was this anaphylaxis? and what about steroids/antihistimines after?

[blessedwithboys]

I had a pretty bad experience Monday night. I had had one of my typical headaches, caused by a venous malformation in my brain. Usually, I use a natural approach in dealing with these headaches, but this last one two days ago was the worst ever.

I usually don't even keep Tylenol/Motrin, etc. in the house, but a few months back I had a wicked period and broke down and bought generic Aleve, on the pharmacist's recommendation. I took maybe two doses, it didn't help the cramps, so I tossed it under the sink and forgot about it. (Side note: I used to take Naprosyn in junior high for a knee injury and had no issues, other that it not really helping much.)

So after a day of head pain, I broke down and took two naproxen sodium tablets. Within 15 minutes, I was having a severe reaction. It started with my feet itiching, then my hands, then my, ummm, vuvla , then I began breaking out in hives all over my body. My face was one giant bump. I didn't connect the dots, so all I did was put on some lotion, thinking my skin was dry. Not sure how I rationalized the hives...Immediately after putting on the lotion, my head began pounding. It wasn't more of hte same headache, it felt like someone was on the inside pushing my skull. I felt my ears pulsating.

I realized I was having some sort of allergic reaction, and I began having a major panic attack. I am a single mother, and I always worry about something happening to me and my kids having to go live with their fathers and being split up. I found an old bottle of childrens Benadryl and swigged half the bottle without measuring. Then I called a dear friend who is my healthcare surrogate to tell her I was driving myself to the ER. Well, she couldn't even recognize my voice, because apparently, my tongue was grossly swollen. She told me she was rushing over, so I woke my teenager and told him to listen for his brother because D was coming to take me to the ER. He was really worried, but stayed calm, my good boy.

I got to the ER 15 minutes later, about 30 minutes after it all started. The triage nurse happened to be an old family friend, so she rushed us right back. I got an IV of famotidine and methylprednisolone. That caused a whole new panic attack to start, because I still haven't totally processed my birth trauma (birth rape, to be more accurate) from 8 years ago. I have PTSD regarding doctors, hospitals, medical treatments, etc.

They told me that if I hadn't just swigged the Benadryl, and had measured out 2tsp, I may not have made it to the ER breathing on my own. I would probably have kept swelling up to the point of needing to have a trach hole cut. My BP was 177/90-something and my pulse was 120 at rest.

I'm now taking a week long course of steroids and 30 days of Pepcid. I'm sure this is protocol, but is it necessary? They told me that since my immune system is so riled up, there's no telling what may trigger it next.

Also, I read online that you could have all the symptoms of anaphylaxis, and yet not actually have it. It has to do with exactly what is going on inside the body. I couldn't get a straight answer in the ER, I don't have insurance, so no PCP, and I want to know if I should be carrying an epi-pen. Obviously, I'll never take naproxen again, but if could react to something I had taken before without trouble, and my immune system just decided to wig out for no reason, what if it happen next time I make myself a PB&J?

Thanks in advance for any insight you may have to share with me!

[sbgrace]

Yes, it sounds like anaphylaxis and benadryl isn't a treatment for that so you could have died anyway to be blunt. Not all anaphylaxis progresses to death but they always can.

So...did you get epi pen prescriptions? You want to read up on the early signs of anaphylaxis and carry those pens with you. They are temperature sensitive so can't be left in a vehicle. If you didn't get them have a doctor prescribe because you need them now in case it happens again. Maybe you could do an urgent care type clinic for this or see a county health nurse perhaps. You need them and unfortunately they are expensive. You want two because sometimes something goes wrong with the first one or a person sometimes needs two to stop a reaction.

The steroids will calm everything down. Drug reactions are tricky in terms of clearance so I would probably take them.

When you get the ER bill I would talk with the hospital about being uninsured. Often they will work with you on payments and even decrease it because insurance writes off so much of the fees off the top and you don't have that option as a self pay.

[blessedwithboys]

I don't think the bill will be a problem. I applied for Medicaid today and will hopefully have share-of-cost retroactive to 8-1-10. Phew! I just hope it comes through in time for me to get a rx for epi-pens. I checked on drugstore.com and a two-pack is $150!

I will go to a walk-in clinic that I have used before to see about getting the rx. I was NOT given epinephrine in the ER, I'm sure of it. Maybe since the Benadryl helped, it wasn't anaphylaxis after all???

[sbgrace]

Usually the protocol for anaphylaxis is epi pen, benadryl and 911. The benadryl can certainly help with allergic reactions. But the epi pen (if administered quickly) is what will affect the ultimate outcomes rather than the benadryl. My dad refuses to carry an epi pen. He's had four or five anaphylactic episodes all while eating out and takes benadryl and goes to the ER and I think they typically do steroids. Someday he might die or this might continue working for him. He shouldn't be taking that risk.

My son's anaphylaxis was biphasic (severe, with a second wave) and he survived without epi administration. We were lucky. You were lucky. Just because you don't die doesn't mean it wasn't anaphylaxis. Anaphylaxis stops at some point no matter what you do or don't do. Sometimes that point is dead of course and sometimes it isn't. But it will stop. My son's stopped. Yours stopped. Still anaphylaxis. You might look up the symptoms. I'm not sure what makes you think you could have those symptoms and not be in anaphylaxis but I don't think that is correct basically.

[blessedwithboys]

I guess I'm not sure because I wasn't given epinephrine and no one actually said the "A" word. Also, my blood pressure was really high, not low. Other than that, I had pretty much all the symptoms. What happened to your ds is what they were worried about with me, and that's why I agreed to the IV meds instead of oral. I didn't want to go back home and die while my kids were asleep in their beds.

[JaneS]

Yes it was.

I don't understand "having all symptoms of anaphylaxis but not actually having it" ... doesn't the symptoms equal the reaction?

I would get on a regular everyday vitamin C supplement, with bioflavonoids, to help neutralize your body's histamine response. I prefer whole food C such as amla or acerola powder that has the bioflavonoids naturally, that keep the C circulating longer.

[blessedwithboys]

Thanks, I will try the C tomorrow.

How come I'm only finding LOW BP when I look up the list of symptoms? Mine was 177/97! Coincidentally, I had taken it earlier in the day just for kicks bc a friend of mine had a wrist cuff monitor laying on her dining room table. It was 118/78.

I don't mean to doubt the very people I am asking advice from, I just don't understand what happened to me or why it happened. It may a few weeks before I can get to a doctor to ask for an epi-pen. I figure they don't just hand out rx for those, and I don't have a regular dr, so I am requesting the ER records to take with me.

So just to clarify, it is possible to have HIGH BP during an episode of anaphylaxis?

[JaneS]

Sometimes our bodies react differently. My son's reaction was fairly mild and only consisted of hives and vomiting a dinner plate sized amount of white mucus. Still anaphylaxis.

I think the high blood pressure was your body trying to make up for the shock by releasing adreneline, but your other symptoms say clearly it was overwhelmed with histamine: hives and throat swelling together is anaphylaxis. Two body systems reacting at same time is anaphylaxis.

http://www.foodallergy.org/section/a

Plus you took a huge amount of Benedryl... and I think that can cause hbp?

[blessedwithboys]

Thank for that link, I don't know how I didn't find it before. I'll go over it thoroughly tonight when the kids are asleep.

Beandryl overdose can cause a rapid heartrate, but it lowers BP, so still don't know where 177/97 came from...

Thanks again!

[purplepaperclip]

Originally Posted by blessedwithboys

Thank for that link, I don't know how I didn't find it before. I'll go over it thoroughly tonight when the kids are asleep.

Beandryl overdose can cause a rapid heartrate, but it lowers BP, so still don't know where 177/97 came from...

Thanks again!

White coat hypertension. You said you are scared of doctors and hospitals, had a panic attack; hence, high blood pressure, would be my guess...

[blessedwithboys]

Hmmm, I didn't think of that...but the high BP started at home, so it could have been nerves, but not so much the white coat part. I really need to get to a doctor and get this figured out.

My feet and legs up to my knees, and my elbows have been itching like crazy since Monday. I only just realized today that those are the only body parts that get lotioned. So now I'm reacting to my organic, paraben-free lotion, the same one I've been using for years with no problems.

[sbgrace]

Originally Posted by blessedwithboys

Hmmm, I didn't think of that...but the high BP started at home, so it could have been nerves, but not so much the white coat part. I really need to get to a doctor and get this figured out.

My feet and legs up to my knees, and my elbows have been itching like crazy since Monday. I only just realized today that those are the only body parts that get lotioned. So now I'm reacting to my organic, paraben-free lotion, the same one I've been using for years with no problems.

You could still be in a hyper-reactive state (particularly if you didn't do the steroid).

Blood pressure doesn't have to drop for anaphylaxis. It's any two symptoms. Often one of the first signs of anaphylaxis is actually severe anxiety or panic--which can indeed raise your blood pressure. No doubt you were anxious at the time?

I wish it weren't anaphylaxis but I don't see how it wasn't given your description. It fits the criteria and then some.

[katelove]

[QUOTE=JaneS;15756661I don't understand "having all symptoms of anaphylaxis but not actually having it" ... doesn't the symptoms equal the reaction?[/QUOTE]

I think the OP may be referring to anaphalactic vs anaphalactoid reactions.

The difference is that anaphalactic reactions are IgE mediated and anaphalactoid reactions are not. The symptoms and treatments are the same so the difference is pretty academic but they are often referred to by the two different terms in the literature. If you did a search for the OPs symptoms you would almost certainly come across references to both.

[blessedwithboys]

Wow, thanks, more info! LOL Well, now I'll research pseudo-anaphylaxsis while I wait to see the doctor.

Just to be clear, I took the 6 day pack of steroids and I'm on Pepcid for 3 more weeks.

One more questions for all of the awesome allergy-knowledgable mamas here...

I have been stung by bees 3 times in my life. Each sting resulted in a progressively more severe reaction, but nothing like what happened last week after the naproxen. My 8yo ds is super sensitive to ant bites. For whatever reason, they seem to always bite him in his sleep, and always on his eyelid. I theorize that his tears taste good to them...anyway, twice he has woken up with an eye swollen completely shut. The first time, when I parted the puffy lids, there was still an ant attached to the inside of his lower lid. I have alway treated his ant bites with apis mellifica or mellificus or something. The second time hsi eye swelled, I resorted to Benadryl because it after 3 days on homeopathics, his ear also swelled for no apparent reason, and we were out of state, far from home, and I got scared.

So...yesterday, ds got his first bee sting; three actually. He was on a play date and my friend called me while I was grocery shopping because she was nervous after what had just happened to me. I left my cart and raced to him, but he had a totally normal reaction. Localized swelling and pain, nothing more.

Do I need to take him to an allergist, or even his PCP, to assess his need for epi? Because of how he reacts to ant venom, is he more likely to have progressively worse reactions to bees? I know he just went 8 full years without ever getting stung, but I am so scared now I feel I can't be too careful. He already has a well visit next week, and I will ask, but I wanted BTDT perspectives as well.

Thank you all ever so much for the info and cyber-hugs!

[infraread]

Please get an epi-pen, even if you never have to use it. The purpose of having one is not to stop an ana reaction, although in some cases it may, it's to buy you time to get medical attention. The steroids they've given you are to basically calm down your immune system, but they should have told you that. Shame on them, if they didn't.

My husband is allergic to yellow jackets, so I'm not really BTDT with this but what I do know is bee venom, wasp venom, and ant venom are all different. Being allergic to one doesn't mean he'll be allergic to all of them. He could become sensitized to bees, but it's not a given. That probably isn't much help, I'm sorry. Hopefully someone with more knowledge will chime in.