Hi Everybody-
I hope everyone's year had been wonderful so far! Even with some of the the terrible tragedies that have occurred, it seems that things may be looking at least a little more optimistic in some regards, and it would be nice to think that things would improve throughout the year and into the future!
I’d been thinking about an experience that my family and I had last year when we were in a meeting with someone that we had just met, and the topic of allergies came up in the conversation. The person we were speaking with brought up the example of peanut allergies, and said something along the lines of “Well, it’s just an allergy. It’s not like it’s going to kill you. You just deal with it.”. While I suppose at the most basic level this comment is true in some capacities, my family and I were somewhat horrified by this matte statement. While this comment may or may not have been based out of mere ignorance or just being unaware of the information, the idea that there are many people that may not be able to recognize that in some cases allergies and asthma are potentially very fatal, and that failure to recognize them as such in these situations could mean the difference between life and death is somewhat terrifying. With this in mind, I thought I would include some information on allergies and anaphylaxis, in addition to giving some information on our experiences and why I’ve applied for a medical response service dog that has training in allergy detection and response. I don’t know how helpful this will be to others, and I am not in any way offering medical advice, or claim to be anywhere near an expert in this field; this is, in essence, a conglomeration of some research I’ve done, and the experience that we’ve had over the years in regard to these medical conditions.
Many people have allergies, with current estimates ranging from 1 in 5 to 1 in 3. It’s an extremely common medical condition that can be caused by a multitude of substances and environmental triggers, and, much the same as photosensitivity, can manifest itself in many different ways, with the immune system inciting an inflammatory response after it has been exposed to the allergen by stimulating the release of mast cells and basophils, both of which are forms of white blood cells. An allergic-type of immune response is one of 4 types of hypersensitivity, and is indentified as a type 1 sensitivity because the reaction that occurs is immediate. The immune response is activated by T cells, a type of immune cell that produces a cytokeine called interleukin-4, and their contact with B cells, a type of lymphocyte whose main function is to produce antibodies. Once the interleukin-4 has been combined with the B-cells, this causes the production of a group of antibodies called IgE (Immunoglobulin E). Once the IgE has been released, it then binds itself to the appropriate receptors on basophils and mast cells, both of which are a type of white blood cell. Because these cells are now combined with the IgE antibodies, this sensitizes them to the allergy, and causes an exaggerated inflammatory reaction. Subsequent exposure to the allergen is then cross-linked to the IgE antibodies, resulting in the degranulation of the mast cells and basophils and the release of histamines and proteases. The allergic reaction itself can be divided into two phases, with the first being the acute phase in which the reaction starts immediately after exposure to the allergen and causes the intial symptoms. The second phase is the late-phase response, and the second phace being the late-phase response in which the allergic reaction is again initiated 2-24 hours after the original reaction as a result of the added involvement of other leukocytes such as neutrophils, eosinophils, lymphocytes, and macrophages.
For most, these reactions then will cause some sort of response, such as hay fever or rhinitis, which is certainly unpleasant, though in many cases, is not considered to be a serious health concern necessitating immediate medical attention except under special circumstances. I think many are familiar with the number of medications that a
re available both over-the-counter as well as by prescription that can be used to treat some aspect of the allergic response, and are available in different formulations, such as in creams or pills, so that they can be used and/or applied directly to the area that is having the reaction. In most cases, these medications are highly successful in treating both the symptoms, as well as the underlying inflammatory response that initiated the allergic reaction in the first place. Particularly in cases where the allergen can be identified, this additionally helps in determining the best treatment solution both for allergy prophylaxis, such as allergy shots, and in cases where there is a more immediate need for allergy treatment upon exposure. In general, allergies in this range are common, and for many it only becomes an issue with exposure, such as those with seasonal allergies, and can usually be relatively easy to treat in most cases.
However, with some allergic reactions, the response that the immune system mounts towards what it considers to be a harmful substances can be potentially fatal, as in the case with anaphylaxis or some cases of asthma. When allergic reactions start to cause bronchoconstriction or a constricted airway that limits an individual’s ability to breath, this is a very real and serious cause for concern; most would associate this type of reaction with substances such as seafood or peanuts, though it is possible to develop reactions of this type to almost anything. Other serious allergic reactions, such as internal swelling or edema, hypotension, or any other type of cutaneous reaction, is also of very real concern, and usually must be addressed by medical personnel as soon as possible to try to limit or stop the reaction. Causes for these types of reaction can vary, though they range from conditions such as mastocytosis, which is the overproduction of mast cells, having a high IgE count or high number of environmental/food/medication allergies, as well as congenital and genetic conditions that predispose to either over-proliferation of certain aspects of the immune system or to certain types of systemic inflammation, either chronic or episodic.
A very real area of concern that is often overlooked is the collective response of many to the idea of allergies, and the potential danger there is in assuming that if somebody mentions an allergy that the reaction they have will be mild and relatively easy to treat. My family and I have seen much eye-rolling and the assumption by many that our allergies are either not as severe as we describe them or that we are truly not allergic, with a frightening majority of these individuals being employed in the medical industry in some capacity. We have found that it is under these circumstances that we are in the most danger; to make the assumption that the information someone is trying to convey, be it under emergency circumstances or not, is either over-exaggerated or is in some way not entirely accurate is under the best of circumstances unwise, and, in many cases, a very frequent cause of serious medical errors and patient injury or death. It seems that for many, allergies are not considered to be a serious medical disorder, though the potential consequences of making this assumption are dangerous, if not fatal, in many cases. While it is true that many allergies will take on the form of eye redness, or sinusitis, this doesn’t hold true for everyone, as is the case with any other medical condition. When this is further combined with other complicated medical conditions, such as an autonomic disorder or vascular condition, the appearance of anaphyalxis or an asthma attack may look completely different than it would in someone who isn’t otherwise compromised in this regard, and may therefore delay proper treatment until it’s too late.
For me, in the majority of cases where I am having an allergic reaction, I won’t experience any type of warning symptoms such as a runny nose, sneezing, or watery eyes, but will instead jump straight to throat constriction and swelling, all over body swelling with a painful raised red rash, sporadic and random changes in blood pressure regulation and heart rate, and, in cases where I haven’t reached my medication soon enough, hypoxia that causes me to pass out and have hypoxic seizures until my oxygenation improves (not to mention a bad headache). And all of this will happen within seconds of exposure to what my body considers to be a harmful substance, such as breathing in particles of macadamia nuts, unwittingly eating something that contains what others consider to be a miniscule amount of whatever allergen it may contain, or simply being within 30 feet of a building that was painted the day before. Once I
experience a severe allergic reaction of anaphylaxis, I will usually enter a cycle where every 2 to 4 hours, I will again start to experience the same allergy/anaphylaxis symptoms, and this can continue anywhere from 2 days after the initial reaction to over 6 weeks. Both my mother and I have been told to wear Medic Alert bracelets to warn emergency personnel of our allergies, though to list all of our medication allergies, let alone environmental or food, on a single bracelet (or 5) would be impossible at this point. We both carry cards that must be constantly updated every time a new allergen is discovered, and while we have seen many medical personnel either copy down the entire list by hand or will make a copy to attach to a file, many times someone will start to question (or argue) the true nature of the reaction, or will flat-out say “You can’t possibly be allergic to this many things,” and will simply leave it at that.
To illustrate this issue, because of an experience I had last year in an emergency room, my family and I have researched the other contents of what usually is put into a Saline-drip IV bag such as what you normally get at the hospital for dehydration. After a particularly bad reaction to what we could only connect back to a bag of saline I was given, we discovered that the
company that produces some types of IV saline conmtain a porcine-based substrate, and/or sodium benzoate, as a preservative for the bag and its contents, in addition to reusing their saline drip bags multiple times and using high heat on the plastic bags as the predominant means of sterilization. Because of the severity of my reaction, my parents always have to check the brand of the IV fluids they’re planning on using, and have to insist that I am indeed allergic to this particular brand of IV fluids and have to either go without or that another brand be used. This almost always leads to the comment “She can’t be allergic to saline,”, to which my parents will respond that I’m not allergic to the saline itself, just to the preservatives used in the IV bag. There are many nurses that have asked why we would even be aware of this information, to which we answer that it’s out of necessity; we have to be vigilant and cognizant of what is being used or being put into our bodies, and regardless of whether it’s something we consume at a restaurant or a life-saving emergency medication, there is always the potential that the compound could cause a fatal reaction to occur so rapidly that there may be no way to respond quickly enough, even in a hospital setting.
Another story that was recounted to us was a surgical nurse that was assisting with a spinal surgery, and as she opened the packaging to something that was needed for the surgery, she immediately fell to the floor and died within seconds of opening the package. Latex had been used in the packaging, and even in an operatory, where all of the equipment to resuscitate her was readily available, the doctors and other nurses just didn’t have enough time between when she initially opened the package and when she stopped breathing. While sobering, this story was recounted to my mother and me by a nurse that had been in the room when this occurred, and it had a major impact on her both personally and professionally; needless to say, she took my list of allergies seriously enough to post multiple allergy warnings outside of my hospital room (for which I was, and still am, immensely appreciative).
In regard to how this issue connects back to my application of an allergy detection and response service dog, because of the extent of some of my allergies and the frequency with which my reactions occur, I’ve been told that a service dog trained in allergy detection and response would be invaluable to my family and me, though I realize that there is absolutely no way to train for all of these allergies. However, because I’m no longer able to smell some compounds, such as latex paint, to which I am the most anaphylactic to, a service dog may be able to check and then prevent me from entering someplace that has a deadly allergen I would not otherwise be aware of, or will be able to summon help if I am experiencing an allergic reaction and need immediate medical assistance. I’ve also been told that the service dog can carry my medications as well as my medication and allergy cards so that they are easily accessible to medical personnel, and my family, at the point where they need them.
I apologize for the length of this post, and if you have read this all the way through to this point, I thank you for all of your patience and willingness to wade through my lengthy description of this complicated topic. This post is not meant to be vent of frustration on my part; in essence, I guess my point is that many times, people will make an assumption about what they consider to be an everyday problem, such as allergies, and may not be fully informed, or even be able to grasp, the gravity of this type of medical issue until it’s too late. This can apply to people both outside and within the medical industry, and I hope that perhaps some of this information may provide someone with a better understanding that sometimes something as simple as walking by a freshly-painted room or eating food with a “hidden” ingredient can incapacitate someone to the extent that they can no longer breath or function, and could possibly die from their exposure. Saying that you learn to live with it is somewhat of an understatement in many cases, regardless of the medical issue. I hope that perhaps you found this of some value, and if you wish, please feel free to comment below, or you can send me an e-mail at hnbain1@hotmail.com. Again, thank you so much for your time!
Heather
I hope everyone's year had been wonderful so far! Even with some of the the terrible tragedies that have occurred, it seems that things may be looking at least a little more optimistic in some regards, and it would be nice to think that things would improve throughout the year and into the future!
I’d been thinking about an experience that my family and I had last year when we were in a meeting with someone that we had just met, and the topic of allergies came up in the conversation. The person we were speaking with brought up the example of peanut allergies, and said something along the lines of “Well, it’s just an allergy. It’s not like it’s going to kill you. You just deal with it.”. While I suppose at the most basic level this comment is true in some capacities, my family and I were somewhat horrified by this matte statement. While this comment may or may not have been based out of mere ignorance or just being unaware of the information, the idea that there are many people that may not be able to recognize that in some cases allergies and asthma are potentially very fatal, and that failure to recognize them as such in these situations could mean the difference between life and death is somewhat terrifying. With this in mind, I thought I would include some information on allergies and anaphylaxis, in addition to giving some information on our experiences and why I’ve applied for a medical response service dog that has training in allergy detection and response. I don’t know how helpful this will be to others, and I am not in any way offering medical advice, or claim to be anywhere near an expert in this field; this is, in essence, a conglomeration of some research I’ve done, and the experience that we’ve had over the years in regard to these medical conditions.Many people have allergies, with current estimates ranging from 1 in 5 to 1 in 3. It’s an extremely common medical condition that can be caused by a multitude of substances and environmental triggers, and, much the same as photosensitivity, can manifest itself in many different ways, with the immune system inciting an inflammatory response after it has been exposed to the allergen by stimulating the release of mast cells and basophils, both of which are forms of white blood cells. An allergic-type of immune response is one of 4 types of hypersensitivity, and is indentified as a type 1 sensitivity because the reaction that occurs is immediate. The immune response is activated by T cells, a type of immune cell that produces a cytokeine called interleukin-4, and their contact with B cells, a type of lymphocyte whose main function is to produce antibodies. Once the interleukin-4 has been combined with the B-cells, this causes the production of a group of antibodies called IgE (Immunoglobulin E). Once the IgE has been released, it then binds itself to the appropriate receptors on basophils and mast cells, both of which are a type of white blood cell. Because these cells are now combined with the IgE antibodies, this sensitizes them to the allergy, and causes an exaggerated inflammatory reaction. Subsequent exposure to the allergen is then cross-linked to the IgE antibodies, resulting in the degranulation of the mast cells and basophils and the release of histamines and proteases. The allergic reaction itself can be divided into two phases, with the first being the acute phase in which the reaction starts immediately after exposure to the allergen and causes the intial symptoms. The second phase is the late-phase response, and the second phace being the late-phase response in which the allergic reaction is again initiated 2-24 hours after the original reaction as a result of the added involvement of other leukocytes such as neutrophils, eosinophils, lymphocytes, and macrophages.For most, these reactions then will cause some sort of response, such as hay fever or rhinitis, which is certainly unpleasant, though in many cases, is not considered to be a serious health concern necessitating immediate medical attention except under special circumstances. I think many are familiar with the number of medications that a
re available both over-the-counter as well as by prescription that can be used to treat some aspect of the allergic response, and are available in different formulations, such as in creams or pills, so that they can be used and/or applied directly to the area that is having the reaction. In most cases, these medications are highly successful in treating both the symptoms, as well as the underlying inflammatory response that initiated the allergic reaction in the first place. Particularly in cases where the allergen can be identified, this additionally helps in determining the best treatment solution both for allergy prophylaxis, such as allergy shots, and in cases where there is a more immediate need for allergy treatment upon exposure. In general, allergies in this range are common, and for many it only becomes an issue with exposure, such as those with seasonal allergies, and can usually be relatively easy to treat in most cases.However, with some allergic reactions, the response that the immune system mounts towards what it considers to be a harmful substances can be potentially fatal, as in the case with anaphylaxis or some cases of asthma. When allergic reactions start to cause bronchoconstriction or a constricted airway that limits an individual’s ability to breath, this is a very real and serious cause for concern; most would associate this type of reaction with substances such as seafood or peanuts, though it is possible to develop reactions of this type to almost anything. Other serious allergic reactions, such as internal swelling or edema, hypotension, or any other type of cutaneous reaction, is also of very real concern, and usually must be addressed by medical personnel as soon as possible to try to limit or stop the reaction. Causes for these types of reaction can vary, though they range from conditions such as mastocytosis, which is the overproduction of mast cells, having a high IgE count or high number of environmental/food/medication allergies, as well as congenital and genetic conditions that predispose to either over-proliferation of certain aspects of the immune system or to certain types of systemic inflammation, either chronic or episodic.
A very real area of concern that is often overlooked is the collective response of many to the idea of allergies, and the potential danger there is in assuming that if somebody mentions an allergy that the reaction they have will be mild and relatively easy to treat. My family and I have seen much eye-rolling and the assumption by many that our allergies are either not as severe as we describe them or that we are truly not allergic, with a frightening majority of these individuals being employed in the medical industry in some capacity. We have found that it is under these circumstances that we are in the most danger; to make the assumption that the information someone is trying to convey, be it under emergency circumstances or not, is either over-exaggerated or is in some way not entirely accurate is under the best of circumstances unwise, and, in many cases, a very frequent cause of serious medical errors and patient injury or death. It seems that for many, allergies are not considered to be a serious medical disorder, though the potential consequences of making this assumption are dangerous, if not fatal, in many cases. While it is true that many allergies will take on the form of eye redness, or sinusitis, this doesn’t hold true for everyone, as is the case with any other medical condition. When this is further combined with other complicated medical conditions, such as an autonomic disorder or vascular condition, the appearance of anaphyalxis or an asthma attack may look completely different than it would in someone who isn’t otherwise compromised in this regard, and may therefore delay proper treatment until it’s too late.
For me, in the majority of cases where I am having an allergic reaction, I won’t experience any type of warning symptoms such as a runny nose, sneezing, or watery eyes, but will instead jump straight to throat constriction and swelling, all over body swelling with a painful raised red rash, sporadic and random changes in blood pressure regulation and heart rate, and, in cases where I haven’t reached my medication soon enough, hypoxia that causes me to pass out and have hypoxic seizures until my oxygenation improves (not to mention a bad headache). And all of this will happen within seconds of exposure to what my body considers to be a harmful substance, such as breathing in particles of macadamia nuts, unwittingly eating something that contains what others consider to be a miniscule amount of whatever allergen it may contain, or simply being within 30 feet of a building that was painted the day before. Once I
experience a severe allergic reaction of anaphylaxis, I will usually enter a cycle where every 2 to 4 hours, I will again start to experience the same allergy/anaphylaxis symptoms, and this can continue anywhere from 2 days after the initial reaction to over 6 weeks. Both my mother and I have been told to wear Medic Alert bracelets to warn emergency personnel of our allergies, though to list all of our medication allergies, let alone environmental or food, on a single bracelet (or 5) would be impossible at this point. We both carry cards that must be constantly updated every time a new allergen is discovered, and while we have seen many medical personnel either copy down the entire list by hand or will make a copy to attach to a file, many times someone will start to question (or argue) the true nature of the reaction, or will flat-out say “You can’t possibly be allergic to this many things,” and will simply leave it at that.To illustrate this issue, because of an experience I had last year in an emergency room, my family and I have researched the other contents of what usually is put into a Saline-drip IV bag such as what you normally get at the hospital for dehydration. After a particularly bad reaction to what we could only connect back to a bag of saline I was given, we discovered that the
company that produces some types of IV saline conmtain a porcine-based substrate, and/or sodium benzoate, as a preservative for the bag and its contents, in addition to reusing their saline drip bags multiple times and using high heat on the plastic bags as the predominant means of sterilization. Because of the severity of my reaction, my parents always have to check the brand of the IV fluids they’re planning on using, and have to insist that I am indeed allergic to this particular brand of IV fluids and have to either go without or that another brand be used. This almost always leads to the comment “She can’t be allergic to saline,”, to which my parents will respond that I’m not allergic to the saline itself, just to the preservatives used in the IV bag. There are many nurses that have asked why we would even be aware of this information, to which we answer that it’s out of necessity; we have to be vigilant and cognizant of what is being used or being put into our bodies, and regardless of whether it’s something we consume at a restaurant or a life-saving emergency medication, there is always the potential that the compound could cause a fatal reaction to occur so rapidly that there may be no way to respond quickly enough, even in a hospital setting.Another story that was recounted to us was a surgical nurse that was assisting with a spinal surgery, and as she opened the packaging to something that was needed for the surgery, she immediately fell to the floor and died within seconds of opening the package. Latex had been used in the packaging, and even in an operatory, where all of the equipment to resuscitate her was readily available, the doctors and other nurses just didn’t have enough time between when she initially opened the package and when she stopped breathing. While sobering, this story was recounted to my mother and me by a nurse that had been in the room when this occurred, and it had a major impact on her both personally and professionally; needless to say, she took my list of allergies seriously enough to post multiple allergy warnings outside of my hospital room (for which I was, and still am, immensely appreciative).
In regard to how this issue connects back to my application of an allergy detection and response service dog, because of the extent of some of my allergies and the frequency with which my reactions occur, I’ve been told that a service dog trained in allergy detection and response would be invaluable to my family and me, though I realize that there is absolutely no way to train for all of these allergies. However, because I’m no longer able to smell some compounds, such as latex paint, to which I am the most anaphylactic to, a service dog may be able to check and then prevent me from entering someplace that has a deadly allergen I would not otherwise be aware of, or will be able to summon help if I am experiencing an allergic reaction and need immediate medical assistance. I’ve also been told that the service dog can carry my medications as well as my medication and allergy cards so that they are easily accessible to medical personnel, and my family, at the point where they need them.I apologize for the length of this post, and if you have read this all the way through to this point, I thank you for all of your patience and willingness to wade through my lengthy description of this complicated topic. This post is not meant to be vent of frustration on my part; in essence, I guess my point is that many times, people will make an assumption about what they consider to be an everyday problem, such as allergies, and may not be fully informed, or even be able to grasp, the gravity of this type of medical issue until it’s too late. This can apply to people both outside and within the medical industry, and I hope that perhaps some of this information may provide someone with a better understanding that sometimes something as simple as walking by a freshly-painted room or eating food with a “hidden” ingredient can incapacitate someone to the extent that they can no longer breath or function, and could possibly die from their exposure. Saying that you learn to live with it is somewhat of an understatement in many cases, regardless of the medical issue. I hope that perhaps you found this of some value, and if you wish, please feel free to comment below, or you can send me an e-mail at hnbain1@hotmail.com. Again, thank you so much for your time!
Heather
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