Friday, March 1, 2013

Guest Interview - Adult Onset Food Allergy

When I posted about the new Auvi-Q™ epinephrine auto-injector on my personal Facebook page, a friend whom I hadn't seen in a while, posted about a reaction her husband had to raw almonds* that I felt would be helpful to share with others, in the hopes that it might one day save a life.  She has my sincere thanks for sharing her family's story and I'm glad everyone is alive and well at the end of this one.

Background:  Selina's husband's name is Mark and they have 4 children - a 4-year-old daughter, and three boys ages 7, 8 and 17.

A&A: Did your husband have a history of food allergies?

Selina: Mark had no history of food allergies prior to this reaction he had and was not aware at all that he was allergic to almonds.  What's ironic is that we had an EpiPen® in his truck, but everything happened so fast that I didn't even think of it.  A few years ago, he was attacked by Africanized honey bees.  He was stung nearly 50 times, so he was given the pen in case he was stung again and had an allergic reaction.  I wish I had thought about the pen.  Mark's sister has some food allergies, but she only knew about them because she saw an allergist that tested her for several things.  She never had any reactions to eating anything either.

A&A: Please describe what happened that evening.

Selina: It was the Friday evening after Thanksgiving.  We were all in our living room watching a movie with the kids before bed time.  Mark was sitting in the recliner eating a bag of almonds like they were popcorn.  He got up and went in the kitchen to get a drink because he said it felt like something was caught in his throat.  When he came out of the kitchen, I could see that he had a "bag" under one eye and looked really tired.  I told him he should go to bed.  He went to the bathroom way in the back of the house.  He was in there for a while.  I thought he was taking a shower, but when he came out he looked horrible. 

He told me he had been throwing up and that he felt weird.  He kept saying there was something wrong with his throat.  By this time both eyes had bags under them.  He went in the bathroom again and threw up more.  When he came out this time, his cheeks looked like they were sagging, and he was having a really hard time breathing.  His mouth and chin were numb, and he was crying because he thought he was having a stroke.  I told him to stick his tongue out (to check for stroke), but everything seemed normal as far as that. 

I wanted to call 911, but he kept insisting that he was okay, and he just wanted to go to bed.  By this time, I knew it was an allergic reaction, and I knew it was the almonds, because that was the only thing he had eaten.  I called his mom because she lives a couple of blocks away, and I knew she would make him go to the hospital.  Plus, my kids were crying and hysterical because they were scared, so I needed help so I could comfort them. 

When she got to our house, she called her son-in-law, who is a paramedic, and he told us to get him to the E.R. immediately.  We didn't want to call 911 because we knew it would be faster if Pat (his mom) just took him.  They left, and I put my boys to bed really fast and took Summer with me to the hospital.  My 17 year old stayed home with my boys.  When Pat left my house, there was a police car stopped right by my house.  She flagged him down, told him Mark couldn't breathe, and he quickly escorted her to the E.R.  The officer had called in to the hospital, which is within a mile of our house, so they were ready for him when they got there. 

Nine doctors/nurses were there waiting, and they immediately took him back and started giving him injections.  They gave him epinephrine, Pepcid, Benadryl, and 3 others that I don't remember the names of.  I got to the hospital within 10 minutes after they had left my house, and when I saw Mark, he looked so much worse.  His eyes were swollen shut.  He had the oxygen mask on, but was having a horrible time trying to breathe.  He was starting to hyperventilate, but he finally calmed down, and the meds started working pretty fast.  From the time Mark started having symptoms to the time they left my house to go to the hospital was only about 10 minutes.  It happened very fast!

The E.R. doctor admitted Mark.  They kept him Friday and Saturday night because he could have had another "episode". [This is a precaution in case someone has what's known as a biphasic reaction, where symptoms can return 48-72 hours after an anaphylactic reaction.  I'm glad they kept him, because many ERs discharge patients right away, which is not the proper protocol.]  That next Monday, his muscles all over his entire body were extremely sore.  I read that this is normal after your body releases natural antihistamines. 

Anyway, the way it started was the feeling that something was caught in his throat, which of course was his airway closing.  Then his mouth and lower face started tingling and got numb.  He looked really old and his entire face looked like it was sagging.  If we had waited just a few more minutes to get to the hospital, his airway would have closed completely.  If he wasn't so stubborn, I would have called 911 right away, and I wish I had.  I also wish I had thought about that EpiPen® that was in the truck.  It was expired, but I'm sure it wouldn't have hurt to use it.  Now we have 4 of our own, and his mom and sister have extras to keep at their homes.  [Kudos to them for being prepared!]  The allergist also gave him a little capsule full of pills [Steroids, perhaps?] to carry on his key chain to take if he has another reaction. 

Sorry this is so long, but I wanted you to know how he changed and the feelings he was having over just a period of a few minutes.  It was very fast.  Every minute that went by he looked even worse.  I knew he wasn't okay.  Even when his mom insisted to take him to the hospital, he kept refusing.  The thing that got him to go was that she asked him, "Do you want to die right here with your kids watching?"  They were in the hallway crying.  I wished she didn't say that in front of them, but I'm glad it got him to agree to go.  I am very thankful that things happened the way they did with the officer nearby, and I'm glad my mother-in-law was home when I called her. 

A&A: Don't worry, my posts are hardly ever short, and this is a very important one!  It must have been so scary for you all and it is wonderful, as you said, that everything worked out, as it did.  Thank you, again, for sharing your story, as I know it's never fun to relive such moments.

*When I first asked Selina about the incident, I asked if her husband had eaten almonds, before: 
"He has eaten lots of almonds before. The allergist tested him for roasted almonds, and he wasn't allergic, so they sent him to HEB [local grocery store] to get the exact almonds that he ate which were RAW, and he tested allergic to them.  [W]e are playing it safe and staying away from all nuts now."  
I did a little research on allergies to raw almonds vs. roasted almonds and found this article.  I agree that caution must be taken, even if past reactions have been "mild".

Takeaways and Points I'd Like to Add:
  • So much of the focus, lately, has been on children with food allergies, but food allergies can develop at any time, even in adults.  Even if you feel you have no reason to suspect you will develop food allergy, you should know the signs, so you can recognize them in yourself or someone around you.
  • Here are two great sites for learning about anaphylaxis: Kids with Food Allergies and Food Allergy Research & Education (FARE)/(formerly FAAN).
  • If you are an otherwise healthy person, and you are having trouble breathing for any reason - seek medical attention ASAP!  In the case of anaphylaxis, there is a point at which is can be "too late" and the epinephrine might not be able to reverse the effects.  You need it in a timely manner.  Do not wait around to see if it will "go away".  Benadryl will not stop airway constriction.  I've stated it before, and I'll state it, again:  BENADRYL HAS NO LIFE-SAVING CAPABILITIES!
  • If you are at-risk for anaphylaxis, ALWAYS carry two doses of epinephrine with you.  There's a new device called the Auvi-Q (Allerject in Canada) that is ultra-portable and even talks you through the process.  There is really no excuse not to carry it!
  • Don't be afraid of epinephrine!  Here are a couple of my posts that will hopefully help alleviate one's fears of epinephrine: Take the Fear Out of Epinephrine and Epi Epiphany.

Many thanks to this family for sharing their story.  I am always grateful when I can share cautionary tales without tragic endings.  Not all stories end so well, unfortunately, so please learn what you can to stay safe!


  1. Interesting post, and a little scary too. I hear more and more about adult onset food allergies. I think it's very helpful to read this family's story.

  2. Thank you for sharing this! My husband and I both have adult onset food allergies. I remember pleading with him to let me use my EpiPen on him, but he just wanted to be left alone so he could take a nap. A friend exclaimed, "He was just one short nap away from meeting Jesus!" And she was right.

    I would like to add one more point to take away. In addition to keeping 2 auto-injectors with you, it is important to store them properly. Auto-injectors need to be kept out of extreme temperatures, which means that they should never be left in a car. (Still working on that one with my husband!)

  3. Thank you for your comment Kendra - it's always scary when people won't listen!

    You are absolutely right - epinephrine needs to be stored at room temperature, with excursions allowed between 59-86ºF.