when to use my Jext pen

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wentworth
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by wentworth on Wed Feb 22, 2012 11:56 am

when to use my Jext pen

Hi, I was wondering if I should have used my Jext pen last night. I had a reaction to a dessert whilst out celebrating my Son's 5th Birthday. Immediately after eating half of my dessert I noticed my lips start to tingle, then my tongue and throat, I took 2 anti-histamines and my blue inhaler and although it didn't clear it up it wasn't affecting my breathing I did start to get a bit worried that it wasn't going to stop. It felt like pins and needles and a lump in my throat, then my right arm started to tingle. I fell asleep after a couple of hours and when I woke later I was fine.
Today I've noticed tingling, although not as bad as last night after eating 2 hot cross bus, today it feels like the aura I get when I'm having a migraine attack, again I'm not having any problem breathing and feel fine in myself.
I don't know what I'm allergic to yet, I had a blood test last Wed and they are testing for allergies to mushroom, soya and lupin, I've rung the restaurant up and none of those are in what I ate so I guess there's something else too!
I was only given my pens on Wednesday last week and am a bit unsure of how quickly I should use them. Should I have used one as soon as my lips and throat went tingly or was I right to wait and see what happens?
Thank you for your help
Vicky

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Dr Stephen Till
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by Dr Stephen Till on Wed Feb 22, 2012 1:17 pm

Re: when to use my Jext pen

Generally if you are prescribed an adrenaline auto-injector you should also be trained to use it and given clear guidance on the symptoms which should prompt use. From what you describe, you did the right thing. You should use the injector if you develop difficulty breathing e.g. because of swelling in throat or mouth) or if you become lightheaded or feel like you will pass out (suggesting low blood pressure). Using the injector is only one part of the management - you should also call an ambulance. Tingling in the mouth by itself should not trigger use of the injector. It that case, taking an antihistamine and waiting is correct. Incidentally, tingling in the arm would be an usual symptom of an allergic reaction.

However, first and foremost it is important to try to establish if and what you may be allergic too. Blood tests alone are usually not sufficient. A full allergic history is essential or the blood tests have little value. It sounds like you should see an allergist and it is worth discussing this with your GP. An advantage of going to an allergy clinic is that the issues about using the injector can also be sorted out at the same time.
Dr Stephen Till
Consultant in Adult Allergy, Guy's and St Thomas' NHS Foundation Trust

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Dr Helen Brough
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by Dr Helen Brough on Wed Feb 22, 2012 1:24 pm

Re: when to use my Jext pen

Dear Vicky,

The main worrying feature in the reaction you described was the lump in your throat. If you felt that this was causing difficulty breathing then yes you should have used your Jext pen, however if it was not affecting your breathing then you did not need to use it yet. In addition if you are having breathing difficulties you should call an ambulance. I hope that when you went to sleep somebody was watching over you!

It is unusual to get tingling down your right arm with an allergic reaction without any overt urticarial rash, hives or swelling. It is important that your doctor confirms whether you do have a food allergy, otherwise symptoms such as tingling could be misinterpreted as food allergy, whereas actually it is due to something else such as a migraine which you said you suffer from also.

Kind regards,

Dr Helen Brough
Clinical Lecturer in Paediatric Allergy
Guy’s & St Thomas’ Hospitals, London
Dr Helen Brough
Consultant in Paediatric Allergy
Guy's & St. Thomas' NHS Foundation Trust

http://www.talkhealthpartnership.com/on ... brough.php

wentworth
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Joined: Wed Feb 22, 2012 11:32 am
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by wentworth on Wed Feb 22, 2012 4:55 pm

Re: when to use my Jext pen

Thank you for your replies,

I think the only breathing issues I had was when I was worried that it wasn't going to clear up and I think I panicked slightly, started to breathe rapidly so tried to controll my breathing, the lump in my throat didn't seem to impare breathing, but swallowing was getting difficult, my Husband was in bed with me but was asleep before me as like I said I was a bit worried and so sat up and watched TV a bit to monitor myself for a while.

I have been refered to an allergy clinic at Kettering GH which is where they did the blood tests and issued me the Jext pens after looking at a food diary that I've kept and asking lots of questions. I was told to use it if I had trouble breathing, swelling or felt faint, but I was unsure if the bad pins and needle feeling in my mouth/throat was swelling or not, and how long to wait and see as a nurse at my GP practice told me to use it at the first sign of any problems with my mouth as things can change quickly, or I could think I'd be ok and a couple of hours later, whilst asleep for example things could deteriorate which is why I was in a quandary as it was getting late and the anti-histamines had made me sleepy. My next appointment at the allergy clinic is in 3 months time.

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Dr Stephen Till
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by Dr Stephen Till on Wed Feb 22, 2012 5:44 pm

Re: when to use my Jext pen

It is difficult to discuss all these issues on a forum - perhaps try the helpline at the Anaphylaxis Campaign (www.anaphylaxis.org.uk), who may be able to provide some further advice. Certainly, from the information you provide you did not need to use the injector on this occasion. If swelling is sufficient that it starts to interfere with breathing, it should be used. However, I think you would benefit from talking this through in person with someone who is trained in this area (e.g. specialist nurse or doctor).
Dr Stephen Till
Consultant in Adult Allergy, Guy's and St Thomas' NHS Foundation Trust

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