Two Severe reactions with a visit to the ER

[bramblef]

Over the last 5 days I've been in the ER twice for reactions. Once for a recurrant reaction.

I'm overwhelmed with everything coming at me. Lots of new information.  Questions I have:
1. How long is it normal to feel terrible afterward? It's been 4 days and I still feel like I've been hit by a bus.
2. Now I fear that I may have a tuna allergy as well to shellfish.  I have no idea where to Start managing this as I have a severe contact allergy to shellfish- tuna is pending.

The first reaction was at a casino. I wear rubber gloves, wash my hands frequently, and do not touch my face etc.  We stay for a short period of time and are probably now eliminating this activity. We do not eat out at restaurants much anymore except one in town which we trust.  Once I felt 'weird" my mother in law was thankfully there and did the epi right before I passed out. I threw up and the casino Staff cleaned up the vomit before calling for an ambulance. I have a great advocate though and she let it be known that I could die if they did not do anything.  Once on the ambulance I got more antihistamines and pepcid(?) I think. It was scary alright- and I was out of it for 4 days. Work challenged me on my ability to miss work. I was prescribed pred- and today was the first day I have kept down a meal or anything for 6 days.

While at work I was informed I needed to take a client out to eat (Adult family Home worker). I stated McDonalds was the only option due to my allergy and got a," Just let him eat and then get in the car" . Due to the clients we serve this does not work....
I suspect that there was cross contamination with my meal which had tuna in it. (Never reacted before to it, have been fine). About an hour after getting back I felt funny and took a benadryl. Not even 5 mins later I was struggling to catch my breath. Again I was at the ER, and got to deal with worker's comp paperwork!  I had epi administered by the EMT's immediately and other I.V. medicines.

I hope the allergist has some better ideas for management....

[Ra3chel]

Bramblef, that sounds really scary.

The first thing I'd do is talk to HR at your work about disability accommodations. It sounds like you may already be doing this, but if you need support, there have been some pretty extensive threads about the process in the "adults with food allergies" subboard, and some useful stuff in the schools subboard as well, particularly if you're in the U.S.

[SilverLining]

Hi, sorry to hear you're having such a rough time.

Let me start by saying I am NOT a doctor.  I am a person who developed food allergies as an adult, and I remember that fear when they first started and when my reactions became anaphylactic.

Is it possible, some of the breathing difficulties are due to anxiety, rather then reaction?  I am not trying to "write off" your reactions, but I did go through that myself for quite a while, ntil I was able to pinpoint and completely eliminate my reactions.

~~~

After having a severe reaction, it was probably about a week before I was back to normal.  I'm not sure how much of that was due to the actual reaction, and how much was due to the meds I got in the hospital (and the prescription I was put on for a week afterwards).  And, I know another adult who always misses about a week of work after an anaphylactic reaction.  Part of that is probably due to being unable to drive safely while taking the meds after the reaction.  (A steroid, I think.)

The meds never made me sick....they just make me stupid

[CMdeux]

One other thing to note is that we view any ER trip as a glorious opportunity to pick up any opportunistic infections, too.   


DD usually gets some kind of major illness within a week of anaphylaxis.  My hypothesis about this is that it is probably the result of a catastrophic immune-system freak-out.  We've seen it happen at least a dozen times over the past decade, though, and that's pretty convincing to me in a kid who has only otherwise been that ill about four times in her life.

  If you happened to get "lucky" enough, you might have picked up something gastrointestinal along the way.

 
I am also shellfish-allergic.  While I am not FISH allergic, there is no way that I will order any type of fish in any restaurant setting.  IMMV, of course, and that's not to say that other people shouldn't do so... but my experience has been that in any restaurant which handles shellfish (shrimp in particular, in my own experience), any food is possibly cross-contaminated, and in any restaurant, the fish is probably so, even without shellfish on the premises.

In the wake of anaphylaxis, it's super important to be aware of a few things:

a) your body is primed for additional major reactions until it 'settles' (often weeks), during which time,

b) you may react to traces that wouldn't bother you ordinarily, and

c) you may even react to THINGS that wouldn't bother you ordinarily (like fish, not just shellfish?), and finally--

d) steroids can do SUPER-FUNKY things to different people (I develop a blistering rash on my hands and feet sometimes, my DD becomes frankly manic, and my DH becomes cranky-cranky-cranky and sick to his stomach unless he eats constantly).


When you were seen at the ER, did they keep you under observation for several hours?  That's important because you sound like a pretty good candidate for what is known as Biphasic anaphylaxis.  That is when initial symptoms (often mild or moderate) resolve, only to recur with a vengeance 2-12 hours later.  Those secondary reactions are really frightening, and can kill within minutes since they tend to be more severe than the initial reaction and involve respiratory and cardiovascular features that may/may not respond well to anything but herioc resuscitative measures.  Clearly, it is best to be where they can be undertaken, if you see my point.

Many ER docs are not educated very well about the risk for biphasic anaphylaxis, since it is a pretty small risk in most anaphylactic allergies.  Food allergy is an exception, apparently.


And yes to what Ra3chel said.  You need to begin speaking with HR about workplace accommodations, since informal objections based on safety have evidently not been enough to negotiate more appropriate risk for you.

Re: gloves.  I have not generally found that gloves are a good way to avoid my allergens or DD's.  Unfortunately, she and I both have this kind of sensitivity and gloves aren't enough because of aerosolized exposures in environments where the allergen is around.  Besides, the way that she has mostly been exposed is through this kind of contact-- we surmise that it is probably not through skin contact, but hand-to-mucous-membrane (which gloves don't prevent other than by making one more aware of one's hands) or via inhalation of a fine aerosol (as from cooking or mechanical disturbance).