She is allergic to shellfish. She ate shellfish deliberately, counting on Benadryl to prevent the reaction, because she just loves shellfish. By the time I got to her, the squeezing in her chest and throat was putting her in a state of panic.
But you don’t understand, see, she does this all the time. Why didn’t the Benadryl work this time? Well lady, it did work, for about 6 hours. Where’s your epi-pen? At home. Where’s home? Three thousand miles away. Vacation. You know how it is.
Can you believe I’ve been an EMT for a year and a half, and haven’t had this call until yesterday? Everyone jokes about the typical “dumbass” patient with preventable allergic reactions, but I was beginning to suspect the phenomenon was a fairy tale. I mean, who goes on vacation without their epi-pen, and decides to deliberately consume something that has put them in the emergency room several times before?
Is that your first ‘deliberate dumbass’ call, versus the felonious stupidity type?
I haven’t had any (first person) DDs, but lots of the FS type. Probably the best so far was a 10 year old kid that shot his toe off while deer hunting with a 12 gauge. The local deer hunters have a habit of resting the muzzles of their guns on the toes of their boots so they don’t plug them with mud; the kid forgot to take his finger off the trigger. Lost about half of his 2nd toe, with no other damage.
Had one guy put a knife through his instep playing mumbly-peg (a knife-throwing game), and more busted arms from skateboard and bicycle hotdogs than I can count.
I did have a second hand deliberate dumbass call a couple of weeks ago. A COPD patient had a bipap machine, and was sick. A family member didn’t think it was doing any good so she took it off, then could not understand why he was suffocating.
That is sad and funny at the same time. Was the family member mentally challenged? Beneficiary on the will? Psychopath, even? It’s hard to attribute something like that to just regular old run-of-the-mill stupid.
This was not the first dumbass I’ve helped by any means, but the first deliberate one. I heard about the “I ate it with benadryl” allergic reaction types before, but this was the first time I saw one in the wild.
My mom works as an RN at Disneyland, and one of the most common refrains they hear from guests in a medical emergency is “but I’m on vacation!”.
Right, because diabetes stays at home, so you don’t need to test your blood sugar and take your insulin. BTW, those incredibly delicious caramel apples you’ve been scarfing? They don’t have any calories or sugar in them at all. Just keep scarfing.
I think the worst one she told me about was where a dad started having symptoms of a transient ischemic attack (a series of very small strokes that may or may not cause permanent damage but certainly don’t bode well). Not only was his reaction “but I’m on vacation!” it was also “but we’re in LA for medical treatment for kid #2, therefore no one else can possible need medical treatment!”. Mom had to take the wife aside and explain there was a four hour window for the clot-busting drugs, and once that was gone, she might as well slap a WonderBread bag on his head, because he was toast. (She didn’t put it quite that way. Disneyland has standards, you know.)
Seven or eight years ago I became allergic to sesame oil. Now I have to carry a couple Benadryl pills in my pocket wherever I go because, although not a common ingrediant, you just never know.
Oh yes, good old TIA (transient ischemic attack)/stroke. You’d think that having one side of your face droop to the point where it affects speech, and having that side of the body not work so well in general would be a bad thing, wouldn’t you? No reason to go to the hospital there, nope, even though you pride yourself on your medical knowledge, take tons of vitamins per day, and even adjust your own medication doses (and your wife’s) because you know sooooo much about your health from your claimed pre-med college days over 50 years ago. Cue waiting until your wife gets worried enough to call one of your adult children who says ‘you’re going to call an ambulance, or drive him to the ER; I’m driving over on my way to the closest ER and you’d better be gone or I’m putting him in the car myself.’
And of course, years later, the story is ‘what TIA/stroke? I didn’t have that. The doctors couldn’t find out what was wrong with me. I was a medical mystery.’ :smack: Uh, no.
I also carry my anaphylaxis kit, though I’m only allergic to chicory. New Orleans coffee and high-fiber grain products are usually right out.
We had to do something like that when my father-in-law had a TIA. We got a call from his son (my wife’s brother), with whom FIL was staying: “Dad couldn’t talk when he came out of the shower. I’m going to soccer. Just wanted to let you know.” Dad didn’t want to go to the hospital, so we had to drive down there (20 minutes away) and put him in the car while he protested that he was fine now (I didn’t know whether EMTs could force someone to go with them against his will - still don’t know, actually).
I understand the old man thinking “That was weird, but it passed”, but I will never understand how his son could be so stupid to ignore the obvious stroke-like symptoms and selfish enough to go to soccer even though he knew something was wrong with his father. If Uncle Ken ever wants to know why my kids don’t sleep over his house, that’s why. “Sorry, kids. Uncle Ken is too stupid and selfish to watch you.”
I sent you the story off-line, because the whole thing is a bit much for a fast reply. The short answer is she is a young woman with the IQ of a toaster. You’re right about run-of-the-mill stupid; this kind requires in-breeding, which I’m certain had occurred.
We can’t. Unless a person can’t make decisions for themselves, they’re allowed to refuse help. It happens all the time. A lady involved in a car accident bad enough to knock out nearly all her teeth refused to go to the hospital. You wouldn’t believe how many people who are sick or hurt refuse to acknowledge it. The rule (guideline?) is generally that the sicker someone is, the more denial they’re in. The opposite is also true, that the fewer symptoms someone has, the more convinced they’re suffering from an exotic disease.
I’ve had a few episodes of cellulitis, with my temperature shooting up to 104 F. When my temp gets over 102, I get incredibly stubborn. Or more incredibly stubborn, if you like. My husband (and daughter, if she’s visiting) now have standing instructions to get me to the ER if I have a fever of over 102, because my brain just isn’t working right. Or, if you prefer, it’s working even less right than is normal for me.
No, it doesn’t make sense. But when you’re that sick, NOTHING makes sense.
I took a call one night regarding an elderly gentleman, on oxygen, who pulled down his mask so he could light a cigarette. He neglected to turn off the airflow to his mask.
His nurse managed to put out his face before too much damage was done. That’s one of my motivators to continue not-smoking - I don’t want to be an old woman on oxygen who sets fire to my own face.
You might very rightly call me an idiot for it, but I’ve refused to be taken to the hospital because of a lack of insurance. So yeah, I can vouch that this sort of thing is common.
A patient died right in front of me, after eating shrimp. Prior to that ingestion, shrimp always made him itch, sneeze, and flush, but it had never killed him before!
But he became a pulseless non-breather (i.e. ‘dead’) as I was examining him.
He’d driven himself to my office, because after eating the shrimp, he began to have more chest pain and shortness of breath than usual. He staggered into the waiting room, where my assistant noticed he was in distress, and dragged him to the treatment room and got me.
I quickly recognized that he was circling the drain as his blood pressure fell, his heart rate accelerated, and sweat poured off him, while hives the size of paperback books came and went on his body. I drew up a syringe up epinephrine.
We had JUST gotten an IV started, and suddenly he said “I can’t see you, doc! I can’t see you anymore!” His heart rate shot up to 190 or so, and his pulse disappeared as his blood pressure fell to zero. He stopped breathing.
I didn’t let him stay dead, but if he’d pulled this anywhere except in front of a doctor with an IV already in place to shoot him up with IV epinephrine and resuscitation equipment right there, he would have remained dead.
Epi brought him back real nice in under 30 seconds, but he sure did bitch about the headache it gave him.
Assuming that your mother was treating the diabetics for low blood sugar as opposed to high (in which case would probably mean DKA and therefore the diabetic patient would not be particularly lucid), in the above example, they are not pretending they’re not diabetic while on vacation, or forgetting to take their insulin, because too much insulin is what makes you low. It’s fookin’ hard to figure out dosages for food you’re not used to eating, like what you get at when you’re on vacation at Disneyland.
Going low while eating unfamiliar food is an unfortunate side effect of insulin-dependent diabetes, and it’s not just something that happens when eating sugary unhealthy food - a sandwich can cause it as easily as a caramel apple. Heck, the worst low I ever had was after eating an ear of corn on the cob!
I don’t mean that there are not idiots out there, or that there are not diabetic idiots, but we’re all about fighting ignorance here, right?
I had a much more recent call for a woman in respiratory distress; she had an advanced case of congestive heart failure, so much so that she was blowing foam with every gasp. We had to call for a paramedic intercept because she needed a CPAP and we don’t have them yet.
Her husband swore up and down that she had no significant medical history. Yeah, right.
A snootful of epi makes you fidgety, and a matching dose of diphenhydramine makes you sleepy. Mix the two, and sell tickets to watch your patient snore and squirm at the same time…
ETA: I bet his epi headache was nowhere near as bad as one caused by nitroglycerin.
Threads like these remind me that maybe I should carry an epi-pen with me…
I stopped getting them when I lost my medical insurance. Now that I have in insurance again, yes, really, I should have one.
Really, what I’d like is a thorough work up by a real allergist as I know my allergies have changed since the last time that was done… oh, 30 years ago. Some things no longer cause a reaction, and I’ve acquired new ones. But I’ve been SOOOOOO good about staying away from allergens that the insurance is not convinced that I need such a thing and won’t authorize seeing a specialist.
>sigh<
Eating while on vacation is a trial - I never know what’s really in the food. The servers don’t care if I live or die, because they don’t believe me when I say it’s really that serious that I not be served tomatoes or the like.
I have some food allergies (tree nuts and most types of fresh fruits), but I’ve never been prescribed an epi-pen. I’ve never asked why. I guess my particular allergies are 1) fairly easy to avoid, and 2) not terribly severe. Just enough to make me itch and wheeze a bit, and all the skin on the inside of my mouth peels off. Icky, but hardly fatal.
I also have a veritable cornucopia of inhalant allergies. Plants of all kinds, stuff with fur and feathers. You know, everything. But after 3 years of allergy shots, I almost don’t feel it at all.
