Arianna Kent
Canada- A Canadian Woman with Winter-Induced Hives
- Challenges of Daily Life
- Constant Vigilance
- Anaphylaxis Risk
- Disbelief and Misconceptions
- Onset and Diagnosis
- Impact on Summer Activities
- Treatment and Prevention
- Workplace Challenges
A Canadian Woman with Winter-Induced Hives
A Rare AllergyAriana Kent, a 21-year-old Edmontonian, Canada, suffers from cold urticaria, a rare medical condition that causes her body to react severely to cold temperatures and sudden temperature changes. She breaks out in a burning, itchy rash; the severity of her symptoms has landed her in the hospital three times in a single month.
Challenges of Daily Life
The cold in Canada, where temperatures can dip to -40 degrees Celsius, makes it difficult for Ariana to live a normal life. Even a short walk to her car can be "potentially life-threatening." She has to bundle up and prepare extensively to withstand the cold for even five minutes, or risk another outbreak. According to the National Organization of Rare Disorders, cold urticaria accounts for 1 to 3 percent of all hives cases. The exact cause of the allergic reaction is unknown.
Constant Vigilance
Ariana estimates she has had thousands of outbreaks, not counting "minor incidents." She has to be on high alert, even when opening the refrigerator or holding a glass with an ice cube. Ice cream is virtually off-limits. "It starts very slowly, with little pin-prick spots on my hands," she explains. "Then they grow in size and number." "The burning and itching on my skin is one thing, but it's the feeling in my throat... it's like getting asthma; you can't breathe and you're wheezing." Ariana describes the sensation during an outbreak as "having something sitting on your chest, pushing down, and tightening."
Anaphylaxis Risk
"I can go into full-blown anaphylaxis," she says, "so I have an EpiPen with me at all times." "It's terrifying when I'm in areas where I don't have access to healthcare and I have my throat swelling up. It's a risk."
Disbelief and Misconceptions
Her condition is so unusual that even medical professionals have been skeptical at times, even when she was at death's door. "You don't hear every day that someone is allergic to the cold," Ariana says. "But it's really hard because people don't believe you and don't understand." The rarity and strangeness of her allergy have led to mockery and even attempts by others to educate her on her own condition. "Even when I was in the hospital trying to explain it to people, I've had professionals look at me like I'm an idiot because they don't understand it," she says.
Onset and Diagnosis
Ariana first experienced an outbreak at age 14 while shoveling snow. She had difficulty breathing and developed "hives that just looked weird." Suspecting a food allergy, it took two more years and an internet search to lead her to the correct diagnosis of cold urticaria. "Going outdoors in the winter is definitely a challenge," she says. "When you live in Alberta, you kind of have to be able to go outside."
Impact on Summer Activities
Ariana's symptoms can be triggered even in the summer by significant temperature changes. A cool breeze or jumping into a pool can set off an outbreak, even in 30-degree heat. "Air conditioners are horrible; we don't get along very well," Ariana says. "Even just trying to cool down a drink, if I put ice in it, there's a chance my fingers will react and swell up." "I can handle not going in a pool that's cold, not having a cold drink, but I can't control when it rains or when it gets chilly outside."
Treatment and Prevention
To alleviate milder outbreaks, Ariana must gradually warm up, "layer by layer." The most severe reactions require the use of an EpiPen. During these episodes, she feels burning in her torso, throat, and up to her face. Once her face "lights up," Ariana knows she is in trouble. "When it's really bad, it takes up to 45 minutes for the swelling in my throat to come to the surface, so it's not as instantaneous as people think," she explains. "But I can definitely feel it; I start wheezing." "Now when I do end up in the hospital, I end up staying for a couple of hours. They give me epinephrine and warm fluids." Ariana's longest hospital stay to date was two days, during which she was under constant observation. Dietary changes have helped her reduce the frequency of hospitalizations to about once a month. Her diet excludes foods high in histamine, a chemical that stimulates the immune system. Ariana avoids cheese, yogurt, cream, cured meats, pineapple, and fermented foods, and relies heavily on a kosher diet.
Workplace Challenges
Ariana, who works in the restaurant industry, has faced criticism from employers who deem her wool cardigans unprofessional for serving customers. "When I'm by the fridge or when there's a draft I break out in hives. That was shocking to management, but eventually they became more understanding."
