The Back of the Medic

She lay on her bed, coughing and having an asthma attack. The bronchospasms in her lungs had woke her up, in spite of the diphenhydramine and albuterol she took hours before. She sat up, which did little to help her breathing. Turning on the light, she saw her arms were covered with hives. Her hands were swollen, as were her feet. She got up to get her albuterol inhaler, that was in her backpack. Then she saw her face. The swelling. It was hours earlier that she began to have trouble with her voice. It was a little hoarse, but not bad. That was in the late afternoon, about 12 hours before. Over the next few hours, it got worse and worse, but her lungs had remained clear, and she was able to breathe in and out without any difficulty. She knew that this was most likely an allergic reaction… she had them before… But to what? There was nothing that she knew of that did this, with the exception of bee stings. And she had not been stung.

She made a decision. She walked out to the living room. Instead of her albuterol inhaler, she grabbed her nebulizer and set it up quickly. She opened 2 of the 3mL doses of albuterol, and placed them in the nebulizer chamber. She sat there for 15 minutes, breathing it in, letting the drug get into her lungs. It worked. She could breathe again without audibly wheezing. She drank water. Lots of water. The diphenhydramine had made her very thirsty. But she also knew it was good to stay hydrated at this point. It had been more than 6 hours since the last dose of diphenhydramine, so she took more. She went back to bed, propping up some pillows, so she wasn’t lying flat. Eventually, she went back to sleep.

She woke up 2 hours later, soaked in sweat. Again, she was coughing and wheezing, however it was not as bad as before. But now, the swelling in her hands and feet had gotten worse. She got out of bed, and walked out to her living room. Again, she used the nebulizer. And again it worked. This time, she also took some prednisone. Her doctor had written the prescription for her, and she had filled it some months before. She started on the burst therapy schedule that they had arranged if she had an asthma or allergy problem that was severe. Well, she thought, this qualifies. During the next few hours, she continued to use the nebulizer, and took more diphenhydramine to counteract the histamine reaction that was going on in her body. And slowly, the symptoms began to go away. The swelling started to go down, the hives were less pronounced. Her lungs were still tight, but she could take in enough air that she didn’t feel like she was suffocating.

Finally, the battle was ending.

—–

That was me very early Monday morning. The symptoms had started on Sunday afternoon. By early evening, I knew it was more than just some wind-related laryngitis. I even had a bad taste in my mouth, especially when I drank or ate something. Yes, I knew I was having a reaction. Yes, I was traveling at the time, although I was with the rest of my EMS team. And they did know about the vocal cord issues. I felt if I started having problems, I was in good hands. I did get home without a problem, per se. And yes, I had taken a lot of diphenhydramine to try and stop the histamine reaction. It worked, sort of. At one point Monday morning, I did give some serious thought to using my Epi-Pen, but decided against it. I have had fast anaphylactic reactions, and slow ones. This was clearly in the latter category.

In hindsight, I probably should not have self-treated, and instead got myself to the ER (Or better yet, gotten transport there), but I can be rather stubborn at times (No!!!). Or perhaps started to self-treat, but gotten a friend to get my behind to the ER.

In either case, I am sitting here, doing well. My voice is pretty much normal again, angioedema is gone, and my lungs are happy.  I am taking the last tapered dose of the very short prednisone burst tomorrow morning.

I am working in the same location this weekend, so I am definitely going to remain aware of my body and any reactions I have. And yes, I carry my epi when I am on duty. Right now, it is my best friend. The culprit may be a pollen I know I have seasonal allergies to (I hope not). Or it may be a food I ate that day (I had tried a vegetarian taco salad for lunch that day. Something in the spices???). Or it may be something totally unknown. But I do want to find out what it was, if possible.

Allergic reactions suck.