Confusion and Euphoria
I've had an Epi-Pen since I was 2 years old, but I've never used it. That's not to say I've never needed to use it, only to say that I've been extremely lucky.
Constantly in a state of caution
Living with deadly food allergies has made me an aggressively cautious person. Even secondhand contact with someone or something that had recently touched a peanut or tree nut could be lethal, so I bump fists instead of shaking hands. I open doors in public spaces with tissues. I don't accept food from strangers or even close friends unless I know exactly where it came from.
I have an extensive set of rules, and sticking to them has kept me safe. I went almost twenty years without a major allergic reaction. But on a long enough timeline, everything happens eventually.
My job as a food delivery driver
The summer after my freshman year of college, I made the mistake of accepting a part-time job as a delivery driver for my favorite café. I knew the chef and the staff well, and they all understood the severity of my allergies. The café was already used to accommodating my allergies as a customer, so I was assured and reassured that I would never be put in a dangerous position at work.
Accidental allergen exposure
But my job required me to pass through the kitchen frequently. One afternoon, I was overwhelmed by a sudden sense of impending doom as I was returning from a delivery. I felt a stark and unfamiliar shift in my orientation in space. I looked down and saw a rich, brown dollop of Nutella on my upper arm and a spiderweb of dark pink hives shooting out from it in every direction and winding up my shoulder.
Experiencing confusion and euphoria because of anaphylaxis
In theory, I knew exactly what to do. I'd received my first training Epi-Pen in kindergarten, and I'd demonstrated the proper technique with it every time I visited my allergist through my teenage years.
What my allergist had failed to tell me, and what it took me a near-death experience to realize, is that 2 of the symptoms of anaphylactic shock are confusion and euphoria. So when I finally did have my first contact with a deadly allergen, all that practice failed me.
How I handled the situation
I clocked out and called my mother. I told her what had happened and that I was getting in my car to drive to the hospital if she wanted to meet me there. She told me not to get behind the wheel under any circumstances, to go back inside where other people could see me, and to use my Epi-Pen. She had been out running errands just around the corner. She could get to me faster than an ambulance, and the hospital wasn't far.
I told her okay, and not to worry. I still felt pretty good.
She found me wandering down the side of the highway. She told me that later. I have no memories between hanging up the phone and finding myself in a hospital bed, an IV drip in my arm. When I climbed into the car, she asked how I felt, and I said I felt fantastic. She asked if I could breathe, and I said, "not really, no."
More visits to the emergency room
I quit that job a month later after 2 more ER visits. Every time, the doctor made me promise I would use my Epi-Pen if it ever happened again. I promised. Of course, I would. But I never did.
I have my Epi-Pen on me at all times. I've known how to use it since kindergarten. I know the consequences of not using it. But my brain has never been able to make the next logical step to actually using it when it counts, and that terrifies me.
Accidental contacts versus ingestions
I've gotten away with not using my Epi-Pen because my accidental contacts were just that, accidental contacts, and not accidental ingestions. I understand that if I failed to use my Epi-Pen after accidental ingestion, I would die.
But the confusion and the euphoria brought on by my contact, even as I could physically feel my airway constricting, created room for just enough plausible deniability that my brain—high on whatever chemical it was producing—tricked itself into thinking maybe it wasn't urgent.
Hoping for the future
I can't do much more than hope that I'm able to retrain the presence of mind to use my Epi-Pen when, not if, I need it next. I hope the difference between "not really" being able to breathe and not being able to breathe at all will be dramatic enough to force me, a grown man, to take action to save myself. But my history suggests it might not be that easy.
In the meantime, I'm going to invest in a MedicAlert bracelet.
When are you allergy symptoms the most severe?