Is it safe to cruise on RCCL if you have fatally severe food allergies?

[NewSalt]

I just wanted to post a slight clarification. EVERY allergy is "potentially fatal." A person can have a mild reaction to an allergen for 10, 20, 30 years and then the next exposure can trigger a severe anaphylactic reaction.

 

Every person with allergies needs to be as cautious as the OP is being.

[BND]

FYI, Shrimp is also in the Shellfish category. I ate shrimp for the first time in my 20s, and broke out in hives everywhere. Eyes and nose swelled shut, etc. The allergist warned me to avoid shellfish completely for the rest of my life, because a second exposure could be fatal!

 

I have lived with this allergy for over 50 years, and I am still fearful of accidentally being exposed. So far I have been incredibly lucky. Your nieces should also stay away from anything that might have been deep fried in the same oil as shrimp - (a common practice in many seafood restaurants).

 

I also had shrimp for the first time when I was 19, but I didn't have any reaction until the second time I ate it. Fortunately, mine is gastrointestinal which appears to be more an intolerance than a true allergy, but I avoid all seafood. That said, I rarely mention it and I've only gotten sick when I've actually eaten a couple of pieces. I'm the only one in my family with the issue. We think it's probably related to iodine and the amount. I can eat iodized salt with no problem, but it's at much higher concentrations in seafood. It's also something I always mention to Dr's as there can be medication/test issues.

 

My friend's daughter who is 7 just had an allergic reaction to pistachios. She had never had them before that my friend knew, which I find interesting because they are in a lot of foods/snacks. Anyway, she had hives, etc so now she has an epi pen and is learning a lot, including the fact that pistachios are related to cashews and mangoes. Now, she has to be very careful what her daughter eats.

 

Severe allergies are scary, but the headwaiter and medical staff are well versed as they see many special needs cruisers every week.

[marci22]

Whenever someone has severe allergies, it is a risk no matter where you eat out. That being said, on land, once they get you to a hospital quickly, there are many medical professionals and plenty of equipment to assist you. If someone cannot intubate you during an emergency, they can ask for assistance.

 

On a ship, there is one doctor? 2? If that person has a problem intubating you, or is inexperienced with severe allergic reactions, or just doesn't get to you in time, your risk of a bad outcome increases. And that would be true with any critical condition.

 

Personally, I would not cruise with a severe medical condition. Plenty of people do it and are fine. It a matter of managing your own personal risk.

[NewSalt]

Whenever someone has severe allergies, it is a risk no matter where you eat out. That being said, on land, once they get you to a hospital quickly, there are many medical professionals and plenty of equipment to assist you. If someone cannot intubate you during an emergency, they can ask for assistance.

 

On a ship, there is one doctor? 2? If that person has a problem intubating you, or is inexperienced with severe allergic reactions, or just doesn't get to you in time, your risk of a bad outcome increases. And that would be true with any critical condition.

 

Personally, I would not cruise with a severe medical condition. Plenty of people do it and are fine. It a matter of managing your own personal risk.

 

 

Are you giving this information based on your own experience? I was on Princess two months ago and came down with the flu and one of the friends traveling with us injured himself. Between us we saw three doctors and several PA's.

 

With an allergic reaction, time is of the essence. Medical help is minutes away on a ship. On land you can be thirty or forty minutes away from a hospital. Your help is much more likely to be in the form of EMT's in an ambulance unit.

[kusuriurikun]

If they don't trust restaurants on land I don't think a cruise is a good choice for them.

 

This.

 

My main concerns would be:

 

a) Cross-contamination risk, especially if they are sufficiently allergic that airborne/non-ingestion contact can cause a reaction. Unlike on land, your husband can't exactly "allergy clear" the ship's kitchen beforehand (and apparently it's a serious enough risk that you don't eat out unless your husband can vouch for their allergen safety).

 

b) If the kids manage to get a hold of something causing anaphylactic shock. On land, you can at least give the kids an Epipen (or similar epinephrine pen) which buys you time to get a medevac helicopter or ambulance to get the kid to the nearest emergency room.

 

The clinic on a ship is not as well staffed as an urgent care facility--it's more the equivalent of the "take care clinics" you see in drugstores or in groceries--and do not really have much equipment for even basic life support other than the automatic defibrillator machines (of the sort often seen in malls). In addition, evacuation from a ship is not trivial, it is expensive (even more so than air medevac), has longer transit times than on shore to the nearest facilities with advanced life support, and cruises outside of Alaskan or European cruises tend to be to ports where medical staff even in hospitals may not be as experienced in treatment of advanced anaphylactic shock.

 

c) In addition--and I'm surprised only one person mentioned this--it's not just the cruise you may have to worry about; you may need to worry about how to get to the cruise port safely. At least where I live (which is sufficiently far from ocean ports that unless I plan 14+ hours of driving any cruise is going to involve at least one if not two flights) I'd not recommend a cruise or even extended air travel to parents with severely allergic kids--there's the aircraft (which often serves peanuts as a snack and which you'll need to notify), the food courts, etc. etc. (At least in THOSE cases it may be easier to get to a hospital in a worst case scenario, unless there's an in-flight emergency.) If you can drive, this might not be as worrisome, though.

 

(And yes, there are people with legume/peanut allergies of sufficient severity that they can't even go on the "Peanut free" flights and almost all public transportation is off limits. Yes, a ship is public transportation, though very, very nice public transportation with quite a bit of food service and a lovely view...)

[dcgrumpy]

You know that's a great question. It's one that's been on my mind as I'm in the process of being tested for a brand new allergy, and I'm the new owner of epipens etc (just in case). They say "if you use the epipen, then call 911", but they haven't told me what the ER will do.

 

Looked at medscape and mayoclinic (and skimmed others) and I see: oxygen, IV, antihistamines, epinephrine, albuterol, steroids. Just making a guess here...I would expect that the ship's medical office would have those. I would also assume that just about any hospital in the Bahamas would have them. Those are pretty basic!

 

I've had to go to the ER twice with my daughter after using an epi-pen. They gave her antihistamines and steroids and then hooked her up to a heart monitor for 3-4 hours.

[knittinggirl]

Pecans and walnuts are both tree nuts. The term tree nuts is used to differentiate them from peanuts, which are legumes.

 

Love your screen name by the way. :D

I asked about almonds, pine nuts and hazelnuts, and was told to avoid those as well, even though I haven't had a reaction to them. There are also cashews, which I can eat w/o reaction. Don't understand why I would be told (without looking at my chart) to avoid them . They don't look or taste anything like pecans.

[dcgrumpy]

I asked about almonds, pine nuts and hazelnuts, and was told to avoid those as well, even though I haven't had a reaction to them. There are also cashews, which I can eat w/o reaction. Don't understand why I would be told (without looking at my chart) to avoid them . They don't look or taste anything like pecans.

 

Because if you have an allergy to one tree nut you have a much higher chance of being allergic to other tree nuts. And allergies often get worse. So many doctors feel it's not worth taking chance. When my daughter was tested she scored very low for almonds, but her doctor still said he thought it was best to avoid all tree nuts.

 

The first time she had a reaction to a pistachio it was so mild we didn't even realize she was having a reaction. We just thought she didn't like it. The next time though, she had a severe reaction.

Edited October 16, 2015 by dcgrumpy

[knittinggirl]

This.

 

My main concerns would be:

 

a) Cross-contamination risk, especially if they are sufficiently allergic that airborne/non-ingestion contact can cause a reaction. Unlike on land, your husband can't exactly "allergy clear" the ship's kitchen beforehand (and apparently it's a serious enough risk that you don't eat out unless your husband can vouch for their allergen safety).

 

b) If the kids manage to get a hold of something causing anaphylactic shock. On land, you can at least give the kids an Epipen (or similar epinephrine pen) which buys you time to get a medevac helicopter or ambulance to get the kid to the nearest emergency room.

 

The clinic on a ship is not as well staffed as an urgent care facility--it's more the equivalent of the "take care clinics" you see in drugstores or in groceries--and do not really have much equipment for even basic life support other than the automatic defibrillator machines (of the sort often seen in malls). In addition, evacuation from a ship is not trivial, it is expensive (even more so than air medevac), has longer transit times than on shore to the nearest facilities with advanced life support, and cruises outside of Alaskan or European cruises tend to be to ports where medical staff even in hospitals may not be as experienced in treatment of advanced anaphylactic shock.

 

c) In addition--and I'm surprised only one person mentioned this--it's not just the cruise you may have to worry about; you may need to worry about how to get to the cruise port safely. At least where I live (which is sufficiently far from ocean ports that unless I plan 14+ hours of driving any cruise is going to involve at least one if not two flights) I'd not recommend a cruise or even extended air travel to parents with severely allergic kids--there's the aircraft (which often serves peanuts as a snack and which you'll need to notify), the food courts, etc. etc. (At least in THOSE cases it may be easier to get to a hospital in a worst case scenario, unless there's an in-flight emergency.) If you can drive, this might not be as worrisome, though.

 

(And yes, there are people with legume/peanut allergies of sufficient severity that they can't even go on the "Peanut free" flights and almost all public transportation is off limits. Yes, a ship is public transportation, though very, very nice public transportation with quite a bit of food service and a lovely view...)

I had a nasty rash and visited medical on Legend. The doctor said that it would take two weeks to run a test, and he didn't have anything stronger than what we brought w/ us (clobetesal). I still think I got something on my hands from all the norovirus cleaning, and touched my neck. I was hoping they would be able to tell our cabin steward to use something else.

 

The other time, I needed a thumb brace/stabilizer, since I left mine in a bathroom on a shore excursion. They had a wrist brace, but not a thumb brace. These days, I take extra thumb braces on my trips.

 

But, they're wonderful at treating norovirus. The times I've come down with it, they didn't even charge for treatment!

[GuavaTechAngels]

My sister doesn't have an account on here but she's read everyone's replies and is thankful for your input. So, I didn't know this but got some details on how severe the girls' allergies are. Their allergist said they scored 100+ for peanuts. The allergist said they probably scored higher but the test only measures up to 100.

[knittinggirl]

My sister doesn't have an account on here but she's read everyone's replies and is thankful for your input. So, I didn't know this but got some details on how severe the girls' allergies are. Their allergist said they scored 100+ for peanuts. The allergist said they probably scored higher but the test only measures up to 100.

THey must use a different rating system. When I tested for allergies by the doctor, they had me on a 4 point system, with 4+ being the highest. Pecans was around a 3. These days, it's peanuts only, and I hate it! Doctors should give out immunotherapy for the foods. The nurse told me to avoid pecans, because insurance won't cover food immunotherapy. That's what the poor man thought he was doing when he bit in to a s-more w/ a peanut butter cup. A friend of mine bit into a croissant thinking it was sweet, not savory and ended in the ER.

[Grandma Petania]

Thank you for the tips Grandma Petania!

I felt it was important to point out the dangers of eating food like french fries that could be contaminated by oil, or even a single frying pan, that had previously been used for shellfish.

How did you manage on RCCL ships during lobster night in the MDR?

I ate lobster only once - in my 20s. I didn't have a noticeable allergic reaction, but I also thought it was a lot of fuss over something that wasn't particularly "special" to my taste buds. After the bad reaction to shrimp (which I also didn't find particularly tasty), I decided not to risk any shellfish. I eat just about every kind of fish. Our family tried to go vegan, and then vegetarian, but two of us weren't getting enough protein, because they didn't like the beans and such that could provide the protein. Now we eat many meatless "meat" substitutes, plus fish 2 or 3 times a week, so I guess we are officially pescetarians. Emotionally I don't want to eat chicken, beef, pork or lamb. However, I do allow myself the occasional steak or pork chop when on a cruise.

 

Lobster night in the MDR wasn't a problem for me. There were always other entrees that appealed to me. (Others in the family chowed down on lobster and shrimp whenever they were offered.) In the past five years we have sailed three times on Oasis, and we have had the same waitress every night. She was such a delight the first time that we requested her as our waitress the other two cruises, and were lucky enough that she was available. She knew from the get-go that I was highly allergic to shellfish, so she made sure my food didn't get contaminated.

[brillohead]

This.

 

My main concerns would be:

 

b) If the kids manage to get a hold of something causing anaphylactic shock. On land, you can at least give the kids an Epipen (or similar epinephrine pen) which buys you time to get a medevac helicopter or ambulance to get the kid to the nearest emergency room.

 

The clinic on a ship is not as well staffed as an urgent care facility--it's more the equivalent of the "take care clinics" you see in drugstores or in groceries--and do not really have much equipment for even basic life support other than the automatic defibrillator machines (of the sort often seen in malls). In addition, evacuation from a ship is not trivial, it is expensive (even more so than air medevac), has longer transit times than on shore to the nearest facilities with advanced life support, and cruises outside of Alaskan or European cruises tend to be to ports where medical staff even in hospitals may not be as experienced in treatment of advanced anaphylactic shock.

 

STOP LYING!

 

Or at least stop talking about things you know ABSOLUTELY NOTHING about.

 

 

 

I don't consider a VENTILATOR to be the equivalent of a mall's defibrillator. Same with a complete arsenal of ACLS medications, blood transfusion equipment, pharmacy stocked with thousands of drugs, digital x-ray equipment, etc.

 

 

 

[Kricktor]

I am deathly allergic to shellfish and tree nuts. The MDR handled my allergies very well. I had my two epi pens and was just fine. However, with the multiple allergies it might be challenging. I was personally fine.... But I don't know about risking what you've listed. MDR is the bomb with accommodations.

[Diplomacy]

I have two beautiful nieces who are 4 & 6. The older one has fatally high food allergy reactions to:

 

Peanuts

Eggs

Soy

Shellfish (no lobster or crab)

Tree Nuts

 

Her younger sister has the same level of sever food allergies to:

 

Eggs

Shellfish (no lobster or crab)

Tree Nuts

 

I did a search and read some posts about people taking their food allergic kids on cruises in the past. We were thinking of taking a cruise during Thanksgiving of 2016 on the Harmony of the Seas.

 

Is it safe for them?

 

You can get epinephrine administered onboard, but you will be a minimum of 6hrs from real hospital care. I doubt the ship's doctor is in a position to intubate...EDIT: I stand corrected.

The majority of the kitchens on board any ship DO use eggs and shellfish.

Edited October 17, 2015 by Diplomacy

[Diplomacy]

STOP LYING!

 

Or at least stop talking about things you know ABSOLUTELY NOTHING about.

 

 

The RCCL doctor's staff is horribly inefficient.

I'm sure they are great in an emergency, but I agree with the other guy. Took me 20 minutes just to get an ace bandage that I proceeded to wrap my own injured ankle(glad I knew first aid). I asked for a dozen so that I wouldn't run out and be forced to wait again...

 

But again, i'm sure they would drop their paperwork, or their knitting, and attend to a little girl in anaphylactic shock.

Edited October 17, 2015 by Diplomacy

[reallyitsmema]

The RCCL doctor's staff is horribly inefficient.

I'm sure they are great in an emergency, but I agree with the other guy. Took me 20 minutes just to get an ace bandage that I proceeded to wrap my own injured ankle(glad I knew first aid). I asked for a dozen so that I wouldn't run out and be forced to wait again...

 

But again, i'm sure they would drop their paperwork, or their knitting, and attend to a little girl in anaphylactic shock.

 

Why would anyone need a dozen ace bandages to wrap an injured ankle?:confused:

[Diplomacy]

Why would anyone need a dozen ace bandages to wrap an injured ankle?:confused:

Because it was a 30 day cruise, and I wanted to wrap it more than once?

 

Might have liked a doctor to take a look at it too, but as I said, everyone was "busy" doing "things," and there was a line out the door.

Edited October 17, 2015 by Diplomacy

[brillohead]

Why would anyone need a dozen ace bandages to wrap an injured ankle?:confused:

 

Because anyone who is a Very Special Snowflake is too good to wash and reuse an elastic bandage, and surely a sprained ankle will take months and months to heal. :rolleyes:

[reallyitsmema]

Because it was a 30 day cruise, and I wanted to wrap it more than once?

 

Might have liked a doctor to take a look at it too, but as I said, everyone was "busy" doing "things," and there was a line out the door.

 

Just like in an ER, priority is given to those who have a more serious problem. Plus, a twenty minute wait is nothing, you can wait more than that for a doctor you actually have an appointment with sometimes.

[Diplomacy]

Just like in an ER, priority is given to those who have a more serious problem.

No, in an ER, a nurse checks you in immediately, and assesses the severity of the problem. On the ship, that procedure was not followed.

 

Plus, a twenty minute wait is nothing

 

kindof my point. they are the definition of inefficient. 20 minutes just to get a nurse's attention is unacceptable.

 

Because anyone who is a Very Special Snowflake is too good to wash and reuse an elastic bandage, and surely a sprained ankle will take months and months to heal.

 

The cheap bandages they use are not reusable(and are also very bad at providing compression)... and yes, my ankle did take well over a month to heal. Clearly you have never had a serious sprain.

Edited October 17, 2015 by Diplomacy

[mollyeilis]

I've had to go to the ER twice with my daughter after using an epi-pen. They gave her antihistamines and steroids and then hooked her up to a heart monitor for 3-4 hours.

 

Yay! Thanks for the actual information as to what was done. So...antihistamines and steroids. Both in the list from Mayo.

 

 

 

I am not asking "what does the ER do" in order to avoid the ER. I'm trying to get information, really GOOD information, for the OP (and for me, to set expectations should it come to pass that I actually am allergic to the silliest thing ever (zucchini) and someday accidentally have zucchini bread), to find out WHAT is done, and IF the ship's staff have those things.

 

 

 

I don't consider a VENTILATOR to be the equivalent of a mall's defibrillator. Same with a complete arsenal of ACLS medications, blood transfusion equipment, pharmacy stocked with thousands of drugs, digital x-ray equipment, etc.

 

Is there a chance you could list out what the ship's doctor's office has? What sorts of (relevant to this conversation) drugs? Like do they have steroids, antihistamines, etc? Do they have heart monitoring equipment?

 

I didn't watch the youtube link; I rarely do. But could you list it out?

 

 

 

Because it was a 30 day cruise, and I wanted to wrap it more than once?

 

Might have liked a doctor to take a look at it too, but as I said, everyone was "busy" doing "things," and there was a line out the door.

 

I've never used more than one ACE bandage on anything that needed to be wrapped. If it gets gross, you wash it and use it again.

 

If I hurt myself and wanted a better bandage, at the next port I'd get off and find a pharmacy/drugstore/etc and buy one.

 

A line out the door means they were busy. A 20 minute wait for a hurt ankle is AMAZINGLY GOOD service.

 

 

No, in an ER, a nurse checks you in immediately, and assesses the severity of the problem. On the ship, that procedure was not followed.

 

 

 

kindof my point. they are the definition of inefficient. 20 minutes just to get a nurse's attention is unacceptable.

 

 

ONLY when someone is coming into the ER by ambulance are they checked over anywhere NEAR immediately by a nurse. At least at the many ERs I've been to since knowing my MIL. And even with an ambulance the EMTs here take their sweet time with the actual *helping*, and then we have always gotten to the hospital well before the ambulance does.

 

Since they haven't yet done anything for her IN the ambulance and it takes longer for the ambulance to get her to the ER than we do, we've started just taking her. The only delay is that she isn't coming in the ambulance entrance, but they can generally see that there's a huge problem, and she jumps the line.

 

The line of people out the door, because they are there because they feel sick, have a splinter, hurt their wrists, etc.

 

I once sat at an ER at the age of 11 with the end of my finger taken off, with the nail hanging on by almost nothing, bleeding (and I had been bleeding at home for an hour while my mom got to work, was notified by our neighbor that I'd had an accident at home, and go back home to take me to the ER) just waiting for my turn to come. My mom said I was as pale as a ghost by the time I was seen because I had lost so much blood. But there were more-injured people in front of me.

 

That's a busy ER for you! Too busy worrying about things that could kill you in a minute vs 5 minutes vs 10 minutes vs 5 hours vs not-likely-to-kill-you-at-all.

[NewSalt]

I walked in the door of the medical facility on board and the person at reception asked me why I was there. I too waited about 15-20 minutes, but a cough doesn't require immediate attention, unlike anaphylactic shock.

 

You're much more likely to receive immediate care on board a ship than you are on land, where you have to wait for an ambulance to arrive. It is my understanding that in treating an allergic reaction, prompt care is more important than more sophisticated equipment.

[brillohead]

Is there a chance you could list out what the ship's doctor's office has? What sorts of (relevant to this conversation) drugs? Like do they have steroids, antihistamines, etc? Do they have heart monitoring equipment?

 

I didn't watch the youtube link; I rarely do. But could you list it out?

 

If you don't have medical training, then me listing all the possible medications isn't going to do you any good. But yes, they have a wide variety of steroids, antihistamine, and cardiac drugs.

 

If you're too busy to watch the whole video (which lasts less than three minutes), just watch this part and you can see the vast shelves of drugs available in their pharmacy (this link goes directly to the part about the pharmacy):

 

 

 

And yes, in addition to doing a 12-lead ECG/EKG (what you call a heart monitor), they can also do blood tests for cardiac enzymes to diagnose/rule out a myocardial infarction (heart attack).

 

The

is two minutes and fifty seconds, and I think you will have most of your concerns about the professionalism and equipment availability on RCI's ships addressed if you simply watch the video, which would be much faster than typing out multiple questions and waiting for multiple responses.

[Diplomacy]

A line out the door means they were busy.

It's easy to look busy when you aren't actually assisting anyone. Lines have a tendency to grow when you ignore them.

 

20 minutes for a hurt ankle is amazingly good.

No, not 20 minutes for a hurt ankle, 20 minutes to say "I need an elastic bandage for my ankle" and receive a bandage. 20 minutes to say 4 words to anyone.

 

ONLY when someone is coming into the ER by ambulance are they checked over anywhere NEAR immediately by a nurse.

I find it interesting that you admit that the concept of triage is a thing, and yet you seem to think it is accomplished through some form of sorcery, or perhaps it's a triage yourself system of some kind?

 

Either that or you are being intentionally moronic, for some reason. Makes you feel less pathetic if you can criticize others from behind a keyboard?

Edited October 17, 2015 by Diplomacy