Anaphylaxis and the ER

Yesterday, Jack and Anna had a (much-belated) well-doctor visit.  I picked them up early from school and took them to their pediatrician in Prince Frederick. While many parents have given up well-visits by this point, they are a necessity for Jack. His doctor won't fill out his allergy paperwork for school if he hasn't seen him in the past year for a check-up. And, since I have to take Jack, I might as well take Anna. While there, we had our usual discussion about carrying his epi-pen. The visit went fine and we headed home.

Once we arrived, I was talking to the babysitter (Summer) and Jack held up a snack from a bag of treats given to us by a neighbor. I looked over and granted him permission to have it. About 60 seconds later, he remarked that his throat felt funny. Summer asked him what he was eating and it clicked for me that I had given him permission to eat a Nutty Buddy! We are not a peanut free house, but we are very peanut careful. I hand-wash anything that has touched peanut butter and then put it in the dishwasher. Kara eats peanut butter and jelly for lunch everyday and we use separate containers for her sandwiches and we always make them on paper towels completely separately from where Jack's are made. If we happen to make a treat with peanut butter, we immediately tell Jack. He is also very cautious. But, this one escaped my attention. I didn't buy it and I just wasn't thinking about his allergy when he asked if he could have it. It wasn't in a box, so the name wasn't immediately available to remind me. Jack didn't taste the peanut butter, so he ate more than half before he started feeling funny. Everything about it was just a bit outside of the norm for our normally careful procedures. Also, if I am being honest, I have gotten a bit lax. I don't always remember to carry his epi-pen. After all, he hasn't had a reaction in years. So, it just wasn't in the forefront for me like it should have been.

Delicious, yet potentially deadly.

I immediately gave him Benadryl. I didn't want to give him the shot if I could avoid it, but I was also nervous since he was talking about his throat. I called Thomas to tell him what happened and he suggested I give him the shot regardless. I did a quick internet search and saw an article about a girl who died in California after her physician father did everything according to protocol. The point of the article was there is no harm in giving the epi-pen and the sooner it is received the better, even if there are no symptoms. Of course, Jack had a very severe, immediate symptom, so I quickly gave him the shot. No more than 10 minutes had passed, but I was feeling extremely anxious that I had allowed even that much time to pass. I called his doctor to see if I could monitor him at home and the nurse delivered a message to hang up and call 911 immediately.

I shot a quick text to my neighbors to see if anybody could come over immediately to take care of Luke. One quickly responded (Amanda H.) that she was on her way. So, I put Jack in the car and pulled out as she pulled in. Luke was sleeping and I didn't want to take the time to wake him and get him ready to go. Another neighbor made sure Kara made it home from the bus stop. A third reported that she had been praying for Jack since seeing my text. All were concerned and I appreciated their thoughts and prayers. I called Thomas to tell him what was happening and he left work. He wanted to meet me at the hospital, but we decided it made more sense for him to go home to watch the other kids.

In the meantime, Jack was reporting that his throat still felt weird and his stomach was now hurting. I ran the only light (a red arrow) to get to the hospital. I have read countless articles about people dying from allergen exposure and I was worried his throat was going to close. I think Jack could tell how scared I was, which obviously didn't help. I also still felt really stupid that I had wasted time and not given the shot immediately and that I even called the doctor. I kept asking myself why I hadn't given him the shot and put him in the car right away. I am a pretty laid-back parent, but this obviously hadn't been the time to take a "wait and see" approach and honestly I was worried that my stupidity could kill my child. Although, I never realistically felt that was going to happen, it did make me think about how I would feel if it did, which is a thought-train no parent wants to ride. Anyway, I was experiencing a lot of emotions and none of them were good!

When we got there, the ER was packed, but Jack was taken to a room immediately. They hooked him up to a heart rate monitor. They also gave him an oral steroid, making it his third drug in a very short time. Shortly after, most of his symptoms went away, although his nose began to run. They kept us there for about 3 hours for monitoring. Jack had access to a private t.v. and they even brought him dinner--pizza, fries, and a cookie. Upon seeing his dinner, he exclaimed, "wow, I need to remember to tell them thank-you!"

I kept everyone apprised and there were lots of concerned texts. His pediatrician called me to check on him. I think he also wanted to make sure I had followed his instructions, everyone's concern was to get his symptoms under control and to make sure there was no rebound reaction.

Upon first arriving, I took this picture to send to Thomas to reassure him, but Jack ended up looking so small and scared that I didn't send it.

Hooked up to lots of wires.

Nearing the end of our stay, he felt better and was so excited when they brought him dinner.

We headed home after the all clear. I wanted Jack to sleep in our room, but he wanted to be in his own bed. I kept waking up in the night to check on him and I think Thomas did as well. I don't know what would have happened if we didn't have the epi-pen handy and thankful doesn't even begin to describe my relief that he is okay. Through the whole ordeal Jack was a trooper. He didn't cry or complain about the shot, he maintained completely composure at the hospital and was very brave.

This was a good reminder for me. I need to do better at making sure his epi-pen is always with him and that we are vigilant about what he eats. I am devastated that I allowed the substance into his body, which research suggests makes future reactions more severe. People frequently ask me how severe his allergy is and what type of reaction he has. For me, one of the scariest things about food allergies is that you just can't be sure what will happen. His first reaction, as a toddler, was head to toe hives. His body was completely covered! His next severe reaction came during a peanut challenge in a controlled setting and his symptoms were watery eyes, sneezing and an upset stomach (required 2 shots of epinephrine to get that one under control). This time, it was an "itchy, funny feeling" in his throat and a stomachache. We just never know! I also worry that this exposure may increase the severity of his allergy. Right now, he can sit next to someone eating peanut butter and be fine. We can go to a baseball game and not worry about the nuts in the stand. Basically, I just feel awful that I didn't prevent this from happening.

But, on the positive side, I feel so grateful for the support of my wonderful neighbors and thankful for modern medicine. The ER staff were very kind to us and Jack was so excited to tell his classmates about his adventure. He even wore his hospital bracelet to school today. I hope that is the last allergic reaction he ever suffers, although I know it is not likely.