Focus Issue 19-4

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Did you know that around the world, millions of people suffer from allergies?

Did you know that allergies are the body’s reaction, usually mild, to environmental allergens? Things like plant pollen, plant fibers, molds, dust, animal dander and fur, chemicals, latex, bug bites, peanuts or certain other foods can set off reactions in some people. The body tries to protect itself by sneezing, watery eyes, skin rashes, even fever. But sometimes our bodies over-react, some bodies more than others. Causes or reactions change, making matters more difficult for some people trying to avoid the cause of allergic reactions. Besides “hay fever” (cold-like symptoms), facial sinuses might swell, or skin blooms into fiery red itchy welts.

Reactions occur in varied ways or areas of the body, and sometimes there is no warning before a severe reaction occurs.

Our body’s immune system has a mechanism that quickly reacts to external influences it perceives to be threats. Sometimes the threat is a serious one, sometimes it’s not as serious as the body perceives it to be; either way, the body goes into attack-mode. In severe cases, the worst life-threat is what the body does to itself, affecting multiple systems of the body.

Within a few vital minutes, swollen airways and shock to the nervous system, including dropped blood pressure and slowed pulse, can be deadly. If epinephrine (adrenaline) isn’t self-administered with an epi-pen, or injected by a physician immediately, death can occur within minutes. Speed to medical help is critical.

 

Initial symptoms of anaphylactic shock begin quickly after exposure to the allergy-causing substance. Symptoms might include itching skin and hives, swelling of the lips, tongue and throat, severe headache, vomiting, sneezing and coughing, abdominal cramping, anxiety and a sense of impending doom. Tightening of the throat, nausea, respiratory distress including wheezing. Quick administering of epinephrine can counter the fatal effects of anaphylactic shock upon the body’s cardiovascular and respiratory systems by rapidly constricting blood vessels, relaxing muscles in the throat and lungs to improve breathing, reversing swelling and stimulating the heartbeat.

Anaphylactic shock can affect anyone, not just someone with known allergies. And it can result from reactions to many different things. Drugs top the list; leading that list are antibiotics (especially penicillin), muscle relaxants, insulin, aspirin. Even contrast materials, such as dyes, injected into the body for x-ray imaging can cause anaphylactic shock, as well as serum used for some types of vaccines.

Foods best known for causing anaphylactic shock are peanuts and tree nuts, milk, eggs, soy, wheat, sulfites and shellfish.

Stinging insect bites–bees, wasps, hornets, yellow jackets, fire ants, spiders–have caused anaphylactic shock.

Sometimes repeated exposure to or ingestion of a substance, or repeated contact with a product, such as latex, can bring on a severe reaction without warning.

Even strenuous exercise can cause anaphylaxis.

To make it even more difficult to avoid, unknown causes bring on anaphylactic shock in about 20% of cases.

I do not want this article to be the causal factor of “anxiety and a sense of impending doom” because anaphylaxis seems unavoidable. There is good news.

The good news is, anaphylactic shock is rare.

 

 

 

 

Except for chronic allergies, he was in good health. Never a smoker, never had a weight problem, he was physically active and carefully watched his diet, eating only healthy foods. He had various allergies and avoided known allergens as much as possible, or took antihistamines for those.

At the time of his death, he’d had an allergy-caused sinus infection for a month and was under a doctor’s care. He was taking an antibiotic, but one he had taken before. His sinus infection was on the mend, but apparently it had caused his old sciatic pain to flare up. For that, he had just begun to take a muscle relaxant medication, but that was too was a med he had previously taken.

Jerry was by nature an early riser. That morning, about 4:30 a.m., he sat, dressed, in his easy chair. He told his wife, Betty, that he was having a reaction. She called 9-1-1 and relayed to the dispatcher his symptoms as he described them to her; he was breathing and talking. They live on the Oregon coast, not within a community, yet teams of emergency medical technicians arrived in ambulances within 10 minutes of the call. Betty had futilely tried CPR. But he was gone. EMTs found his throat tightly closed.

His family physician and other medical experts said, including in the medical examiner’s notation on his death certificate, that he died from anaphylactic shock. Their educated guess was that his death was caused by a reaction to the muscle relaxant medication.

The one time Jerry briefly experienced anaphylactic shock, it killed him.