Epi First + Epi Fast: Lessons Learned from my Third Anaphylactic Reaction

It’s ironic that I have had to spend so much time convincing myself that I’m not having an allergic reaction, that this time I actually needed convincing that I was… The scratchy throat that cried wolf!

All Things Allergies

Thanks to a PTSD diagnosis following a series of life-threatening anaphylactic reactions, I have spent countless meals convincing myself that a sudden lump in my throat is likely a trick of my traumatized brain, rather than swelling from a peanut. The impossible struggle to differentiate the two became so commonplace that I got a chance to practice nearly everyday. In fact, the continued Anxiety or Anaphylaxis? battles have had such a profound impact on me that I have dedicated my entire doctoral dissertation to comparing their physiological and psychological similarities.

So when my throat became scratchy after a few bites of pesto chicken last Saturday, I immediately kicked my coping skills into high gear. Here we go again, I thought.

You could tell my therapist and I had put in some good work together as I started grounding myself in the present moment. Taking deep breaths and sipping on cold water to settle my racing thoughts, I assumed I’d be adding this to the long list of times that I’ve tackled allergy anxiety with some well practiced relaxation tools.

But the feeling didn’t dissipate after a few rounds of box breathing, and waves of nausea began to crash over me. Quite the stubborn panic attack! So I retreated to the bathroom to try to gather myself in private. But those few steps were enough to send my stomach churning, and I began vomiting before I could even get a text message off to my awaiting boyfriend.

When he accompanied me toiletside, I managed to communicate through tearful breaths that while I was having symptoms of an allergic reaction, I was pretty certain it was “just” an escalating panic attack. Let me and my post traumatic distress suffer through this in silence please!

“I think we should take you to the emergency room,” he announced.

“It’s probably just anxiety,” I assured him and myself. “I had coffee jitters this morning and I’ve been on edge ever since.” But as the gravity of his declaration hit me, I had to let myself consider the alternative. Could it actually be the real thing this time? After nearly 20 years of these debates, I had truly lost any sliver of trust in my mind or body to make the distinction.

Recognizing the severity of the situation and my usual stubbornness, my boyfriend hurriedly got my parents on the phone. And even from 500 miles away, they were on the same page – We needed to go to the ER. This Anxiety or Anaphylaxis? dispute was ending in the latter.

Doctor’s Orders

It was these four golden words that snapped me back to reality and got me on board with the plan – Epi First, Epi Fast.

The tagline was coined by Dr. Sublett, Wallace, and Fineman of the American Academy of Allergy, Asthma, and Immunology to demystify the use of auto injectors. The pen can be unnecessarily intimidating, and we often hesitate to escalate our response from an antihistamine to a needle. But this straightforward slogan leaves no room for interpretation or second guesses – Epinephrine auto injectors are a safe, effective, and fast-acting treatment for severe allergic reactions, and doctors agree that they should always be your first line of defense.

So in route to our local emergency room, I self-administered my epinephrine auto injector in the passenger seat of my boyfriend’s car – My gravelly throat softening within minutes.

Upon arrival, I was triaged in the code room and immediately started on a IV of Prednisone, Benadryl, Pepcin, and Zofran. My body continued to reject the food swirling in my stomach, and I required a stronger second dose of anti nausea medications before being moved to a private room for observation.

With time, the emergency room attending recognized the color and smile returning to my face as my vitals stabilized, and we were discharged after about four hours. We picked up my prescription steroids and any food I was willing to snack on, and headed home to continue managing the Invisible Consequences of Anaphylaxis.

Lessons Learned

It’s ironic that I have had to spend so much time convincing myself that I’m not having an allergic reaction, that this time I actually needed convincing that I was. A debrief with my therapist chalked this up to a loss of trust in my own body after decades of it playing tricks on me. I had worked so hard on minimizing worst-case scenario thinking that I didn’t want to listen to my gut when it told me otherwise. The scratchy throat that cried wolf!

So I am grateful for my level-headed support system who immediately jumped to action and got me the care I needed – Even when I couldn’t trust myself, I could trust them.

So lesson learned – Epinephrine first and epinephrine fast. Even in the case of a false alarm, the unwarranted medication is harmless and we’d much rather be safe than sorry. Anaphylaxis symptoms progress quickly, and the consequences can be fatal, so the allergy community has made it abundantly clear what we should do.

I’ll be keeping that tagline in the back of my mind from here on out.

Moving Forward

As I laid stoic in the hospital bed, drowsy from the medications and mentally drained from the events prior, a range of emotions plagued my mind. Despite everything, I was most fixated on what would come of my mental health in the upcoming weeks, considering the aftermath of my previous reactions. While I undoubtedly will need time to recover from this experience, one thing is certainly different this time around.

On the other side of this reaction, I am grateful to have our food allergy community to lean on. When I walked out of the emergency room in 2018, there weren’t resources like Spokin or the Food Allergy Counselor Directory. My friends and family supported my healing, but no one could relate to my individual experience. This time, I walked back into a world alongside The Hivey League, who can assuredly connect to my story – And I imagine it will make all the difference.