Hi, I’m Sam. Do you know what immunotherapy is? Have you seen The Princess Bride? If you answered no to the latter, go watch The Princess Bride and come back. Do not use this brief recap as an excuse to not watch the film in its entirety. To do such a thing would be inconceivable. That’s another PSA for free, folks.
Not included in the above video is the Man in Black’s explanation for why he won the battle of wits despite Vizzini’s ruse. In the next scene he tells the princess that, in fact, both cups were poisoned. The Man in Black has protected himself from the poison through mithridatism, building up an immunity by administering very small doses that increase over a span of time.
This is the same concept behind immunotherapy. After developing a solution of the allergens to which you would like to become immune, your allergist will inject heavily diluted doses directly into your bloodstream once or twice a week and slowly increase the intensity over time. You may be thinking that this sounds dangerous. Or maybe you aren’t.
Well, actually, the reason it’s not particularly dangerous is that the doctors know what they’re doing. Certainly The Man in Black doesn’t mind taking his life into his own hands, but your doctor would very much prefer that you do not. Doses are administered according to a strict regimen, typically requiring a complete restart if you so much as move to another doctor. What’s more, the most time-consuming part of the process is actually just thirty minutes of sitting in the waiting room to see if you have a reaction.
This is where I come in. After a few months of twice-weekly doses, I had never had more than a red bump that felt like a bee sting. I never left the office before the nurse came to observe my reaction, but that was more of a sense of habit and respect for doctors than an actual sense that I was in any danger. Last Thursday, it all changed.
Ten minutes after my shot, I was itching all over. Then I started sneezing and coughing and my eyes started to water. In moments I was wheezing to the receptionist, “I think I might be having a reaction.” Then I was surrounded by medical professionals who insisted on wheeling me through the health care center in a chair regardless of whether I myself felt I was fit to walk.
I felt pretty much fine through all this. If that seems strange, note that I have experienced each of these symptoms individually and at no point had any of them been life threatening. So, when the nurses told me not to be afraid and I wouldn’t die, I said “why should I be afraid I’m going to die?” I wonder if the fact that I was shaking like a jackhammer from being given three epinephrine* shots had anything to do with the seeming over-concern over my emotional state.
It was when I was feeling pretty much great that they decided I should go to the emergency room. They said that I needed four to six more hours of observation, and even the length of an Uber ride to Rex hospital without professionals staring straight at me could be fatal. So I obediently climbed into a surprisingly comfortable gurney and enjoyed the comedy stylings of my EMT, who told me that I was shaking like a dog pooping razor blades and that he was going to steal my identity through my digital signature.
Wheeled to my room, I climbed out of the gurney and lay on a substantially less comfortable hospital bed. A nurse pumped me full of Benadryl, and left me in the room unobserved. I sat semi-catatonic on the bed for an hour and then another nurse came in to give me a prednisone prescription and tell me I was free to go. I took a Lyft back to my house, then drove to Harris Teeter to buy some pork ribs and kale for supper.
Three morals I want you to draw from this experience:
- Don’t wander off when you should be under observation during an immunotherapy shot.
- Sometimes healthcare practitioners in an ER have a very different idea of how much danger a patient is in than their peers in a company health care center.
- You should watch The Princess Bride
This has been a public service announcement.
*also known as adrenaline
Image Credit: https://www.youtube.com/watch?v=EZSx3zNZOaU