The stinging kiss of anaphylaxis

[Gearhead]

I went in for my weekly allergy shots yesterday. I've been getting them for roughly four months now. And every single week, I get a welt and several days' worth of itching on my right arm. That's where they've been injecting the ragweed. I am violently allergic to ragweed and have been since I was a kid,

Three weeks ago I told the very nice nurse who does my injections that I had been progressively worse reactions each week. She halved the amount of serum she shot into my right arm (my left hasn't been bothering me), and I still got the welt and the days of itching. Yesterday she asked me about whether that had helped with the reaction or not, and I said sort of-it was maybe on as bad as the full dose had been, but I was still reacting. So she gave me the shot, and I went to wait in the waiting room.

Within five minutes I had a lump the size of a pea at the injection site, and then a patch the size of my palm of red inflammation, and it itched really badly. Here we go again, I thought. Actually, this is worse.

About five minutes after that I suddenly felt really strange. Like full-body strange, like I had just been drained of all body sugar or something, like a huge sugar crash, only I don't eat much sugar at all and I don't eat a lot of carbs, so it made no sense. And then I realized I was breathing sort of fast and shallowly. And then I got a searing, unreal pain in my stomach, which quickly spead all the way down my abdomen. My nurse came out to collect someone else for a shot and I flagged her down. She took me in back and I had trouble walking. I was getting a sort of tunnel vision. She got me sitting down and called two other nurses, then left to do the other allergy shot. The pain in my guts was getting worse by the minute and they kept telling me they knew it was hard, but I needed to take deep, slow breaths, which was my first clue that I wasn't. Then all of a sudden my temperature shot up and I was sweating all over. "She's diaphoretic," they said, which meant nothing to me. "I'm going to throw up," I said, but I couldn't. Then I thought my intestines were going to explode, so they took me to the bathroom, but I couldn't even pee. Within minutes I was collapsed on the bathroom floor, semi-coherent, flailing (convulsing?), unable to explain what was happening. The pain was like nothing I've ever felt before. The kept asking if I was pregnant. I kept trying to explain I'd been surgically sterilized in 2008.

They asked if I wanted them to call my husband, or maybe an ambulance, and all I could manage was "I don't care." My lips were numb and it was still hard to breathe, and they couldn't get my blood pressure. I didn't care at all. Finally the doctor came in, looked down my throat and said my airway looked pretty open even though my throat was swollen, and said well maybe they should call the ambulance since the hospital was right across the road anyway. I got the chills as fast as I'd gotten the fever. I was beyond caring what happened.

The ambulance came. I was in the fetal position by then and couldn't walk. I stayed in the fetal position the whole ride. With my eyes shut. I didn't see a thing. One of the EMTs tried to get an IV into my arm and couldn't. I have problematic veins; even under the best of circumstances, professional phlebotomists have trouble with my veins. As he was digging around in my wrist the other EMT asked how the pain of that was in comparison to the pain in my abdomen and I asked if he was kidding. He asked if I could feel my wrist and I said of course and he said to his partner "Well, we know she's in real pain."

And then somehow I was in a room in the ER, and then my husband was there, and a very voluble doctor, and the discovered hives and rashes all over me, and I could hardly talk, and they shot me full of epineprine, and then of Benedryl, to which I have a paradoxical response, and my heart started beating so hard it was shaking my torso, and my pulse jumped up to 95 BPM and stayed there for the next seven hours. They gave me steroids too, plus a take-home supply of prednisone and a warning that it will probably make me manic for a week. I also got a stone-cold bag of IV fluids and shivered hard for the two hours it was dripping into me.

The thing that is really pissing me off is the fact that at my allergist's office they thought i had sudden onset flu or was losing a baby or having an ectopic pregnancy or an appendix rupture because abdominal pain "isn't a symptom of allergic reaction." Except that the first thing the ER doctor said was "Inflammation of the whole GI can be a symptom of allergic reaction. [Turns to computer and types for 30 seconds] Look, it's right here on WebMD."

So I got home at 11:00 pm, and my heart is still beating 25 BPM too fast, and I itch and feel like shit. And I have to leave right now for an appointment with my pdoc, and I have to follow up later this week with my internist and my allergist. And now I get my own Epipen, because so far no one has been able to tell me conclusively what's going to happen when ragweed season rolls around.

[gizmo]

I can't believe that an allergist's office wouldn't be properly trained to recognize anaphylactic (sp?) shock! That's pretty shocking, to be honest with you. I'd demand to speak to your actual doctor, tell them what happened to you in the ER, see what they say in response, and then switch allergists!

The next time this happens to you, things could get much more serious (worse than it did this time!)

I hope you feel better ASAP.

[dedoubt]

I totally agree with gizmo. That is unreal that they couldn't figure out what was happening to you. They probably just didn't want to take the blame, in case you sued them. Sigh. I hope it doesn't happen again.

[AirMarshall]

I've had two reactions from allergy shots. It can be pretty scary.

Any doctor who is giving allergy shots should be prepared to give epinephrine on a rapid basis. There was no need for you to go through such a prolonged and risky wait to get to the ER. My allergist gave me similar meds as a follow up: a tab of my regular allergy med, some prednisone and something else for my lungs as I have asthma.

You might consider interviewing other allergists.

[y58]

I had a similar experience when I was 14. Come to find out, the allergist nurse misplaced a decimal point and injected me with 10 times the correct amount. After I recovered, a few days later I demanded she show me how to inject myself, and from that point forward I self-injected for years without any problems.

[Gearhead]

I have an appointment with my allergist on Thursday, and then I'm never going to see him again. They told me that they had all the epinephrine and Benedryl I could need if I was having a reaction, so why they didn't give me anything is a mystery. And I see my gdoc on Friday.

Thanks to everyone for your concern. I still have the elevated pulse (is it going to stay like this for the next five days because of the prednisone?), my lips are burningly numb, I itch all over, and my whole abdomen feels like one giant bruise. And my hands are shaking, probably from the heartbeat thing. I feel like hell, but compared to how I felt exactly 24 hours ago, I'm Supergirl.

[Sjs]

FWIW i get horrible stomach pain from thr smallest exposure to any of my anaphalixis allergies. It is excruciating! The only thing that makes it go away is benedryl (if its no to severe of a reaction) or epi. That plus time to recover. And i hear you on the bruised stomach. It feels like youve been kicked repeatedly.

I am truly surprised that your allergist didn't epi you right away! Mine is about three blocks from the hospital but they still epied my son right in the office when he reacted to his shot.

If its even a possibility you might consider finding a better allergist.

[Gearhead]

I did find a better allergist, a very nice old man who makes me think of what Jon Pertwee as Dr. Who might have been like had he been human and gone into otolaryngology. I've gotten through the first part of ragweed season pretty well so far on a nasal spray called triamcinolone, Zaditor eyedrops, and Singulair. But he thinks that the inflammation in my sinuses might not be allergies, but maybe scarring from having been so swollen for so long (years), and that I may need turbinate surgery if I'm ever going to breathe right through my nose again.

I can't deal with that right now, so I'm just not thinking about it.

[Antigone]

Omg, you are fucking kidding me right this second.

Yes, switch allergists. My daughter is peanut allergic, we have epipens everywhere, including school, AND she wears an epipuppy at all times, plus bright red medic alert bracelet, and both she (at 5) and my other daughter (at 9) are capable of injecting it at the first sign of anaphylaxis, no questions asked, and would not hesitate to "give epipen, call 911" at the very first sign.

Why? Because epinepherine will not do harm, but anaphylaxis will kill, sometimes in seconds.

And abdominal pain is a huge sign, plus nausea and vomitting. My daughter's teachers have a trainer pen so they are not intimidated and so they can train parent volunteers or substitute teachers, too. I have a trainer pen so my kids can practice.

I'm surprised the medics didn't give subQ epi right away, honestly.

But, nevertheless, ask your new allergist if you need to carry epipens now. Once you've had anaphylaxis to your allergy, the cascade is more likely again. You've reached the threshold point.

And thank God you are okay. I will say a prayer of thanks to God.

[Gearhead]

And thank God you are okay. I will say a prayer of thanks to God.

Thanks, Antigone. Thank you.

I do have an Epipen now, which feels totally normal since I've been lugging one around for my husband's shellfish allergy for years.