One of the few unfortunate aspects of Northern California living, especially for someone like myself who suffers from hay fever, is the ungodly high pollen count in the spring. In the year 2000, at the age of 40, I started seeing an allergist and started a regimen of immunotherapy (allergy shots). The decision came after an especially severe episode at Eagle Ridge Golf Course in Gilroy that had me taking about 6 times the recommended dosage of a combination of Benadryl and Allegra. The call I made to Dr. Blessing-Moore in Palo Alto was probably one of the most important, life-changing phone calls I’ve ever made. It made a huge difference in my health, both physically, and emotionally. I did have a harrowing misadventure about two months into my treatment:
THE MOUNT WHITNEY JOURNALS — Book II– 2002
There are some critically important safety protocols that the patients receiving immunotherapy are required to follow. And they become even more important as the patient graduates to the more potent vials of antigens. Adverse reactions to the shots become more likely as the dosages and dilutions become stronger. There are three main safety precautions. The first is that the patient is required to remain in the waiting room for 30 minutes after the shots are given in case a negative reaction occurs. It’s generally undesirable for the patient to be driving down the freeway when his eyes or air passages swell shut. Precaution number two is that each patient is required to have an Epi-pen, a long epinephrine-filled plastic tube with a needle on the end. In case of a full systemic reaction, the patient can inject himself in the thigh with the device, similar in concept to the scene in Pulp Fiction when John Travolta (Vince Vega) stabs Uma Thurman (Mia Wallace) in the heart with an adrenaline-filled syringe, albeit without the snappy, profanity-laced dialogue. Although I suppose depending on the patient, some ad-libbing of profanity might be appropriate. The third safety measure is that the patient must take an antihistamine at least an hour before receiving their shots. The 30-minute wait and the Epi-pen were deeply embedded in my memory and I followed both of them religiously. Somehow the antihistamine part of the safety triad wasn’t properly entered into my short, medium or long-term memory and therefore didn’t get incorporated into my safety regimen. Nevertheless, it wasn’t much of an issue as I made my way through the first few months of my shots as I was being given the weaker dilutions of my antigens. The only adverse reactions I’d experienced had been some mild swelling and inflammation in my triceps where the shots were administered.
After several weeks of shots, I was ready to graduate from dilution 2 to dilution 3. To my chagrin, there was no ceremony, no speeches, not even a cupcake. But I took the disappointment and my shots like a man and returned to the waiting room to read for 30 minutes and then head to the gym. In recent weeks, I’d been cheating a bit on my after-shot waiting period, leaving a few minutes early at times. I figured that the systemic reactions I’d heard about would only happen to the weak, the infirm, and Republicans. Until then my reactions had been minimal, a little bit of itching and swollen triceps, which I really didn’t mind because they made my arms look beefier. I even lobbied, to no avail, to have the shots injected into my biceps and pectorals. I had no reason to believe that today’s reaction would be any different, although I should’ve been more wary since I was on a new, stronger vial. After 20 minutes of waiting I was growing a bit restless and was considering leaving early for the gym. Instead, I left the office for a moment to get a drink of water from the fountain in the hallway and to use the bathroom. On the way out of the bathroom, I splashed some cold water on my face and then returned to the waiting room. As I took my seat, I found myself becoming nervous and agitated. Moments later, the insides of my ear warmed and started to itch violently. I began to realize that perhaps this wasn’t quite normal so I got up to inform the receptionist at the front desk. My well-honed instincts told me that I was having a negative reaction to my shots. This instinct was confirmed when I approached the receptionist and nurse at the desk because I was only able to get, “Excuse me, I think I’m having…” out of my mouth when they grabbed me and yelled out something dramatic like ‘Code Blue’ or ‘Yahtzee’ or ‘Free beer’. Within seconds I had a crew of nurses and Dr. Blessing-Moore herself working on me like a NASCAR pit crew. They seemed to come from nowhere; coming out of trap doors in the floor, clambering out of cabinets and dropping down from ropes in the ceiling. Suddenly Dr. Leonard McCoy from the Enterprise materialized and blurted out ‘dammit Jim, I’m a doctor, not a bricklayer’ and I realized that my mind might have been playing tricks on me.
I was immediately given several injections by a couple of the nurses, and directed to take some pills by Dr. Blessing-Moore as she felt my pulse. Another nurse took my blood pressure and another put a heart-rate monitor on the end of my fingertip. At first I didn’t consider my situation alarming and I was almost clinically fascinated by the proceedings as if it were happening to someone else. But as I saw how fervently the staff was reacting and continuing to work on me, I started to feel that I was in more danger than I initially thought. This was not the ideal situation for one who is predisposed to hypochondria. As I sat there, I was only moments into pondering the end of my life, wondering who’d attend the rosary and funeral services, what would be said during the eulogy, if ham sandwiches and linguica would be served, when the doctor patted me on the shoulder and said I’d be fine and then breezed out of the room.