Anaphylaxis -- anyone BTDT (fish allergy)

[bubbaray]

OMG, what a night. One call to 911, one fire truck, two ambulances, and a trip via ambulance to the ER. DD#2 had an anaphylactic reaction to salmon.

At the ER, they gave her prednisone and epinephren and I now have an Rx for an epipen for her (and one for daycare). And 3 days of oral prednisone.

Does ilovetivo still hang around this board? I could use some advice....

The whole thing was freaky. My head is still spinning. Off to sleep on the floor beside her crib.

[Kungjo]

No BTDT advice for you regarding the salmon allergy, but I'm glad that she's okay. Now that this has scared you half to death, I'm sure you'll be real worried and extra vigilant in trying to keep her from getting another exposure to it. I can sort or relate to this and am glad that she's okay.

This isn't food related, but my oldest DD does have a fire ant allergy. It's something I constantly worry about year round because we live in the south where there are fire ants year round. When she first got bit, she swelled up really bad at the bite area and I was really worried as well. She gets it from her daddy who is so allergic that he ended up in the ER due to bite reactions. We have two epi-pens for her. One at school and one at home just in case. Her teachers and the school nurse know about her allergy and have instructions to treat with Benedryl and observe for at least 30 mintues as the 1st line of defense and then proceed to the epi-pen if she starts to swell up really bad or have breathing difficulties. I worry about her more when she's on field trips so I go with her and make sure I have the epi-en on me at all times. The teacher does bring the spare one from school with her on the trips, but she's got 26 kids to watch where as if I go, I can watch her alone. Still, it worries me. We're teaching her to avoid fire ants when possible and to tell the teacher if she gets bit. I don't know what else to do, but hope that she can somehow become less sensitive to them as she grows older.

Good luck and hugs to you!

[anamika]

That sounds scary. I am so glad she's okay and I hope someone can weigh in with some advice.

[tnrnchick74]

I personally have several food allergies. It's no fun. You have to be VERY diligent in reading every label...even things you wouldn't think might have ingrediants that are suspicious.

I would definately get your child allergy tested, because more times than naught one food allergy can mean sensitivities to many other similar things.

HUGS! It is super scary!!!

PS - keep an epipen with you at all times as well as benadryl. Epipens expire after 1 year, so make sure to note the expiration date in a calender and have new ones ready to go! If your child has another reaction, give benadryl and the epi...then get to the ER!

PSS - feel free to PM me if you have any other questions!!

[elliput]

:hug: :hug: :hug: OMG! How scary! Here is the link to ilovetivo's allergy thread with all of the resource links. http://windsorpeak.com/vbulletin/showthread.php?t=283206&highlight=allergies

[LarsMal]

SO SO SCARY!!!!

DS has egg and dairy allergies. He's had some reactions over the past year or so, but Benedryl has always been enough. A couple weeks ago- of course the day after Christmas while we were 14 hours from home!- he had his first true anaphylactic reaction. It was so incredibly scary. The coughin/wheezing/retraction was horrible. He ended up in the ER, too. He never did get epinephrin, though. He got a double dose of Benedryl, a dose of steroids, and a nebulizer treatment.

I carry his epi pen and benedryl with me everywhere we go, as well as some Purell and Wet Ones. The ER doctor (and our allergist) basically told me to save the Epi Pen for when he absolutely cannot breathe on his own. I don't know if I'm comfortable waiting THAT long, but we have been okay with Benedryl so far.

I haven't seen Julie (ilovetivo) around her in a while, but I know she really likes the kids with food allergies website. I think it's www.kidswithfoodallergies.com. I think you have to pay $25 to have full access to it, but you can still sign up and receive newsletters and emails.

Welcome to the club!!!!

[buddyleebaby]

Melissa,

Just wanted to send you hugs. I have seen my husband go through anaphylaxis and it was incredibly scary. I can not imagine watching my child go through it.

[Marisa6826]

Girlie, I'm so sorry. Thank God she's OK and that you were around to realise what was going on.

Jonathan is at the ER at this very moment due to some sort of whacko reaction to what we suspect was Pepperidge Farm rainbow goldfish (his tongue is hideously swollen).

hugs

-m

[bubbaray]

Thanks everyone! Of course, today DD#2 is as perky as ever, like nothing happened! And, her eczema is better because of the oral steroids....

Just curious, how much are EpiPen Jr's in the US? They were nearly $100 each here. Good grief, what do people without insurance do??? Lots of people in Canada don't have insurance for prescription drugs. I wonder how they afford these things?!

Marisa, I hope your DH is OK!

Thanks again

[bubbaray]

The ER doctor (and our allergist) basically told me to save the Epi Pen for when he absolutely cannot breathe on his own. I don't know if I'm comfortable waiting THAT long, but we have been okay with Benedryl so far.


The ER dr told me benedryl for anything from the shoulders down. Head and neck (hives, swelling or both), I use the EpiPen and call 911. He said if there is swelling in the throat, you can't give benedryl orally.

I have a LOT of questions for my dr this week.

[bubbaray]

:hug: :hug: :hug: OMG! How scary! Here is the link to ilovetivo's allergy thread with all of the resource links. http://windsorpeak.com/vbulletin/showthread.php?t=283206&highlight=allergies


Thank you thank you thank you!!!! I *knew* I should have bookmarked that link ages ago.

I wonder what happened to ilovetivo?!? Hope she comes back!

[LarsMal]

Thanks everyone! Of course, today DD#2 is as perky as ever, like nothing happened! And, her eczema is better because of the oral steroids....

Just curious, how much are EpiPen Jr's in the US? They were nearly $100 each here. Good grief, what do people without insurance do??? Lots of people in Canada don't have insurance for prescription drugs. I wonder how they afford these things?!

Marisa, I hope your DH is OK!

Thanks again

DS was the same way- by the time the stuff kicked in at the hospital he went from scared and lifeless to jumping on the hospital bed- in a matter of about 1/2 hour! His cheeks, which almost always look slightly flushed, were clear as ever, too, from the steroids!

My EpiPen Jr, with two pens and one practice pen, was $70. That was with our prescription coverage! I don't know if we had met our deductible at the time, though, so maybe this time around they won't be as much, although it is a new year...oh well! Which reminds me, I think his expired at the end of December.

[Marisa6826]

The ER dr told me benedryl for anything from the shoulders down. Head and neck (hives, swelling or both), I use the EpiPen and call 911. He said if there is swelling in the throat, you can't give benedryl orally.

I have a LOT of questions for my dr this week.

That is VERY good to know. Thanks!

-m

[ThreeofUs]

Oh, ouch! Sounds like quite a night, but glad to hear DD is feeling better.

Having BTDT and seen a lot of this in myself and others, I'll second the benadryl for anything shoulders down. Just remember that sometimes you can't see a swelling in the throat, or it may come as a secondary reaction. You're supposed to engage the person in talk, to see if their air passages are clear, but sometimes that's hard if they are unresponsive.

If someone has a big reaction anywhere, many people consider it smart to use the Epi as well. Check on it and see what your doc says.

Sorry to hear you had to go through this!

[Kungjo]

We pay $20 for our 2 Epi-Pen, Jrs and the practice pen. DH works for a hospital and we get them at the hopsital pharmacy. I don't know if it's because we satisfied the deductible or not. Some things are super expensive through the hospital pharmacy though. Don't have an answer as to how they calculate it.

[bubbaray]

The ER dr told me benedryl for anything from the shoulders down. Head and neck (hives, swelling or both), I use the EpiPen and call 911. He said if there is swelling in the throat, you can't give benedryl orally.

I have a LOT of questions for my dr this week.


Just wanted to update this. My/DD's dr (we saw her this Wednesday) said given the severity of DD#2s reaction, any sign of swelling or hives anywhere on her body, just give the epi pen, don't screw around with "what do I do" -- just give the EpiPen.

[ilovetivo]

Melissa - I'm here. I'm so sorry you've joined the FA club. :hug:

Thanks for asking for me :) Sorry i didn't see this sooner. With the transition and the board being down, i've gotten out of the BBB habit. I wish there was a way I could get all new posts with "food allergy" in it. Also, I get messed up with FA threads now being in the Kid Food section mainly. When I check in, it's over there first.

Anyway, what can I answer? Here's some things off the top of my head.

Here's a couple of my threads:
Food Allergies: Good Info For All, Even Ones That Don't Get It
http://www.windsorpeak.com/vbulletin/showthread.php?t=283206

For Food Allergy reaction, here's what I have in my diaper bag medicine kit
http://www.windsorpeak.com/vbulletin/showthread.php?t=283291

Make sure you have a Food Allergy Action Plan http://www.foodallergy.org/downloads/FAAP.pdf

I'm glad your dr is on board. You might want to see a ped allergist. Discuss holding off on other allergens that dd hasn't had yet. Most will tell you not to discontinue allergens that dd tolerates. All fish, i assume, may now be off limits.

Have epi always accessible and "with" dd. It can take seconds to go into ANA. You should have 2 epi's with you at all times, in case you need 2 (2nd one if 1st doesn't work, doesn't work enough, or sx come back - all of which happens a lot. I don't have stats though. Epi's are heat/cold sensitive. If exposed to extreme temps for awhile, they need to be replaced. Practice with the trainer. Practice with real epi's, if you can, on oranges.

Canada has some good online and local support groups i believe. I don't know abt their labeling laws but there is Sabrina's Law (in Ontario)i believe it's been enacted). http://www.allergicliving.com/features.asp?copy_id=41

Allergic Living is also a great Canadian FA magazine. I get it too.

Join www.kidswithfoodallergies.org if you can. Even a free membership is helpful (read only for main forum)

***For those that want to use the ER's quote benadryl for anything neck down, that's not necessarily true. You need to do what your allergist says to do. These are neck down and anaphylaxis (From FAAN action plan sheet):

􏰁 Skin Hives, itchy rash, swelling of the face or extremities
􏰁 Gut Nausea, abdominal cramps, vomiting, diarrhea
􏰁 Throatâ€* Tightening of throat, hoarseness, hacking cough
􏰁 Lungâ€* Shortness of breath, repetitive coughing, wheezing
􏰁 Heartâ€* Weak or thready pulse, low blood pressure, fainting, pale, blueness

â€*Potentially life-threatening. The severity of symptoms can quickly change.

[ilovetivo]

Melissa - can you describe for us what happened with the reaction, how it happened etc? It might be very useful for people. Also, I forgot to mention, dd's never needed epi/had ana, so i can't speak for that myself.

Hugs again to you and your family!

[ilovetivo]

Melissa - sorry, i just noticed you already deal w/ FA's with your other dc. Correct? I've read so many fa thread in the past 12 hours my brain is mush. If so, a lot of my info you already knew i'm sure.

[bubbaray]

Melissa - can you describe for us what happened with the reaction, how it happened etc? It might be very useful for people. Also, I forgot to mention, dd's never needed epi/had ana, so i can't speak for that myself.

Hugs again to you and your family!


Sure. Last Saturday, at lunchtime, I fed DD#2 her first fish -- fish sticks, so mystery white fish of some sort. She liked them. The dr's (she sees a pediatric dermatologist at Children's Hospital for severe eczema) are always telling me that I should feed her a normal diet, not treat her like she has FAs just b/c she has eczema (they say diet is completely unrelated to eczema). We were having salmon for dinner (wild Pacific salmon, not sure of the species), so I figured, she can have some too. I cooked the salmon in lemon and soy sauce. We already know she's not allergic to soy as she's had other things and her skin test at 3m was negative for soy.

About 30 seconds after she first started eating the salmon, she broke out in hives and welts (the size of dimes) on her hands and up her forearms to her elbows. I raced and got the benadryl, gave her 2.5ml (about 3.025mg) of that orally. DH wanted me to call 911 right away, but I figured, its hives on her hands, no big deal. I called the nurse line and started to discuss it with the nurse. About 30 seconds later, DH is screaming at me to call 911 and as it happened, the nurse was at that point asking me to check her breathing and if there were hives anywhere else.

DD#2s bottom lip had swollen to about 10x its normal size, her tongue was swollen and sticking out of her mouth and she had hives on her cheeks and neck and her cheeks were really swollen too. The nurse freaked, told me to call 911.

I called 911, told them the situation and basically, the fire truck was here less than 3 min (so about 5min from the beginning of her eating it). About 2 min after the fire guys got here, the first ambulance showed up and they were just bringing in their gear and taking a history from me when the second ambulance with the specialized infant transport/peds team showed up. They took over and had all the specialized equipment for babies.

The peds EMT guys gave her 12mg of benadryl IM (shot in the arm). It didn't help, but her condition didn't worsen after that point either. They took her basic vitals and had me get her carseat. They strapped her into the carseat, carried her out to the ambulance and then strapped her to a stretcher and we left for the hospital.

We got to the hospital and they brought her in on the stretcher. About 2 minutes later, we were in the ER and she got a shot of epinephren (drug that is in an EpiPen, but hospitals use syringes, not the pens) and 9mg of prednisone orally. Within about 5 minutes of the epi, she looked completely normal. We had to wait there for about 2 hours all told so that they could make sure that she didn't take a turn for the worse again. That is also the reason why she received prednisone (along with a 3-day Rx for it), to lessen the chances of a biphasic anaphylactic reaction (which I didn't know about until that night).

Things happened REALLY quickly.

We saw her pediatric dermatologist at Children's this Friday and she said that this is a classic food allergy. She said that lots of parents "think" their children "might" be allergic to a food, but when a baby is allergic to something, you know. The reaction is quick, not later in the day and not mild.

My dr wanted us to see a different allergist than DD#1's pediatric allergist. We got referred to that pediatric allergist by DH's dr and frankly, none of the other dr's (including mine and DD#2's specialist at Childrens) has much faith in him as he tested her at 3m for FAs, the rest of the drs (6 in total) that we've seen about her eczema have said that basically he d/n know squat.... As it turns out, the allergist that my dr (who is also the girls' dr) wanted us to go to d/n see children. His office recommended the ped. allergist we've already been to. Argh! So, I have an appointment with that ped. allergist, but would rather see someone else.

The specialist at Children's is going to try to get us into the top allergist in Canada. He has a huge waiting list, but she's friends with this guy and thinks that she can get him to squeeze her in.... I'm hoping! :)

Sorry for the length of this. If you've made it this far, thanks!

[ilovetivo]

Wow, so scary!!! It all happens so fast, it's amazing. I'm so glad that she's ok. We always have the epi with us so she could get it with 1 minute if necessary.

So did you see a ped allergist yet? Does DD#1 have food allergies or just seasonal/environmental?

Research and experts say 1/3-1/2 of eczema is FA related (it's at least 1/3, i think the upper number is 1/2)

How is she doing?

[bubbaray]

Research and experts say 1/3-1/2 of eczema is FA related (it's at least 1/3, i think the upper number is 1/2)


The pediatric dermatologist is adamant that FAs do not CAUSE eczema. FA are often coincidentally found in children with eczema, but the FAs themselves are not causative of the condition. We have been over and over and OVER this point with the specialists and residents, as well as DD#2's regular dr.

She sees the top allergist guy on Feb. 8. Her "quick" appointment was April 28 (he has a 6m wait list at the best of times), but when I called to confirm the appointment, I whined and basically weazled my way into an earlier appointment just by mentioning the word "anaphylaxis". Funny how that definitely gets peoples attention, sigh.

[lablover]

Food definitely causes eczema flare ups for my DD. If she eats dairy, within 24 hours she has spots on her body. (I've done several tests and it is clear that this is the cause of the eczema. I trialed it several times because she skin tests negative for dairy, but it clearly causes the eczema reaction along with painful burn like spots on her bottom, so either the test is wrong or she just has a sensitivity to it. At any rate we avoid.) Her allergist confirmed that eczema from food usually shows up within 24 hours. Also, during the summer she had constant eczema behind one of her knees/upper thigh area and I believe that it was caused by someone holding her with peanut residue on their hands. Once she finally tested positive to peanut (I had her retested because she reacted to airborne particles) and I made sure everyone started taking every precaution when around her, that eczema spot went away. She still can have minor spots here and there but nothing like when she has ingested a problem food. Currently her skin is very clear.

It's frustrating that doctors have so many different opinions regarding allergies.

[colleenfs]

I'm so sorry this happened to you! Julia is allergic to peanuts, tree nuts, sesame, dogs, and cats. I carry Epi Pens and Benadryl with me everywhere we go. We have not had any dramatic reactions, but there was one incident which resulted in massive vomiting.

Best of luck with this. Stay vigilant and get her tested for EVERYTHING. I pray that you never have to go through something so scary again. :hug5:

[ilovetivo]

Food definitely causes eczema flare ups for my DD...

It's frustrating that doctors have so many different opinions regarding allergies.

Ditto to both.

I hope I didn't upset you Melissa. It's just the info I've experienced, heard and read. I'll try to find the medical research/information link.

FWIW - my ped dermatologist also said the same thing as yours, when we saw him before our diagnosis.

[ilovetivo]

Everyone needs to go by the advice and info of their specific doctor.

However, I finally looked for some actual fa/eczema connection info:

http://www.nationaleczema.org/lwe/aboutad.html

http://linkinghub.elsevier.com/retrieve/pii/S0022347607004465

Also in Dr. Scott Sicherer's book Understanding and Managing Your Child's Food Allergies (Dr. S is one of the top FA experts)
Pgs 28-30:

"Various studies, including ones performed by my research colleagues and me, have shown that about 1 in 3 children w/ moderate to severe atopic dermatitis [eczema] has a food allergy." ...

"Children with very milk atopic dermatitis are less likely than children with more extensive rash to have a food allergy."

Children w/ eczema "often test positive to foods even though many can tolerate the foods w/o apparent illness or increase of the atopic dermatitis rash. Therefore testing w/o a specific suspicion of a food allergy can be misleading if the rash is only mild"

[bubbaray]

"Various studies, including ones performed by my research colleagues and me, have shown that about 1 in 3 children w/ moderate to severe atopic dermatitis [eczema] has a food allergy." ...

"Children with very milk atopic dermatitis are less likely than children with more extensive rash to have a food allergy."

Children w/ eczema "often test positive to foods even though many can tolerate the foods w/o apparent illness or increase of the atopic dermatitis rash. Therefore testing w/o a specific suspicion of a food allergy can be misleading if the rash is only mild"


That's what DD#2's pediatric dermatologist did say -- often children with eczema have FAs. However, there is (according to her) no scientific studies proving that FAs *cause* eczema. Causation, in a medical sense, is far different than correlation.