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.