acute allergy onset-husband nearly died - anyone else developed this after sub or total gastrectomy?

Hi guys

After my husband made a seemingly terrific recovery from a subtotal gastrectomy in June last year, where he had most of his stomach removed & had 12 weeks of ECX chemo - and returning to competing in triathlons earlier this year - he's done 3 races up to Olympic Distance & also smaller Club Triathlons, plus a 5km running race last weekend .........

On Friday, shortly after breakfast, he showed me a bright red rash that was under his arms, around his groin & neck with noticeable swelling - then his speech started slurring ...... I rang our GP & made an appointment re the rash and we went to her surgery to wait for the appointment 15 mins later. Before we left, he had also had a severe bout of diarrhea and thought he was going to pass out. He was sweating profusely.

At the surgery, reading a magazine, I thought he had said something to me that I didn't hear properly and turned to him, only to find that he was having some sort of 'fit', with his whole body jerking in the chair, but remaining upright, his eyes rolling into the back of his head & then stopping breathing, remaining in a rigid upright position! He didn't slump.

I YELLED for the receptionist (Doc's husband who had his back to us) and both him & the Doc came running (the Doc leaving a patient to attend to my husband) and immediately pulled his chair away from the wall & gently lay the back of the chair onto the floor with him still on it, with me supporting his head so that it didn't hit the floor hard. He had been unconscious for at least a minute at this point in time. The Doc kept his lower legs/feet elevated by putting a chair in front of him & supporting his feet.

He 'came to' as soon as he was lowered & couldn't understand the fuss and has no memory of the event, other than arriving at the surgery & feeling ill and then waking up on the floor. The Doc checking his pulse all the time, to make sure all was well there, ready to grab an injection of adrenalin if needed. An ambulance was called & he was transferred to the local hospital, 1/2hr away. He was given an antihistamine in the ambulance, which reduced the swelling so much that by the time he arrived at the hospital, he was no longer deemed an 'emergency' and joined the other people in the waiting room to be attended to as Doctors became available. 2hrs later, he was seen, put onto a drip (had 2 1/2L of saline,) given another antihistamine, an ecg and thoroughly checked over.

They were going to discharge him, but my GP had contacted me (I was keeping her informed with what was happening) to make sure he stayed in overnight, as a 2nd episode is common within 8-12hrs from the first, whether the offending food was eaten or not! So I had to convince him to say he was concerned of a repeat episode as the medication may not have been absorbed correctly, given that he only had 1/10 (if that) of his stomach! He stayed overnight with no further incident and the discharging Doctor is also going thru major allergy tests to find out why his lips blow up 10 times bigger than Mick Jagger at 4am - long after any food trigger may have been eaten!

Apparently there is an increased incidence of Sudden Acute Allergy Onset resulting in Anaphylactic Shock, which if not acted upon immediately, may result in death. We have narrowed it down, possibly, to nuts and had full blood tests today and after receiving those results will most likely go down the 'allergy' tests road - to try & determine what triggered the Anaphylaxis! He has never had an allergic reaction to anything before, but we had been eating more Macadamias than normal, having purchased 5kg of fresh nuts in the shell recently! On top of this, he has about 10 different nuts/seed with his muesli & it must have been the peanut butter on the cracker shortly after, that 'put him over the top' and set off the frightening trip to the hospital! It seems that Adult Acute Allergy may be a gradual 'cumulative' effect that can take weeks or even months to result in an Anaphylactic Shock episode - it may also never happen!

A terrific book that we have called "Family Guide to Complementary and Conventional Medicine" ISBN 978 1 74033 622 2 (pbk) says ..... Quote " True food allergy is not common but can be very dangerous. The immune system reacts instantly to the food, forming immunoglobulin E (IgE) antibodies that may cause the skin and the mucous membranes to swell. In a severe reaction, blood pressure may drop suddenly, causing anaphylactic shock."

It has a section on ''Food Sensitivity and the "Leaky Gut" Theory'' which has not been widely accepted yet - but researchers believe that QUOTE ... "if the intestinal lining is more permeable than normal, it allows incompletely digested food proteins to be absorbed into the bloodstream, where the immune system reacts to them and becomes sensitized to them. According to the ''leaky gut'' theory, this then gives rise to an allergic reactoin whenever the food concerned is eaten.''

With the major change in all sub & total gastrectomy patients' absorption of food into the intestine, this would make sense with my husband's 'sudden' reaction to a food that he has eaten readily all his life, prior to his sub-total gastrectomy, without incidence.

Anaphylactic shock can be a fatal conditon. If action is not taken immediately, death may result in minutes. It really frightened me that if I had not turned to him when I did - he may well have died then & there, in a room with 10 other people, none of whom heard a thing to indicate that he was in distress & imminent danger of dying, until I yelled out.

We will now be taking antihistamine tablets with us 24/7, in the event of another attack, as any subsequent attack may be more severe than the initial attack. Our GP is also keen for him to have an epipen (single dose of adrenalin administered in an automatically activated pen), in the case of a severe reaction, such as the one he had in the surgery.

Please keep an eye open for this, in case it happens to your loved one. Initial indications of an allergic reaction may be as simple as an 'itch' soon after eating. The area (usually around the glands) then becomes bright red (under the arms, both sides of the groin and around the neck, with obvious swelling of the throat & tongue.) If an antihistamine is taken immediately, it should prevent a more serious episode, but calling an ambulance would be recommended if the swelling does not go down quickly.

This attack, when my husband virtually had 'a fit & passed out', was pretty well silent. If he had been in the house in the garage & I was upstairs, I would not have been aware that he was in trouble. I've really stressed to him now, that at the first sign of an allergy, he needs to take an antihistamine IMMEDIATELY, before it becomes an Emergency situation.

Illaussie