Wednesday, April 20, 2011

Asthma And Cycling: Got A Pen?

Cycling Emergency Checklist
Spare tube:    Check.
Multi tool:       Check.
Patch Kit:       Check.
Epi-pen:         Wait....what?
I’ve been hedging my bets that I’ll never need to use an epi-pen (a portable little shot of epinephrine that treats an anaphylactic reaction). I used to have one, but it was such a hassle to have along, you know? It doesn’t quite fit into a pocket, and I refuse to carry a man-bag around with me. Epi-pens can’t be stored in places that get too hot or cold.  So they’re just not very convenient, you see.
Remember the “triggers” that were mentioned in the last post? Well, when it comes to anaphylaxis, these are the usual triggers that get people into trouble:
  • Foods, especially nuts, fruit, fish
  • Drugs, including pain-killers
  • Latex
  • Bee Stings
  • Exercise, especially after food intake
  • Unknown triggers (about 25% of cases)

I’m thinking about how many of these triggers are part of a cyclist’s normal routine. Yikes.
Although I’ve never used an epi-pen, the truth is I’ve needed one several times and just didn’t have one with me. Like the times I thought I was eating a peanut (not allergic), but was actually eating a cashew (severely allergic). With even the tiniest piece of a tree nut, my mouth will immediately start to tingle, then comes the itchy swelling in my mouth. Quietly I panic, somehow convincing myself that I can just wait it out. Yeah, that never works. No epi-pen, either. Scary.

Come to think of it, I’ve gotten pretty good at scaring all of the people closest to me. Nice.

Anaphylaxis is the strongest of allergic reactions. It’s usually accompanied by symptoms that don’t go away on their own. Swelling is just the first thing on the list.  There’s also obstructed airways, severe asthma, vomiting, hives, even cardiac arrest. The best response is to call 911 and use an epi-pen. These signs can disappear and reappear over a 12-hour period, so you need to go see a doctor. During a bad reaction I can convince myself that I’ve got things under control (my usual response), and I could be completely wrong. Deaths to anaphylaxis are rare, but almost always happen no epi-pen is around. I've been playing the odds.

Now let’s imagine that this is happening 50 miles from home while bicycling on a country road. When I ride, I’m prepared for almost every kind of emergency, just not the one that might kill me. So if I get into a jam out there, I’d have to improvise while I’m in the middle of a reaction.

I’m exactly that statistic that doctors warn about, and I’m no exception. There are a lot of people just like me who don’t have epi-pens, but should. It’s sort of like having a fire extinguisher in your home. You probably never will need it, but it’s really smart to have one.

My asthma plan is seriously incomplete, and it will be, until I get a prescription, fill it, and have it with me when I ride. More to follow.


The Hillbilly Banjo Queen: said...

My Dad scares us all the time. He is allergic to apples, any stone fruits, all nuts other than cashews and peanuts, and I'm sure a few other things I've forgotten. He used to be able to eat a spoonful of sugar and it would take care of the swelling but that quit working. Epi pens are the way to go.

Kelly Carlisle said...

Hmmm. I wonder why sugar worked for your dad. For me sugar tended to exacerbate my asthma symptoms. I almost always got really bad asthma the day after Halloween, until my parents figured out that the sugar intake was the culprit. Hopefully your dad and I can both make sure we have an epi pen with us, especially at restaurants and potlucks and stuff. I gotta get better at doing that.

RCMC467 said...

Dude, what are you playing at? Be...more...careful...

Jessica said...

Thankfully my allergies are all enviroment related and not food related. I've never had a bad enough reaction that I needed an epi-pen. I carry allergy meds with me all the time, but I don't even carry my inhalers everywhere like I used to. We're all guilty of not being prepared, but we need to fix that! (And I'm proud to say that I do actually have a fire extinguisher in my house! LOL!)