Dr. Hive: Allergy shot reaction question and epinephrine effects

[Karen in CO]

My daughter had her first allergy shot today and broke out in hives about 20 minutes after her shot then went downhill from there. She ended up with a shot of epinephrine. She's on a ton of antihistamines and still on prednisone from last week's fun with scallops. I'm afraid how bad her reaction would have been without medication. The allergist is going to reduce her to the lower that normal lowest dilution of serum for next week's shot, but does anyone have any experience with allergy shots for someone this reactive? Any words of advice?

 

AND should I worry more about long-term effects of epinephrine for a growing girl? She's had three shots (which varied in dosage) in the past week. I've read a lot about short-term effects but haven't seen much about long-term effects.

[momtotkbb]

I realize that each person's reactions are different, but I can tell you that my youngest ds is highly allergic to a long list of things - including foods and meds. We were referred to a new allergist by our pediatrician after a particularly severe asthma reaction - the allergist after testing wanted us to do shots. She was shocked that we wanted to wait and research more, think about it, etc. BUT, then ds had a reaction to an asthma inhaler which caused hives and an asthma attack. She then told us that because his body so overly reacts that we should not do shots bec his reactions involve more than one body system - she said she was sorry she suggested it and that in all honesty she would be afraid that the shots could kill him. It was once when I was glad I went w/ my mommy gut. That said, I've known others that allergy shots were great for them and really helped them to lessen their allergic reactions -- but their reactions were itchy eyes, sneezing, hives --- not the full blown hives/restricted breathing that my ds experiences.

 

In all honesty - I would ask for a second opinion. I'm a little surprised that if she had had a reaction the week previously to something and was one meds that they went ahead and did the shots. That was one thing that the allergist told us was that if we went the shot route and ds had had a reaction then we'd have to wait several weeks to go back on a schedule for shots. Which we laughed at bec at the time ds was having lots of reactions so we figured if we had decided to do shots we'd always be off schedule.

[brehon]

:grouphug: no words of advice for the allergy shots. One of my kids is allergic to peanuts and we don't do allergy shots for that.

 

As for the epi I'm fairly sure there no long term effects. After all our bodies need epi (& nor-epi) & produce it constantly. The short term effects can be annoying to deal with; but, there is a reason it's given in anaphylactic reactions - if anything will break the rxn, epi will. I've given patients IV epi and it has saved their lives. Good luck.

[Karen in CO]

ugh. That is the best I have to say for these allergies. Her doctor was pretty certain that she'd start having the severe (anaphylactic) reactions to pollen the way her system was progressing. She was getting hives and had restricted airways, but the drop in blood pressure and suffocation that doesn't respond to the inhaler is all new. It is exactly what her allergist had predicted would happen. He wanted to start shots before next tree season because trees are much much worse than the weeds that are currently blooming. He was hoping we could get a little ahead instead of continuing to spiral downward. Right at this moment, I'd like to lock her in a bubble until winter then move to Antarctica. I need a better plan-B than that.

 

thanks

[celticmom]

I took allergy shots throughout my childhood and adolescence. One thing to check, the doctor I went to as a child had both pediatric and adult crash carts in his office and an ambulance on speed dial. I was a very reative patient and I never needed those things but I think that it was good that they were there just in case. If your child is very reactive, you might want to ask about emergency plans. You definitely do not want to find out that they are not prepared for a serious emergency during one.

[Karen in CO]

They have plans that I didn't pay a lot of attention to until recently. They were monitoring her blood pressure which is a good thing and prompted the dose of epi. Our little pre-shot talk really emphasized the local reaction and downplayed the chance of a systemic one, but they were monitoring her anyway which is great.

[Sandragood1]

My kids have severe food allergies, plus environmental & animal allergies. I also have environmental and animal allergies. My kids haven't had shots, but I have. They helped TONS!

 

My suggestion would be to research and find an allergist more familiar with highly allergic individuals. Does your dc take an antihistamine at least 60 minutes prior to the shot? My allergist required that. Also I had to wait 20 or 30 minutes in the office after the shot to watch my reaction.

 

Second, select a subset of allergens - rather than the whole list - for which to get treatment. For example, I'd choose the most frequent environmental allergens (pollen, dust mites, etc.) and have the serum just for those - or even a subset of those if the list is extensive.

 

You know that each person has an allergy threshold below which they don't react? So every little thing they are exposed to, it all adds up and if it tops that person's threshold, they have a reaction of some sort. That is why treating "little" allegens can help.

 

In your case, if your child has tested positive for any animal allergens I would (sorry) remove those animals completely until such time as things are under control. Your child's life is at stake, so you have to.

 

FYI, my allergist told me that "cat" serum provokes a strong reaction, so definitely avoid that one for dc.

 

Long term effects of epi-pen? My dd has had the epi-pen a number of times. It is only adrenalin. She should be fine.

 

Sandra