*I’m completely fine,  Don’t freak.  Don’t tell me you’re sorry for it isn’t your fault.  Just tell me you’re happy that I was prepared, and now you can be too.  Ant bites happen.  Life goes on.

* I take a generic brand of benadryl.  It doesn’t need to be fancy.

In June of 2008, I wrote How to Survive Anaphylaxis Shock Part 1.  Since then I’ve gotten many emails with various questions and requests for how I’m doing.  Since then, I’ve been bitten by ants twice, not bad considering I live in Texas.  Two incidences in nearly three years is not a big deal to me.  The first of my latest incidences was likely NOT fire ants, but another species of ants.  I was bitten three to four times with only a systemic reaction and no signs of anaphylaxis after two benadryls.  I always take benadryl right after an ant bite of any kind.

The second incident was this morning, March 23rd, 2011, around 7:45 am.  I was in the garden investigating what damage my garden varmint had caused the night before and moved around some plants that had met their demise.  Cold weather veggies were on their way out, and spring veggies were ready to be moved into the outdoor garden.  I was wearing my bright green gardening boots, and I felt intense pinching on the inside of my right calf.  Both of my boots were covered with fire ants, and soon I felt another sting on my left calf.  I took the dogs inside, and proceeded the drill from part 1.  I popped two benadryls, covered the bites with a prescription grade cortisone cream, and waited.  Immediately, I had dizziness, headaches, tingling all over, motor weakness, muscle pain, swelling in the mouth and tongue, cramping, slight nausea, and the bite sites were burning like crazy.  After an hour, my symptoms were about the same with no signs of throat closing.  At this point, the danger of acute anaphylaxis was over.  The wait period for me is generally 20 minutes, but I’m still at risk for a secondary anaphylaxis episode.  This can happen anywhere from a few hours to 72 hours later without being re-exposed.  This is often called biphasic anaphylaxis, and I haven’t experienced it yet.

It is 5:06 pm now, and I’m feeling alright.  I went to work, attended my meetings, and I’ll be attending the Slow Food Austin event tonight.  I’m still woozy, slight headache, swelling and tingling in my mouth, and the bite sites are swollen and painful.  But I’m alive, and I still have my epipens with me.  I’ll probably take two more benadryls before bed tonight.  I’ll be in pain for the next two to three weeks, but nothing I can’t handle.  I would not advise doing what I do.  I would highly advise seeking medical attention immediately.  Don’t wait.  YOU DO NOT WAIT.  You don’t know how your body is going to react.  I’m a veteran at this now, and my body was not telling me I was in immediate danger.

Photos of my calf look funny. Taken about 9 hours after the initial bite.

Now onto selection of questions I’ve received since 2008. Some questions are silly and thusly, omitted.

How do you feel after going into shock?  A few weeks after it is over, I’m completely fine.  There are no long-term effects.

What do you mean by pain? The bite site will swell, become itchy, and be painful to the touch.  I typically have joint pain and muscle pain for a few weeks after the shock.  The pain is often soreness.

Why don’t you stay indoors or move to a place where fire ants aren’t prevalent?  I’m not about to allow a six-legged creature dictate my life.  Also, the frequency of bites is pretty low consider how much time I spend outdoors.

Why don’t you avoid standing by fire ant beds?  Fire ants are vicious little creatures.  In every incident that I have been bitten, there was no visible ant bed.  Fire ants will seek and attack you.  In 2008, I was bitten in an area that was mostly concrete with no grassy areas.

Why don’t you take steroids? I avoid steroids like the plague.  After the initial anaphylaxis shock, there’s not much steroids will do for besides possibly prevent the biphasic anaphylaxis or help the swelling go down.  In my opinion (in which my allergist agrees), the potential long-term negative effects of steroids greatly outweighs the benefits.  I will refuse steroids so long as I’m conscious. Whether or not you decide to take steroids is up to you and your allergist and other medical staff.  My allergist typically does not prescribe it to patients after anaphylaxis.  Again, that is on an individual basis.

Why don’t you use the epipen first?  Because after the initial injection of epinephrine, I’ll have zero motor control.  I will not be able to call for help.  I will not be able to take benadryl.  I would not be able to drive.  I’d be helpless for the next 30 minutes.  If I have to, I’ll use the epipen AFTER I have taken benadryl, called 911, and moved to a safe location.  Once you have used the epipen, you might hurt yourself due to the lack of motor control.  I suggest you lay down somewhere soft.  Also, keep in mind that the epipen’s purpose is to buy you time so you can get medical treatment.  It does not cure anaphylaxis.

What will my insurance cover?  Yes, people email me this question.  I don’t know what your insurance will cover, but better safe than sorry.

Why don’t you take ant venom shots?  I hate needles, and it only makes me more allergic.  I’m that 10-20% of the population that doesn’t respond well to immunotherapy.  At best, immunotherapy will only protect you up to four or five ant stings.  If you get bitten more than that, you’re at risk for anaphylaxis.

Ant bite and cowboy boots. That is so Texan. This is about 7.5 hours after the bite.

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