Thursday, August 13, 2009
I got stung by a stinging insect on Saturday while riding my bike. I didn't even see it, since I was descending Stevens Canyon road at well over 30mph. First I felt a burning, and then I felt my glove feel extra tight and a burning sensation. Fortunately I was headed home anyway and got home within 15 minutes. By that time, my hand had become incredibly swollen! I had been stung many times before by insects, but never had such a reaction!
What really scared me, however, was that old sting sites started popping out of my skin as my body remembered every sting, every insult inflicted upon my body by insects previously. It was scary. I went to a doctor and he didn't seemed terribly worried, but prescribed me an epipen and prednisone "just in case I wanted to take a more aggressive approach." I did take Claritin right away, since my research on the web told me I should take an anti-histamine and I had it handy.
The next day, the swelling still wasn't down, so I took Prednisone and Benadryl. It took until Monday for the swelling to come down a little, and I stopped taking prednisone then, but kept taking claritin. By Tuesday I could ride and now I'm almost perfectly normal.
I did see my allergist today, however, and she told me what I should have done. First of all, epipen is nothing more than adrenaline, and your body knows how to produce it. So the first thing I should have done was to immediately turn around and hammer up a hill at maximum heart rate to induce my body to generate adrenaline. That works for at least 15 minutes, and apparently there are stories about folks who produced enough adrenaline to eliminate any reaction whatsoever (usually those were folks running from angry beehives!). Then, I should have immediately popped benadryl and then prednisone. Apparently, the sequence of events goes like this: sting -> epipen (works within a minute, lasts about 15 minutes --- long enough to get you to a hospital) -> benadryl (works within an hour) -> prednisone (takes about 6 hours to be fully effective, but starts working after a first hour). The epipen is just to get you to a hospital where the doctors will make you pop benadryl and prednisone. Claritin works too slowly to be of use in insect sting situations. Apparently, if the doctor I saw knew what he was doing, I could have saved myself a lot of grief, and might even have averted a severe reaction. This is not the first time that made me realize that the same huge difference between programmers also leads to a huge difference between doctors.
I asked, "So why don't I just do that and not go to a hospital?" "Because you're not a doctor," came the reply.
In any case, I was warned not to get stung again within the next month (I wasn't planning on it, thank you!), and then to submit to a skin test and then start insect venom immunotherapy sessions. She also gave me a prescription for 2 more epipens, along with instructions to carry benadryl and prednisone while I'm traveling in Japan.
Followup: I'm now on allergy immunotherapy shots