No New News...

The skin prick test revealed no new allergies. 

I'm still only allergic to: peanuts, to a lesser extent crab, shrimp, and housedust (woo).  They didn't test for drug allergies, but I do suspect that I have an allergy to certain classes of broncho-dialators (which were in the first packs of pills that the hospital gave me.)  As soon as I suspected this, I told the doc and asked him not to prescribe them, although he kept telling me that A: they were very safe (given that I take Albuterol w. no problem) and B: I was on steroids to prevent any kind of reaction.  I insisted nonetheless.  

In happier news, I'm off to Jeju Island for a mini-break this weekend.  The only snag in those pantyhose is that my work has commandeered my passport and alien registration card for some job-related changes and I'm scheduled to take a plane tomorrow morning.  Just sent a frantic e-mail to my superior and I'm hoping I can get back my docs in time...

   

Anaphylaxis Adventure: Part 3

Tuesday (7/29)

This time, I only waited until 1:50am before dialing 119.  I debated just taking a cab back to Chilgok Catholic University Hospital, but decided to call the ambulance just to be safe, figuring that at the very least, they would have oxygen.

At the ER, I explained the situation with the pill pack, and that I hadn’t eaten any food (so I knew it wasn’t a food allergy).  They gave me another shot of Dex, Pen, and put me on a drip.  As soon as it started going in, I felt itchy and asthmatic.  It seemed an odd reaction, but I figured I was probably just anxious and needed to relax, so I sat there and let the drip finish.  I asked the doc (same one as the night before) for the name of the drip and if there was any possible way I could react to it.  "Melpros." he said.  "It's a NSAID (Non-Steroid Anti-Inflammatory Drug)" He said.  "Very Safe."

They discharged me around 8am.  All the cashier windows on the discharge floor were closed, but I rang the bell on the pharmacist’s hutch and a woman answered and handed me an envelope of drugs.  I asked her how much and she shook her head.  I figured that maybe I had won a free pass, but as I was walking home again, I got a call from the hospital with the only English words I heard were "money".  "Great" I figured "There's no way I'm walking all the way back there now." 

I got home and still wasn't feeling at all back to normal.  Just out of curiosity, I checked to see if there was any possibility of an allergic reaction to an NSAIDs... AS IT TURNS OUT... In individuals with asthma, approximately 10% may have their asthma symptoms worsened by NSAIDs and that NSAIDs are also a trigger for some patients with anaphylaxis... Lovely.  I turned around, got in a cab and went right on back, for my third hospital visit in two days.  They gave me another shot of Dexamethasone, Peniramin, Epi, and put me on a drip of Solondo (Prednisolone).  This time they also sent me up to consult with an internist for my "allergy problems".   

Total cost (including 2nd ambulance ride and 3rd ER stay) = $44.670

Cost for drugs (including an Advair wheel, albuterol inhaler, 2 days of prednisone and Allegra) = $17.90

Got home around 3:30pm.  Did not go into work. 

I spent Wednesday and Thursday in a petrified daze, because I still have no idea what set off the initial attack.  The burrito came from a virtually peanut-free western restaurant downtown AND I had eaten it before.  Very cautiously, I ate bananas, almonds, dried plums, a packet of plain oatmeal, broccoli, carrots, swiss chard, and some cheese.  I had yet to feel completely "back to normal" as I kept having these mini-attacks where my lips and tongue would start tingling, my throat would feel like it was swelling and my chest, constricting.  I was still taking the little packs of pills (which I had repeatedly confirmed were only Prednisone and Peniramin) and hope that I can chalk those attacks down to either anxiety or remnants of the NSAID in my system.      

Anaphylaxis Adventure: Part 2

Sunday (7/27)

I was eating a burrito left over from a restaurant dinner the night before.   I boiled some carrots to eat with it (gotta be healthy) and was looking forward to a nutritious meal.  I ate about a tablespoon full of the burrito, some of the carrots... then stopped.  and felt like something was wrong. This was at 9pm.  My lips and mouth felt tingly and my throat felt like it was beginning to swell.  I tried to shake it off and convince myself that I was probably just anxious, but the symptoms got worse and it began to feel like I was running into sheets of pins and needles in my chest and all down my arms and legs.    I took a packet of pills left over from a reaction I had had earlier in the week and tried to calm down.   

I called a friend at 1:20am.  "I'm wondering if I'm just freaking myself out here or if there's really something wrong." I asked her.  "Go for a walk," she advised.  "Clear your head.  If it gets to the point where you feel like you've been running on a treadmill and you can't catch your breath, then I'd be concerned." 

At 3:55am, when my lungs started to itch and breathing was clearly becoming a problem, I felt like I would have to do the inevitable.  I prepared myself and the plan was to shoot the Epi and then call 119 (the Korean 911) immediately after.  I found the numbers of two major university hospitals, as well as a translation service and the Daegu emergency line (#1339) I backed myself into a corner, uncapped the Epi pen, counted to three, and then "swung and jabbed" into my thigh.  I heard a click, felt a pinch in my leg, and then counted to ten (and then to ten again) to make good and sure that all the medicine had been deployed.  I finally pulled my hand away from my leg and felt a trickle of fluid run down my thigh.  "OH great," I thought.  "The epi wasn't finished going in."  Not so, as the metallic tang filled the air and a dark line of blood appeared beneath the hem of my pants and pooled into my shoe.  The epi pen needle is about an inch long and I later discovered that I had scratched myself as I pulled it out of my leg. 

Next up, I dialed 119 and got someone one the phone.  Had no idea what he was saying, and it took a few call backs, (with me repeating "EMERGENCY!" and "ENGLISH!" they were finally able to put an English speaker on the phone who was able to understand my apartment address.  According to the Seoul national government website, 119 is equipped with global positioning satellite tracking technology, but I'm not sure how reliable that technology is with cell phones.  To anyone who may have to dial 119, don't stop calling until someone repeats your address back to you. 

Once they confirmed my location, the ambulance was flashing down my side street within 10 minutes.  In the meantime, I called a co-worker who has similar allergies and asked her to come meet me with her epi pen, just in case I required another dose.  I had no idea if this ambulance carried on-board adrenaline or if the hospital would be equipped to handle me.  These stouthearted co-workers set off to meet me at my apartment, but the ambulance beat them to it.  "We just saw your ambulance go the other direction," she said.  "I'm not sure where they're taking me," I answered.  "It sounded like Chilgok Catholic something..." which it was, but I had no idea how to get there.  So the stouthearted co-workers were awakened for nothing, but I am forever grateful for their offer of aid. 

The ambulance dropped me off at the Chilgok Catholic University ER and the attending Doc spoke English well enough to ask me about my symptoms.  I first asked him in a panic if they had Epinephrine.  "Yes," he said.  "We have Epinephrine.  Do you want Epinephrine?"  "I'm not sure."  I told him I was having an episode of anaphylaxis and he prescribed a shot of Dexamethasone (an anti-histamine), Prednisolone (a steroid), and put me on a Prednisone drip.  It still felt as though someone had tied a rubber band around my neck and I had to ask again for another shot of Epi.  My chest felt better, but my throat was still tight and it took a good five hours for that feeling to ease even a little.   

Total bill (including the ambulance and drugs) $32.14

Walked home, slept for two hours, then woke up and went to work.

That evening, exhausted, I came home and took one of the pill packs the ER doc had prescribed (containing the oral bronchodilator, Formoterol).  Not twenty minutes later I started to feel that same tingling around my mouth and lips.  "What the heck?!?" I thought, in fury.  "I haven't eaten anything today!"  The tingling got worse and my tongue started to swell. Again.    

Anaphylaxis Adventure: Part 1

Your girl's been in a bit of distress lately.  

Here's the story: rough cut.  

For background, I have an extremely severe Anaphylactic allergy to nuts: peanuts, walnuts, cashews, pistachios, and pecans… (all nuts except almonds, which are OK) The allergy was first discovered when, at three years old, I ate a bagel with peanut butter on it and my head swelled up to basketball size.  The allergy was diagnosed and my family learned how to manage it.  My food life involves scrutinizing ingredient lists and questioning restaurants to see if they use peanut oil or use nuts of any kind. I have to be very suspicious of baked goods (much to my chagrin—I am a carb-o-holic). 

As soon as I got to Korea, I learned the words for “peanut” (ddang kkong) and walnut (ho-du) and wheeled a Korean friend to write me out a note that I could show to a restaurant waiter informing them of my allergy.  I buy a lot of western food and try things slowly, relying heavily on fruits, veggies, and Costco.  I avoid bakeries all together (with the exception of bagels from the aforementioned Costco) and any fried food (Chinese, Thai, and that famous Korean fried chicken are all out of the question).  At the request of several friends, had my mother send me an Epi Pen, an easy to use pre-loaded syringe full of Epinephrine, which will save your life if you are in the midst of an anaphylaxis attack.  I had never had to use one before…  Until last Sunday.