Tuesday, October 23, 2007

A Scary Reaction

Today was going pretty well. For lunch, I decided to go get my allergy shots and then grab a sandwich on the way back to the office. Little did I know, I would not get that far.

At the allergist's office, I signed in as usual and had to wait for this guy who came in before me to finish. I was called in to the nurse's station, asked the usual question of whether I had any reaction after my last shot, to which I honestly answered no. I think I've had one reaction in my life, and it was a severely itchy throat. The adrenaline given to me at that time fixed it. I have been taking allergy shots since 1983 when I first diagnosed with allergies and asthma, so the shots are no big deal to me. They also help with my symptoms.

I get four shots about every 3-4 weeks, two in each arm. There's one for trees and other pollen. There's one for animal dander. There's one for grasses, and a final one for foods. Yeah, I'm allergic to a LOT of stuff.

I got my receipt, and then I went back to the waiting room. The policy is to wait for 30 minutes to be sure that you don't have a reaction. I grew up being told that if a reaction was going to happen, it almost always happened within 20 minutes, so I wait at least 20 minutes before leaving.

Upon sitting in a chair, I was suddenly overcome with nausea, and although I did not know why, I felt I could vomit any moment. I went to the bathroom in the office, and halfway dry heaved twice. Then I started sneezing....and sneezing....and sneezing some more. The nausea passed, but I felt the need to cough. When I did, it felt like a firestorm going on in my upper lungs, and I could almost feel my alveoli closing up with each cough. The alveoli are the air sacs in your lungs where oxygen is transferred to the blood and carbon dioxide released. If those close, you're in serious trouble.

I felt that I was having a reaction, and one look in the mirror confirmed it. My face was bright red, as if my skin was about to spontaneously bleed. The whites of my eyes were red. I knew I needed to get help.

I walked out of the bathroom and went to the nurse's station. No one was there, so I pressed the button that you usually press if a nurse is not present when you arrive for your shots. A nurse was around the corner, and one look at me caused her to say, "Oh shit. Sweetie, come here." She immediately gave me a shot of adrenaline, and then took me in the back to an examining room.

On the way, the allergist was in the hall. He was not my usual allergist, but he was the partner on duty at this particular location today. He was a cool customer. I know why; the last thing you need for a patient having a systemic reaction to his allergy shots is panic. He acted like this happens every day, and asked me what I was feeling while he listened to my chest. A female med student was in the office and she listened to the front of my chest. He had me breathe deeply, and that caused another coughing fit and a round of tightening in my lungs. My cough had a raspy quality to it that almost whistled. He ordered liquid zyrtec, which is an antihistamine, and chewable benedryl. He also ordered another dose of adrenaline along with a nebulizer treatment to open my lungs. I've had those nebulizers before when I've had to go to the hospital with a bad asthma attack.

It was difficult to do the breathing treatment because the medicine was causing me to cough, and I kept sneezing with a running nose. My eyelids felt swollen. I could not breathe out of my nose, and I could not hear. My ears felt swollen and on fire. I could feel pressure building up behind my ear drums, and I had trouble hearing. My face was on fire with flushing. My blood pressure measured at 90/70....I'm not sure if it's EVER been that low. My pulse was 90. I'm not sure how I was not passing out, although the doctor kept asking if I felt light headed or dizzy. I felt slightly light headed, but nothing serious.

The doctor sat on a chair in front of me, talking with me and then explaining everything to the student. Why he asked certain questions, what the answers mean, and what physical symptoms to watch for to be sure the reaction is being controlled. He had another shot of adrenaline, half as strong, given to me again.

The sneezing finally abated, but I kept having to blow my nose. I had a light yellow liquid coming out, which is likely plasma from the increased blood flow. After a few minutes, my nose started to bleed, which was from the expanded blood vessels and the forceful blowing. At this point, my left nostril was completely swollen shut and my right nostril was probably 99% closed. Luckily, my throat was open, and the asthma attack was abated.

I called work to tell them that I was not going to make it back this afternoon, and then I had to call Daniel and Tim to tell them I was not going to be able to go with them to the Emory YD meeting as we'd planned. Even with all the adrenaline in my veins, I was feeling tired already from the ordeal, and I knew when it passed, I would not be worth crap to anyone. I also called my mom to tell her what happened, because I knew if I did not, I'd catch hell later when I told her. We are all the other has in the world, and I know if something happened to her, I want to be told about it as soon as possible.

I had an ice pack to help with the nose bleed, and it felt so good against my still-flushed face. The doctor felt comfortable enough to see other patients and have nurses keep an eye on me by visiting every few minutes. After nearly two hours, I still was slightly flushed, but my eyes were much better, and my face was not nearly as red. My left nostril was still clogged, so he gave me one last dose (1/3 the strength of the first two) of adrenaline to be safe. I was handling the adrenaline pretty well, only shaking slightly. The last shot opened me up all the way, and it made me slightly jittery.

Since I had not eaten, the doctor told me to get food, and that would help with my body metabolizing the adrenaline. I stopped for lunch on the way home, and then went to bed. I could only lightly rest though, because the adrenaline had my heart racing, and my arms were hurting from all the shots.

I'm still tired, and I'm pretty amazed at how QUICKLY the reaction came on, and the severity of it. They asked all kinds of questions to explain how I had a reaction THIS time, when I have always handled the shots well. I had not been drinking, angry, running, excited, or exposed to an allergen in the last day or so. I did not take any aspirin, ibuprofen, or Tylenol. There was nothing to explain why I had the reaction this time. I will be back in about a month for another set of shots, severely decreased I'm sure.

This was a frightening episode, but I find that when faced with a crisis, I become extremely calm. I focus on doing what I need to do at the time, which in this case, was getting help. I do not know why I am like this, but I am quite grateful for it.

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