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Forum -> Children's Health
Anaphylaxis- if ur familiar with this, can you please help?
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amother
Pearl


 

Post Mon, May 11 2015, 10:33 am
My daughter is 31/2 years old. she suffers from eczema and minor allergies. shes allergic to basic allergy food such as nuts, fish, egg whites...
she bh never had severe allergic reaction, the most common thing that would happen after eating the wrong foods would be a bubble on her lips and her eczema would flare up and she would become very itchy. This friday night she was eating a marshmallow cookie choc and right away started itching (which was normal) and didnt get me concerned. but half hour later, she was very irritable and I took her on my lap and gave her benadryl and thats when I heard her wheezing... I panicked since I have a niece with severe anaphylaxis reaction and called hatzolah. Hatzolah told me her lungs are not clear and gave her epipen. After giving epipen, one needs to be admitted to ER because epipen can affect the heart. so I ended up spending my friday night in the Er.
Now yesterday, I was on the street shopping when I noticed my daughter was helping herself to some bamba snack left on the floor by some careless person. I quickly rushed home scared of another reaction, she became itchy right away but her breathing was fine and she fell asleep. then an hour later she became very irritable again, I wasnt sure if her breathing was fine, so I called hatzolah to check her lungs. At first, her lungs were clear they told me, but after being there a half hour, they checked again before they left, and this time they heard her wheezing and they right away administered the epipen....

now, im sooo confused! I dont know who can help me with this. Why has she never had bad allergic reactions and all of sudden one after the next? is it because it got worse, or because my anxiety got worse and im sooo tuned into her every move versus the previous times.... also, Hatzolah told me they HAVE to administer epipen, but im wondering, was it really necessary? wouldn't a nebulizer or benadryl be enough? is this called anaphylaxis?
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ChutzPAh




 
 
    
 

Post Mon, May 11 2015, 10:36 am
Time to go back to your allergist and get yourself educated. Make a longer appointment slot.
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Scrabble123




 
 
    
 

Post Mon, May 11 2015, 10:37 am
Wheezing may be a symptom of anaphylaxis but may also be a symptom of allergy triggered asthma. You need to have an appointment with your child's allergists and discuss her allergies, their severity, and when to or to not use an epipen.
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sneakermom




 
 
    
 

Post Mon, May 11 2015, 10:39 am
Go to a good allergist to get better clarity as to what she is allergic to and what those reactions really where.

I had an anaphylactic reaction as an adult to something that I was never that allergic to before. An allergist really helped me figure out what to avoid and also what to do in case of an emergency.
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Frumdoc




 
 
    
 

Post Mon, May 11 2015, 10:43 am
Please see your pediatrician to establish what the cause of the wheezing is and what to do about it.

Last edited by Frumdoc on Tue, May 12 2015, 3:43 pm; edited 1 time in total
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iamamother




 
 
    
 

Post Mon, May 11 2015, 11:22 am
as a general rule, when a reaction effects 2 body systems (like the itching and the wheezing) you give an epipen. epipens save lives so better safe than sorry...
you should for sure make an apt with an allergist and find out the severity of each allergy. it can be entirely possible that she became more allergic to things too..
good luck- I know it can be overwhelming... I have been allergic to things since im 3 and I carry an epipen... BH I have never actually used it because I am extremely careful of what I put in my mouth. my parents taught me to ALWAYS ask someone before I eat something and at a very young age I knew to read the ingredients...
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amother
Peach


 

Post Mon, May 11 2015, 1:36 pm
Kosher marshmallows contain fish gelatin. My fish-allergic child can't eat them either. And yes, wheezing as a reaction to a food definitely warrants an EpiPen.
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amother
Pearl


 

Post Mon, May 11 2015, 1:46 pm
Kosher marshmallows contain fish gelatin. My fish-allergic child can't eat them either. And yes, wheezing as a reaction to a food definitely warrants an EpiPen.

it did not have fish gelatin- I check the ingredients. The only thing I could think of is egg whites.....
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amother
Seafoam


 

Post Mon, May 11 2015, 2:55 pm
My allergist said to administer Epipen only when there are 2 symptoms, I.e. itching and vomiting. (ETA I noticed that someone else wrote this too. But according to OP, the Epipen was administered 1.5 hours after the itching. OP doesn't mention itching at the time the Epipen was given)
Wheezing in and of itself would warrant a nebulizer treatment. Did Hatzolah try that first?

Definitely time to meet with your allergist again. Perhaps your child is developing more allergies or stronger reactions. Hatzlocha.
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amother
Peach


 

Post Mon, May 11 2015, 3:54 pm
amother wrote:


it did not have fish gelatin- I check the ingredients. The only thing I could think of is egg whites.....


Which brand is this? We've searched high and low for marshmallows without fish gelatin and could not find a single kosher brand that did not have it.

Quote:
My allergist said to administer Epipen only when there are 2 symptoms, I.e. itching and vomiting. (ETA I noticed that someone else wrote this too. But according to OP, the Epipen was administered 1.5 hours after the itching. OP doesn't mention itching at the time the Epipen was given)
Wheezing in and of itself would warrant a nebulizer treatment. Did Hatzolah try that first?


Most allergists (and FAAN) say that when breathing is involved, you don't need another symptom to give an EpiPen. And a nebulizer is NOT considered appropriate treatment for an allergic reaction, though it can be used after the EpiPen is administered.
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Frumdoc




 
 
    
 

Post Mon, May 11 2015, 5:15 pm
Apologies for confusing the issue, please see your doctor.

Last edited by Frumdoc on Tue, May 12 2015, 3:46 pm; edited 3 times in total
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Mishmish




 
 
    
 

Post Mon, May 11 2015, 11:52 pm
Please take a look at the NIH Guidelines for treatment of anaphylaxis, around page 25 of this link and like someone else said, book an appointment with your allergist to go over this. And also the itchiness after eating--that sounds concerning as well and is not typical. Food allergy reactions can change from time to time. I would want guidance from the allergist on whether to continue using those foods that she gets itchy from.

NIH Guidelines:
https://www.niaid.nih.gov/topi.....t.pdf

Also, the reason one goes to the ER following use of epinephrine is because the allergic reaction could return. And often the biphasic (second wave) is more severe than the first. The monitoring of vitals is most important in relation to that. In other words, whether you give epi or not, you still need to go to the ER. The epi helps the patient get there and in better condition. The effects of the epi typically wear off fairly quickly. And per the NIH Guidelines, epi is the first line treatment for anaphylaxis both in and outside a hospital setting.

You did good calling for help. Just please speak with your allergist and get a written anaphylaxis action plan so you can feel confident on when to give it if/when there is another reaction. Unfortunately there is not always time to call for help and the faster epinephrine is used, the better the chance it will help. It took me a few times before I felt confident with it. Practicing on an orange with an expired epi can help.

Hope your little one is feeling better.
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Mishmish




 
 
    
 

Post Mon, May 11 2015, 11:59 pm
Here is the NIH document tailored for clinicians if you want more in depth information. It's a good read IMO. Well, not a page turner, but I found it helpful to read more on the subject. Also some good stuff in there about diagnosis of allergy.

http://www.niaid.nih.gov/topic.....y.pdf
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amother
Peach


 

Post Tue, May 12 2015, 1:57 am
Frumdoc wrote:
deleted.


As a mother of a food-allergic child for more than a decade and a patient of one of the leading allergists in the country, I feel a responsibility to point out that a lot of the information in this post contradicts what our allergist and what FAAN recommend regarding treatment of anaphylaxis, so please speak to your own allergist and get a specific allergy action plan for your child.
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yaelinIN




 
 
    
 

Post Tue, May 12 2015, 3:22 am
I would like to agree with the AnonyIma posted just above me. Allergists now suggest that Epi (or Auvi-Q) be given if there are two systems involved (skin, mucus, breathing, gastro, etc) or you worry that the reaction (even one system) seems to be getting out of hand. Our allergist doesn't recommend waiting out an allergic reaction if you see progressive symptoms.

You don't necessarily have to go to the ER if you Epi(Auvi) either. We have Epi-ed (Auvi-ed) our peanut allergic daughter multiple times and have never gone to the ER. We call our allergist and keep her advised on what's going on. Your information is out of date FrumDoc. Please OP, talk to your daughter's allergist and get a very clear and understandable action plan and methods to contact your allergist in case of emergency.
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Frumdoc




 
 
    
 

Post Tue, May 12 2015, 3:40 am
IGNORE FRUMDOC AND JUST SEE YOUR DOCTOR.

I was just trying to educate but clearly the wrong message came across.


Last edited by Frumdoc on Tue, May 12 2015, 3:47 pm; edited 1 time in total
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Frumdoc




 
 
    
 

Post Tue, May 12 2015, 3:47 am
NEVER OVER RIDE YOUR OWN DOCTORS ADVICE BASED ON SOMETHING YOU READ ONLINE!

Ignore everything on here except to see your doctor.


Last edited by Frumdoc on Tue, May 12 2015, 3:48 pm; edited 1 time in total
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Frumdoc




 
 
    
 

Post Tue, May 12 2015, 3:54 am
See a doctor

Last edited by Frumdoc on Tue, May 12 2015, 3:50 pm; edited 1 time in total
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amother
Peach


 

Post Tue, May 12 2015, 4:36 am
Frumdoc wrote:
I apologise for not making it clear I was trying to explain the non anaphylaxis but allergic type reactions which are extremely common and do not necessarily require adrenaline. I am not referring to anaphylaxis and said multiple times that you should use an epipen if advised by your doctor and to be evaluated for the type of allergic reactions, whether this is anaphylaxis or another type of allergic reaction.

Perhaps it is not clear that I used very specific language that does not get read accurately by non medical professionals.

NEVER OVER RIDE YOUR OWN DOCTORS ADVICE BASED ON SOMETHING YOU READ ONLINE!


I intentionally omitted the fact that I am a medical professional as well since in this particular area, my knowledge comes from being a mother and not from being an MD. Since you're implying that the issue is my lack of understanding of medical jargon, I am now including that fact.

I have no intention of debating the medical aspect of things since I really do feel it's important for that information to come from the patient's allergist, but I still take issue with some of the information in your post, which is why I will reiterate to anyone here who has a child with food allergies to please seek information only from a board-certified allergist and not from anything you read from anonymous posters on the internet.
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JAWSCIENCE




 
 
    
 

Post Tue, May 12 2015, 8:22 am
Enough with the medical advice that is probably confusing readers (and OP) and is inappropriate. None of us saw this child, nobody can say if her wheeze was upper/lower or even existed at all. I would really hate to see a parent not give an epi pen to a child who is not breathing because a physician online said epi has dangerous side effects and would not be their first choice for wheezing related to allergy. I would also hate to see a parent not take a kid t to the ER after using an epi pen because somebody online said you don't have to. These are things to be discussed WITH YOUR OWN DOCTOR. Nobody has any business posting about what worked for their child as general advice or what they as a Dr. would do in a given situation since each child and situation is different.

The main problem here is that OP seems to either not have an allergist or has an allergist who has not really explained allergy and all its possible manifestations and progression to her. I assume all this running to call hatzolah is because OP has no idea what to do/nobody else to call. Which is completely reasonable, and the right thing to do, if you don't have an allergist and have never had this explained to you. But it needs to stop. Get an allergist. If they are even decently competent they will tell you what to do in an emergency and how/when you need an ambulance.

I personally use the Jaffe Food institute at Mt. Sinai (they are all great) and have been happy. There is sometimes a wait for an appointment though. I also heard people recommend Dr. Ehrlich at NYU, but I never used him so I cannot comment on if he is good or not. If you do not live in NY try posting your area so people can give you a recommendation, or ask your pediatrician.

Bottom line: we all want to keep these kids safe and healthy. The best way to do so is by hooking them up with an allergist, not giving out medical advice about when to use/not use medications online.
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