On a cold icy snowy afternoon in the winter of 2010 I used my EpiPen for the first time ever, whilst in the grip of a terrifying anaphylactic attack. Little did I know when I took this beautiful photograph that in a few hours I would be in A&E.
I had been out for lunch with a friend and had what I felt to be a safe meal; smoked Salmon and scrambled eggs with brown bread and salad (I didn’t eat the brown bread!). During the meal I did experience a slight tingling in my mouth and throat. I foolishly ignored these early symptoms and carried on eating the food until I’d finished everything but the bread. It was delicious and I thoroughly enjoyed it, all washed down with a large glass of red wine.
Now I ought to explain, I knew I had a serious nut allergy so I had made a judgement that this meal would be OK. It was my local pub and I’d eaten there before on numerous occasions. I also knew that eggs and dairy could give me bad eczema but occasionally I used to eat bad things for a treat, and suffer the consequences.
I felt fine, full and satisfied after such a lovely meal. I usually avoid eggs, suspecting that I have a mild intolerance to them, but today I was being naughty. During the short five minute walk back to my house I began to feel a little short of breath. Now I always walk fast and the path is uphill all the way, usually not a problem and I barely notice the incline normally. A few puffs and the inhaler didn’t seem to be working. The attack then took hold and advanced very quickly. I realised my face, lips and throat were swelling and my nose was streaming.
I have honestly always been mildly terrified about using my EpiPen; imagining in my head, the huge needle, the pain and something going wrong. In the throes of a full on anaphylactic attack I was beginning to panic and not behaving in a rational way.
What did I do?
The first thing I did was take some anti histamines. Then I phoned my husband, who on hearing my strangled struggling voice, ordered me to take the EpiPen, get off the phone and call 999. (Not the right order I know, but I was scared, and panicking fast) I was terrified and shakeing with shock, on top of all the other unpleasant side effects of this dreadful affliction, the itching, the swelling, the feeling of impending doom, my throat was hurting, my nose was streaming, my eyes swollen and watering profusely, I could not swallow or speak properly, I felt like I was spiralling out of control. I WAS spiralling out of control and I had to act fast.
Luckily I did administer the EpiPen immediately. I am amazed to say that it didn’t hurt at all and I was able to do it easily. I would like to thank Catherine, a lady I met at a wedding last year. Her job was to visit schools and educate members of staff in how to use an EpiPen safely and effectively. She explained to me the key things you should and should not do and was horrified that I had never used mine before – despite having numerous anaphylactic attacks.
I did check the instructions just to check I was thinking of doing it correctly. The important thing to remember is that once the cap is removed the EpiPen is ready to use. Grip the pen in your fist near the base above where the needle will come out, push the EpiPen firmly and swiftly into the side of your thigh. Then you’ll hear the click of the adrenalin being charged and injected into you. Wait till it’s all been injected, carefully remove the needle and massage the area where you remove the needle. I think I was vaguely aware that it had clicked into action but I felt nothing except the punch of my hand hitting my thigh. When I removed the pen there was a tiny pin prick mark and it didn’t bleed. The needle was actually much smaller than I had imagined it would be.
Phone 999 and stay calm
Quickly I phoned 999. By now I was crying and getting very upset. I was all on my own at home in the middle of nowhere and beginning to feel very out of control and frightened. I could hardly speak when I got through to the operator and could not communicate my name and address and what was wrong. The operator was a god-send and stayed on the line keeping me calm and updating the ambulance with my condition, assuring me that she had found my location using my phone number. She also made sure that the paramedics could get into the house, asking me to put the door on the latch and try to stay calm until they arrived.
I only have praise for the paramedics. They were very professional and immediately took control of the situation, which helped me to calm down a lot. They gave me another dose of Adrenalin and I think some more anti histamines via an injection – although I’m not quite sure what went on. Before I knew what was happening I was on my way to my local hospital in the ambulance.
I stayed in the hospital for about four hours under observation where they also administered steroids to ease the symptoms. Within an hour of the first adrenalin that I administered I was in the hospital and beginning to feel the symptoms easing and my breathing finally heading back towards normal.
I was very anxious about the cause of this latest attack. Having checked with the pub where I ate, they insisted the meal contained no nuts (I thought I only had a serious allergy to all nuts – and numerous intolerances) and the menu for lunch contained no dishes with nuts in the ingredients. The nuts they do use are kept in sealed containers in the kitchen – so it is unlikely that I consumed nuts. They even produced packaging to prove that the salmon and bread did not contain nuts. So what did I react to? It seems I have developed a new allergy. My doctor thought the most likely offender was probably the eggs. If they are cooked quickly and contain any raw egg anaphylaxis can occur. However, I also discovered that the eggs were cooked in lashings of butter, a bit of milk AND cream! A very serious dairy hit for someone who had been religiously avoiding dairy. Why the thought hadn’t occured to me that scrambled eggs would very probably contain dairy I don’t know.
However the fact that on each occasion that I’ve had anaphylaxis has occurred after walking fast, getting hot and out of breath. There must be some connection here.
Check your EpiPen expiry date
Both my EpiPens had expired. I had not realised this in the heat of the moment, but the ambulance staff did notice. They said I did the right thing by using them in the emergency – but that I should really be more aware of their expiry date – and renew them accordingly. I would urge you all to check the expiry dates on your EpiPens now. Once you have your new pens, you can go to http://www.epipen.co.uk to enrol online for the expiry alert service. After registering you can edit your profile, request an EpiPen trainer and update your EpiPen expiry dates online. You can also register by post by completing and returning the tear off form attached to the instructions that come with your EpiPen.
Every anaphylaxis sufferer should also join the Anaphylaxis Campaign. www.anaphylaxis.org.uk. They provide amazing help and support and also an alert service by post to flag any products that have been recalled due to incorrect labelling and possible contamination with allergenic food types.
Wear a medical bracelet
Do you wear a medical bracelet or necklace? I have a MedicAlert necklace but had got into the habit of not wearing it. I know of two companies who supply these; MedicAlert and SOS Talisman. Contact the Medic Alert Foundation – www.medicalert.org.uk or for an SOS talisman visit: http://www.medical-bracelets.co.uk/. I now make sure I wear mine every day. All medics are trained to recognise these and they will then have instant life saving information about you if you can’t tell them yourself.
Write an Action Plan
Finally, I would urge everyone to write an Action Plan. I didn’t have one and clearly when I look back on this attack I did everything in the wrong order and panicked under the pressure. I have now written one, and a copy is now stored in my EpiPen pouch. For inspiration you can download my sample Action Plan.
Make sure all your family, friends and colleagues know where you keep your EpiPen and how to administer it in case of emergency. Include in your Action Plan emergency numbers and explain in layman’s terms exactly what needs to done and when. You can also get a free trainer pen to use to demonstrate the technique. I would recommend all allergy sufferers do this as you can then demonstrate how to use your EpiPen safely with no worry of activating your real pen by mistake. http://www.epipen.co.uk/patient/epipen-extras.html
I hope that by sharing my experience I will allay some of your fears. I am quite alarmed to think that I could be so frightened myself about using my EpiPen. I always felt like I didn’t want to make a fuss and that I might get better naturally.
I urge you all to use your EpiPen fast if you think you might be having an anaphylactic attack. You wont harm yourself if it just a mild attack, and these things come on very fast so act quickly and you will increase your chances of recovering – and it could save yours or a friends life.
I wish you all safe eating and an allergy free life. But if disaster does strike lets all be prepared.