Living with Food Allergies, 2013 and on

[GoingNuts]

Last night I was with the last patient of the day, and I was taking some medical history.  She told me she was allergic to shellfish, and when I asked her what happens when she eats it, she said if she even touches shrimp she swells up and can't breathe.  When I asked if she carried an epipen, she didn't even know what it was.  She had never heard of it.  She's been to the ER 4 times in the past several years, and was only told to "Drink Benadryl with Pepsi".

I wrote "Epinephrine" down for her, and told her to speak to her MD about it.  GGA. 

[spacecanada]

There. Are. No. Words.

[name]

It may not be her fault. As of the time I write this post in late 2017, the national EMT standards for anaphylaxis are only to administer epinephrine ONLY if bronchospasm and hypotension present.  These are the offline protocols from our regional medical director. We are trained that full body hives, GI distress, and dizziness are not signs (observed) or symptoms (reported by patient) of anaphylaxis. The rest is assumed to be attributed to patient anxiety or simple hives regardless of history.  Our textbook, which is considered the gold standard, makes no mention of mast cells, etc., only the release of histamines. 

The bottom line here is making administration of epinephrine possible for BLS (EMT-B) has not transferred successfully in concert with recognition of anaphylaxis as allergists and all major allergy and anaphylaxis organizations have defined for years. Short 'N Sweet version: EMS are trained to administer only if wheezing and blood pressure drop present. We otherwise are trained to consider it anxiety or benadryl the appropriate drug for histamine.

[GoingNuts]

It's not her fault at all. The ER staff should had recommended f/u with an allergist, and given her an Rx for an autoinjector.  Swelling + not being able to breathe?  Yeesh!

[Ciel]

Scary story GN!

I need to book some food challenges with my allergist. I am frustrated (who isn't?)

My skin and blood tests are both negative for tree nuts and peanuts. I have a definite reaction history with peanuts and a murkier history with cashews and pistachios specifically. I am a little afraid to do the tree nut challenges but I am planning to do them. I'm really not sure what to do about peanut -- I am not willing to do a challenge right now, but then I'm also second guessing and thinking maybe I am being unreasonable. ugh.

My latex and shellfish tests were also negative. I'm confused about latex, and I am not willing to mess with shrimp either right now.

My friend told me to stop being a baby and just do it already. Does wanting to avoid another round of anaphylaxis really make me a baby? I don't think it does! 

I have documented reaction history but I REALLY want these tests to be true, ya know? It's the finding out that is scary.

[Penny]

Quick question:  how long should I eliminate a food from my diet in order to see if it is causing a specific health problem? Thanks.

[Janelle205]

Penny, I would guess that it depends on the health problem.  When we were checking to see if my soy allergy was real (it only causes GI issues and isn't quite as obvious as my other allergens) I cut it out for two weeks.

[Penny]

Thanks Janelle. I'm trying to figure out what causes my chronic/severe allergic conjunctivitis. I'm pretty sure it's not environmental as there's no seasonal change nor any difference when I'm in another part of the world. I've ruled out cosmetics, soaps, etc. I use the clothes detergents that are free of dyes/perfumes and a variety of brands....but as I write this, I'm wondering if I should try washing my sheets in nothing but vinegar and hot water. Going dairy-free so will try it for two weeks, if I can stand it!    Thanks.

[rebekahc]

Yep, when we were trying to narrow down DS's allergies from positive test results, it was two weeks. Be forewarned, when reintroducing the food after two weeks, it can cause a more severe reaction.

[spacecanada]

When you see a new quick service Mexican restaurant is going to be opening soon near your house... thoughts of Chipotle-esque experience started bubbling up in my head... only to find their online menu and it has mole sauce.    I still sent an email asking about ingredients but my I won't get any hopes up.

I still dream of Chipotle coming to the island one day.  I'd even drive three or four hours up-island to go there every month or so if I could.  (Not that there are any big cities that far up-island.)

[GoingNuts]

DA has an important job interview tomorrow, and after the interview he is to go out to lunch with some of the associates.  In addition to prepping for the interview itself, he has been studying the area restaurants to see whether there are any he could eat at.  It really sucks that this has to be a factor for him- like isn't stressful enough. 

[notashrimpwimp]

  GoingNuts.

Thank goodness they have the background and confidence to ensure their safety. That will carry them far beyond an interview.

I'm redoing the skin rest with a third allergist. The first told me not to do it again after my aunt shoved my head out the window and told me to breathe. The second didn't even make sure I was off antihistamines and didn't take my history.

[spacecanada]

When you give the newest hypoallergenic tape at the physiotherapy office a try... And end up with a huge red welt the shape of the tape, itchiness, and hives STILL - two days later.  (With constant Benadryl cream.)

This one is going to need hydrocortisone and more Benadryl.  Maybe I will ingest some Benadryl liquid tomorrow afternoon.

Sorry, not hypoallergenic enough.  (That crosses off every single tape option.)

But I didn't react to the massage lotion (we read the ingredients: contains sesame!) used for a cupping treatment on my messed up calf muscle - so that's a win. 

[notashrimpwimp]

When you give the newest hypoallergenic tape at the physiotherapy office a try... And end up with a huge red welt the shape of the tape, itchiness, and hives STILL - two days later.  (With constant Benadryl cream.)

This one is going to need hydrocortisone and more Benadryl.  Maybe I will ingest some Benadryl liquid tomorrow afternoon.

Sorry, not hypoallergenic enough.  (That crosses off every single tape option.)

But I didn't react to the massage lotion (we read the ingredients: contains sesame!) used for a cupping treatment on my messed up calf muscle - so that's a win.

It is sometimes the tiniest victories that change the complexion of our day. I had issues with the tape after my surgery too. Just sucks to have to pay attention to that as well as concentrating on healing.

[GoingNuts]

Oh yeah, the tape thing.  I had a bad reaction to the paper tape they used to hold an IV in place after surgery once.  Fun times. 

I feel your pain, SC.