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Allergic Reactions and Swallowing Challenges

My body resists most medications. I had my first allergic reaction at age 20, breaking out in hives from head to toe as I stood in a post-game locker room. I don’t recall the infection I had, but the pill I’d been prescribed to treat it was penicillin. Since then, my allergy list has expanded to include almost all antibiotics except Bactrim, Flagyl, and Macrobid. I also get heartburn from baby aspirin, itching from Vicodin, and dizziness from steroids.

I opted for only one COVID-19 vaccine, and before getting it—fearing my body’s reaction—I took Benadryl.

My PCP feared the day I might contract pneumonia, which unfortunately I just did during a bout with COVID. The diagnosing emergency department (ED) doc was an anti-vaxxer, so she decided no Paxlovid for me and railed against the boosters.

A follow-up in urgent care led to an ultrasound and a diagnosis of left lobe pneumonia. I detailed my allergy history—hives; facial swelling; raised, rose-like designs on my chest—but the MD prescribed two antibiotics anyway: Bactrim and Ceftin. I told him that Ceftin had in the past given me lips that looked like they’d gotten a Botox injection—and that despite treatment with intramuscular Benadryl I’d suffered a few weeks of a fat mouth. He said I needed to take both meds to combat this infection. In the end, insurance covered only the Bactrim, and my pneumonia abated in time. I am a firm believer in less is more as far as meds are concerned anyway.

I also explained that I couldn’t swallow the big 500 mg capsules of Mapap he’d prescribed for my 103.7F temperature. He replied, “You’ll figure something out.” As a provider myself, I prescribe meds all the time—but personally have a hard time swallowing pills of almost any size. Advil gel caps slide down okay, but Tylenol tablets stick in my throat. I melt them (and Bactrim, when I need to take it) in a spoon with water, like my mother did when I was a kid (except she added sugar).

I am sensitive to my patients’ requests for meds as liquids, small tablets, or gel caps. I tell them I’m right there with them. Also, I pay attention and empathize when people tell me about allergic reactions. Except maybe for folks who claim they can only take anti-anxiety drugs like Xanax, Klonopin, or Ativan because of allergies to hydroxyzine or SSRIs. I wasn’t born yesterday.

Mary Lou Heater
Houston, Texas

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