Tuesday, September 1, 2009

Allergies

A popular topic on all medical blogs, it seems, but always fun. This (almost) alphabetical list was given to me by today's 9:00:

"I'm allergic to Ambien, Aspirin, Axert, Bextra, Butalbital, Caffeine, Celebrex, Codeine, Pistachio Ice Cream, Darvocet, Depakote, Fentanyl, Amitriptyline, Hair Spray, Erythromycin, Fosamax, Imitrex, Keppra, Marinol, Klonopin, Lamictal, Lyrica, Mountain Dew, Mirapex, Mobic, Breathing Strips, Morphine, Treated Leather Products, Cardizem, Neurontin, Model Glue, Oxycodone, Penicillin, Jell-O, Relafen, Vanilla flavoring, Relpax, Requip, Artificial Cookie Dough, Sinemet, Sonata, Sulfa, Peanuts (but peanut butter is okay), Steroids, Talacin, Tetenus, Artificial Creamer Stuff, Topamax, Toradol, Some M&M colors, Tramadol, Hydrocodone, Vioxx, Xylocaine, Zoloft, Zomig, and Zonegran"

I can only assume this person has kids at the school Mrs. Grumpy works at.

61 comments:

  1. Why do I think this patient was coming to see you for headaches?

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  2. I'm jealous that hers is alphabetized. I'm going to have to do that to mine...Even if it's not nearly as impressive.

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  3. I would shoot myself if I was allergic to pistachio ice cream!

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  4. Looks like a dye allergy? Or inert ingred allergy? With peanuts tossed in for good luck?

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  5. What on Earth do peanuts have, that peanut butter doesn't? Usually people argue that it's the synthetic stuff they're allergic to.

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  6. This could become the next Tom Lehrer song.

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  7. Pistachio ice cream, but luckily not pistachios, and not ice cream.

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  8. Should you mention to the patient that an upset stomach is not an allergic reaction? Lord knows how often I see that. I had one patient come in and say they were allergic to Lortab, but not Vicodin.

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  9. How did they find out they were allergic to tetenus? LOL! I assume that is a mispelling of tetanus.

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  10. Artificial Cookie Dough? Guess the real stuff is fine, especially if it is found in non-pistachio, non-m&m (some colors only) peanut butter ice cream.

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  11. Holy shit. This means this person has been prescribed all of these meds and tried them! My gosh, I'm 40 and have probably tried 10 prescription medications en toto my whole life.

    WF: Re-evoid-a: The latest and greatest medication for internet/blog addicts.

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  12. If he/she used the Treated Leather Products, Model Glue, Jell-O and Artifical Creamer Stuff all at the same time, it would have been a great party. Maybe even worth the reaction.

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  13. Tex- The patient's consumption of Oxygen is causing ME to have adverse effects.

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  14. If time weren't an issue, this would be a fun list to examine further with the patient. "Marinol gave me the munchies and I felt really paranoid. Hair spray makes my hair brittle. Model glue makes me light-headed & dizzy if I breathe in too deeply." The possibilities...

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  15. Dreamingtree- I did that, but resisted publishing it as it may have weakened confidentiality.

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  16. I work in a parmacy and had someone say she was allergic to Epi-Pen because it made her heart race!

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  17. I'm sorry but you are allergic to the only treatments for your condition. I have nothing to treat you with. You will just continue to have these symptoms for as long as you live.

    It's even more fun in the hospital when you can say "the disease you have is life-threatening but you are allergic to every possible treatment. Hospice will be here in 2 or 3 hours to help you prepare for your death and keep you comfortable."

    Amazing how that changes the allergy list...

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  18. I am aching to know if the patient is allergic to pistachio pudding as well. Or pistachio brittle...

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  19. I am wondering how this patient found out she was only allergic to some, not all, colors of M&M's. How does one figure this out? Hummm... I am only going to eat the green ones today and see what happens.
    Also, what is the difference between real cookie dough and artificial cookie dough? Any specific flavor? Maybe it is the kind with vanilla flavoring added.

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  20. I once had a patient as a resident that listed glucose (among other things). The poor pharmacist was diligent and called to clarify the order for D5W. Though she did end up dying...maybe she wasn't crazy??!!

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  21. You just gotta wonder if this person has a life outside of testing themselves for 'allergies'. (What say, the power of suggestion goes a long way toward creativity?)

    Would it be safe to assume the patient can still take benzos, ibuprofen, strawberries, tomatoes, and Jack Daniels?

    What happens when the patient misplaces this list? One would imagine some of this info gets truncated on free-form pharmacy allergy lists, unless there's a check box for allergy to penicillin, sulfa, and opiates?

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  22. OK, so the previous commenters already pointed out the issues that intrigued me.

    Anon--Earlier this week, I had the same epi-allergic patient--it caused her heart to race, too! Oh, my god! How shocking they'd have the same reaction!

    Good luck trying to treat her for anything.

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  23. That's true anonymous...they DIDN'T list any alcohol...

    with that and the chocolate that they arent allergic to..it's a party!

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  24. She probably left out she was allergic to air, light, and herself?! ha!

    She has low wattage that's for sure! or as my Daddy used to say, she has been upstairs for years! and that's probably where she needs to stay if she's allergic to all that! good gravy Mabel!

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  25. Five allergies equals one personality disorder?

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  26. Doc Grumpy,

    I've been lurking for a couple of months, but man - I had to comment.

    What the hell is artificial cookie dough? It's either cookie dough or it isn't...it either makes cookies or it doesn't...what the hell?

    Are there specific flavors of Jell-O that they are allergic to, or is gelatin in general a no-no?

    Allergic to tetanus? Don't we all suffer adverse affects from tetanus?

    I wonder if they're allergic to their own farts too...I noticed crack wasn't listed.

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  27. After reading this, does anyone else have that hotel chain commercial's song stuck in their head? "I've been everywhere, man, I've been everywhere!"

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  28. I think it should be set to music, like Tom Lehrer's song "The Elements".

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  29. You left off what it was she specifically asked for. What does she want you to prescribe?

    How about a referral to an Allergist?

    StephRx

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  30. There's Ambien and Aspirin and Celebrex and Marinol,
    Darvocet and Depakote and Fosamax and Toradol,
    Treated Leather products, Amitryptyline and Hair Spray,
    And Model Glue and Peanuts (but Peanut Butter is okay...)

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  31. looks like someone is getting buprenorphine nasal spray!

    Who honestly has had all those different medications prescribed for them?

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  32. Maridyth: Thanks! Now I do!

    Totally great post...thanks!

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  33. is this for real? is this a real list? allergic to mountain dew, artificial cookie dough, some m&m colors??? did this person read what he/she wrote??? is this person playing a joke on you? this is ridiculous. i don't know how you can keep a straight face Dr.G.

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  34. How exactly can you be allergic to breathing strips? The thing that opens your air passages mechanicly on your nose? The benign piece of sticky paper that barely touches you?

    This patient is confusing what they are allergic to with what they enjoy...

    On a side note, 5 posters have affirmed that this was, indeed, a woman who has the allergies even though no sex was stated. Not one believed it could have been a male. Just saying...

    -Flavius

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  35. I have a feeling the patient confuses migraine triggers with allergies, or is chemical sensitive. I have tried about that long of a list of medications too, sadly. Thanks for the laugh!

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  36. I'm with one of your Anonymous commenters: "I'm sorry but I have no medicine to treat you because you're allergic to everything." I wouldn't go quite as far as sending to hospice but...

    I've had a couple of these "allergic to everything" patients. One has an A1c way in double digits and is legally blind from diabetic retinopathy. She was the one allergic to glyburide, glipizide, metformin, avandia, actos, and insulin, not just porcine insulin but human insulin! And was angry AT ME when I couldn't help her get her blood sugar down. I sent her off to another provider but I ran into her recently and asked about her blood sugar levels. Still 300 - 500.

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  37. I hate idiots. For every douche that comes in with a list like that, it makes my life x10s harder.

    My allergic reactions=a 911 call and at least one shot of epi. Mine are weird. Flu shot, horse dander, soy products.

    Couldn't she have Googled adverse reactions and culled the list?

    At least your not a pediatrician. My SIL has a list of over 40 things her kid is "allergic to" per her chiropractor.

    LD50 Rat

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  38. My poor brother is allergic to everything....perhaps even other humans. But I doubt he has a list at all. To him, sneezing, wheezing, and itchening is part of life

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  39. Let me guess, she wanted Demerol?

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  40. @Pharmer Jane

    I was reviewing a Med Rec Form one day...and it was totally incomplete. It had a couple medications listed on there...but nowhere near the number that I actually had to write down. The poor MA at the doc's office had to waste many a sheet of paper to fax it to me. It came out to roughly 7 pages of paper, listing out 39 *different* medications. No two were the same, but some had to be for the same indication.

    So, start with HEENT and Neuro drugs, and work your way down the body.

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  41. What the hell? Were they a medical lab rat for the FDA so they could pay for college?

    "Subject's face swells after ingesting a peanut, but can eat nearly 25lbs of Reeses Peanut Butter Cups... Dear God, that's just not human!"

    Yeah, I couldn't live without Lamictal and Jell-O

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  42. @Holly, I'm allergic to some M&M colours, the green and blue ones. The problem is with the artificial blue 133 colouring used. I discovered this years ago, before blue M&M's were made, when my kids loved to drink green cordial. Everytime I drank the stuff with them, I'd get an itchy rash. Now, when I buy M&M's the kids get all the green and blue ones.

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  43. Flavius, maybe everyone assumes it's a woman because of all the migraine meds in the list? Mostly women on those.

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  44. Flavius:

    I don't have a problem thinking it could be a man.

    Who cares? As if there aren't just as many idiot males as females. Are you some kind of neanderthal throwback? Misogynist.

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  45. Makes your job easy. Just prescribe her a peanut butter and jelly sandwich and be done with the psycho.

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  46. what is artificial cookie dough?
    And whichM&M colors? Do they change depending on the day of the week??

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  47. Sorry, I have to do this:

    SING ALONG, EVERYONE, WITH JULIE ANDREWS AND THE VON TRAPPS!

    Ambien, Topamax, Jello and Codeine/

    Cookie dough, Xylocaine, peanuts and morphine/

    Aspirin, caffeine, and yes even glue/

    These are a few things I'm allergic to . . .

    When my legs itch/and a rash flares/and I wheeze all night/

    I must avoid all these bad allergens/

    Oh, please doctor, make it right.

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  48. "Flavius:

    I don't have a problem thinking it could be a man.

    Who cares? As if there aren't just as many idiot males as females. Are you some kind of neanderthal throwback? Misogynist."
    Posted by Gert


    Gert,

    I merely pointed out a fact with no analysis of the subject. If you take offense with my observation then perhaps you should be taking a look at why. In fact, looking at your comment, did you even read what I wrote?

    I would imagine a normal person would see my post and think, "Wow, more people assume this is a woman than a man with these allergies, that sounds stereotypical." Yet you call me a mysogynist saying I have a hatred for women or girls, however you have no apparent basis of that from my post.

    I might or I might not have a hatred and disrespect for women, but that is irrelevant to my point. Try again, friend.

    Sorry to use your space, Dr. Grumpy, but hope you understand :)

    -Flavius

    Ironically, the captcha used was "HOTHO"

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  49. Best entry blue ribbon winner is the Sound of Music entry.

    NICE.

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  50. I really do have food/chemical and pollen allergies/intolerances and it's hell to live with. That woman is clearly crazy as you can't be allergic to peanuts and not peanut butter, and you can't be allergic to everything, or you'd be dead. Do laugh if you feel like it, and remember that karma really does happen.

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  51. Fiz, I meant no offense.

    There are plenty of people out there with allergies that can make life unpleasant. I am well aware of this.

    This patient (please note, I do not list a gender for them) had obviously taken this to an extreme, of the "I'm allergic to sleeping pills, they make me sleepy" kind.

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  52. Dr Grumpy, it wasn't you that I was annoyed with, it was everybody that chimed in and claimed that people don't have allergies like that, or are crazy if they think they do. I am well aware that your patient was over-exagerating. I am sorry as I do not mean to make you think I was getting at you.

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  53. Fiz, no offense meant and none taken!

    It's a 3 day holiday on this side of the pond, so I'll have to find something to write about beside my office for the next few days.

    I'm sure something will come up. It always does.

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  54. Ok, so obviously someone needs to explain side effects, normal effects of medication, and allergy. Do you swell up beyond belief and can't breathe? Or, do you itch from head to toe? Vomit profusely for 12 hours? If not, call it intolerable, not allergic. I agree with ER...if it can save your life, deal with the uncomfortable side effects. People who are allergic to Lortab but not Vicodin know that if they call it Vicodin on the street, they will get more per pill for it than Lortab. Doesn't matter if you explain they are filled with the same generic, beacuse then they want to know which manufacturer of the generic you have in stock!! Wow!!

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  55. this blog is very important because we have the answers to a doctor almost instantaneous.

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  56. I didn't know it was possible to be allergic to caffeine.....

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So wadda you think?