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The EpiPen: Long-Time Owner, First Time User

Posted May 09 2011 10:30pm

On Saturday, I went to Anaphylaxis Canada’s annual conference. I came away from it with some new and interesting information, freshly reminded of how serious allergic reactions can be. I fully planned on (and still am) blogging about the conference. I spent the first half of the day thinking about what I’d write on my blog. That conference blog post, however, was pushed aside so that I could write this one.

In a strange bit of irony, the second half of my day was spent administering an EpiPen for the first time in my life, and dealing with the aftermath of an anaphylactic reaction.

First and foremost, let me say that everything is fine. My number 3, five year old son, had an allergic reaction today. He is allergic to dairy, eggs, bananas and tree nuts. He is home now and for the most part, seems relatively unscathed.

The EpiPen did what it was supposed to do. I didn’t wait until he was in respiratory distress and he was conscious and aware of what was going on at all times. The situation was serious, but under control. Paramedics arrived fairly quickly and he was transported to hospital without any trouble.

I’m not even sure what he reacted to. I suspect that he somehow ingested the cow’s milk that his sister was drinking, but I’m not sure. I saved the packaging from everything that I could remember he’d eaten today. Tomorrow I will call all the companies to see if anything he’d eaten could have been cross-contaminated or if there could have possibly been some undeclared allergens present.

Here’s what happened: we were getting ready for lunch. I had it served on plates and we were about to eat. The kids had eaten some marshmallow candies a little earlier, plus they’d had some juice and other snacks. Number 3 first started complaining about his back being itchy. Any time he says he’s itchy, I take note. I checked over his back and didn’t see anything but the slightest bit of redness. I thought it was from him scratching.

He continued to complain of itchiness and I checked his back a few times – not much was there. I checked his mouth and tongue, and it all looked normal. I thought maybe he had some dry skin. After he continued to complain, I suggested we put some cream on his back. The only cream I could find was one scented with lavender essential oil. I worried that it might irritate his skin but it was all that I could find and the itchiness was starting to drive him crazy. He had also been wheezing and coughing a little and so I gave him some ventolin.

He started complaining of his ears being itchy and I started to think that something was going on. At this point his back was quite red and I thought the cream was irritating him. I thought if he had a bath, it might settle the itching down. I really started to think that something wasn’t right so I decided to give him Benadryl just in case. I figured it couldn’t hurt and I thought it might help with whatever was making his back so itchy.

He and Sister happily climbed into the tub and I rinsed his back and tummy to get all the cream off. As I was doing this, I noticed that hives were coming out on his back. And his back was bright red in areas that he couldn’t have possibly reached and scratched. Then he said his throat was itchy. It was at this point that I knew it was an allergic reaction and I knew that it was pretty serious.

Let me pause the story for a minute to tell you what was going through my head. I know that an anaphylactic reaction is a reaction that involves two or more body systems. Anaphylactic reactions are the ones that can be deadly. Once a life threatening allergic reaction starts, there is a point of no return. There is a point at which no amount of epinephrine, steroids, or any treatment can stop a reaction. The key with anaphylaxis is to administer an EpiPen as soon as there are signs of an anaphylactic reaction. When there are anaphylactic deaths, it is usually because an EpiPen was administered too late or not at all.

At the anaphylaxis conference on the weekend I listened to a speaker talk about a study in which severe anaphylactic reactions were studied. In all the cases where there was a death, the EpiPen had either not been administered, or had been administered more than 30 minutes after the onset of symptoms. Cases where people had severe reactions and survived, all had been given the EpiPen within 30 minutes of symptoms. Another thing discussed at the conference is how common it is for people to hesitate giving the EpiPen and other reasons that administration might be delayed.

One final thought that was going through my mind was this: Number 3 had had an anaphylactic reaction once before. He was about two and he’d eaten a handful of banana. He experienced wheezing, sneezing, vomiting and hives. He ended up being okay and it wasn’t until after the fact that we’d realized that it was an anaphylactic reaction and that we should have administered the EpiPen. Mr. FamilyNature and I said that if he ever had a reaction like that again, we would give the EpiPen, without a doubt. We knew that we’d dodged a bullet that day and we were not going to make the same mistake again.

So back to today, I called Mr. FN and told him what was happening. I blurted out that it was two body systems and that I was going to call 911. Mr. FN said he was on his way home. Now even at this point, after all this going through my head, and knowing that I should give the EpiPen, I hesitated. I called 911 first.

Naturally the 911 operator told me I had to give the EpiPen. She said, “Based on what you’ve told me, you have to give him the EpiPen NOW.” She was great; very calm and patient but her voice was firm. I tried to keep my composure as I ran to get an EpiPen out of my purse.

I told Number 3 that I had to give him the EpiPen. I was trying my very best to be calm and strong but I had tears in my eyes and I knew he could hear my voice cracking. He starting whimpering quietly and asked “is it going to hurt?” I told him that it would hurt for a minute but that he needed the medicine.

I put him in my lap and gave him the pen. He screamed. Sister screamed. I was trying to keep it together and keep everyone calm. I held him and rubbed his thigh and told him over and over again that I was sorry. He cried and cried.

After a few minutes the paramedics arrived. By this time the hives were going down (man, that EpiPen works fast!) and he and Sister had calmed down a bit. The paramedics were wonderful; they came in and assessed the situation quickly. He was a bit wheezy but was okay. He was still really scared, shivering (still naked with a towel wrapped around him from the bath) and his leg was sore from the EpiPen.

Mr. FN arrived home a few minutes later and he rode in the ambulance with Number 3 to the hospital.

At the hospital, he was assessed and then kept for about 5 hours. Everyone who talked to Mr. FN told him that we did the right thing. The EpiPen was the right thing to do.

They gave my little boy pediapred (a steroid) and a long-lasting antihistamine. He was released with a prescription for a 4 day course of pediapred and instructions to watch him carefully.

He’s in bed now. We’re all a little shaken, but we’re okay. Stay tuned for more on this and my thoughts on the Anaphylaxis Conference.

Special thanks to everyone who has called, emailed or facebooked me. Your thoughts and kind words mean a lot. xoxo

Photo by Hopkinsii via flickr .

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