Epi-pen

[netskyblue]

Completely off topic but... does anybody know if it's possible to be prescribed an epi-pen without knowing what you're allergic to?

I just had a severe allergic reaction (NO clue to what), and it's the third I've had this year, or in fact, my life, but it was the scariest yet.

Started with tingly then itchy palms, then flushed beet red all over, then hives all over, then (and this is the first time this has happened) my eyelids and lips swelled up.  All this in less than 2 minutes.

I've got as far as the hives, once in April and once in June, and went to a walk-in clinic one of the times.  The doctor prescribed me to take fexofenadine (Allegra) for 2 weeks even after the hives went away, and told me to take Benadryl for quicker relief if it happened again.

So I slammed down 2 Benadryls and took a cool shower, and the symptoms eventually passed (about 30 minutes to feel any better, and quite a bit better after an hour).

But I'm scared if it happens again, what if my throat DOES close up?  The facial swelling had never happened before today, either.

And no, I've not eaten anything unusual or used any new products, nor did I eat anything that was the same as either of the previous 2 times I had the reaction.  The doctor I saw the first time told me it would be very hard, if not impossible, to tell what I was allergic to even if I did have a scratch test.

So... anybody know what is the criteria for getting an epi-pen prescribed?  Do you HAVE to know what you are allergic to?

[fa]

You are right to be concerned about a violent allergic reaction next time.  You do not need to know what you are allergic to, because epinephrine is effective against anaphylaxis regardless of the cause.  Just realize that these pens are pretty large, expire relatively fast, and are expensive.  Your MD should have no trouble prescribing an epi-pen based on your recent symptoms.

Allergens can be very difficult to identify.  Sometines the results of various tests are inconsistent.  Sometimes they never find to what you are allergic.  I hope you get spared a life threatening emergency.

[GizmoTX]

You really need an allergy screen. This can be done with a blood test or a skin scratch test. The blood test screens for far more allergens but not necessarily their intensity. Your best prevention is knowledge to avoid your triggers.

A true anaphylactic reaction feels like getting the flu in 5 minutes, with accompanying mucus & vomiting, plus your throat swells & starts to close. You are correct in that your next exposure could escalate to this -- every allergic reaction gets increasingly more severe. An epi-pen & benedryl only buy you time to get to an emergency room -- if you have to use either, it's not a cure.

[Jacana]

Definitely go see a doctor soon and consider consulting an allergist directly instead of a GP. I went to an urgent care clinic after a bad wasp sting reaction, and was given an epi-pen prescription for nowhere near the severity of symptoms you described. My daughter was prescribed a Jr epi at the age of 1 due to a horrible reaction to an allergy test at the allergists office and they still don't understand what caused it (go figure). Oh, and her first pen was free thanks to an offer from the manufacturers given to us by the allergist. Her preschool has some on hand at all times as standard procedure that they can use in emergencies regardless of the allergen; it is not specific. So go, describe what happened, and ask for one. Peace of mind if nothing else.

[GizmoTX]

Just know that an epi-pen does not stop an anaphylactic reaction -- it just slows it down so you can get help. Yes, get the epi-pen, but if you have to use it, get to an ER as fast as you can.

I've had 2 anaphylactic episodes. My second one required 6 doses of epinephrine. Yes, I carry an epi-pen. When I travel, I carry cards that explain my food allergies in that country's language.

[Primm]

What Gizmo said. Get the pen, use it if you have to and use the time it buys you to call an ambulance. No messing around. True anaphylactic reactions have a tendency to get worse each time they occur.

[GizmoTX]

Always call an ambulance if you are alone. This college student recently died: http://www.washingtonpost.com/news/post-nation/wp/2014/11/28/college-student-dies-after-severe-allergic-reaction-to-peanut-butter/. He injected himself with his epi-pen but then attempted to drive himself to a hospital. He was found in the parking lot.

I chose not to drive in all my episodes -- my eyes became almost swollen shut, not to mention the difficult breathing & non-stop mucus generation.

[stripey]

I would strongly reccommend trying to find out what the allergen is by getting a consult with an allergist, IN ADDITION to getting an epi-pen. Who knows, the offending allergen(s) may be something you can be desensitised to, which may save your life. In addition you can try and avoid the allergen too.

[highcountry]

I have had epipens prescribed to me twice, and I am not, to my knowledge, anaphylactically allergic to anything.  The first time, I asked for it because I spend a substantial amount of time out of range of medical care, and wanted one for my first aid kit.  I asked for it, the doctor gave it to me.  The second I was prescribed because I was getting allergy shots, and they give them to everyone getting that procedure as a precaution.

They are not closely controlled.  Apparently the high is not very fun.  I would ask your doctor, and  I doubt they will say no, especially considering what you are describing.

Be sure to carry two and benedryl.  The epipen just gives you the time for the antihistamine to kick in, and from what I've understood, the time lag for the antihistamine to take effect is often slightly longer than the first epinephrine dose lasts.

[Datastache]

I would get a second opinion and try to get tested for different allergens anyway - preferably soon. Although it sounds like an Epipen would indeed be a good thing for you to have, knowing what you're allergic to would go a long way toward preventing future episodes in the first place.

[MikeBear]

I have had this happen to me about 5-6 times over the last 7 years alone. In EVERY case, it was due to something I ate. In all cases except for one, the "something I ate" was a pre-processed food (hot pocket and the like) that had all sorts of weird preservatives in it.

It's really horrible, because you immediately tend to 100% panic, and in my case your throat shuts down so fast, it's like it removes even that 2~ minute reserve of air you figure you have available before unconsciousness. Immediate, and complete, utter panic! Completely terrifying.

You'd be best served into thinking real hard into your immediate circumstances, and try to narrow down EVERYTHING that was going on about you in those last 5 or so minutes before it hit. I can't believe it would come completely out of the blue, something overt happened and caused this, and you have to put on your detective hat and figure it out.

1: Eat or drink anything?
2: Smell anything in the air?
3: Put on a hand-crème or something like that?
4: Changed a piece of clothes?
5: Pet a dog or cat?
6: Touched anything, (even a surface) even something that's never caused an issue before?

Issues like this almost never take more than 20 minutes maximum to manifest, after your "trigger" was activated. Keep thinking, and you might be able to narrow it down.

[netskyblue]

I wish I knew.  It does SEEM like it should have been something very immediately before the reaction, the way it came on so fast, but what do I know?  About an hour before, I ate a bowl of spaghetti.  I'd eaten from that same box of spaghetti and the same container of parmesan cheese.  The sauce was a new jar, but it's a brand/flavor I always use.  Cooked in the same pot I always use for spaghetti.  I've eaten spaghetti a million times, approximately once a week.

After that, I sat in my armchair knitting the same blanket I've been working on every day for months, and watched a show on Netflix.

I checked my phone logs, since my husband called me right as I was finishing eating.  I finished just about one hour exactly before I had the reaction.

The previous time, it was after eating homemade chicken marsala, leftover from a meal a couple days prior.

[Jacana]

Do you have pets? Any chance you encountered fleas or a spider or anything else bugwise in the chair or blanket? Were you doing anything or sitting somewhere similar last time?

[arebelspy]

A former coworker of mine developed a tomato allergy at age 40.

She's a vegetarian and it was part of all her favorite foods (salad, pastas, etc.)

Apparently you can become allergic to things as you age that you weren't previously allergic to before, so don't assume you're fine and ignore things you think you aren't allergic to, but track everything you eat and look for patterns (and eat little bits of stuff to not have a severe reaction).

[GizmoTX]

I developed an off the charts allergy to sunflower seeds around age 35. I didn't even eat them, but our parrot did. Apparently I became sensitized to the seed debris while feeding & cleaning up after the bird. One day at work I ate a small handful of trail mix with sunflower seeds in it, had a full on anaphylactic reaction in less than 10 minutes, & was rushed to my doctor's office. I went for allergy testing to discover what could do this. I replaced the parrot's food with a sunflower free diet. Several years later I had another exposure at a restaurant, which used sprouted sunflower seeds in a green salad. Who knew? This episode was much worse, & I was at a hospital for many hours.

There's a food trial regimen you can try if you don't want the blood or skin testing. It involves cutting everything out of your diet except for a very few foods known to be non-allergens to most people. Then you add back a small amount of one new food each day. Obviously this could take a long time & you'll be really tired of your lack of choices. It also assumes that your trigger is a food rather than something environmental -- you could be doing it for nothing.