BajaNomad

Insect stings and bites

vandenberg - 2-9-2006 at 11:31 AM

Since childhood have been stung and bitten numerous times with never any kind of reaction. This includes bees,wasps,black widows, our black spring bumblebees, scorpions and stingrays. Last summer I got stung on the wrist by a little honeybee and the following day my arm swelled up to make me look like Popey. After 3 days, it only got worse. Went to doctor and was told that I had an allergic reaction. Got Flanax against the swelling, which didn't seem to do much good. Than, about 3 weeks ago, I got stung again by the same kind of bee, and at about the same spot. Took my Flanax right away, but the following week the arm this time swelled up twice its size ,all the way from shoulder to fingers. And at the sting site I developed a 4 x 4 spot with huge blisters. The med book says to have a eprinephine shot to counteract the reaction, but haven't been able to find it. The pharmacist, after consulting with a doctor, gave me Celestone (Betametasone) with Cloro Trimeton pills for follow up. Hate like hell to get stung anywhere near my neck and have this stuff not work. Seems dangerous. So, the reason for this epistle is to see if any of you Nomads had a similar experience and maybe can give me some advice.:?::?::?::?:

Debra - 2-9-2006 at 11:45 AM

Vandenberg:

Check out the thread "Just a heads up reminder for us with children"

I had a real scare with my middle child. Info. for you there.

Bruce R Leech - 2-9-2006 at 11:50 AM

http://forums.bajanomad.com/viewthread.php?tid=11523#pid9083...

Debra - 2-9-2006 at 11:58 AM

Thanks Bruce, wish I could do that!

Soooo, Epi Pens

Dianamo - 2-9-2006 at 12:18 PM

Can we get'em Baja farmacias?:?:

vandenberg - 2-9-2006 at 12:38 PM

Diana
Like I said Epi must be short for Epinephrine, and the pharmacist, here in Loreto ,had no idea what I was talking about. I need to know if this Celestone she gave me at the doctors advice, will be of any use.

vandenberg - 2-9-2006 at 12:40 PM

And Bruce, thanks for that thread referal.

Keep us posted on your recovery!

Dianamo - 2-9-2006 at 12:47 PM

we hope that you are feeling much better soon! ......and thank you for letting us know what you find out about the Epinephrine pens.

Thanks,
Diana

Osprey - 2-9-2006 at 01:40 PM

Van, see if any of your Mexican friends will part with or go get you some Guaco. It's a roadside weed that grows north of and south of La Paz (San Pedro por ejemplo). You just crush it, put it in a jar of Tequila or Mezcal, put it under the sink. INSTANT RELIEF for anything that gets you on the skin. Bitachis and avispas got me good, kicked my butt but now, No Worries with Guaco.

do you...

neilm - 2-9-2006 at 01:44 PM

put it on the sting, or in the patient, for that instant releif?

Neil
Quote:
Originally posted by Osprey
Van, see if any of your Mexican friends will part with or go get you some Guaco. It's a roadside weed that grows north of and south of La Paz (San Pedro por ejemplo). You just crush it, put it in a jar of Tequila or Mezcal, put it under the sink. INSTANT RELIEF for anything that gets you on the skin. Bitachis and avispas got me good, kicked my butt but now, No Worries with Guaco.

oladulce - 2-9-2006 at 02:07 PM

Quote:
Originally posted by vandenberg

Like I said Epi must be short for Epinephrine, and the pharmacist, here in Loreto ,had no idea what I was talking about. I need to know if this Celestone she gave me at the doctors advice, will be of any use.


Epinephrine (adrenaline) actually reverses or blocks an allergic reaction and it's the only medication that will do so.

Histamine is the chemical that's released by the body's cells in response to an allergen ( stings, medications, foods etc) and histamine is responsible for most of the symptoms of an allergic reaction such as swelling, redness etc.

Anti- histamines like Benadryl will reduce the symptoms in mild to moderate allergic reactions and may be all that is needed to make you comfortable until the reaction subsides.

Anaphylaxis is life-threatening allergic reaction where the exposure to an allergen (shellfish, nuts, and stings are the biggies) results in the release of proteins and chemicals that cause generalized swelling and the severe dilation of blood vessels. That swelling (from the release of histamine) is what can make an airway close off to the point of complete obstruction. The overwhelming dilation of the body's arteries will result in extremely low blood pressure and inefficient delivery of blood and oxygen to the cells. Anaphylaxis is actually a type of Shock and has the same outcome as the Shock from severe blood loss- not enough blood volume or pressure to meet the body's needs.

Severe allergic reactions are treated with Epi to block the reaction, and then an anti-histamine to reduce symptoms such as swelling. Benadryl alone will not prevent the circulatory collapse of anaphylactic shock and it does not reverse an allergic reaction.

The Celestone you were given Vandenberg, is a type of steroid which will reduce inflammation- in your case the swelling which was caused by the release of all the histamine when you were stung. Celestone was an appropriate treatment for your inflammatory response, but it will not block an allergic reaction and it has no effect on the release of histamine.

Oladulce, R.N.

oladulce - 2-9-2006 at 03:23 PM

I found this article on the American Academy of Allergy, Asthma and Immunology site:

9/28/05

Epinephrine auto injector availability
Summary
Background - Epinephrine auto injectors such as Epi Pen or Twinject are frequently prescribed to be carried by those with severe food allergies or other allergies with potential for anaphylactic reactions.

Findings - ... This group surveyed representatives of 39 countries who were members of the World Allergy Organization. They found that epinephrine auto injectors are widely available in the USA, Western Europe, Canada, Israel, South Africa and Australia.

Epinephrine auto injectors are not available in Bulgaria, Turkey, Russia, Egypt, Mexico, Argentina, Chile, Ecuador, Uruguay, Paraguay, Venezuela, China, Thailand, Vietnam, Philippines, Malaysia or Indonesia.

In some countries, only the adult dose Epi Pen is available. In some European countries, other epinephrine kits (not auto injectors) may be available.

Editor's Comments
It is not clear why epinephrine auto injectors are not available in some countries that have generally advanced medical facilities/systems (at least for those who can afford it). These findings should prompt physicians to alert their patients who carry epinephrine auto injectors to carry an extra supply of adequately dated units with them on any trip to countries that may have no or limited supplies available.

vandenberg - 2-9-2006 at 03:31 PM

Oladulce

Thanks. You have answered my question. Doesn't look like my case is one of anaphalyctic shock, so this Celestone should do the trick. Thanks again.

Natalie Ann - 2-9-2006 at 04:19 PM

EpiPen for adults - (Epinephrine) Auto-Injector 0.3mg

They are widely available in California with a doctor's prescription. Cost is minimal, and they are formulary drugs (covered by insurance) for both Kaiser Permanente and Medi-Care members. Do not refrigerate these devices, and be sure to check the expiration date - it is important here.

Seems to me they should become a part of any basic first aid kit. They save lives.:bounce:

David K - 2-9-2006 at 05:17 PM

My son has been stung too often and now will get a case of anaphylactic shock if stung by a bee. He has an 'epi pen' at school and home to self dose if he gets stung. I checked with a farmacia in Baja, and they have never heard of this... even searched their drug books... Benadryl only...

[Edited on 2-10-2006 by David K]

David K - 2-10-2006 at 09:12 AM

Might just make a note here that it is a good idea to carry a bottle of Tea Tree Oil (Oil of Melaleuca alternifolia) with you when hiking or in your vehicle... The oil has been documented to neutrilize venom, as well as being a powerful antiseptic for cuts... A one ounce bottle is about $9 at many natural food/vitamin stores... Henry's, Sprouts, etc. There is a direct marketing company called Melaleuca Inc. that has many products containg tea tree oil, as well... The oil comes from the leaves of a specific variety of melaleuca tree in Australia.

It is a great treatment for sunburn, as well.

VANDENBERG

longlegsinlapaz - 2-10-2006 at 09:13 AM

There's a lot of information on the internet about wasp, bee & insect stings/bites. Some of the sites are more detailed than others, just do a search for wasp or bee stings. For starters, you can go look at:

http://ohioline.osu.edu/hyg-fact/2000/2076.html

I've been stung by bees & wasps many times during my life time, always had a localized reaction...UNTIL I was stung by a small swarm of wasps out near La Ribera (sp?). I was stung several places on both hands & fingers, but one sting was directly into a vein on the back of my hand. It was late in the day & the only farmacia I could find was closed; thankfully I was able to find track down the owner & they sold me some strong oral antihistimine & a topical ointment; those two items saved my life! It was raining & what would have normally been an hour's drive back to La Paz took more than 6 hours because of the rain fillled arroyos. I was admitted to Fidipaz Hospital & kept on IV's for 24 hours. I started carrying Benedryl & Andantol in my car.

Approximately a year later, I was stung on the back of my tongue drinking from a can of iced tea...having the Benedryl with me & getting it into my system within 5 minutes of the sting saved my life...I got to Fidipaz Hospital within 45-60 minutes & was immediately put on IV's and kept on them for 24 hours.

A bee sting in my pool about 6-8 months ago resulted in a huge, but localized reaction for which I took Benedryl & used Andantol & monitored myself for light headedness & dizziness.

Everyone's reaction can be different, based on what nails you & how many times you've been stung, but with wasps, the reaction gets worse with each subsequent sting, even years apart. The information I've found on the internet says that bee stings aren't supposed to have that cumulative effect...but do bees read those kinda rules on the internet? :?:

A "home remedy" that I've found that works great for me personally is to put bleach on any bug bite site, it really minimizes my localized reaction for mosquito/ant bites; I think it neutralizes the toxin if you can get it on immediately.

I keep a bottle of Benedryl & a tube of Andantol both in my car & at home...but if it's a wasp sting, I self-dose & IMMEDIATELY head for the hospital.

Read up on it; better to be safe than sorry; it could save your life!

[Edited on 2-10-2006 by longlegsinlapaz]

Tea Tree Oil

Dianamo - 2-10-2006 at 10:09 AM

I have used Tea Tree Oil (Melaleuca alternifolia) for years! It is great. I just bought a new 2 oz. bottle at "The Politically Incorrect Big Box" store for $4.99. A bargain compared to what I have had to pay in the past. Hope I don't offend anyone by shopping there!:no:

vandenberg - 2-10-2006 at 12:01 PM

Nomads,
One more question. Does Benadryl come in different varieties and dosages?
In this case, which one is recommended ?

longlegsinlapaz - 2-10-2006 at 12:30 PM

I have two different bottles at the moment....one is actually Benadryl-D for children; active ingredient is Diphenhydramine hydrochloride 12.5 mg....recommended dosage for children 6 - 12 is 1 teaspoon....over 12 & adults is 2 teaspoons.

The other is a Rite Aid brand same active ingredient, same potency; the difference being that the adult dosage is 2-4 teaspoons.

I don't carry a spoon in the car, nor do I use one at home....I use the "swig" method!! I mark the level in the bottle between each use & take the bottle with me to ER so they know what I've got in my system already & how much. I would guesstimate that my "swig" is the equivalent of 4 teaspoons. I'm 5'10" & 160 pounds & that's worked to keep me alive twice; albeit in various stages of anaphalacic shock; to get to the hospital. To me, getting it in my body is more important than taking the time to get a teaspoon to accurately measure out a dosage! ;)

Debra - 2-10-2006 at 04:54 PM

Nat: I'd like to know where you find Epi Pens for a "minimal cost" up here they are $80 without insurance. :o Or maybe you "minimal" is different than mine? :lol: Really glad I have good insurance!

Natalie Ann - 2-10-2006 at 08:50 PM

Wow, Debra, that is a lot of money. Mine came from MediCare via Kaiser Permanente and co-pay was $15 for 3. Receipt said my insurance saved me $25. I felt that was a minimal cost; musta been my lucky day.

Hyposensitization or allergy desensitization

Don Jorge - 2-11-2006 at 07:54 AM

Years ago the same thing happened to me. Mowing a field I was attacked by some bees. Having been stung many times before I was shocked when for some reason I went hypersensitve and ended up in the ER at the hospital.

Since I raise bees for pollinization and honey, have about 20 hives, it was a problem. I chose to go with a Hyposensitization treatment. It is a gradual exposure to the antigen through a long series of injections of gradually increasing doses. It worked for me. I have been stung many times since and never a reaction.

Although not for everybody, it is worth discussing with your doctor.

Good luck.

Bob and Susan - 2-11-2006 at 07:57 AM

I have a girl at work that's stinging herself to get rid of arthritis...

Bee Therpy:barf:

bajalou - 2-11-2006 at 08:18 AM

Glad you all reminded me about all this - I need to get some new ones. I have been alergic to honey bee stings all my life, getting adrenalin injections after each sting since about 5 years old.

But the really (to me) interesting thing is that the bees in Mexico do NOT affect me at all. I've been stung about 12-15 times in the last 10 years. Small bump, itch for a day and that's it. So I keep the kit for if I need it (or someone else does) and say "Thanks" that the Mex bees are different.

:light:

bajajudy - 2-11-2006 at 08:34 AM

Same for me Bajalou
I was stung in a nursery about 10 years ago, when I reached down to pick up a plant down close to the soil it was in. I let out with a yell and my husband came running. I warned him that I was allergic and to keep an eye on me.
The nursery helper took the plant for me and I paid for it, all the time wondering where my husband had gone.
When I got back to the car, he had the dictionary out frantically looking up wasp, allergy, etc.
BUT I had absolutely no reaction.:bounce:

David K - 2-11-2006 at 08:46 AM

Quote:
Originally posted by Debra
Nat: I'd like to know where you find Epi Pens for a "minimal cost" up here they are $80 without insurance. :o Or maybe you "minimal" is different than mine? :lol: Really glad I have good insurance!


Debra, I get Chris' at COSTCO... about $50.

oladulce - 2-11-2006 at 06:04 PM

Quote:

...I would guesstimate that my "swig" is the equivalent of 4 teaspoons. I'm 5'10" & 160 pounds & that's worked to keep me alive twice; albeit in various stages of anaphalacic shock; to get to the hospital.


I've been trying to figure out how to write a response without sounding know-it-all-ish, but I'm worried that some of you guys might give Benadryl too much credit for the treatment of a severe allergic reaction, so here goes:

I once had a 30 year old patient who was allergic to shellfish. He was leaving a restaurant with his wife, and she handed him the doggie bag from her shrimp dinner as they began to cross the street. From the time he stepped off the curb til they got to the middle of Pacific Coast Hwy, some shrimp juice leaked through the bag and on to his hand. He went in to full arrest (cardiac and respiratory) in the middle of the Hwy. This is an anaphylactic reaction and Epinephrine is the treatment.

My husband and I came in from surfing 9 Palms one day, and were talking with a guy on the beach. He was eating some trail mix and suddenly became anxious and restless looking. He admitted that he was allergic to cashews but "Dude, I was really hungry", and was now having trouble breathing. We "convinced" him to let us give him a shot of Epi because it would have been a long trip back to San Jose on the dirt road with one of us doing CPR on the floor of our camper. His wheezing subsided within a few minutes. This is an example of a severe allergic reaction and the treatment is Epi.

Benadryl would not have delayed the symptoms or treated either of these scenarios, and the same is true for some sting reactions. Benadryl is not a substitute for Epinephrine- it is an adjunct to Epi when it's used in the treatment of severe, potentially life-threatening allergic reactions.

That being said, everyone should keep Benadryl on hand especially when you live or travel in Mexico where you may not have immediate access to medical care. Benadryl can greatly reduce the localized symptoms of an allergic reaction such as swelling, redness, or itching at the site of a sting but an oral dose won't take effect fast enough to decrease tongue or airway swelling which can occur within minutes of exposure. By all means, go ahead and take some Benadryl capsules on your way to the hospital in Baja. But please seek further medical care if you have a history of allergic reactions and carry some form of Epinephrine if you've been advised to do so.

Over the counter Benadryl (Diphenhydramine) comes in 25 mg capsules in the US and I would guess it's of similar strength in Mexico. The adult dose for an allergic reaction is 50-100 mg. (the 100mg dose is usually for IV or IM administration).

So Vandenberg, an initial dose would be 2-3 of the 25 mg capsules. The liquid Benadryl is the pediatric strength. It would work in a pinch but would require twice as much and does not take effect any faster than the capsules.

[Edited on 2-12-2006 by oladulce]

Debra - 2-12-2006 at 01:20 PM

'oladulce" PLEASE "know it all away!" I was in the middle of responding to your post of a couple of days ago when my computer disconnected me and my G-Son was demanding attention (I never went back to finish)

I wanted to thank you for your good info. You sounded in that post that you knew what you were talking about (Dr., Nurse?) I stated in my first posts about this that I am not a Dr. just passing on the information my son's Dr. gave me........Your info. was much more detailed, Thank you....

Nat: I have Group Health which is also KP.....perhaps the difference in the price you were charged was the Medicare that you mentioned? I only paid the $15 that you mentioned, but for only one. On the package also shows the non-insurance price of $80.

David: Since this all happened with Dustin I have often thought about Chris and you needing to carry a Epi Pen for him..... My concern is what was stated on the package about how to use it and at what temp. it must be stored. (As I stated in my post) I know you have Chris's in the glove box of your truck, which is handy (where needed most often since you are there so much) but, with the high temps. will it be effective when needed?........Maybe "Oladulce" can give us a heads up on how to store them best? (in Baja conditions) This has really scared me since Dustin had his episode.....(he was, according to the ER Dr. 10 mins. from death, MAX!)

Also as I mentioned in my original post.....Benadral is just a first responce, only to be used if it is all you have while you get as fast as you can to a Doctor!