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    Old 07-17-2006, 10:43 PM   #1
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    Question Questions About Severe Allergic Reactions


    I am not new to the allergy game, unfortunately, I have seasonal allergies and the dog, cats, nature as a whole allergy problem. However, normally nothing that impairs my ability to function.

    Anyhow in the past three months I have had four severe allergic reactions. Two back to back. Last time I had to give myself my epi-pen and was ill for a week after with what felt to be a lump in my throat. I was unable to eat and even think clearly to be honest. I also have had had random small allergy symptoms, which are not normal for me since. Such as a hive will pop up...which is normal for me...but now it will turn into a blister. I also have a rash under both my ears. Nothing huge but bumps none the less. I also have other syptoms such as with my tongue, skin, lips, eyes...etc etc. The one that concerns me the most if the tightness in my chest and the feeling as though there is just not enough air getting into me.

    Needless to say, I am going to see an allergist. My question is, I have no idea what is causing this so I am now keeping a journal of daily activities, however, what should I be emphasizing to this allergist? What type of testing should I be asking him for? I know I am allergic to trees and grass and all that. Should I be asking for a "food allergy test" a "medicinal test"? I don't want to waste his or my time and I want to get to the bottom of this ASAP.

    I was also wondering if someone would be able to tell me more about the effects of using an epi-pen? They always perscribe me two....and mine are the new "twin-jects" which esssentially then equates to me having 4 epi-pens. Epinepherine has a major impact on the heart...however....should I really be giving myself 4 epi-pens? Or should I be giving myself the first and then checking my blood pressure (i.e. if it is really low) to determine if I should be giving myself the second. Last thing I want to do is wreck my heart!

    Any help or advice would be most appreciated as I am finding this whole thing mentally, physically and spiritually exhausting,

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    Old 07-21-2006, 08:59 AM   #2
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    Re: Questions About Severe Allergic Reactions

    Oh my! You have been through a lot. Emphasize to the the allergist that you've had very scary life threatening allergic reactions, that required you to use the epi-pens, and I assume go to the hospital. You don't want him treating you like you just have a stuffed up nose. Tell him about your known allergies, but he will probably test you for a variety of allergens.

    I would ask the doctor who presribed you the epi-pens how to use them. Using 2 at a time seems like a lot, but I suppose some people need to do that. I've been prescribed one as a precaution with my allergy shots, but have thankfully, never needed to use it.

    Old 07-21-2006, 12:30 PM   #3
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    Re: Questions About Severe Allergic Reactions

    I can't believe your doctor has been prescribing epi-pens on more than one ocassion and hasn't sent you to an allergist or immunologist. I'd fire that doctor. You what they call the guy who graduates last in his class at medical school? Doctor.....think about it.

    Old 07-22-2006, 04:01 AM   #4
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    Re: Questions About Severe Allergic Reactions

    This is going to make treatment much much easier for you...

    You identified "lump in the throat" sensation as a new problem for you. This realy isn't an allergy problem, instead you have identified the classic symptom of a condition called "laryngopharyngeal reflux" (LPR). It's a category of acid reflux in which a small amount of acid escapes the stomach via the lower esophogeal spinchter muscle, and backflows up the esophogous into the laryngeal/pharyngeal area (the very top of the esophogous). The acid irritates that area, typically causing "lump in the throat" sensation.

    "Lump in throat" is a hallmark of this condition, and by identifying it, you are well on your way to treatment.

    This condition also goes hand in hand with allergies that have been resistant to antihistimines like Allegra and Claritin. It seems like you know cat allergies well - the suddden onset of massive secretions, sneezing, wheezing, misery that typically can be offset with a claritin. But mild allergies that begin driving you nuts that don't respond to claritin - that's typically caused by the acid reflux causing erosions in your nasal passages. Once the acid reaches your pharynx/larynx, it mixes with your throat secretions, then spreads all around your sinuses and nasal areas, literally causing erosions that make those areas extremely sensitive to common irritants. You need to let all those erosions heal.

    The way this is done is by reducing the acid level of the stomach. Sadly, there isn't a method in place to stop the backflow of acid short of surgery, but reducing the acid levels with medication is quite effective. It can take 1-30 days for the problem to go away once you start the meds. Most people will need to take the medication indefinately - the prob never really "goes awa" permanently, and we take the meds as long as we have too.

    So the meds are called PPIs (proton pump inhibitors), and you will need to take 2 doses of the maxium strength PPI of your choice every day.

    Your choices are:
    Prilosec (Prescription strenght, NOT the OTC stuff)

    For instance, Nexium is available in 20 and 40 mg sizes. You will need 2 doses of the 40 mg size each day, for a total of 80 mg of Nexium. I use Nexium myself, and it works very well. Some people find that one PPI works better than another and must experiment.

    Remember, you need to go and do a little research of your own on "laryngopharyngeal reflux" and "lump". You'll be amazed at what you find.

    It's funny but most LPR patients get 1 or more of the following symptoms:
    -Lump in Throat Sensations
    -Increased sensitivity to allergens that are unreponsive to allergy meds.
    -Chronic Cough
    -Hypersensitive Smell
    -Asthma-like symptoms unresponsive to asthma meds.

    Old 07-22-2006, 04:06 AM   #5
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    Re: Questions About Severe Allergic Reactions

    By the way, most allergists are completely useless in treating LPR. LPR, while virtually unknown 10 years ago, has gained much more prominence and is now becoming well known in the ENT and gastroenterologist communities. But every allergist I went to when getting diagnosed was clueless. I suspect it's a business issue, and that they are letting it interfere with their hypocratic oath. Many many cases of chronic allergies are actually caused by this type of reflux, and imagine the number of patients they would lose if they could tell them to just go and take PPI. Allergists are typically the med-school losers, so they don't really keep abreast of what's happening in cutting edge medicine anyway.

    The great news is that you can go to your PCP for a PPI prescription - they prescribe them all the time to patients with "heartburn", which is the same acid reflux condition, only it affects the lower esophogous, instead of the upper esophogous.

    If you want proof of LPR though, you need to see an ENT. An ENT will "scope" you - stick a thin tube with a miniature camera up your nose and down your throat to get a visual of your larynx on a monitor. Someone with LPR will have the classic red, swollen larynx. If you crave a direct diagnosis, that's how they do it. Otherwise, you can simply see how you respond to the meds.

    Old 07-22-2006, 04:25 AM   #6
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    Re: Questions About Severe Allergic Reactions


    I suffer the chest tightness also. I have LPR for which my Allergist rx'd Nexium. That helps alot but, I also have Asthma which LPR can aggrevate. Allergies and Asthma are a very common combination. When you go to the doc, be sure to tell him about the tight squeezy feeling and not being able to get a full breath. They will most likely run a Lung function test. Good Luck.

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