My Day as a Lab Rat. Getting Tested for Penicillin Allergy.

As a wee lad of 18 years of age, some 46 years ago, during my freshman year at Oklahoma State University, I came down with some malady, the name of which I cannot now remember, but substantial enough to cause me to report to the campus infirmary. Upon examination by a doctor, I was administered a dose of penicillin.

The next day I reported back to the infirmary with a bright red rash that covered the whole of my body. “Penicillin allergy!” declared the doctor. And so it was for the next 46 years, dutifully reporting to every new physician, every hospital and lab, my allergy to penicillin. For many years I even wore a necklace or a bracelet declaring my allergy and carried a warning card in my wallet.

Occasionally, a new doctor would ask me how I reacted to that penicillin shot many years ago. I would describe the bright red rash covering my entire body. In each case, a thoughtful look would cross the doctor’s face, he would purse his lips and nod, “Sounds like a penicillin allergy.”

A couple of months ago I heard a news story on television reporting that many people who had been diagnosed with penicillin allergies were not, in fact, allergic. The next time I visited my primary care physician for routine care, I asked if he thought it would be a good idea to get tested. He agreed and referred me to a local allergist who performed testing for penicillin allergies.

I made my appointment with Jeffrey Davidson, M. D. here in San Francisco. On the date of my appointment, I was late and for some reason had failed to complete the medical questionnaires they had sent me by email. Not an impressive start. Nonetheless, they gave me the questionnaire again there in the office. It was a rather lengthy and extensive request for medical history, medications, etc.

First in the office was a medical assistant took my pulse, blood pressure, temperature and other vital signs. I was asked to blow into a device that measured my lung capacity. Apparently I passed.

Next into the room was Dr. Davidson, a slender man of about my age, who was very familiar with my primary care physician. He carefully went over my records and then explained the process.

That day they were going to do an allergy test for histamines on the inside of my forearms to see how I reacted. If I reacted sufficiently, a follow-up appointment would be scheduled at his downtown office where the actual sensitivity testing would be conducted.

After about 15 minutes, I had not reacted to the histamines, which is quite uncommon apparently as I guess most people do. I was queried extensively on what kinds of medications, other than those which I had previously disclosed, I had taken. He seemed a bit skeptical when I responded, “nothing.”

He had me fill out a disclosure statement where I had to acknowledge that the penicillin sensitivity test could kill me, after which he reiterated that fact several times. He suggested that we schedule a 2nd appointment, that I consult with my primary physician regarding discontinuing the beta blocker I was taking for a few days prior to the 2nd appointment and that I procure an EpiPen from my pharmacist, just in case.

Needless to say, the repetition of the “this could kill you” part and the request that I obtain an EpiPen, did not make me any less nervous about the process. Nonetheless, I got an EpiPen.

For some reason, the part about consulting with my primary care physician and stopping the beta blocker for a period of time completely escaped my consciousness until a day before my next appointment. Again, the histamines did not react. Obviously annoyed, but giving no signs of abandoning this inattentive patient, he reiterated his instructions about contacting my primary care physician, stopping the beta blockers, and making it yet a 3rd appointment in the very near future.

This time I complied, and to my surprise, my primary care physician completely took me off the beta blocker. When I arrived for my 3rd appointment I had been beta blocker free for a week.

First, I would again be tested for reactivity to histamines. Then, I would be pricked with the teeniest amount of active penicillin to see if I reacted. (Think about going to an allergist being tested for various substances. It is the same concept.) If I did not react after 15 minutes, I would be given a slightly higher dose by injection under the first layer of skin. If that was nonreactive, I would be given a capsule containing amoxicillin. If I didn’t die or that dose did not cause a reaction, I would have the mantle of “penicillin allergy” removed from my records.

I was a little more than a bit anxious. After all, the doctor was very clear that I could die from all of this experimentation.

The initial histamine test was only mildly reactive, nonetheless we decided to proceed. Next followed the needle prick with a small amount of penicillin, which did not react, although I reported a tingling in my chin and the feeling that my throat was closing up a bit. The doctor returned to check me out and after looking at my throat informed me that there was no swelling, and in his best bedside manner told me that it was most likely, “all in my head.”

Ahem.

Boldly on to the next step, which did not react. Next up was the capsule of amoxicillin which I washed down with plenty of water. It was a good thing I brought a book with me because this part of the test took an hour, at the end of which there was no sign of any allergic reaction.

At the end of the appointment I was given a letter from the doctor which stated in part, “Larry is not at increased risk for immediate anaphylactic reaction to penicillin drugs compared to members of the general population.” I think I am happy with this. Although a letter containing somewhat more absolute language would have been nice, I am not afraid of getting accidentally treated with penicillin in the future.

Long story short. If you have long been diagnosed as having penicillin allergy I highly suggest get this test. It is really very safe with safeguards built into the process at every step. I am amazed that for the past 46 years I have had this allergy. Was I ever really allergic to penicillin? I don’t know. I know that it is possible for people to grow out of their allergies and that could possibly be the case with me. The point is, if you don’t know, check it out.

Knowledge is power.

In case you were wondering . . .

 

 

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