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Allergy shot question-Judy ???

Funny you should ask, Sue. When I came in last for my shots (about 2 weeks ago), they had to mix new serum for me. I had seen the allergist just a couple of minutes before, for my periodic followup, but it didn't seem to be a big deal.

What my allergist's practice is, is to initially order enough serum up front to last me for a long time. (Don't know how long, but it must be a couple of years, since they've only ordered it once back in November 2006.) Then in the office they dilute some of it to the concentration that I'm at and save the concentrated remainder for future dilution and use.

Maybe ordering new serum would be different, I don't know. I suppose with new serum there could be a possibility that it would affect you differently, due to a different manufacturer, possibly. I don't see how it could be "stronger," because they dilute it to the concentration you're at before you get your shot. With emergency procedures and personnel readily available where you get your shots, it seems more likely that your doctor wanted to bill for an office visit rather than for a (much cheaper) shot visit. Or if you have had serious reactions to shots in the past, maybe they're being overcautious.

Anyway, those are my thoughts. I'd be annoyed as well with this situation. Hope it helps! Take care. Judy

Just wondering if you guys have an EpiPen?

When I was going though the allergy shot program I had to have an EpiPen. The nurse who seem to know my habits, wouldn’t even let me have the scrip for the Pen, she called it in to the Pharmacy and then requested to see the pen at every trip to the office…LOL.

I’m not much help with new batches of serum, although I remember having to stay at the allergy office longer after the shot (in case of a reaction) every time they started a new dosage level.

Rich

I don't have one either, but it sounds like your shot nurses were as strict as mine are. When I went once for new serum, I caught a virus the day before the dr appt. I coughed a couple of times in the waiting room, a nurse came out & said "who was that coughing" I raised my hand & she said, "well you're not getting a shot today" I can't seem to hide anything from them although I have sure tried many times. Judy, they say that the serum, once diluted weakens over time. My serum lasts almost a year because the # of ccs they put in my shot is slightly less than normal. So they say that by the end, it is weaker, & when you get a new serum, it is more potent because it has just been prepared. I don't think it's my dr wanting an extra fee though, because I would have to see him at least once/year anyway. My annoyance was that I agreed to see him to have him prescirbe the serum, I just wanted to hold off on getting the shot for a couple of weeks. I think that the rule must have been put in place for people who take their serum elsewhere, & they weren't flexible enough to bend it even though my situation was different. Oh Judy, don't you love those arms? I once had swelling all the way around my arm, up into my shoulder. That kind of freaked me out. The good news is, I was getting sick after almost every shot so the dr reduced the dose slightly, & now my reactions are much smaller. I still get swelling & redness, but just huge welts instead of the whole arm. Yours might get better after you have been at maintenance for awhile. The bad news though-one of the nurses told me that a patient who stopped the shots a few yrs ago told her his arm still itches during pollen season. Yuck!!!!!!!!!!

Hmm, that's interesting about the serum. I can see how it would get weaker over time, that makes sense.

About getting a shot when you're sick -- I made the mistake once, early on in my shot regimen and being fairly ignorant of things, in getting a shot when I was in a mild asthma flare due to a cold. And then I went to a party where the homeowner had a dog (which I'm allergic to). What a huge mistake! I think I had to go on pred for about 2 weeks after that. Never again. Now I don't even go for shots if I'm having the least bit of allergy or asthma symptoms. I know it's wimpy of me.

I have been on maintenance for quite a while now (truly, I forget how long) and only get shots once a month. I find that when I space them every 2 weeks I don't get such a reaction, so I try to remember to do that. When my arms swell like that I just tell everyone it's extra muscle from weightlifting, LOL. Just call me Popeye.

Judy

Nope, I do not have an Epi-pen. I'm more on the mild end of the spectrum in terms of allergy shot reactions -- although my arms usually swell up like a gorilla's after my shots (which is a very beautiful look, let me tell you), I have only had asthma symptoms a couple of times and not very serious ones at that.

Rich, I do suspect the docs save the Epi-pens for those who are NORMAL like you!

Judy

Thank you all for this discussion. I am new to allergy shots. My mom had them when I was younger, but that was a long time ago and a different less, allergy prevalent state.

I thought my allergist was a little cautious. It is a research institute and she uses a stronger serum than most. They are very strict with everything. Every person receiving shots from them must have an Epi-pen with them and extra anti-histamine within an hour of shot time. They are also strict about having any asthma symptoms the week before shots. Since I am on weekly shots and barely have my asthma under control (and have VCD also)...I haven't had a week with no symptoms. I go any way...LOL. It is impossible to avoid my worst trigger (any kind of odor including food smells) and have any kind of a life. So I don't worry about mild problems. I haven't gone yet this week because I am having a lot broncho spasms and coughing (and I decided I had to break down and admit I was in the yellow zone again last night). I haven't been caught yet, but I did scare the poor girl when I coughed (choked) a little turning in my timer last week.

I haven't reached the point of having more serum mixed, but I have heard it mentioned and they have a "procedure."

About the swelling. I have had some large reactions also. Most have been around the size of a softball, but one went from my elbow on the inside of my arm up to my shoulder on the outside of my arm and around to the back side of my arm. That was about 6 weeks ago, and I am still have a little of the redness. I called and the head nurse did not seem too concerned. My doctor was out of town lecturing, but they sent her a message and she said that she thought it was just the location of the needle that time. They did say that if it happened again to be sure to come in and have it checked, they may need to reduce my concentration. They have me taking an extra Singulair an hour before my shot also. That seems to help some. How do you all treat your swelling, pain, redness and itching? I have found that the more I do for 24 hours after the shot the worse it is (ie - exercising and house work are out of the question). The office staff says to elevate and ice it - but doing that once a week for a day or two wastes a lot of time.

Thanks, Sonya

Hi Sonya, my office doesn't get upset about the swelling if it's small, but if it is big or is still there the next day, they want to reduce the dose. I don't tell them anymore, because my arm is always more swollen than they like & it always lasts 2-3 days. Ice, ice ice is the ony thing that helps me. I got an ice pack, one of those thin ones with some kind of fabric on the outside. I got some of that self sticking medical tape & just wrap it around to hold it on my arm so I can still do whatever & not just have to sit around.

Judy, btw, now that you mentioned it, I had a lot of problems when I switched from 2 weeks to monthly, I had more & more reactions. That is when we decided to lower the dose. I tried to take my shots sick a number of times, but got busted every time. those nurses are like detectives, lol.

Sonya, I do a couple of things. First off I take extra antihistamine (an extra 5 mg Zyrtec on top of my daily 10 mg Zyrtec), I take ibuprofen or Aleve (which are anti-inflammatories that help with pain), and I will sometimes use a topical Benadryl gel. And like Sue, I use ice, usually putting it on when I'm at home at night reading. But my reactions seem so variable and I haven't hit on one magic solution for avoiding reactions or for reducing them once they occur. It does help to get my shots every 2 weeks rather than once a month, though.

Regarding activities after shots, my allergist told me two things: number one, try to avoid your allergens as much as possible after your shots; and number two, no exercise for 2 hours after the shot. Number one is hard to do -- when there's high mold or pollen in the air, should I stop breathing? LOL

Hope this helps. Take care & good luck. Judy

Thanks Judy and coffee16.

I take Claritin everyday, and can take several extra of those if I want (and with current pollen counts, I am starting today), but I take a XyZal (sp? - prescription anti-histamine) and an extra Singulair as pre-shot meds.

I can't take NSAIDS - asthma attack. It only happened once and was very mild, but I have avoided the ibuprofin and aspirin ever since, and the way I have been this year - I am not going there! I haven't tried Tylenol because I have been on so many meds this year that I didn't want any more and I didn't think it would help much not being an anti-inflammatory drug. However, Tylenol should help with the pain and localized fever. So I guess I will add that to my pre-shot routine this time and see how it works. Thanks for the idea.

I have used a topical Benadryl, but it didn't seem to help. The nurses recommend allergy eye drops. Those do seem to help with the itching only.

coffee16 - I personally don't consider soft ball size swelling small, but the office staff is not concerned with it. Nor are they concerned that it lasts a week sometimes. I have gone in for my shot a week later and shown them the swelling and redness from the last shot. They just say, "That happens sometimes," and give me my next shot. I haven't been too concerned about it because I am not having breathing problems along with it, but...? I wonder if their attitude is because it is a research institute and they are using a stronger serum and they are used to people freeking out as a result?

I have thought about trying to tape (or an Ace bandage) an ice pac to my arm, but I haven't done it yet. I guess I will try that one this week too. As a home school mom, I can't be sitting on the couch with my arm elevated and an ice pack on it all day! I have a school and a house to run!

Thanks to all of you, Sonya