Month: October 2025

Managing A Flare-Up from Fish Poisoning

Flare-ups are a common occurrence with Mast Cell Activation Syndrome (MCAS) – triggers (such as food or chemical intolerance) can exacerbate existing symptoms of immune hyperactivity or be a catalyst for new symptoms to occur.  Managing these flare-ups is a constant challenge for someone like me who has MCAS, as their occurrence is often unpredictable and, sometimes, confounding.

Creating a story from a single object or event

At our October Creative Meetup, an online group for writers-with-chronic-illness, we were introduced to the idea of writing a story from an object.  Our facilitator, Jennifer Crystal, showed a video of Billy Collins reading his poem, Lanyard, as an example of how this is done.

The idea of focusing on an event or object is also illustrated by Melissa Febos in her book, The Dry Season, a memoir about her conscious choice of twelve months of celibacy after a tempestuous time of cyclical relationships that proved to be harmful to her health and self-esteem.  In particular, she focused on her “maelstrom”, a two-year toxic relationship with another woman that proved to be controlling and destructive and was the catalyst for her chosen period of celibacy. 

Throughout her memoir, Melissa revisits this event (story object) to highlight its impact and to serve as a benchmark against which to evaluate other potential relationships.  Her period of celibacy was designed to provide sufficient distance from the maelstrom to facilitate self-insight, overcome her fear, find herself again (having suffered from “the-need-to-please”) and to achieve peace with her experience of the maelstrom.

Creating my story of a recent flare-up

At our Creative Meetup, we were encouraged to write our own story using one or both of the following prompts:

  1. Make a list of five prompts you associate with your story. Pick one and write about it (poetry or prose) OR
  2. Write something (poetry or prose) that includes all five objects.

I chose to address the second prompt and drafted a poem around the five objects I identified that were associated with my recent flare-up:

fish, hives, rash, poisoning, pain

The poem that I have included at the end of this post is the outcome of my writing and reflection as well as the group sharing and discussion that occurred during the Meetup session.  Participants shared their writing and their vulnerability in stunning prose and poetry (given they had only 20 minutes to write their story). 

A flare-up from fish poisoning

My story began with having Red Emperor, a wild-caught fish, for dinner. I am allergic to soy so I avoid farmed fish that are typically fed on soy products.  I thought it would be safe to eat the Red Emperor as it is not farmed but wild caught in deep waters such as those off the coast in Northern Australia.

What I experienced, however, is an immediate reaction to the Red Emperor (unlike previously where I had eaten it without negative consequences).  My body reacted strongly this time – resulting in a bright red rash on both upper arms, accompanied by itchy hives and a burning sensation on my affected skin as well as night sweating and headache. 

This led me to do personal research on “fish allergy”.  What I established is that there are two major forms of fish poisoning:

  • ciguatera poisoning
  • scombroid, also known as histamine poisoning.

My first thought was that I had experienced histamine poisoning given histamine intolerance stemming from my MCAS chronic illness.  However, on further research, I established that the reaction is more likely to be caused by ciguatera poisoning.  The symptoms of each form of fish poisoning are similar but the causes differ substantially; a distinctive symptom of ciguatera poisoning is “extreme itchiness” which was my experience. 

Histamine poisoning is caused by bacteria developing on dead fish that have been stored ineffectively (e.g. not deep frozen or stored on ice).  Ciguatera poisoning, in contrast, results from the food chain which commences with small fish eating marine toxin produced by algae in reefs and being consumed by larger reef fish which are then consumed by humans.

Ciguatera poisoning is more common in fish that live in warm waters and “spend some or most of their time in reefs”.  Red Emperor is explicitly implicated in carrying this form of fish poisoning.  Freezing, cooking or cleaning do not destroy the ciguatera toxins.  The presence of ciguatera toxins are not visually detectable, nor can allergy to the toxin be detected by allergy testing.  

Recovery from ciguatera poisoning

A disturbing fact is that ciguatera poisoning symptoms can recur without further exposure to a poisoning source.  The likelihood of symptom recurrence is increased by drinking alcohol.   Recommendations for recovery include avoiding fish for at least 6 months and abstaining from alcohol for 3 months after eating the toxic fish.

A detailed article on ciguatera poisoning in the National Library of Medicine maintains that relapses in symptoms “may be triggered by consuming alcohol, nuts, seeds, fish, chicken, and eggs”.  The authors advise that “patients should be counselled to avoid fish, caffeine, alcohol, and nuts within 6 months of poisoning”.

The itch and burning sensation from ciguatera poisoning made it difficult to sleep despite the use of Dexeryl – “an emollient cream that reduces irritation, itching and scratching”.  Eventually, I had to resort to using Eleuphrat, a type of Cortisone cream, to reduce the itch and pain and enable me to sleep.

I have had a series of flare-ups since the initial contamination after eating Red Emperor.  The first was following a glass of wine; the second after eating a salmon and avocado sushi roll.  Others involve accidental consumption of egg or chicken.  Research has shown that farmed salmon, typically used in sushi, can lead to ciguatera poisoning because of toxins in the fish food. 

One of the problems associated with fish poisoning is that you can tolerate a particular type of fish at one point and yet at a later time react severely to eating it, sometimes with fatal consequences.  For example, a newspaper report recounted the case of a father-to-be who collapsed after eating barramundi at a restaurant and died five days later in hospital.  He had experienced tingling in his mouth a few years before when eating barramundi.  A Victorian health website identifies barramundi as one of the more common causes of fish allergy.

Reflection

It is easy to jump to a conclusion re the cause of symptoms without undertaking the necessary research and/or seeking medical advice.  The problem of accurate diagnosis of symptoms is compounded by cross-contamination and the commonality of symptoms (e.g. hives and rash) among various food allergies. 

For example, consumption of coffee can cause a rash and itchy hives resulting from histamine poisoning caused by impurities in coffee such as  “molds, mycotoxins, pesticide residues, yeasts, and other biogenic amines”.  Purity Coffee seeks to provide quality coffee beans and a coffee process to avoid these issues and enable people with MCAS and histamine intolerance to have their regular coffee.

We can be more mindful of the factors influencing our symptoms if we take time to research and reflect on our findings and related experiences.  As we grow in mindfulness, we can become more self-aware and conscious of what is impacting our body and develop creative ways of achieving recovery from ill-health.

I developed the following poem In reflecting on my experience with ciguatera poisoning:

The Flare-Up

Flaring up like a campfire flame,
fighting feverishly a toxic invader.

Redness spreading across swollen ridges,
a painful path of itch and burning sensations.

Awash in a sea of marine toxins,
overwhelmed by a challenged immune system.

Elimination diet a testing time,
complex interactions of food and drink.

Seeking answers through research and inquiry,
wild caught fish traced as the trigger.

Unanswered questions,
uncertain future,
unpredictable outcomes.

Where is my anchor?

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This post is provided for information purposes only and is not intended to replace personal medical advice provided by a trained medical practitioner.  Please seek advice from a qualified professional before deciding on treatments for yourself or other members of your family.  This article reflects my personal patient experience – MCAS and related diseases affect each individual differently.  I frequently share my research findings with my medical practitioner and this informs my treatment.

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Image by Thomas from Pixabay

By Ron Passfield- Copyright (Creative Commons license, Attribution-Non-Commercial -No Derivatives.

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Finding Stability and Predictability in Times of Uncertainty

In the previous blog post, I discussed a UCLA talk by Bhanu Joy Harrison on the topic of Unpredictability and Adapting.  Bahnu emphasised our constant mind-body search for stability and predictability despite continuously encountering uncertainty in our personal lives as well as the world at large. She maintained that we are constantly seeking “an island of coherence in a sea of chaos”. 

The reference to “islands of coherence” is based on the work of Nobel prize winning chemist, Ilya Prigogine, who stated that when systems move away from equilibrium and create chaos, “small islands of coherence” can “shift the entire system to a higher order”.  When applied to our inner world, this concept relates to our capacity through interconnectedness to develop stability and predictability that, in turn, provides us with “strength, calm and groundedness”.

Bhanu maintained in her UCLA podcast that mindfulness practices are a way for us to create our own “islands of coherence”.   On the InsightTimer website, she offers a range of guided meditations on topics such as slowing down, getting unstuck and managing anxiety.  During her podcast, she also  provided a guided meditation on supporting ourselves by creating “islands of coherence”.

Guided meditation – providing support and groundedness

Throughout the guided meditation, Bhanu encouraged us to trust our support. As a starting point, this trusting involved letting our chair support us by enabling our weight to sink into the chair. While being conscious of this support, we can let our mind focus on the power of gravity to hold our posture in place (not allowing us to fly into the air but to stay grounded on the earth).  We can sense the “grounding effect of gravity” on our body.

While being conscious of this groundedness, we can notice what is happening in our body – a slowing of our breathing, loosening of our muscles and bodily tension.  The aim is to drop from our brain into our bodies like dropping an anchor “into the bottom of a lake”.

If we want to contain ourselves bodily we can give ourselves a hug – placing our left hand on our right shoulder and then reversing the process.  Alternatively, we can “feel the solid edges of our body” by squeezing along the length of our arms.  I often found that joining the fingers of both hands together can have this grounding effect as I feel the sensations pulsing through them.

Bhanu reminded us  that “our body holds so much”, including the visceral imprint of trauma.  She suggested that one way to calm the body and mind is to hold our head with two hands – one holding the base of the skull while the other holds the forehead.   Again, she encouraged us to notice any change in bodily sensations, our emotions and our mental activity. 

Bhanu then suggested that we focus on our legs because our legs help us to carry a lot of weight embedded in our torso from the “intensity of life”.  Our body, especially our torso, is activated by stress and being aware of this activation through our legs can “help spread out that activation”.  In particular, exercises such as pressing our feet into the ground (together or alternating) and squeezing down our legs with our hands, can serve to reduce the activation in our torso by spreading the load.  Squeezing down our arms can have a similar positive effect.

Working with the predictable – breathing

Bhanu suggests that when we are overwhelmed by the unpredictable, in whatever form it takes, we can focus on the “predictable” things in our life.  A key element of this strategy is to focus on our breath because “our body knows how to breathe”, no matter what is going on in our life.  Mindful breathing is an important aspect of mindfulness practice and there are many ways to achieve this re-focusing.  James Nestor, for example, promotes intentional breathing as a path to improved health and longevity.

We can breathe with the earth, engage in lower-belly breathing, or rest in our breathing.  Richard Wolf argues that we can develop deep listening through focusing on our breathing which he calls “the sound of your life”.  He maintains that we can listen to our breath just like a musician listens to music.  He provides a number of ways of doing this including listening to the sound of our breath (the inhalation and exhalation), resting in the silence between breaths and breathing in time.

Mast Cell 360 offers breathing as one of the strategies to de-activate the body’s over-active nervous response to perceived “invaders” (food allergies and, in particular, high histamine foods).  For example, in the masterclass, Mast Cell Nervous System Reboot, the course creator, Beth O’Hara provides examples of  “alternate nostril breathing” as one of the strategies she employed to redress the histamine activation effects of Mast Cell Activation Syndrome (MCAS).  “Resonance breathing” also forms part of her holistic approach to MCAS and histamine intolerance.

Working with the predictable – alternative strategies

In addition to breathing practices, Bhanu offers other strategies that we can easily employ on a day-to-day basis to focus on the predictable and work to de-activate our bodies from the stress effects of the “unpredictable”.  These practices include:

  • focusing on the seasons of the year which are predicable, especially winter and summer whose arrival is often celebrated with special rituals
  • consciously viewing the sunrise and sunset occurring each day
  • observing the emergence of flowers in Spring, the fall of leaves in Autumn (Fall), the shortening of the day in winter and their lengthening in summer
  • noticing the sun rising early in summer and later in winter
  • thinking about the way you are greeted by your children and your dog when you return from work each day
  • observing the millions of stars that appear each night.

Bhanu suggests that these grounding practices can help us to find peace and calm in times of turmoil – they can become our “island of coherence” in the advent of chaos.

Reflection

Chronic illness is often unpredictable and can prove to be complex and difficult to resolve.  The uncertainty about its development and resolution and the lack of help from the medical profession can exacerbate the situation.  Chronic illness too is disruptive, impacting quality of life and self-identity.

The mindfulness practices proposed by Bhanu can help to manage chronic illness.  As we grow in mindfulness, we can better regulate our emotions, draw inspiration from people who have mastered their debilitating situation, and find creative ways to address our own limitations and constraints.

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Image by Kanenori from Pixabay

By Ron Passfield- Copyright (Creative Commons license, Attribution-Non-Commercial -No Derivatives.

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.