Comments on: My Newest Medical Problem

By: ******

****** — Mon, 15 Feb 2010 17:56:51 +0000

I remember my mother telling me I was allergic to sulfa. If I take it I’m totally wacked out….
I start talking to people that are not really there……
I have also developed a allergic reaction to those hard round peppermint candies…I used to eat them 20-30 times a day and now when I eat one I get an abdomin ache (all most feeling like I’m going to explode) and REALLY bad direah….

By: Marry

Marry — Sun, 11 Oct 2009 18:14:33 +0000

I know I am late but I had to comment. I come at this from the other side. I am one of those people allergic to “all antibiotics”. Well in actuality I am allergic to penicillin and all derivatives, doxycycline and all derivatives, erythromycin, clyndamycin, sulfonamides, Ceclor, and Levaquin. Most of these reactions involved trouble breathing although amoxicillin caused my skin to slough off. I now have severe reactions to new antibiotics on the first dose even when there is supposedly no cross reaction. All challenges have failed.

I carry around a note from my allergist (head of the department at a well known hospital) stating my allergies. I still get told on a regular basis that my allergies are impossible. I now tell the ER they must call my allergist if they want to give me antibiotics as no one will believe me. The fifth time I get asked, “So (insert antibiotic here) causes nausea and diarrhea right?” I feel like screaming.

By: Pat

Pat — Mon, 10 Aug 2009 00:25:28 +0000

Annoy people often enough and, lo and behold, they might not bother to reply.

By: Reporting Allergies Inaccurately Can Cause EMR Alert Exhaustion

Reporting Allergies Inaccurately Can Cause EMR Alert Exhaustion — Mon, 20 Jul 2009 05:09:58 +0000

[...] a satisfying post on WhiteCoat where he rants against patient-reported allergies. A sample: When I ask patients about [...]

By: dr nic

dr nic — Sun, 19 Jul 2009 22:04:37 +0000

No, he should tell people that he gets a rash from it.

By: dr nic

dr nic — Sun, 19 Jul 2009 22:04:00 +0000

LOL In five years of anesthesia I haven’t heard that one yet.

By: Better Health » Reporting Allergies Inaccurately Can Cause EMR Alert Exhaustion

Sun, 19 Jul 2009 20:00:37 +0000

[...] a satisfying post on WhiteCoat where he rants against patient-reported allergies. A sample: When I ask patients about [...]

By: LibraryGryffon

LibraryGryffon — Wed, 15 Jul 2009 18:17:42 +0000

The problem I’ve had with this is that very few hospital or doctor’s forms have a place for drug intolerances. And my reactions to sulfa and sulfates are such that, allergy or intolerance, I will not take them unless the only other option is death. (It took months for my guts to recover from three days on gent sulfate eye drops – I really don’t recommend severe abdominal cramping with diarrhea changing to mucus and then to blood over several hours. Taken orally, I vomit for hours after every dose, and albuterol sulfate by nebulizer just leaves me with severe nausea, even with compazine or similar drugs.)

I explain this at triage, and I invariably end up with a red drug allergy bracelet. Nursing and medical staff tell me that it’s not an allergy, but it’s the only way to make sure they don’t give me any.

So I usually just say it’s an allergy.

And then get given sulfates anyway.

Being “allergic to oxygen” does make me laugh, but also reminds me that I have real trouble being given oxygen in the hospital because of the smell of the tubing. It’s definitely not an allergy, I have had no obvious reaction of any kind the two times it’s happened, and it’s completely irrational, but I can NOT tolerate it. There’s one brand of plastic wrap which smells the same way, and I can’t eat anything that’s been wrapped in it for any length of time because it acquires the smell.

By: WhiteCoat

WhiteCoat — Tue, 14 Jul 2009 16:04:35 +0000

Your analogy fails, though because most “reactions” are deemed allergies after a single exposure. Once deemed an allergy, then no one gives the medications over and over again to see whether the same reaction occurs EVERYTIME they get the medication. How does one reliably determine an allergy based on one event?
You’re right that there is a communication gap. Due to simple economics, many doctors can’t afford to spend inordinate amounts of time with every patient. You’ll see that once you start practicing. I could just as easily make the argument that the lack of communication is because patients don’t want to pay the doctor more to spend the extra time with them.

By: WhiteCoat

WhiteCoat — Tue, 14 Jul 2009 15:54:12 +0000

I’m not going to reiterate what I’ve already stated in previous comments, but will make these few statements.
I try to educate my patients – even in the rushed emergency department. Few of them want to hear me disagree with conditions they have embedded in their persona. In fact, not too long ago a patient complained about me to the hospital administration because I told her that her diarrhea was not an allergic reaction to medication and she believed otherwise. Most people think that I’m questioning the intelligence of their primary care physician or think I don’t know what I’m talking about when I try to help them, so for the most part I stop trying.
I think that physicians are to blame for many “false alerts” with allergic reactions. Those false alerts could stem from a lack of knowledge, fear of liability, desire to please the patient, or a combination of all of the above. Unfortunately none of those motivators is likely to change in specific physicians.
There is a spectrum of reactions – real and imagined – to any medication. On one end of the spectrum are allergic reactions such as wheezing/throat closing/trouble breathing/rashes, ect., and serious reactions to medications. No one takes issue with those. No one is “making fun of people” who have or who claim to have those symptoms. Nowhere have you read anything close to “Hey Joe, it was hilarious – my patient took penicillin, she started wheezing, and she flopped on the floor holding her neck. You should have seen the look on her face!”
In the middle of the spectrum are annoying side effects from the medications which are not allergic reactions and are listed on the product insert. Some of the more common medication side effects claimed as allergies I take issue with. Antibiotics commonly cause diarrhea. No, isolated diarrhea is not an allergy. Flagyl causes a bad taste in your mouth. Isolated bad taste is not an allergy. If you’re saying that you think doctors should sit down and recite every potential side effect from every medication they prescribe, you’re being unrealistic. Patients have to take some initiative to at least read product inserts.
Further down the spectrum are people who experience intended effects of medications, yet for some reason term those reactions as “allergies” – Benadryl makes me sleepy, succinylcholine paralyzes me, codeine knocks me out. Again, reading the product insert would be a good first step.
At the other end of the spectrum are people who have reactions to things such as water, the color white, and air. These are akin to a child saying that a cloud bit him on the arm. Humorous because most people know that such a thing can’t happen. It’s obvious that you don’t find humor in the oddity of those type of complaints, so we’ll leave it at that.
Mottsapplesauce is correct. Talk to your doctor. Just realize that not every doctor knows everything about every medical topic.
Even me.