxiety to mean that the oral food challenge will result in the worst case scenario.
What Helps OFC Anxiety and Worry?
When you experience increased anticipatory anxiety - that is, anxiety about a future event, it can be helpful to prepare for the event in order to to increase readiness and decrease fear.
Here is a brief list of ways to prepare ahead of time for your or your child's oral food challenge:
Additional Resources and Tips to Help Manage OFC Anxiety
Be sure to listen to Episode 14 of Exploring Food Allergy Families called, "Tips for Managing Oral Food Challenge Anxiety & Worry". In this episode, fellow allergy-informed therapist Fawn McNeil-Haber, PhD and I discuss helpful strategies for navigating oral food challenges. We offer preparation tips and guidance on navigating anxiety and mindsets prior to and during the food challenge. Here are specific topics we explore in this episode:
You can listen via your favorite podcast app, including Apple Podcasts, Spotify, and iHeartRadio. Don't forget to subscribe so you don't miss future episodes!
ORAL FOOD CHALLENGE PREPARATION WORKSHEETS:
Download these Oral Food Challenge worksheets which help prepare before the appointment, offer helpful reminders for the day of, and prompts for processing after the food challenge. (There are separate worksheets for kids and teens/adults).
You can find these worksheets below or on the Therapeutic Worksheets page here on the Food Allergy Counselor website.
FAWN McNEIL-HABER'S RESOURCES ON ORAL FOOD CHALLENGES:
Hopefully reading this and checking out the podcast, worksheets and other resources offers you some reassurance that oral food challenge-related anxiety is normal and manageable. Don't hesitate to reach out and let me know if these tips have helped you or your patients, or to share tips of your own! And if you're looking for an allergy-informed therapist in your state (many of whom provide telehealth to residents of their state), visit the Food Allergy Counselor Directory.
You can connect with me on Twitter (@TherapistTamara and @FACounselor), Instagram (@TherapistTamara & @FoodAllergyCounselor) and Facebook (@FoodAllergyCounselor and @TamaraHubbardLCPC).
Thanks for reading!
Note: I'm not an allergist, so this piece should not be taken as medical advice. However, I'm a licensed clinical professional counselor that often works with those managing food allergies, as well as a parent of a child with a food allergy that has taken part in a clinical trial and follow up treatment. I've experienced the feelings that many parents feel while pursuing treatments, but also have the clinical background to know it's important to explore any and all emotions while pursuing food allergy treatments. Please always be sure to communicate all thoughts and feelings with your allergist or treatment team. [Article Updated July 2021]
When we think of pursuing food allergy treatments, hope tends to be the leading emotion. Hope for positive outcomes. Hope that pursuing the treatment will result in the ability to tolerate accidental, small or maybe even large amounts of the allergen. Hope that quality of life will improve once in maintenance.
However, the reality is that food allergy treatments don't always go as planned. With oral immunotherapy (OIT) for instance, some can tolerate doses, while others can't. In cases where OIT doesn't go smoothly, working with your allergist on adjustments, such as changes in dosing amounts, dosing foods, or time of doses may help resolve potential roadblocks.
But SOMETIMES, tweaks and changes don't resolve the issues. Whether it's for medical reasons or due to psychological barriers, sometimes food allergy treatments come to a screeching halt. Therefore, it's no surprise that some of the emotions that may follow this scenario are...
It's these less popular emotions I'd like to explore. I'm fully aware that this piece may be encouraging you to visit thoughts and feelings that may feel better staying put, stuffed down deep inside. While exploring these emotions may make you feel vulnerable and uncomfortable, it's important to process them, as they themselves can create food allergy treatment roadblocks if left unchecked. Read through some of the thoughts and feelings below to help identify if any have been involved in your journey so that you can process them and move forward.
*NOTE: While the content below is helpful in exploring thoughts and feelings, please be sure to always discuss any treatment-related thoughts, feelings, decisions, or potential roadblocks you're experiencing with your allergist or treatment team.*
Guilt may come in two forms: Guilt for not pursuing a food allergy treatment, and guilt for pursuing a food allergy treatment. Let's explore both separately.
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