AJ Buckalew took two bites of his pepperoni pizza and immediately knew something was wrong. He touched his mom’s arm to get her attention.
“Mom, something’s not right,” he said. Irene Buckalew glanced down at his plate in the restaurant.
“Oh my God, it’s regular cheese,” she said. She injected his leg with an EpiPen to try to stop the life-threatening allergic reaction her son has to dairy.
It didn’t take.
The Chesterfield, Missouri, family has been in this situation before, but never at Mellow Mushroom, a pizzeria chain they first tried on vacation after reading positive reviews about it on allergy-friendly restaurant guide Allergy Eats. That was the first time in his life he’d tried pizza at a restaurant. In fact, they’d celebrated AJ’s 13th birthday there a few weeks before, and this was their third visit in two weeks.
“We rarely eat out,” Irene said. “I make everything from scratch all the time.” It’s too risky, given how severe her son’s food allergies are.
Those first pizza outings had gone well.
“I thought it was pretty good,” AJ said of his first slices.
This time was different. AJ got scared when the first shot from the EpiPen didn’t help. He felt his chest tighten. It was getting harder to breathe. He felt flushed. Some hives appeared. He asked his father to call 911, and an ambulance came to take him to the hospital.
The chef told Irene that he had made the pizza with vegan cheese himself. She and AJ left on the ambulance.
“We let our guard down a little bit,” said Irene, who disputes the restaurant’s account.
“We take allergy issues very seriously,” said Chris Deatherage, general manager at the restaurant. They offer gluten-free and vegan pizzas, clean the pizza cutters and use gloves when making them, he said. He spoke to the manager working that night, and says all the proper protocol they have was followed. “We’ve never had an issue like this before,” he said.
Meanwhile, AJ received three more EpiPen injections at the hospital and eventually needed an intravenous epinephrine drip to stop the allergic reaction.
Even when the teen, the parents and the restaurant try to be vigilant and careful, life-threatening mistakes can happen for those navigating the world with severe food allergies. Between 2007 and 2016, treatment of severe food allergy reactions increased by nearly 400 percent, according to data from Food Allergy Research and Education (FARE), a nonprofit that advocates for a more inclusive world for those living with food allergies.
While many people think it’s toddlers and young children who are most at risk when it comes to food allergies, that’s not actually the case, according to Gina Clowes, FARE’s national director of training and outreach. Research shows that teenagers and young adults with food allergies are at the highest risk of fatal food-induced anaphylaxis, she said.
Adolescence is a time of wanting to fit in with peers, and some degree of breaking away from parental rules and testing boundaries. Clowes, who is also raising a teenager with a severe food allergy, says she has learned to prioritize the most important rules, such as never leaving the house without an EpiPen and making sure any friend’s parent has her contact information.
Mistakes can easily happen. There might be recalls on food products, human error or things a teenager might not even think about, such as kissing someone who has eaten something to which they are severely allergic or sharing a vaping product that could trigger an attack.
Irene knows firsthand the stakes attached to the smallest mistakes. When AJ was 10 years old, he ate half of a cupcake that he thought was safe. It turned out to have dairy and egg in it. His mom rushed him to a hospital, where they pumped his stomach, gave him medicines and eventually had to put him on a ventilator for seven or eight hours. He spent two days in the pediatric intensive care unit to recover.
But the newly minted teen rarely complains and says he doesn’t think about his allergies much.
“I try to keep it as not such a big deal,” AJ said. He brings his own food when he goes to sleepovers and parties. He’s learned to trust his own body. Certain parts of childhood that many of us take for granted -- going for ice cream with friends, trick-or-treating on Halloween -- have never been part of his life.
“We’re trying to have him live in this normal world,” his mom said.
But it’s doubtful he’ll try pizza again anytime soon.