Should we have used the epi?

[daisy madness]

DS had a weird reaction yesterday that I'd like to brainstorm.  We went to a baseball game.  I didn't even think about the peanut situation until I noticed bags of them (with shells) when we got there.  We were with a largish group and were in a relatively empty area.  I asked our group not to get any peanuts.  We got him a soft pretzel.  I looked up the ingredients online and double checked them at the counter.  He drank a Gatorade that no one else drank from.  At one point, I noticed peanut shells/fragments on the ground in another part of the park.  Little bits would blow with the wind.  We took him out of that area. 

As we were leaving the stadium (3 hours since he ate the pretzel and probably 1.5 hours since being near the peanuts) he started having red itchy eyes, nasal congestion and sneezing.  It seemed like a seasonal reaction, just a little bit worse.  Gave him Benadryl.  It helped a little. Showered him immediately when we got home. Reaction lasted until bedtime.  He still ate dinner as normal.  My gut was telling me it wasn't seasonal, but in the absence of a known ingestion, with seasonal symptoms, it didn't seem right to use the epi.  Although the kicker was that he asked me to give him the epipen so he could stop sneezing.  He's never done that before, but he doesn't know it's a shot. We used it once, but he was too young to remember. The other time was during a food challenge but they used a regular injection rather than the pen.  I stayed in his room and watched him sleep until 11. 

He vomited this morning at 5am. Now I'm sure it wasn't seasonal.  Since it started after leaving the stadium, my guess is that he was exposed to airborne peanut kicked up by everyone's trampling feet when walking out.  Or there was an allergen on a railing or something that he touched. 

I may call his doc.  Because of his history,  I know he wants him to get the epi for any known ingestion that results in any symptoms at all, no matter how minor.  But there was no known ingestion here.  Watching and waiting seemed like the right thing to do at the time.

[GoingNuts]

Very hard to say, especially with all the weird viruses going around right now - at least where I am. 

I suppose when in doubt, use it - but I doubt I would have either under the circumstances you describe.

Any other symptoms since the vomiting this morning?  Does he usually vomit just from lots of mucus if his seasonal allergies are particularly bad?

[momma2boys]

Right or wrong, in that situation I probably wouldn't have used it either. I would guess like you said, airborne peanuts or railings contaminated. Hope he feels better now.

[daisy madness]

The nurse from his allergist's office called. She thinks today's vomiting is unrelated to yesterday's reaction.  He was a frequent vomiter a few years ago, but now he just seems to vomit when he has a stomach virus.  There was a horrid 18 month span where he vomited anywhere betweek 2-12 times every 2 weeks in the middle of the night.  He was tested for everything under the sun.  They finally put him on reflux meds and it eventually tapered off and went away. 

[Macabre]

We have a protocol for places like that. We do not eat anything unless that concession stand has no peanuts. We ripe down seats (the backs tend to be the worst because of how folks deal with the shells), take a crib sheet if possible and a plastic bag to put it in. We wipe our should down and put them in a bag at the car before getting in--or wipe them down and have paper mats below that get thrown away. If possible, shoes go through the washing machine at home (this is a great place for crocs). 

We don't go to stuff like this often. It's easy not to, because our son hates sports, but as he's grown up this would be done at the circus, a few shows that he saw with PBS characters in arenas, the rodeo  and a few college football games.

Even now, when the school band plays at our state hockey playoffs at the big arena downtown, I invoke his 504, and he doesn't go. It's too much to deal with to stay safe (and for something he wouldn't normally watch anyway).

A few weeks ago he was at a grad party where there were peanut shells on the ground and bowls of peanuts everywhere. The grad was from Nigeria--totally made sense.  But I had DS use a Clorox wipe on the bottom of his shoes before getting in the car. Peanut protein is such sturdy stuff!

You didn't ask about all this--but we put this stuff into place because of the kind of reactions our DS has had. Your DS' reaction could have been from the peanut protein swirling in the air, but it's very likely it was contact. Peanut protein is everywhere at a baseball stadium. I've mentioned before that my DS has had anaphylaxis from accidental contact ingestion at school. He did get the Epi then--based on symptoms.

I probably wouldn't given then Epi to your kiddo, given what you described.

But it's easy to see how it could have been a reaction.


Fwiw others here go to ball games no problem. Also, there are PF games/sections now.

But I've got to say--our lives have been easier because of DS' interest in dance and theatre, lol. People may be eating peanut M&Ms, but they're not throwing shells on  the ground. 

[hedgehog]

I doubt I would have used the epi.  But, I would say that if you had, it would not have been wrong.  It is rarely wrong to use it, unless you are talking about kids playing around with it or that kind of thing. 

[my3guys]

Very timely post.  My DS and I were at a local semi-pro baseball game last night.  He had no issues, but people weren't eating a ton of peanuts around him.  Rewind back two years ago, where people were eating a lot of peanuts. He had a reaction, after we left the game.  Headache, dizziness, stuffy nose, which responded to Benadryl and symptoms came back right at the 4 hour mark, and responded to Benadryl again.  He didn't eat any unsafe food and has attended other ballgames without incident.

Given the dizziness, I most likely should've given epi.  I think denial kicked in since he'd never reacted at a ballpark before.

Moral of the story, yes I think your ds could've been reacting to peanuts in the air.  Since I didn't give the epi, I'm in no position to say you should've...That epi always has to be ready doesn't it?