Monday, September 7, 2009

Bee stings

On Sunday, while I was descending at fairly high speed, a yellow jacket ended up in the space between my thumb and my index finger and being stuck there, stung me. The sting went right through the glove. I am moderately allergic to bee stings and the prospect of spending another week with a swollen hand caused me a lot of concern.

As a kid I got stung many times but I never developed an allergy. Nobody in my family is allergic to anything and so it never occurred to me that I might one day become a victim. That day happened more than ten years ago when I got stung on the upper lip while on a bike ride. My lip turned into a bright red, ready-to-burst sausage that disfigured my face for almost two weeks. Since then I have gotten stung in my right arm once, resulting in an equally grotesquely swollen tube that kept me out of circulation for another ten days.

Then one day, something remarkable happened. I got stung in the eyelid while at the SJ international triathlon. Thinking my race was over I hurried to the transition to get help. However, it took quite a while for me to get there and by the time I did I had all but forgotten about the sting. I went through transition and ran a 10K without ever thinking about the bee again. I finished, took a shower, got dressed and was walking though the remnants of the expo when I suddenly noticed that there appeared to be a curtain hanging in front of my eye. It was strange. At first I did not know what was happening.

And sure enough, within 10 minutes, my eye was swollen shut. It was as if the whole reaction had been delayed for an hour or more, while I finished the race. Now however it was in full swing as if the clock had been reset. The swelling lasted for 5 days.

Taking some lessons from that episode I knew that if I removed the offending insect carefully and kept riding, the reaction would be postponed. I would get home in time to do something about it.

The problem was that soon afterwards my left crankarm came loose and I could no longer ride. After some manual adjusting I made it to a Round Table pizza place where I could call for help. They also had a soda machine there that dispensed ice. I used it to keep my hand cold and elevated until my ride arrived. The swelling was moderate and nicely under control, and the pain was less too.

When I got home I kept the hand elevated and applied many layers of a strong (prescription) steroid ointment. I put the hand in a glove to keep the ointment from rubbing off. I also took two Benadryl. And I am happy to say the remedy worked like a charm.

Today I have a kidney-bean-size swelling with some very mild edema in the surrounding tissue (but not much). The "bean" itches a bit but nothing dramatic. One can see that the reaction is still abnormal because no red elevated spot formed (that I take to be the hallmark of a normal sting reaction). Instead the sting site is hard to see and somewhat lost in the surrounding tissue swelling. But the result is spectacular to say the least. I think I finally found a way to deal with this.

Here are my recommendations (for mild allergies--no respiratory symptoms):
-carefully remove the stinger and poison sack --do not squeeze
-if away from help, keep your exercise level high. The adrenaline will postpone the reaction. I.e. don't stand around.
-as soon as possible, apply ice and keep the limb cold and elevated. The ice will cause vasostriction which will prevent edema and prevent uptake of the poison.
-as soon as possible, apply steroid ointment and reapply often. Keep area cold until you can get medication.
-take antihistamines.

I have followed these procedures twice now and the results have been encouraging, preventing major swelling from happening and keeping symptoms under control.

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