Just about two weeks after my daughter, Shaylyn’s 4th birthday, she was with my husband in our downstairs family room and pestering him for a pistachio nut which he ate quite frequently around her but she had never shown interest in before. (I do not like nuts of any type, so we never had food with nuts in it in our home. My husband only ate pistachios.) He finally gave in and handed her one, she put it to her lips and immediately she said my lip burns. She had a small cut on her bottom lip and he thought it was the salt so he told her to put it in her mouth and chew it up. She did, she started to gag and cough, he thought it was the texture so gave her a drink of Gatorade® to wash it down. She started crying and coughing (I believe she knew something was not right and could feel the reaction). He could not calm her, so he sent her upstairs to see me, by the time she got to the kitchen her lips were swollen, her face was swelling and she was coughing and wheezing, this had been only a couple minutes at most.

I had no idea what was going on, at about that time my husband came upstairs. I asked what had happened and he said, “I don’t know”. I said, “Something must have happened down there”. His response was “I just gave her a pistachio to eat”. I said, “call 911, she is having an allergic reaction to the pistachio.” My husband could not believe it was from the nut, he kept asking, “are you sure, are you really sure?” He had no knowledge of food allergies at all. Fortunately, I had past experience in caring for a child who had a severe allergy to milk and also a young lady in a high school choir who had anaphylactic allergies to peanuts and tree nuts. I just knew this reaction was more severe than a mild allergic reaction by how fast it was progressing and spreading.

Just after placing the call to 911 she started to turn bright red with hives, huge welts that covered her entire body and her skin was very hot to the touch. Then her entire body proceeded to swell, arms, legs, torso. She eventually stopped talking to us and was no longer taking in much air as her airway was swelling shut. By the time the paramedics arrived at our house 7 minutes after the call was placed to 911, our daughter no longer had breath sounds. Her entire body was swollen to the point that we could not make out any facial features and could just barely see the tips of her eyelashes.

They immediately gave her a shot of Epinephrine, Benadryl® and steroids in her leg. They started her on 100% oxygen and listened for any airway sounds, there were none. They said, “Who is going with us we are leaving now?” Once in the ambulance they placed an IV to force fluids into her to keep her blood pressure up as it was dangerously low. They started her on an Albuterol nebulizer in conjunction with the 100% oxygen to help her breath.

When we arrived at Memorial Hospital the ER doctor gave her another shot of Epinephrine and steroids, she still was not stable. The respiratory therapist came and started the Albuterol treatments again with the oxygen. Then Shaylyn started vomiting. They said this was part of the reaction and a good thing, as her body was getting rid of the allergen.

About 2 hours after the initial reaction started the doctor felt she was stabilized. However, he did not feel she was well enough to go home and needed to be hospitalized. So she spent the next 24 hours in the Pediatric Special Care Unit. While there, she was given Albuterol nebulizer treatments every four hours, Benadryl®, and steroids. When she was released late the next day, they sent us home with two Epipens®, instructions to continue the Albuterol treatments for another 24 hours and the Benadryl® and steroids for another week. Shaylyn continued to show swelling for about a week after the allergic reaction.

Four years later, Shaylyn remembers the reaction and knows that she does not ever want to feel that again. She is very good about telling what she is feeling when she is experiencing a reaction and asking for her medication when she needs it. We have learned to listen very closely to what she says and that in turn gives us a clue as to how to treat her.

Alicia
Colorado Springs, CO