Eppi pens

[Boarmaster]

I carry anything and everything I might need at home into the field. Even if its for a day hunt.

 

[Thread Savage]

My dad and I both have weird, inconsistent allergic reactions to various stings, and we both tried to keep EpiPens on hand for this reason, but the problem is they expire like 18 months from the date they were manufactured. It seemed like a losing battle to keep seeking out more EpiPens only to never use them before their expiration.

I'm not telling anyone NOT to keep these on hand. It's certainly best to have one and not need it. But I'd put a lot more focus on always having plenty of insect repellent and bug spray, wearing insect-repelling clothing, treating your gear with insect repellent, all that stuff.

Every single one of us most likely has some allergy that is totally impossible to nail down. Could be a bug, plant, animal, food, anything. The tiniest grain of some random spice that wasn't even intended to be in the food you're eating, could make your whole face swell up out of nowhere, and a team of scientists might never be able to dial in on what exactly you're allergic to.

And yeah, you can develop different allergies as you age, AND the bugs can develop different venom, so it's just a total crapshoot to me. I'm not even that bad of an allergic reaction guy, but I do treat every bug with a mouth and/or a stinger the same way I'd treat a firearm- it's always loaded.

 

[Backyard]

Reading this today caused me to remember that I needed to refill my Rx. It also got me looking at Neffy. I asked my Dr to prescribe it if it’s available and it was. Wow! This is a game changer for me. Less than 1/3 of the price and the size and weight difference is ridiculous. 2 pens weigh 5.2 ounces, while 2 Neffy’s come in @ .8 ounces.
Probably the best part is not having that feeling that I was just kicked in the leg by a horse for a day after use.


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[SCHUNTER73]

I keep a pair of epi pens with me. I stumbled on the Benadryl/pepcid combo years ago.

 

[fwafwow]

Reading this today caused me to remember that I needed to refill my Rx. It also got me looking at Neffy. I asked my Dr to prescribe it if it’s available and it was. Wow! This is a game changer for me. Less than 1/3 of the price and the size and weight difference is ridiculous. 2 pens weigh 5.2 ounces, while 2 Neffy’s come in @ .8 ounces.
Probably the best part is not having that feeling that I was just kicked in the leg by a horse for a day after use.


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Thx for this. I’m getting some. Apparently they come in 4’s.

 

[isleofGough]

Epinephrine is the only effective treatment for anaphylaxis - Harvard Health

Many people have experienced mild allergic reactions to a food, medication, or other allergen, but a severe reaction can be harmful or even fatal. Anaphylaxis must be treated with epinephrine as qu...

www.health.harvard.edu

 

[RichardSkinner]

This is very relevant to me, as I am severely allergic to yellow jackets, and I have recently found out honey bees as well (luckily they aren't aggressive).

Like you, I had been stung in my younger years. I was last stung without a reaction at 23 years old when riding my motorcycle. Three yellow jacket stings in a row when they flew down my collar and sleeves.

When I was 27, I was stung once in the crook of my arm. I had no idea about anaphylaxis, and kept target shooting thinking it was just a nuisance to get stung. About 5 min later I noticed my ears feeling funny, my arm pits itching like crazy, and hives starting. I popped 1 Benadryl (again, didn't know to take multiple) and began to speed home. When I got home, long story short is I blacked out and fell into the bushes and my wife called an ambulance. Blood pressure was like 60/40 when they took vitals and threw me in the back.

I started carrying epipens, made a hard rule to always wear pants, and those long sleeve SPF shirts with hoods when its yellow jacket season. I managed to avoid another sting until last fall when coming back to camp from setting up game cams. I got complacent and thought I hadn't seen any and was good, so I popped into shorts to dry out from a sweaty hike. Welp, 10 min later I stepped on a yellow jacket ground nest and got hit 3 times in the leg and saw like 5 on my boot trying to sting when I bolted out of camp. I made it about 75 yards outside camp and was yelling at my buddy to grab my bag with my epis and Benadryl when I kid you not, a damn yellow jacket came in like a laser beam and whacked me on the side of my face. If you've been paintballing, it looked like how you can see it coming in for a split second and WHAM. Anyway, 4th sting. Shit!

To shorten this story, my buddy was a stud and brings me my bag, I pop 2 Benadryl and we throw everything, tents assembled and all, in the back of my 1st Gen 4runner and absolutely moto my rig through the rocks home. I tuned my Ham radio to the local repeater and gave my buddy my epipens and told him how to use it if I for some reason pass out before I decide it is injection time. About 40 min post sting, I start to get small hives, so I pop a third epi and keep heading out. My criteria was the moment I feel any bit of low blood pressure, swelling of the lips, throat, tightness in chest, or any life threatening sign at all, I am shooting up and we are radioing to start a life flight. (I was 3 hours into a hardcore rock crawling trail). Luckily I hauled ass and made it out in 1hr 30 min with no more signs.

SO WHAT CAN YOU DO??
Set up an appointment with your allergist to be tested and get on immunotherapy. I did this immediately after and it is WELL worth it in my opinion, even though I haven't been stung yet to test it.

They can give you a panel of microdoses of venom to pinpoint which types you're allergic to - this is how I know Yellow Jackets and Honey Bees are my nemesis, but wasps, mud daubbers and others aren't supposed to send me into the netherworld.

IMMUNOTHERAPY:
After the test panel, I began a weekly regimen of increasing microdose injections of sting venoms. As the doses increased, I began to get serious swelling in my arm. Like a fluid balloon like a fat woman has hahahaha. The doc takes not of this and that I specifically am high reactive and adjusts. After about 4 months I reach max dosage, which they claim is equivolent to a full sting and am now on a maintenance dose of this full sting once a month. You preload your body with Zyrtec 1 hour before the appointment. We will see whether this works eventually, as with my life style I will be stung again. What I can say is the little welt I get now from the maintenance dose(full value) is absolutely nothing compared to how my body reacted to some of the earlier smaller doses when I started - so I feel it must be working.

LASTLY:
I have no idea why I never did this in the past, but before any outdoor event where there is a slight chance of a sting, PRELOAD YOUR BODY WITH AN ANTIHISTAMINE!! (ZYRTEC). It's so basic, but this is a game changing defensive strategy.
I see a lot of talk on Benadryl and other histamine blockers. My doctors specific advice is to always use Zyrtec as it is a generation 2 antihistamine, vs Benadryl being 1950's tech generation 1. It is always non drowsy, so there is no reason not to preload with it.

Also if I am hit again, I am preloaded, and I will immediately pop two more zyrtec. Doc cleared that as ok and prudent for me.

Long post - sorry.

 

[xsn10s]

I used to do the Benadryl popping prior to eating shellfish. My brother who's a doctor strongly advised me against doing this. I've gone into anaphylactic shock from shellfish and bee stings and was diagnosed when I was a kid. I carry an EPI pen now when going out in the woods along with Benadryl and Primatene mist inhalers. The new Primatene mist that has epinephrine as the active ingredient.

 

[xsn10s]

LASTLY:
I have no idea why I never did this in the past, but before any outdoor event where there is a slight chance of a sting, PRELOAD YOUR BODY WITH AN ANTIHISTAMINE!! (ZYRTEC). It's so basic, but this is a game changing defensive strategy.
I see a lot of talk on Benadryl and other histamine blockers. My doctors specific advice is to always use Zyrtec as it is a generation 2 antihistamine, vs Benadryl being 1950's tech generation 1. It is always non drowsy, so there is no reason not to preload with it.

I'll ask my doctor but that sounds like good advice. Thanks for the tip!

 

[rkcdvm]

H1 and H2 blockers
Epi

Oral Pepcid
Benadryl
Epi

Typically what we do
First line is Epi

I never thought about the pepcid in that manner. Makes sense though.

 

[go4thegusto]

I am also allergic to wasps and hornets. I carry Epi's but have never used one.
The last time I was bitten was at our remote cabin. I immediately became flushed all over and broke out in a sweat. Heart starts to race. I came inside and sat in a chair. I got tunnel vision, put my head in my hands and BARELY stayed conscious. It passes in about 15 minutes, Then a sweat cool down and some nausea.

In talking to my ER doctor neighbor I did everything wrong.

What is happening is the allergic flush reaction "pushes" blood to your outer skin. Your blood pressure drops so your heart races to try and get it back.

What I should have done: He said to lay on your back and elevated your legs to keep blood in your core. Much the same as someone in shock. Get cool at the same time if you can. Wet a towel or something to lay on you.

I wondered what I would do in the mountains during Sept archery elk hunting miles from help. I often thought I would lay right in a stream and elevate legs as long as a buddy is their monitoring you.

My thoughts in case it helps someone. Great thread here. I am going to look in to the new mist inhalers etc

 

[fwafwow]

FYI/FWIW - update on my Neffy efforts. The website shows my insurance company (CVS Caremark) is in the list of "Covered with Prior Authorization." I learned the hard way that "prior authorization" is more than having a doctor approve and send in the Rx. Caremark CS: "it's excluded." Caremark Pharmacy specialist: "It's not excluded, but it's 'non-formulary' and you need a pre authorization form to be completed." That person makes it sound like it's a form laying around and in the hands of every doctor. Not the case. Now working with Neffy to see if they can confirm the correct form.

Maybe no one else will have the same problems, but I'm hoping my situation will save someone some time.

 

[Southern Heritage]

Getting a neffy

FYI/FWIW - update on my Neffy efforts. The website shows my insurance company (CVS Caremark) is in the list of "Covered with Prior Authorization." I learned the hard way that "prior authorization" is more than having a doctor approve and send in the Rx. Caremark CS: "it's excluded." Caremark Pharmacy specialist: "It's not excluded, but it's 'non-formulary' and you need a pre authorization form to be completed." That person makes it sound like it's a form laying around and in the hands of every doctor. Not the case. Now working with Neffy to see if they can confirm the correct form.

Maybe no one else will have the same problems, but I'm hoping my situation will save someone some time.

Getting a neffy has been a pain in the pants.
I finally got approved and still had to pay $199.00
Took almost a month of getting letters saying no approval only can you OviQ to your parroted but out of pocket $199

 

[fwafwow]

Getting a neffy

Getting a neffy has been a pain in the pants.
I finally got approved and still had to pay $199.00
Took almost a month of getting letters saying no approval only can you OviQ to your parroted but out of pocket $199

I just got today the form Caremark requires. Fingers crossed.

 

[Pilsner]

Just wondering how many people carry Eppi pens and what’s their plan if in the back country and or just in general.
I’m allergic so I always have one on me. However after this last event I will have 3.
I grew up working honey bee’s, grew up getting stung by yellow jackets, wasp, etc.
I landscape for a living so it’s the norm. In 2015 I got stung in the upper lip. My buddy found me out cold and not responding.
So I get allergy tested and I’m allergic. Doctor says limit time outdoors don’t take unnecessary chances. Been popped a few times since then. No huge reaction.
Fast forward this weekend. Red wasp pops me on the arm. I needle my self after almost instant shock sets in.
Chug Benadryl and say good night.
2 days later I’m driving down the road. Throat starts closing up again.
I happened to be next door a family care. Walk in. Get another shot of Eppi and a steroid shot.
As I’m planning my fall trip of 15 days in the back country. Im re thinking my Eppi situation.
Doctor says being out side is not worth the risk. I laughed. As I’m sure they have to say that.
I did qualify for the new Neffy which is a nasal injection and much lighter.
My thoughts are I’m going to take both Neffy and 1 Audi-Q then Liquid Benadryl.

This isn’t made to sound like a poor poor pitiful me. I know it may come off that way.
It’s a who else deals with this and have you had a bad experience in the back woods? What’s your protocol.

If you can find some local honey and take some daily, you can significantly lower your reactiveness to bee stings. This is in addition to, and NOT instead of, carrying injectable Epi and Benadryl and orally dissolving Benadryl. I am a retired military combat medic, and I first heard of this in the Amish/Mennonite community. Since then I have heard about it from several other sources including local beekeepers.
I would carry all of the above for a layered system of defense including Epi, Audi-Q, Neffy, and both injectable and oral Benadryl. I would also not leave the truck without something like a Garmin Mini sat device with OhShit! button.
-Doc Jaynes

 

[Oakman]

Self desensitization

 

[BCDJR]

My wife carries EPI per her doc’s recommendation. They do have an expiration date

 

[Oakman]

Drug expiration dates are a whole different discussion. Yes, chemical stability and potency start to degrade over time, but that doesn’t mean a med just “goes bad” the day after the printed date.

 

[mattmann]

Just got back from South Africa a couple of months ago now to learn our 28yr old photographer died a couple weeks later from a bee sting. Unclear why but his pen “didn’t work”. So sad man but obviously serious if you’re to the point of death. If I was ever that allergic Id be a nervous wreck. But then again, I’m sure it becomes “normal” and you become used to it.


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[Oakman]

An option of desensitization therapy, often called allergen immunotherapy, it is risky too but effective