After an anaphylactic shock, an Epipen saved my son in France
WE have just returned from a three week tour around Europe which for the main part was an incredible experience — travelling from Rome to Madrid by train and stopping in various places along the way, it all went off without a hitch — apart from the very serious issue of a language barrier relating to a medical condition.
My eldest son is anaphylactic to nuts and allergic to several types of seeds. Because of the current trend for being ‘allergic’ to every foodstuff under the sun, many people do not seem to realise the danger of anaphylaxis.
It is a very different condition to the extremely mild ‘intolerance’ and even to the allergic reactions people get which usually manifests in an itchy rash, some mild swelling, nausea and a feeling of being unwell for several hours after the allergic reaction (even after anti-histamine has been given).
Anaphylaxis on the other hand, is a potentially fatal condition which causes a closing of the airwaves and possible death within a very short period of time.
We never go anywhere without a supply of Epipens and over the years while travelling, we have always learned how to explain to restauranteurs the nature of our son’s condition.
However, a lot is lost in translation — as we learned to our cost — having looked up the word for nuts in various languages, we used Spanish, Italian and French the most frequently and were informed that it was nueces in Spanish, noix in French and noce in Italian.
We have been using these words with success over the years but on this trip we visited all three countries and on several occasions our warnings were greeted with confusion and in those cases my son opted for something which couldn’t possibly contain nuts (like a steak and chips).
But last month we discovered that the aforementioned words often only refer to one type of nut and therefore for years I had been informing waiters in Spain that my son was anaphylactic to walnuts when in fact his most serious reaction is from hazelnut — and in France the situation was similar with restauranteurs in one part of the country saying the word meant one thing, while it meant something entirely different elsewhere.
Noting this serious confusion, we found a wonderful French restaurant where one of the owners was English so, therefore, understood our predicament entirely and we were assured that she would alert the kitchen to the serious nature of the allergy.
While waiting for the food to arrive, we were brought some nibbles which we all duly tucked into but less than a minute later, the owner rushed over to say that before she had time to inform the kitchen we had been given food containing hazelnut.
My son had just swallowed a small amount of food and already I could see his lips beginning to turn blue and swell up.
I can hardly begin to describe the terror I felt in that moment.
With shaking hands I grabbed his Epipen and taking him away from the table, told him that I would have to administer a shot to him.
I had never had cause to do this before and although I practised so many times with the dummy pen, I could hardly figure out what to do – what seemed like about 20 minutes, but was probably only 20 seconds later, I jabbed the pen into the correct spot (at the top of the thigh) and held on to my son as the restaurant called for an ambulance.
He was shaking all over and no doubt as terrified as the rest of us were, but did his best to reassure us that he was fine.
By this point he was bright red and swollen from head to toe but the ambulance arrived quickly and thanks to the swift action of both the restaurant owner telling me immediately about the allergen and most importantly the fact that I had given him the shot of adrenalin straight away, he was pronounced out of immediate danger but would still need to be taken to hospital.
While my husband went off with him and I looked after his brothers, I spent the next few hours in agony as I couldn’t get through to anyone to find out what was going on (a lack of signal in the hospital rendered my husband’s phone useless).
But after spending four hours strapped up to a heart monitor and receiving specific medicine to further reduce the reaction, he was discharged.
Arriving back to our hotel, my poor son was still several shades darker than he should be and was utterly exhausted from his ordeal. I was afraid to let him go to sleep but he could hardly keep his eyes open so I made do with a twice-hourly check-up throughout the night.
The next day, he was totally drained from the experience and still needed a lot of sleep, but thankfully this was the only side-effect.
Needless to say, this was a really shocking event for all of us and highlighted the need to be 100% sure of how to communicate a serious allergy in whatever country we happen to be in.
It also made us realise the importance of making a nuisance of yourself if necessary to ensure that the food served up is totally free of allergens.
A couple of years ago, there was talk of the need to introduce Epipens into public places in Ireland — I thoroughly supported this at the time and really believe this is something which needs to be addressed immediately.
A jab of an adrenalin pen will save someone’s life and if given in error, there are no problematic side-effects, so it makes no sense to me whatsoever that restaurants, bars and airplanes in particular, but also schools and public places have no access to these life-saving devices.
Society and even the Government doesn’t seem to be aware of how serious anaphylaxis can be.
Allergy specialist, Dr Paul Carson, believes that because so many people are ‘allergic’ nowadays, the distinction between feeling unwell and having a life-threatening condition has been blurred and that the public has no understanding how dangerous anaphylaxis actually is and don’t realise it can kill — in a very short space of time.
“I do believe the abuse of the word allergy reduces the impact of serious allergy issues like anaphylaxis which is an aggressive, life threatening total body allergic crisis.
“The sufferer has multiple organ involvement, including circulation collapse, swelling throughout the entire breathing tract obstructing the airway, skin swelling and the emotional sense of impending doom,” he says.
“Then, even if the auto-injector (Epipen) has been used the patient must get proper medical attention ASAP.”
This is based on ‘second wave’ anaphylaxis attacks in those who are extremely allergic — mainly children with eczema, allergic rhinitis and asthma.
They and may need more than one injection or need more intense supportive measures such as I/V fluids.” Dr Carson, who runs Slievemore Clinic in Dublin, says very few people know what to do in the event of an attack.
“There are no rules (regarding administering adrenalin to a person with anaphylaxis),” he says.
“Schools have to come to their own arrangements and often refuse to be involved and when it comes to the general public or members of staff; it’s just pot luck whether anyone would know what was going on or feel confident about administering an injection.
“And I know of no airline which offers in-house expertise in injection administration.”
After our experience this month, I urge the Government to put in place some measures to ensure that adrenaline pens become available in public places (particularly where food is consumed) in the same way that businesses and local authority buildings are required to have a first aid kit – sticking plasters and iodine will help to make someone comfortable in the case of a cut or a burn but an Epipen will save someone’s life — it’s a no brainer.
Difference between anaphylaxis and allergy allergies
The most common food allergies in young children are milk, egg, and peanut.
An allergy will manifest itself initially with a rash, lip swelling, cough and hives.
Many childhood allergies improve as the child gets older.
Allergies to peanuts, shellfish and tree nuts tend to persist and a portion of sufferers will continue to have a reaction to these foodstuffs throughout their adult life.
Hay fever and asthma are the most common allergies in Ireland
Anaphylaxis
2% of adults and 6% of young children have food allergies which have the potential to cause anaphylaxis.
Symptoms of anaphylactic shock include swelling of the throat, wheezing, vomiting and loss of consciousness.
In the event of anaphylaxis, medical help needs to be sought immediately. And even if given a shot of adrenalin, the patient must be taken straight to casualty.
Young children need to be reassessed every six months, phasing out to yearly appointments as they get older.
People who suffer from anaphylaxis should carry an Epipen with them at all times. They should also wear an SOS bracelet to alert people of their condition.
For more information see www.anaphylaxisireland.ie
