Wednesday 5 June 2019

Penicillin Challenge

Yesterday I went through a "Penicillin Challenge" test at the Epworth Allergy Clinic in Richmond.

I had a reaction possibly due to penicillin 30 years ago and haven't had it since so my doctor and I decided to do the test, given the superbugs out there nowadays means there are less things that are effective.

I posted this pic of my forearm on Facebook in the morning when we were just getting started. My skin reacted to the alcohol wipes and the pen but that's pretty normal for me, but it meant we had to wait for that to subside before we could get started. I had a few questions from Facebook friends, and I'm sure when it comes back up in "Memories" next year I won't remember either, so I thought I'd document!

The letters down the left stand for: H - Histamine and C - Control. You're meant to react to H and not to C (which is saline). If you don't react this way the test might not work on you. (My H SPT spot spread outside the box and is still red and itchy today).

The rest on the left are various types of penicillin. The SPT column is "skin prick test", which is a drop followed by a skin prick through the drop. The 1:100, 1:10 and 1:1 columns are needle-under-the-skin injections. One of them (I think it was BPen?) stung like a bitch but the rest only stung a little bit.

They did injections in all rows in 1:100 but only 2 in 1:10 and 2 in 1:1. They measure each spot when they've done the injection and again 10-15 minutes after and if it's grown by more than 3mm they stop the test. After 1:10 my head and hands started itching like crazy and I got really hot, but I didn't have more than +2 on anything so we decided to keep going (with a layer of clothing removed). The lady next to me got a +3(ish) and they decided to keep going too. After 1:1 (and in a t-shirt) I was OK so we kept going. Apparently if there is going to be a severe reaction, most people are going to have it at the SPT or 1:100 stage, and "itchy head and hands" isn't on their list so I guess I'm weird. 😀

Then there were 2 oral doses of increasing strength. Now I'm on a 5-day penicillin course to test "tolerance".

I haven't gone into anaphylaxis or anything severe which is excellent, although I have a mild rash on my forearm today from wrist up to where the drip was, my head and skin still feels randomly itchy and I feel a bit nauseous, so it's fair to say while I'm not fully allergic to penicillin, I'm still not totally fine with it and if I have a choice I'll get something else in future. But at least I know now I won't die if I do need it.

I have a clear set of instructions for signs and what to do in case of "mild to moderate" allergic reaction (take a photo and email it to them, stop taking the penicillin and take an antihistamine). If I have breathing difficulties or any of the severe signs we have to call an ambulance.

I arrived at 9am and left at 3.40pm, several hundred dollars lighter. The lunch was surprisingly good and the doctor and nurses were fantastic. While I was sitting there I helped one set up a new Instagram account for her pet, and I was kept well-caffeinated with biscuits, so I guess it wasn't a bad day all up. :)