Tag: Allergies

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epi-pen

A great visual explanation of how to administer an epi-pen to someone experiencing severe anaphylaxis as a result of a food allergy, bee sting, etc. Plus commentary from Tumblr.

I’ll add: Absolutely don’t be squeamish if someone needs you to do this for them. Once I accidentally bounced the epi-pen off my leg when I jabbed myself with it during a severe reaction. You need to jab and hold it. Basically none of the medicine actually went in. Fortunately I carry a two-pack and was able to use the second injector, and I’m still around to tell the story.

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When I was around four years old, I went on a field trip to a park with a pond, and we fed the ducks. Unfortunately the duck food included peanuts. I rubbed my eyes after handling it, and they swelled shut. Fortunately this was long before my food allergies got really bad, so I only had to go into the doctor’s office, not the emergency room.

It might be my oldest memory related to food allergies, though it was something my parents and I already knew about. (I’ve quite literally had this allergy as long as I remember.)

Last month I went with my four-year-old son’s preschool class on a field trip to a park with a pond, and they fed the ducks.

It was a little unnerving!

Nothing happened this time around.

It got me thinking, though. I tried to remember as much as I could about the incident. Since I was so young, I’m not entirely sure how much is first-hand and how much is just remembering the story as it’s been retold. Memory is a tricky thing, nowhere near as accurate or stable as we’d like to think.

I wrote down the fragments I do remember, then asked my parents to tell me what they remembered about it. It was interesting to see what did — and didn’t — line up.

I remember a wide, curved pond, encircled by a wide sidewalk, with dense trees on the far side. The day is overcast, possibly drizzling a bit. A red box sits on a post, a vending machine for the duck food.

My parents are pretty sure it was the Woodbridge neighborhood in Irvine, which has two artificial lakes. The breadth and curvature fit. I’m not so sure about the trees, and the distance across seems too far, but it’s a big enough area that some part of the lake might fit.

My dad also remembers duck food dispensers “like gumball machines” along the shore, so I didn’t make those up.

OTOH, it was a summer day camp, so I’m probably wrong about the jackets and weather…but then I spent most of this week in June gloom, so who knows?

I remember looking at my face in a mirror. Not what I looked like, though I’m told I laughed like it was the most hilarious thing I’d ever seen.

The odd thing is that I picture a wall-mounted mirror on a tile background, but my dad remembers a handheld mirror.

I vaguely recall a crowd of children walking around in jackets, with maybe two or three adults, and the feeling of itchy, swollen eyes.

I didn’t remember the paramedics or my dad taking me to the doctor. Though now I can dredge up a faint memory of a van and an EMT looking at me. I picture an awning connected to a building, like you’d find at the drop-off point of a hospital or entryway of a hotel, with yellowish or off-white walls and glass doors. I’m not sure that location makes sense, though.

And one mystery that had baffled me: Why were there peanuts in the duck food? Was it like trail mix? Was it some sort of pellets with peanut butter as the glue?

It turns out we ran out of food from the dispenser and started tossing in bits of another kid’s peanut butter sandwich.

That’s kind of weird, because this time around, when we stopped for a snack, the child who sat nearest to us had a peanut butter and jelly sandwich.

It’s probably just as well that I made sure not to touch my eyes after helping feed the ducks.

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Teal Pumpkin

The idea behind the Teal Pumpkin Project is to offer alternate Halloween treats that aren’t candy, so that kids with severe food allergies can still go Trick-or-Treating. It started last year in Tennessee, and FARE picked it up and promoted it nationwide this year.

When I was a child, I always had to either decline or discard some of my Halloween candy because of my peanut allergy. Fortunately it wasn’t life-threatening for me at the time (that came later), so I could separate them out at the end of the night. A lot of kids develop severe allergies younger than I did, and a lot of them are sensitive enough that the risk of cross-contact — whether in the candy bowl or at the factory — is a major issue.

So in addition to candy, we picked up an assortment of pencils, plastic dinosaurs, hair ribbons and more, and kept them in a separate tray. We painted a fake pumpkin so we could keep it around (though we’ll have to go over it again with better paint or maybe a coat of primer next year), and set it out front where it could be seen from the street. (Update 2021: You can buy plastic pumpkins in teal from a lot of stores these days!)

I’m not sure how many of the kids who chose the toys over the candy did so because of allergies, but we had enough of both to go around.

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Wow. A study finds that only 54% of patients experiencing an anaphylactic episode requiring an ER visit or hospitalization get an epinephrine prescription within a year, and only 22% visit an allergist or immunologist in that time. (via this week’s FARE newsletter)

The article treats this as an education/compliance issue, but I have two big questions:

  1. How many of these patients discussed the incident with their regular doctor? It’s possible that more than 22% followed up with a doctor, just not with a specialist.
  2. How does insurance coverage correlate? If you don’t have insurance, it’s expensive to see a specialist, and expensive to get an Epi-pen (though there are generics now that are a bit cheaper)…especially after you’ve just received a bill for thousands of dollars for the emergency room.

Regarding #2, the study looked at “healthcare claims,” so if I’m reading that correctly, they may have only looked at people who do have insurance. If that’s the case, I wonder if it would be possible to break it down by type of insurance: HMO vs. PPO, do they charge a higher co-pay for specialists, etc. Our current system could do a lot more to encourage preventative care.

For the record: The first thing I did when I got home from that San Diego trip was to order a replacement Epi-Pen, and Monday morning, I called up my allergist to schedule an appointment. But then, I already had an allergist, a prescription, and insurance.

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Allergic Living has advice on how to respond to a severe allergic reaction, particularly when to administer epinephrine and seek emergency medical treatment.

At first she didn’t show any symptoms and her mother gave her a dose of antihistamine; but in 20 minutes the systemic reaction began. Her father, a physician, gave her three doses of epinephrine, but it wasn’t enough to stop the rapid-fire chain of events. She began vomiting, her throat swelled to the point where she could no longer breathe and she went into cardiac arrest. She died in his arms.

Natalie’s story has spiked fears among Allergic Living’s readers, in particular parents of children and teens with food allergies. It has also raised questions about just what to do in case of an accidental allergen ingestion, so we turned to two experts for answers.

The key takeaway: you can’t always be sure a mild reaction will stay mild, because it takes time for the body to absorb the food. I was fortunate enough to survive learning that lesson, exactly one week before Natalie Giorgi’s death. All I lost was an afternoon and the $200 co-pay for the emergency room. It could have been so much worse.

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I’ve been attending San Diego Comic-Con for more than 20 years, but this was the first time I left the con in an ambulance.

I’m OK now. Though I might not be when I see the bill.

It started at lunchtime. We went to New Break, an independent coffee shop near Ralphs, which we’d been to before. They were offering samples of a blended peanut butter banana coffee drink, and while I really wanted to try their blended mint mocha, it was safer to skip something made on the same equipment.

What I decided on was a Mexican Mocha. Generally, these add cinnamon, maybe nutmeg or chili powder. I’ve had drinks with that and similar names, and Mexican hot chocolate, plenty of times. I didn’t ask what was in it, but I had just told them I was allergic to peanuts when I decided to skip the blended drink.

I considered getting it iced, but there was some confusion as to what was included in the lunch deal, so I got it hot instead. That turned out to be a wise decision, since I probably would have started out chugging a few ounces of a cold drink.

Two sips in, the back of my throat and my lips started tingling — a bad sign. I stopped, flagged over one of the baristas, and asked whether there were any nuts in the drink. She didn’t think so, but said she’d check.

I pulled out my emergency kit, took my Benadryl and Pepcid, and set my Epi-Pen on the table in case it progressed. I probably should have just taken it right then, but who wants to spend the afternoon in the emergency room instead of Comic-Con?

Meanwhile, the coffee shop staff had been unable to find ingredients for the mix, and had to call the owner to confirm that yes, there were peanuts in it.

Great.

Over the next hour, it felt like the reaction was under control, so I figured we could return to the convention center. Unfortunately, anaphylaxis can take several hours to run its course, and medication can wear off before it does. Continue reading →