“This is going to hurt. I don’t want to do this. I don’t want to do this.”
I’m staring at the Epi-Pen in my hand. The lid and case are below my feet, wobbling on the ground in the parking garage. I can feel my throat tightening, and focusing my vision on the bright yellow epinephrine pen in my hand is getting increasingly difficult as my eyes continue to swell.
I am not sure how and when I am going to die, but I am certain that moment is not inside a rental Toyota Corolla in the basement of a Seattle parking garage on the eve of my 31st birthday.
It is time to take action.
As my hand begins to make the necessary motions required to save my own life (by this point, my eyes are pretty much useless), thirty years of pivotal moments come to me at once.
For starters, the Epi-Pen in my hand was not easy to obtain. In my many years with food allergies, it is something I often take for granted, refilling it yearly and tossing the expired ones without a second thought. Of course, this was before the cost of two Epi-Pens soared passed 600 dollars, and before there was a shortage of the device, making refills difficult to obtain. These days, I get to spend hours on the phone with my insurance and my pharmacist in order to get the appropriate medicine at an achievable price. I followed this exact process less than a week ago for the drug in my right hand at this moment. Ten seconds pass.
While the Epi-Pen is about as brand name as a person can get, I am not one for designer anything, including drugs. The problem with Epi-Pens is they’re a specific auto-injector that I practice on a regular basis, and have those closest to me practice, too. I could prepare and use a test Epi-Pen with my eyes closed before I could do long division, and it is a skill I keep as sharp as possible. While there are other injectors out there, they all behave a bit differently. And while it may not seem like much, a sudden change like this would be like giving a surgeon a new tool in the middle of a surgical complication.
Years of training and arguments with insurance is about to pay off, however. Since I cannot see, I am using the device by memory, and what was stupid party trick as a kid is now going to save my life. Eighteen seconds pass.
As I take a deep breath and press the pen against my leg, my friend yells that he found a nearby urgent care and is loading the map. In my three decades of allergy experience, my parents taught me to not only be prepared, but to prepare those around me. While I am fumbling around, I have a friend at the restaurant we just left verifying the food’s ingredients that may be causing this, and another friend is finding out where to take me once I get the courage to use the pen. There is no discussion on what to do in these few seconds — everyone knows their role.
I finally push hard enough to active the epinephrine auto-injection. The needle punctures my pants, then my leg, and immediately injects the simple yet life-saving adrenaline medication. The horrible pain I expect does not come, only the feeling of pure, well, adrenaline. It’s working.
No longer focused on the Epi-Pen, I turn back into the car to see my friends ready to get me to the urgent care.
I took the necessary steps to prolong my life enough to get the care I need. My friends know where to go to make sure I get that care in time. I make a quick joke about a car enthusiast almost dying in a Corolla. Thirty seconds pass.
Living with food allergies is not so bad, day-to-day. But allergies are a difficult problem to have, because you’re fine until you’re not. There is little incentive to follow patient adherence, and since no action of any kind is the appropriate response 99.9% of the time, it is difficult to justify the time it takes to train those closest to you, and even more difficult to justify the costs of epinephrine.
But here’s the deal — all that training, preparation, and diligence matters. Within 30 seconds, 30 years of preparing came into play. While an ounce of prevention may be worth a pound of cure, a moment of preparation may be worth a fully-lived life.
Final Note: If you have a peanut or tree nut allergy, stay clear of lupin powder. You’ll probably find it in some gluten-free foods.