Epi Pen Fear

[mskelly]

Why am I so scared to use the epi pen on my son? He has food allergies and we've had the pen since he was about 1. I've never used it, but I do keep it current. The past 2 reactions probably were epi worthy, but I didn't do it. I give him a double dose of Benadryl the second I suspect he's having a reaction and wait a few minutes. THe symptoms usually start to subside in about 5 minutes with a huge improvement at 10 minutes. The past two reactions happened 2 hours after he ate. Last night's episode has been the worst so far and I don't even know what caused it. :confused:

We talked about allergies at his last well child visit and the dr. stressed "DO NOT BE AFRAID OF THE EPI. IT IS HIS LIFELINE." Yet, when it happened again I still didn't grab it. How awful is that? Early on in the allergy journey I was told not to use the pen unless it was a true emergency because I can do more harm than good. That was a different doctor, but I can't get it out of my head. Now, I think they'd rather I give it to him and then go to the hospital. I know food allergies aren't something to mess around with. It's a horrible feeling to see him in such pain. The past 2 reactions were severe stomach pain and vomiting, no visible swelling of lips or mouth area.

Thanks for letting me ramble.

[Parrothead]

I don't know. If it makes you feel better, my doc told me not to use mine unless there was swelling lips/mouth or other signs of airway closing. Luckily I've not had to use it. I treat reactions the same way you do with anti-histamines and wait.

[Chris in VA]

Have you practiced with the "fake" one? I was afraid of the epi-pen, too, until I got to use the fake one on a friend (whose allergic child I was watching). Doing a dry run really, really helped.

[GoVanGogh]

We have had one for our son for probably 8 years and I have never used it. I think, in the back of my mind, a saintly nurse should suddenly appear to administer if we were in public and he needed the shot.

 

My husband did have to give me an Epi shot many years ago. He still says it was the hardest thing he has ever done. I remember sitting on the edge of the bed, unable to breath, thinking, "Just give me the shot!" The look of panic in his face is still very real, nearly 15 years later. He was frozen for what seemed like minutes, though I know it was only seconds.

 

I do hold that picture in my mind and hope it would help me, if I really did need to give my son the shot.

[Spryte]

:grouphug:

 

I was scared to use the epipen, too. How old is your son?

 

Our kiddo got his at 1 also, and we waited out many epi-worthy episodes with benadryl and me watching like a hawk. I was not afraid of doing harm with the epi, thankfully no doctor ever said that to me. It has always been stressed as very important to use it early enough, not to wait too long to administer. But after too many times going to see the allergist and being told that, "You were lucky this time, you probably should have epi'd." ...I finally got it. Each time, our allergist would explain to me that any time there are two systems involved, we must epi. That if we wait too long, that's when there are real problems. That if we wait too long, they may not be able to help him. Here's what finally did it: My son knew he needed it, and asked. Four times, while I assessed the situation. Really. He had a reaction, and he *knew* he needed the epipen. He stayed calm, we talked each other through it, we counted together. And then we called 911. It was good we used it, too. The hospital staff, his doctor, his allergist, and all the ambulance team were so proud of him. So am I.

 

Using it once is an icebreaker. It gets easier.

 

Have you practiced with your expired epis on an orange? That helps. Have your kiddo practice, too.

 

The worst part, for me, was pulling it out of his leg. The needle is longer than you'd think! Does it help to know that DS said it doesn't hurt? The worst part was pulling it out for him, too. I wouldn't share that with your kiddo yet, but be prepared for it.

 

If you don't have an allergist, you might consider finding one. They can help you develop an action plan so you'll know exactly when to epi without all the wondering.

Edited November 2, 2012 by Spryte

[brehon]

:grouphug: it can be difficult. Generally, epi-pens are used in severe anaphylactoid and anaphylactic reactions. As I'm sure you know by now, the worst symptoms include difficulty breathing, airway swelling, and hypotension. Stomach pain and vomiting *in the absence of other more life-threatening symptoms* are usually not reasons to administer epinephrine. So, it sounds like you actually did the right thing by not administering the epi. What makes it hard is that vomiting can sometimes indicate that a severe reaction is happening or will soon. Allergies are so tricky sometimes.

 

Epi does have side effects, of course, but in otherwise healthy people, especially healthy young people, these are usually tolerated very well. After all our bodies make and need epinephrine. What do you think you're scared of? Giving the shot itself? Accidentally giving epi when it may not be needed? The side effects? Something else? If you know what your fear is, you can work on overcoming it.

 

One of my kids carries an epi-pen for a peanut allergy. I know it's scary to think about having to use it. Were you given a practice pen? If not, ask your doctor for one and practice administering it to your son. This may help you. Oh, and if you do ever administer the epi-pen, immediately call 911 and have your child transported to the hospital. A reaction severe enough to require epinephrine may return when the epi wears off which could be in as little as 10 minutes.

[countrygal]

I think it's only for when they start to have severe breathing problems, which can happen very fast. The vomiting is distressing, I'm sure, but maybe it's good because he's getting the stuff out of his body. Open the package and make sure you know how it works atleast. My sister got stung and was trying to read the fine print while her eye were swelling shut and she couldn't breathe. She ended up stabbing herself in the thumb, thinking it was the trigger. Thankfully it worked, but she had a swollen purple thumb! She had an old pen, and said her new one is redesigned so this doesn''t happen. HTH

[HeatherDanae]

I have problems as well! I guess for me, needles in general are nerve-racking, but it's worth it obviously for the health of your child!

[Karen in CO]

My dd has used her epi twice this year and been given an epi shot at least 4 times in the ER or doctor's office. She had a shot of epi last week. It is amazing how fast it works and how quickly she gets better. Anaphylactic reactions aren't just swollen lips or stopping breathing or stomach pains and vomiting. There are severe symptoms that you don't see. Last Thursday, 10 minutes after her allergy shot, my dd11's blood pressure was 80/50 with a heartbeat of 110. She was itchy and had chest pain. The doctor gave her antihistamines, prednisone and epinephrine all within about 45 minutes while checking her blood pressure every 3 minutes to make sure it didn't get lower.

 

The first time we used the epi pen was very scary. My dd chose to give herself the shot so she would get over her fear, and we were on the way to the ER. We both knew she needed the shot and couldn't wait until we made it to the ER. She's still terrified of it, but it is easier. We have a mental checklist of symptoms and an escalating set of treatments so that the epi pen has a place in our mental framework as something normal. When her allergies are really bad, we go over her symptoms and what needs to happen. Our allergist, family doctor, two ER doctors and our pharmacist have all told us to not give her benadryl when she needs epinephrine.

Edited November 2, 2012 by Karen in CO

[happypamama]

We got DD's epipens after a swelling episode last year (face/nose, not to airways, but I expect it could escalate), and yeah, I'm a little scared of actually needing to use it. I think that, in an emergency, my brain would take over and tell my body to just DO IT. I hope. I think the hardest thing would be that she's almost as big as I am, and if she was scared and resisting, it would be very hard to hold her still.

 

Anyway, we watched them try to get a vein on DD at the ER when she was still swelling. They tried multiple times before being able to get one, and she had bruises in three spots. Poor girl was pretty miserable -- they were so gentle, but it still hurt. Plus the swelling and hives. I will try to keep that picture in mind if we ever need the epipen -- surely one swift stick would be better than multiple attempts at digging into her veins.

[ktgrok]

I had to get injections of epinephrine many times as a child. (this was before they had the pens, so we had to go to the doctor to get it!). I can say that I have no memories of it hurting, but VERY distinct memories of how much better I felt afterwards. i can totally remember chatting away in the car on the way home, so relieved, and feeling so much better. (I had to get it for asthma, not allergies)

[Spryte]

Anaphylactic reactions aren't just swollen lips or stopping breathing or stomach pains and vomiting. There are severe symptoms that you don't see. Last Thursday, 10 minutes after her allergy shot, my dd11's blood pressure was 80/50 with a heartbeat of 110. She was itchy and had chest pain. The doctor gave her antihistamines, prednisone and epinephrine all within about 45 minutes while checking her blood pressure every 3 minutes to make sure it didn't get lower.

 

[...]

 

We have a mental checklist of symptoms and an escalating set of treatments so that the epi pen has a place in our mental framework as something normal. When her allergies are really bad, we go over her symptoms and what needs to happen. Our allergist, family doctor, two ER doctors and our pharmacist have all told us to not give her benadryl when she needs epinephrine.

 

These are such important points. Anaphylaxis does not look the same in every person. It is so important to have an action plan, and a clear understanding of which symptoms and combinations of symptoms mean epinephrine is needed.

 

If anyone has questions, I'd encourage a visit to an allergist who can give you a specific list of symptoms that mean it's time to epi. Then just follow the plan.

[sbgrace]

Can you see an allergist? It sounds like you've been given incorrect (and scary) information. I think what you're experiencing and feeling is so normal. It also sounds like you need to progress beyond the fear since you've had those types of reactions and hesitated.

 

Once a life threatening allergic reaction starts, there is a point of no return. There is a point at which no amount of epinephrine, steroids, or any treatment can stop a reaction. The key with anaphylaxis is to administer an EpiPen as soon as there are signs of an anaphylactic reaction. When there are anaphylactic deaths, it is usually because an EpiPen was administered too late or not at all.

http://familynature.wordpress.com/2011/05/09/the-epipen-long-time-owner-first-time-user/

Blood pressure drops can't be seen on the outside and those are very hard to reverse with an epi pen.

 

You really do need to push past your fear. I know you know that. Do you still have expired pens? It's a good idea to practice on an orange. It kicks back on you and maybe trying a few will help you feel more comfortable.

Edited November 2, 2012 by sbgrace

[Karen in CO]

Can you see an allergist? It sounds like you've been given incorrect (and scary) information. I think what you're experiencing and feeling is so normal. It also sounds like you need to progress beyond the fear since you've had those types of reactions and hesitated.

 

http://familynature.wordpress.com/2011/05/09/the-epipen-long-time-owner-first-time-user/

Blood pressure drops can't be seen on the outside and those are very hard to reverse with an epi pen.

 

You really do need to push past your fear. I know you know that. Do you still have expired pens? It's a good idea to practice on an orange. It kicks back on you and maybe trying a few will help you feel more comfortable.

 

That is a terrific post about using an epi pen on a child. Thanks for sharing it.

[brownie]

It is normal to be afraid. It seems like a big deal because it's a needle. But that said, you NEED to use it for vomiting. He clearly didn't need it, but if you were missing a symptom, he could have died.

 

I was afraid to use the epi too. Then in 2nd grade ds thought he was having a rxn at a restaurant. He was saying, "my throat!" "Now it's my stomach!" "Now my throat again!" He told me to go ahead and give the epi. Not wanting to be one to ignore my child and have him lack confidence in managing his allergies, I gave it right through his jeans (though I had my doubts it was a rxn). We followed the protocol...called an ambulance, called the allergist, kept him lying down on the sidewalk while we waited. A pediatrician happened by and stayed with us. DS got shaky from the adreneline. Turns out, he had developed severe reflux. I knew something weird had been going on (he had been losing weight), but we didn't pinpoint it until after this incident. No harm done.

 

Let me tell you, I am SO glad it happened. It was no big deal. DS was fine...never even mentioned that it hurt. We went through the plan in a somewhat scary situation and did everything right, and now I'm not nearly as hesitant.

 

Most people die from food allergy bc they don't get the epi or don't get it fast enough. You are doing your child a disservice by being too scared to do it. You need to show him that you are OK with it so that when he's old enough, he will be OK with it too. And you might just save his life next time.

 

Brownie

[brownie]

Sorry - I just had to say...after I posted I read the above article SBGrace posted. It was awesome and I am crying now. It's a really important read.

 

Brownie

[bolt.]

My brother had an epi pen when we were kids (probably still does). Each time one expired, he got to choose a piece of fruit to practice on. He loved it! I don't think they had practice ones, so this was the way he got used to the idea of actually using it.

 

Maybe it would help you to jab a few oranges, just to get over your nerves?

[Researcher]

Have you practiced with the "fake" one? I was afraid of the epi-pen, too, until I got to use the fake one on a friend (whose allergic child I was watching). Doing a dry run really, really helped.

 

:iagree:

 

A dry run will make you feel much more comfortable with the process. I remember our Epi Pen Jr. kit coming with a fake one to practice with. If you don't have one, just ask the pharmacist or Dr. next time you see them.

[NoPlaceLikeHome]

Why am I so scared to use the epi pen on my son? He has food allergies and we've had the pen since he was about 1. I've never used it, but I do keep it current. The past 2 reactions probably were epi worthy, but I didn't do it. I give him a double dose of Benadryl the second I suspect he's having a reaction and wait a few minutes. THe symptoms usually start to subside in about 5 minutes with a huge improvement at 10 minutes. The past two reactions happened 2 hours after he ate. Last night's episode has been the worst so far and I don't even know what caused it. :confused:

We talked about allergies at his last well child visit and the dr. stressed "DO NOT BE AFRAID OF THE EPI. IT IS HIS LIFELINE." Yet, when it happened again I still didn't grab it. How awful is that? Early on in the allergy journey I was told not to use the pen unless it was a true emergency because I can do more harm than good. That was a different doctor, but I can't get it out of my head. Now, I think they'd rather I give it to him and then go to the hospital. I know food allergies aren't something to mess around with. It's a horrible feeling to see him in such pain. The past 2 reactions were severe stomach pain and vomiting, no visible swelling of lips or mouth area.

Thanks for letting me ramble.

 

You were given wrong advice!!!

 

I specifically asked our allergist about the scenario where our son's teacher might give the epi-pen when not needed since I was worried they might give it to ds when he did not need it. The doctor said it is more dangerous that the epi-pen not be given right away than given accidentally. It said it is not a danger to give it accidentally.

 

Also, as a RN, we gave epinephrine (the ingredient in epi-pens) all the time as a life saving drug for all kinds of emergencies. Epinephrine is natural hormone found in our bodies that comes into play with the flight or fight response.

 

Lastly, I accidentally gave the epi-pen to myself!! It felt like I drank 10 cups of coffee (which is expected) but no ill effects. I never hurt anyone by giving them epinephrine which I had to do hundreds and hundreds of times. Yes it is a strong drug but you would be calling 911 after giving it anyway. The drug is a lifesaver!!

 

Please do not hesitate to give epi-pens since it is dangerous to delay giving. Treatment should be epi-pen first, then call 911, then benadry last (check with your doctor since I am not a doctor but this si what our doctor told us).

[NoPlaceLikeHome]

I forgot to add that when I accidentally gave it to myself, I did not realize that I gave until about 30 seconds after I gave it:tongue_smilie: I only felt the pressure. I was showing a teacher and thought I had the trainer which I showed her just prior but oops!!!!

[NoPlaceLikeHome]

I don't know. If it makes you feel better, my doc told me not to use mine unless there was swelling lips/mouth or other signs of airway closing. Luckily I've not had to use it. I treat reactions the same way you do with anti-histamines and wait.

 

I would ask a second opinion since I think this is the wrong info:( Also, check foodallergy.org web site.

[Trillian]

I just want to thank everyone whose contributed. I'm still madly soaking up information and shaken. We see the allergist on Tues. and it can't come soon enough.

[Supertechmom]

Please use the Epi pen. I get very jittery, restless before I pass out within minutes of a sting. If I get the Epi when I am restless and anxious, things are much better in terms of outcome. I don't pass out, I am still breathing and my BP stays up instead of bottoming out. If I take that Benadryl because I think it is not worthy of an Epi pen, I still continue to have breathing issues and still pass out and my bp drops. Some times it may delay the time giving me a little more time to get to the hospital but it has never stopped me from having the reaction. When my body is going into shock, Benadryl is not going to pull me out of it. When I was little and epis were not doled out like today, my mom had a massive amount of Benadryl (way more than a double dose) she was told to give me just to get me to the hospital to try to give us enough time to get the Epi shot. And it was a liquid and a hell of a lot to suck down in the car heading to the ER. It might give you some time in the sense of slowing the swelling but it isn't going to take care of shock. You've gotten lucky. Especially if he has delayed reactions. I have an initial reaction and then a delayed reaction and sometimes a rebound reaction. Those can be worse than the initial. Please use the pen!!!!

[mskelly]

Well, I'm glad I posted. I do feel worse for not giving him the shot, but I feel more confident that I will do it next time. I don't want to play roulette with my kid's health and well-being. My fear isn't giving the shot. I've always been more afraid of what it would do to him if he didn't really need it.

 

I think it is time to find a new allergist!

[mskelly]

Thank you for linking to that blog post. That was a great read.

[Supertechmom]

:grouphug: I didn't mean to make you feel bad. I've lived with this most of my life and still debate every single time if I should give myself the Epi pen. Even just last year, I called my hubby and said " hey I was stung but I think I'm okay. I'm just going to lie down for awhile. I took some Benadryl. I'm feeling fine." Hypoxia sets in quickly Lol! Fortunately he works nearby and came and took me to the hospital where they promptly gave me a iv drip and a shot and kept me for the entire day and pumped with stuff throughout that time. :001_smile: It is just hard to know especially if you have reactions that have some time to them. I'm not one that immediately drops but has issues in a few minutes instead of instantaneously. My mom always struggled with do we take her in, is she gonna be okay, are we wasting a trip this time, wasting the drs time for something we could have handled at home? Once Epi pens came out, the allergist was very firm in use it as soon as you can and don't worry about what it will do. Just use it and get to the hospital. We will handle it from there. If it wasn't necessary,we can take care of that too. So don't feel bad. Even us old pros still go round and round.

[mskelly]

It wasn't you that made me feel bad, no worries. I make myself feel bad without any help at all. Moms are good at that aren't we?