How Do We Confirm Benadryl Can Mask Anaphylactic Reaction?

65 replies [Last post]
By on Sun, 10-29-00, 16:46

It has been posted on this site that Benadryl can mask the symptoms of an anaphylactic reaction. This makes sense to me. If I give my PA son his asthma puffers when he's in anaphylactic shock rather than an Epi-pen, it would APPEAR that his breathing difficulties were easing. However, how do we actually confirm that this is, in fact, true? I know that because it did make sense to me, I have posted that information in posts myself and now I'm questioning whether that was okay to do. I'd like for this not be a Benadryl vs. Epi-pen thread, 'cus we already have one going like that, but actually, information on how we can confirm whether this is, in fact, true. Thanks! Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By morgansmom on Sun, 10-29-00, 17:51

Great idea Cindy!! See that's why you have so many posts, you think of all these things!!

I would like to know if there is medical literature written on this topic!!

If I think through it, benedryl would take care of the following anaphylactic symptoms:

.sense of foreboding fear or apprehension-NO
.flushed face, hives, swollen or itchy lips, mouth, eyes or tongue-YES
.tightness in mouth, or throat-PERHAPS IF BENEDRYL TAKING CARE OF SWELLING IN THROAT
.Tightness in chest - NO
.Difficulty breathing or swallowing -PERHAPS IF BENEDRYL TAKING CARE OF SWELLING .drooling, wheezing, choking, coughing -NO
.running nose, voice change -YES
.vomiting, nausea, diarrhea, stomach pains-NO
.dizziness, unsteadiness, sudden fatigue, rapid heartbeat, chills -NO
.pallor, loss of consciousness, coma, death-NO

Agree or disagree?? ...better if there was research, but if this is what benedryl would be masking, then I'm pretty comfortable with masking these symptoms, and waiting for further signs to use epi. Wouldn't it be a good thing that you are keeping your child breathing properly with benedryl?

If your child is breathing fine because you have given benedryl, are they suddenly going to fall down and die??? ...because you've been masking symptoms?? Cuz... I certainly don't want to be taking that chance!!!

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By Cayley's Mom on Sun, 10-29-00, 18:37

I think I've found what you are looking for, Cindy. I will provide the website link, but first I will post the relevant information:

MYTH: Anaphylaxis can be prevented by taking Benadryl (an antihistamine) or other medications before eating the problem food.

FACT: While it may be possible to block a mild allergic reaction with medication, preventing anaphylaxis will usually not be possible. In fact, the medication might prevent the early phase of the reaction, such as hives, which could serve as a warning sign to get help, thereby leaving one even more at risk for a dangerous reaction.

This information is provided by The Anaphylaxis Campaign Newsletter, under the heading "Myths Surrounding Anaphylaxis". It is a very informative newsletter, discussing other issues such as "Peanut Oil: Is It Allergenic?" and "Teenagers Ignore 'may contain' Warnings". Definitely worth checking out. Here is the link: [url="http://www.anaphylaxis.org.uk/news1.html"]http://www.anaphylaxis.org.uk/news1.html[/url]
Hope this helps, Carolyn

[This message has been edited by Cayley's Mom (edited October 29, 2000).]

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By morgansmom on Sun, 10-29-00, 21:19

Thankyou Caylee's mom. So, so far we know that it can mask hives. I can live with that. Any other information anyone can provide on this topic would be appreciated!!

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By Lam on Sun, 10-29-00, 23:59

We have experienced only one anaphylactic reaction so far - Huggies... you probably know the story. Before we knew what we were dealing with, we were told to keep giving our son Benadryl to help with the hives. It did for awhile, but they kept coming back stronger at the end of the 4 hr. dosage. We kept that up for almost 24 hrs. About 1 hr. after an evening dose, the hives came on so strong I could SEE them coming, and the coughing worsened to the point of our son barely getting a breath between coughs. We gave him the Epi and went to the ER. Everything turned out okay.

My point is this - Even after almost 24 hrs. of being on Benadryl, it DID NOT stop the anaphylaxis. I don't consider Benadryl a way to "mask" symptoms. I think of it as part of the necessary treatment to deal with any and all reactions. Think of this: what if your child gets hives from a contact reaction? Our experience has been that Benadryl will stop the hives and the reaction. If we wouldn't give the Benadryl, I'm pretty sure the hives would progress to an eventual anaphylactic reaction. That's not a proven fact, just a guess. Are you saying that at the very first sign of any reaction you'd Epi? We all do what we're comfortable with. I Benadryl first, then watch. If he starts to have an additional symptom, indicative of anaphylaxis, I Epi. Good question, Cindy!! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By Cayley's Mom on Mon, 10-30-00, 01:00

Researching this a bit more on different websites, I have found that Benadryl "helps slow the runaway immune reaction", but will not resolve a case of true anaphylaxis. Benadryl blocks the release of histamines in the body, but histamines are only part of a severe reaction.

I think what the concern is here, is that a child might have Benadryl for a severe reaction, and it might temporarily "mask" the obvious reaction signs (hives, swelling). Then, if the child is put to bed, anaphylaxis might occur hours later when no one is around. It is reiterated in each website I have visiting regarding anaphylaxis: Even if your child is recovering from the allergic reaction with only Benadryl, the doctor's office should always be called. Anaphylaxis sometimes takes up to 2 hours to manifest itself, so the child should be observed closely for these 2 potentially deadly signs - 1. Swelling of the throat/difficulty breathing and 2. Loss of conciousness.

The above info is available at this website: [url="http://www.users.globalnet.co.uk/~aair/anaphylaxis.htm"]http://www.users.globalnet.co.uk/~aair/anaphylaxis.htm[/url]

Lam - you have given very good advice. If the reaction starts out very mildly, definitely give Benadryl, and observe closely, plus let your health professional know what has happened. On the other hand, if the child is having a severe reaction, with difficulty breathing, etc., give the Epi first, then Benadryl as an adjunct. We definitely don't want to give the Epi for every little case of hives!

Cindy - I don't think you were wrong to post this information. In fact, I also recall reading somewhere (the dreaded "somewhere") that Benadryl may mask anaphylaxis. The article in question was written by a doctor, and my husband printed it out back in July. The only problem is, we have given the article to "someone", or put it "somewhere" and we can't find the website again. I will keep looking for it, in the meantime, it seems that Benadryl does nothing to mask the most serious reactions, which is helpful to know. Take care. Carolyn

[This message has been edited by Cayley's Mom (edited October 29, 2000).]

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By on Mon, 10-30-00, 02:46

Wonderful information everyone, thank-you, and especially a lot of research Cayley's Mom, thanks so much. I was really concerned because I had read that in one post and had taken to quoting it to other people in concern that they may give their child a dose of Benadryl when an Epi-pen was actually required. But, as you also all probably know, I don't even have Benadryl at home. My 1st course of action, and this is only based on Jesse's reactions, is the Epi-pen. Should I find that if he has his next reaction and it's only mild, then I would purchase some Benadryl. I was concerned that because of what I had originally seen in a couple of posts about Benadryl masking an anaphylactic reaction that I was actually passing on false information to someone else, which I definitely didn't want to do. So, that's why I started this thread.

I know that Morgansmom uses Benadryl on a regular basis and I know and completely understand why. I don't know, I still kinda like what PeanutKate posted, that if you do give Benadryl for a reaction, to have it followed-up at emerg or with your doctor, but that also depends on you, your child, and obviously, their history of reactions. Morgansmom KNOWS from Morgan's reactions that she doesn't have to follow-up every dose of Benadryl with a trip to emerg, but for as many PA (and other food allergy) parents that know, I'm sure that there are a lot that don't, and for the one's that don't, I guess I say, I feel comfortable with dose with Benadryl and head to emerg. Does that make sense?

To me, this would be very similar to me not knowing when my son had his last anaphylactic reaction that you give the Epi-pen and go to the hospital. Now that we're on this site and appear to know a lot, a lot of you are probably looking at that and saying "What, she didn't know that?" No, I didn't know and was not told by either the prescribing physician or the pharmacist. I had no literature to read on-hand. I only found out through experience and one that nearly cost me my son's life!

I'm just hoping that maybe by me posing this question, those of us who needed to sort out the Benadryl ? could comfortably (and with me actually not being one of them!). Thanks so much though for so much input. Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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[This message has been edited by Cindy Spowart Cook (edited October 29, 2000).]

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By Mom of Wonderful PA boy on Mon, 10-30-00, 03:44

I do go with what Lam has already posted. I have used Benadryl a few times with my son and that is always the case here...he has not had anaphylaxis.

Tonight he has a bit of red around his lips and chin and my husband and I thought about all the foods he had this eve(we had company and had a big dinner and dessert and then my husband made the boys popcorn with margarine for a bedtime snack)...well we looked at the bulk margarine container (I bought before reading about hydrogenated foods) and it has hydrogenated and liquid canola!! So perhaps I have found the culprit...but as he has only some skin reaction I will check on him frequently this eve ...he is just going to bed...but I will not at this point give benadry or epinephrine....I will watch for any progression of symptoms. As well I would like to say that I think we have to each have our own approach to this, there is no absolute right or absolute wrong to treating the various reactions we have with ourselves or our children.

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Take Care.
o) Maryanne

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By on Mon, 10-30-00, 04:14

Mom of Wonderful PA Boy, see, that's why I wanted to start this thread. I know how I deal with Jesse's PA and I know that each parent has their own way of dealing with their child's PA. But, I had read somewhere about Benadryl masking an anaphylactic reaction, and IF THIS WAS TRUE, I didn't want to say that to someone in advising them against Benadryl. I actually tend not to question how people deal with their children's PA, for example, I wouldn't question how you deal with your son's, in any way. We all know from our children's reactions how we feel, or what we have been told by our doctors to do, in case of a reaction. I was terribly concerned however that when I was saying that, that I was giving other PA parents the WRONG information which is never my intention. Both of my children get red around their mouths when they eat tomatoes, somehow I've never even thought of it as an allergic reaction, but the acid in the tomato. Now, another time, both of them seemed to have the same type of reaction to Multi-Grain Cheerios which had the warning "may contain trace almonds". I called the manufacturer and they were made in a peanut free facility. So, if they were allergic to anything in this batch, it had to be the almonds, as they had been eating them for quite some time. I simply discontinued buying them. I guess I will know "everything" about this tomorrow. Perhaps they are allergic to tomatoes and almonds! No, it is never my intent to try to tell another PA parent how to deal with their child's reaction, but in helping a parent that is new to this sort out what to do, I didn't want to post incorrect information so that's why I posted this thread. Does that make sense?
Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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[This message has been edited by Cindy Spowart Cook (edited October 29, 2000).]

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By Mom of Wonderful PA boy on Mon, 10-30-00, 05:54

Yes Cindy,
it does make sense.
It does appear the question has been answered and Benadryl will not mask an anaphylactic reaction.

As for my sons' outcome tonight...he is sleeping and breathing quite well...his facial redness has dissapated...I don't know what the cause was...perhaps just irritated skin resulting from him sucking on his shirt sleeve...a thing he is doing these days...so he has a lot of moisture on his lips and around his mouth......or...some food irritated him, some times we just never can get the answer.
Well...ciao for now...time to sleep.

__________________

Take Care.
o) Maryanne

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By on Mon, 10-30-00, 06:14

Yes, it would appear that the question has been answered.

However, I still like what was posted by Cayley's Mom, which hopefully turns out here (it's only part of her post).
I feel that somehow that should be considered when making our Benadryl vs. Epi-pen decision, of course, dependent on our own children.

[quote]Originally posted by Cayley's Mom:
[B]
FACT: In fact, the medication might prevent the early phase of the reaction, such as hives, which could serve as a warning sign to get help, thereby leaving one even more at risk for a dangerous reaction.

Also, I'm glad to hear that your little guy is okay tonight. Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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[This message has been edited by Cindy Spowart Cook (edited October 30, 2000).]

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By morgansmom on Mon, 10-30-00, 22:36

Thankyou very much everyone who posted, I also appreciate it!!

So, the answer to me is, benedryl will not mask an anaphylactic reaction but it will mask some of the early symptoms of an anaphylactic reaction, so in giving your child benedryl be aware that you may be masking hives and swelling.

Does this sound correct?

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By Cayley's Mom on Tue, 10-31-00, 04:33

Hi Everyone - I think it's also important to note that even though Benadryl does not, on its own, resolve a severe reaction, it is an important part of recovery from an episode of anaphylactic shock.

I mentioned above that Benadryl should be given AFTER the EpiPen, in the case of a severe reaction (difficulty breathing, loss of conciousness). The EpiPen only lasts about 20 minutes, so obviously medical help has to be on the way, or the child/person has to be transported to hospital immediately.

At the hospital, antihistamines are given to help fight the reaction, in addition to more adrenaline, if needed. Benadryl has the highest concentration of antihistamine, so it is the accepted brand to use in an allergic reaction.

The EpiPen alone is not enough - Benadryl must still be used, or will be used at the hospital. I posted in an earlier thread, under schools, that I don't send Benadryl with Cayley, just the EpiPen, because I didn't want the staff to mistakenly underestimate a possible severe reaction. I will now be sending Benadryl, after all my research here, because it will be used anyway by medical staff.

Benadryl is a valuable tool in fighting a severe attack, and I wanted to pass along this information. Histamines are only part of an severe allergic reaction, but using an antihistamine immediately, gives the immune system a fighting chance.

I hope I haven't turned this into an EpiPen vs. Benadryl thread (sorry Cindy!). The medical profession uses both together to fight a severe reaction, so I thought I should post about it. Take care, Carolyn

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By MattsMom on Tue, 10-31-00, 04:50

Just a question. We've determined that Matt's 2nd reaction was anaphylactic by looking through this site and all the "definitions of" posts etc. At the time we hadn't a clue how serious PA was, and only gave him antihistamines (generic brand). I was watching him from the time he took the pbj bite from his sister, and as soon as his eyes started watering, nose started running, face/hands started to swell, and the sneezing started, I got the med in him. (Reaction started within 2min, I had the meds in within a minute of onset of reaction.)

My question is this... by definition, his reaction was anaphylactic, but stopped with ONLY antihistamines, not antihistamines AND epinephrine/adrenaline. Because it did not require the epinephrine to stop the reaction, does that mean his reaction was NOT anaphylactic, even though he had skin and respiratory symptoms??

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By on Tue, 10-31-00, 07:01

Matt's Mom, wow! I'm really not clear how to respond to that. Jesse has had three reactions, two of which were anaphylactic.
However, the second one, when I called the Medical Centre and told them what was happening and told them that I had an Epi-pen on-hand, they still advised that I bring him in right away. I live right next door. They gave him the Epi-pen there and some Benadryl
and also a prescription of Prednisone (Pedi-Pred) for his lungs for a week. His third reaction which entailed all of the symptoms outlined as defining anaphylactic shock, he was given an Epi-pen, which wore off 20 minutes later, then given another Epi-pen at the hospital along with Benadryl and again, a prescription for Pedi-Pred for the week following. We were also kept in intensive care for over 8 hours and had to be checked by his family doctor before he left.
I know that this is not true in every case, but what I have found with Jesse is that each reaction is worse with less exposure to actual peanut product. I do understand your question because Benadryl did solve the problem. Oh, also, when he had his third reaction he was given the Epi-pen and then his Ventolin asthma puffers before we went to the hospital. I'm not clear what I would do in your case, because you won't know until Matt has his next reaction if it is worse than the last one or not. Wow, maybe someone else can help you out with that one.

Cayley's Mom, you have done absolutely wonderful research into this, for which I thank you. See, for me, because of Jesse's history of reactions and because I do not want to confuse the school and will go on my doctor's advice, I am not supplying the school with Benadryl as I know he will receive it at the hospital. Does this make sense? I think it shows, once again, that we all have different ways of dealing with PA and have to figure out what emergency procedures to put in place with the school should a reaction occur. As I posted somewhere, should Jesse ever have a slight reaction and the school calls me, I will then supply them with Benadryl. However, in speaking with the allergist to-day, he did indicate, that given Jesse's history, he considers him severely allergic. It's just such a hard thing to figure out. But, I think for you, and for Cayley, you're making complete sense.

Matt's Mom, again, I'm hoping someone else can help you out with your dilemma because I honestly would not want you to go through what I experienced with Jesse during his last attack. Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By redtruck on Tue, 10-31-00, 16:46

Sorry, i just had to respond to this after reading a few posts (i was going to leave this one alone since i already made my comments on this topic on another thread this past summer Benadryl vs. epi)
And i must admit, i didnt read all of the posts here, so if i missed something pertinent, excuse me.

Lam, as i was reading your post about how your child had a reaction and after 24hrs, hives were still appearing even though you kept administering the benadryl...as i was reading i was nodding my head agreeing that you were coming to the same conclusion that i was thinking about benadryl, But instead you baffled me with your conclusion that benadryl should still have been administered after successfully arguing that giving the benadryl "masked" the hives temporarily and they kept coming back!

You gave us the perfect example of what could happen (and what i envision happening after giving benadryl) and then concluded that it was ok...instead of saying that yes indeed it can and did mask the symptoms (hives)!
Anyway, no dont take any offence, this is just a friendly discussion about it!

My bottom line....i'm not sure if we actually threw away the bottle of benadryl (that i was originally told to keep on hand) or if we just have it tucked into a corner...but for us, no benadryl as a first line of defence...Always Epi or hospital, but no benadryl...i dont want the false impression that my daughter is ok after getting benadryl only to find out hours later that she still reacting!

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By morgansmom on Tue, 10-31-00, 18:43

I agree, this confirms again that we all have different emergency action plans in place, and for good reasons!

I think we all agree that the epi pen is the first thing you do for an anaphylactic reaction. -bottomline

Where we begin to disagree is whether to use benadryl for less minor reactions where only one symptom is present ie. hives ... knowing that it could still possibly be the beginning of anaphylaxis and temporarily mask some of the symptoms.

Some parents are choosing to not use benadryl when child has hives only, because they don't want to take the risk of it possibly being the beginning of anaphylaxis and others are choosing to use benadryl knowing that they must watch for more signs of anaphylaxis. Both are good parents, if they are making informed decisions!!

It is clear that benadryl will not totally mask a serious anaphylaxis reaction. It will however, temporarily mask some of the first signs of anaphylaxis such as hives, runny nose, sneezing, itching, and possibly some skin swelling.

What is important is not what other parents are choosing to do for their children, but that we all make informed decisions with our doctors based on our child's history and allergies.

When this was first discussed, I felt like people were suggesting that I was a bad mom for giving benadryl to my daughter. Maybe it was just the way I was taking it! ...and no, Cindy, I don't mean you, you have said several times that you know why I chose to use benadryl. But like Lam said:

"... what if your child gets hives from a contact reaction? Our experience has been that Benadryl will stop the hives and the reaction. If we wouldn't give the Benadryl, I'm pretty sure the hives would progress to an eventual anaphylactic reaction. That's not a proven fact, just a guess. Are you saying that at the very first sign of any reaction you'd Epi? We all do what we're comfortable with. I Benadryl first, then watch. If he starts to have an additional symptom, indicative of anaphylaxis, I Epi."

Some of us are dealing with hives on a weekly sometimes daily basis. I would hate my daughter to have to suffer without benadryl, progress the reaction by not giving benadryl, and I would certainly not think of giving an epi pen if she has hives only, that would be a bit stressful on us all.

I guess I not only wanted to confirm for myself that I'm not a bad mom, but also with all of you that we can't keep telling people that they are not being responsible parents because they are putting their children's lives at jeapordy by using benadryl. The one post I read was an angry faced symbol, and the poster continued on about how angry they were because people continue to not give epi pens, epi's will not kill!! etc..

I'm not suggesting that we don't use the epi, in fact two or more symptoms and the epi must be used. ...and I would hate to be sending a message out otherwise. Just go lightly on us parents who have to use benadryl, I've had sleepless nights, wondering if I'm doing the right thing lately. I now feel, thanks to many of you who have posted that I've been doing it all right! Phew! I can relax.

Matt's mom, you should see your doctor very soon to discuss all of this with him/her. I don't know what you mean with respiratory symptoms, but that would worry me if my child was having problems breathing!! Perhaps you were lucky with just benadryl this time!!

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By Cayley's Mom on Tue, 10-31-00, 18:50

Back to the original thread re: Benadryl masking severe symptoms. We now know it doesn't mask the most severe symptoms, but might mask minor ones.

I can certainly understand the hesitation some people have administering Benadryl FIRST and then waiting to see if the reaction will progress, so this post isn't meant to address that.

Once the EpiPen is administered for a severe reaction, Benadryl follows, but at this point it isn't masking any symptoms, but rather helping the patient recover. There is a fine line between a product "masking" a reaction, and a product helping one to recover from a reaction. Benadryl is also sold in an injectable form, is case the patient has already lost conciousness, so it would seem to be very important to get this antihistamine into the bloodstream ASAP after an EpiPen injection.

I know, I know, everybody hates a nag (!) so I'm sorry for harping on this. It just occured to me that the patient might feel more comfortable after an antihistamine - we parents don't know what the attack actually feels like.

I wonder if anyone can describe how a reaction feels after receiving both Epi and Benadryl, as opposed to just receiving the Epi. This is a question I'm asking, so I will have a better understanding of the recovery process for my daughter, should she have another severe reaction (she's never had an EpiPen injection).

I am not suggesting that you redtruck or Cindy get some Benadryl, or I would have suggested that a few posts ago (and it's none of my business, anyway)! I just wonder if, aside from the medical benefit of Benadryl, is there a comfort factor, as well? We can research all we want, but to actually get answers about comfort, we need to ask the people who have been there. Carolyn

[This message has been edited by Cayley's Mom (edited October 31, 2000).]

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By Lam on Tue, 10-31-00, 19:36

redtruck:
I am not posting this reply with a defensive attitude - just so everyone knows. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

I don't know if you are familiar with the whole 'Huggies incident' or not, but looking back on it now (hindsight 20/20) I think I can safely say that if we had known the cause of the hives, had removed the cause and the residue (ie. given our son a good bath), the Benadryl would have taken care of the reaction on its own. The anaphylactic symptoms didn't really start until we had put the Pull-ups on him again, and he hadn't had a bath between wearings.

I also want to say that I have a hard time with the term "masking". If the Benadryl takes away the hives, I don't call that "masking". I say it's doing what it's supposed to do - treating the problem it's designed to treat. If more is going on than what Benadryl is to be used for, then it seems clear the next step is Epi.

Anyway, we all seem to agree to disagree on this, and that's okay, "comfort zones" and all. I see Benadryl as a part of the whole treatment process and I think an anaphylactic reaction will occur with or without Benadryl.

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By on Tue, 10-31-00, 21:03

Cayley's Mom, you have raised a really good question and I'm not clear if anyone except a teenage or adult PA person could answer that. I know yesterday, when Jesse had his allergy testing done, his back was an absolute mess. He could hardly wait to get home and get his Claritin! So, does Benadryl ease some of the discomfort that a reaction can cause and perhaps make it easier, if anything can, on the person experiencing the attack? Good question!

Morgansmom, I ALWAYS knew why you felt comfortable with Benadryl. It makes complete sense in your situation and I wonder what would happen to Morgan physically if she were given an Epi-pen every time she developed a rash. I compare you giving Morgan Benadryl for hives to me giving myself an antihistamine for my environmental allergies BUT, and here's the big BUT, you have to watch her carefully each and every time, which as you've said has led to many a sleepless night for you. You are quite aware and watching for any 2nd sign of anaphylaxis.

It's obvious that Redtruck and I have the same "comfort zone" when it comes to Benadryl and it is probably because of the experiences we have had with our children and their reactions. However, even during this thread, I have wanted to say to some people, as Redtruck actually had the nerve to, "I think maybe you're doing something not okay" here, but I don't want to question another PA parent's CONFIRMED comfort zone.

Again, my main reason in starting this thread is that for people that are just dealing with PA, the first couple of reactions or whatever, I didn't want them dosing their child with Benadryl and thinking they would be okay when maybe this would not be the situation at all. This was out of special concern for one PA parent in particular.

I also think it's wonderful how this thread has been handled, in light of the way things have been on the board lately. Everyone seems to have accepted each other's "comfort zone" with Benadryl vs. Epi-pen kinda thing without the thread disintegrating to the point where there is no longer any discussion of the original post going on. Hey, kudos to us all, for that!

Cayley's Mom, again, I would like to reiterate that I completely understand why you have changed your decision about providing the school with Benadryl. I completely both understand and respect that decision.

Anyway, best wishes and have a safe night tonight! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By MattsMom on Wed, 11-01-00, 01:26

Morgansmom- I was referring to Matt's 2nd reaction. He was given a bite of pbj sandwhich by his sister, and within 2min his face and hands started swelling (skin) and his nose started to run and he started sneezing (respiratory), also his eyes started watering. I gave him the antihistamine within a min of the reaction starting, but WAS watching for problems breathing. I sat on the couch with him in my lap, purse on shoulder, keys in hand in case we needed to make a trip to the ER.

It's weird actually, I only knew you could be allergic to peanuts, not how serious it could be, but I did know that in extreme cases of allergies to bee stings, anaphylactic shock, or breathing trouble was possible, so I was watching for signs of trouble...even though I didn't expect any. I had never heard of people having bad problems breathing or what have you after eating foods, but something still told me to watch for signs of trouble. Like I said though, thankfully Matt's reaction stopped with the antihistamine. No breathing problems other than the runny nose and sneezing. Knowing what I know now, I'm actually surprised it did stop, and I feel bad for not having taken him in to the ER regardless, but I simply had no idea we needed to. Hopefully there will not be a next time, but if there is, we'll be headed for the ER immediately...even if he ISN"T having problems breathing.

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By on Wed, 11-01-00, 01:59

Matt's Mom, I definitely would NOT be beating myself up about not taking Matt to emerg during his 2nd reaction. You gave him the antihistamine and you watched him. You watched him not even being clear about what you were watching for. Do not second guess how you dealt with his last reaction. I think you did great. Please, do not let this stay in you as some kind of guilt, because, believe me, you do not need to feel any whatsoever. Look at how many posting in this thread give their child the Benadryl and then watch and wait. That's what you did. Yes, you know that you may or will do it differently if there is a next time. Please also remember that this is from a woman that almost had her son die because of her sheer stupidity during his 2nd anaphylactic reaction. I should be carrying guilt, you definitely shouldn't be! I think you've done wonderfully and should Matt have another reaction, I know that you and Matt will be fine. Best wishes! I hope you had a safe evening! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By redtruck on Wed, 11-01-00, 04:01

Ok, let me clarify a little more...
Not saying Benadryl should never be used, or that it couldnt be used in conjunction to an epi (for example) to help make a child more comfortable (if thats something it can do), but rather, i am simply saying that i wouldnt use it as my first defence since the reaction could start out mild and turn more violent later (which i wouldnt want to "mask" with benadryl) even though the benadryl on its own might be enough (but then again, probably doing nothing would be enough too in that case).

I see benadryl to be equivalent to asperin or tylenol...relieves pain and symptoms...it does not cure. When one has muscle pain from an injury, or minor surgury, or dental work,...doctors may prescribe or tell you to take tylenol etc., not to cure your problem, but to help alleviate the pain and discomfort (temporarily), but after the effects of the pill wear off, the pain usually returns.

So benadryl helps with a minor reaction (just like tylenol would help a minor headache), but taking nothing will probably also yield the same result in both cases...

If benadryl were any stronger than it actually is, it would not be an over the counter product, but instead would be a prescription, like an epi is!

Anyway, hope my position, is clearer.
My intention is certainly not to berate anyone with any of their comfort choices, but rather to have a discussion, that if i'm convinced otherwise, would gladly change my mind.
Some good points made by morgansmom and cindy.
P.S. I dont think anyone should think themselves to be a "bad" mom (or dad)by the decisions they made during a reaction, and the fact that you are on this board reading, discussing, and learning, makes you a "good" parent (if a label must be placed)!

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By on Wed, 11-01-00, 05:07

Redtruck, I basically spoke for you in my above post where I said we had the same comfort zones re the Epi-pen and it was probably because of our history of reactions with our children. I know that for Jesse, it's his lips that go funny first, they swell up enormously and turn blue - this happened even with his 1st reaction and then he develops hives. That was his first reaction pretty well covered. But his last two, anaphylactic, progressed VERY quickly, with the lips swelling and turning blue, hives, then full body flush, etc. For me, if I saw his lips turn blue and swell and any other symptom of anaphylaxis, out would come the Epi-pen. End of story for ME. Only because he has had two anaphylactic reactions which progressed very quickly would I not use Benadryl first when his lips swell and turn blue and his breaks out in hives. I would be afraid that I was "masking" the more serious progression of anaphylactic shock. But that is me and that is me with Jesse. I completely understand where you're coming from, but I think it's because we're coming from the same place. I am not prepared, after him almost dying during his last anaphylactic reaction, to give him some Benadryl and then wait and see because it is just not something I could do. Also, the doctor at emerg that treated him that night and the allergist again yesterday said that because of the severity of his reaction to such a slight exposure to peanut products, I should consider this a very severe allergy. And, when it came to having his Emergency Plan done by his family doctor (who had to see him before he could be released from intensive care after his last anaphylactic reaction), the doctor was very clear in that he did not want the school to have Benadryl.
But again, this is for Jesse. That's why I go with the Epi-pen. Redtruck, I truly believe you and I are on the same page and for the same reason. Best wishes all! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By MattsMom on Wed, 11-01-00, 05:46

quote from Cindy's post---"it's his lips that go funny first, they swell up enormously and turn blue - this happened even with his 1st reaction and then he develops hives. That was his first reaction pretty well covered. But his last two, anaphylactic, progressed VERY quickly, with the lips swelling and turning blue, hives, then full body flush, etc. For me, if I saw his lips turn blue and swell and any other symptom of anaphylaxis, out would come the Epi-pen."

Cindy...this really sounds like you're describing Matt's 2 reactions! Only I did not notice that his lips turned blue, and I never saw hives pop up on the second, just flushing on his hands and face. (and the runny nose, etc...) And after doing all this research the last two weeks your next statement "For me, if I saw his lips turn blue and swell and any other symptom of anaphylaxis, out would come the Epi-pen." describes my and my husband's view on things too (once we actually get the epi of course, for now it would just be head to the ER, not epi, then ER). But like you said, that is how WE feel for OUR son...circumstances are different all over the board, so plans of action are going to be different all over the board too, and that's the way it should be, IMO. =)

Seeing you describe Jesse's first 2 reactions like this, and seeing how closely Matt's resembled...I am that much anxious to get that epipen!! I worry that Matt's 3rd (hope he never has one though!!) will be like Jesse's 3rd. Just going by Matt's *2* reactions, I would say that his will get more severe each time, as did Jesse's. But then again, he has only had *2*...so it's kind of hard to establish a pattern for sure.

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By morgansmom on Wed, 11-01-00, 11:33

Matts Mom & Cindy:

I think you are both correct. Any sign of swelling and I would also epi right way. You can't fool around with swelling!

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By on Wed, 11-01-00, 16:47

I didn't read I these posts just scanned quickly. During the last Food Allergy conference in Va last spring the doctors had a T/F question very similair "I would give Benadryl to my food allergic child before going out to eat" The answer was False-because doctor's were teaching us that it can mask the early symptoms of life-threatening reaction! With my son being allergic to 7 foods,5 with >100 CAP RASTS scores I feel I must go on the doctor's directions and rely on always having EpiPens available and strict guidelines of approving "safe" bought or homemade foods.

EpiPens are what has been proven most likely to safe lifes when reation occurs and deaths may occur when no EpiPen was given or it was delayed in being given.
I hope this doesn't sound cold- just factual.

Plan safe foods but keep those EpiPens Ready,
JanBP

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By on Wed, 11-01-00, 16:50

Matt's Mom, I was actually saddened to read that Matt's reactions read like Jesse's. I'm terrified of the day should he have another reaction because of that 3rd one. But you, you have the PA much more researched, more more under "control" then I did at that time. I certainly had all of the safety measures in my home that I have now and my comfort zone wasn't probably much different than it is now even. But, we were out when it happened and
it was "snack time" where we were. Jesse had run ahead of me, I believe his father was very close by and he was given the snack by another gentleman, not knowing yet to ask.
His father did glance at the snack he was given but didn't realize there was anything wrong with it. As soon as he brought it to the table, I could smell that ghastly pb smell and as he touched it to his lips I started to scream. The rest of it, I don't have to go into again, because I'm sure everyone knows the story well by now, BUT, MattsMom, it was my fault that things progressed as badly as they did. As soon as that bloody thing touched his lips I should have given him the Epi-pen, I knew right then that he was "going" but I watched each symptom progress as I argued with my husband. For this I will never be or should be forgiven. Also, the other thing that you do know that I didn't know at that time, is that when you administer the Epi-pen, you go to the hospital. We had never been told that. So, we gave him the Epi-pen only to have him start to "go" 20 minutes later. Then we rushed him to emerg. Now I know differently. I'm fairly sure though that all of the safety measures I have in place in my home now are the same as they were then and the only difference would be that my husband finally "got it". This is why I am so clear about what I would do if there is a next time because I did not do things fast enough the last time and did not know enough the last time. This time I feel I am totally prepared, although I know you can never really be. You are so much farther ahead of me that I'm sure should Matt have another reaction, he will be fine. What's up with getting the Epi-pen - 'script from the ped in a couple of weeks and approval from your husband's drug plan? I almost feel like sending you one of mine 'til you get one! No, I know you and Matt will be fine! I've said that more than once to you now on this board because I really truly feel that way. Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By Jackie on Thu, 11-02-00, 05:35

After eight years of dealing with a peanut allergy (9 year old son) I have decided to go strickly with the epi-pen. This plan has been in place for about 1 1/2 years.
I've been told: if you go with just the Benadryl you have no way of knowing if your child's blood pressure is falling. I was told to always give the epi and immediately call 911 and ask for life support. I was told to not drive my son myself in case he requires CPR.

I have also heard about Benadryl "masking" a reaction. I really don't know if this is true or not. For our family we deal only with the epi now. It's convenient too with the epi-belt (I don't know how he could carry around a bottle of Benadryl). There is only one plan in place which makes it easier for the school and when visiting friends. We use Benadryl only if he has inhaled the peanut fumes.

We used to give Benadryl (and no epi) and it did help him. But looking back, it makes me shudder to remember how exhausted he was after his reactions and how he just wanted to sleep. I did not have the knowledge then - that his blood pressure could be falling.

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By Mom of Wonderful PA boy on Thu, 11-02-00, 05:54

OK guys...
If your child is having only a reaction of swelling or hives at a hand that touched...say, a table where some one ate peanuts...are you really going to give an Epi?
I guess it depends on previous reactions and comfort zones....I really wouldn't as my son has distal reactions...to his skin only, no airway symptoms and I am not poking him...a waste of Epi and an unnecessary ambulance trip...not for him or me....
So...we do what our childs/or selves history has taught us is needed for them/us.

__________________

Take Care.
o) Maryanne

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By MattsMom on Thu, 11-02-00, 06:19

Thanks Cindy! I sure hope you're right! I do feel better knowing that we know what we're doing now. (if that made any sense! lol) I just really hope we never have to test our knowledge. And I really don't think you should be so hard on yourself. I've been in the arguing spot too (though not in a situation like this), and I know with me at least, it was like I didn't want to do something to/for/with the kids unless Mike was in agreement because they are his kids too. Ya know? I think part of it is fear that HE will be right, and I will be wrong and he might get upset or what have you. Also a lot of times, like Matt's 1st reaction, and another time when he fell and busted his lip pretty bad... I will be thinking "maybe we should take him to the ER", but I'm not SURE, so I ask Mike what he thinks. Well, HE never knows either, or else will say "no, I think he'll be alright", and that gets me to thinking maybe he's right, maybe I'm just being an overreactive mommy, and I'll fuss and fidget and wait. Both of those instances (his 1st reaction and the busted lip) this is EXACTLY what happened, and both times we ended up not going to the ER. (btw, his lip did stop bleeding--eventually--and heal up fine, but it sure was a mess for a day or two!)

Anyway, my point is, if you are telling ME not to feel guilty, then I am going to tell YOU not to feel guilty, because in a sense we did the same type thing. I DID think about taking Matt to the ER with his 1st reaction, but pussy-footed around and then just gave him some antihistamine and said "let's wait and see". (Because he was 'ok' with the 1st one, I didn't even think about it the 2nd time, except in that I was prepared to take him had he started having problems breathing.) I know that both of us will never, never do this again, and I think that is what is important. We should both (and anyone else in this position!!) focus on THAT aspect of it...not on the past and what we should/shouldn't have done or did/didn't do.

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By on Thu, 11-02-00, 07:25

Thank-you, Matt's Mom for your very kind words. After I posted to you this morning, I ended up crying remembering Jesse's last reaction. I believe it is true that we should focus on the future and not dwell on what we did wrong in the past. However, my child almost died because of my stupidity. He had every symptom of anaphylactic shock and I was still arguing with his father. What the hell was I thinking? My child was almost literally dying before my eyes (and his father's as well) before he got the shot.
I really really appreciate what you said and certainly am focused on to-day and the future for the most part, but I will never forgive myself for that last reaction. Never. As I've posted somewhere here, neither Jesse or my husband will ever know that though and the only positive thing about it was that my husband finally "got it". But, thank-you, your words were very kind and thoughtful.
Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By Lam on Thu, 11-02-00, 16:50

I'm sorry to prolong this thread - I really thought it was coming to a close awhile ago, but it hasn't, so here I go...

I really am trying to understand the reason behind skipping the Benadryl - I don't 'get it' yet. As Mom of Wonderful PA Boy pointed out, do you give the Epi at the first sign of ANY kind of reaction? Even just one hive? This is how I am following this:

If your child has even one or two hives you:
1.) wait to see if the hives go away on their own, or
2.) let the hives progress until another symptom appears, then Epi, or
3.) give the Epi right away, even if it's 'only' one hive.

Am I understanding this right? If I am, I politely disagree with you.

I do want to say that I completely understand the "history of reactions" part of making the decision. Example: Cindy's son's immediate anaphylaxis. I would Epi our son immediately if he ingested something peanutty, because his past reactions were severe and fast after ingestion. His contact reactions, so far, have been controllable with Benadryl, so that's what we do.

I hope I'm not coming across wrong - it's easy to do on here. I truly don't 'get' the reasons for skipping Benadryl in reactions that are not anaphylactic in nature. Maybe there's just no easy way to answer this question...?

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By on Thu, 11-02-00, 17:28

Lam, I'm probably not going to be very helpful at all to your question. Jesse has never had a reaction where he just got hives.
However, he has yet to have a contact reaction whereby he may or may not only get hives. If he did have a contact reaction where he got hives and absolutely no other sign of impending anaphylaxis, then, yes, I would give him Benadryl. I would not dose
him with the Epi-pen for a case of contact hives.

His last reaction, anaphylactic, was by merely touching the pb product to his lip, so, to me, essentially contact only but not the same as say him touching residue on a table. This required the use of the Epi-pen, which should have been immediately. However, I also have another indicator that I know to look for - swollen very large lips and lips turning blue. The thing is, the reactions happen so quickly and progress to near death so quickly (or in Jesse's case to-date) that I want to be clear about Epi-pen use should he have another reaction.

But, no, if he had a reaction from contact through residue and did develop hives alone, I would certainly feel comfortable giving him Benadryl and then watching for further signs, as all of the people giving Benadryl are doing anyway.

It's in a totally different thread and I'm not even clear now, but a person posted about what she considered her son's mild reaction.
She listed three symptoms. Going by the definition of anaphylaxis, I wanted to tell her that I thought her child had suffered an anaphylactic reaction, but I didn't. I simply held my tongue. She chooses to believe that it was a mild reaction and her son was fine, recovered quickly, etc., so who am I to question whether it was an anaphylactic reaction or not. I can only speak for myself and the experiences I have had to-date with Jesse. Anyway, I'm not clear if this helped you at all in your mission for an answer to your particular question. Best wishes. [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By Cayley's Mom on Thu, 11-02-00, 19:08

Hi Lam - It's too bad we all can't get together and sit at a round table and hash this out! It is so difficult to "discuss" things post by post, when you aren't sure if your post means what you think it means. People misunderstand posts all the time, so it's definitely easier to discuss in person!

However, since that's not going to happen...!

There is a valid concern, in some cases, that the anaphylactic reaction will not occur right away. There is a 2 hour window, after which time, it's safe to assume anaphylaxis will not occur. If Benadryl is given at the first sign of a reaction, it will clear up the external symptoms, but if an anaphylactic reaction were to occur in, say, 1/2 hour after Benadryl was given, the question remains: did the Benadryl mask it, or would it have been a delayed reaction anyway?

It also depends on the history of your child's reactions to things - Cayley gets the odd hive from a crying episode for example, and I don't use Benadryl, because I know it will resolve itself in a few minutes. But if a child has hives from skin contact with an allergen, it might be more comfortable for the child to have Benadryl.

I wish I could come to the point without so much rambling! I am trying to say that some parents might feel it is a gamble to use Benadryl, when their child doesn't have a history of hives.

Cayley's episode of anaphylaxis was also resolved with Benadryl (3 doses at the ER), and at no time did the doctor mention needing an EpiPen. I was assured that this might not be the case next time, though, so I guess my own answer to your question would be 2.) let the hives progress until another symptom appears, then Epi.

I reiterate my above post - I will only use Benadryl AFTER the EpiPen has been administered, and I will not use the EpiPen at the first sign of a hive, but I think it's pretty obvious when a PA child is suffering a severe attack, isn't it(or are some severe attacks subtle?)? Along with the hives, come the vomiting/drooling, severe agitation, not to mention breathing difficulties, so a hive on its own, to me, is not a severe reaction.

However, if I am absolutely positive that my child has ingested peanut protein, and my child developed a hive, then, based on her past reactions, I would Epi, Benadryl and rush to a hospital. This is a very difficult question to answer, hence the musings.

Well that's my unlearned opinion, so there you have it. Take care, Carolyn

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By DMB on Thu, 11-02-00, 19:50

Ditto to Carolyn, Lam & Mom of Wonderful PA boy! Because of my son's history of anaphylactic reaction to INGESTION of peanuts, I will use the epi-pen immediately if I know he ate something.

In addition, because of my son's history of reactions to touch and reactions for reasons unknown, I will only give benadryl. He just had another one today after being at a friend's house who has a dog. Red, itchy, watery, swollen eye--relieved by a dose of benadryl within minutes.

Which brings me to another question--for the parents of children who have never had hives during a reaction--are your children on a daily preventative medication for other allergies?? My son's pediatrician doesn't want to put him on any kind of a daily pill (i.e. Claritin) until he's four (since he's showing signs of animal and environmental allergies). But I'm wondering if his mystery hives will suddenly disappear once he's on a preventative maintenance program. Maybe I should start a new thread with this question. Deanna

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By Jackie on Thu, 11-02-00, 20:11

(Second try - hope you don't have to read this twice)

The above post explains it for me. My son has never had hives. His reactions have included: nausea/vomiting/dizziness/headache/distress/
crying/extreme ear pain/glassy red eyes/drooling/wheezing.

As mentioned earlier, based on his reactions, I have been advised to epi first and call 911. In the past I used to give him Benadryl and it would certainly help him. He is always exhausted after these reactions and wants to rest/sleep. He appears to be comfortable. This is where the problem is - his blood pressure could be dropping and I would never know it! For my son - this is certainly a situation where Benadryl could mask a very serious reaction.

We have Benadryl in the house for situations where he may inhale peanuts. He has never come into contact with peanuts - but if he did and if hives developed I would probably give him the Benadryl and watch him closely.

Every situation is different and we do what we have to do. It has taken years for me to come to my plan of action. I just wanted to add this "blood pressure falling" subject - because it was news to me when I heard it.

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By redtruck on Fri, 11-03-00, 01:59

Ok, see now, the discussion has raised a few questions...thats good!
First, Lam dont think we are reading yours (or any others) arguments as combative, rather than opposing view.

Now you've raised some interesting questions (at least in my mind), but i do think your questions are teetering on a different topic...When to give an Epi? as opposed to giving an epi vrs benadryl.

Do you give an epi at the site of one hive?
Probably not, unless you see other signs, but then at the same token, why (if this is what youre alluding to) give benadryl at one hive?

(Aside from the masking issue, it seems from other posts that it causes drowsiness, which i dont think you would want in a child you are monitoring for breathing problems etc.)

You do raise this question in my mind...Does Benadryl do anything? in other words, if you gave no benadryl (at a benadryl type of reaction) then would you yield the same result as if you did nothing (aside from possibly comforting a child, like a tylenol or asperin?) Or does the benadryl actually have some ingredients that will actually act like an epi, in a "milder" way?

Is that clear, or have i made that more confusing?

Sometimes things are clear in your own mind,and when you go to write it out in argument form, it doesnt quite come out the right way!

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By on Fri, 11-03-00, 03:31

DMB, my PA son is on a daily antihistamine for his environmental allergies. He has been on it for 2 to 2-1/2 years now. I started out with Benadryl but then switched to Claritin because it is non-drowsy and he was entering school. This may be why he does not develop hives, or has not to-date. Good question, I think you should post it! Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By morgansmom on Fri, 11-03-00, 03:55

Yikes! I was going to just give up on this thread but .... I can't!

Benadryl does not mask symptoms of low blood pressure! ...this I am sure of. I have given my daughter benadryl for hives and then very clearly saw signs of low blood pressure, (fell into unawakenable sleep) The exact same symptom you would see without benadryl.

Benadryl also does not make my daughter drowsy. Does it make kids drowsy?

This thread has given me much:

.First I have cleared it up in my own head that benadryl is the right choice to make if your child is experiencing many bouts of hives
.Second, I have met others who are like me, thankyou, Lam and Mom of Wonderful PA Boy, for understanding me, I needed to find people like you.
.Third, I have learned a way to put into words what I have always believed about benadryl from my experience with it, thankyou again Lam. Benadryl does not mask an anaphylactic reaction, it simply does what we ask it to do, control hives, runny nose and itching. Yes, these are the early symptoms of an anaphylactic reaction, but from what I seem to be hearing no one would give an epi pen if their child just had hives anyways, so you are no further ahead, we are both waiting for further symptoms
.Fourth, this thread has been great for education. Some of you understand why it is important for parents to give benadryl to kids who had many episodes of hives and so that is great. Thankyou Cindy for someone who chooses to not give benadryl to your son, you still understand the necessity of benadryl for those of us who need it.

The down side of the thread for me has been that some people are still not getting it! You know our mother-in-law thread, well it's the same thing. ...and you are suppose to be our support.

You don't have to choose to do it this way but can you recognize that we must. Can you say at the end of your thread, but I understand why you must choose to use benadryl??

Ok, one last attempt here! ...and I'm really not angry just frustrated! Let's just say, that in a full year my daughter has 40 episodes of hives. If we average that out for her life span so far she has had 200 episodes. Of those 200 episodes how many were anaphylactic? Well one that was diagnosed at 15 months and possibly 3 others that were before that time, so lets say 4.

Now the 200 cases have been contact or ingestion ranging everywhere from one hive to many many hives at once.

Have you ever had hives covering mass parts of your body?? Me either! ...but I can tell you it makes a little girl scream, squirm, cry and itch like heck!!

Benadryl takes it away immediately or very close to immediately. Not only does it correct the hives that appear on the body but the body does not produce more hives. ...and then the whole episode is over! ...and that is all I have had to do for 196 of her 200 episodes!! A pretty good record.

If I let hives go, it's very likely that they will keep coming.

Now, I know hives mean that we could possibly be dealing with an anaphylactic reaction, so the question is do I wait to see if there are further signs. Not on your life, my daughter's in distress NOW!! ...and I know that benadryl is not going to mask more serious symptoms, only hives, itching, runny nose. Therefore, I observe her very carefully and should another sign appear the epi is given.

Do I follow up with a visit to the emergency department. No, because this would totally disrupt our lives 40 times in a year. Needless to say what effect it would have on my daughter rushing her in to the emergency department for each case of hives.

Please, I can say to you, I understand why you choose not to use benadryl, please say it back!! We are not using benadryl as a treatment for anaphylaxis. We know the epi pen is the only treatment and then to hospital. Yes there is a possibility that in treating hives, it will mask early symtoms of anaphylaxis, we are quite aware, but that is the chance we must take to live a normal and comfortable life in this world that is full of the things my daughter is allergic to.

So the next time can we say, the right plan for me is ______, but we understand that others must use benadryl because they are dealing with hives on a regular basis. Can we give our rubber stamp to two different emergency plans, one that uses benadryl and one that does not!!

Thankyou for letting me get that out!! Really I'm not angry, so I hope I did not come across that way!

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By DMB on Fri, 11-03-00, 04:18

Redtruck,

O-k. . .so are you arguing the point that benadryl should never be given for any type of an allergic reaction or just as a first line of defense against a peanut-ingestion-anaphylactic-reaction??

If it's the latter, then there is no argument. The epi-pen should be given first after known peanut ingestion--especially if there is a history of anaphylaxis. But I will still give benadryl (per instructions from the allergist) as will the hospital when you get there.

If we are arguing that benadryl should not be given for any type of an allergy, then I disagree. I don't feel that benadryl "masks" the symptoms--it relieves the symptoms. When my son comes into contact with peanut residue, he will get hives at the point of contact and if he rubs his eyes, then they will get red, itchy, and watery. This is very uncomfortable for him. Sure, if I don't give benadryl at all, then I'm sure the symptoms will clear up on their own at their own sweet time. But why make him suffer while I sit back and wait. If I can relieve the discomfort, I will.

Another example, awhile ago my son broke out in hives around his eyes after eating a nutrigrain bar. I called the company and they told me they are made in a peanut free facility so there wasn't even a chance of cross-contamination. I called the allergist and he said to go ahead and give him benadryl every 4-6 hours for 3 to 4 days since it would take this long for his body to rid the "unknown" allergen. Every 4-6 hours the hives would come back around his eyes and the benadryl would relieve his discomfort. Again, I don't feel his symptoms were being "masked". Benadryl was giving him relief from the discomfort until his body could rid the allergen naturally. And as Lam said, in hindsight she felt that if they would've taken the huggies off her son and given him a bath, they probably wouldn't have had to use the epi.

Sorry this is so long. . .but I'm confused as to what we're arguing about. I am in no way being confrontational, but I just want to be clear on this and to give my reasons for using benadryl. Deanna

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By redtruck on Fri, 11-03-00, 04:20

ok morgansmom, youre obviously referring to me, lol...no problem, and i wont rehash all of what been said already, just one question (cause i'm still trying to learn and so i'm using these boards to learn, not to say that my position is the only way or the right way, but rather i'm trying to form my opinions based on information that persuades me)

So, when you say that the benadryl gets rid of the hives and they dont come back, how come Lam said earlier that the hives kept coming back a while after the benadryl?

If you left the hives alone and gave no benadryl, would the hives have disappeared, or would they have grown and continued?

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By DMB on Fri, 11-03-00, 04:42

Morgansmom and Redtruck,

I was posting while you both were posting so I didn't get to read your posts before I posted (follow all that?? LOL!).

First of all, morgansmom, I completely understand where you are coming from. My son has many reactions for unknown reasons and it would be ludicrous to give him the epi every time.

I don't want to speak for Lam, but in regards to your question, Redtruck, the hives kept coming back on her son because they didn't realize the culprit--the huggies. As she already said, if they would've taken the huggies off of him the hives probably would've cleared up on their own with the use of the benadryl. Just as my son's hives cleared up after the allergen from the nutrigrain bar passed through his body. I used benadryl during that time to relieve him of his discomfort.

Again, I don't mean to speak for anyone else. And I'm not saying my way is the right way, but it is the right way for us. Deanna

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By on Fri, 11-03-00, 05:43

I, for the life of me, cannot understand where the misunderstanding is coming from in this thread.

It was very clear from Morgansmom's 1st post why she chooses Benadryl.

Now, DMB raised a very good question about those of us who have our children on a daily antihistamine anyway. Jesse has never had hives. But, perhaps he has never had hives because he has his daily dose of Claritin in the morning.

Also, with regard to that specifically, the Claritin, given to him the morning of his last anaphylactic reaction, did not, in any way, mask the early warning signs of anaphylaxis, say 10 hours later (and this is a once a day antihistamine, so "good" for 24 hours). I remember this reaction so clearly and know that he had the early symptoms 1st, just as if he hadn't taken an antihistamine that day. That was also one of the things I was concerned about when we got to emerg, I was trying to tell the doctor that I had given him Claritin that morning but he explained that that did not matter.

Morgansmom, I spoke with the pharmacist when the Kid's Claritin first came into the store. He said that if he was giving an antihistamine to a child on a regular basis, as I am with Jesse, he would choose Claritin as it is non-drowsy (it is non-drowsy by chemical nature, there is nothing put in it to make it non-drowsy, I made sure I checked about that), whereas Benadryl CAN make you drowsy. That doesn't mean it has to. I take a generic Chlortripolon on a daily basis for my environmental allergies and it does not make me drowsy although it CAN. I factored what the pharmacist told me in along with the fact that I would only have to give Jesse one dose of the antihistamine per day instead of the two with Benadryl. We recently tried the Kid's Reactine which is also non-drowsy, but it was grape-banana flavour or something like that and Jesse really did not care for it.

Also, since Benadryl is the antihistamine of choice for PA, why not use that anyway, especially if it doesn't make Morgan sleepy? Now, when I saw the allergist on Monday, he gave me a prescription for a totally different antihistamine, the name of which I cannot recall, which I still have to check out. He said that it is about $50.00 per month.

Redtruck, I think before I could address your concerns I would have to know how many reactions your daughter has had and what symptoms were present. I've outlined Jesse's anaphylactic reactions fairly well and I think that's why no one has questioned why I have the Epi-pen first attitude, although, as I stated above, if he broke out in hives alone from contact, which he has not done to-date, I would purchase some Benadryl and give it to him (after checking with the pharmacist to make sure that it was okay on top of his daily dose of Claritin) and then watch him very clearly. But, it has been my experience, with Jesse, that his reaction will progress VERY quickly if he is going into anaphylactic shock (and I'm not sure but that could probably change from reaction to reaction) and that is why I go with the Epi-pen first emergency plan. I believe that is why the doctor has that as our emergency plan at the school, based on his experience with Jesse's two anaphylactic reactions.

This really depends on your experience with your child and their reactions. I still do not understand why Morgansmom had to write down every detail again of Morgan's reactions, when it is very clear why she is giving her Benadryl. I understand completely why she would not follow-up every dose of Benadryl with a trip to emergency. That's simply ridiculous. This woman knows what she is doing with her daughter and her daughter's reaction and I don't understand why people aren't getting it (I'm probably angry, whereas she isn't - LOL!) I give Jesse Claritin every day so he does not suffer from itchy eyes and watery nose from his environmental allergies. Morgansmom gives Morgan Benadryl when she develops hives, which is regularly, and the only difference is that Morgansmom then has to watch for the possibility of anaphylaxis.

If someone is extremely clear in their post, I don't understand why it is questioned, period. We have the answer to the basic thread starter question - does it mask the symptoms of anaphylaxis - yes, the early ones, but no to the later ones (is that worded right?). Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img] And Bensmom, if you're out there, you better be reading my posts because I now have to go back in and paragraph this bug out (I know, Redtruck, you have asked me to do it too).

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By morgansmom on Fri, 11-03-00, 11:59

Redtruck: I really wasn't pinpointing you out! You probably were the poor soul who posted above me so sorry if you felt I was directing everything at you, I wasn't. However, you may have been included in that group LOL!! There have been several new posts that are going back to the beginning of our discussion of this thread, stressing that the epi pen is used only, with no benadryl.

As far as the hives go, yes, the benadryl takes away the hives, if I do not give benadryl they will probably go away eventually, ...but if I don't give benadryl then often more hives will continue to appear until it is a very uncomfortable situation.

Lam's reaction was different just this time. The allergen was still contacting the child. Lam stated that the hives continued to come even through the benadryl dose which was Lam's clue that this was something more than a case of the hives.

I guess my point is, there are two emergency plans in place, not one.

1. Give epi pen and go to hospital. (at no site of hives or for some of you even when you see hives) With some of you following with a dose of benadryl, and some of you waiting for that to happen at the hospital

2. Give benadryl at the first sign of hives, wait for further signs and then immediately give epi pen and go to hospital.

Both are valid! Perhaps even the first is preferred if you are not dealing with hives on a regular basis and you can wait after seeing hives to see if there are more symptoms.

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By on Fri, 11-03-00, 13:32

Morgansmom, this was VERY clear and most welcome. Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By morgansmom on Fri, 11-03-00, 14:43

Cindy wrote: We have the answer to the basic thread starter question - does it mask the symptoms of anaphylaxis - yes, the early ones, but no to the later ones (is that worded right?). Best wishes!

Cindy: I also forgot to say in my above post, yes! ...it is worded very clearly. Thankyou!

PS, How do you quote someboday anyways!! LOL

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By DMB on Fri, 11-03-00, 15:38

Morgansmom,

How many things is your daughter allergic to? Is she on a daily antihistamine or have you looked into that?

I'm just wondering (for my own son) IF he was on a daily antihistamine, if it would reduce the number of reactions he has to touch and whatever else out there in the world he's allergic to. Maybe this would prevent the hives from even appearing.

I'm going to call his allergist next week to see what he thinks about this. As I mentioned earlier, my son's pediatrician doens't want to start him on anything until he's 4. Maybe the allergist has a different opinion. Take care. Deanna

P.S. I'll start a new thread with this question, Cindy! Right now I have to take the kids to gymnastics. Be back later!

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By on Fri, 11-03-00, 15:42

Morgansmom, thank-you for saying that my wording was clear. If you check the time on my posts, you'll see why sometimes I'm not sure. LOL! Actually, I'm probably not clear all through the day - you should hear me when I try to have an adult conversation!

DMB, I think it is an excellent question. Because Jesse is on a daily dose of Claritin I'm wondering if that is why he never has a case of hives from a contact reaction or if he's simply never had a contact reaction. I'll actually ask the doctor what he thinks about it, if I can remember, next time I'm in. Best wishes! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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By Mom of Wonderful PA boy on Fri, 11-03-00, 17:04

I feel a need to clear up some of the mysteries of Benadryl (Diphenhydramine Hydrochloride-its' generic name). It comes under many Trade names...too many to list but is Best known as Benadryl(read the active ingredients of any drugs you are using to see if it is a dipenhydramine product). It is availabe for use in form of tablets, capsules, elixer, syrup injection and now chewable tablets.

Ok, now this next part is technical but here it is to attempt to help your understanding:
MECHANISM OF ACTION
Competes with histamine for H1 receptor sites on effector cells. Prevents but does not reverse histamine-mediated responses, particularly histamine's effects on the smooth muscle of the bronchial tubes, GI tract, uterus, and blood vessels. Structurally related to local anesthetics, diphenhydramine provides local anesthesia by preventing initiation and transmission of nerve impulses. Also suppresses the cough reflex by a direct effect in the medulla of the brain.

Sooo...where it says "prevents but does not reverse histamine-mediated responses..." It means it will stop a reaction from happening, but if it is already going on it can not reverse it.

A histamine-mediated response is when histamine is released in an allergic, inflammatory reaction...Histamine is a compound found in all cells, produced by the breakdown of Histidine. It causes dialtion of capillaries(widening of capillaries...the smaller, most distal blood vessels), decreased blood pressure, increased secretion of gastric juice, and constriction of smooth muscles of the bronchi(breathing tubes in the lungs) and uterus.

Benadryl is CONTRAINDICATED (should not be given) in acute asthmatic attacks.
USE CAUTIOUSLY in narrow-angle glaucoma, prostatic hypertrophy, pyloroduodenal and bladder-neck obstruction, and stenosing peptic ulcers; in newborns; and in asthmatic, hypertensive, or cardiac patients.
Reduce GI distress by giving with food or milk.
coffee or tea may reduce drowsiness.
sugarless gum or sour hard candy, or ice chips may relieve dry mouth.
Diphenhydramilne should be stopped 4 days before allergy skin tests to peserve accuracy of tests.
USED WITH EPINEPHRINE IN ANAPHYLAXIS.
One of most sedating antihistamines; often used as a hypnotic.
May cause photosensitivity (increased sensitivity to the sun)
Antihystamines are not recommended for use by wormen who are breast-feeding because small amounts of drug are excreted in breast milk.

There you have it. I have obtained this information from Nursing Drug Handbook.

I hope it somehow increases your understanding of Benadryl....I will not to try to read more into it....If you have questions not yet answered about Benadryl please do not hesitate to see your Pharmacist or Physician!

[This message has been edited by Mom of Wonderful PA boy (edited November 03, 2000).]

__________________

Take Care.
o) Maryanne

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By on Fri, 11-03-00, 17:36

Mom of Wonderful PA Boy, excellent post! I often wish I had a CPS at the tip of my fingers. This is wonderful and SHOULD clear up any questions re Benadryl. I think maybe if people do have questions, they could still post them, just you don't have to feel compelled to answer them! I think there might be some because of the medical wording, etc., but I found it clear. So, don't take offense if anyone does have a question, just simply feel that you don't have to respond to it. Also, in the past, when someone has had a question on this board, or even to-day, I will check with the pharmacist to see what they say about something and then post it. I was amazed when even the pharmacist's advice/information was questioned, but I didn't feel compelled to go further with it.
Best wishes and many thanks! [img]http://uumor.pair.com/nutalle2/peanutallergy/smile.gif[/img]

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