For Some Kids, an Insect Sting Means the E.R.

Sure, insect bites itch and sometimes sting , but mom Karen Mantione never thought she needed to take them seriously. Then a yellow jacket sting put her son in the hospital and Karen started to look at allergies in a new way.

The first time my son was bitten he was three. He was leaving preschool and walked through a nest of tiny, red fire ants. I didn’t see the nest until he was going through it. Fire ants are common here in suburban North Carolina where we live—you can see their nests of loose gravel all over the place—but I never knew too much about them. Now I know that they rarely bite once. When fire ants perceive a threat they release a chemical that causes them to swarm and bite repeatedly. That’s what happened to Noah. He got bitten about 30 or 35 times. It hurt, and he was crying. But I didn’t think too much about it. I brushed Noah off and cuddled him and put him and my infant in the car to wait for my older son to get out of preschool. Noah was crying and then he started screaming and whipping his head back and forth and hitting himself in the face. I immediately called our pediatrician and the service put me on hold. Something was clearly wrong with Noah so I started driving the 25 minutes to the urgent care facility near the preschool. A few minutes before we got there, Noah stopped screaming and got very quiet. I didn’t realize it but he was unconscious. As soon as the medical staff saw him, they whisked him to the back without even taking our name or insurance, and struggled to revive him. They gave him Benadryl, a shot of epinephrine and packed him in ice from head to toe. This was our first indication that he had an allergy.
 
After that, we started carrying a double EpiPen Jr., an auto-injecting dose of epinephrine, the first line treatment for severe allergies. We became very vigilant about keeping our yard, where our kids played, free from fire ants. Five years went by without incident and one day, he was playing in our yard and stumbled into a ground nest of yellow jackets. It wasn’t something we could have foreseen. The nest is underground with only a small entrance where they go in and out. Yellow jackets aren’t like bees, which can only sting once. The sting multiple times. Noah got stung three times. He came running in and he had a yellow jacket still clinging to his sneaker. I smashed it and put it in a sandwich bag. I brought him inside and for about a half an hour he looked fine – no hives. Then his foot started to get red. Then the red line was running up his leg. Thank God my in-laws were at my house. I put Noah in the car and started driving to urgent care – fast. All the time, he’s shouting out the progression –My ankle is itching! My knee is itching! My groin! When we got there, I showed the medical staff my yellow jacket in a sandwich bag and told them he had an anaphylactic reaction to fire ants. By that time, Noah had broken out in hives from head to toe. The doctor there thought he’d been bitten on the face not the foot. They gave him Benadryl and epinephrine but soon, Noah was having trouble breathing and the doctors at urgent care called an ambulance. The EMTs gave him an IV, an oxygen mask and an asthma rescue inhaler to help his breathing and rushed him, lights and sirens, one tenth of a mile to the emergency room.

I didn’t realize it, but he was in critical condition.

How have our lives changed? At first we became very overprotective. Think about it: Insect stings, which are just annoying for most people, are life-threatening for Noah.

For the next year after the yellow jacket incident, Noah didn’t go outside much at all. He was afraid and I was afraid. Then gradually, in the fall and winter, he started going out more. I mean, he’s still a kid. We allow him to play in the yard but first we walk every step of his play area and, if he plays next door, our neighbor's yard.

If we see fire ants, we have a pest control person who knows about Noah’s
allergies and makes it a point to come that day. Whatever the season, the school doesn’t let him off the blacktop – he can’t go in the wood chips or on the grass. Our community has been terrific. Most people associate severe allergies with peanuts so its been a matter of educating them a little. Noah’s Little League coach, who is also a landscaper, personally treats the field where they practice. When there’s an away game, the coach and my husband walk every inch of the field to make sure there are no fire ants and if there is, Noah doesn’t play. Every place he goes, he has allergy medication and epinephrine. At the gym (Noah is a competitive gymnast), in school, in my purse, in the glove compartment of my husband’s car. If he’s in a carpool, the adult who drives has to carry an EpiPen. And everyone has strict directions: If he gets stung, call 911 right away. We understand now that his reaction is fast and severe and there is no time to waste. We've learned to be vigilant. We don't want to take any chances.

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