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PostPosted: Sun Jun 10, 2007 5:26 pm 
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Joined: Thu Aug 24, 2006 1:42 am
Posts: 222
Location: Victoria, British Columbia
Ok, help me out here. . . I feel so reckless.

We all went out to dinner last night, to a place where we have been many times before. However, the menu had been 'revamped' (how I hate that!) and I noted that there were now peanuts on top of the spinach and the Thai salad. Having loose nuts in the kitchen is new, as far as I am aware.

Of course when ordering, we mentioned that our son has a peanut allergy. I felt that almost relief when the meal took a lonnnnnng time go get served -- I had hoped that meant the were really careful in the kitchen.

So as we are waiting, I notice my son is more sniffily and sneezy than we came in. It never really got worse as we sat there longer restaurant -- just sort of constant runny nose which continued after the food arrived.

Once we we finished dinner and got home, the sniffling didn't stop and those 'allergy shiners' really came up as well as (??) bright red and hot ears. Both my husband and I suspect he had a 'traces' encounter at the restaurant....and we battered around that he was just snifflly because it is just how he is a lot of the time. But ultimately the stupid thing is. . . we didn't give him anything to fight it.

I had thought we might want to give him Benedryl, but we didn't and I don't know why - denial? I subsequently couldn't sleep and checked on him about 4 times (and also discovered he wanted to start watching tv at 4:50 am!!). He was fine in the end and all but now I am feeling so upset with myself that we didn't medicate. Why were we just watching this, hoping it didn't get worse?? Ugh.
Caroline

ps OMG -- as I write this, I realize this is exactly what he was like when we went to Dairy Queen when he was two! We didn't stay at all -- we just went in, he got weepy eyes and couldn't stop sneezing. Those of you in BC, I think it would be wise to also avoid ABC Country Restaurant if you have a peanut allergy.

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PostPosted: Sun Jun 10, 2007 8:42 pm 
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Joined: Tue Nov 29, 2005 4:04 pm
Posts: 2044
Location: Gatineau, Quebec
Quote:
Why were we just watching this, hoping it didn't get worse?? Ugh.


I think that is pretty normal behaviour, and I would bet most of the folks on this forum have done it. We just hope that it isn't a reaction and so don't deal with it as we maybe should.

I did that a few years ago when my youngest (diagnosed as ana to dairy) accidentally took a sip of milk. I waited a bit and hoped. And of course should have given him his EpiPen and eventually had to take him to the hospital where he got epinephrine and other medications. Now it makes the hair on my arms stand up when I think of it, because it was not a smart thing to do. But I think I was in denial.

Because of Sabrina Shannon and because I am now better educated about anaphylaxis, I have become much more ... reactive, if that's a good way to put it. My DH and I jump on every reaction (or possible reaction) now - but it's taken a few years to get like that.

So don't beat yourself up. Just live and learn.

K.

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Karen, proud Mom of
- DS1 (12 yrs): allergic to cashews, pistachios, Brazil nuts, potatoes, some legumes, some fish, pumpkin seeds; OAS
- DS2 (1o yrs): ana. to dairy, eggs, peanuts; asthma


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PostPosted: Mon Jun 11, 2007 7:14 am 
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Joined: Tue Mar 22, 2005 11:17 pm
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Location: Ottawa
Yeah, I think that it's denial and we've probably all been there.
This is why my husband started to drive our daughter to the hospital during her first (and thankfully-only) reaction only to turn around and give her the EpiPen half way there.
Part if us goes on alert and part of us desperately wants to believe that it's just a spring cold or asthma or something.
No one wants to medicate their child more than is necessary. No one wants to give Benedryl if it makes the child sleepy because we might miss something if they aren't awake to tell us what they're feeling. No one wants to given Benedryl if it will mask the symptoms of an anaphylaxic reaction.
I believe that we need to give ourselves permission to medicate our child if we feel it is warranted. I believe that we need to listen to that gut instinct that can't fully form the words but recognizes that there are enough potential triggers around and the symptoms are similar to and some part of subconcious vaguely recalls a book article or recounted event... What is the worst thing that will happen if we medicate our child in this situation? What is the worst thing that can happen if we don't?
Will I medicate our daughter the next time she gets the sniffles? I can't say for sure, but I do hope to be able to listen to what my gut is telling me.

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Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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PostPosted: Tue Jun 12, 2007 1:12 pm 
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Joined: Fri May 18, 2007 11:43 pm
Posts: 24
Location: Vancouver, BC
_Susan_ wrote:
No one wants to given Benedryl if it will mask the symptoms of an anaphylaxic reaction.


Benedryl will stop anaphylaxis. The trouble is that it works relatively slowly, and that is why epinephrine is the preferred emergency treatment.

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8 year old: dairy, seafood, peanuts, tree nuts, sesame, cats, dust; asthma
4 year old: dairy, eggs, soy, peas, lentils, cats
4 year old: dairy, eggs


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PostPosted: Tue Jun 12, 2007 3:47 pm 
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Joined: Mon Feb 07, 2005 6:39 pm
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Location: Toronto
I'm with Susan on this - you get to know your own or your child's allergy (allergies) and try as best you can to judge whether it's anaphylaxis or not. Perhaps it wasn't really an EpiPen episode. If I were you, I'd make an allergist's appt. and see what he or she thinks of this type of reaction in the context of your child's medical history.

I know that as an allergic person, I will sometimes get mystery "flaring" of the face. I usually will go for the Benadryl if I'm not otherwise feeling nauseated or not feeling anything in the throat.

It could have been a trace reaction - or sometimes we allergic people just get a little "reacty". Could there have been a food in the food high in histamine? e.g. I can't eat spinach or I get flaring, even hives. It's not always the big allergy.

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PostPosted: Tue Jun 12, 2007 10:52 pm 
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Location: Gatineau, Quebec
ahn wrote:
Benedryl will stop anaphylaxis.


I have never heard this, ahn. Can I ask what you are basing this statement on? It isn't in the Benadryl literature that I've read. The packaging on my Benadryl says that it provides relief for hay fever symptoms and itch due to allergic reactions.

According to Allergy Safe Communities ( http://www.allergysafecommunities.ca/pa ... atsubid=20 ), which is based on the national anaphylaxis guidelines, epinephrine is the front-line treatment for anaphylaxis.

Quote:
Epinephrine is the treatment or drug of choice to treat anaphylaxis and as a result is widely prescribed for those at risk of anaphylaxis. All efforts should be directed toward its immediate use. [...]

Epinephrine helps to reverse symptoms of an allergic reaction by opening the airways, improving blood pressure, and accelerating heart rate.


As far as I know, Benadryl cannot open airways, improve blood pressure, or accelerate the heart rate.

I would just hate for someone to think that Benadryl is a substitute for epi in an anaphylactic emergency. Once the epi is given, my understanding is that Benadryl can be (and is) given for hives and itching and hay fever symptoms (runny nose, itchy eyes) and such - assuming that the person's airway isn't compromised and they won't choke on it - but not before.

K.

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Karen, proud Mom of
- DS1 (12 yrs): allergic to cashews, pistachios, Brazil nuts, potatoes, some legumes, some fish, pumpkin seeds; OAS
- DS2 (1o yrs): ana. to dairy, eggs, peanuts; asthma


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PostPosted: Wed Jun 13, 2007 11:09 am 
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Joined: Thu Aug 24, 2006 1:42 am
Posts: 222
Location: Victoria, British Columbia
I will check this out with the allergist because I want to know what to do if this sort of reaction occurs -- there were no hives but certainly I witnessed a systematic reaction that involved the sinuses. If my son's allergies were enviromental I would just think he needed some sort of antihistimine.

But this conversation has I am really stumped -- when *does* one use Benedryl when we are talking about a food allergy? Ever? The whole risk of anaphylaxis part makes the stakes so high if you don't recognize a reaction. But do we use the EpiPen if there is just the sniffles?? It's very scary trying to figure this out!

Caroline

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PostPosted: Wed Jun 13, 2007 1:52 pm 
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Joined: Fri May 18, 2007 11:43 pm
Posts: 24
Location: Vancouver, BC
KarenOASG wrote:
ahn wrote:
Benedryl will stop anaphylaxis.


I have never heard this, ahn. Can I ask what you are basing this statement on? It isn't in the Benadryl literature that I've read. The packaging on my Benadryl says that it provides relief for hay fever symptoms and itch due to allergic reactions.

[...]

I would just hate for someone to think that Benadryl is a substitute for epi in an anaphylactic emergency. Once the epi is given, my understanding is that Benadryl can be (and is) given for hives and itching and hay fever symptoms (runny nose, itchy eyes) and such - assuming that the person's airway isn't compromised and they won't choke on it - but not before.

K.


Benadryl is a H1 antihistamine, and histamines are responsible for the swelling that occurs in the airways. Administering Benadryl after an initial reaction, when there are no signs of anaphylaxis, can sometimes prevent the swelling that leads to anaphlyaxis. It is common to use Benadryl in emergency treatment on anaphlyaxis AFTER administering epinephrine because epinephrine is a short-acting agent.

My intention was to counter the fear that giving Benadryl would mask anaphylaxis. Benadryl works slowly (30-40 minutes for full effect) and we all know that in anaphylaxis, seconds matter.

Perhaps I should have been more careful with my wording.

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8 year old: dairy, seafood, peanuts, tree nuts, sesame, cats, dust; asthma
4 year old: dairy, eggs, soy, peas, lentils, cats
4 year old: dairy, eggs


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PostPosted: Fri Jun 15, 2007 10:39 pm 
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Joined: Sat Oct 01, 2005 8:55 pm
Posts: 412
Location: Vancouver, BC
This is confusing to me.

I have read (can't remember where) that the reason NOT to use Benedryl if a reaction is occurring, is that it will mask symptoms like hives, while not being effective against dangerous things that are happening inside the body, so that it would lead people to assume that the rection is not as serious as it is, as they will not be seeing internal organ involvement, and the skin reaction will be masked by the Benedryl.

The thing that makes the most sense to me as far as when to give the Epipen rather than an anti-histimine is this (this was part of a discussion allergists at the World Congress in Vancouver 2004 were having): If you KNOW or SUSPECT that someone with a previous history of anaphylaxis has ingested their allergen, give the EPI.

I likd that statement when I heard it as it covers all the bases. There is very little danger in giving a dose of adreneline, especially in kids, but there's lots of danger in waiting. So I think it's better to be on the safe side, but that being said, Caroline, if I was in your shoes, I would have waited, too.


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PostPosted: Sat Jun 16, 2007 7:24 am 
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Joined: Tue Mar 22, 2005 11:17 pm
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Location: Ottawa
Caroline, why don't you submit this to Ask the Experts?
It's obvious that we all would really like to know what is the best way to treat this situation. :)

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Daughter: asthma, allergies to egg, milk, peanuts, tree nuts, most legumes (not soy) & penicillin. Developing hayfever type allergies.
Husband: no allergies
Me: allergies to some tree that flowers in May
Cat: allergic to beef, pork and lamb


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