Surviving the Afternoon: Anaphylaxis Attack

             “Lights and sirens the whole way?” came the slow question from my mother as I relayed the tale of my unexpected ambulance ride to the local ER earlier that day.  The brief phone call ended and I sat with my Epipens around me, terrified my reaction would start again.  Even though I was now safe at the home of a family friend outside of D.C., my panic remained despite the exhaustion of the post-epinephrine come down.  The events of that afternoon are not all completely clear to me…but I knew at that moment that I was still breathing despite having had another severe anaphylactic reaction.

                I had ordered a steak salad for lunch.  It was delicious.  There was no way for me to know it was harboring a severe allergen that would soon threaten my life.  The server carefully noted my allergies and I felt safe.  Maybe too safe because I enjoyed my meal and disregarded the first hint of an allergic reaction that occurred after finishing the salad, thinking to myself it couldn’t really be a reaction.    Perhaps it was a walnut or pecan that made its way into my food through contaminated hands or gloves in the kitchen.  There was never a crunch to alert me to the intruder.  The attack was silent and unnoticed. 

                My colleague had to rush back to the office and we hurried through the bill and goodbyes.  I did not tell him that I thought I was having a reaction.  By the time I was at my car (approximately 10 minutes post exposure), the reaction was obvious.  I drove the ½ mile back to the office in denial.  Upon entering the almost empty office, my reaction was increasing in severity.  Following my reaction protocol at the time, I needed to take an antihistamine but quickly realized I had let myself run out. 

               With my illogical anaphylaxis brain in charge, I decided to drive the two blocks to the drug store up the street.  I don’t recall parking my car, but I do recall the moment I realized how severe the reaction had become so quickly.  Sitting alone in my car with no mobile phone, fast action was paramount.  I vaguely recall fumbling in my purse for my Epipen and plunging the needle into my thigh expecting to stop the reaction. 

                “Oh no! Oh my God!” I cried to myself as I quickly realized the reaction was not stopping. The injection didn’t work! I needed to get help.  With the used Epipen discarded on the seat of my car, I searched for the door handle and stumbled out of the car.  Seeing the store’s front door, I knew all I had to do was make it inside and they would call the ambulance. 

                Upon entering the drug store, I remember trying to place my hand on the counter to steady myself.  It didn’t work and I began to fall.  Someone helped me sit on the floor as I got the words out, “I am having an anaphylactic reaction and I need an ambulance.”  I felt my eyes roll back in my head and my body slump and all I could think was I am going to die right here on the floor!!  Suddenly and yet slowly all at the same time, someone shook me.  I saw a white lab coat next to me and an Epipen.  The pharmacist helped me administer the epinephrine – my second dose in a matter of minutes.  I became more alert; it was slowing the reaction.

                Despite the second dose, I was still not safe and when the paramedics walked in the door, they knew it.  I was quickly strapped in and injected with either more epinephrine or perhaps an antihistamine or steroids.  I could hear the ambulance sirens and I was jostled around by each bump in the road.  With so much epinephrine surging through my veins, I became agitated.  I demanded they stop and tell me where we were going.  I was terrified and confused, but they reassured me we were going to the hospital.  I told them we didn’t have to go so fast.  Looking back, I imagine these statements were relieving to the paramedics – I was finally alert.  I don’t know how I survived that day (nor how I avoided injuring anyone else while driving my car), but despite making multiple unsafe choices, I lived through it with nothing more than injection marks in my arm and thigh.

Every allergic reaction I survive comes with its lessons.  Before that day, one Epipen had always been enough and a salad had never attempted to kill me (haha).  It was a day of new concerns.  Even now, I get anxious when eating a salad in a restaurant.  If I have any reservations, I skip ordering it altogether.  Some of those reservations include seeing several salads with nuts in them on the menu or even other non-salad entrees with nuts.  And since that day, I always carry two Epipens when eating outside my home.  I also now have a more aggressive anaphylaxis protocol to follow that includes immediate injection of epinephrine at the first sign of a reaction.  Navigating a danger that is part of my daily life, and actually healthy for most, requires that I always stay vigilant to protect myself from severe food allergies.