Monday, April 25, 2016

The Allergic Reaction...

So this is the post that I have NEVER wanted to write.  It finally happened... we had to use the epi-pen.  For four years, I've carried that thing in my purse, in backpacks, on water rides, in the grocery store, while hiking, on planes/monorails/cab rides, etc.  I've re-filled the prescriptions every summer and made sure we had enough sets for school, my purse, the house, and so on.  I've shown family, friends and babysitters how to use and inject them.  I returned our Auvi-Q pens when they were recalled last summer and stalked our pharmacy to get new epi-pens in a timely manner.  I've read ingredient lists and questioned waiters and chefs time and time again.  But, until Saturday, I was proudly able to say, "but we've never had to use it."  Unfortunately, that sentence is now long behind us.

Saturday started off quietly enough.  We had tball pictures and then a game in the morning.  We were back at the house relaxing after lunch and killing a few hours before an afternoon birthday party in the neighborhood.  Nick was snacking and I heard him say to Georgia, "Do you want one?"  As she took the cashew from his hand, the little warning bell went off inside my head, but I shushed myself and figured I was over-reacting.  Typical mom response.  Although she had never eaten just a regular raw cashew before, she had previously passed the oral food challenge (the gold standard) to cashews the previous summer.  However, those were baked into cookies.  It's the only difference that I can think of at this point.  

Within seconds of eating it, Georgia immediately stated, "That was spicy."

And my heart landed on the floor and my radar instantly went to code red.

Within 1 minute, she started coughing and complaining that her throat hurt.  I did my best to deny what was happening in front of my very own eyes.  But, I knew.  I already had gone to the mudroom and put on my shoes.  My body was preparing to go somewhere.  My head just hadn't caught up yet.

I had high hopes that perhaps she was just having an oral reaction in her mouth, even though my heart was pounding and I knew where this was most likely going to end.

I suggested that we all go upstairs and have her brush her teeth and wash out her mouth.  Again, I just kept thinking that perhaps, just maybe, if we were lucky, the coughing would be it and we would go back to our regularly scheduled lives in just a few minutes.

However, as Nick and Georgia headed up the stairs, I went to my purse and quietly slipped the epi-pens into my back pocket.  I remember saying, "I can't believe this is happening."  I mumbled it again and again as I went up the stairs to join them in her bathroom.

By the time I got upstairs, Georgia was brushing her teeth.  She was starting to get upset and as calm as I was trying to be, I'm sure she could sense my panic and horror at the situation.  I just wanted to keep her talking so I asked her lots of questions.  Nick sat on the toilet lid and she crawled onto his lap.  All along, she just coughed and coughed while I quietly begged God for this to not happen.  We tried to reassure her that she would be okay and to keep her calm.  I could hear my pulse pounding in my ears.  

Our emergency action plan from our allergist calls for the epi-pen if there are more than two symptoms present.  So far, the coughing was the only symptom.  I still held a smidgen of hope in my heart that it would go away quickly.  I kept scanning her body looking for swelling, hives, splotches, etc.  Nothing.  The epi-pen case was never more than a foot away from me.

At some point, Georgia said, "I'm gonna throw up."

I told Nick point blank, if she throws up, we have to epi-pen her.  He agreed.

I realized at that moment that both of our phones were downstairs, so I quickly ran down and grabbed my phone.  I keyed in the code to unlock it and waited.  I almost typed in 9-1-1, but again, this tiny ray of hope was still there for me.  So, I put the phone down on the bathroom counter and watched as my daughter continued to cough.  No wheezing.  No raspy vocal quality.  She wasn't struggling to breathe.  It was just a dry cough... again... again... and again.  My eyes were glued to her.

Georgia complained of being cold, so we took her next door into her room and wrapped her in a big blanket.  Nick rocked her a bit and she started getting drowsy.  Looking back, that was our second symptom.  We should have given her the epi right then and there.  But we waited.  In total, probably a grand total of 3-5 minutes had passed since she had eaten the cashew.  It felt like a lifetime.  I remember saying to Nick, "Don't let her fall asleep."  In the back of my head, it wasn't sleep that I feared but a loss of consciousness.

Seconds later, she projectile vomited everywhere.  I ripped open the epi case and handed it to Nick.  I said, "Do it" and I immediately dialed 9-1-1.  Georgia screamed and cried as the needle hit her in the outer thigh (we later discovered that although she knows that the epi-pens go everywhere with us, she had no idea it was an actual needle).  I did my best to spell our address 10x before the 9-1-1 operator understood the word "British" in our address.  My bitchy/bossy side was in full effect.

Epi-pens are magic drugs.  I'm a firm believer that every house in America NEEDS one, even if your child(ren) does not have diagnosed allergies.  Georgia was back to "being Georgia" within 10 seconds of being injected.  The coughing immediately stopped.  She started shaking like crazy, so I wrapped her in a new blanket and laid her on her bed as we waited for the ambulance to arrive.  I stripped her of her clothes that were now covered in vomit and Nick ran to our bedroom to throw on new clothes as well.  We knew we had a trip to the hospital in our future.  It was only then that I looked down and realized that I had put on my shoes already downstairs.

The ambulance crew arrived within minutes and I greeted them at the door as neighbors stared from their driveways.  By the time we all got back up the stairs, Georgia was just lying on top of her bed calm and quiet.  Too quiet.  My chatty little socialite just laid there and cuddled with her blanket.  The ambulance crew looked her over and declared that she looked pretty good and that her breathing sounded great.  They instructed us to give her a dose of benadryl (if we had it), which we did.  She drank it right down.  They noticed that her belly looked a little splotchy, which was new since the epi-pen and they said it could have been caused by the epinephrine pumping through her little body at that point or just a side effect.

The EMS crew was wonderful with her (Dave and Tim will be getting a reward from us this week!) and gave us a few options, which included:
     * Not going to the hospital
     * All of us going to the hospital together in the ambulance
     * Our family driving to the hospital in our car and the ambulance following us there
     * Our family driving to the hospital in our car with one of the EMS guys going with us
At that point, I knew Georgia was "with it" enough for her to decide, so I asked her opinion.  She said that she wanted to go in our car and I asked if Mr. Tim could come with us.  They thought that was a great option, so we all headed down to the car.  I passed an iPad on the way and figured we might be at the hospital for awhile, so I threw that in my purse.  The other epi-pen never left my hand/back pocket.

It was a 15-20 minute ride to the hospital (thanks to a new detour in our neighborhood as they expand a major road nearby).  Mr. Tim was quite impressed that Georgia could tell him how to spell her first and last names.  She knew her date of birth when he asked.  The only question she couldn't answer was her social security number.  As we pulled up to the hospital, Mr. Tim commended Nick and I on a job well done.  As Nick parked the car, I wiped away my first tears of the day.

When we got to the hospital, Mr. Tim walked us right back to the pediatric ER department.  Georgia walked right behind him clutching her blanket and a stuffed animal that I had grabbed on the way out of her room.  All the nurses and doctors were great with her that afternoon.  They put her on a monitor and checked her out.  Eventually, she got a dose of steroids.  Mostly, they just observed her for a few hours while Nick and I texted and messaged with family/friends to update them on the situation. Our ER nurse happened to be good friends with our allergist and sent her a text notifying her of the situation.  

Chasing down the steroids with some apple juice

I was so proud of Georgia.  She never cried once.  She never complained.  She never whined. She never asked when we could go home.  She did what she was told by the doctors and nurses and answered all their questions.  I was doing okay until a nurse repeatedly said to Nick and I, "You saved her life."  Cue the water works.  Every paramedic, nurse, doctor, etc. kept telling us that we did what we needed to do to save her life.  That's a tough sentence to swallow.  Georgia asked why I was crying silently and I told her that I was sad and scared, but that everything was going to be okay.  

After a few hours of monitoring, we were discharged home with instructions to follow-up with our allergist and pediatrician.  It had been just over 2.5 hours since the entire event had started.

Overall, Georgia was much more upset that she had missed a birthday party vs had gotten stabbed with a giant needle!  You know your kid is back to normal when she passive-aggressively states in the car, "It's a beautiful day to go to the playground!"

We were in the house for about 3 minutes when Georgia noticed me outside talking to a neighbor (as I reassured our entire neighborhood that we were all good).  She came out and started playing with her little friends next door.  Less than 3 hours since the entire event started and she was out playing in the yard.

3 hours post epi-pen

Nick cracked open a beer and sat on the patio chatting with a neighbor about the experience.  He found the bag of cashews, still open on the coffee table, and threw them directly into the trashcan in the garage.  I paced.  I think the adrenaline rush for me lasted a good 24 hours.  I could have easily PR'ed a race of two that day!  After dinner, Georgia took a nice long shower while I continued to run around the house (did I mention that my thighs were KILLING the next day??!?!).  I'm surprised I didn't start washing windows!

Nick and I slowly digested the event.  We came to the conclusion that we did what we needed to do.  It was the "ideal" situation - we were home, we were together, it was a quiet weekend afternoon, etc.  My greatest fear has always been that she would need to get the epi-pen when I wasn't around (at school, at a party, at a friend's house, while with a babysitter, etc.).  So while we had hoped to never use it, it was an "ideal" time for us to have to do it.

It was also a great learning experience. I will never, ever, ever hesitate to use the epi-pen again.  It was magic.  I joked with a friend that I might be arrested this week for administering epi-pens to anyone who coughs near me in Target!  

It was also interesting to see how different this reaction was from her first reactions as an infant...  no hives, no wheezing, no swelling, no redness.  This was all coughing and vomiting.  Since I didn't sleep a wink on Saturday evening (I was too glued to her baby monitor and checking on her periodically), I sent off emails to the daycare director, her teacher, etc.  I stressed how different this reaction looked vs what we expected from a reaction from her.  Point learned - every reaction can look different and be unique in its presentation.

Georgia woke up on Sunday morning like she didn't have a care in the world.  The only evidence of the day before was a slight red mark and some very slight bruising to her outer thigh where the epi needle went in and did its magic.  My phone rang early on in the day and it was our allergist calling in absolute disbelief.  For now, we'll go back to avoiding all tree nuts except coconut and almond, since she eats those regularly and has for years.  All those food challenges that we've done the past year - walnut, pecan, pistachio, etc.  All can't be trusted at this point.

Georgia returned to school today and life goes on.  I find myself re-reading labels that I haven't checked in years.  I find myself hugging her a few seconds longer than I did last week.  I find myself saying ""I love you" a few more times a day than I did before Saturday.  We keep telling her how amazing she did and stressing to her that the epi-pen worked and made her feel better.  She's had no trouble talking about it and has told all her little friends about her trip to the hospital.  In essence, she's being a kid and has already moved onto her next big life moment... turning 5 at the end of the week!

1 comment:

Lucy said...

Oh my God, this is terrifying and made me cry. My worst nightmare! I'm so happy everything ended up ok. What a brave little girl - and brave parents!