Monday, October 15, 2012

Feeling a bit blasé?

I poisoned my self quite nicely this weekend. A combination of impatience and excitement led me to overlook how long I should let the glue dry on my scuba equipment before I got it near me under pressure.

Fortunately for me, our wonderful scuba gear guru for the club came over to do all the hazardous material handling -- acetone and silicone glue, even taking the drysuit outside at 10:30 at night so that the acetone fumes would not come into the house! What a guy! I, unfortunately, did not think through how long I had let this glue cure and get washed out the last time I had used it to repair a wetsuit. This time it was going to be pretty close to me, pressurized inside a drysuit -- I should have let it cure for a a few days and washed it for a few more before getting it anywhere close to me. I am now paying for that little lapse of judgement. Also -- I was feeling a bit indisputable since I have been eating prednisone and zantac like skittles to survive a big gala at work.. All and all a recipe for disaster. Hoist by my own petard, mas non?

So, now on day 3 of having hands like catechers mitts and a face like a basket ball, sporty but uncomfortable, I was ready for hypocondria search time on the interwebs. Just looking for a way to reduce swelling post reaction -- I know what I did and that clearly I'm a horrible warning and menace to myself. No need to remind me.
I may, however, may be getting a bit too blasé about this whole "life threatening allergy" concept.
The first answer I found, on WebMD, "Allergic reaction. Sudden swelling of the hands and face may be a severe allergic reaction (anaphylaxis) and needs immediate medical evaluation."

The first thought that popped into my head, "I can breathe, it's not an emergency. This is useless."

When is it an emergency? I noticed during our second descent that I was working too hard and using my air quickly. I was having some issues and brought my buddy back to the surface after about 10 min since we were just doing a quick tour around the shallows to adjust some equipment. Since I felt off, I opted to hang out while the instructor took him out to test his navigation skills. I hung around near the shore testing my new valve and just floating around checking out the adjustments to the suit to make sure nothing was leaking.

When they came back to shore, my instructor noticed that I looked odd -- I told him that I thought was breathing a bit to hard on the easy dive and was going to drink something hot and see how I felt. Also, I opened the neck seal on my suit to see if I was just asphyxiating a just little from being sealed in too well.

Is is a fish or Christine having a reaction?
My buddy and I slogged our way back up the hill (this is cold water quarry diving -- drysuits or 5-7mm wetsuits are de rigueur pretty much year round) -- leaving our gear at the bottom for the next dive. Not thinking that I was having a reaction, I was SHOCKED when I saw my face in the window of the SUV. I looked like an unhappy grouper -- mottled skin and puffy puffy lips. As much as I like the fish, I really don't want to look like one of those guys!

My dive buddy, who was working on his skills for his advanced certification, clearly earned his advanced allergy card that day.  All I said was "I think I'm having a reaction to my suit, I need to get out of it."  He dropped his sandwich on the ground and was ready to jab me with a the epi-pen, cut me out of my suit (Please, please, please,  no holes in the drysuit!) or grab the oxygen tank and crank it up in a flash. Had I needed any serious assistance I would have been in good shape. But I was already popping my meds, proceeding calmly and waiting till I could get a hand to get the neck zippers open calmly and carefully, since I'm still looking for a corn-free wax for the zippers.  Not only did he get me divested of my corn-y gear in record time, he carried my tanks and heavy gear back up the hill while I staggered around while the corn-free Benadryl was kicking in -- and then he drove my car back home. That is major points in Do Not Kill Christine.

So when is it an emergency? I'm getting good at staying calm and watching what is going on, probably because I don't want to: 1. accidentally drop dead, 2. unnecessarily use the Epi-pen.  That's a very fine line.  It can be a bit of an out of body experience to watch yourself be almost consumed by the sensation that you choking and the concomitant urge to run in circles making the international throat-grabbing sign for "I. Can't. Breathe! while instead keeping your butt planted in your seat and  slowly counting your inhales and exhales. Calm, Slow, In, Out. I'm breathing. My nail beds are not blue. It's not really an emergency.

For me, there are two signs that it is time to crack out the Epi-pens.  When, after a few moment (that feel like years) I can't catch my breath after I've moved into the easy-breather position -- head toward knees, shoulders moving up and down with each inhale in an effort to make more space -- and and I'm getting confused about what to do. At that point it is hard to remember that when I can't figure out what to do, it is a sign that it is Epi-pen time. The other sign is the "feeling of impending doom" or just the plain old "Oh $h*%" feeling where it becomes clear that this is not going to end well.

Then it is Epi-Pen time.Uncap, swing and jab firmly into thigh. Fight the urge to pull it out at the first sting and count to ten.  By the time I get to eight, that band that has been tightening around my ribs and the squeeking stiffnes in my lungs has disapeared. The world starts to swing back into focus on nine and by ten, I'm gulping in a full breath and so so so so very happy that I can get so very much air into my so very open lungs. Bliss for a moment or two, while I grab my allergy buddy and head off to the ER to get stabilized.

 I've had two rebound reactions, so I'm a big believer in following up with IV prednisone, benadryl and a nice nebulizer of albuterol or xopenex.  And in theory being observed for the next 6 hours. That depends on the ER. I have had a few reactions where I can see in retrospect that Epi-Pen would have been a good idea, but it ended well and I had a watcher with me at the time. I just didn't want to go spend the next 8 hours in the ER particularly on a weekend night when it would be full of the drunk/drugged/overdosed/crazed. Afternoons are a much better time.  But really, that should not be a factor in the decision.

Not every reaction sets off the entire cascade where I need to go to defcon-whatever and jab myself with adrenaline, and I do live VERY carefully.  When it does, I am SO grateful that to have Epi-pens. I'm even more grateful to my absolute rockstar friends who will jab me, since it is hard for me not to flinch and pull the pen back out when it stings.   That's a real friend.

Today I look like a cross between an unhappy grouper and a baseball beta-version of Edward Sissorhands. I'm conjested and less than 100%, but I can breathe.  This is not an emergency and not likely to become one unless my fashion crisis, of wanting to wear a retro hat w/ a veil till I look less pelagic, counts.

When is it an emergency for you?

A handy site that lets you prepare a customized anaphylaxis / Epi-pen action plan:

You can add your photo, specific allergy information and 3 emergency contacts.  There are also fill in the blank sheets with Epi or Twinject instructions available


Joseph said...

Luckily I don't have emergencies really. My allergy impedes my breathing to an extent that I choke at night and get infections (lesions! gross!). So I'm not likely to die quick, I die slowly from severe apnea and respiratory infections.

I guess you'd call me a slow reactor. No big shock, just a slow swelling of the sinus including gross sores and infected nastiness.

4 surgeries on my respiratory system since the nineties and I finally figure out on my own I have a food allergy. Shit was just getting worse and worse until I cut out all the common allergy foods and felt a ton better.

Tomorrow I get my food allergy blood test results back, and we'll see what it is. It's definitely corn, but I suspect maybe wheat and maybe dairy. We'll see. Hopefully the test is conclusive.

I'm excited to be healthy again and get back to work. I was an attorney. A damn good one. No one should retire to disability at 30.

Avoiding corn is damn hard, but when you lose your career and see your family ruined it's easy to be a no corn 'trooper.'

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Tomorrow I get my meals allergic reaction blood vessels analyze outcomes back, and we'll see what it is. It's definitely maize, but I suppose maybe rice and maybe milk. We'll see. Hopefully the analyze is definite.
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