The first time

I was getting ready for spring break my junior year and I had a project due.  I left the house after breakfast and headed up to the engineering campus, about 4 miles away by bus. I went to class and went to library/labs as needed to work on the project, skipping lunch.  The coop where I lived provided room and board so I was not accustomed to buying meals. I was living on a student budget. Around dinner I was still at it, and finally realized I had to make the last bus back to main campus, so finished or not, I wrapped up what I was working on, turned it in and headed down to the bus stop.  It was late, snowing, I was hungry, and I had to get up early tomorrow to get to the airport.

I got home and the house was nearly empty, most of my housemates had left or were sleeping.  There was a grad student, Mark I think was his name, living in our house.  He was not going away for spring break. I went down the the kitchen for some food.  I was famished.

When I got to the kitchen I was struck by a powerful smell. Someone had burned something,… badly.  Cookies, … someone had baked cookies, and they were sitting on a cookie sheet in the middle of the kitchen.  Hmmm, I thought, Appetizer! So I scraped a cookie off the pan and I bit it.  I swear it was 60% charcoal and 40% cookie, but I wolfed it down anyway, and I might have eaten a second, not sure, There was a horrible taste in my mouth, so I got some milk, then picked up another cookie and started scraping off the charcoal.

Uh oh! … Peanut butter cookies.  Hmmm,… and I had no idea how severe the reaction would be.  My first thought was to vomit, but nothing would come up, so I ate some fruit salad and tried to vomit again, nothing.  Then I started feeling this impending sense of doom, and hot and chilled, and itchy throat. But the thing that I remember clearest was the feeling that something terrible was happening.

I found Mark and told him I needed to go to the hospital and he never questioned why.  We got in a pickup truck and pulled out in the street.  It was about 2 miles to he hospital and there was 8 inches of fresh snow on the road.  The streets had not been plowed.  Later, Mark told me he was worried about what he would do if the truck got stuck in the snow. [For all you younger readers out there… this was about 5 years before the 1st hand held cell phone was invented.]

About halfway to the hospital I started feeling funny, so I told Mark every thing that I know about the situation (which wasn’t much), and told him my symptoms.  I told him he had to bring me into the ER.  And shortly after we arrived and he walked me in.  I got up to the desk and the nurse asked what was wrong.  I tried to speak, but I couldn’t, My throat was swelling and I couldn’t vocalize. Mark was right there and told the nurse what he knew, and they whisked me into the ER.

ER Treatment

To the best of my knowledge I never lost consciousness. I was laying on an ER bed and medical personnel were swarming around me. They put IV’s in both my arms and took my blood pressure over top of a heavy flannel shirt… I kid you not, I heard “it’s forty over zero” and I thought, “that’s not possible”.

By now I could tell I was starting to swell all over my body and a heavy weight started pushing down on my chest making it harder to breath.  It wasn’t that my throat was closed, rather I was starting into respiratory collapse.

While this was happening the docs and nurses weren’t just standing there, it was pandemonium and here comes the epinephrine injected directly into the IV which were both running wide open. First one dose in each arm, then one more (one arm) and finally I started to feel like I wasn’t going to implode and I could breath again. 2 liters of saline gone and they hook up 2 more. Prednisone goes into the IV bag, and I start to relax. The doc checks on me and things start to settle down. I’m feeling a little tired, but I don’t fall asleep.

In less that a half hour I start feeling funny, fortunately the nurse is right there. I go from feeling fine to panic in an instant, the epi had worn off and the reaction was coming back. Two more doses of IV epi and I start to feel better again. Then I’m on observation for the next couple of hours.  Finally they say I can leave, but first I have to get rid of 4 liters of saline which takes quite some time, so long in fact the nurse knocked on the door to make sure I was ok.  I get a prescription for prednisone and get it filled at the pharmacy. They tell me to avoid eating peanuts and to see my allergist. What allergist?? I don’t have an allergist.

I have about 2 hours before the shuttle to the airport will pick me up.  So I walk out into the ER waiting room and Mark is there, waiting for me.  [Mark Hall, I can never thank you enough for being there that night. Someday I hope we can meet again.]

The flight to CA was uneventful. Back then the stewardess would take your drink order, and hand you the drink, a napkin and a bag of peanuts. They basically pushed peanuts into everyone’s hands, even those people that wouldn’t ask for them if given the choice.  No, I really don’t mind if you eat peanuts in my presence, PROVIDED THAT YOU DON’T EXHALE.

Spring Break. California. Was that just a bad dream?

My first experience with prednisone. Meh.

Otherwise I tried to put it behind me. When I returned to school I went to see the allergist and had a round of skin tests. Back then they would apply the liquid, then come back later with a tool and scratch each site. Not very repeatable compared to what they do today. As they applied the allergens to my back one of them felt like I was being stabbed by a needle, and that was before the scratch.

After time was up they started assessing the results on the 5 point scale. Some mild allergies to common airborne and seasonal things, scoring 1 to 3, but the tree nuts were 5/5. Then I watched the nurse mark off the peanut line item.  She crossed out the 5 point scale and drew a wheal that was about the size of a quarter.

The consult with the allergist was pretty low key.  I shouldn’t eat nuts, peanuts could kill me, if I do eat them I need to seek emergency treatment right away, and here is a prescription for an ana-kit.

OK, ok, fine.  But that was just a fluke, I made it 20 years without a reaction, I should be able to make it 20 more. Or so I thought.  One thing I did do was I always carried the ana-kit. At some point in my life I decided I would not eat unless I had my ana-kit with me. Going all day without eating makes you remember to bring it along. In the last 30 years I probably went out without it once or possibly twice.

Food is necessary for life, but if you are ANA it can kill you too.

© MICHAEL G SPORER AND LIVING WITH PEANUT ANAPHYLAXIS:ADULT VERSION, 2015

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