On Sunday mornings, Curt Boger and his family used to return home from church for a brunch that included favorites such as eggs, bacon and French toast. Boger, a computer programmer, husband and father of two, never thought that this simple family tradition could one day land him in the local emergency room.

Now, years after a diagnosis of food allergies to eggs and mushrooms, Boger knows that a brunch like this could do just that.

Prior to his diagnosis, Boger had no known allergies and had never known a family member or friend with food allergies. So the diagnosis came as a shock. But with the advice of his doctor and the continued support of his family, he's been able to educate himself, manage his allergy and cope with the anxiety that often comes with it.

"Mr. Boger manages his allergy well because he has a good understanding of it," says James Li, M.D., a specialist in allergies, asthma and immunology at Mayo Clinic, Rochester, Minn. "He asks good questions, follows his doctor's advice and manages the risks of his condition so that he can lead a normal and productive life."

VIDEO

• Living with food allergies

Food allergies are the body's immune response to a specific food or component of food. They affect up to approximately 2 percent of the adult population, but for those who have them, the problem is potentially serious. Common signs and symptoms include hives, itching, swelling, wheezing, abdominal pain, diarrhea, nausea and dizziness.

Food allergies are not the same thing as food intolerances. Food intolerances don't involve the immune system and the release of histamine. Food intolerances are much more common than food allergies, but because many of the symptoms are the same, it can be difficult to tell which condition you have. A doctor certified by The American Board of Allergy & Immunology can help you determine whether you have an allergy or an intolerance.

A severe allergic reaction to food may lead to a life-threatening condition called anaphylactic shock, in which the airways constrict and blood pressure drops dramatically, causing lightheadedness, difficulty breathing or even unconsciousness or death.

Boger describes this condition as a feeling of impending doom, a feeling he's experienced several times over the last few years.

Many foods can cause a food allergy, but the most common culprits are peanuts, tree nuts, fish, milk, eggs and shellfish — especially shrimp.

Eggs, mushrooms and rice cause problems for Boger.

One day while doing some work in his basement, Boger looked down and saw his hands swell and hives appear. His skin was red and itchy, and he could feel himself puffing up as his nose, ears and lips began to swell. Then breathing became difficult.

"My initial reaction was not knowing what in the world was going on," says Boger. "I'd never experienced an allergic reaction." Boger says he didn't take it very seriously at first. He had no idea that he was having a life-threatening anaphylactic reaction.

Fortunately for Boger, his wife, Lynn, was home and took him to the emergency room.

Boger doesn't remember what it was he ate that set off his first reaction. What he does remember is arriving at the hospital and sitting in a wheelchair as he slipped in and out of consciousness.

When he regained full consciousness, Boger was told he'd had an allergic reaction. He'd been given antihistamines to slow the reaction, a shot of adrenaline (epinephrine) to raise his falling blood pressure — a result of the anaphylaxis, and corticosteroids to reduce the swelling. He spent several hours in the ER and was sent home that evening with the advice that he should see his doctor.

Boger did see his doctor, but the doctor couldn't identify what had caused his reaction. He suggested Boger see an allergist and advised him to keep track of what he was eating, in case his reaction had been to food.

During the 4 to 6 weeks following his first attack, Boger had one or two minor reactions a week, which included hives, diarrhea and abdominal cramping. He noticed that many of these reactions took place on Sundays — the only day of the week he ate eggs.

This period was a stressful time for Boger. He wasn't sure what had caused his severe reaction and was concerned that it might happen again.

He went to an allergist, hoping to find some answers. The allergy tests indicated what he suspected — he was allergic to eggs. He was also allergic to mushrooms.

His doctor advised him not to eat anything that contained these foods and gave him epinephrine to inject in his leg should another severe reaction occur.

"If someone believes he or she has a food allergy, it's important to be evaluated carefully by a doctor," says Dr. Li. "With a consultation and allergy tests, the doctor can take steps to establish how severe the problem is and what the person really needs to avoid, as well as give the individual instructions on how to plan for and react when reactions occur."

The next 6 months weren't easy for Boger. He hadn't had allergies before, so he didn't believe he really had them. Adjusting was difficult.

"At first it was denial," says Boger. "I stopped eating eggs on Sunday, but … I didn't stop ... having mayonnaise on a sandwich, for example, or going out to a restaurant and eating anything I wanted."

"Although some people with food allergies are overly cautious, avoiding many foods they actually don't need to avoid, some individuals aren't concerned enough," says Dr. Li. "They may experiment with different foods or eat whatever they want when going out, which can be dangerous."

Boger soon realized that his casual attitude toward managing his condition wasn't going to work.

"About 6 months after he had his first reaction, he woke up at 4 in the morning with another really severe reaction," says Boger's wife, Lynn. "I think that probably was the turning point."

During this reaction, Boger injected the epinephrine for the first time and again went to a nearby emergency room.

"It finally came to the point where I had to get more serious about it, or I (knew) I would be continually in the emergency room," he says.

For Boger, getting more serious about it meant that he and his wife focused on educating themselves on food allergies by reading books, searching the Internet and signing up to receive information from The Food Allergy and Anaphylaxis Network.

Learning about the condition helped them feel more comfortable with what to look for, gave them an idea of what potential problems there might be and lessened their anxiety about future reactions.

"There are a … lot of books out there that are not only informative about the allergies but also (informative about) cooking — how to cook without eggs, how to avoid certain things that don't sound like eggs on the label but are (egg byproducts)," says Boger. "For example, one of them is … albumin … the other is lecithin."

Lynn Boger explains that her husband's diagnosis created a lot of anxiety about causing another severe reaction. "The way I dealt with it was trying to find a way to make it better … to find out so much information about it (the allergy) … and to be more in control of it," she says.

Both Curt and Lynn Boger say that an important part of educating themselves was discovering that others had the condition, and that they weren't alone.

Curt Boger decided to carefully read labels and eat only food that was prepared at home until he could feel more comfortable managing his allergy.

"I went for many months without any reactions at all," says Boger. "And that's when I realized that that's what I had to do — and it was worth doing it at the time."

As he's learned more about his allergy, Boger is more comfortable with managing it. He knows what to look for on labels, is gradually eating out more often and occasionally travels. He knows he can do these things if he does them right:

• Reading labels. Because his allergies are so specific, Boger knows he's safe with most fruits and vegetables. Bread is usually OK, too. When buying anything prepackaged, Boger carefully reads the labels for anything containing egg, lecithin — soy lecithin is OK — albumin, rice or mushroom. If the ingredient list is too long, he just chooses something else. "Over time we've come to know which things are potential problems and which things aren't," says Boger.

• Eating out. When going out to eat at a restaurant or a friend's home, Boger calls ahead to ask about the ingredients in certain dishes or asks when he arrives. He makes sure that what he's eating hasn' t been contaminated. For instance, Boger knows that ordering pizza generally is unsafe, because though he might not order mushrooms, mushroom protein may find its way onto his pizza if the person preparing it handled mushrooms before handling his ingredients.

• Traveling. When traveling, Boger generally brings along food that's safe for him to eat. He chooses places where he can prepare his own food. Planning ahead is key. He makes sure he has access to food he can eat and brings along the necessary antihistamines and epinephrine.

Boger also has less anxiety about severe reactions now that he's gotten a sense of how to judge the severity of his reactions. He has a plan in place for what to do should a reaction be severe.

Although everyone's experiences differ, when Boger has a reaction to food, the progression of his reactions is fairly predictable. "Cramping and diarrhea are the first thing I experience," Boger says.

In his most severe reactions, Boger explains that at the same time he has cramping and diarrhea, he becomes flushed, notices hives on his arms and experiences swelling in his face, nose, mouth, lips and ears. A rapid heartbeat is another sign that lets Boger know he's experiencing a severe reaction and is going into anaphylactic shock.

When Boger feels a severe reaction occurring, he tells someone immediately and calls for an ambulance. He takes antihistamines to slow the reaction and injects himself with the epinephrine he's been prescribed, to slow the progression of anaphylactic shock.

Boger and his wife have also taught their oldest son, Timothy, what to do in the event of a severe reaction, in case he's the only one with his father.

When asked how his food allergy affects his quality of life, Boger says that it really hasn't affected it much. "Now that I've managed it (the allergy), and I've come to the realization that it's something that is going to be with me, I can treat it," says Boger. "I have my medications … the ERs know what to do about it … and knowing that my diet is safe relieves my mind quite a bit."