Can moderate bee sting allergies get worse?
March 6, 2018 4:49 PM Subscribe
Can a "large local reaction" to bee stings become a systemic reaction in the future? Should I take any special precautions?
I have a history of large local reactions to insect stings, including/especially bees. The last time I was stung, by a honeybee on my upper arm, I had swelling for 48 hours all the way down to my hand.
Separately, I also have other risk factors for allergies (adult eczema, prior systemic skin reaction to an unknown allergen).
Can my large local reaction become a worse systemic reaction with future stings? Should I take any precautions when, for example, going on a week-long backcountry rafting trip this summer?
I have a history of large local reactions to insect stings, including/especially bees. The last time I was stung, by a honeybee on my upper arm, I had swelling for 48 hours all the way down to my hand.
Separately, I also have other risk factors for allergies (adult eczema, prior systemic skin reaction to an unknown allergen).
Can my large local reaction become a worse systemic reaction with future stings? Should I take any precautions when, for example, going on a week-long backcountry rafting trip this summer?
Yes.
Go to your doctor, explain what you said here, and ask if you can have an epipen prescription. Take the part about always having it in arm's reach seriously. The next sting could kill you.
posted by bile and syntax at 5:17 PM on March 6, 2018 [2 favorites]
Go to your doctor, explain what you said here, and ask if you can have an epipen prescription. Take the part about always having it in arm's reach seriously. The next sting could kill you.
posted by bile and syntax at 5:17 PM on March 6, 2018 [2 favorites]
Best answer: Yes, and my doctor prescribed me multiple epi pens for that reason. His biggest worry was that I would be stung on the neck because the reaction I was already having would be enough to block the airway.
Please get the shots if you can.
posted by lepus at 5:41 PM on March 6, 2018 [5 favorites]
Please get the shots if you can.
posted by lepus at 5:41 PM on March 6, 2018 [5 favorites]
Mandatory I am not a doctor.... But based on experience, yes or they may never progress. However either way, I would ensure you have appropriate medication, especially if you are going to be remote from high quality EMS. If you are camping/hiking/ourdoorsey things where you're more likely to be stung, I would ask your provider about multiple epi-pens (or epinephrine in ampules/syringes if you have a medically skilled member of your party....MUCH cheaper, and in a remote area you need to have several epi-pens= $$$), benadryl and if you are in very remote areas (backcountry/less developed areas), carrying other medication such as oral steroids/H2 blockers. Ensure you AND your companions know when/how to use them, and have a reliable plan for getting to help/getting help to you. Not to be the alarmist, but the backcountry is NOT where you want to find out you allergy has progressed to life threatening without a solid plan for managing it (or even just trip threatening, if a bad local reaction, say on your hand means you are suddenly useless as a member of your party). You may want to consult with someone with an interest in backcountry/travel/wilderness medicine as not all GP's are comfortable with helping folks develop 'self help' plans that don't include: Proceed immediately to the closest ER.
posted by Northbysomewhatcrazy at 6:07 PM on March 6, 2018
posted by Northbysomewhatcrazy at 6:07 PM on March 6, 2018
Response by poster: Follow-up on the planned backcountry trip: It's a large group activity with professional guides, and their intake form specifically asks about bee allergies, which is why I thought to ask this question in the first place. But it sounds like I ought to acquire/bring my own epipens just in case.
posted by serelliya at 6:10 PM on March 6, 2018
posted by serelliya at 6:10 PM on March 6, 2018
Best answer: It's unlikely they're asking if you have a bee sting allergy because they carry an epipen if you do; it is more likely they will not let you sign up for the trip without an epipen, likely one secured according to their protocol.
posted by DarlingBri at 6:39 PM on March 6, 2018
posted by DarlingBri at 6:39 PM on March 6, 2018
Get your own EpiPen. You have reason to be alarmed, because allergies can absolutely progress unless you manage the underlying inflammation (changing your diet for example). I'm not a doctor, this is just my understanding of part of why people have allergies/get ezcema.
posted by tooloudinhere at 7:02 PM on March 6, 2018
posted by tooloudinhere at 7:02 PM on March 6, 2018
Best answer: Yes. Not worth the risk.
Sure, the odds are on your side that your reaction to future stings won’t be life-threatening, and odds are that you won’t get stung on the neck.
I haven’t had an emergency room-level “bad” reaction per se, but I’ve stayed home sick and had to pick up prescription steroids due to a single sting, as recently as last fall. Doctor told me that less than 10% of people with my reaction go on to have worse reactions in the future. She did mention the “getting stung on the neck” thing, and that with my delayed systemic reaction I probably don’t have much to worry about. And then she wrote me an Epipen prescription.
I’m not worried about having the Epi pen handy when I’m in the city, because help is only minutes away. In the mountains? Bring it, and tell everyone in your party which backpack pocket it’s in, and explicitly tell them that you consent to it being used on you in case of emergency.
Also: DO NOT assume that your guides/wilderness first responders have an Epi pen. Carry your own so they can use it if they have to.
posted by halogen at 8:20 PM on March 6, 2018
Sure, the odds are on your side that your reaction to future stings won’t be life-threatening, and odds are that you won’t get stung on the neck.
I haven’t had an emergency room-level “bad” reaction per se, but I’ve stayed home sick and had to pick up prescription steroids due to a single sting, as recently as last fall. Doctor told me that less than 10% of people with my reaction go on to have worse reactions in the future. She did mention the “getting stung on the neck” thing, and that with my delayed systemic reaction I probably don’t have much to worry about. And then she wrote me an Epipen prescription.
I’m not worried about having the Epi pen handy when I’m in the city, because help is only minutes away. In the mountains? Bring it, and tell everyone in your party which backpack pocket it’s in, and explicitly tell them that you consent to it being used on you in case of emergency.
Also: DO NOT assume that your guides/wilderness first responders have an Epi pen. Carry your own so they can use it if they have to.
posted by halogen at 8:20 PM on March 6, 2018
People have already covered that allegergic response often gets worse, and that the epi pen is good if your are lucky enough to easily afford one in the USA.
But I will also add: learn your specific allergies and your specific bugs— this can give you peace of mind and practical safety.
Honeybees almost never sting on purpose if you are not raiding their nest. Yellowjackets (cross response) are aggressive assholes that will fight you to the death for no reason. Recognizing the Hymenoptera and responding accordingly can help you stay safe on a back country hikes, even if that means keeping your cool and walking smoothly and confidently away from Bee/wasp investigators.
PS: honeybees are not that common in the wilderness, they are a domestic/invasive species in most of the world, and found mostly in cities, suburbs, and some ag/horticulture areas.
posted by SaltySalticid at 8:26 PM on March 6, 2018
But I will also add: learn your specific allergies and your specific bugs— this can give you peace of mind and practical safety.
Honeybees almost never sting on purpose if you are not raiding their nest. Yellowjackets (cross response) are aggressive assholes that will fight you to the death for no reason. Recognizing the Hymenoptera and responding accordingly can help you stay safe on a back country hikes, even if that means keeping your cool and walking smoothly and confidently away from Bee/wasp investigators.
PS: honeybees are not that common in the wilderness, they are a domestic/invasive species in most of the world, and found mostly in cities, suburbs, and some ag/horticulture areas.
posted by SaltySalticid at 8:26 PM on March 6, 2018
Reposting my comment from a previous thread, because EpiPen cost is such an issue:
EpiPens are available as a generic -- as "Adrenaclick," via CVS, and from original maker Mylan. Also, another auto-injector, Auvi-Q, is back on the market. All are prescription-only in the U.S. (unlike, say, Canada, in case you are near the border or wish to try mail order), and pricing for all varies depending on your insurance and other information. Discounting is available through GoodRx and the makers' own programs.
posted by Iris Gambol at 10:28 PM on March 6, 2018
EpiPens are available as a generic -- as "Adrenaclick," via CVS, and from original maker Mylan. Also, another auto-injector, Auvi-Q, is back on the market. All are prescription-only in the U.S. (unlike, say, Canada, in case you are near the border or wish to try mail order), and pricing for all varies depending on your insurance and other information. Discounting is available through GoodRx and the makers' own programs.
posted by Iris Gambol at 10:28 PM on March 6, 2018
To follow up to what Iris Gambol posted, if you have insurance, ask which epipen is cheapest. Costco was giving me the generic for $80 because I’d gotten that in the past, but after double checking, we realized that the online epipen coupon made the brand name one $0 because now I have a copay for prescriptions.
posted by artychoke at 5:38 AM on March 7, 2018 [1 favorite]
posted by artychoke at 5:38 AM on March 7, 2018 [1 favorite]
Beekeeper here -- confirming what mostly everyone has said. If you already have a strong localized reaction, the more you get stung, you could react more strongly to bee venom, or your body might build a tolerance to bee venom and your reaction could lessen. You just never know. If you are that worried about it, contact your doctor and get an epi pen Rx. As a beekeeper, I've gotten stung many, many times and I have a similar reaction to you -- lots of swelling, itching and even pain. I do have an Rx for an epi pen, but have never gotten it filled (they're $$ and have a short shelf life). When I am out hiking or camping, I don't take any extra precautions (but then I don't have any known allergies); I know bees are out there, as well as other stinging insects (I live in TX, everything bites and stings) and are careful to not piss any off.
Have fun on your trip!
posted by ATX Peanut at 7:35 AM on March 7, 2018
Have fun on your trip!
posted by ATX Peanut at 7:35 AM on March 7, 2018
This thread is closed to new comments.
And if an allergist ever recommends the injections to desensitize you, by all means do it. The allergy shots for stinging insect allergy are very effective.
posted by artistic verisimilitude at 4:55 PM on March 6, 2018