The Reaction
I took M.onistat for awhile while this yeast infection was taking its own sweet time to heal. I knew it would take some time, but it itched like nothing ever had.
Again between Christmas and New Year's something awful happened. Soon after Christmas, my husband took our dog for a long walk and I decided to apply the topical creme to cut the itching. The next thing I knew I was looking up at the toilet paper holder and hearing water running. I was confused - I hadn't flushed the toilet. Then I saw. The toilet tank was shattered. The bowl was intact - not overflowing. I started screaming.
No one came.
I calmed down enough to crawl around and turn off the water supply to the toilet tank - or at least mostly. I start picking up stuff and think I hear my husband return. I start screaming again.
No one came.
I had been expecting a phone call, so I had my phone on the vanity. I couldn't reach it. I couldn't get help. I couldn't stand up. I was in terror. I started screaming again.
My husband came. He found me trying to pick up peroxide. He thought I was pouring peroxide. He didn't know what to do.
At some point he helped me get to the bed. Before we got there, I threw up - falling to all fours - I threw up. At that point, I knew I was in the throes of anaphylaxis. I just wanted to go to sleep.
My husband was panicked. He didn't know what to do. He was trying to get his mom - a Registered Nurse - but he couldn't find the phone.
My phone rang. It was my Mother-in-Law. She was dropping something off at our house. Thank goodness she had her nurse's bag with her. My blood pressure was 90/20 and falling. I presented with glassy eyes and flushing. She said that she would have thought it was diabetic shock except that my blood sugars were normal. This is called shock.
No one was getting my epi pen. I thought I was telling them to, but they tell me I wasn't coherent.
At some point my husband called the EMTs. They were less than helpful in some ways. They asked my husband if I was safe to move. Um... they are the EMTs. They read my medic alert, asked where my epi pen was, and never got it or used it.
Instead, they kept trying to get an IV line into me. 90/20 BP and falling? Baby veins? Think they were successful? I was screaming in pain.
They then had the two little girls - where there were 4 large men - carry me out on the stretcher. Truthfully, I had no bruises except for the ones I got from them trying to carry me out.
The ride on the stretcher was so bumpy I had to throw up. I told them this before I got to the stairwell - but they didn't listen. My brain said, "F*&K them!" and I sat up as they were yelling to throw up. I was actually thinking, wrongly, that I could walk without them keeping me on the stretcher.
I didn't know where my husband was for a short time and I was terrified as I didn't trust these people. Anaphylactic shock includes a sense of impending doom - you are convinced you will die - not a pleasant place to be. Trust me on this. He was in the front of the ambulance. His mother followed us to the hospital. He tells me that the ambulance driver had to ask him for the best route to the hospital. The hospital is a straight shot down the main thoroughfare for our neighborhood.
Things didn't get much better at the hospital.
I was not 100% conscious when I was first there. I know that my husband was there for a little bit. He then sent his mom back while he was doing paperwork. During the time no one was with me, there was a student nurse there. At some point, someone gave me oxygen - I have no idea when.
Soon, his mom was back there with me. I know I told the young (idiot) ER doctor I was in anaphylaxis. He and the attending nurse argued with me. I told them to call my allergist. It was his late day so I know he would have been there. They didn't. I kept telling them to call.
For what seemed like hours they did nothing. I seemed to be drifting in and out of consciousness. At some point they send a nurse to try and get an IV line in.
The American Academy of Allergy, Asthma, and Immunology (AAAI) clearly sets the following guidelines for
the treatment of anaphylaxis:Intramuscular Epinephrine injection followed by Benadryl + H2 Inhibitor +
Prednisone
This was obviously not being followed. They wanted to put an IV line in. This is somewhat inadvisable as I was conscious. (It is the preferred treatment for the unconscious.) In order to get the proper treatment I had to say that I had "atypical anaphylaxis." It wasn't.
Atypical anaphylaxis? Nope, not even close to atypical as anaphylaxis does not always present with swelling and/or hives. A sudden drop in blood pressure is a pretty sure sign of it. The (idiot) ER doctor told me syncope (fainting) was not a symptom of allergy. Yeah. If your blood pressure drops, you are gonna stay conscious.
Finally, my mother-in-law asked what my allergist did when I was in reaction. I told her the AAAI treatment - which is the same. She told the nurse to go get the doctor. Finally they gave me the proper treatment plus diflucan and a diflucan prescription. The (idiot) ER doctor came over and said he didn't think an IV line would be hard to find. I told him I could have told him if he'd asked. He and the attending nurse said they'd never heard of anaphylaxis like this. I suggested they read past the first three symptoms.
This started at about 3:00 / 3:30 and ended at about 7:00.
The Other Doctors Don't Think Much of ER Physicians
I had gotten orders to get into my primary care physician. I talked to the nurse since he wasn't in. She was appalled at what had happened - but my PCPs partner did not want to see me. I went on to call my RE. He wanted to see me that day. (This was the next day.) Unfortunately, my allergist had closed for the day by the time I called and wouldn't be back till after New Year's. Since I knew I would see the RE, I was ok with that.
We told the RE the whole sorted story. He muttered something indicating the lack of knowledge on the part of ER doctors. The term vaso vagal was thrown out. He checked the yeast infection and gave me a prescription for diflucan. The fact that I somehow escaped major injury while destroying a toilet tank amazes the medical staff.
I get in to my PCP that Monday - after returning to work. I also called the makers of M.onistat who want a full report on everything, so I give them permission to contact everyone involved. My husband and I tell our Family Practitioner everything and he insists on a consult with my allergist. He also mumbles about ER incompetence without saying it outright. He is upset that they did not call him and writes me a prescription for diflucan.
So, we get the referral to my allergist who sees me the next day. The allergy nurse hears this and rolls her eyes when I tell her that the ER doctor said "syncope is not a symptom of allergy." You must remember, these nurses are trained to watch and pull in trouble patients into the back room if they start reacting to a shot without realizing it. I know. I've been there. Did I mention I can't take allergy shots because they constantly caused reactions?
We tell my allergist what happened. He is completely unsurprised by all that happened. He actually says ER doctors don't know anything about allergy! I find out that the AAAI thinks ER doctors don't know anything about allergy through a literature search - and that even the international allergy associations have a similar opinion.
Honestly, this scares me to death - possibly literally.
My allergist starts saying something about a vaso vagal reaction. Now, you must remember that I was heavily medicated on benadryl. It completely wipes me out. I had also had a major reaction. For some reason, my husband did not understand I would not bounce back immediately. Psychologically, I'm still not 100% ok about this, in all honesty. So, I'm getting irritated with people using terms like vaso vagal for my allergic reaction where, as far as I'm concerned I almost died. He explains to me that vaso vagal is a type of thing that can happen and what probably saved my life was the fact that I had antihistamine in my system.
I take Claritin-D every day. No matter what. I like breathing.
The allergist gives me another script for diflucan. He doesn't think testing will be necessary since, well, we know I hadn't eaten anything that caused the reaction. All self-prepared food that I had eaten since with no reaction. It was definitely the M.onistat.
So, now, I'm very paranoid about everything and am preparing to go into surgery.
I know at this point that I can't rely on anyone to save me. I'm angry and hurt that neither my husband, or my mother-in-law (a nurse) thought to give me epinephrine.
My husband claims it is because he was afraid I would jerk and hurt myself further. He was concentrating on the fall. The fall was secondary in this emergency. All the doctors told him point blank that if it happens again, use the epi pen. It could mean the difference between life and death.
So now I'm nice and paranoid and prepping for surgery. How would you feel?
After all, 3 physicians had said the same thing:
- ER Doctors Don't Know Anaphylaxis
- I Need To Have Diflucan On Hand
- Husband Admonished To Give Epi Pen Next Time - Everyone seems to think something bad is bound to happen again.
Next is the Surgery.
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