What if a simple trip to a restaurant or a pastry from a bakery could pose a threat to your life?

For 15-year-old Ariella Nelson of Mercer Island, this scenario is an everyday reality. The Lakeside High School sophomore has had a tree nut allergy since she was a small child.

Hazlenuts, almonds, walnuts and cashews can prove deadly for Ariella if she is not quickly given a shot from an EpiPen. Everywhere she goes, Ariella must carry around this injection of epinephrine, which opens up airways in the lungs when her throat starts to swell in an allergic reaction. Coughing, choking and a swollen face are all signs that a reaction is happening and that getting to a hospital is crucial.

The allergy has impacted Ariella every day of her childhood and youth. On a school trip to London, Ariella wrote down 14 instances when she had to watch her classmates eat foods that she couldn’t have. Her parents later made up for this with 14 safe treats.

“She was the girl who had to bring her own cupcake to the party or who can’t eat when treats are brought to the classroom,” said Ariella’s mother, Melissa Nelson.

Even on a routine sleepover at a friend’s house, the friend’s parents must be equipped with an EpiPen just in case the worst happens. Reacting badly to a food and going to the emergency room have become common occurrences for Ariella.

This is especially a concern when traveling; unfamiliar restaurants and bakeries can be a danger, especially when waiters cannot say for sure that cross contamination has not occurred.

“Name a city, she’s probably been in the ER there,” Melissa said.

After a particularly bad reaction in September 2016, Ariella and her family decided enough was enough. Ariella’s grandmother found a clinical research trial at Stanford University that aims to help people with tree nut allergies become desensitized to nuts. Ariella flew down to California and in January 2017 began the study that would transform her life.

“It was amazing that her profile fit what they were doing at Stanford,” Melissa said. “It’s been a very difficult year, but well worth it.”

Paradoxically, to cure herself of her nut allergy (or at least, to get it to a much more manageable stage), Ariella must ingest pieces of hazlenuts, walnuts, cashews and almonds every night, as if she were taking pills.

It is not just a matter of eating the nuts, however; Ariella has a strict regimen of actions she must follow before and after taking the nuts. She can’t go to sleep for an hour after eating them, must be monitored for two hours and cannot raise her body temperature for 45 minutes before and two hours after taking her dose. This means that exercise, hot showers and going outside on a hot day are all no-nos. Her mother said that it’s not an exaggeration to say that Ariella has had to plan her entire life around taking her doses of nuts.

“It was the main focus of my whole year … It’s very difficult to schedule everything around having these nuts,” Ariella described.

Despite these extra challenges, Ariella has still scored straight As and taken part in tap, ballet and show choir.

“People don’t realize how difficult it was to do this on top of everything else she does … You have to be very motivated to do a program like this. Your body is trying to figure out how to function with this poison,” Melissa said.

When Ariella heard the theme of this year’s Washington state Parent Teacher Alliance’s Reflections contest, “Within Reach,” she knew right away what the theme of her entry would be — “Reaching for Health,” a story of her journey to desensitize herself to tree nuts.

“It’s good to tell people about … even though it takes so much of my life, friends wouldn’t know unless I told them,” Ariella said. “The theme was perfect for getting the word out there.”

The Reflections contest allows artistically-minded students throughout Washington to show their skills in visual arts, photography, literature, music composition, dance choreography and film production. Ariella created a five-minute video telling her story, from being diagnosed with the allergy as a young girl to taking part in the trial. Through family photos and her own drawings, Ariella outlined her entire journey in detail.

Ariella’s dedication and creativity paid off; “Reaching for Health” won “Outstanding Interpretation” in film production.

Melissa and Ariella both praised Reflections for the opportunities it gives students who are not athletes. In comparison with high school football, volleyball and basketball players, Melissa said that artistic high schoolers are left out of the limelight.

“It’s a thrill and such a blessing for someone like Ariella, who has been doing artistic endeavors her whole life,” Melissa said. “For her to have the opportunity to shine … at the end of her program was very personal to her.”

As for the future, Ariella will have to take the doses of nuts every day for the rest of her life. And while this does not mean that she can seek out nutty foods, she can go to restaurants and order what she wants without having to be worried about cross-contamination.

“I’m so thankful it’s working because sticking to a rigid schedule is much better than having to worry every time I eat a cupcake,” Ariella said.

And it comes at the perfect time — like other 15-year-olds, Ariella is preparing in the coming years to get her driver’s license, go off to college and grow in independence.

“It’s great to know I won’t have to worry about this on my own.”