By // by Caroline Moassessi 13 Comments
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[…] If you’ve ever worried about what to do in the case of anaphylactic shock, you can’t miss Caroline’s post over at The Grateful Foodie on four missed anaphylaxis emergency care opportunities. […]
One of the hardest things I find about managing both life threatening food allergies and asthma is talking to others. I hate to be the one that might be perceived as demanding, pushing or for asking too much. What I now know, fourteen years later, is that honest, clear information presented with kindness works!..
I concur with Dr Jacobs. ER docs do not routinely prescribe epi in the ER or field -I hope that explains my own hesitancy about it. It is a dangerous drug when not used properly and can cause the pediatric (or any patient) to go into cardiac arrest. No healthcare practicioner wants that… not to mention liability & fear of litigation.
Per insurance protocals, patients are referred to their primary care physicians (PCP) -including pediatricians- after a allergic/anaphylactic event. Per most insurance protocals, the PCP will refer the patient to the allergist or pulmonologist & prescribe the epi pen. Part of the fear with the prescription from the ER is that the patient and/or caregiver will not use it properly and/or will not follow up with the appropriate medical care. It is very common for patients and/or caregivers to avoid the follow up appointment with the PCP, regardless of the importance and instructions given during discharge from the ER.
There are a variety of reasons patients do not follow up with their PCPs after an ER visit. This is an issue that needs to be addressed just as much as the others mentioned in your blog.
Great post, Caroline! Thank you taking the time to interview your (apparently awesome) allergist!
Love that man! He has been with our family for 12 years. Watching my children grow up.
I never thought about #3 until now. All the times we’ve been to the ER, no one has ever offered us a new prescription. We always have a handful of them around anyways, so it’s no biggie for us, but I can’t imagine I would remember I needed another epi right after the stressful hospital trip.
Aggie, sometimes the obvious are the ones we always miss? I realized that I don’t have my kids practice with the Epi Pen trainers enough. I think #3 applies to folks never had an Epi Pen or carry limited and just used what they had. We have plenty since I have two kids with food allergies and I always carry a backup too.
I had an allergist tell me that he did NOT want to prescribe me an EpiPen because he didn’t want me to use it unless absolutely necessary; he was afraid I’d use it willy-nilly – and I was like 28 at the time! This was after I had what I believed to be TWO anaphylactic reactions! I had to beg an ALLERGIST to prescribe me an EpiPen, which he only agreed to give me AFTER I PROMISED not to use it unless I HAD to. DUH!
I did find out, however, that I in fact did NOT have food allergies a year or so after that whole fiasco by a new allergist I trusted (they believe I was having asthma coupled with severe heartburn and possible panic attack from the sensation of not being able to breathe, because a food challenge indicated no food allergies along with further testing). The first allergist didn’t find the asthma, nor did he do a proper test in the first place to find my allergies, but that isn’t what gets me. What gets me is that, though the first allergist’s results were probably tainted, he believed them accurate and he was willing to risk my life by NOT giving me an EpiPen. Did I mention they were also concerned that I might be allergic to steriods, too? The EpiPen would have been my ONLY lifeline! Crazy!
Fast forward to today. My dad is dealing with food allergies, some identified through testing, some suspected though testing was negative, and some suspected that haven’t been tested yet. He told me that he was not, in fact, prescribed an EpiPen by the allergist for 2 reasons: He’d never had an anaphylactic reaction (though he had chronic hives for months and continues to have breakthroughs) and because my dad doesn’t want one. Now, I am glad that my dad is not a paranoid wreck and that he doesn’t want food allergies to control his life and I know he’ll read labels and be good in avoiding at all possible, but I am seriously bothered by this. My mom is trying to talk him into it, and I have even said that I will hold onto them (I don’t live far away), and I’m even willing to buy them, but gracious!
Am I crazy to be concerned? He has several seasonal allergies along with asthma and now this. I just can’t shake the feeling that he’s playing with fire, even if he has never had anaphylaxis. He’s been on steriods off and on for months and tons of allergy meds, so I’m kinda thinking he may have been keeping an episode at bay and not even known it!
Anyway, I digress. I am definitely going to be passing this info onto them and let them mull it over. I would feel so much better if he’d agree to at least have the EpiPen. I know he doesn’t want the label, but his life is worth too much to me to take the risk. I think he’ll come around…just praying that nothing serious happens between now and then!
Hi Julie, you are a lovely and passionate daughter! Make sure your dad is seeing a board certified allergist too. It’s important to see someone who truly is a specialist and keeps up on current research and news too!
Thanks, Caroline! I will do what I can, you can trust me on that. 🙂
Very well done indeed! A timeless message. For more on topic see: http://www.asthmaallergieschildren.com/2012/12/09/food-allergies-prescribed-injectable-epinephrine-know-practice-carry-use/
Henry, I LOVE your book and can’t wait to finish it so I can blog about it! I really am impressed that your website compliments your book with up-to-date information. Brilliant my friend.
Great post, Caroline! I find this particularly helpful, given that I have absolutely zero allergies but my husband has several food allergies & various sensitivities. As we introduce our toddler to new foods, I, frankly, have been a bit worried about the risk of a severe reaction, mostly because he’s a) my baby and b) I have no first-hand experience with serious food allergies. (In other words, it’s very unfamiliar territory.)
Thankfully, my son hasn’t exhibited allergy symptoms. But knowing how to identify a serious reaction – and now, what to do immediately following – is very important to keeping my family safe. I don’t live in fear of an allergic reaction, but I do believe that forewarned is forearmed! Thanks so much for the valuable info.
Erin, you are right, we just can’t live in fear! But … having this information really helps move us along. As you can see why my family adores Dr. Jacobs. He is a good doctor, but certainly knows which data to share.