75 down Silas

Everything was going smoothly until yesterday morning. Andrea had arrived the night before and we had spent a wonderful evening together. Andrea juggles her full time job as a labor and delivery nurse with full time nurse practitioner school, mommy duties, and training for the Richmond marathon. How? That's a good question! Apart from general sister bonding, she came to Winston to practice her history taking skills and physical exam techniques. As the younger sis, I love being in a position to help the person I've always looked up to. That evening I demonstrated how I do an H&P by practicing on her. By the time we were finished, I knew her medical history inside and out... little did I know, in a matter of hours that information would be critical for me to know.

We woke up Saturday morning and got ready to hit the gym for a great shoulder workout. A quick protein bar was supposed to be an easy and tasty source of fuel. I was eager for An to try my favorite protein bar and after a cursory glance at the ingredients, we decided it was safe. Andrea has a horrible nut allergy, so much that ingestion of even a trace of nuts is enough to take her life. The problem with processed foods is that everything seems to be "processed in a facility that may contain tree nuts." Usually there isn't an issue, but in this particular case that "trace" was all it took.

Andrea knew immediately that the bar was off limits after the first bite. Her tongue started to tingle and she vomited right away. She had me convinced that she was ok (and she looked great!), so we set off to the gym and started on shoulders. After five minutes of lifting Andrea went from strong and healthy to weak and woozy. Once she told me that she didn't feel well and that the nut was making its way into her system, we immediately power walked our way to the car and headed towards home.

Over the next five minutes Andrea developed hives and started to lose her airway. Her tongue, lips, and uvula were so swollen and a faint stridor was all I heard. I panicked. My sister could hardly breathe. When an emergency hits this close to home, it is nearly impossible to think clearly. I called my brother-in-law who is a physician and could hardly talk, I was so overwhelmed. We didn't have time for an ambulance. She wasn't talking, she was getting worse by the second. While driving 75 down Silas Creek Parkway (flashing my lights and blinkers) I reached for her Epipen and injected it into her thigh. I'm sure it helped somewhat, but the instant rally that I had hoped for failed to occur. Finally (finally!!) we screeched into the Emergency Department and she was rushed into the trauma room. There must have been fifteen bodies in the room, all working to stabilize my sister. Her blood pressure and oxygen saturation were dropping quickly and they administered 3 rounds of epinephrine, blasted her with steroids and Benadryl and threw in some Pepcid and Zofran for good measure. They called pharmacy for back up and even almost intubated her. I have never been more scared in my whole life. At first nothing seemed to be working. When they asked me her code status and whether or not she was an organ donor I panicked! God was with us, I could not stop praying. In a matter of minutes, she started to improve and despite aggressive rigors, she was laying calm and breathing comfortably (albeit, with the help of the respiratory team). My sister was back. I felt an overwhelming sense of calm and knew that everything was going to be ok. The ED physician wanted to keep her overnight to ensure that she didn't have a rebound reaction. Fortunately, I convinced him that I would keep a very close eye on her and bring her back at the first sign of trouble. While we were waiting for her swelling to go down, we finished practicing H&Ps to prepare Andrea for her test. I guess that answers the question of how she accomplishes it all. Not even a little anaphylactic shock will prevent her from pushing through and getting things done ;) !

What a relief it was to be discharged. After a nice long showers An was totally back to herself. We were able to meet up with friends and enjoy some time downtown. This morning we met my trainer and training buddies at the stadium for a grueling workout. To quote my sister, "that was the hardest workout I've ever done!" As if that weren't enough, we proceeded to head to the Metabolic Effect studio for a workout with Jill (which was filmed!). What an absolutely, ridiculously, 100% crazy weekend.

I love my sister so much!!