Today worse than yesterday - home from ER

[Sailorsong]

First off thanks for  the comments about my trip to the VA resterday.

Today I spent most of the day resting as my brain has not been functioning today. Things like having to go to bathroom, get walk into bathroom, flush toilet, return to living room only to realize I never went. Duhhhh! It usually take me a couple of days resting to recover from the drives to the VA. So after a few naps during the day it got to be time for dinner. SO Off I go to town or at least that was the plan. Instead just as I walked out the front door I got stung by a wasp.

For those that don't know me or just don't remember I am deathly allergic to wasps. I had been stung in the past my wasps and had severe reactions to the point when I got to the ER they would immediately bring over the defibrillator cart as they would think they would need it any second. I also have always had two reactions to a single sting. The second one would happen about 8 hours after the first one once the epi wore off.

SO I'm not sure where this one came from but I immediately slapped and ice pack on the site of the sting and then headed for the local semi-ER. Evidentially I did the right thing as the difficulty breathing didn't start until just as I got there (about 15 minutes). In the past I was having severe breathing problems within 5 minutes. It took only about 5 more minutes before they gave me an Epi shot and probably another 15 or 20 minutes for it to calm everything down. I was headed for home after only 30 minutes in the ER. The other times they would have me in the ER for 3 - 4 hours before they could release me.

The nurse in the ER also told me that the Epi could make you a little shaky and that seems to be an understatement for me. Since I was headed out for dinner I figured I stop for something on the was home. By the time I got to the restaurant both of my arms were having severe tremors and I wondered if I would even be able to get anything into my mouth. But somehow I did manage to eat even tough resting my forearm on the table didn't calm the tremors in my right arm completely.

So now here I sit with questions running through my mind.

1) Since I take an immunosuppressant (CellCept) did that lessen the effects of the sting?
2) Was it the ice I used that slowed the reaction to the sting?
3) I normally have an MS tremor in my right arm but this tremor was way worse. SO does Epi enhance MS symptoms?
4) And most importantly! Will I have a second reaction to this sting. I'm not to sure I want to try to stay up half the night just in case?

Dennis

[Sailorsong]

First off it isn't really an ER. it is more like a large walk in clinic.It takes a good hour to get to the nearest real ER.

Then there is the cost. to be seen at the VA ER it costs me $50. the last time I went to that other clinic it cost me $315.

I figure that the money I save is worth the extra time.

[Lulu54]

well, see there - I have again flunked the medical exam.  I hope you are comfortable with their answers.  But I want to know why you drove the 2 hrs to the VA instead of stopping at your local ER?  

[Sailorsong]

Well I just got home from the VA.

So the answer to question 4 is yes I will have a second. Well Actually I'm on reaction number 5 right now. But at least now I have meds to control them.

I had gotten the Epi shot locally at  7PM and about 10PM I notice the swelling and itching was coming back. By 11 my entire right forearm was swollen and the hand was filling numb.  So I head up to the VA (2 hours) and could get there before things got worse,

Of course no sooner did I hit the road when a very very powerful thunderstorm started up  At times during the first 20 miles I could not see more than about 2 feet in front of me so I was only going at most 10 MPH during those downpours. But I got with 5 minutes of the VA hospital when the tightness in my chest started up.

I was seen by a doctor in less then 2 minutes and after telling him what happened I was soon getting an IV access put in my right arm followed by more Epi (0.3ml), Benydrill (SP) 125ml, and also the drug a lot of you are familiar with from IV infusions for MS flares. I didn't catch the dosage but the string was 1 inch in diameter and 3/4 full. SO I expect it was a fairly large dose.

I was really impressed with that one drug because within 5 minutes the chest tightness was gone (Suspect it was MS hug triggered by the venom. My tremors also stop completely and most of my other MS symptoms seemed to be  be not as pronounced.  The ER nurse had drawn a line around the swollen area on my arm and you could see that the swollen area was starting to shrink.   They also informed me that the ER doctor was admitting me because of worry about the swelling cutting of blood flow to hy hand and thus causing severe damage to the hand.

After waiting for several hour from them to get the paperwork out and the swelling had returned to a point that exceeded the line the nurse had draw l filled out and find a bed for me the meds they had given me were wearing off so the gave me another shot of Beydril. Of the funny part of this is they told me the benydrill would make me very sleepy. NOT ME. I never seem to respond to meds like others. The benydrill had made me wide wake and hyper.

So by now it is 4AM and I have been there 3 hours by the time they send me up to the ward. By 6 am the swelling is back again. With each shot of benydrill all of the swelling has gone away until it starts to wear off. We are now up to 4 flare ups from a single sting.

This load of benydrill has lasted the longest and when the attending, my doctor and several student arrive on 7AM my arm looks perfectly normal, weel except the line draw with a marker on it. HA HA. My doctor then starts going over my history for the students and what the plans are for treating me in the future by giving me EpiPento use if I ever get stung again. At this point the attending stopped her and asked what BP meds I wear taking.  He continued with "you do know what the three most common outcomes if he takes Epi are"? "They are stroke, coma, and death due to very high BP".  My doctor then said I guess we better get his PC to change his BP meds. My doctor then said that she doesn't expect any more problems for the sting so we could send him home and the attending agreed. She also said they should get me an appointment with my PC with a week or two.

I told them I already had an appointment scheduled with my PC on the 29th so they said they would make sure she knew about the BP med problem and that I should make sure I bring it up too.

So now came the very long wait to get discharged and that didn't happen until 11:30. It is hospital policy the discharge patients around noon. Why that I have no idea. But by the time they did discharge me the swelling in my arm was starting to come back and I wanted to get out of their so bad I didn't mention it. They had given me a RX for 50mg benydrill an 2 EpiPen. Several of the doctors spoke to me about this stressing that if stung I was to take 2 benydrill and head for treatment. I am only to use the EpiPen if I have breathing problems on the was for treatment and then I am only to go to an ER if I do use the EpiPen.  

So as soon as I pick those up and got into my car I took one of the benydrill. This perked up for the long drive home and it didn't take long for all of the swelling to again clear up (reaction # 5).  

Summery:

The answer to question 1 according to the doctors I talked with is yes the CellCept did lessen the impact of the sting on my body.  

The answer to question 2 is also yes. The ice caused by body to close off the capillaries in order to preserve by core body temperature. Of trick is to get the ice there quickly as the venom starts to enter by blood steam almost immediately. But the ice will inhibit much of the venom from getting into the blood stream. At least this is what the doctors would tell me.

The Concensus for question 3 is also a yes according to the doctors. Epi is fact a large dose of adrenaline which triggers you brain into working hard.. Since the neurons are firing more the effects of the MS symptoms will show more.

And of course I already gave you all the yes answer to question 4.  The doctor explained it to me this way. When you get stung by a wasp/bee the body is really dealing with two items in your blood stream. The first is the Histamine with your body fights with Antihistamine once that has been cleared up your body then starts fighting of this other substance which I can't remember the name of.   this substance is another component of the immune system and fight this substance in another fashion. Most people don't even know this is happening as a second reaction because the body isn't over reacting for this phase of fighting off the venom.

[debgen]

Sorry Dennis, I really can't answer any of your  questions, but I do hope someone of your many medical peeps can!

I feel really bad that this happened right after the grueling day you had yesterday. I imagine you ra wiped out. Try and rest up. I hope tomorrow is a much better day. I will be sending positive energy your way...

Hugs,
Deb

[supermum_ms]

Only you hey! :o(

1 and 2 i've no idea, its possible so maybe?
3 The epi is pure adrenaline so i'd expect it to enhance CNS problems.
4 its possible that you've been building up a slight resistance, the more stings the less the reaction, basically what they do in allergy therapy. Not sure i'd count on it though, because its also possible that you didn't get enough of the wasp venum into you this time.

Try to rest up, though i'll keep an eye out for you, if you end up staying  awake.

Hugs...........JJ

[HVAC]

Epi always makes everyone messed up. It is powerful stuff. Dumb question, why do you not have an epipen or do you? I had anyphalaxis Tuesday night after chemo and it is scary. It had never happened before. They had given me benadryl and steroids in the hospital during chemo but I still had it. I hope that never happens to you again. You needed that like a hole in the head. tell God you are not in the all you can eat buffet line your plate is full.

Alex

[Lulu54]

dennis, I can't answer your questions for sure, but I have also had an allergic reaction to a wasp sting and I know it's no fun.

I think to ? #4 - you won't have second reaction to the sting - if you are feeling better, I would think it would stay that way.  But you also know I am no medical expert.

feel better, L