Updated: Nov 5, 2020
Ever since I can remember, I've had bad allergies. Cats, bunnies, horses, some dogs, dust and everything outside can cause a reaction. I sneeze, my nose runs, my eyes itch, my skin itches, my entire body will get cold and feel prickly inside. All I will want to do in this state is stand in the shower with hot water pouring on my face and head. I have even rolled up tissues and stuffed them into my nose to stop it from running non-stop. I take daily pills (basically prescription Zyrtec) and keep Wal-Phed Sinus and Allergy in every bag, at work, and in my car. I've also been known to keep cortisone and steroid creams in my bag. I've taken my fair share of Benadryl and actively avoid touching outdoor plants and animals. I've tried local honey, the allergy trio of essential oils, so many kinds of allergy pills, allergy covers on the mattress and pillows, etc. I have no doubt that all of these things help, but I continue to put up with these restrictions and reactions year after year.
When an allergy attack hits me full force, I'll take multiple pills in one day. For instance, last weekend I was around my grandparents' cats, outside playing with my niece and nephew, and around Keith's sister's dog all in one day. I took my normal morning allergy preventative, three or four Wal-Pheds throughout the day and by the time we got home I swallowed two Benadryl to go to sleep hoping I would wake up able to breathe. I showered three times that day and it's only February...Spring isn't even in full bloom. I have come to hate all of Spring because my allergies make me miserable. My coworkers know I'm at work in the mornings because they have to say, "bless you."
It has been really frustrating because most people don't understand when I say I'm avoiding something because I'm allergic. I feel guilty not petting cute dogs and cats and opting out of the family Easter Egg Hunt because I don't want to touch anything outside. I felt silly saying I couldn't ride the horse at my niece's 4th birthday party. It's almost like sometimes they don't believe you or act like you're overreacting. Or you can just take a pill...or five...and it will be okay. Maybe that part is all in my head. Then I start to question if I am overreacting or being too sensitive. It's like you're sick and feel like total shit, but since "it's just allergies" you have to suck it up and carry on. You're not contagious so you're expected to work and play regardless.
So why have I put up with this for so long? That's an excellent question. I'm 28 and finally decided to see an allergist and sort this out. I've made excuses about time and money and coped using the methods I've found that help the symptoms and reactions. I think the real tipping point is realizing that all of the antihistamines make my heart condition and anxiety worse because they are stimulants. So here I am in March 2020, taking the plunge to do something about it.
Allergy Testing - The First Appointment
I had seen Alabama Allergy & Asthma Center on my many trips to Target and had been thinking about it for a long time. I finally called to schedule an appointment for testing and to discuss my options. I was a little frustrated to be told new patient appointments last up to 4 hours and I would need to take off work half a day (I try to avoid taking off for anything that isn't vacation, but decided this was necessary).
After filling out a lot of paperwork online, I was told I had to be off all allergy medications for five days before the testing. This gave me a lot of anxiety about being completely miserable for a week, but luckily the universe delivered a week of so much rain which kept my sneezing at bay! I made it Monday through Friday coasting on hopes and prayers and the appointment was finally here. I should have taken how excited I was to spend half a day being poked as an indicator of how much I truly needed this.
I left work at noon on Friday, March 6th and drove through Starbucks on my way. Armed with a good book from the library (The Year of Less) and my venti decaf skim latte, I was ready for the afternoon's revelations.
They took the standard vitals and asked basic questions about what I hoped to get from my visit. I gave them the condensed version of the explanation above and basically that I wanted to explore options and shot pricing and that I believe I am allergic to cats, dogs, horses, fuzzy critters, dust, and everything outside. Their recommended course of action was skin testing for the categories of allergens I mentioned and we could move on to my options based on what I am allergic to.
Skin Prick Test
For the skin prick test, you remove your top half clothing items and put on a paper vest that only exposes your back. You lay on your tummy and tiny pricks are administered in sets of eight on your back. From what I could tell, they dip the pricking apparatus in oils of the allergens. It doesn't hurt per say, but it's kind of like being poked with sharp toothpicks which doesn't feel good. I had 48 pricks. They also have controls for positive (straight histamine) and negative. After you've been pricked, you wait 20 minutes to see what you test positive for on the skin, which will show sort of like a mosquito bite. You're not supposed to scratch even thought it itches like hell. I guess I'm used to itchy skin, because it wasn't unbearable and I was able to read while I waited.
Skin Prick Results
When the nurse came back after eight minutes she glanced at my back and said "Oh, wow...WOW. You were right and there are still 12 minutes left." She said I tested positive (highly allergic) to 34 of the 48 allergens. I wasn't able to remember all of the placements, but I do remember the top right are grasses, I believe the ones under that are cats and dogs, and the bottom left is horse. They measure the 'wheal' which is the swelling and the 'flare' which is the redness. Of the fourteen I didn't react to, they were mostly molds and trees. To get a reaction on the skin, you're highly allergic but the wheal and flare indicate how severe the reaction is for that particular allergen. When you are allergic to something and breathe it in, you have the same reaction in your sinuses.
I tested positive for the following:
Dust Mite Mix
Once you've gotten the results of the skin prick test, they take all of the allergens you tested negative for and inject them under the skin in your arm. Typically, if you test negative on the skin you will still have a reaction underneath the skin's surface. Surprisingly, I still tested negative for the fourteen.
Although this picture looks pretty gnarly, the swelling and redness calmed down after the 20 minute waiting period. I will say this part was much more painful than the skin prick test. They actually inject the needles under the skin's surface. It basically feels like a normal shot. My arm is slightly bruised. I can't imagine little kids getting this testing procedure.
This particular facility is also a research center, which I found fascinating. They measure pollen counts and provide a pollen forecast.
The doctor said typically she will advise medicating during certain times of the year depending on what you are allergic to. She explained the time frames for people allergic to trees, people allergic to weeds, and people allergic to grasses. Since I happen to be allergic to trees, weeds, AND grasses I will need to be medicated year round. This is not surprising to me so I just laughed and said, "of course."
Not that I'm happy about being allergic to everything obviously, but I have to admit it feels really good to have solid proof that I actually am allergic to all the things I've suspected my entire life. The doctor said, "A lot of people come in saying they are allergic to many things, but they are usually only allergic to a few. This is a lot. You're our worst case today. You must have suffered through a lot over the years." Having a professional confirm what I've been through and that I'm not overreacting or over-exaggerating feeling like total shit when I'm exposed to allergens is just comforting. Having someone say they can help you...I'm really looking forward to the results.
Honestly, I'm sharing this experience here for those who feel the same way and are looking for hope or inspiration to try something new. To say: here is what I'm trying and maybe it will work for you too. I'm also sharing this for those who have loved ones with seasonal or animal allergies. To hopefully help you understand what we go through and encourage compassion.
So we decided I'm a good candidate for allergy shots. The premise of allergy shots is to inject you with gradually increasing doses of your allergens until you've built a tolerance to them. Allergens that currently elicit a histamine response eventually will no longer elicit histamines when you're exposed to them. You are then tolerant.
The serum is made specifically for you using your allergens, a cocktail if you will. Only certain allergens can be mixed together, so depending on how many you're allergic to determines how many vial mixtures of serum and shots you need. Your shots are administered in the office and you are required to have an epipen in order to get them (they prescribe one for you). At each shot visit you have to wait 30 minutes before leaving to make sure you don't have a severe reaction.
Shots weekly for the first year
Shots every 2 weeks for the second year
Shots every 3 weeks for the third year
Shots every 4 weeks for the fourth year
After five years you stop needing shots because you've developed a tolerance to your allergens (so we can get a cat or dog in 5 years???)
There are two other schedule options that speed up the first 6 months of the first year (Cluster and Rush) but I chose to go with the conventional schedule just due to time commitment and cost.
Let's just be honest, this is freaking expensive. Don't compare my exact numbers to what it would cost for you because it all depends on location and insurance. But to be transparent, here is what it is costing me and I have really good BCBS insurance. This is the estimate I was given so I'll provide updates as I actually spend.
So to get shots for all the things I am allergic to, I'd require four vials (individual serums). My insurance only pays for a certain amount of vials per year. Specifically, they cover 180 units the first year and 120 units for every year after and a basic 80/20 plan. If I purchased the recommended serum vials and doses, I would surpass the allowed amount and pay the overage completely out of pocket. When I added up the estimated startup serum cost plus refills and visits was over $3,000 for the first year. I can afford that but I sure as fuck don't want to spend that much when I could be investing it.
I spent a solid 20 minutes going over the numbers and asking questions. Figuring out all the totals and what it would look like was slightly confusing and I consider myself pretty intelligent. After a lot of pondering I asked if I could pick and choose which allergens I wanted shots for and if we could cut four vials of serum down to two. They were really great about working with me to get it down to two vials and re-running my numbers. I decided to keep cats, dogs, dust, pollens and grasses. We cut the molds and horses since I'm not exposed to them very often.
Copay for Testing: $35
Start-Up Serum Cost: $1200.44 (one time/hits my deductible)
Injection Charge per Visit (weekly for the first year): $2.63-$13.16
Refill Serum Sets (2-3 times per year): $298.08 each set (until deductible met); $59.62 (after deductible met)
Epipin: $TBD at Pharmacy...
Prescriptions for the Meantime: $40 (it can take up to 6 months to start getting good results)
So we are looking at a $1,800-2,000 total for the first year and $1,200-ish for the second year. They do offer a payment program over 6 months (no interest) but I haven't decided if I'd rather just pay it up front so I don't have to think about it and inflate my monthly personal capital budget. I can also plan out the costs for next year and start putting that amount in my flex spending account at work tax free at the beginning of each year.
I sat there thinking about if the cost is worth it to me since it is so outrageous. I finally landed on a resounding yes. If this works as promised, my quality of life will improve. From where I stand now, I can't go to my grandparents' (cats), my parents' (dogs), my sister's (dogs), Keith's parents/sister's (dogs) or be outside during certain times of the year without getting miserable 70% of the time. Spending time with all of these people is so important to me and non-negotiable, as is being outside if I want to be. So if my experience of these situations is drastically improved, it will be worth it to me. The fact that the treatment is limited to five years also makes it justifiable. I'm choosing to look at it as a $6-8,000 investment in myself and my quality of life. Thirty-three year old me without allergies at all will be so happy I committed to my health and happiness even if that total makes me want to throw up right now.
To Be Continued...
I plan to post updates on this process so stay tuned!