Having Anaphylaxis as a Nurse Because of a Latex Allergy
At 18 years old, I was officially diagnosed with an allergy to latex. Looking back I recognize it had been developing; as a child I had difficulty with putty and bandages. When I started in healthcare at 17, latex gloves were standard. I was having progressively worsening reactions with local hives and swelling every time I wore them. An IgE blood test confirmed I have a latex allergy. This diagnosis signaled a drastic change in my life.
Less than 1 percent of the population is allergic to latex, however it is estimated that 8-17 percent of healthcare workers have a latex allergy. It is hard to imagine living with a latex allergy, and sometimes people have a hard time believing something that’s a part of everyday living can be so dangerous. I can’t change a tire, I can’t touch the bottom of my shoes, yet I leave my shoes on when in other people’s homes in case there is rubber backing on the flooring. I have to be careful when I shop for clothes, and attending parties is hard if there are balloons.
Nursing while allergic to latex poses a unique threat. Latex hides in places most people don’t notice. Let’s walk through a few moments of my day. You send me a chart and I pick it up. I don’t see the rubber band stretched around the back cover to keep a folder in place. I reach into the drawer to grab something and there’s a pencil in there, I hit my hand on the eraser. The physician refuses to use synthetic gloves because it affects their sense of touch. The pressure dressing tape you stretch sends particles of latex flying. I believe I spend more time reading packages in the hospital than anyone else. Does the cap have latex under it? If it’s not labeled as “latex free,” but not labeled as “contains latex,” how much of a risk do I take?
A few months ago, I experienced my first anaphylactic reaction. I’ve been working in healthcare my entire life. As a nurse, I always knew a latex allergy was a progressive allergy, but you never expect it happening to you. Someone opened a product I usually don’t work with before I arrived. It grazed my arm, just barely. I was fine, as usual. My arm swelled a little and got a little red, it’s happened before. A little antihistamine and I’d be fine. And I was, until rapidly I wasn’t. Suddenly, hives were around my lips and my mouth was swelling. I had been carrying an epinephrine auto injector due to what I thought was an over abundance of caution because of my work environment. I injected myself, and feeling a bit foolish headed to the emergency room. The wonderful ED physician took me seriously and started an IV, gave me some steroids and an H-2 receptor antagonist and told me I had to wait six hours before he could send me home.
Shortly after, I told him I just didn’t feel right. I was that patient, the one who can’t tell you what is wrong but something definitely is. Thankfully, this doctor was smart enough to realize this was what we refer to as “impending doom.” I felt this way because I was beginning to go into anaphylactic shock. I couldn’t breathe, and my voice was hoarse. I had hives all across my torso, arms and neck. Friends and doctors gathered at my bedside and discussed intubation while I was now unable to speak. Nebulizers and more epinephrine and more antihistamines and sheer terror as they cracked open the orange “airway box” next to my bed. Tears rolled down my cheeks even when I couldn’t squeak out a word. We managed to avoid intubation due to my emphatic shaking of my head no. Looking back, I am sure I was foolish and it was the safest option, but I got lucky. This, however, was sadly a cycle that would be repetitive with two more near- intubations. It was not until multiple reactions had occurred we discovered I was having anaphylaxis to the rubber stopper in the IV steroids prescribed to break the cycle.
Every day I live my life with these risks. I know I am anaphylactic, and it’s scary. I am grateful for my co-workers, who routinely take rubber bands off my charts and wipe them down, who will fish in the drawer for me so I don’t have to worry, and who graciously accept when I need to step away from whatever I can’t avoid. Friends have learned to use the epinephrine auto injector, in case I am unable to do so myself. I wear a medical alert bracelet and have a living will complete with power of attorney in case I am unable to speak for myself. I can’t stop my life due to this allergy, but I can surround myself with people who are willing to help me live with it. And I can educate more people about it and try to make healthcare workers more compassionate about taking care of allergic patients.
Latex allergy is real. The feeling of impending doom is real.
Some patients really are allergic to strange things, and they aren’t joking. Anaphylaxis is the most frightening experience I can imagine. The quick actions of an astute physician, and the love and support of my friends is the reason I am here today. Sometimes the patient with allergies too numerous to count really is right. The line between life and death is thin and our patients are counting on us.
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Thinkstock photo by: robeo