Academic journal article Health and Social Work

Anaphylaxis: How Do You Live with It?

Academic journal article Health and Social Work

Anaphylaxis: How Do You Live with It?

Article excerpt

The scarcity in medical, psychological, and social work literature on the needs of families living with anaphylaxis in a child demands attention. Anaphylactic shock has been characterized as "an explosive overreaction of the body's immune system to a triggering agent" (Anaphylaxis Canada, 2000, [paragraph] 2). The term anaphylaxis is derived from the Greek words meaning "without" (ana) and "protection" (phylaxis). Despite some disagreement among physicians and scientists about the precise definition, anaphylaxis is generally understood to be an allergic response affecting multiple body systems: skin, upper and lower respiratory, gastrointestinal, and cardiovascular. The onset and progression of an anaphylactic reaction may be rapid. Symptoms can include swelling (especially lips or tongue and throat), difficulty breathing, abdominal cramps, vomiting, diarrhea, circulatory collapse, coma, and death. Typical allergy medications such as antihistamines act too slowly and cannot reverse all the effects of the chemical mediators. Adrenaline or epinephrine, therefore, is the treatment of choice and must be administered by injection promptly (Sampson, Mendelson, & Rosen, 1992). The most common food allergens are peanuts, tree nuts, seafood, eggs, and milk. Exercise, latex, certain drugs, and insect stings can also trigger an anaphylactic response.

Approximately 1 percent to 2 percent of Canadians may be affected by potentially life-threatening allergies. The incidence has increased dramatically in the last decade and may be higher in children (Anaphylaxis Canada, 2000). Onset can be quite early in life, but some allergens--such as peanut and tree nuts--may he outgrown (Hourihane, Roberts, & Warner, 1998). Because reactions differ from person to person and even from episode to episode for an individual, avoidance is the primary mode for preventing potentially life-threatening reactions (Asthma and Allergy Information and Research, 2002). Avoidance, however, is complicated by the fact that the presence of allergens is not always obvious or discernible. When the allergen is not identifiable (idiopathic anaphylaxis), systematic avoidance is not possible.

The course of anaphylaxis cannot be monitored and treated in prescribed ways. It is an invisible condition that threatens to kill if the child and the caregivers are not sufficiently vigilant. Anaphylaxis presents a Hobson's choice of sorts. Families must learn to cope regardless of whether it suits their capacities, personalities, experiences, and inclinations; otherwise, they may increase the risk of exposure to danger or death. They may cope admirably and find that circumstances beyond their control put their child at risk. They may also tend toward hypervigilance and prevent their child from enjoying as normal a life as possible. In either case, when emergencies arise, they must respond in a timely and effective way or rely on others to do so in their absence.

Some parents have difficulty grasping or accepting the severity of their child's condition or what is required of them as a result of it. Others exhibit high levels of anxiety and may be seen by physicians, psychologists, and social workers as overreactive and overprotective. Avery and colleagues (2003) found that anxiety might be helpful and functional (protective) or unhelpful. Helping professionals may find it challenging to sort out the stresses on parental or parent-child relations arising from the pressures of coping with anaphylaxis versus maladaptive ways of coping. Undoubtedly, the interaction of the two eventually becomes recursive (Jerrett & Costello, 1996; Seren Cohen, 2000), potentially creating a complex presentation of tensions and behaviors that make it difficult to identify what is needed. We therefore sought to document and analyze the experiences of families living with anaphylaxis in a child to develop a better understanding of the informational and support needs involved in coping. …

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