Thursday, May 27, 2010

The Big Peanut Kaboom

From time to time here on the blog I've referred to the night Ryan ate peanuts as The Big Peanut Kaboom. And I've shared the story, in bits and pieces mostly, but never in a big comprehensive fashion, I don't think (and I really searched the blog to see if I'd done that). I've had a couple of questions about the BPK lately, so I thought I'd write a post detailing what happened that night, and then I can link back to it in the future and hopefully minimize confusion/maximize clarity.

If you've heard this story before, please feel free to move on by. :o)

It was Sunday evening, May 16, 2004. Ryan was just over two years old. We'd spent the day at the Marietta Greek Festival, and decided to head to Cold Stone Creamery for some yummy ice cream. I don't even remember which kind of ice cream I got, but Brendan got chocolate-peanut butter. It was delicious.

We shared our ice cream with Ryan--just me at first, because we hadn't yet given Ryan peanuts. With our family history of allergies (including anaphylactic ones), and Ryan's persistent eczema, the docs had advised us to wait on peanuts for a little while, "sometime after he's two" if I recall. He'd had shrimp and walnuts and milk and eggs and strawberries. He was fine with all of those.

So that night, when Ryan wanted a taste of Brendan's ice cream, we looked at each other and hesitated. Looking back on it, that hesitation was a moment of my life I'll never forget. "He's over two. I'm sure he's fine." I think it was I who uttered the fateful words.

Ryan ate several bites of Brendan's ice cream. He LOVED it and rejected mine completely after a while. Brendan and I watched him carefully, and breathed a sigh of relief. No reaction.

We went home shortly after that, and it was bedtime. We put Ryan into jammies and read our story, sang our song, then left him in the crib. I turned on the baby monitor, even though we could normally hear him from downstairs if he cried.

After a little while, he started sneezing. Sneeze after sneeze after sneeze. Then, coughing. Coughing and sneezing and coughing some more. We listened to the monitor, thinking he'd settle down and go to sleep. He didn't. The coughing and sneezing got worse, though he didn't cry or call for us. After a little while, exasperated, I headed upstairs, thinking "Man, this baby is sick! Ugh, what a pain! I'll be up all night with this kid!" Yeah.

I found him sitting up in his crib, smiling happily. His face was unrecognizable, one eye swollen nearly shut, lips enormous. His skin was crawling with hives. I lifted up his shirt and watched them move all over his abdomen, growing larger and larger, smaller ones morphing into larger ones. I knew instantly what the problem was.

Horrified, I ran downstairs with the baby. We didn't know what to do, but I had sense enough to think: allergic reaction = Benadryl. So we gave him some Benadryl, which we happened to have in the house. I called the nurse hotline at the pediatric hospital, because we'd used them before and they were sometimes quicker than the after-hours service at the pediatrician.

The nurse asked me what happened and I told her "Well, my son has hives and swelling all over him, he's coughing and sneezing like crazy, and his chest is rattling a bit. Oh yeah, and we gave him peanuts for the first time ever a little while ago." She said "Hang up right now and call 911." "Really?" "Yes, really. Do it now."

So I called 911, all the while feeling a little silly, as if this couldn't possibly be THAT bad. Not really. The Benadryl had helped matters a little bit, he wasn't as hivey (think 95% covered instead of 99% covered). He was still wheezing a little though. I told the 911 dispatcher what had happened. She said they'd be there within minutes. Brendan and I tried to stay calm, and Ryan just smiled and smiled. He couldn't have been a happier guy.

Within a minute, we heard the sirens, and again, I could hardly believe they were coming HERE. But they did. Two firetrucks, and then an ambulance. For real. The Fireman Peopleguys came in, listened to his breathing, told me to give him more Benadryl, and we all sat and watched him. He was showing a little improvement, but the fireman (they're also paramedics in our county) was concerned that the wheezing hadn't improved. He recommended we get to a hospital right away, and suggested the nearest one, a hospital I'm not a big fan of. I suggested the children's hospital (twenty more minutes away by car), and he tried to talk me out of it. He suggested that we take him if we wanted instead of going in the ambulance. (Looking back on this conversation infuriates me.)

At any rate, we decided to take him to the children's hospital ourselves. The fireman said he'd be fine. Ryan was fascinated by all of the firetrucks and got to touch one. He was so happy and calm and excited. Half the neighborhood was out of their houses, looking to see, so I briefed my next-door neighbor on the situation and we headed out.

He hadn't improved much by the time we got to the hospital. Looking back, I know how fortunate we were that he was at least stable. Also, when you walk into the ER at 10:30 at night with a hivey, sneezing, wheezing kid and say "peanuts" you get the star VIP treatment, let me tell you. They whisked us back so fast I barely had time to think.

In triage, they started him on breathing treatments, with a neat little kid-sized dragon mask that looked all smokey with the vapors steaming out. And that is when Ryan finally decided to stop being happy and smiley. Who can blame him? The next couple of hours were monitoring, breathing treatment, monitoring, Benadryl, etc. Finally they decided to keep him overnight for more breathing treatments and monitoring. They got him a bed and we spent a sleepless night. Ryan cried and clung to his Green Bunny, Brendan sang Spider-Man over and over and over, and I lay there in the dark, crying and scared.

It was now Brendan's birthday.

When they discharged us, they told us to call the allergist and make an appointment. So I did, and he went in a couple weeks later, had the skin test that confirmed it, and got his first Epi-pen prescription.

You might be wondering why nobody gave him an Epi-pen. Yeah. I've been wondering that myself, for six years. When the allergist found out, he almost exploded, seriously. If I'd had any idea that's what was needed, I would have 'sploded all over the ER.

So, that was the night of the Big Peanut Kaboom. I can't dwell too long on the mistakes that were made, because it still makes me see red, six years later. The next months were even harder than that night in a way, because ignorance really is bliss sometimes.

This post was extremely difficult to write, but I'm glad I did it. Thanks for listening.


Mrs. C said...

You sound like you feel guilty about giving him peanuts, though I read the story and thought, "Thank GOD she went upstairs just to check things over!"

I don't wonder if your other children just get allergy tested every few years because of Ryan's severe allergic reaction?

Jenn Casey said...

Hi Mrs. C! Hope things are well!

I don't feel guilty about it, although I used to. The thing is, we would have given him peanuts at some point and a similar story would have unfolded. But thinking back to that moment where we hesitated, is very, I don't know...emotion-filled I guess.

The thing that still haunts me is imagining if I'd just not gone upstairs. We thought he was safe, since he didn't react at the ice cream place, not realizing that anaphylaxis can occur within a two hour window.

Morgan has been tested and has no food allergies, and eats peanuts (away from Ryan) just fine. We'll have Sean tested just to get a baseline ballpark idea if he's allergic, probably sometime in the next year. So far he's eaten other foods just fine, except for most nuts (he's had almonds only, accidentally, sigh), peanuts, fish and shellfish. He does have eczema so I'm mildly concerned about it. We'll see!

Liese4 said...

At least you know what causes it and can stay away from it. My daughter has RAD (reactive airway disease) and she isn't allergic to anything that sets it off. It could be a perfume, a cat, the wind, a person who coughs on her, it's irritating. We always end up in the ER during the wee hours of the night too.

My other daughter is 'intolerant' to peanuts, soy, milk, tomatoes and corn. The allergist said that the red swelling she gets when the things touch her skin, or the vomit after eating peanuts is just an intolerance. I disagree, but we just stay away from those things.

9to5to9 said...

Your story is SO stunningly similar to the time Big Guy went into anaphylaxis, except it was with egg instead of peanut. He also reacted an hour after dinner, which was shepherd's pie with only ONE egg in the entire casserole. We found out about the peanut a few years later. And it also took me years to write about it, but I'm glad I finally did. It was cathartic, and I also hope it helps some stray visitor who lands on my blog someday to understand that allergic reactions aren't just a few sneezes and a bit of hives.

Stephanie Ozenne said...

Thank you for sharing the story - it sounds *terrifying.*

Amy said...

Arg, that story makes me so mad, too. Is it not SOP to give the epi-pen in these circumstances? And shouldn't they have insisted that you go to the closer hospital? Why all the ambulances and fire trucks if they were not going to treat it like an emergency when they arrived? It makes no sense.

I also had no idea that an allergic reaction could take so long to manifest. Thank you for explaining that.

I'm glad to hear that you no longer feel guilty. You and Brendan obviously did an excellent job protecting Ryan.

I think that it's reasonable for all parents to keep Benadryl on-hand at all times, just as we do Children's Tylenol or ibuprofen. I'm going to check the expiration date on my bottle right now. As always, thank The Producers for modern medicine!

Jonathan said...

What an amazing story. I can't imagine it with my own kids.

One note here - I'm not a doctor but I'm pretty sure the breathing treatments you describe have epinephrine (the drug in EpiPens). At least that's what I recall from one croup experience. Of course, that doesn't explain why the paramedic wouldn't administer the drug!

Rose said...

Thank you for sharing the story. I almost burst into tears half way through reading it. My youngest quickly outgrew her hives from nightshades (tomatoes/potatoes/peppers) and they were never even close to what you described but they still scared the @#%% out of me!

I'm glad you got over the guilt cause it sounds like your son is safe because you were so alert. Looking back with allergies there are a million innocent things we can blame ourselves for... but no way of knowing they would be a problem before hand.