A Personal Encounter with Anaphylaxis
Friday, April 20th, 2012, 3:49 amAsk any doctor why they went into medicine or their chosen specialty.
In between stories of “wanting to help others” and enjoying the challenges within the field, you may hear a few personal stories of illness.
Here is mine:
I would not say I was “sickly” but allergies were a huge part of my life. I took medication in between classes at the nurses’ offices, endured years of allergy shots, and had allergy symptoms for most of my childhood even on daily medications. I am not sure I could breathe through my nose until I was 18. As adult moving to Texas actually helped my symptoms, but I still cannot have a pet and have to be careful exercising outside to avoid wheezing. I think my life would have been much better without allergies and it was impossible for me not to be interested in allergies.
That being said, I had never had a truly life-threatening allergic reaction until this year.
It began when I took a new antibiotic for a common infection. Within 10 minutes I developed severe-curling over-abdominal pain, felt very flushed and hot. I thought that there was something wrong but allergy did not cross my mind. At first, I did not realize the signs of anaphylaxis – the most serious allergic reaction! After a few minutes of convincing myself I was feeling better, I splashed water on my face and I looked in the mirror to see my neck covered in hives. I started having difficulty breathing and coughing and then, I knew what it was. I called for help.
Luckily, I was among friends with expertise in allergy and an Epi-pen and Benadryl. They immediately recognized I was in trouble and I was transported to the hospital. The ER staff acted quickly. I was in a room and started on IV medications. It was only a few minutes and I started feeling like myself again – but very itchy!
Anaphylaxis, a life-threatening allergic reaction, can be treated when recognized early. Deaths are uncommon but usually are associated with delayed care.
To review the symptoms of anaphylaxis:
Hives and itching
Generalized erythema (redness) and flushing
Swelling in the face, eyelids, lips, tongue, throat, hands, and feet
Swelling in the airway
Difficulty breathing, wheezing, chest tightness
Coughing, hoarseness
Nasal congestion, sneezing
Blood pressure may be low
Rapid or irregular heart beat
Dizziness, faintness
Loss of consciousness, collapse
Tingling or sensation of warmth - Often the first symptom
Difficulty swallowing
Nausea, vomiting
Diarrhea, abdominal cramping, bloating
Anxiety, fear, feeling that you are going to die
Confusion
Common allergic reactions including hives, wheezing and edema (swelling) around the eyes or insect bite are distinct from anaphylaxis which by definition involves multiple organ systems.
Causes of anaphylaxis in at-risk patients are:
Foods – including peanuts, shellfish
Insects particularly stinging insects
Medications including penicillin
IV contrast
And rarely, allergy shots
The treatment is Epi-Pen, antihistamines, and steroids. Patients with a history of anaphylaxis should avoid whatever caused the reaction and have emergency medications on hand with their “action plan.”
I will go into more into allergies, sinusitis and new treatments on the horizon in this blog as there is much to discuss.
For now excellent resources :
http://www.entnet.org/healthinformation/noseandmouth.cfm – our academy's website
http://www.aaoaf.org/ - our otolaryngic allergy's website
http://www.foodallergy.org – food allergies are serious and increasing, one of my patient's referred me to this site
and for the video fans out there an informative video by Mayo clinic
http://www.youtube.com/watch?v=TTcL7u05aUU
On another personal note, thank you to the wonderful staff at Presbyterian Hospital (THR) Allen ER. I hope that we see each other from now on when I am consulted rather than a patient.
Gretchen A Champion, MD
Board Certified in Otolaryngology
Fellow, American Academy of Otolaryngic Allergy
Tags: abdominal, airway, allen, allergic, allergies, allergy, anaphylaxis, antihistamines, benadryl, edema, emergency, epi-pen, erythema, flush, hives, itchy, pain, presentation, reaction, steroids, swelling, urticaria
Category: ENTTX specific, General Medical, Interesting Stuff, Nose, Throat