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Forum Index -> Full Moon Saloon -> bee sting reaction?
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Dane
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Joined: 14 Mar 2006
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Post Sat Jun 28, 2008 5:10 pm    bee sting reaction?
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So yesterday I was riding off Mercer Island onto the I-90 bridge, and a bee apparently didn't like me hitting it at 35mph and decided to sting me in the thigh through my cycling shorts. I wiped the bee off my leg and pulled over to see if the stinger was still in me, but I couldn't see anything so I continued with my ride.

Today I woke up with a 2-3" rash around the sting site, which was swollen and tender. I haven't been stung by a bee in a long time so I figured this was normal. The swelling has gone down somewhat, but the rash has spread and is now a little smaller than the size of a CD, with a distinctly darker center and lighter outer. My skin over the dark inner circle of the rash feels stiff (it is too stiff to pinch), and the underlying tissue feels hard, even deep under the skin level.

Unless this bee's venom was extra potent I'm guessing part of the stinger broke off and is still under my skin, which is causing this reaction. Has anyone experienced this or other unexpected bee sting reactions?

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BeyondLost
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Post Sat Jun 28, 2008 5:22 pm   
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My Dad kept bees and I worked with him as a kid. The reaction of people varies widely but the longer the stinger stays in the more venom and more reaction. At this point I suspect all the venom in the poison sac has gone in so not likely, anything you can do now except take benadryl.

This used to be the medical advice.

Quote:
The bee's stinger is barbed. In the act of stinging, the stinger is torn from the bee, along with the venom-filled poison sac and attached muscles. The barbs continue to work the stinger deeper into the flesh for several minutes, while venom continues to be injected. This led to statements such as this, which appear in most books on pediatric advice: "The stinger should be removed with a scraping motion by using the rigid edge of a credit card or a dull butter knife. Never attempt to pull out the stinger using fingers or tweezers, since this will result in the injection of more venom."

An excellent study published in the Lancet, August 1996, turns this advice on its ear. Researchers at the University of California, Riverside, and Pennsylvania State University tested what really happened by measuring the size of the weals raised on their own forearms by bee stings. After stings in the left arm, they left the stinger in for 0.5 seconds, 1, 2, 4, or 8 seconds and then scraped the stinger out with a credit card. On the right arm, the stinger was removed by pinching the stinger between the thumb and forefinger at the same time intervals. There was no difference in weal size between the different methods of extraction. The weals did get larger, though, with each second that the stinger remained.

If one is stung, the wound can be treated in the following ways:

* Remove the stinger with all haste, in whatever manner is most convenient. If you see a little black dot in the wound, part of the stinger is still present.

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"If you rest you rust."  Helen Hayes
"I would rather wear out then rust out." Helen Klein
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mtnwkr
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Post Sat Jun 28, 2008 10:11 pm   
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Thanks for the info Crazy Bob.. I haven't been stung in probably 20 years, I have a feeling this is my year. paranoid.gif

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Magellan
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Post Sat Jun 28, 2008 11:35 pm   
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I've read in wilderness manuals that anaphylactic shock is the number one attributable cause of death in the backcountry.  I keep thinking I should get an Epi-Pen in case someone in my party goes down.
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mtnwkr
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Post Sun Jun 29, 2008 12:01 am   
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I've been thinking the same thing. I was stung quite a bit as a kid but its been forever and I'm not sure how I'd react now. My father was never allergic till his mid twentys, now he carries an epi-pen with him everywhere, Its life or death if he gets stung.  hmmm.gif

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MCaver
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Post Sun Jun 29, 2008 12:04 am   
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I got stung on the top of the head when scoping waterfalls back in february. I think I disturbed the nest on the way down the bank, and walked by it again on the way back up. The sound of the rushing water would have certainly drowned it out even if I walked right by it. Much of my family is allergic, so it's always been a bit dicey for me to get stung, but I've never had much of a reaction, this time included. It stung for about 15 minutes, then throbbed for a few hours, but was all but gone by the next morning. I did rub a little bee sting ointment from by first aid kit, but it didn't really help.
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BeyondLost
Crazy Bob



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Post Sun Jun 29, 2008 7:41 am   
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Magellan wrote:
I've read in wilderness manuals that anaphylactic shock is the number one attributable cause of death in the backcountry.  I keep thinking I should get an Epi-Pen in case someone in my party goes down.

That is true. Problem is the epi pens have a limited life so one has to keep replacing. One needs a prescription and cost is around $100.
Certainly if someone in your group has a history of major reactions, even if not anaphylactic, it is a good idea to carry. If no known problems, the cost is probably prohibitive for a lot of people.
My younger son used to carry one after he had a severe reaction and he was working outdoors in Montana as a wildlife biologist.

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"I would rather wear out then rust out." Helen Klein
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Mike E.
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Post Sun Jun 29, 2008 9:57 am   
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My dad suffered severe brain damage from an anaphylactic reaction to a wasp sting on his wrist  while working in his back yard in Issaquah. He is only about half "with it", ten years later. Dying is bad, living in a fog with no short term memory, (or whatever part of your brain gets nailed when your breathing stops), is not a whole lot better. An epinephrine injector, (Epipen), is cheap insurance against one of the biggest threats to your health in the wilderness...or your back yard.  I get stung every year, at least once, and haven't had a bad reaction yet. Still, I always carry two Epipens, just in case. If you do get one I'd suggest making a strong carrying case from a short length of PVC pipe, since the cases which come with them are cheesy. This site has some good info about this sort of problem:
Allergy research site  UK
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BeyondLost
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Post Sun Jun 29, 2008 10:56 am   
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Mike,
I'm curious if your father ever had any kind of significant reaction before his severe reaction. It is possible to have an anaphlactic reaction as an initial event but far more common if one had a bad local reaction before.
Statistics are not very good in this area but the best estimates are 25-50 deaths a year in the US from bee and wasp stings. Yes, it's a lot more common then say death from bear or cougar (average one a year) in the wilderness but that's because they are just unbelievably rare.
Is it a good idea to carry $200 worth of epipens you have to replace every couple of years if you have never had a significant reaction? Maybe, but for a lot of people that is not cheap.
I certainly understand your decision and do not disagree. I'm just not sure a lot of people are going to look at the still extremely low individual risk and spend that much money if they've never had a problem.

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"If you rest you rust."  Helen Hayes
"I would rather wear out then rust out." Helen Klein
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Lono
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Post Sun Jun 29, 2008 11:46 am   
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Here's how the NOLS wilderness medicine school taught us to treat anaphalaxis in training earlier this year, it might help someone who finds themselves in a situation of treatment out there on the trails - for me it boils down to having both an EpiPen or TwinJect to open the victim's airway, and an anti-histamine such as Benadryl to counter the histamines which have been released in the allergic reaction, most often by a bee sting.  All this is dealt with in much better detail on the wikipedia site for anaphalaxis, which is actually a pretty good account of things.

Your victim has been stung, and they are suffering a rapid and severe allergic reaction - their body has released a whole host of chemicals, chief among them histamines, which act to restrict their breathing and drop their blood pressure.  In a particularly severe reaction their breathing may be cut off, so quick action is necessary.  Inject the EpiPen or TwinJect as directed, most often it will literally give them time to breathe.  Immediately after you have reestablished an airway, administer a dose of Benadryl.  Benadryl is an anti-histamine, and is specifically meant to help counter the histamines doing battle in the victim's body.  In other words, Benadryl or another anti-histamine is just as critical to treating anaphalaxis as the EpiPen or TwinJect is - the EpiPen gives you time in which to administer an anti-histamine, it may not by itself stop the histamine reaction.  The TwinJect actually contains a second dose of epinephrine and advises that you should administer it shortly after the first injection, but regardless you need to get anyone showing signs of anaphalaxis to immediate medical help, as the body has a tendency to rebound and experience another anaphalaxis.  Its the battle between the histamines and anti-histamines, ongoing until the victim can be stabilized.

So those with allergies, always carry an EpiPen or TwinJect, tell your co-hikers you have it, where you keep it, and make sure they know how to use it in an emergency.  Carry with it an anti-histamine, such as Benadryl.  Benadryl is available in liquid, tablets and a melt-on your tongue paper form - with a restricted airway you may not be able to get the victim to swallow, so the paper or possibly liquid forms may be better to administer.  Co-hikers, carry some Benadryl, and know when your friends have allergic reactions and may require the use of epinephrine. www.epipen.com has the instructions on how to inject the victim, its dead easy and instructions are also on every pen, but save everybody some time in an emergency and familiarize yourself now. Since its only available via prescription its unlikely that anyone who isn't allergic can carry the pen, although with proper medical credentials some can.  But anyone can carry Benadryl, and in a bad situation it may be the only hope you have for treating a victim on the trail.  Just remember - epipen or twinject, benadryl, repeat (twinject), then rapid evacuation to advanced medical care.  Treatment may not end with the EpiPen, a handshake, and moving on down the trail.

Usual disclaimers - I'm not a doctor, I've been trained for a couple days in wilderness medicine.  NOLS or WMI aren't responsible for what I say here, etc.
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Mike E.
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Post Mon Jun 30, 2008 9:07 am   
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BeyondLost wrote:
Mike,
I'm curious if your father ever had any kind of significant reaction before his severe reaction. It is possible to have an anaphlactic reaction as an initial event but far more common if one had a bad local reaction before.
.
.
I'm just not sure a lot of people are going to look at the still extremely low individual risk and spend that much money if they've never had a problem.

Bob,
The only reaction that he'd had previously was one to shellfish. Yep, a $200 choice between a new pair of boots or a couple Epipens would undoubtedly favor the boots. I wouldn't do this myself, if this hadn't happened to him, and it just made me a bit leary to not have any re-course if I, or someone around me, had a problem.

Lono's comment about taking an antihistamine had me wondering if taking an antihistamine prior to a hike, as a preventative, would do any good. It would be nice to know if taking something prior to a potential exposure would limit a person's reaction.
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BeyondLost
Crazy Bob



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Post Mon Jun 30, 2008 9:47 am   
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Mike,
That history of a prior shellfish reaction probably was meaningful. People with an "allergic history" (and I don't mean nasal allergies etc) are more likely to have anaphylaxis with a different exposure like bee, wasp or ant sting.
Regarding taking an antihistamine prior to a hike I doubt that would have much if any benefit.
Lono,
All good advice, but I think the key message  is

Quote:
So those with allergies, always carry an EpiPen or TwinJect



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GlacierGlider
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Post Mon Jun 30, 2008 10:41 am   
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I was on a 4 day forray back in 2003 to Gamma Hotsprings, and at the time had never had a problem with bees.  Well on this trip after making the Hot Springs in record time, averaging 3.5-4 mph the trip was going great.

Then it happened, we decided to go down the creek instead of climbing back up as we should have after spending the night at thte springs.  It was a cool 75 degrees along the creek and about 90 something out of the ravine.  Well anyways we came to a certain point where the 50 feet of rope that we had was not enough to get down a waterfall, so we hit the woods.

After bushwaching for about an hour I stepped over a dry, rotten, falling apart stump, and wouldn't you know it....bees nest.

Well, I managed to escape with only one sting, but that was enough.  I was on nearly vertical terrain, as we all know it is hard on the feet when trying to keep balalnce with full pack and having to use the berry bushes as belays.

The problem was I had this stinger on the topside of my hand about 2 inches down from the wrist.  I had taken out the "bite and sting kit" and tried to pull it out.  Didn't get it totally.  Within 15 minutes I started getting dizzy and was having trouble breathing.  I started puking not long after.  I had some Benedryl with me which I had taken right away.

Luckily we met up with the Gamma Way Trail about 45 minutes later.  From that point it was about 4.5 miles to Skyline Brindge where the PCT crosses the Suiattle River.  By the tiem we made camp I was having cold sweats and plumbing was running "really rich".  I made it out the next day, but it took alot longer than the 3.5 hours it had taken to do that 12 miles 2 days earlier.

When I got back I went to the doctor, and they said that I was having  an allergic reaction, they gave me an Epi-Pen, which I have one in the car and in the first aid kit in the pack, it is my 11th essential.  I was also dehydrated, as I was letting go of all my electrolytes, out both ends.

I have been stung one time since this trip, but it was not as bad and I did not need the Epi-pen.  It happened on the "pipeline" fishing trail up Lime Ridge a year later.  But I dosed up with Benadryl and was okay.  Plus I got the stinger out.

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Dane
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Post Mon Jun 30, 2008 12:41 pm   
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Damn that's terrifying Glacier Glider. eek.gif

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AOW
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Post Mon Jun 30, 2008 1:04 pm   
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As a kid, I had  pretty severe allergic reactions to a couple of specific types of bees with one rushed trip to the emergency room. Over the next couple of years I went for weekly, then monthly allergist visits to get shots of bee venom to desensitize me. Only had a few embarrasing reactions to those. I carried an epi pen everywhere for a while but as was pointed out above, they do expire so after many stings with no issues I stopped carrying one.
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