So we are switching to a new computer system at work. Not everything will carry over and we have to do some manual entry of certain things. Allergies is one of the items that falls onto that list. We are able to print out that info from the old system so we can put in onto the new, so the information has all been verified at some point by nursing staff or physicians. Which also means at one point it was all ENTERED by someone with a license or someone who is supposed to have enough medical knowledge to do such things.
Some of the "allergies" (complete with reaction, since it's a required field):
Nitroglycerin---"it makes my ears ring"
Tetnaus shot---"my arm hurts after I get one"
E-mycin---"diarrhea"
iron supplements---"makes my BM dark"
and my favorite:
Epinephrine---"makes my heart race"
Seriously?! I can shrug and say "meh" to many things, but truly?! WHY do trained professionals DO this? Go ahead and put some of these things down and attribute the poops after an ABX to a side effect, but not an ALLERGY. Yes, side effects, intolerances and allergies are all options to choose from.
I am not even entering the epinephrine "allergies", nope, not doing it.
My mouth will start to get tingly, then it will be very itchy and sore for a while. With fresh pineapple the reaction stays mostly in my mouth, but with nuts I'll get an upset stomach and cramps if I eat enough of it.
30 years ago if a child could not speak at 5 and did not meet development milestones, he was given "r" word as diagnosis and that was basically that.
Now, the much younger baby can be given any diagnosis out of a good dozen, and some of them attempted to be treated, more or less successfully. Moreover, everyone knows and pays some attention and so doctors tend to be involved earlier. Does it really mean that we now have THAT much cases of developmental delay? Probably not, we just find and manage some of them better, and that's good.
25 years ago, "pure" anaphylaxy had close to 100% mortality within 3 years from first attack. Since this, we got Epipens available to everyone who need them, we got brain cooling techniques, we learned how to treat shock better, we have better awareness and better laws protecting patients. Again, there are still about 1 person in 500000 suffering from it.. there are just more of us because we survive. Unfortunately, it also means that we multiply and our children carry high risk of allergies.
10 years ago, irritable bowel disorder sounded like something from last NEJM and someone who came to doctor complaining on gas, cramps and diarrhea with periodic constipation was given Tums and advice not to eat that much chili. There was one (1) center for the whole country where children with functional GI disorders were treated. Now, we can test for gluten sensitivity, diffirentiate between three absolutely different forms of milk protein intolerance and do many other interesting things...it doesn't mean that suddenly everyone got functional GI disorder or gluten intolerance, we just know much more about it all, and that's much better than just habitually spending hours doing you know what.
Last I checked (today), there are no biological markers (i.e., no "test") for gluten sensitivity. Diagnosis is made by eliminating Celiac Disease, IBS, or wheat allergy as the cause of symptoms, and then by an elimination diet. Did that change?
This just isn't true. Many people have gluten intolerance as opposed to Celiac Disease that make them very ill. I know...I'm one of them and I assure you it's not because I'm trying to be "trendy". I had to have extensive and expensive testing that showed I was positive to sensitivity and had the gene that predisposed me to it, as well as large numbers of antibodies. Normal gluten testing for Celiac disease does not show that. Please do some research before you make sweeping and ill-informed statements. The ignorance on this thread is astounding.
I do know what I'm talking about. I don't doubt your symptoms, and of eliminating gluten has helped- glad to hear it. But the evidence just isn't on your side on the non-celiac, gluten intolerance thing. Sorry.
"In a placebo-controlled, cross-over rechallenge study, we found no evidence of specific or dose-dependent effects of gluten in patients with NCGS placed diets low in FODMAPs."
I'm not saying you're a trend follower, but for many people- it is a trendy diet.
Specializes in Medsurg/ICU, Mental Health, Home Health.
My favorite was a patient who was "allergic" to artificial sweeteners. Now, I'm sure that's possible, but the reaction listed was "blood sugar dropped to zero."
Insulin allergy in patients with diabetes mellitus on insulin treatment is a rare condition. It is suspected upon noticing immediate symptoms following insulin injections
......
Yes, people can be allergic to a naturally occurring substance in their body
Nothing in the article said that, if you read the full text it actually goes into good detail about what causes allergic reactions to insulin analogue preparations, nowhere does it claim someone could have an allergy to insulin in general, if that was the case your pancreas would have killed you long ago.
As you mentioned earlier, you were on a sliding scale regimen because you were on steroids, which is usually reserved for IV steroids. It's quite probable that you could have received both your steroid and your insulin in the same med pass. If you've just received both a steroid and insulin and have sudden onset tachycardia and hypertension, it's pretty much guaranteed that reaction was caused by the steroid, particularly since an anaphylactic reaction to insulin would cause hypotension, not hypertension. Sudden onset tachycardia and hypertension are actually quite common following IV steroid administration.
Last I checked (today), there are no biological markers (i.e., no "test") for gluten sensitivity. Diagnosis is made by eliminating Celiac Disease, IBS, or wheat allergy as the cause of symptoms, and then by an elimination diet. Did that change?
Not yet, but if elimination works, then it works, supposedly. Although I personally kinda sceptical about things like "foggy mind" attributed solely to gluten sensitivity unless patient constantly has to spend too much nighttime in the restroom.
BTW, Ds of IBS is made the same way - just by exclusion of everything that could cause symptoms and then seeing if certain specific changes in diet/lifestyle/meds bring improvement. We know much more now, but still way not enough.
There may be some sort of rare non-celiac from of gluten intolerance, but there actually is very good quantifiable evidence that "gluten allergy" does not exist at anywhere near the level people claim it does, it's a "fad" in other words. In tests where those who claim to have non-celiac gluten sensitivity (NCGS) were given a gluten placebo they claimed to suffer from gluten exposure symptoms, and when they were given gluten but were told they eating gluten-free products they denied having symptoms. There are no validated tests for NCGS, although that doesn't keep unscrupulous medical (and "medical") professionals from performing tests and implying they are of some significance in diagnosing NCGS.
Things like this wouldn't be funny (to some of us anyway) if there was no truth at all to them:
Nothing in the article said that, if you read the full text it actually goes into good detail about what causes allergic reactions to insulin analogue preparations, nowhere does it claim someone could have an allergy to insulin in general, if that was the case your pancreas would have killed you long ago.
As you mentioned earlier, you were on a sliding scale regimen because you were on steroids, which is usually reserved for IV steroids. It's quite probable that you could have received both your steroid and your insulin in the same med pass. If you've just received both a steroid and insulin and have sudden onset tachycardia and hypertension, it's pretty much guaranteed that reaction was caused by the steroid, particularly since an anaphylactic reaction to insulin would cause hypotension, not hypertension. Sudden onset tachycardia and hypertension are actually quite common following IV steroid administration.
And IV steroids are very commonly used to treat respiratory ailments- which could explain the hyoxia. Being on steroids and being in the hospital are both risk factors for PE as well. Obviously I don't know the full details of the circumstances, but there seem to be scenarios more likely to account for the symptoms than a rare insulin allergy. However, thankfully this poster doesn't need to pursue an allergy work up at this time. Might not be a bad idea to anyway, in case a similar circumstance were to arise again, though.
Get emergency medical help if you have any of these signs of insulin allergy: itching skin rash over the entire body, wheezing, trouble breathing, fast heart rate, sweating, or feeling like you might pass out.
Insulin allergies are real and people do suffer from them. It can be life threatening real quick. They try to do sensitizations to it simnce people may need it. Even thbough your body does produce it, the manufactured insulins are still different.
In my case, it was not the steroids that caused the reaction, it was the insulin. I am not going into my medical history, but suffice to say after 28 years of nursing, I know the difference between an allergy and a reaction. I also list reglan as an allergy as it gives me panic attacks, and restless legs. It is not a true allergy but a bad enough reaction that I wont take it.
We're really not disagreeing on the insulin issue. I'm saying you can't be allergic to insulin itself, but can be allergic to components in the commercial insulin preparations. You're insisting you CAN be allergic to insulin, then linking case studies were people are allergic to certain preparations- such as the Insulin Nation link, which is a non scientific article about someone allergic to Lantus that was fine before they took Lantus. I can't take Lantus. I got awful welts at my injection sites when I did.
The second link in your most recent post is about a 12 year old allergic to metacresol- an antiseptic component found in commercial insulin preparations.
Again, I'm not arguing that you can't be allergic to certain components in insulin preparations.
CountryMomma, ASN, RN
589 Posts
My mouth will start to get tingly, then it will be very itchy and sore for a while. With fresh pineapple the reaction stays mostly in my mouth, but with nuts I'll get an upset stomach and cramps if I eat enough of it.