- What Happens When You Go Into Anaphylactic Shock?
- Living With Food Allergies
- WHAT YOU NEED TO KNOW:
- Steps to take for signs or symptoms of anaphylaxis:
- Call 911 for any of the following:
- Return to the emergency department if:
- Contact your healthcare provider if:
- Follow up with your healthcare provider as directed:
- Safety precautions:
- Further information
- Learn more about Anaphylaxis (Aftercare Instructions)
- After the Epi – Our Real Nightmare Begins!
- After the Epi: The First 48 Hours.
- After the Epi: Days 3 & 4. The Bottom.
- After the Epi: The Rest of Week 1.
- After the Epi: 4 Weeks Later.
What Happens When You Go Into Anaphylactic Shock?
Earlier this week, Nina Dobrev was hospitalized after going into anaphylactic shock. The severe allergic reaction, chronicled by Dobrev’s bestie Julianna Hough on Instagram, looked pretty scary.
Fortunately, though, it didn’t seem to be a huge deal to Dobrev, who’s already on the road to recovery. “It’s pretty routine/has happened to me quite a few times because I have a lot of allergies,” Dobrev wrote in her Instagram Stories. “Depending on the severity, I sometimes go into anaphylactic shock as a result.”
Image zoom Instagram/@nina
ICYDK, anaphylactic shock is serious—if not treated right away, it can cause respiratory or cardiac failure, says Omid Mehdizadeh, M.D., otolaryngologist (ear, nose, and throat doctor) and laryngologist at Providence Saint John’s Health Center in Santa Monica, CA. But on the bright side, most people with these types of severe allergies are aware of the issue, increasing the likelihood they’ll get treatment ASAP, as it sounds like Dobrev did.
What happens when you go into anaphylactic shock?
Neither Dobrev nor Hough specified what exactly caused Dobrev’s reaction. Regardless of the cause, though, all anaphylaxis starts the same way, explains Dr. Mehdizadeh. First, your body quickly releases a flood of histamine (a chemical involved in immune responses that causes many types of allergy symptoms, like runny nose or sneezing) into the bloodstream. This causes a severe influx of fluid into the body’s soft tissues, which makes you swell up. Sometimes it’s just the skin that swells, but in other, more worrying cases, swelling can happen in the floor of the mouth, under the tongue, the tongue itself, in the lips, the soft palate, the back of the throat, the uvula, even down into the voice box. “If these structures swell enough, that can potentially completely obstruct your airway and cause someone to suffocate,” says Dr. Mehdizadeh. (Related: This Woman has Life-Threatening Allergic Reactions to the Cold Temperatures)
Anaphylactic shock is the extreme end of anaphylaxis, aka a severe allergic response. The difference between anaphylactic shock and anaphylaxis comes down to whether your vitals actually change: That fluid transfer inside your blood vessels (anaphylaxis) can cause enough swelling to impair blood flow so your heart is seeing less circulating volume, which can then cause your blood pressure to drop and your heart rate to skyrocket (anaphylactic shock), explains Dr. Mehdizadeh. This “shock” can cause hypotension, arrhythmias, even cardiac arrest, all of which could kill you if you aren’t treated in time, he says.
How common is it for a severe allergic reaction (anaphylaxis) to develop into anaphylactic shock?
Fortunately, anaphylaxis isn’t super common, and full-blown anaphylactic shock even less so: Up to 5 percent of people in the U.S. have experienced anaphylaxis to some degree, but less than 1 percent of sufferers have died from the reaction, according to research published in The Journal of Allergy and Clinical Immunology. The most common causes of anaphylaxis include certain foods like nuts and shellfish, insects (like bee stings), medications like penicillin, and latex, per the research. (Related: 5 Signs You Might Be Allergic to Alcohol)
Again, most people who have a severe allergy are aware of it, as it usually starts happening in childhood, says Dr. Mehdizadeh. However, if you aren’t exposed to an allergen like shrimp or penicillin as a child, that allergy could be a surprise in adulthood, he explains. Plus, you can develop an allergic or anaphylactic reaction to something as an adult, even if it’s something you previously had no issues with whatsoever. (FYI: No one really knows why or how these later-in-life allergies develop, adds Dr. Mehdizadeh.)
What’s scary, however, is that you don’t necessarily have to ingest or come into direct contact with your allergen to have a reaction. “If you’re severely allergic to shellfish and you breathe in cooking fumes at a restaurant, those fumes have the same proteins that may cause your body to react,” explains Dr. Mehdizadeh. Similarly, if you’re severely allergic to peanuts, having your seatmates tear into bags of the stuff on an airplane could send you into anaphylaxis. FWIW, while the Federal Aviation Administration (FAA) does require airlines to carry vials of epinephrine and a syringe on planes, they aren’t required to carry an auto-injecting EpiPen (though you can bring your own EpiPen on the plane). Even scarier, still: The FAA recently granted U.S. airlines exemptions that allow passenger planes to fly without any epinephrine in their onboard medical kits if the airline “runs out” of the drug; the airline simply has to claim it cannot replenish the drug in a cost-effective way, according to the New York Times.
What are the signs of anaphylactic shock?
While anaphylaxis isn’t super common and sufferers are usually aware of the risk, it is serious enough that everyone should know the signs of the reaction, says Dr. Mehdizadeh. (Related: 4 Surprising Things That Are Affecting Your Allergies)
Initial symptoms can include a little bit of hoarseness or a raspy voice thanks to swollen vocal cords, explains Dr. Mehdizadeh. If your throat starts to swell, it’ll create a “hot potato voice” which essentially sounds muffled, like you’re trying to talk through hot food in your mouth. Many people also experience a scratchy sensation and wheezing, adds Dr. Mehdizadeh. If you reach stridor—a narrowing of the airways that creates noisy, labored breathing—your anaphylaxis is getting serious, he says.
Most people with a history of severe allergies carry an EpiPen on them at all times, explains Dr. Mehdizadeh. But any swelling of the airways, shortness of breath, wheezing, or chest tightness should be an alarm bell to head to the emergency room. Even if the initial reaction seems like it’s not that bad, anaphylaxis can progress and cause you to go into anaphylactic shock hours after coming into contact with the allergen, says Dr. Mehdizadeh. (If you have a rash or mild swelling of the skin, just take a Benadryl and keep an eye on it, he adds.)
Living With Food Allergies
Take Steps to Avoid Anaphylaxis
The best way to avoid anaphylaxis is for your child to stay away from allergens. Teach your child about his or her allergy in an age-appropriate way. Teach your child to tell an adult about a reaction, how to avoid allergens and how and when to use an epinephrine auto-injector. Here are some first steps you can take for each type of allergy:
Food. Learn how to read food labels and avoid cross-contact. Read the label every time you buy a product, even if you’ve used it before. Ingredients in any given product may change.
Insect allergies. Wear closed-toe shoes and insect repellent when outdoors. Avoid loose-fitting clothing that can trap an insect between the clothing and the skin.
Medicine allergies. Tell your doctor about medicines your child is allergic to. Know both the generic and brand names of the medicines.
Latex allergies. Tell your doctors, dentists and other health care providers about your child’s latex allergy. Ask them to put a note in your child’s medical chart about your child’s allergy. Also remind them of the allergy before any medical procedure or test.
For all allergies: Educate family, friends, the school and others who will be with your child about your child’s allergies. They can help your child avoid allergens and assist if anaphylaxis occurs.
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Medically reviewed by Drugs.com. Last updated on Sep 24, 2019.
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WHAT YOU NEED TO KNOW:
Anaphylaxis is a life-threatening allergic reaction that must be treated immediately. Your risk for anaphylaxis increases if you have asthma that is severe or not controlled. Medical conditions such as heart disease can also increase your risk. It is important to be prepared if you are at risk for anaphylaxis. Your symptoms can be worse each time you are exposed to the trigger.
Steps to take for signs or symptoms of anaphylaxis:
- Immediately give 1 shot of epinephrine only into the outer thigh muscle. Even if your allergic reaction seems mild, it can quickly become anaphylaxis. This may happen even if you had a mild reaction to the allergen in the past. Each exposure can cause a different reaction. Watch for signs and symptoms of anaphylaxis every time you are exposed to a trigger. Be ready to give a shot of epinephrine. It is okay to inject epinephrine through clothing. Just be careful to avoid seams, zippers, or other parts that can prevent the needle from entering your skin.
- Leave the shot in place as directed. Your healthcare provider may recommend you leave it in place for up to 10 seconds before you remove it. This helps make sure all of the epinephrine is delivered.
- Call 911 and go to the emergency department, even if the shot improved symptoms. Do not drive yourself. Bring the used epinephrine shot with you.
Call 911 for any of the following:
- You have a skin rash, hives, swelling, or itching.
- You have trouble breathing, shortness of breath, wheezing, or coughing.
- Your throat tightens or your lips or tongue swell.
- You have difficulty swallowing or speaking.
- You are dizzy, lightheaded, confused, or feel like you are going to faint.
- You have nausea, diarrhea, or abdominal cramps, or you are vomiting.
Return to the emergency department if:
- Signs or symptoms of anaphylaxis return.
Contact your healthcare provider if:
- You have questions or concerns about your condition or care.
- Epinephrine is medicine used to treat severe allergic reactions such as anaphylaxis. It is given as a shot into the outer thigh muscle.
- Medicines such as antihistamines, steroids, and bronchodilators decrease inflammation, open airways, and make breathing easier.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Follow up with your healthcare provider as directed:
Allergy testing may reveal allergies that can trigger anaphylaxis. Write down your questions so you remember to ask them during your visits.
- Keep 2 shots of epinephrine with you at all times. You may need a second shot, because epinephrine only works for about 20 minutes and symptoms may return. Your healthcare provider can show you and family members how to give the shot. Check the expiration date every month and replace it before it expires.
- Create an action plan. Your healthcare provider can help you create a written plan that explains the allergy and an emergency plan to treat a reaction. The plan explains when to give a second epinephrine shot if symptoms return or do not improve after the first. Give copies of the action plan and emergency instructions to family members, and work or school staff. Show them how to give a shot of epinephrine in case you are not able to give it to yourself.
- Be careful when you exercise. If you have had exercise-induced anaphylaxis, do not exercise right after you eat. Stop exercising right away if you start to develop any signs or symptoms of anaphylaxis. You may first feel tired, warm, or have itchy skin. Hives, swelling, and severe breathing problems may develop if you continue to exercise.
- Carry medical alert identification. Wear medical alert jewelry or carry a card that explains the allergy. Ask your healthcare provider where to get these items.
- Identify and avoid known triggers. Read food labels for ingredients. Look for triggers in your environment.
- Ask about treatments to prevent anaphylaxis. You may need allergy shots or other medicines to treat allergies.
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Learn more about Anaphylaxis (Aftercare Instructions)
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Mayo Clinic Reference
What is anaphylaxis?
Anaphylaxis (pronounced ana-fill-ax-is) is a severe and potentially life-threatening allergic reaction affecting more than one body system such as the airways, heart, circulation, gut and skin. Symptoms can start within seconds or minutes of exposure to the food or substance you are allergic to and usually will progress rapidly. On rare occasions there may be a delay in the onset of a few hours.
What are the causes of anaphylaxis?
The common causes of anaphylaxis include foods such as peanuts, tree nuts, milk, eggs, shellfish, fish, sesame seeds and kiwi fruit, although many other foods have been known to trigger anaphylaxis. Non-food causes include wasp or bee stings, natural latex (rubber), and certain drugs such as penicillin. In some people exercise can trigger a severe reaction – either on its own or in combination with other factors such as food or drugs (e.g. aspirin).
What are the symptoms of anaphylaxis?
You may notice any of these severe symptoms:
There may be a dramatic fall in blood pressure (anaphylactic shock). The person may become weak and floppy and may have a sense of something terrible happening. This may lead to collapse, unconsciousness and – on rare occasions – death.
In addition to those severe symptoms listed above, there may also be:
- Widespread flushing of the skin
- Nettle rash (otherwise known as hives or urticaria)
- Swelling of the skin (known as angioedema) anywhere on the body.
- Swelling of the lips
- Abdominal pain, nausea and vomiting
These symptoms can also occur on their own, without the more severe ones. Where that is the case, the reaction is likely to be less serious but you should watch carefully in case any of the more severe ones develop.
There are several different types of reaction which could occur:
- Uniphasic – these come on quickly and symptoms get rapidly worse, but once treated, the symptoms go and don’t return.
- Bi-phasic – these are reactions which may be mild or severe to start with, followed by a period of time when there are no symptoms, and then increasing symptoms with breathing and blood-pressure problems.
If you have an anaphylactic reaction, you will need an observation period in hospital after you have recovered in case you experience a biphasic reaction. Most biphasic reactions occur within hours of the initial reaction but rarely they can be more delayed (Lee et al, 2015). On very rare occasions, a biphasic reaction has been known to occur as long as 72 hours after the initial reaction.
The length of the observation period would be for your treating doctor to decide. The National Institute for Health and Care Excellence (NICE) recommends that people who have had a severe allergic reaction should be monitored for 6 – 12 hours within a hospital setting because of the risk of a bi-phasic reaction. Children are likely to be admitted to hospital at least overnight (NICE 2011).
- Protracted anaphylaxis – this can last for several days and may need treatment in hospital for some time.
Watch Professor John Warner OBE, a member of our Clinical & Scientific Panel, explain anaphylaxis and allergy:
What is the treatment for a severe reaction?
Pre-loaded auto-injectors (sometimes referred to as ‘pens’) containing adrenaline are prescribed for people believed to be at risk of anaphylaxis. Adrenaline is referred to in some countries as epinephrine, which is the internationally recognised term for adrenaline.
- Find out more about adrenaline auto-injectors
- Our online training programme AllergyWise provides information on what to do in an emergency.
- View our tips on what to do in an emergency.
What increases the risk of a severe reaction?
There are times when you may be particularly vulnerable and at increased risk of a severe reaction. Times when you need to be particularly careful to avoid the culprit allergen include:
- If you have asthma that is poorly controlled
- If you are suffering from an infection, or have recently had one
- If you exercise just before or just after contact with the allergen
- If you are also suffering from aeroallergen symptoms, such as hay fever
- During times of emotional stress
- If you have been drinking alcohol
All the information we produce is evidence based or follows expert opinion and is checked by our expert clinical and research reviewers. If you wish to know the sources we used in producing any of our information products, please let us know, and we will gladly supply details.
Revised March 2017
Review date Oct 2019
After the Epi – Our Real Nightmare Begins!
Almost four weeks ago, I wrote a blog post entitled “Our First Experience With the Epi – All the Details and 16 Lessons to Take Away.” As the name implied, the post was a detailed “play-by-play” of our first use of an epinephrine auto-injector, after living 14 years with multiple kids with food allergies. We thought that sharing this story (particularly with those who have never had to use an EpiPen or AUVI-Q) would be helpful in taking away some of the mystery, easing some concerns, reiterating important lessons, and strengthening everyone’s conviction to use their auto injector if and when it’s needed. Frankly, we were proud of the clear-headed and calm way we managed this situation as our son was suffering an allergic reaction which ultimately required epinephrine, and we wanted to share all that we learned – before, during, and after – that was applicable on that day.
To recap, my oldest son (“T”) had an allergic reaction after ingesting a product from a nut-free table at a fundraiser (his only allergy is to tree nuts). It was a delayed-onset reaction, but one in which we ultimately knew – thanks to what we’ve learned in this community – required epinephrine. (Later, the ER doctor not only thanked us for giving T the injection – too many people don’t, which makes the situation a lot more difficult and dangerous – but told us she was sure he would have experienced full anaphylaxis had we not done so.) After giving him the epi, which provided immediate relief, we followed protocol by calling 911 and having an ambulance take my son to the hospital. While in the hospital, 75 minutes after the initial exposure, T experienced a 2nd (biphasic) reaction which was easily treatable by the ER staff (to whom we give many, many thanks).
Five hours later, we were discharged. It was roughly 5AM on Sunday morning. That’s where the story was supposed to end. Happily.
Looking back, with the years I’ve spent working in this wonderful food allergy community, and learning all the proper protocols for how to treat someone having an allergic reaction (epi, 911, ER), I now realize that I never learned what happened AFTER the ER. I always assumed that once the observation period is over, the patient goes home and resumes normal life. Nothing else. It’s done. Nightmare over.
I was wrong.
Now, before I share Part 2 of the story, let me be clear that what you are about to read relates to our specific experience. This story is not textbook and, unlike the last blog entry, is not meant to provide broad lessons that would be applicable to all. In addition, due to the sensitive nature of some of what transpired, and given that my son is 16, I am toning down some parts to respect his privacy and sensitivity. However, we think it’s once again important to share what we faced in the hope that others may take away something of value from our experience and/or potentially have a more informed discussion with those providing care after the epi.
So back to the story…
After the Epi: The First 48 Hours.
We left the hospital with 2 prescriptions and a plan. One prescription was for replacement auto-injectors. (OK, there IS a lesson in this story – always get prescriptions for replacements when leaving the ER.) The other was for Prednisone, which was explained to me as necessary to reduce swelling. Arriving home, my son and I both fell asleep (it was a long night!). My wife dropped off the prescriptions later that morning. When she returned to pick up the meds, the pharmacist asked her to come back as he had a question about the Prednisone that he wanted to clarify with the prescribing doctor. (Did he foresee something? Or did he in fact just have a simple question?)
Anyway, we also left the ER with a plan. The plan was for T to take Benadryl 4 times that day (Sunday), as well as 80mg of Prednisone on Sunday and another 80mg on Monday. After that… done.
As you can imagine, having had very little sleep and adding in Benadryl, Sunday and Monday were wash-outs for T. He could barely keep his eyes open on either day. He missed one day of school. Big deal. He diligently took the Prednisone as well.
I wrote Part 1 of this story Tuesday for publication on Wednesday. I thought I was recapping a completed experience. However, Tuesday is when it all went wrong.
After the Epi: Days 3 & 4. The Bottom.
T went to school Tuesday as usual (he’s in high school). My wife picked him up at the end of the day for the ride home. This, as you can imagine, is generally an uneventful time. However, when I got home from work, my wife pulled me aside, looking worried. She was very concerned about T because not only did he seem uncharacteristically down on the car ride home, but he said “I don’t have anything good to look forward to anymore.” Now, you have to understand, my wife and I have been blessed with 5 amazing kids, and T has always been the model older brother for his siblings. He is as nice a 16-year-old boy as you can imagine, he is empathetic toward others, he LOVES his younger siblings and plays with them as much as he can, he has a ton of friends, and he is a VERY upbeat, fun-loving kid who plays sports and always drives to win, yet who doesn’t mind losing and who I have seriously never seen get really angry at anyone. Despite being a hockey player of smaller stature (drawing the “attention” of bigger kids on other teams), he has never even thought of retaliating from a cheap shot (despite me admittedly advocating for him to do so) and has actually never drawn a penalty in almost 10 years of playing. Basically, he’s an easy-going, well-balanced kid in many important ways.
So you can imagine my shock and concern upon hearing what T said to my wife in the car! I tried to get the “real” context of his statement out of her – after all, that just wasn’t him! – but she stood hard and fast that she knew what she heard and the sadness in his voice.
My wife and I thus spent a great deal of time on the phone with doctors that day. My wife spoke to T’s allergist, his pediatrician, and another ER doctor. I spoke to a psychiatrist I know. The message to us was clear: T was given a very high dose of Prednisone – a drug that a lot of people have horrific reactions to.
Of all the doctors we spoke to, there wasn’t a general consensus on how T should have been treated after the ER. There was some question about the high amount of Benadryl he was told to take, but that was the least of our concerns. We wanted to understand what was happening due to the Prednisone… and what we should expect. One allergist/friend I spoke to (10 days later) shared with me that the formal guidelines for Prednisone actually would suggest about 50-80mg/day for T, given his age and weight. However, of the four doctors we spoke to that day – the allergist, pediatrician, ER doctor (not the one who gave the initial prescription), and psychiatrist – all felt that 80mg/day was way too high. 60mg would be a full dose for an adult, we were told, and for a 125lb boy, 40mg is the highest they would have prescribed! T took double this most aggressive recommendation!
Fortunately, we were told by all the doctors that the mental effects of the drug would fade away, probably by the weekend. (Effects? Plural? What were we in store for?) We were heartened. However, one of the doctors suggested that we don’t leave T alone and that we even have him sleep in our room until the negative effects died down.
But things seemed calm that Tuesday evening. T sat doing his homework. He definitely didn’t seem himself – he was tired and distracted – but there didn’t appear to be any concerning behavior. I felt a little heartened and relieved.
That night, as I worked in my study, T climbed into bed around 12:30. He then called for me almost immediately. This has never been a good sign in the past, and hadn’t occurred in a very, very long time. When I went into his room, T was beside himself with anguish! He tried to explain to me what was wrong. Suffice it to say that he seemed to have become obsessed with what he described as a dry area in the back of his airway above the mouth which became very uncomfortable every time he took a breath. He was adamant this had nothing to do with the allergic experience he had just gone through. I asked when it began. He told me it had been like that for YEARS but was worse now than ever. Further, he told me it was distracting him all day at school and he couldn’t concentrate. He couldn’t get it out of his mind!
What could I do? Despite feeling pretty sure that this was an obsession brought on by the Prednisone, I racked my brains for how to help him temporarily relieve this sensation, but couldn’t come up with any reasonable ideas (let alone any that he believed would work). I scoured the internet trying to find something similar to what T his feeling. Nothing. Finally, having no solution in mind, but knowing that this obsession was truly bothering him, on top of what he had told my wife earlier, I had him sleep on the window seat in our master bedroom so we could more easily stay on top of anything that might transpire with him that night. Eventually, he fell asleep. Meanwhile, I stayed up much of the night researching Prednisone. I’m sure doctors sigh when they hear that someone is researching the internet for medical information… and they should. However, what I read that night scared me. Of course, I was only reading the horror stories, but they were bad – really bad! Most involve individuals practically going out of their mind with severe, temporary mental issues – depression, anxiety, obsessions, even suicidal behavior. I have since spoken to a few friends who have sworn off Prednisone after sharing their nightmarish stories with me. The only glimmer of hope I ended up with that night was the constant reminder that these negative effects would eventually go away.
T was a disaster the next few days. He was down and depressed. He was obsessing over this feeling in his airway. He couldn’t concentrate (later verified by some friends and a teacher at school who said they noticed his atypical behavior). And he was scared! He was scared that this feeling would never go away. We kept him home from school Wednesday and notified his guidance counselor so we could coordinate a workable plan for when he returned (this was the big test week before the review period that led into finals – i.e. a bad time to miss school and have to make up tests).
My wife also remembered something important on Wednesday. She remembered that T had once before been prescribed Prednisone. And she remembered that at that time he had obsessed about an infection on his ankle. I don’t know the dosage he was on, but I do remember this “weird” and drawn-out concern he had about his ankle.
In any case, nothing changed that Wednesday when T stayed home… except that we saw these issues all day first-hand. It was bad. He was scared. The only thing that seemed to reassure him was telling him that all these feelings were related to the Prednisone and that they would fade away. He was anxious to know when. We shared with him the best guess from what we were told – by the weekend – which gave him a small glimmer of hope. That was good… because we were wrong. We didn’t leave T alone that day. We kept him in our room again that night. And he stayed home from school again Thursday (with emails flying back and forth between the understanding guidance counselor and my wife and I).
After the Epi: The Rest of Week 1.
Thursday saw a continuation of the theme of obsession, concern, an inability to concentrate, and anxiety. Yet the degree of sadness and anxiousness seemed to have made its first turn for the better. My wife and I were not going to bring up the issues unless T initiated the discussion, which we knew he would do if necessary. He did come to me for more reassurance now and again, especially before going to bed (the night is always worse for “mind games” as many of you probably know), but for the most part we were feeling more comfortable. We let T slept in his own bed again that night, and he went to school the next day.
Friday was a tough day at school for T, but the distraction of having his friends with him helped. He continued to share with us his inability to concentrate and now, on top of it all, he had a ton of tests to make up during finals’ review week. Regardless, we encouraged him to be social and have his friends over during the weekend. This was a good call. He was in great spirits around his friends. The negative side effects of the Prednisone were clearly fading. And when he wasn’t sitting… thinking… he seemed to be really good.
We did have small “relapses” of severity every now and then thereafter. The most notable was Saturday night.
On Saturday night, our family of 7 went out to eat. As the dinner dragged on, my little ones (4- and 7-years-old) became more and more restless – shocking, isn’t it? Anyway, my very excitable 7-year-old, who idolizes his big brother T, was talking a million miles a minute in his ear. Finally, T yelled at him to stop… and then looked down. He seemed unusually upset all of a sudden. As his little brother went to talk someone else’s ear off, my wife and I asked what happened. His response – again, from a young man who NEVER gets really angry and has never been physical in his life – was “I just got SO MAD!” I asked “Do you mean ‘mad’ like you wanted to hit him?” T shook his head in acknowledgment and looked down again in sadness.
Fortunately, that was the only situation of such anger – and, as I mentioned earlier, the various relapses have subsided more and more with time.
We had now survived this first horrible week after the epi. Our biggest problem now was that T was still constantly distracted with his obsession when he wasn’t actively engaged with others, particularly when he was studying. In addition, we thought all the negative effects of the drug would have worn off by now – I had told him so – which led to disappointment and concern on his part about whether they ever would. All we could do was more research (calling doctors) and keep giving him the best information and support possible. We did.
The studying and schoolwork itself didn’t help either . He had missed 3 days of high school at a critical time and was now cramming to study for tests he had to make up after school, instead of utilizing that important time to study for finals. It was very tough at first, but by the Sunday night before finals and into Tuesday (2 weeks into our ordeal)… he was shockingly upbeat! While he admitted that focus was still an issue, he was plowing through what needed to be done – and doing it well! Now, in my life, I don’t ever remember being upbeat in the midst of studying for 6 finals in 3 days. But he was.
And finally, we knew the worst had passed.
After the Epi: 4 Weeks Later.
We are now 4 weeks past our epi experience. My wife and I rarely ask T now if he’s having trouble. He’ll tell us if he is (and we can read him like a book anyway). I did ask twice in the last week when he seemed like this issue was on his mind. (It was.) He said that the intrusive thoughts still kept popping into his head, even though the thought itself wasn’t bothering him as much anymore. Yet, the fact that he couldn’t shake the obsessive thoughts was upsetting. But he has gone about his usual 16-year-old life – enjoying the beginning of summer, working, spending time with friends, driving alone (for the first time – that’s a whole ‘nother story!), playing video games… you get the picture. I would say he’s 95% back to “normal T”. I don’t know when he’ll be 100%, and more and more docs are now telling us these side effects can drag out for some time – so there may be more relapses I currently don’t expect – but 95% is good enough for now… and certainly better than where we were 4 weeks ago!
Our post-epi trauma has just about run its course, I believe. My son feels much, much better and – most importantly – recognizes that this was not the result of the epinephrine. This was extremely important for him to understand so that he will never hesitate to use it again in the future if necessary (in fact, I think he’ll be more likely, having felt the great immediate effect it had when he needed it!). We also now know what to expect post the ER visit and we are better informed to discuss with the doctor the follow-up medical plan.
During these last few weeks, many people have spoken to me about their own horror stories involving Prednisone. I can’t believe the sheer number of bad experiences I have heard about and the incredible details. This is obviously a drug that doesn’t sit well with everyone. That said, I am not a doctor and know nothing about Prednisone besides T’s experience and that which others have shared with me. From what I hear, it is a great and effective drug for what it is meant to do – so I don’t want anyone to say to an ER doctor “I won’t use this drug because this guy said a lot of people have horrible side effects.” However, I believe our story was important to share. Perhaps this will help others prepare in advance for the “post-epi” experience, maybe even helping them have a more informed discussion with the ER doctor.
As an aside, I want to thank the tremendous number of people who expressed their concern about T after I reported the initial epi experience and again, soon thereafter, when I posted on Facebook that our nightmare had actually just started (without details at the time). The outpouring of support meant so much to us and once again made me incredibly grateful to be a part of such an amazing, tight community. We are always all in this together!
How Our Community Can Keep Helping Each Other.
It is customary for me to end AllergyEats Blog entries with a call to please rate your restaurant experiences on our core AllergyEats site or app. And while it doesn’t really feel “right” to end this personal story with that “commercial call to action,” the fact of the matter is that your ratings on AllergyEats have helped an incredible number of people since inception and I’d like to make that request again given my last line: “We are always all in this together!” So if you’ve dined out recently, please help our entire food allergy and intolerance community by spending just the one minute it takes to rate your restaurant experiences at www.allergyeats.com or on our free smartphone app. Thank you.