This was anaphylaxis wasn’t it? Nuts.

[Mytortoiseisbetter]

Ds2 (16) has always had hay fever/throat-clearing type symptoms ans the odd rash after food but last night something more serious happened.

he ate 4 Brazil nuts and a few minutes later his throat felt weird and his breathing became noisy. His eyes were red.

We happen to have a neighbour who is a local GP and he kindly came over. He got ds2 to take antihistamine. Then he got an inhaler, then a steroid inhaler. The throat cleared a bit and he sent ds2 to bed saying he should go to hospital if it didn’t settle. He said “we’d know by now” if it was going to be severe (he stayed with us for an hour)

I slept in the same room as ds2. Shortly after going to bed he got very agitated saying his heart felt like it was on fire. I thought it was a panic attack but then he threw up and after that it all subsided. He says his throat still feels a bit “cottony”.

I had assumed the vomiting was a response to the inhaler but Google tells me that vomiting and heart issues are actually part of anaphylaxis especially if food-related.

this morning I obviously called our own GP who ordered a RAST(?) test but that’s not till next Friday. She said normally you call 999 with any breathing issues.

I realised I’d failed to tel, her about the heart and vomiting to called back and gave a message to the receptionist.

dh is in complete denial saying “it could be nothing”.

it’s not though is it?

my neighbour has shown us where their epipen is (it went out of date in 2020).

Not sure what I’m really asking here. I guess a handhold? My older son had a life threatening emergency just a month ago requiring neurosurgery and I’m only just recovering from that!

Steroids can make your heart race.

She said normally you call 999 with any breathing issues.

Yep. Quite honestly your neighbour sending him to bed after such a reaction that hadn't even settled down yet was bizarre.

Sorry - posted too soon. The steroids could have caused caused the anxiety and heart racing.
My dd has had non anaphylactic reactions to food. She has never vomited though.
I think all you can do is make sure he avoids nuts until the test results come back.

ventolin inhaler gives you the racing heart/shakes.

Your local GP friend is risking all sorts - your son needed a steroid injection, those symptoms could easily have worsened into something disasterous.

Thank you.

can anyone tell me what happens after blood test? Does it just go back to GP and you get an epipen?

I guess a steroid injection is different to adrenaline?

certainly seems like some sort of reaction (my DS is allergic to peanuts) get a referral to the allergy clinic, GP's are useless with allergies.

Sorry I mean different to epipen medicine?

999 would have been the best call but I understand why you called your neighbour, dont use their epipen.

Oh and avoid all nuts OP until he is tested and go to A&E if it happens again.

next time skip the neighbour and go to A and E or call 999.

giving a steroid inhaler makes no sense at all given they take a few weeks to build up in the system

my DN is allergic to nuts and has a similar reaction apart from the heart racing. His mouth throat feel funny and he’s sick, once he’s been sick he feels better. His response is not the usual presentation of anaphylaxis but after tests he’s allergic to most nuts especially peanuts.

If it wasn't anaphylaxis then it was certainly borderline.

Keep a careful eye on him over next couple of days because anaphylaxis can spontaneously reoccur up to (I think) 48 hours after contact with the allergen.

(*not a medic but witnessed anaphylaxis)

Epipen is adrenaline, a steroid injection is usually hydrocortisone, they are different drugs

Is it his first exposure to nuts?

You'll need a referral to an allergy consultant - GPs are no good for this. Avoid nuts till then. And any further reaction like this, call 999.

DS has a severe peanut allergy which we've dealt with for 12 years. It sounds like your DS had an anaphylactic reaction, and I'm very surprised that your GP neighbour didn't call 999 straight away. There is something called a biphasic reaction where allergy symptoms subside but then reappear a few hours later.

Your DS now needs an allergy test for all nuts, and he should avoid eating nuts until he gets the results. If something similar occurs, go straight to A&E or call 999. Go to your GP and try to get a prescription for an Epipen.

Definitely avoid all nuts for now as future reactions could be more serious. You can only have an allergic reaction to something you've previously encountered or ingested so don't think that because he's been safe with other nuts that he won't react, cross reactions are common.

If it happens again call 999 and say you suspect anaphylaxis.

Antihistamines and steroids are not generally recommended as recovery meds in the U.K. and can mask anaphylaxis signs. Allergy plans might include their use but it needs to be consultant recommendation. GPs are rarely very knowledgeable about allergy/anaphylaxis IME.

If your son has any symptoms in the throat after eating something you should treat it as urgent. I woudl not consult your neighbour again as their advice was very strange, you are also putting them in a difficult situation as they do not have the required equipment to treat emergencies.

For the next week I would assume a nut allergy and avoid them. Carry antihistamines at all times in case.

Yep sounds like anaphylaxis. If it is serious though it’s quite obvious as they can’t breathe so ndn wasn’t wrong but it’s still best to 999 it. The protein he reacted to can stay in the system for ages.

Has he had Brazil nuts before or was it his second time eating them?

BTW this was not necessarily anaphylaxis - allergic reaction can cause vomiting and sore throat, and as PPs have said steroids and inhalers can cause heart racing.

It's unlikely he has never been exposed to nuts in 16 years.

Definitely sounds like an allergic reaction. I had a reaction like this a few years ago in a restaurant. A few hours later I was feeling much better after having vomited and went on a very gentle walk with DH. Unfortunately about 10 minute into the walk I went into full blown anaphylaxis as the nut proteins were still in my system and were being pumped around my body due to the exercise. I nearly died. Please push as hard as you can for testing so they can get him 2x epipens and get him to take it easy for the next couple of days.

These messages are incredibly helpful, I'm very grateful.
Epipen neighbour is not GP neighbour. I'm leaving poor GP neighbour out of it now (it would be wrong on all levels to do anything else!).

DS2 is adamant that he has had Brazil nuts before (so maybe this was that second reaction...)

I'm focussing right now on what I can control. Firstly this means getting across to DS2 and DH that any further breathing problems means straight to hospital. DH seems to be coming to terms. DS2 knows he has to avoid all nuts till test results and is pissed off about that but has several friends with epipens so not too pissed off. I've asked him to stay close to home for 48 hours. Fortunately it's GCSEs so he isn't out partying anyway.

Secondly I've made an appointment to see a consultant privately - I'd been thinking of this for DS2's hayfever anyway tbh - have to wait till 1st July but at least we'll have the blood test results then.

Thirdly I've applied to join the facebook group that I've seen recommended on here.

Would you all agree that (frustrating as it is) without the blood test results there's nothing more I can do to speed things up?

Firstly. Don't panic.
If he has another reaction, call 999.
I'd get some liquid piriton in. Easier to swallow than pills.
GP is likely to refer for blood tests. If he is allergic, he may be prescribed EpiPen.
You can have eaten nuts without problems before and then get a reaction. Now he's had a reaction it's perhaps more likely to happen again. I'd avoid knowingly eating nuts (he may be fine with nut traces) and carry some antihistamines if you eat outside of home.
I have a similar issue with certain nuts and as long as you're fairly careful you should be fine. If he does have a really severe reaction, again it is manageable but you can't pretend it's going to go away.