Ana Reaction at Work (K-8 Public School)

[gufyduck]

After almost eight years of no major reactions, I had a full blown anaphylactic reaction at work last Friday (at a K-8 School in front a few kids to boot).  I know it was my fault, as I have been doing more and more may contain foods of the past few years.  That bit me in the butt big time.  At this point, best guess was the bread was cross contaminated with sesame, which is also scary because sesame has never given me a reaction of this degree. 

I have spent so much time going over and over this in my head, I just can't get past it.  I know many things were done right but others that could be improved.  When my mouth started getting itchy, I took benedry, as I have done successfully many times before.  I also moved myself to the main building instead of my office to be closer to people, which was good, but was still in a small room alone, which was bad.  I also didn't think to grab my purse, with my epi pens in it; they were left across the playground.  Mistake #1 & 2.  I did let the school nurse, who just happened in that day, know what was going on. At that point she felt I was on the fence of needing epi, but I was being stubborn and she let my judgement stand.  Mistake #3.  At this point, things stayed about the same for ten minutes, then began going down hill fast.  In less than a minute my tongue and lips  blew up, and went from no breathing problems to coughing and wheezing so badly I couldn't speak.  Thankfully the nurse was only a few doors down, and she sprung right into action.  Since my epi pens were across campus, they grabbed the school set, as they were on a shelf in case of an emergency.  911 was called, and they actually gave me a choice of ambulance or not (WTF?).  I chose the ambulance as it was a 20 minute ride to the nearest hospital.  They were able to give me steroids, which was nice, as my tongue started to swell again but it was able to get controlled before things got scary.  I am still questioning if they should have given me epi.  I know I had a very hard time thinking clearly, and couldn't even remembering the meds I was allergic to.  I don't think I should have been given the choice if my lips and tongue were swelling, but still can't figure out why they asked me if I wanted it as opposed to saying I think you need this.

In a way, even though I am horrified I went through this in front of my co workers and a few students who happened to be in the office, I was lucky this was at a school.  I was around many other adults, and even a RN, who are trained in anaphylaxis and administering epi. I was not in a position of self administering, and they took charge which was needed.  I was somewhere that epi pens were almost within arms reach, and no one was scrambling to get mine. I'm still beyond freaked out over how fast this reaction progressed.  I know the nurse also regrets not keeping me in the office when I let her know I had taken benedryl. 

Some things have already changed.  Since I leave my purse in my office when working with students, and I don't have somewhere to lock it up in every classroom, I have given the office a set of my own epi pens, just in case the school's set is with a class on a field trip.  If something were to happen again, I know they will likely use the school ones, which are never allowed to expire and just sitting out, but having mine there as backups.  I am comfortable with this.  I will be talking with my doctor about when to epi.  I was scared with how fast this progressed from just an itchy mouth to oh sh** levels. I spoke with our nurse today, and she feels any symptoms should be an automatic epi for me, given how fast it happened and how rural we are.  Even if my doctor doesn't want me to epi that quickly (I will talk about this on Friday) at school I agree with it.  We are very rural, 20 minutes to an ER, and while we have a local volunteer fire department, paramedics have to come from the town over.  Comfort zones have been adjusted to no may contains and calling companies.  The other thing I have changed is entering emergency info on my phone.  It now has all meds I take and all allergies with their reactions. I couldn't remember allergies and medications, and that will help in communicating that.    One teacher who I work with a lot (I'm essentially IT, computer teacher, and algebra teacher at my school and am all over campus regularly) has offered to have a nut free signs and keep nuts out of her room. I've also decided for the big nut eaters on campus, when I have to work on their computer, I am either going to take control remotely or bring my own keyboard and mouse.  I've also stashed stuff to wash my face in my desk, just in case of contact reactions which happened yesterday.

Overall, I'm happy with the changes I've already put in place, but also still so anxious over how this entire thing played out.  Most of this is my venting and processing everything, but I figured I'd put it out for others as well. 

[hezzier]

Sounds scary, glad you are ok! 

[rebekahc]

Wow - very scary! So glad you are okay!!  It sounds like you have a good plan moving forward.

For DS, his basic action plan is that 1 symptom but no eating/no exposure = wait. Any symptom after possible exposure or eating = epi. Any time 2 or more body systems are involved (even with no exposure) = epi. Maybe something along those lines would work for you and your doctor.

[spacecanada]

I'm so glad you are okay.  Reactions are scary.  Take time to heal and recover.   

For DS, his basic action plan is that 1 symptom but no eating/no exposure = wait. Any symptom after possible exposure or eating = epi. Any time 2 or more body systems are involved (even with no exposure) = epi. Maybe something along those lines would work for you and your doctor.

That sounds similar to my action plan, too.  Only, if that 1 symptom without eating is breathing difficulty I can try Ventolin first, but then Epi.  If it's feeling faint and 'like something is wrong', then Epi.  I think it would be good to review this incident with your allergist and review your action plan, just for good measure.  I need to review mine way too often adds till don't follow it for whatever reason sometimes... allergies are hard. 

Feel better soon.

[gufyduck]

For DS, his basic action plan is that 1 symptom but no eating/no exposure = wait. Any symptom after possible exposure or eating = epi. Any time 2 or more body systems are involved (even with no exposure) = epi. Maybe something along those lines would work for you and your doctor.

That seems like a pretty good plan.  I will ask my doctor about it or something similar.

One odd thing was that morning I did get a flu shot, but it was a few hours before the reaction.  I know I am not allergic to eggs.  However, having eaten lunch 10 minutes before all this began, I am suspecting food.

[GoingNuts]

Gufy, I would suspect food as well, but maybe worse because of the vaccine if your immune system was already getting riled up? 

That said, I would still go with your new plan and the rules you have set for yourself - especially given how rural you are.

I'm glad you're OK. Allergies totally suck. 

[PurpleCat]

So glad you are OK.  That was very scary.  How are you feeling and doing today?   

[Macabre]

I'm just now seeing this. Wow—I'm glad you're okay. That is so scary.

I'm so glad it was at school. And this was probably good for the school, too. Not that having a reaction was good, of course. 

Our plan is similar to RC's, and if that one system involves the throat, epi. With the swelling you had, I would consider that requiring epi.

DS had two symptoms with no known exposure at school once, and he had epi—then required it again with a second trip to the hospital eight hours later.

FWIW, I used to be able to just peel sesame crust off bread, but my allergy got worse, and my most recent anaphylactic reaction was from CC. It really sucks when a food allergy gets worse.     

I'm sorry you experienced this. How terrifying.  But wow—how wonderful that you had people with you. Have you thought about AuviQ that speaks directions in case someone needs to administer again?

[becca]

That is scary, how fast it progressed.  I'm going to share your post with dd. 

I'm glad you're okay, and making changes to prevent future reactions, and revising your action plan.  Hugs.

[gufyduck]

I'm so glad it was at school. And this was probably good for the school, too.

Have you thought about AuviQ that speaks directions in case someone needs to administer again?

The more I've thought about it, work/school may have been one of the best places for a reaction to happen.  They were prepared for it, and there was no question of how to handle it. Even with me forgetting my epi pens in my office (which I still can't believe I did) treatment was available.  I can't think of any other place that would have a box of epi pens sitting out in case of an emergency.

I don't think I want to switch to the AuviQ.  I have been in school wide training on the Epi Pen, so most of my coworkers know what it is and how to use it.  I also really like that the trainer they come with, so I can let others practice as I see fit.

[hezzier]

I know you don't want to switch but the AuviQ comes with a trainer as well.

[Macabre]

That makes a lot if sense. We use both. We always kept Epis at school, but DS personally carried auvis, and with his peers, we liked that it would guide them through administration. And he trained his closest friends.

But yeah, if epis are working for you, no need to change.

[gufyduck]

Had a follow up with my doctor.  I do have a new action plan similar to what many here have.  One symptom after eating equals epi from here on out.  There are two exceptions - hives suspected to be from a contact reaction or explainable asthma attacks.  I forgot to ask about reactions without eating, but I will epi if I suspect it is a reaction. 

My doctor was horrified that in the ambulance, it was left as my call to get more epi when my lips and tongue started to swell again.  She said that should have been an automatic. 

As for the food allergy vs. the flu shot question, she agrees it is likely food given the timing.  Because of ending up on steroids after getting my flu shot, she does want me to get another one, as the steroids could have reduced my immune response to it.  However, this will be done in her office, which is right across the street from a hospital. 

I'm getting used to having a much tighter comfort zone.  Still working on finding safe packaged choices, but I have this week off of work for fall break, so plenty of time to make calls. 

[spacecanada]

This is great to hear, other than the ambulance situation - that's scary, agreed.  I've had paramedics give me more epi at the first sign of any new/reappearing symptoms.  If you need product suggestions, many of us have long lists of safe foods for a variety of allergens; just ask. 

Interesting to learn about the flu shot being potentially nullified by the steroids.  Good call! 

I hope you're feeling better.