My son vomits, usually within 10-15 min. after ingesting anything containing peanut. This has been our 1st warning that something is wrong if we don't see him eat it or he doesn't tell us. Of course, after the vomiting begins, his eyes turn red & the hives appear & his throat tightens, etc. Most of you know the drill! - Anyway, my question is - I have been told by Dr. to give him 2 Tbsp. of benedryl - If he usually throws up with 10-15 min - will the benedryl do what is should - or should I skip the benedryl step & go right to the epipen. I would use the epi immediately if I knew he had eaten a peanut - but, sometimes in the past, a peanut butter cookie has merely brought vomiting & glassey eyes. What do you all do? SM/ [img]http://client.ibboards.com/peanutallergy/smile.gif[/img]
On Jul 11, 1999
I can tell you from first hand experience that a pnt butter cookie is just as dangerous as the dread peanut itself. My son's first and only anyphylactic exposure came from eating a tiny bite of a pnt butter cookie. You can bet I will be giving the epi when I notice the vomiting and hives whether I believe he has had pnts or not. My son also sneezed and had the tightening in the throat during his episode.
I have been told not to hesitate to give the epi if you suspect an exposure.
Good luck and Stay Safe, Deb
On Jul 11, 1999
Hi SM! My daughter's reactions always start with vomiting, too. And like you, I wonder how much, if any, of the Benadryl is actually still in her doing its job. Her allergist told us to give her the epi-pen even if we just suspect she is having a reaction; and that getting epinephrine when she doesn't need it shouldn't hurt her, while needing it and not getting it could kill her. After we give her the shot and head for the ER, I make sure and tell them how much Benadryl I gave her, when I gave it, and how soon she vomited after that. They usually end up giving her more Benadryl or another anti-histamine anyway.
On Jul 12, 1999
SM - I agree with the peanut cookie issue. Our only reaction came from a peanut cookie and it was almost his last! Always give the epi pen and call the EMT's!
------------------ Kelly M Another Mom in Michigan
On Jul 13, 1999
One of my son's reactions involved persistent vomitting. I tried giving him liquid Benadryl and he could not keep it down. I did not administer the Epi-Pen but drove him to the ER (we're only 5 minutes away) and he was given an injection of Benadryl. That did the trick.
I'm still somewhat on the fence about administering the Epi-Pen immediately. I'd rather save the extreme measure of using the Epi-Pen for any signs of breathing difficulties. But I have heard some good arguments for going for the Epi-Pen no matter what. But just to let you know my son did not get the Epi-Pen during a severe vomitting episode and he recovered quite quickly with only the shot of Benadryl.
On Jul 15, 1999
I was told to always give the Epi - no matter what. And I have been told by several people that each exposure gets worse, so my advice is, DO NOT WAIT for that 'extreme' circumstance. To me, waiting means death for my son, so I won't take that chance. Stay safe.
On Jul 15, 1999
(I am not picking on you I just want to be sure everyone knows how important administering epinephrine quickly (Epi-Pen) is.
Have you heard how important it is to get epinephrine and what waiting ten minutes does to the survival statistics? I read them about a year ago and if anyone recalls where this information is please post it here.
What did your allergist tell you Benadryl does and what epinephrine does?
I would like others to post what they think each medication does so we can all discuss it and make sure everyone is clear on it.
Homework: List the drug(s) that may (in most cases) stop anaphylactic shock.
------------------ Stay Safe
On Jul 16, 1999
My understanding is the:
Benadryl is for the hives and itching...
Epinephrine is to keep the airway from closing...(prevents or reduces swelling)
a Steroid (Prelone) is administered to help prevent a second reaction from happening hours later.
[This message has been edited by Connie (edited July 16, 1999).]
On Jul 16, 1999
All literature I've read says that future reactions are typically (not always) similiar to previous reactions. However, the primary factors effecting severity are:
1. Route of exposure (i.e. touch, ingestion) 2. Amount of allergen 3. Other medical complications (i.e. asthma)
Several people have posted on this site that each exposure gets worse, does anyone know of peer reviewed medical documents to support this?
On Jul 16, 1999
There are two major issues I am familiar with the first is that my allergist told me that if I found out that my daughter ate someting by mistake I should give the Benadryl and Epi right away--unles she was vomiting (her previous reaction)and then to just administer the Epi. The Epi works on alpha and beta systems-heart rate (speeding it up) and lung (reducing swelling increasing blood and oxygen flow).
The second thin I have learned is that regardless of what may or may not be in the literature, my daughter has gone from severe coughing after injestion to vomiting and now has actually had 2 occacions where her airway has been partially obstructed. The Benadryl did nothin the first time-I followed with an Epi in less than 5 minutes. The second time I used a diffent antiistamine, not knowing what was coming, then the nebulizer. They took a lot longer to work and I am certain if I am ever faced with situation again I will not hesitate to use the Epi to get faster more certain relief.
On Jul 16, 1999
My understanding about the two different drugs, epinephrine and benadryl is that bendadryl does very little for true anaphylactic reactions where major systems are involved. Bendadryl does little to counteract the dangerous effects of respiratory and major organ failure. This is what I gathered from my allergist.
While I hate to mention anphylactic deaths, after reading the posts about the two young men who have recently had fatal anyphylactic reactions, it seems that death is not always immediate as these two young men lived several days after their exposure. Does anyone know what the main cause of death in anyphylactic reactions is? Is it true organ failure where medical personnel cannot get the organ(s) to begin responding again? Sorry for this morbid curiousity, but it has been something I have been thinking about and have not had the nerve to ask.
Stay Safe All.
On Jul 17, 1999
My understanding was that the epinephrine worked on the immediate problems associated with anaphylaxis, but has a short term effect, so the Benadryl is given to help block the massive release of histamines that are causing the reaction; it's effect is slower, but longer lasting.
[This message has been edited by KWest (edited July 17, 1999).]
On Jul 19, 1999
Try going to
Reference number 74 at the end of the article refers to an article from 1984 where children with a previous history of atopic dermatitis suffered anaphylactic reactions when the food was re-introduced after a preiod of avoidance. I have not, however, looked up the original article so I don't know how reputable it is!
On Jul 19, 1999
As I said, I think there are many good reasons for giving the Epi-Pen immediately but I have no regrets about not giving my son an immediate injection when his primary and only symptom was persistent vomitting. (Sigh) What I'd really hate to see is kids being used as pin cushions every time a hive appears.
Once again, this is highly personalized, but part of "winning against the peanut" is not only to keep my son alive but to impinge as little as I can on the quality of his life. That means that I will drive him to the Emergency Room (which is 5 minutes away) instead of adding to the trauma with an ambulance *if* he has not passed out or is in extreme distress. Fear exaggerates an allergic reaction, narrows the airways, and my son is already a fearful personality so I tailor my personal gameplan to minimize his anxiety.
What I have read from the adult anaphylactics on this Board is that reactions are unpredictable. Some reactions can be minor, others quite severe. My hope is that I don't treat every reaction as a Four-Alarm Fire. And with that said, I always carry two Epi-Pens with me at all times and would use the Epi-Pen in a second if needed.
Keeping my son alive is a very important priority but having him *enjoy* his life is just as important. Part of winning against the peanut is minimizing risks and having a sound emergency plan in place. However, one month ago my son attended a birthday party at a gymnastics center. This was the first time he had ever been to this kind of birthday party and the instructors had been well-versed in maximizing the fun for his particular age group. As I sat on the sidelines, watching my son have the time of his life, I had to wipe away some tears. For you see, I was winning against the peanut with each of his belly laughs. And within that same hour, I called to speak directly to the manager of the bakery during the party to make sure the birthday cake was peanut-free.
We have to give more to our kids than just keeping them alive.
On Jul 20, 1999
My 4 yr old daughter can also be very afraid of the unknown, esp. when it comes to allergic reactions. However, since I had been told that once an Epi is given an ambulance ride is important in case of a breakthrough as the Epi wears off, I have talked to my daughter about ambulances. We have also started watching re-runs of tv shows that show people being treated by paramedics and riding in ambulances. We talk about what the people are doing, where they are going, and what will happen when they get there.
We have also brought her to town run safty programs and have seen what the inside of an ambulance looks like.
I say this to preface telling you that when my daughter did have to ride in an ambulance on June 2, as advised by our doctor's office, she thought that was the best part of her day. It turned out that she was fine, and a few days later she was happoly retelling her tale to playmates. "Guess what!" she would greet her friends "I got to ride in an ambulance!"
She is still talking about it. Mary Lynn
On Jul 20, 1999
My son shares your daughter's thrill!
Ever since he rode in Rescue, he has had a "Fire/Rescue" fettish. He must own 100 toy fire trucks, ambulances, fire/rescue helicopters, etc.
Anytime he hears a siren, he tells me to "pull over so they can get through just like other cars pulled over for him."
When it comes to the Epi Pen, he refers to it as "making me feel better." Not at all is it associated with pain.
On Jul 20, 1999
Hi Mary Lynn:
I like your idea of advance preparation for a possible ambulance ride and will look into getting my son a tour of the inside of an ambulance. What rather complicates my son's particular situation is that he has a mild neurological disorder called sensory integration dysfunction which makes sounds like ambulances, for instance, excrutiatingly painful. In fact, due to his sensitivities, there is no way I'd be able to keep a Medic Alert bracelet on him right now. He is currently undergoing occupational therapy and I hope will be prepared to wear a Medic Alert bracelet by kindergarten. Like I've said many times, each peanut allergic person is different and each action plan differs accordingly.
I did talk to my son's allergist today and he does recommend using the Epi-Pen immediately if there is any sign of respiratory distress. He says it is better to err on the side of caution because the younger ones can't yet explain symptoms like the throat tightening up, etc.
Part of my son's sensory defensiveness also includes a needle phobia. When he recently had to get a blood draw for the RAST, it took me and two male phlebotimists to hold him down. I will probably give my son an Epi-Pen injection were he to have another accidental ingestion. Still, it ain't going to be a picnic, that's for sure.
On Jul 21, 1999
Noreen, That's got to be tough to deal with. Just some things I have noticed to see if they help at all. The first is that if you call 911 you could always request that they come in with lights and no sierens. When the police and ambulance were approaching we could hear them, but when they turneed on our bloc, the sirens went off and stayed off. Luckily we were doing alright so the ambulance did not need it's siren to speed through the red lights.
The second is that the Epi-pen works best if you have a booster seat where you can still access your son's thigh. That was the way I felt safest. Bar that, my mother has been working for a family physician and has had to inject a lot of children, so she came up with a way to try and keep everyone safe during injections. Put your child on a counter with his knees over the edge, stand in front of him with your body leaning against his legs so he can't kick, stick the Epi in the side of his thigh.
Another thing, I just remembered, after using the Epi I went out and got my self an Epi Pen trainer. I practice on my daughter so we will be more prepared if we ever have to use it again. It does not have the needle, but you do learn how mch pressure to apply.
Good luck and stay safe.
On Jul 25, 1999
Noreen, As far as your son's sensitivity issue. How about getting an ID tag made up (like dog tags) and attach it to your sons shoelace on his sneakers with the medic alert info on it. That way you will have some added protection for him. Lidia
On Jul 25, 1999
What a great idea about having a Medic Alert tag tied to his shoelaces! I might even do that for kindergarten if his sensitivities persist.
As it stands right now, my son is mostly with me except for the time he is with his preschool teacher or babysitter. Both are informed of his peanut allergy and have been trained to use the Epi-Pen. So I'm not sure the Medic Alert tag is absolutely necessary at this point in time. But I do remind my son periodically that he will be wearing a special bracelet letting people know peanuts make him very, very sick when he goes off to kindergarten.
On Jul 26, 1999
Noreen, The medical community is trained to look for a medic alert bracelet or necklace. In an emergency I wonder how effective a medic alert tag would be. It's certainly better than nothing. Would your son tolerate a medic alert necklace?
On Jul 26, 1999
My son and I were at The Jungle today (a play area for kids) with our playgroup and this was the very first time *he* asked the kid i.d. band be placed around his wrist. He did pull at it quite a bit but it leads me to believe there is some hope. [img]http://client.ibboards.com/peanutallergy/smile.gif[/img]
Still, I think it must be easier being female than male with this peanut allergy. Girls and women can stash their Epi-Pens in their purse and wear bracelets without harrassment. I sometimes wonder about the two young men who died recently because they did not have their Epi-Pens with them. Just seems like it is harder to carry and conceal Epi-Pens when you are male. And how many guys get harrassed for wearing a bracelet. (sigh) Some of those long-range concerns I have as a mother of a peanut allergic son.
On Jul 26, 1999
My grandson went to get blood drawn last week. He went in with a smile and came out with a smile. His doctor wrote a script for emla cream. His mom put in on 1 hr before going. It worked like a charm. It is a topical anesthetic-lidocaine + prilocaine. His first blood test sounded like Noreen's son. It was hard and scary for him to be held down. This time he even watched and asked if that was his blood. Says he will do it anytime the doctor needs his to!
On Jul 27, 1999
Noreen, Like you I have motherly concerns about my son carrying his epi-pens or wearing his medic ID bracelet as he gets older. He is only 9 years old now but I am already seeing the "rebellious" attitude when I remind him to carry his back pack with his benedryl, epi-pen & his asthma puffer. He is just a kid and lugging all this stuff is so "uncool". Also, he gets so wrapped-up in some of his activities, he forgets to watch about his "stuff". I am usually with him now, so I carry everything in my purse - or my husband has his little red medicine bag - I wonder what boys/men who have the PA do/have done as they grew older. Anyone out there who has experienced this - "Boys to Men w/PA"?
Mimajut - Thanks for the information about emla cream. I think I read about that on another post on PA.com. My son has only had blood taken twice. The first time it took 2 people to hold him down (only 1 year old!!!) the second time was about 2 years ago and he was very "brave". I can't help but wonder WHY all doctors don't prescribe this cream for these little guys. I wish I had known. [img]http://client.ibboards.com/peanutallergy/frown.gif[/img] - Thanks for the info - I'll be ready next time.