On a cloudy afternoon in October, tennis coach Les Smith came to our home in New Jersey to pick up my 16-year-old son Josh. The coach and his players will soon be on the road, heading to Delaware to participate in the U.S. Tennis Association National Championship. Tennis is Josh's hobby. He worked hard in the game, was talented, and became competitive in the National Youth Tour. However, he also has a severe peanut allergy, which makes him more diligent in a sport that requires traveling to participate in competitions.

Coach Rice and his players will leave from Friday to Monday afternoon. I calculated in my mind: Josh would eat 11 meals and countless snacks without any input from my husband or me.

I let Les come in for a few minutes, then took him to a table with two grapefruits and a bunch of expired epinephrine auto-injectors on the table. Les needs to confidently use an auto-injector to treat allergic reactions in order to prevent a reaction, and understand how it feels to inject adrenaline into the thigh. This is a good exercise and Les is very happy to see that neither Auvi-Q nor EpiPen have large needles.

I am glad that the coach is now more familiar with auto-injectors. Les also has a copy of Josh's anaphylaxis emergency plan and knows the symptoms of the reaction.

However, it is the easy part to train the instructor on the correct auto-injector technique. As a parent, the most difficult part for me is to transfer control of allergy management to someone else.

Although Josh lives under our roof, my husband and I have taken steps to protect his safety. We taught him to read the ingredient label, advocated for him in school, and we ensure that he always carries his auto-injector with him and knows how to use it. But I know that when Josh no longer lives in our house, he will need to know how to protect and defend himself. It was crucial to transfer food allergy management to him when he was a teenager, but of course it was a process-for both of us.

In a competitive tennis game, Josh faced some challenges from the beginning because of food allergies. 

Our son participated in his first USTA Intermediate Championship when he was 8 years old. We were on vacation in Florida and the games were all outside, starting at 8 am on a hot and humid day. At noon, everyone walked into the club to watch a professional tennis match on TV. It seemed like a good place to rest-until I saw the big bowl full of peanut M&M.

All players' hands are in that bowl. Those were the days before the COVID, and everyone would shake hands after the game. I forgot to bring wet wipes. I grabbed Josh, let's go buy some. Then we sat in our parked car until his next game. I never forgot the wipes again.

Josh's first USTA National Championship was held in Rochester, New York. Our 13-year-old son unfortunately got the No. 1 seed in the first game. To cheer up Josh after losing, my husband took him to a local ice cream shop.

In the consolation game not long after, our son started to react. The score was 4-3. The opponent told my husband that Josh started coughing, then he played less forcefully, and then said on his knees that he had difficulty breathing. Although the ice cream they ordered is peanut-free, we think there is a cross-contact.

My husband treated Josh immediately and took him to the emergency room, only five minutes away from the game. Josh was observed and released a few hours later. Although the incident ended well, this is a valuable lesson my husband and Josh will never forget. There is always a problem of cross-contact when eating snacks in unfamiliar food stores when going out.

In another game, I saw a player eating the biggest peanut can I have ever seen between games. Josh wants me to keep him in the club until his next game. I was horrified, but he assured me that he would be fine. He reminded me that he would choose peanut butter at lunch every day at school.

The normal teenage years are full of peer pressure and risk-taking behavior. When it comes to food allergies, research has shown that teenagers and young adults with this disease are at the highest risk for fatal food-induced allergic reactions. The important thing is that Josh has established a network of friends on and off the court, who are highly aware of and support his food allergies.

I will never forget to hear his 14-year-old friend Nate say to a player who has just eaten peanuts: "Man, you have to wash your hands, Josh is allergic to peanuts." That player was about to play a game with Josh. Eavesdropping in a corner, my eyes are full of tears.

We have learned that there is always a "Tennis Go" package. Wet wipes, food, medicine are all inside. Perishable food is always put in a freezer lunch bag, because sometimes the game will last until late at night, trying to find a safe restaurant after get off work is a difficult task.

When traveling by plane or driving overnight, we have a different "tennis walk" bag with some important accessories. For example, I make pancakes, freeze them and put them in a freezer lunch bag. In our destination, they can be easily heated for breakfast. We bring more perishable snacks, safe desserts, microwaveable macaroni and cheese, and nut-free protein bars for those who are on the go between games.

To ensure success, I conducted serious research before traveling. I tried flying JetBlue because they have a written peanut allergy policy, but they will not fly to all locations. I have also had success with Delta Air Lines, United Airlines and Alaska Airlines. After choosing an airline, if possible, I will choose the earliest direct flight of the day. I make sure to indicate food allergies when booking, and we always remind the gate staff when checking in. We board the flight early (all passengers with food allergies have the right) and clean the seating area (to prevent residues)-then put a seat cover on Josh's seat. We also require an allergy PA announcement when possible.

Our family is very careful about hotels; we only choose rooms with microwaves and refrigerators. Sometimes, we rent an apartment with a full kitchen. Josh likes Jersey Mike's, a restaurant chain with branches in many states. We will look for one close to the destination, but will still ask questions about cross-contact, just in case the other exit does things differently. We also call restaurants in advance, so we know in advance whether they can handle peanut allergies.

Over time, Josh learned that Mom and Dad had designed a food allergy "script" that needed to be followed carefully to ensure that he stayed away from home. We hope that the script becomes second nature like playing tennis. Over time, we have seen Josh become more and more aware of how to protect his own safety. When he entered high school, he began to ask if he could go to play tennis with his coach. To be honest, we were reluctant for a while.

Last summer, Josh qualified for the USTA National Championship in Michigan. Coach Les accompanied Josh and my husband. We thought this was the first step and showed Les the steps we took when flying and eating with our allergic son. After all, the situation in the air far from the medical institution is very different from the situation on the ground. As the main advocate for the rights of passengers with food allergies, I know that airlines do not have to carry auto-injectors, and flight attendants do not have mandatory training on food allergies.

On the flight to Michigan, my husband was able to show Les how we boarded the plane early, cleaned the seating area, and never ate airline food. The restaurant was vetted in advance and a safe chain sandwich location was also discovered.

When the USTA National Championship was announced in Delaware in early October, my husband and I clashed. Josh asked: Can he go alone with the coach? Realizing that we must let the 16-year-old Josh take control of his safety, we said "yes".

The long weekend was a huge success. Josh finished sixth in singles. Then he and his doubles partner Giuseppe won the 16-year-old doubles match. After this game, Josh is currently ranked in the top ten in doubles matches of the same age group in the United States.

His coach told me that he was "proud of Josh's performance on and off the court." Music in my mother's ear. He mentioned how easy Josh is to get along with and how he talks about his food allergies in restaurants. He told me that Josh asked all the right questions about cross-contamination. I am proud of Josh, and he is also proud of himself.

The college age is in the near future. I am still nervous about Josh managing his food allergies without us. However, this trip with his coach gave me an optimistic understanding of how Josh will deal with his food allergies in the future.

Lianne Mandelbaum is the founder of NoNutTraveler.com, a website advocating the rights of passengers with food allergies.

Related Reading: Adventurous and Allergic Teens-What I Learned DOT Warning American Airlines: The rights of food allergic families are violated at 30,000 feet, why can't we count on the adrenaline vials on the plane

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