Severe Allergic Reactions and Emphysema

[MagicBullet]

I have severe allergic reactions to all types of scented products for the past 10 years. When this happens my airways "shut down"  The only thing that works is epinephrine.  I carry an Epi-penand still end up in the ER.  I was diagnosed with mild COPD 4 years ago.  Recently I had 3 allergic reactions in 5 months which resulted in ER visits.  One ended up with a 3 day stay in a hospital isolation room with Epinephrine shots around the clock.

Recently I had a PFT.  It showed irreversible damage to the air ways and air sacs.  I have seen a pulmonologist for the past 10 years.

I am a 54 yr old woman who exercises 2-3 times a week, has a healthy diet and is not overweight.  I have never smoked and have no family history of lung disease. I do however have a severe neck injury and take narcotics to knock down the pain.  

It seems that it is getting harder and harder to control and recover from these severe reactions.  I take every precaution to avoid people wearing scented products.--short of becoming a recluse that is!  In between these reactions I don't have any other symptoms.

I take Symbicort and Atrovent daily.  I have had negative reactions to all other types of medications.

Question:  What is my lookout?  What else can I do to control these sever reactions so that I can slow down the damage to my air ways and air sacs?  Is there something else I should when I have these allergic reactions besides Epinephrine?

Any suggestions would be greatfully appreciated

[David Tinkelman, M.D.]

There are individuals who are very sensitive to strong odors.  The individuals experience reactions similar to the ones you have described.  These can be on an allergic basis or on a hypersensitivity type reaction that does not follow the exact same pathway to a reaction.  To you, the end result may be the same with either mechanism.  One other possibility is that you may be experiencing a reaction in your vocal cords, such that with an irritant exposure the vocal cords shut creating a situation that causes difficulty breathing, just like a severe allergic reaction.  Other types of therapy might help this problem.

In an allergic reaction, avoidance is the best means of controlling this problem.  However, to rule out an abnormal response by your vocal cords, it may be reasonable to consult with an ENT specialist.