Tag Archives: Allergies and Hospitals

A Verbal Stream of Consciousness: My Worst Allergic Reaction

I’ve had two major allergic reactions in my life, well three if you count the initial reaction I had when we discovered my food allergy but I was three years old and I don’t remember it; So let’s rephrase: I’ve had two major reactions in my life that I remember.

My worst reaction had me on the edge of anaphylactic shock if it wasn’t for a handy auto-injector and a thoroughly prepared father. This reaction was to a previously unknown allergen: fish. Fresh water fish to be clear, perch to be precise.

Grilled pikeperch
I couldn’t in my wildest dreams fathom having this allergy. I was around perch a lot as a kid because my family had an annual reunion called “The Fish Fry” where the main dish was – you guessed it: perch. The funny thing is I never ate it, it smelled “gross” to me and I never had any interest. So fast forward a few years in the future to a lazy Saturday dinner. My family was cooking perch and with no other options I decided today was the day I was going to eat perch.

I took a thumbnail sized bite, maybe ever smaller but the second I took that bite I knew immediately something was wrong. From this point on my thought process was more sporadic then a cat chasing after a laser pointer.

Let me break it down for you best I can:

Something is wrong; I need to spit this out, ok now I have to clean out my mouth. I can’t swallow anything, and my lips are swelling. Wait so is my tongue. I need help.

It was at this point my family figured out something was wrong. As mentioned before, my dad sprung into action grabbing an auto-injector and promptly administrating it. My brother called an ambulance, and I sat in the kitchen with my thoughts.

Now those thoughts went into overdrive running off adrenaline and fear.

WHOA! Ok let’s get some medicine to keep it from returning, oh ya I can’t walk, I can’t really breathe, my lips and tongue are swollen- they hurt. I wonder when the ambulance will be here. Ohhh it’s getting better, thanks Epi-Pen®, glad I have you…and extras, oh hey the ambulance, that was quick considering we live in the countryside. Should I bring my purse? I sure hope someone grabs my coat. What are we going to do with the leftover perch?

Now this is where things get a little fuzzy. I remember getting into the ambulance and asking for my brother to come with me, but other than a brief discussion about how my parents would follow us, I don’t remember much. Here are the snippets I do remember in order of importance to me at the time:

  1. I’ve never been in an ambulance before
  2. They’re driving fast.
  3. Where is my purse and coat?
  4. Hey we’re here already.

Main Entrance Of Modern Hospital Building With SignsI’m sure I had plenty more thoughts, but at the time these felt like they were the most important.

After arriving at the hospital, I was seen right away by a doctor who gave me another shot of Epinephrine and hooked me up to some machines to monitor me and to give me medicine if needed, which spoiler alert: I did.

After one tiny piece of perch, almost 18 hours of hospital rooms and IV’s, I left the hospital with a new allergy and a new plan for how to tackle this allergy.

My thought process during my reaction was sporadic, hazy, and random looking back now. I barely had time to figure out what was wrong with me before my symptoms became more than I could bear. My thoughts regarding my reaction afterwards were crystal clear and it’s something that I still think about from time-to-time in no particular order.

 I need to get my allergies checked more often so I know my levels.

 I’m glad I always have an auto-injector with me or around me.

I should always trust my gut, if something doesn’t seem right, or is continuously gross to me or makes me sick, maybe I should stay away from it until I know.

I should continue telling/training people with an auto-injector

Thankfully I have people around me who are trained and can identify an allergic reaction.

I need to trust myself enough to know when I am comfortable and when I am not.

I need to be more comfortable listening to myself, and asking for help.

I love my family for always ensuring my safety.

Our thoughts and inner monologue can sometimes feel like a random strung together process that doesn’t make sense at times. It can seem like an avalanche of ideas ranging from funny, scary, and puzzling that come so fast we can barely keep track. It’s useless to compare your thoughts or ideas to anyone else’s because we’re all unique. However, that should never stop us from expressing ourselves or talking out our feelings and thoughts with others. The best we can do is try and find that little voice of reason and help prepare it with a predetermined list for emergencies so we don’t lose track of what’s important. We have to go with our instincts but also have a plan A, B, C, and Z in case of an accident. We need to trust, forgive, and have faith in ourselves because it is the only way we’ll be comfortable expressing our inner thought processes to others.

– Arianne. K

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Allergy Testing: An Important Part of Your Diagnosis

Doctor writing prescription

Any specific medical information that follows stems from the following article and is not intended to be taken as definitive or wholly sufficient information. Consult your physician or, in this case, an allergist regarding these topics:

James, T. (2002). Allergy testing.  American family physician. 

http://www.aafp.org/afp/2002/0815/p621.html

 

When living with food allergies, the irritable symptoms that certain foods can produce serve as a prominent indicator for identifying what foods need to be avoided.   That being said, also undergoing allergy testing is important to be fully diagnosed with a food allergy and to initiate effective management of food allergies.  An official food allergy diagnosis is described as consisting of a medical history, physical examination, as well as an allergy test.  Allergy testing is also a way to legitimately distinguish between food allergies and food intolerances.  Food allergies and food intolerances can easily be confused.  In basic terms, a food allergy is a reaction that is triggered by the immune system to a food allergen while food intolerance is related to issues with other body systems, such as digestive problems, which also trigger unpleasant symptoms.  Allergy testing works to identify the body’s immune reaction to specific allergens.
While many of us have gone through a variety of allergy testing, we also may have been fortunate to outgrow allergies or, less-fortunately, developed allergies later in life.  Both of these occurrences are good reasons to seek out allergy testing as adults.  Tests available include IgE skin tests, challenge tests, and blood tests. IgE skin tests (or immediate type hypersensitivity skin tests) are the most common form of allergy testing. This test involves exposing the skin to a small amount of allergen through making a small indentation or ‘pricking’ the surface of the skin.  A reaction should occur within 20 minutes and appears as a small red swollen bump on the skin (also known as the ‘wheal and flare’). If a test is negative, and there is still a suspicion of a food allergen, an intradermal injection can be performed injecting a small amount of the allergen just under the surface of the skin. The physician will again observe for a small red bump to form.  Challenge testing for allergies involves eating a small amount of the suspected allergen.  As I’m sure you would agree, this is a form of testing that should ONLY be performed with your allergist present.  Finally, blood tests involve drawing blood and performing an IgE assay to determine the IgE antibody levels present in the blood that correspond for certain allergens.

If preparing to undergo allergy testing, it can be beneficial to know the benefits and drawbacks of each test compared to one another.  Skin tests can be preferable because they give the fastest result and are relatively less expensive than blood tests.  A drawback to these tests includes the obvious annoying itching that is produced with a positive test.  As well, this test may not be appropriate for those on certain medications such as medications with antihistamine properties that include anticholinergic medications, phenothiazine, and tricyclic antidepressants. Skin testing may also be contraindicated in those with certain skin conditions such as atopic dermatitis. The risk of undergoing a severe reaction with skin testing is extremely low with one retrospective study in the USA finding that, out of 18,331 participants whom underwent skin testing over a period of five years, only 6 developed mild systemic reactions (James T.). In terms of the sensitivity and specificity of skin testing, this has been shown to vary with food versus environmental allergens.  Another study conducted found that, when percutaneous skin testing for an allergen was done as part of a two-part allergy test that included a challenge test, the sensitivity of the test ranged from 76-98% with a specificity of 29-57% depending on the food being tested for(James T.). For those unfamiliar with these terms, Sensitivity represents the accuracy the allergy test correctly identifying someone who is in fact allergic. Specificity represents how often someone who doesn’t have an allergy is correctly identified as not having an allergy.  Intradermal tests were found to have a higher sensitivity, but also have a lower specificity.  When comparing this to blood tests, which allow for a laboratory test called an IgE assay to be performed, the IgE has found to be more specific but less sensitive than skin testing(James T.).  It is still more common for skin tests to be performed and blood tests to be more useful only when there is some contraindication to a skin test.  In terms of a challenge test, this is usually performed for one of two reasons: the finding of another allergy test was inconclusive or suspicious OR there is reason to suspect an individual has outgrown a certain allergy.  In some cases, a ‘double blind’ challenge test may occur where the individual eating the food and the medical professional are aware whether the individual is eating the suspected allergen or a placebo.  This is to avoid the possibility of a reaction being triggered based on the idea of eating risky food.  As previously mentioned, this test should only be done under STRICT medical supervision.

Whether you are interested in having an allergy test performed in the near future or not, it never hurts to educate yourself on the ins-and-outs of the testing you may undergo. And it is be better educated on managing as well as understanding your allergies!

 

Caitlyn P.

 

 

 

 

 

 

Knowing Your Nearest Hospital


Do you look up the hospital(s) nearest where you will be staying when you’re planning a trip to another city or country? I always do. When you are in a new place, a few minutes spent trying to look it up could mean a delay in getting care and potentially make your situation worse. I always print out the address and phone number and/or enter it into my phone for easy access. My worst fear would be having an anaphylactic reaction without myself or my peers being aware of the location of a nearby hospital. When in more remote locations, it is important to know how far you will be from the nearest hospital; it may, in fact, be significantly faster to have a friend or family member drive you there rather than wait for an ambulance depending upon where the nearest hospital is located. Where I grew up, it could take the ambulance up to 30 minutes to get to our house from the time we called. So my parents would always drive in an emergency situation. Consider where the nearest hospitals are if you are moving to a new area of town for school or work. I like to know where they are and wouldn’t want to live more than 30 minutes away from a hospital. For me it is important to be close to a hospital because I know that, even if you are as careful as possible, cross-contaminations, undeclared ingredients or preservatives can trigger a life-threatening anaphylactic reaction. It has happened to me before. I feel much safer knowing that we have a plan if an anaphylactic reaction were to happen at home. A few years back, I had a fellowship at an Oceanographic Institution. Our team was planning field studies in a very remote area. I was unaware just how remote the area we’d be staying was until my supervisor advised me that, if there was an emergency, I would have to be airlifted by helicopter to the nearest hospital. That raised some red flags right away. My supervisor asked if I still felt comfortable going on the trip with this information in mind. I said, yes! I was not letting that get in my way. My preparation for the trip and extreme precautions throughout our stay were directly impacted by the fact that there was no hospital nearby. Upon arrival, myself and a few of my colleagues cleaned and scrubbed the kitchen until all surfaces had been cleaned (including the fridge, microwave and oven). I made all the food from scratch in our motel suite (which had a full kitchen), and I never ate out. When my colleagues went out for dinner, I joined them; but didn’t eat or drink anything as they used peanut oil to cook.  I was, ultimately, worried that even the water glasses may have some residue left on them if not cleaned properly. Knowing that the hospital was so far away, I knew I had to be on my “A-game” at all times. I equipped myself with extra epinephrine auto-injectors and a lot of antihistamines. It is all in the planning process. You plan the food you will be taking with you, restaurants you feel safe going to, and ensure you know the location of the nearest hospital. These should all be parts of your pre-trip planning. Have you ever had an experience where knowing the nearest hospital was especially helpful for you? How did knowing where the nearest hospital was help you?

Erika