Tags: anaphylaxis

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Tuesday, June 6th, 2023

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It all started with a trip into the countryside one Sunday a few weeks back.

The weather has been getting better and better. The countryside was calling. Meanwhile, Jessica was getting worried about her newly-acquired driving skills getting rusty. She has her license, but doesn’t get the chance to drive very often. She signed up to a car club that lets her book a hybrid car for a few hours at a time—just enough to keep in practice, and also just enough for a little jaunt into the countryside.

We went for Sunday lunch at the Shepherd and Dog in Fulking, near to Devil’s Dyke (I swear that sentence makes sense if you live ’round these parts). It was a lovely day. The Sunday roast was good. But it was on the way back that things started to go wrong.

We had noticed that one of the front tyres was looking a little flat so we planned to stop into a garage to get that seen to. We never made it that far. The tell-tale rhythmic sounds of rubber flapping around told us that we now had a completely flat tyre. Cue panic.

Fortunately we weren’t too far from a layby. We pulled in on the side of the busy road that runs by Saddlescombe Farm.

This is when the Kafkaesque portion of the day began. Jessica had to call the car club, but reception was spotty to put it mildly. There was much frustration, repitition, and hold music.

Eventually it was sorted out enough that we were told to wait for someone from the AA who’d come by and change the tyre in a few hours. To be fair, there are worse places to be stuck on a sunny Summer’s day. We locked the car and walked off across the rolling hills to pass the time.

The guy from the AA actually showed up earlier than expected. We hurried back and then sat and watched as he did his mechanical mending. We got the all-clear to drive the car back to Brighton, as long we didn’t exceed 50 miles per hour.

By the time we got home, we were beat. What a day! I could feel the beginnings of a headache so I popped some ibuprofin to stave it off. Neither of us could be bothered cooking, so we opted for a lazy evening in front of the telly eating takeaway.

I went onto Deliveroo and realised I couldn’t even manage the cognitive overhead of deciding what to eat. So I just went to my last order—a nice mix of Chinese food—and clicked on the option to place exactly the same order again.

And so we spent our Sunday evening munching on Singapore fried noodles and catching up on the most excellent Aussie comedy series, Colin From Accounts. It was just what I needed after an eventful day.

I had just finished my last bite when I felt I needed to cough. That kicked off some wheezing. That was a bit weird. So was the itchy sensation in my ears. Like, the insides of my ears were itchy. Come to think of it, my back was feeling really itchy too.

The wheeziness was getting worse. I had been trying to pass it off, responding to Jessica’s increasingly worried questions with “I’m grand, I’ll be f…” Sorry, had to cough. Trying to clear my throat. It feels a bit constricted.

When Jessica asked if she should call 111, I nodded. Talking took a bit of effort.

Jessica described my symptoms over the phone. Then the operator asked to speak to me. I answered the same questions, but in a much wheezier way.

An ambulance was on its way. But if the symptoms got worse, we should call 999.

The symptoms got worse. Jessica called 999. The ambulance arrived within minues.

The two paramedics, Alastair and Lucy, set to work diagnosing the problem. Let’s go into the ambulance, they said. They strapped a nebuliser onto my face which made breathing easier. It also made everything I said sound like a pronouncement from Bane.

They were pretty sure it was anaphylaxis. I’ve never been allergic to anything in my life, but clearly I was reacting to something. Was it something in the Chinese food? Something in the countryside?

In any case, they gave me a jab of antihistamine into my arm and took us to the emergency room.

By the time we got there, I was feeling much better. But they still needed to keep me under observation. So Jessica and I spent a few hours sitting in the hallway. Someone came by every now and then to check on me and offer us some very welcome cups of tea.

Once it was clear that I was fully recovered, I was discharged with a prescription for an EpiPen.

I picked up the prescription the next day. Having an EpiPen filled with adrenaline was reassuring but it was disconcerting not knowing what caused my anaphylactic reaction in the first place.

After that stressful weekend, life went back to normal, but with this cloud of uncertainty hovering above. Was that it? Would it happen again? Why did it happen?

The weather stayed nice all week. By the time the next weekend rolled around, I planned to spend it doing absolutely nothing. That was just as well, because when I woke up on Saturday morning, I had somehow managed to twist something in my shoulder. I guess I’m at that age now where I can injure myself in my sleep.

I took some neproxin, which helped. After a while, the pain was gone completely.

Jessica and I strolled to the park and had brunch in a nice local café. Then we strolled home and sat out in the garden, enjoying the sunshine.

I was sitting there reading my book when I noticed it. The insides of my ears. They were getting itchy. I swallowed nervously. Was it my imagination or did that swallowing sensation feel slightly constricted. And is that a wheeze I hear?

It was happening again.

The symptoms continued to get worse. Alright, it was time to use that EpiPen. I had read the instructions carefully so I knew just what to do. I did the EpiPen mambo: hold, jab, press.

It worked. We called 999 (as instructed) and were told to go the emergency room. This time we went by taxi.

I checked in, and then sat in the waiting room. I noticed that everyone else had white wristbands, but mine was red. I guess my place in the triage was high priority.

As I sat there, I could feel some of those symptoms returning, but very slowly. By the time we saw someone, there was no mistaking it. The symptoms were coming back.

I was hooked up to the usual instruments—blood pressure, heart rate, blood oxygen—while the hospital staff conferred about what to do. I was getting a bit clammy. I started to feel a bit out of it.

Beep, beep! One of those numbers—blood oxygen?—had gone below a safe threshold. I saw the staff go into action mode. Someone hit a button—the red light in the ceiling started flashing. Staff who had been dealing with other patients came to me.

Instructions were spoken clearly and efficiently, then repeated back with equal clarity and efficiency. “Adrenaline. One in ten thousand.” “Adrenaline. One in ten thousand.” They reclined my chair, elevated my legs, pulled down my trousers, and gave me my second shot in one day.

It worked. I started to feel much better straight away. But once again, I needed to be kept under observation. I was moved to the “recus” ward, passing through the corridor that was so familiar from the previous weekend.

This time we’d spend a grand total of twelve hours in the hospital. Once again, it was mercifully uneventful. But it gave us the opportunity to put two and two together. What was the common thread between both episodes?

Ibuprofin. Neproxin. They’re both non-steroidal anti-inflammatory drugs (NSAIDS). That fits

Foods are the most common trigger in children and young adults, while medications and insect bites and stings are more common in older adults. … Any medication may potentially trigger anaphylaxis. The most common are β-lactam antibiotics (such as penicillin) followed by aspirin and NSAIDs.

The doctors agreed—the connection looked pretty clear. I saw my GP a few days later and she’s reffered me to an allergy-testing clinic to confirm it. That might take a while though. In the meantime, I also got another prescription for more EpiPens.

Hopefully I won’t need them. I’m very, very glad that I don’t appear to be allergic to a foodstuff. I’d rather do without ibuprofin and aspirin than have to vigilantly monitor my diet.

But I do need to get into the habit of making sure I’ve got at least one EpiPen with me wherever I go. I’ll probably never need to use it. I feel like I’ve had enough anaphylaxis in the past couple of weeks to last me a lifetime.

Oh, and one more thing. I know everyone says this after dealing with some kind of health emergency in this country, but I’m going to say it anyway:

The NHS is easily the best thing ever invented in the UK. Everyone I dealt with was fantastic. It was all in a day’s work for them, but I am forever in their debt (whereas had this happened in, say, the USA, I would forever be in a much more literal debt).

Thank you, NHS!