A Long Night in the ER

So here's what happened.  We were at my mom's for Sunday night dinner.  The kids were starving, as dinner was somewhat delayed, and I was coming down with something so it had already been a long day for me when we sat down to eat around 6:15.

Addi had already had a few helpings of salad because that was first to come out.  Tristan sat down, famished, after being too preoccupied with video games to notice that his stomach was grumbling like a volcano about to erupt.  He reached for some salad, then eyed the appetizers that came out next.  They were polenta rounds with a savory topping, an extra tray of something my stepdad had made for a party that afternoon.  "Are they safe for Tristan?"  I asked.

"Yes," he said, nodding.

He has cooked for Tristan a million times.  For some reason, I had a bad gut feeling about it.  Over a matter of a few seconds, my instincts had told me that (1) we had never let Tristan try this particular dish before so I wasn't familiar with it, (2) I hadn't asked exactly what the ingredients were, (3) the dish wasn't meant for him, but rather, a non-allergic guest list, and (4) polenta is often paired with cheese.  But Tristan was so hungry and so willing to try something with mushrooms in it, that I let that momentum overtake my instincts. 

In less than a minute, Tristan was complaining that the dish was "spicy."  I had tried one earlier and had not noticed any spice.  This is a very common first reaction Tristan has to ingesting an allergen.  I wasn't sure, but gave him a Benadryl anyway.  I kept asking him, "How does it feel now?"

"It's spicy, really spicy all over my mouth!"

I was starting to get nervous.  Then, "My stomach hurts!"

"Does this have cheese in it?"  I quickly asked my stepdad.

"Yes," he replied.

I rushed Tristan over to the sofa with a plastic bag.  He started complaining about pain in his stomach.  "Try to throw up," I was saying, over and over again.  He wanted to, but he just couldn't.

As the complaining turned to screaming, I started getting really anxious.  "How is your throat?  Are you having trouble breathing?"

"My stomach just really hurts!" he kept saying.  In a few minutes, Tristan looked at me and said, "My throat is starting to hurt and my breathing is getting hard."  I ran to get the EpiPen and administered it, while he sobbed.

He felt almost instantly better.  We've landed ourselves in the ER after administering an EpiPen a couple of times now, and each time it had felt like a long 4 hours of waiting around and watching a few movies.  I was feeling sinus and body ache, had two other kids to get fed and to bed, and I just really didn't feel like going to the ER.  Tristan was already back to reading the book he had brought along, and I had a fleeting thought to skip the ER.  "Why do we have to go to the hospital, mom?"  Tristan asked as I was contemplating my next steps.

"Well, we go just in case your symptoms come back," I told him.

"Then I think we should go, just in case," he advised me.  My 8-year-old was right.  It was protocol and it was the right thing to do.

Once we got in the car, he asked for the bag and said he felt like throwing up.  His stomach was starting to feel nauseous again, and I knew we had made the right decision, just in time.

When we arrived at the ER, all I had to say was "anaphylaxis," and they admitted us immediately.  They hooked him up to the monitors, and started asking questions.  He was still feeling nauseous, but was well enough to ask for the DVD binder once the nurse had left the room.

The plan was to give him some Zofran for the nausea, then a steroid.  Right before the nurse came in with the meds, Tristan threw up into the plastic bag we had brought along.  The nurse gave the oral Zofran, but after 10 minutes of still experiencing nausea, they decided he wasn't well enough to take the steroid orally.

Plan B was to give the steroid through an IV.  At the next check, his throat was still bothering him and his stomach pain had not gone away, so the team made the decision to go ahead and give another Epi injection.  Then, they set him up with the IV, through which they administered several drugs over the next few hours--Prednisone (steroid), Pepsid, and Benadryl for a rash and hives that had developed and was ill-treated with ice packs. 

After about 2 hours in the ER, Tristan was feeling much better.  He was hungry.  He hadn't had a chance to eat much dinner, and whatever he had eaten that afternoon had been vomited out.  He wanted crackers and juice.  About 10 packs of crackers later, he was smiling and ready to dig into some "real food," some chicken sausages that my mom had brought in as reinforcements.

After a couple of hours in the ER after accidentally ingesting cheese, Tristan is covered in cracker crumbs and on the way to a full recovery.  Hives and rash that had developed while in the ER had disappeared thanks to the meds.

With a full belly, he started getting sleepy.  But his blood pressure had dropped, not out of range for his age, but lower than what he'd been trending so far.  So they administered liquids for hydration through his IV.

After another hour, no change in blood pressure and no other symptoms, they decided he was fit to go home.  It was possible his normal blood pressure was on the low side, and he seemed to be sleeping comfortably. 

One AM in bed never felt so good.  We are so thankful for EpiPens and for the doctors and nurses at the CPMC Pediatric ER for their wonderful treatment.  Thank you for saving my child's life.

The next day in the pediatrician's office for his follow-up--Tristan is all smiles.  The doctor recommended we ask our allergist about shots in the near future.

Upon reflection, I don't know if I should conclude that this is the life of a food allergic kid.  And that having a food allergic kid means accidents will happen.  Maybe his allergies are growing more severe,  maybe he'll grow out of them and maybe he won't...should we expect to just live each day as it comes, be prepared, and try not to let guilt pull us down?  Should there be a more invasive next step?

I do know that being alongside my son as he has been faced with a number of possibly life threatening situations allows me to each time regain clarity in life.  I've been able to reassess what is important and what isn't, to think about our core values and what I want my kids to learn from growing up as a part of our family--empathy, love, kindness, and caring for one another.

It's possible that Tristan's food allergies are part of why he has always been so exuberant about life, seizing every opportunity to try something new or different, ideas constantly swirling around in his mind.  "Oh, I know!" is a common exclamation heard around our house.  Of course, that phrase can be heard on a lazy Sunday afternoon or at the most inopportune time such as bedtime, homework time, middle of his brother's tantrum.

To see life through the vulnerability of a food allergy kid is the greatest gift he could ever give me, filling me with courage, grace, and empowerment.  

The kids have been pretty good this year, and their stockings were certainly filled to the brim with goodies; as for me, I've already gotten my gift.