The mother of all allergic reactions

Yesterday I went in for my allergy shots. I've been doing this immunotherapy for several years now, after innumerable yearly bouts of debilitating bronchitis that lasts for 6-8 weeks. Silly me. If I had done the allergy shots back in my 20s, I wouldn't have had to suffer all these years.

My allergy scratch test was. . . interesting, shall we say. The nurse drew a grid on my back and started pricking me with antigens. By the time she got to the end of the first row the pricks on the left had left welts bigger than the box they were in. By the end of the test my back was one big itchy welt. The allergist was impressed. "You are a very allergic young lady!" he pronounced.

The upshot is that I get four shots to cover the environmental allergens--trees, weeds, pollen, dust mites, cats and dogs, and molds. For the past year or so I've also gotten an injection of honeybee venom, since I am a beekeeper and will get stung more frequently than the average person. My progress has been slow because of my overactive immune system, but back in May I reached my maintenance dosages of all five shots.

Yesterday I went in for my shots as usual and felt fine immediately afterwards. By law I have to wait 30 minutes after the shots before leaving so I was just sitting there knitting. Twenty-five minutes into my wait I started feeling flushed in my face and neck, and weird all along my GI tract. The nurse took me back into a room and took my vitals. My blood pressure was low-ish but my O2 sat was fine and my breathing unaffected. Just to be safe they called in the doctor to check on me. He gave me a dose of Benadryl and prednisone.

That must have been about the time my blood pressure started tanking. I remember feeling vaguely woozy and unhappy about the state of affairs. My guts were still griping and I was feeling hot on my face and cold everywhere else. They gave me an IM shot of epinephrine to stop the allergic reaction. The doc said, "This will stop the allergy but make you feel lousy." Boy, he wasn't kidding. My heart was pounding and I was still shivering.

By this time I was lying down feeling sorry for myself. I never lost consciousness but probably would have had I been sitting upright. My blood pressure didn't come back much and I got another shot of epinephrine and they started an IV to get some fluids into me. At this time they called 911 and were starting to look really worried. My blood pressure was about 60/30. That's pretty damn low, even for someone like me whose BP is on the low end of normal anyways. Apparently by the time the EMTs came to get me I was really pale. At least I was able to get onto the gurney myself.

This was my first time inside an ambulance. The EMT, a very nice man named Jorge, tried to start another IV in my other hand but couldn't get it going because my veins had collapsed due to lack of pressure. I was strangely unworried when he told me that. It took about 2 minutes to drive from the allergy doc's office to the hospital, where they set me up in the ER for observation. Since I had been given all the appropriate meds at the allergist's office they didn't give me anything else after I got to the hospital. By that time my BP had risen to 100/70, which is close to normal for me.

"Observation" in the clinical sense means just that. I was left alone for the most part, with a nurse coming in to check my vitals every half-hour or so at the beginning. The ER doc came in at the beginning and I didn't see her again until hours later. She told me they needed to keep me until the effects of the epinephrine wore off, to make sure the allergic reaction didn't start up again. Poor Alex had to take the day off work and sit with me. What a guy! He let me read the Time magazine he had scrounged from somewhere and found me a sandwich to eat. The hospital discharged me at about 4:30 p.m., almost six hours after I had been dropped off.

What does a blood pressure of 60/30 feel like, you ask? It's strange. I could hear my heart thumping because of the epinephrine, but my head was empty feeling and slow. I think I was talking coherently but don't know if I was actually making any sense. My thought process was very slow and I remember having to think about words before I could say them. All in all, I don't recommend the experience.

We returned to the allergy doc to show them I was still alive and to ask if we could leave my car there. They were all glad to see me standing upright. The doc said that anaphylaxis manifests in several ways: hives, difficulty breathing due to swelling in the airway, and a sudden drop in blood pressure. I never had the first two, but had the third in spades. And I didn't have just an anaphylactic reaction, but a severe anaphylactic reaction. Until then I hadn't realized just how bad it was. I am very grateful for the mandatory 30-minute wait after allergy shots. The waiting period was extended from 20 minutes to 30 minutes a while back, and if I had waited only 20 minutes I would have been on the road to the marine lab when the reaction occurred.

Today I am more or less back to normal, except for the Benadryl hangover. It is amazing how quickly the body recovers from such a severe shock like anaphylaxis. I think I'll wait until tomorrow before driving, though. And it remains to be seen what we'll do about continuing the immunotherapy injections. I had been rather cavalier about the whole thing but now will definitely be more conservative and cautious.

5 thoughts on “The mother of all allergic reactions

  1. Paul Gong

    Your write up helps me to know what to look for in a possible reaction; they never told me the symptoms and I've never had one even when I did shots as a teen. They usually let me go after about 25 minutes but maybe I'll stay for a full 30 just in case.

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  2. algong

    I had never had a reaction, either, except for itchy bumps on my arms. I'm going to stay for a full hour after my shots now, because it's too scary to contemplate leaving the office and being somewhere else when anaphylaxis sets in. They were very good at quickly administering the meds I needed and calling for the ambulance when it was necessary.

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  3. Betty Gong

    Wow! after reading your reactions to the whole episode, It's kind of scary. Yep, better to stay longer after the shots to be on the safer side. Guess you'll be carrying the epinephrine pen with you all the time? So glad you are ok and more or less back to normal. Love, Mom

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  4. algong

    Yes, the epi pen comes with me everywhere now. I have to get used to carrying it (it's kind of bulky). At least now I know what it will feel like if I ever have to use it.

    The really scary part, with hindsight, is that I wasn't very scared while it was happening. I remember feeling sorry for myself and thinking, "Well, this would be a stupid way to die," but not actually being frightened.

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  5. Moriah Sevier

    Wow I am so glad they have the 30 minute rule, and that you recovered. Now you kind of know what the thought process would be like if you were a cold ectotherm?

    Reply

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