So happy your DS is okay!  We all learn from mistakes.  Often times, we learn more from our mistakes than our successes.  Hope all is well. 

Thanks CM I thought you would probably know that answer!

Yes-- it's not that epi causes it, though-- it's just how biphasic reactions tend to present.  I suspect that there is a cytokine priming effect that happens in the first phase that makes them really refractory to treatment, but there isn't a ton of evidence on mechanism.  It's mostly anecdotal reports in clinical studies.

 I know you can spell Mac!  And I agree that presenting with only a stomach ache would probably have resulted in rolled eyes at the ER.  I thought of that too...but just kept telling myself one more symptom and we're off to the ER.

Thinking about this a bit more...So is there a possibility that a biphasic reaction could be stronger after epi administration (almost like a rebound effect)?  I will research this a bit and see what I can find.

Oh ha--I started my last post before taking DS to school anout 45 minutes ago and finished it just now.

Quote from: Macabre on October 06, 2014, 11:06:15 AM
Confessuon--I might have done the same thing.

I swear I can spell in real life.

The reaon I asked was because in a situation where I was going to epi myself, I have thought that it might not be mission critical to go to the ER. It was for breathing. And really, as long as it cleared things up for me, I woukd have not needed further medical treatment.

I think I'm your situation, you simply gave him Epi rather than Benadryl. And had it progressed, you would have called EMS.

I think we know how EMS and the ER would have responded had you gone in--I hate to say. I see a huge eye roll happening. Of course, we should never avoid calling 911 because we are worried about how medical staff would think of us, but I am guessing if you had gone to the ER you probably would have been the recipient of a resounding "Huh??"

I'm not advocating not calling 911 after administering Epi, but I can totally understand why you didn't in this very particular situation.

Again

Thanks you guys, you're the best (and not just because you supported my wrong and potentially dangerous decision! )! It's so helpful to have these conversations, and I hope that they help other people too.

CM: I've refrained from giving the epi before to avoid the whole ER scenario too given some very challenging logistics we were faced with at the time of reaction. But, after seeing him in the allergist's office the last time where they waited since it was just a stomach ache and to painfully watch it turn to an epi moment where he was so uncomfortable and I was worried...I just had to epi.  However, I can see how not heading to the ER afterwards can put a patient in a really bad spot if there's a biphasic reaction.

Will definitely have to keep that in mind for future!!

I missed this.  So glad your son is OK!

Something that was recommended to me by one of our old swim coaches, was to let DS (or help him) give himself the epi so that he learns what it's like and that he can do it himself.  This is obviously dependent on the child's age and having more than one epi in case it doesn't go well.  With this being said, in a reaction situation will I remember...that's the real question.

Confessuon--I might have done the same thing.

I completely understand-- the reason why we've done wait-and-see in the past WITHOUT epi is that in our protocol, there is a hard-link between epi and hospital.

{sigh}  So that strategy obviously isn't a great one, either.

I think that the dangers of THAT one are really really obvious-- but the danger in giving epi and then not being in a hospital setting is that a relapse or a biphasic reaction can (and often, really, is) incredibly refractive to treatment with EPI.

So if you do see a recurrence, you'll want all of the resources of an ER to be brought to bear. 

Mac and CM...ok I'll fess up. We stayed home. NOT suggesting this was the right course of action, but it's what we did.  My thought was that if he had any other symptoms, I'd epi again and call 911.  Giving the epi is an improvement for us given 3 other egg reactions where there's just been a stomach ache, and we've given Benadryl only.  There was one other accidental ingestion and challenges in the doctor's office.  I gave the epi this time because 1) it wasn't baked egg and had no way to gauge how much he'd had and 2) last challenge in doctor office resulted in epi.

And I agree with what you said Mac about experiencing the epi as a tween.  If DS accidentally ingests egg again, I want him to think epi, not Benadryl and wait like we'd done in the past.

Now...why did we stay home?  I'm thinking because he exhibited the one symptom only, and it was complicated by the fact that we had friends over at the time. Not saying this was the right move, but it was what we chose.  Being open and honest here, and do want honest thoughts about our choice (I think) . 

You did good!!

And yeah-- I had the same question as Mac, but was also going to say the same thing-- that my one major regret about DD's reaction as a tween is that she didn't get EPI.  So she recalls anaphylaxis just fine-- which is good, because it reminds her to be careful... but she does not have that data point of "epinephrine is not that big a deal and it REALLY helps" which I think is just as important to know.

So did y'all go to the ER or just stay at home?

You clearly did the right thing. If his stomach was hurting after Epi, I think he would have been worse without it. Good for you! 

Also--I know this is going to sound strange, but having the Epi as a tween or teen is a good thing. They realize they don't have to be afraid of it, and that can make all the difference as they have more independence. Not that I would cause a kid to need it--but this is one good thing that comes out if a serious reaction.

((Hugs)) to you!

Thanks all. Today's a new day right? DS is a bit grouchy but otherwise fine. Hezzier DS is 12. Hopefully I've reassured my friend enough that she's not still feeling badly.