MLO Knitting

This just makes me madder and madder:

How Common Are Severe Food Allergies?

Let me start by telling you a story:

Between Christmas and New Year’s I had an infection (which will remain nameless) for which I was taking a cream (also remaining nameless). I had noticed a little light-headedness when applying the cream in the past, but, thought it was related to the pain.

My husband had just taken the dog for a looong walk when I noticed it was time to reapply the cream. I went to the upstairs bathroom where I kept the medication and applied it. I felt very dizzy and sat down putting my head between my legs…

I woke up staring at the toilet paper holder being confused by the sound of running water. “Is the toilet on the fritz? Wait… that doesn’t make sense.” I thought when I noticed the water all around the bathroom floor. I don’t know how long it was before I noticed the toilet tank had been shattered.

I started screaming for help. No one came. I wasn’t really able to move, at first. I calmed down enough to crawl around to the valve to shut off most of the stream of water.

I had been expecting a phone call so had my cell phone on the vanity – but I couldn’t reach it.

I thought I heard my husband and dog return. I screamed again. Ran out of breath. Screamed again. My husband came upstairs to find me trying to lift a peroxide bottle that must have spilled when I fell. To him, it appeared I was pouring peroxide out.

I don’t know how long it took, but he helped me get up to go to our bed. On the way I threw up. I knew then that I was having a severe allergic reaction. I also just wanted to go to sleep. My husband panicked. (He claims otherwise, but who wouldn’t?)

He couldn’t decide whether to call an ambulance or his mom. His mom is an R.N. with over 35 years of experience. She might have an idea of what to do. Just as he was struggling with this, she called. We had left some stuff at her place on Christmas and she was going to stop by to drop it off if it was ok.

Husband, of course, starts telling her what is happening and she instructs him to call an ambulance. Mother-in-Law (MIL) gets there almost immediately. Husband had helped me change out of cold wet jeans into big sweats. MIL just happened to have gotten her new nurse’s bag and takes my blood pressure: 50/70 and falling.

According to MIL I was glassy eyed, looked like I was in diabetic shock – but, a little later we find out my blood sugar was perfect. I thought I was telling them it was an allergy but they tell me that I was non-communicative.

The ambulance arrives. Six, big, burly guys, and 4 short little girls come into our bedroom and start trying to give me an IV. (I have “baby veins” and with FALLING blood pressure, there was nary a vein to be found.) I am screaming everytime they poke me with the needle as, well, my skin was flush and hypersensitive.

They read the medic alert that stated plainly I carried epinephrine with me. They promptly ignored it.

They asked my husband if I was ok to move. My husband, not a medical professional.

They finally get me on the gurney – after finally giving up on giving me an IV – to begin bumping me around. I throw up again. Of course, it probably didn’t help matters that it was the four short women who were carrying me.

I tell them I need to throw up BEFORE we get to the stairs and they ignore me. I, thinking their incompetent, sit up on the way down and throw up. They yell at me to lie back down. At some point during this I start claiming the untruth that I can walk by myself. (I was feeling like a bumper car.)

Finally, they get me into the ambulance where they do the blood sugar test and find my blood sugar is just fine. I know I was asking for epinephrine. Well, I thought I was.

My husband tells me that the ambulance driver (Star Ambulance) asked him how to get to the hospital. We are a straight shot to the hospital and if you know our area at all, you will know this.

I threw up again on the way there.

I get to the ER and am alone with a nurse trainee for a very short time before my husband is with me – or was that after – but before long my MIL was there. Thank goodness she was a surgical nurse in her time.

At some point they gave me oxygen. Honestly, I don’t really remember this. I just remember at some point it was irritating my ear and I wanted it out from the back of my ear. But noticing that came later. I think I was on oxygen at this point.

The young ER physician at Pontiac Osteopathic came up and started going prattling on about nonsense as far as I was concerned. I kept telling him it was an allergic reaction. He actually said the following:

“Syncope is not an allergic reaction.”

Um… ok, yeah, blood pressure dropping suddenly wouldn’t cause loss of consciousness or anything like that.

He kept prattling on about there was no swelling or hives. At some point I suggested he read past the first 3 symptoms of anaphylaxis. I have no idea how long this lasted. But I know I was left unattended without epinephrine for a very long time.

He came back with the nurse on duty who also said she had never seen such a thing in her 20 some odd years. I said the same thing to her, sighed and said “Fine, atypical anaphylaxis I never swell.” I told them to call my allergist. He is on the Medic Alert, and I know he answers calls if his patients are in the ER. He’s an older doctor with an actual work ethic, you know?

To those of you who are unfamiliar with the joys of the orphan disease known as anaphylaxis, it is any systemic allergic reaction. The dangers are if it is affecting the respiratory system or the cardiovascular system. You don’t have to swell or have hives.

The ER doc then decided to try and give me an IV. IDIOT. Blood Pressure Dropping? Baby Veins? The poor nurse – not the same as before – kept trying to find a vein – my MIL even helped him look. I was beginning to feel better, so I was helping. (You can spontaneously recover, but if untreated, a relapse can be more severe.) Finally, my MIL asked me what my allergist did when I had reactions.

My allergist, I love my allergist, he does what you are supposed to do. Intramuscular injection of epinephrine followed by Benadryl + H2 Inhibitor and a course of Medrol. This is the recommendation of the AAAI. Of course, study after study has shown ERs have very poor compliance with this.

This incident started at about 3:30 or 4:00 PM. I did not receive proper treatment (epinephrine) until 6:00 / 6:30 PM. This put me at risk for a biphasic anaphylactic reaction. If you have a secondary reaction it is most often worse then the first. The first had me unconscious immediately. I don’t want to think what else could have happened.

Oh, they also gave me an alternate treatment for the infection.

I then proceeded to try to get in with a doctor. I called my GP first, he was on vacation so I talked to his nurse. She was appalled by the actions of the ER. His partner didn’t want to see me, so I called a specialist I am seeing about another matter related to the infection. He pretty much confirmed it sounded like a severe allergic reaction.

I called my allergist, but his offices were closed – he is close to retirement. I dread that day. At this point I didn’t consider it an emergency. I was just getting ready for a surgery for another matter and was worried about cross reactivity.

So, I called the next week to get into my GP and he was also appalled by this. It was obvious to him what had happened. He was not pleased that the ER had not tried to contact him. And, like me, and all of the other doctors, kind of told my husband he should have given me epinephrine. Because of my medical history, just assume I’m in reaction if presenting like that. He had us go see my allergist.

My allergist didn’t feel there was any need for additional testing since the course of events went applied cream –> unconscious -> came to. He thinks the thing that saved me was that I take an antihistamine each and every day without fail. He was unsurprised by the ER. I get the feeling allergists on the whole are not well-pleased with ER treatment of their patients.

Of course, everyone is obsessing on how the toilet tank got shattered in the fall but I was unmarked. The thought was head injury by my husband, he keeps going on about afraid of me jerking and hurting myself more. (Epinephrine needle goes in the thigh, mostly like a bee sting.)

“While many people think that anaphylaxis requires that the victim is in shock, this just isn’t so, he says. “A person doesn’t have to have falling blood pressure or be in shock before a diagnosis is made. Any multisystem allergic reaction with symptoms such as shortness of breath, rash, or vomiting is anaphylaxis.” Dr. Carlos Camargo, MD (from WebMD article linked to at top of post).

Um… shock? HELLO!??!! Think maybe there is even more education needed than Harvard Allergist Dr. Camargo suspects?

Every allergic person I know has had a similar experience. Every one of us lives in fear of being killed due to the inaction of improperly trained medical personnel. Allergies seem to be growing in the population.  It is vital ER physicians learn about the presentation of severe allergic reactions.

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