Getting Allergy Shots – and Setting the Clinic Record

Allergies and asthma often go hand in hand, and controlling allergies can help control asthma.¹

Collegiate daughter had a miserable year. In fact, last year was the worst she's ever felt with her asthma. She said the last time her asthma felt this bad was when she was hospitalized several times when she was young.

New Allergist asked if my daughter had ever considered allergy shots to help control her asthma. Daughter told the Allergist that she had nearly 6 years of allergy shots when she was young, but that was under the care of the Allergist who used to run the practice (but sadly passed away from cancer.)

When those test results came back, she was allergic to everything they tested for – except rats. The shot nurse joked and said we should get a pet rat for Daughter.

Narrator: She did not get a pet rat.

Going through allergy testing – again

Fast forward 15 years, and New Allergist suggested that daughter be retested for allergy shots. Daughter knew the drill but was still uncomfortable as they started the scratch test. In fact, I noticed that within seconds, some of the locations started to develop large hives. To help Daughter understand what her body was doing, I took photos as they were starting the scratch test, 10 minutes later, and as they came in to read the results. The change from the first photo to the last was astonishing. Her back was covered in angry red welts.

I was baffled because she had already gone through allergy shots for almost 6 years. And yet here she was again, and her welts were worse than they were the first time she had the skin prick test done. Had the last series of allergy shots been a waste of time?

I asked Daughter what she wanted to do. She knew what she was in for – going in for shots twice a week with injections in each arm, gradually reducing to once a week, then once a month. She knew she was in for years of discomfort.

Consulting the national asthma guidelines

She also knew that she was on the maximum dose and strength for asthma inhalers in her treatment plan. As a certified asthma educator, I showed her the chart for the  "Stepwise Approach for Management of Asthma in Individuals 12 years and Older," part of the "2020 Focused Updates to Asthma Management Guidelines."²

She was able to see that she was on the highest step (step 6) and the maximum amount of asthma meds, yet her asthma was still uncontrolled.

If you are an asthma nerd like me, you may be interested to know that the national asthma guidelines were called the "Expert Panel Report 3," EPR 3. EPR 3 was created in 2007 and was not updated until 2020. The 2020 Focused Updates are the most recent national asthma guidelines, replacing EPR 3.³

Side note: Some people mistakenly call the 2020 Focused Updates to Asthma Management "EPR 4." The new guidelines are NOT called EPR 4. There were only selected parts of the national guidelines updated. Hence the name "2020 Focused Updates to the Asthma Guidelines."^2,3

Setting the allergy shot record

The newest asthma guidelines suggest Daughter needs to get her allergies under control (again) to help control her allergic asthma. Sadly, this meant repeating another 5 years worth of allergy shots.

As she went for her first injection, she came back to tell me that she had set a clinic record! She was allergic to so many things that the clinic had mixed 6 vials of serum. This meant she received 3 shots in her left arm and 3 shots in her right arm – twice a week. So, she was getting 6 different shots each day, for a total of 12 per week!

The shot nurse said in all the years the clinic has been running, they have never had anyone with 6 vials of allergy serum. And no one has needed 6 injections at one time. We think Daughter should get an award or a trophy. Or the clinic should at least start a Wall of Fame, and Daughter can be the first photo.

Is your allergic asthma still uncontrolled, despite being on high-dose inhalers and after making your house allergy- and asthma-friendly? Did allergy shots help control your allergies, and in turn your asthma?