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Anyone else carry an epipen?
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Home › Forums › General Forums › General Lightweight Backpacking Discussion › Anyone else carry an epipen?
- This topic has 25 replies, 16 voices, and was last updated 7 years, 7 months ago by Ito Jakuchu.
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Apr 25, 2016 at 9:32 am #3397892
We’ve added one more item to our first aid kit for backpacking, but it’s not something we suggest for everyone. As you may know, I am an avid cyclist. I try to ride just about every day for 15+ miles, and have regularly ridden over 5,000 miles a year.
But over the past few years, I’ve been stung by bees a few times, and each time the reaction to the sting has become more pronounced. The last time I was stung, about month ago, it was on the thigh, and my entire thigh swelled up to about 150% of it’s normal size., and growing.
That’s when I decided it was worth going to the doctor about this. The doctor prescribed some massive dosages of prednisone, and then asked me what I liked to do for fun. When I mentioned backpacking, the doc immediately prescribed a couple of epipens. He was concerned that if I were stung near my head by a bee, the reaction could easily prevent me from breathing, and I’d would be far from medical help. There’s a happy thought.
So we’ve added this to our FAK for in the mountains, even though it adds a few ounces to our packs. Wonder if there is an ultralight version?
Apr 25, 2016 at 9:46 am #3397895Having just started reacting to bees a couple years ago, I always have one pretty close by. I just accept it to be a part of everything I do and add the weight into my kit. I did hear that “Auvi-q” might have had a lighter form factor than the “normal” pens, but I understand they were recalled this past fall.
A good friend of the family’s died last spring on a dayhike w/ his wife – due to being stung multiple times by bees. He didn’t have a pen.
Apr 25, 2016 at 9:49 am #3397896A couple of pens and a PLB should be in the kit of anyone with a bee allergy. The pens aren’t a cure, every time — evacuation to a hospital is the next step. Symptoms can reoccur after using a pen.
Apr 25, 2016 at 10:31 am #3397901like Lori just said …
use of an epipen assumes immediate evacuation to a hospital. in remote areas this is not possible. if you are sensitive enough to need an epipen you should also be carrying several prednisone pills and several antihistamine pills. it is these pills that will actually fight back the reaction, the epipen merely gives them time to work.
right after using the epipen you should immediately begin taking the prednisone and antihistamine pills, consult your doctor about how frequently to pop them in this kind of situation.
Apr 25, 2016 at 1:34 pm #3397943Paul,
I’ve carried them as a combat lifesaver and had access to them as an EMT for when the paramedics weren’t available. The military issued a two stage syringe where you turned the plunger 90 degrees to give a second dose. This wasn’t an auto injector but more like a normal syringe with the epi already drawn up. This was a time in my life where it was fairly common to have a mortar round in my pack for the mortar maggots or a brick sized battery for our RTO in my pack, so it never occurred to me to weigh it as that was the least of my worries. Since it’s two doses in one, stands to reason that it’s lighter than carrying two auto injectors.
I did some searching but couldn’t find it. It’s possible that it’s not available to civilians. Dunno. You may want to ask your Dr and see if they are familiar with it.
+1 on carrying copious amounts of Benadryl as well.
Apr 26, 2016 at 6:49 am #3398048The only problem with “copious amounts of Benedryl” is the drowsiness factor. Benedryl is a “histamine-1 receptor agonist”. Other antihistamines are available.
Zantac (ranitidine) is commonly used for heartburn. It is also a “histamine-2 receptor agonist”.
Zyrtec (cetirizine) “can treat hay fever and allergy symptoms, hives, and itching”. Zyrtec is a “2nd generation histamine-1 agonist”.
Neither Zantac nor Zyrtec have the drowsiness problem.
Apr 26, 2016 at 5:16 pm #3398181BRING Benadryl… it is the quickest acting antihistamine and could save your life. If you take zyrtec you’ll be waiting for it to kick in while your neck swells.
I also carry an epi pen for the same reason. There is no ultralight version that I know of for this. If I were you I would look into a PLB as well. Don’t fuck around when it comes to allergies in the backcountry.
One downside of carrying epipens is that they must be kept in a very narrow temperature range to stay viable and potent. This gets really difficult in cool or cold weather, and even slightly warm days. A really cold or hot day ruins the epipen.
Apr 27, 2016 at 12:51 pm #3398318Something else worth noting, that was taught in our Wilderness First Aid class.
The glass phial contained inside an EpiPen actually contains more medicine than is delivered when you engage the spring loaded needle. In a dire wilderness emergency, you can cut open the epipen to access the additional medicine.
Here’s one Youtube video which demonstrates the procedure. Video
What is unclear in the video and what I don’t remember from WFA, is exactly how many extra doses are inside. I thought it was around 4 – i.e. you wouldn’t want to inject the ENTIRE CONTENTS of the capsule as a 2nd dose.
Do some research, talk to your doctor, maybe carry an extra syringe that you could use to draw up and measure the medicine before injecting a known quantity. Document with tape or a laminated card in your FAK how many ml of medicine could be given per dose. And be sure you and your hiking partner have taken WFA or WFR, and know about all this stuff.
And in this case, something more substantial than the Swiss Army Classic knife may need to be carried in case you need to cut through that plastic Epipen.
Apr 27, 2016 at 5:17 pm #3398361That is super helpful info Jeff!
Apr 27, 2016 at 7:18 pm #3398387Glad you found it useful. :-)
Apr 29, 2016 at 8:08 am #3398616Ask your Doc about this dose and needle length information… … and know where to inject on Your body with Your needle.
TwinJect 2 Doses in 1 Device for Greater Reassurance
“The new Twinject auto-injector delivers epinephrine rapidly and easily. If symptoms reappear before emergency help arrives, Twinject provides a built-in second dose of medication.”Apr 29, 2016 at 8:25 am #3398619” . . . If symptoms reappear before emergency help arrives. ”
and this is why you carry antihistimane (benedryl) and prednisone (a steroid) pills and begin taking them immediately after the epi injection. take the prednisone sublingually (let it melt under the tongue). prednisone works faster and stronger than antihistimane. consult your doctor for how often, but every 4-6 hours is common.
Apr 29, 2016 at 9:26 am #3398627i used to be an EMT. 2.5oz epipen + 1oz of antihistamines and steroids seem like they’re worth the weight to me! my girlfriend is allergic to bees, and this is in our FAK almost every trip. like Sr Al said…i wouldn’t mess around with this stuff.
Apr 29, 2016 at 10:17 am #3398645This is not medical advice..
I’ve noticed with my wife and I that diet very much effects our allergies and how severe the reaction is to allergens. Sugar and refined carbs, store bought dairy (not raw), anything inflammatory, seems to have a big impact. By cutting out those things her asthma and allergies have gone away.
I have no idea what your diet is like but it could be worth looking into cutting out those things and seeing if it has any impact. It seems that we have a limit to what our body can handle with toxins and inflammation. The fact that the reaction is getting worse, perhaps it’s due to lifestyle things you can correct now?
Apr 29, 2016 at 10:53 am #3398663Paul,
Have you considered going to an allergist and getting de-sensitized? That’s what I did after I went into anaphylactic shock from a yellow jacket sting. I did not used to be allegeric to them, but then started having more severe reactions every time I got stung. I went thru the de-sensitizing program probably about 15 years ago. It was a series of shots of very small amounts of venom. The process was about 3 years as they start you off with a couple of shots a week and then slowly transition you to shots 6 weeks apart. If your insurance is good, the cost is minimal. I still carry a little waterproof vial of benedryl with me everywhere- as I will still react to the sting, it just won’t kill me.
May 1, 2016 at 10:30 pm #3399141Carried an EpiPen for a couple of years after an unusual reaction to a yellowjacket sting. Decided the doc-on-call overreacted, and didn’t refill after it expired. Even with very good insurance, EpiPens were ridiculously expensive and going up in price rapidly. Generic injectable epinephrine is dirt cheap.
In a WFR course many years ago, they taught us that some people might carry vials of epinephrine with a traditional needle and syringe. We practiced injecting each other with saline solution. I don’t know if vials + syringes would be any improvement in cost, portability, or lifetime over EpiPens. You certainly would not want someone using a vial and syringe on you for the first time during an emergency. Check with your doctor if this might make sense for you.
Internet searches found researchers developing and patenting “sublingual epinephrine tablets” about 10 years ago, to replace injected epi, but I couldn’t find any commercial sources. Check with your doctor or pharmacist if these ever made it to market.
Greg’s reference to the Emerade auto-injector looked promising, until I found this:
Emerade is not yet approved by the FDA and is not available in the USA.
Twinject injectors were discontinued several years ago. Right about the time EpiPens started rapid price increases. Just a coincidence.
Auvi-q injectors (www.auvi-q.com) were all recalled last fall, and Sanofi is returning production rights to the developer, i.e. don’t hold your breath waiting for Auvi-q to return to the market.
— Rex
Jul 5, 2016 at 11:09 pm #3412555Having just an hour ago been stung by something – bee, yellow jacket, not sure but it’s nasty! – I’m resurrecting this thread to ask a question about that video. When you use the extra dose in the epipen, do you inject into the leg muscle again as you would with the spring-loaded dose? How do you get the pressure needed to do it without the spring?
Don’t worry – I’m fine! Just a hypothetical question while I’m sitting here with an ice pack on my neck. I do carry an epi for my son, who has a life threatening nut allergy, but I’m always thinking it may end up being used for something or someone else. I’ve had loads of stings and no truly scary reactions, but you never know, and miles from help it’d be nice to know what to do.
Jul 8, 2016 at 11:01 am #3413122Just thought I’d follow up my original post….
I am currently getting desensitizing injections for the next 2-3 years or so. And taking the epipen, although how much that would have helped on our recent 5-day trip in the Emigrant Wilderness is debatable. We were 20+ miles from the nearest trailhead, so pretty much on our own. I do carry both the antihistamines and steroids along with the pen…and my doc says to take the antihistamines and steroids immediately after being stung. Only use the one if the anaphylaxis shock symptoms appear.
As for diet…despite being married to a pastry chef, I eat an amazingly healthy diet, very high in veggies, low on both meat and processed carbs if all kinds. Drives her crazy…?
Aug 16, 2016 at 4:41 pm #3420600Life-Saving Allergy Treatment Is Becoming Too Expensive For Families To Afford
Over the past nine years, since Mylan bought the rights to the EpiPen, the price for the easy-to-use injectors has quintupled — increasing about 450 percent, from around $50 for one injector to $600 for a pack of two. … There is virtually no alternative: EpiPen’s one major competitor, Auvi-Q, was pulled from the market in October 2015.
More here:
— Rex
Aug 16, 2016 at 5:44 pm #3420634Amazing markup!
“The actual dose of the hormone epinephrine (also known as adrenaline) delivered by the device costs approximately $1.”
Aug 16, 2016 at 7:24 pm #3420665This is where the drug companies are crooks. A 1mg glass vial of Epi was less than $1 10 years ago. No new research, no new production issues, just rip off. Now it is about $7 but still 75x cheaper than an epipen if you are comfortable and have time to draw it up in a syringe and stick yourself or someone else. And the vial and syringe weigh considerably less than the epipen. The Narcan being used for opiate overdoses is exactly the same story. Nothing new in 40 years except the price.
Aug 16, 2016 at 7:41 pm #3420669This is infuriating to read. How hard is it to just get a vial and syringe? has anyone done that?
Aug 25, 2016 at 3:20 am #3422444More on the all but monopoly:
intercept.com article
edit – seems like link doesn’t come through on the phone. Here is for copy pasting:
https://theintercept.com/2016/08/24/epipen-uproar-highlights-companys-family-ties-to-congress/
Aug 25, 2016 at 7:16 am #3422459Title to the contrary, this is for a “Two-Pak”.
Egregious nonetheless.
CEO compensation went from $2M to $18M over the same time period.
Aug 27, 2016 at 7:12 pm #3423035Adrenaclick is an Epi-Pen alternative you can buy today, if you are persistent, according to Consumer Reports:
http://www.consumerreports.org/drugs/how-to-get-cheaper-epipen-alternative/
A generic Epi-Pen might be available in 2017, but it’s stumbled on the way to market:
http://money.cnn.com/2016/08/26/investing/epipen-price-hike-generic-alternative/
Lots of Congressional, media, and Internet outrage over Epi-Pen pricing, but apparently it’s business as usual for drugs facing imminent generic competition:
— Rex
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