Personal reflection: How I accidentally injected myself with an EpiPen
I am now a part of the club of people who have had an EpiPen injection.
I am also a part of the “didn’t need it but accidentally used one on themselves” club. I can’t say I ever thought I’d be in either one of these clubs — and yet, now that I accidentally injected myself with an EpiPen, I can say I’m glad it happened. I learned a lot. This post is rather long, but many folks have asked me to share how it happened, how it felt and what I learned from the experience. How it happened: First, a little EpiPen 101. There are two devices available – the EpiPen Jr for children 33-66 lbs (at .15 Epinephrine) and the regular EpiPen for those who weigh more than 66 pounds (at .30 Epinephrine). My daughter has been prescribed the EpiPen Jr and we always have two of the units on us and one training device. You can see here what they look like.
They are identical in shape and size, although one is marked “Training Device” while the other has a slightly more colorful label. After this experience I wish the training device was MORE obviously a different color. Accidentally using an EpiPen is not dangerous, but it may require time at the doctor for monitoring and they are expensive to replace. After three years of managing my daughter’s food allergies, I’ve become pretty used to training folks in on what foods to avoid, which symptoms to watch for and how to treat a reaction (which may or may not include the Epi, depending on the symptoms).
My daughter has not had an EpiPen injection, and until this point, neither had I. But I have become vigilant about keeping them with us and keeping the prescription active at home and daycare (they expire after 12 months). Just last week, I had been checking the expiration dates of the pens, at the drive thru of the pharmacy (in the dark). I remember popping each one out of their case to look for the “expires on” date. And this, I think, must be where and how I mixed up one of the EpiPens with the training device. I typically store them with both medicine units in the hard plastic case, and the traning device separate and floating in our emergency kit. For three years this is how I’ve done it – and I’ve trained in at least 15, 20, maybe 25 people over the past few years. I’ve always grabbed the correct training device… until now.
On this day, our daycare was closed, so my 4 year old was spending the day with some friends. We had talked in advance of the visit to discuss food and other care needs. That morning, I provided plenty of safe food options (as did they), went through the list of what to avoid and then talked about watching for symptoms. I shared the Food Allergy Action Plan that describes which symptoms require an antihistimine and which symptoms are anaphylaxis and require the EpiPen. ”Don’t worry, this doesn’t have a real needle in it, I’m not going to hurt myself,” I said as I was about to demonstrate the EpiPen. I did not double-check the unit. I did not look for the words “Training Device.” I simply grabbed the item out of its usual spot in the medicine kit and assumed it was the same thing I had always used. And then I heard a strange click when I pulled away the unit from my leg and said something like, “I think I just felt a needle!” The click is a distinct sound that only happens with a real unit, not the training device.
I slowly began to realize that I just gave myself a real injection. I opened the hard plastic case and popped out the training device and sat there a bit stunned. I was embarassed for making this mistake. And then I tried to focus enough to ramble off the rest of her care instructions before heading out the door in a hurry to get my son to school. While driving, my mind was racing. How did this happen? How did I mix them up? I didn’t feel any different and thought maybe I didn’t get all the medicine because I pulled it away too quickly instead of holding for 10 seconds. And yet, I know from practicing on fruit with expired EpiPens that typically all the medicine is released right away.
How it felt: Many people asked me how it felt when I got the shot, and how my body reacted afterwards. The fact that I barely noticed there was a needle means it definitely did NOT hurt when I got the shot. The injection site was a tiny bit tender afterwards… far less than the flu shot I get every year. I wonder, though, if I was nervous or stressed about it, if I would have been more tense and therefore experienced more pain. But, because I wasn’t expecting it to be a real shot, I was very calm and relaxed about the whole thing. The good news is that I had experienced epinepherine before so I kind of knew what to expect. Back then I had an allergic reaction to a medication with serious hives all over my body. I had a full dose of the medicine at Urgent Care and they kept me there quite awhile to monitor me. This time, remember I had only had a “junior” dose of the medicine, which is half the adult dose. I didn’t feel anything right away, except feeling nervous that I just gave myself the shot.
After about 20 minutes I felt a bit jittery and found myself rambling on a bit to my son’s teacher when I dropped him off at school. While driving to work, I called two people – first, my “food allergy buddy” through the Food Allergy Support Group of MN. I wanted to tell her what happened and get her thoughts. This was helpful, mostly from an emotional standpoint, to be able to process what had happened with someone who might understand. The food allergy buddy program in this group is such a great thing – pairing up families who have similar food allergies for support and help. The second call I made, at the urging of my buddy, was to the allergist office. We first considered calling a regular nurse’s line or my doctor, however I was worried they would urge me to go in to get monitored (to be safe) and I was worried about missing work.
By calling the allergist office, though, I knew I’d be talking to staff who have deep experience with this drug and be able to give me specific advice. If THEY told me to go in, I would. Instead, the nurse was very confident that because it was only a half dose AND I had no other medical conditions, that I should be fine (but, of course, to watch carefully for any other strange reactions). She said if it was a full dose, they’d ask me to come in. From what I understand, epinepherine is a relatively safe drug and can’t hurt you if you have it by mistake or when you don’t need it. However, it can make your blood pressure rise and typically people are monitored for safety.
By the time I got to work (next door to a hospital, by the way) 40 minutes later I was at the peak of the experience and pulled my boss aside to let him know, just in case, you know, something happened. I remember looking at the clock two hours later and still feeling a bit wired, but by four hours it had totally worn off. To other people it probably seemed like I was amped on coffee. My mind was racing a bit and my body felt jittery, but I could still participate in my work meeting and function okay.
What I learned: In the last three years I’ve been a part of the food allergy community, I’ve seen and heard a lot of fear of the EpiPen. People are terrified to use it because of the needle (I was one of these people). I’ve heard of situations where parents called 911 and let the EMTs decide if the child needs an EpiPen because they were too afraid to do it themselves. This is wasting precious time when your child’s life is at stake.
I never saw the needle. I barely even felt the needle. If you stay calm and cool, your child will stay calm. Please believe me, when I tell you from experience, that getting the epinepherine is NOT a bad thing. It won’t hurt you, but it could save your life or the life of someone you know.
The reason the EpiPen autoinjector exists is so people have the medicine available IMMEDIATELY in life-threatening situations, because you may not have the luxury of time while waiting for an ambulance or the ER doctor. Unfortunately some people do not fill their prescriptions for EpiPens or know enough about food allergies to know that they need to get them. It is important to have an EpiPen on you at all times and USE it if you have symptoms of anaphylaxis.
One thing I’ve learned the hard way is how important it is to get your food allergy advice from a board-certified allergist. And if you have a pediatric-allergist in your area, they can be especially great with kids. Pediatricians, urgent care and ER docs, chiropractors and homeopathic practitioners may know a bit about food allergies, but they are not specialists. I have personally been given bad medical advice and I have heard shocking advice come from these folks to families with food allergies.
On a side note, I was really upset a couple of weeks ago to hear about the 7 year old girl who died at school from a peanut allergy reaction. From what I understand, there was not an EpiPen at school for her. Another child on the playground gave her a peanut and she had a severe reaction and went into cardiac arrest. This is horrific and every food allergy family’s worst nightmare. There is a movement underway right now called the “School Access to Emergency Epinephrine Act” that would allow schools to have the option to keep EpiPens to use on any student or adult who has a severe reaction. I liken this to having an automatic external defibrillator (AED) available or administering CPR.
Finally, the biggest takeaway for me from this experience is that I can tell my daughter I’ve had the EpiPen and that it will be okay – and mean it. And to all of you out there who have fear and anxiety about the EpiPen, I hope this brings you some comfort and encouragement, too. To read more about our food allergy experiences, click here to go to my Food Allergy page. Also, please connect with me on Facebook and Twitter!
p.s. I talked with the makers of the EpiPen today to let them know of my mistake. The patient safety folks wanted to hear all the details. If you’ve ever had an EpiPen accidental injection, they would like to hear from you, too. You can find the EpiPen contact info here.
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