One peanut butter-filled pretzel nugget = one overnight hospital stay

Food allergies can be life threatening

My four-year-old son had a severe allergic reaction (anaphylaxis) yesterday after eating a single peanut butter-filled pretzel nugget. It resulted in several hours at an urgent care center, an ambulance ride to an ER and an overnight stay at a hospital. We were discharged this afternoon, about 24 hours after we arrived at the urgent care facility.

Here's what went down:

Yesterday, Nolan was offered a few snacks, including the pretzel nugget, while I was preoccupied during a yoga class. I glanced over and nodded my approval but I did not inspect the snacks closely. It was only after Nolan said his lips were burning that I realized something was wrong. His lips had been chapped so at first I thought he had merely peeled off some loose skin that left his lip feeling raw. He said he didn't feel well, though, so I gave him some Benadryl and we drove home. 

In the car, he threw up multiple times. At home, I gave him a bath and while cleaning up the vomit, I detected the smell of peanuts. 

We have known since Nolan was nine months old that he has a serious peanut allergy. When he was a baby, my dad ate a peanut butter sandwich near him and it triggered a major allergic reaction. Nolan's entire body was covered in hives and his face turned red and puffy. Since then, we have maintained a nut-free household and carry Benadryl and epinephrine pens everywhere we go.

At the end of his bath, Nolan threw up again. I gave him some more Benadryl, loaded him and his brother in the car, and drove to the Palo Alto Medical Foundation Mountain View Urgent Care Center. 

When we arrived, Nolan was not exhibiting any signs of an allergic reaction. The Benadryl had taken effect and he looked normal. We waited for the doctor and I called my husband to tell him where we were and what was going on. I said it would be good if he could leave work to come over but that everything was under control. 

Nico, my nine-year-old son, was amazing throughout the ordeal. He busted out his homework and kept himself busy through all the chaos. He didn't even flinch when his brother vomited inches away from his backpack. 

The doctor ordered an oral steroid medicine for Nolan and by the time he drank it, the Benadryl had started to wear off. The nurse helping us told us he had seen children deteriorate suddenly and severely with allergic reactions and that it was important to keep vigilant. Pretty much right after he said that, Nolan projectile vomited the medicine. Things went downhill rapidly. 

The next few hours were a blur. Vic arrived in the midst of the drama and was stunned at what he saw, particularly since the last words I had said to him were, "Things are under control." At some point, we moved from an exam room to a space directly in front of the nurses' station. It looked like a hospital room. Nolan was administered a steroid injection in his right thigh and an epinephrine injection in his left thigh. He started to develop tiny circular hives, first on his stomach, then on his neck, then everywhere. Then, the hives transformed. They were no longer circles but long, wide and thick raised welts covering him from head to toe. His body looked like a topographic map. He was given a second epinephrine injection and he vomited violently again. Nolan's blood pressure dropped and he became drowsy. An IV was administered. As the needle went into his arm, he woke up and screamed, "All of you are mean! Leave me alone!" The medical team seemed relieved (and amused) that he was so feisty. 

Around 7 p.m., an ambulance crew was summoned to take Nolan to an area emergency department. Our hospital was over capacity so we went to Stanford Hospital. I rode along with Nolan. Nico wailed, "Luuuucky!"

At the emergency department, we were greeted by a team of medical doctors, nurses, assistants, students. By now, Nolan was stable. His blood pressure was back to normal and his hives had disappeared. We had to wait as they determined which area of Lucile Packard Children's Hospital we would be admitted to. Apparently, when a patient is given two epinephrine injections, it basically guarantees an overnight stay. 

I spent the night with Nolan in his hospital room, while Vic and Nico went home. Nolan was hungry and thirsty but he was not permitted to eat or drink anything for several more hours. Eventually, he was allowed to drink apple juice. The saving grace was that he was able to watch movies on the hospital TV in his room. I knew he was back to his normal self when he asked to watch a cooking show. So we watched "Cupcake Wars". By this time, things were stable. Nolan and I settled to sleep on his bed, me still wearing my yoga clothes from this afternoon - now stiff from dried vomit. 

In the morning, Nolan was ecstatic when he was cleared to eat food again. He devoured a huge breakfast of turkey sausage, hash browns, wheat toast, raisin bran cereal, fruit cocktail, rice milk and apple juice. 

I was impressed with the medical staff throughout the experience. The doctors, nurses and students were all quite knowledgeable, caring, empathetic and helpful. Also, every person who left our hospital room asked, "Is there anything else I can help with?" before they departed. It was pretty amazing.

The attending physician told me her daughter also has a peanut allergy and that they have trained her to be extremely careful when eating new foods, accepting food from people outside her family, etc. Our pediatrician called to check on Nolan and said she also has a daughter with a peanut allergy. She shared an experience where her daughter ate a dessert that had nuts buried underneath whipped cream, even though they had specified "no nuts" when they ordered the dish. It's amazing how prevalent peanut allergies are these days.

So after a long scary afternoon and evening, Nolan was discharged from the hospital this afternoon. Everything turned out just fine, but it has been an eye-opening experience. I used to be squeamish about using the epi-pen but I am not any more. Our family now has first-hand experience that food allergies can be life-threatening.