To Benedryl or Not?

[bwallace23350]

I took 2 stings today and did not benedryl because someone told me it could mask the onset of anaphylaxis. I wait 30 minutes to take medicine and boy does it itch and hurt until then. How do you treat your stings?

[iddee]

I took 3 on the face today. I laugh at them. Told them they were getting slow. My norm is 5 plus on a stormy day.    

[flyboy]

Put Rescue Remedy on it. Put it on a few times after the sting and no discomfort. Prepare it like this. Take a one ounce dropper bottle, put 4 drops of the RR in it and then fill the rest up with water. Then just drop the mixture on one drop at a time to the sting (or actually any kind of wound. Then a few minutes later put another drop on it. Do that a few times and the sting will still be visible but will not hurt.

[BeeMaster2]

When I started beekeeping, I used Benedryl cream and hydrocortisone cream. I think it helped my body to not react to the stings.
If you think you might have a reaction to the stings, do not delay taking the Benedryl.
I had a severe reaction to Gassex. The Benedryl gave me time to get to the hospital. I also had a young boy have a severe reaction to fire ant bites. I offered his mother Benedryl and she gave it to him. It took 20 minutes for the ambulance to arrive and it was severe but he survived.
Jim

[tjc1]

I'm not allergic, but I am sensitive to stings. Sometimes no more than the usual soreness and itching, but on a couple of occasions swelling of the hand then the forearm, then around the elbow and... was given prednisone for that one. SO to avoid that happening, I keep a bottle of children's (liquid, so faster acting) benedryl on hand and I take it asap after a sting. 4 teaspoons is the usual adult dosage equivalent. I hate taking it because it really knocks me for a loop (so drowsy I have to lie down and sleep for a while after), but I haven't had any of those kinds of reactions since using it.

[divemaster1963]

I take a benadryl tab before doing removals. More for the poison ivy  dust in the nose. Stings don't bother me first hurt the go away in 20 min. Unless several in same spot the alittle sore for few hours. But I like to get stung always every 2-3 weeks for the rumatiod in my shoulder.

John

[yes2matt]

I'm not allergic, but I am sensitive to stings. Sometimes no more than the usual soreness and itching, but on a couple of occasions swelling of the hand then the forearm, then around the elbow and... was given prednisone for that one. SO to avoid that happening, I keep a bottle of children's (liquid, so faster acting) benedryl on hand and I take it asap after a sting. 4 teaspoons is the usual adult dosage equivalent. I hate taking it because it really knocks me for a loop (so drowsy I have to lie down and sleep for a while after), but I haven't had any of those kinds of reactions since using it.

I wonder if it matters where you take the sting, in relation to nerve centers and lymph channels etc.

I got stung on the back of my left hand, the "meaty part" inside the thumb, and just like you describe I eventually had swelling all the way to my elbow; I felt that sting for three days. The next day I got stung on my right hand on the outside of the thumb. It itched for a day. 

[Wombat2]

As a Pharmacy Student many years ago we did a prac class on the "Histamine Response" Basically we scratched the skin with a pin and measured the time and size of the welt that developed. We then repeated with different people taking /using various medications to see what difference there was from nil treatment.

The best result was application of an anti-histamine cream immediately (unfortunately these are no longer permitted in Australia - but I make my own) and take an oral anti-histamine within 30 minutes - sedating ones are more effective than non-sedating( ie Benadryl, Phenergan as opposed to Tagamet, Zyrtec)

My 2 cents worth.

[JackM]

HIstamine is a body response to an external insult OR an allergen.  Benadryl is an ANTIhistamine, which means it counteracts histamine.  The sooner you get it in your system the sooner it can work against the histamine and reduce the body's reaction to the HISTAMINE, not the insult.

Using that medical explanation, my belief is that the sooner you get it on the better.  I am allergic to bee stings, and have to be very careful.  If I get a sting and can get the benadryl onboard in 5 minutes or less, I have a less severe reaction.  Best to avoid it all and really suit up.

Additionally some folks use liquid benadryl.  Myself I take 100 mg as soon as I can, and put on topical benadryl and topical Vagisil (better anesthesia effect).

So the facts are out there now, between what the pharmacist said and this you should be able to make a decision.

[little john]

I wonder if it matters where you take the sting, in relation to nerve centers and lymph channels etc.

Certainly does for me.

On the feet or legs - absolutely nothing - I get more of a reaction from a stinging nettle.

Head and face, not too bad - slight swelling for 24hrs, but that's about all.

But hands and arms - they swell-up like balloons, and still itch even after all these years.  In the early days the itching used to drive me crazy, and keep me awake at night - but the best tip I ever got was NOT to use ice or cold water - quite the opposite - a wet flannel, as hot as you can stand it applied to the swelling.  Only if you're not allergic, of course ...
LJ

[tjc1]

I wonder if it matters where you take the sting, in relation to nerve centers and lymph channels etc.

I got stung on the back of my left hand, the "meaty part" inside the thumb, and just like you describe I eventually had swelling all the way to my elbow; I felt that sting for three days. The next day I got stung on my right hand on the outside of the thumb. It itched for a day.

Yes, this is very similar to my responses, as with Little John, though my knee did swell up pretty god once. Top of the head, just a hard itchy bump. I don't want to find out about the face - as a kid I took a wasp sting between the eyes and my eyes swelled shut for a couple of days.

[bwallace23350]

The face for eme was the worst place to take a sting so far. Had bad swelling there. The hand has swollen when it gets popped but not like the face. I have not taken one really on the body as I usually wear my ultra breeze but the face was when I was in shorts and that was it.

[BeeMaster2]

I have taken at least 6 stings between the eyes, another 4 inside my nose, several on the checks and lots on my ears. If that had happened my first year they would have been really bad but for the most part, after 5 minutes, I hardly can tell where I got stung.
Jim

[PhilK]

...The best result was application of an anti-histamine cream immediately (unfortunately these are no longer permitted in Australia - but I make my own) ...

Any recipes for us there, Wombat? When I get stung on my hands they swell like crazy and it's a couple of days of major discomfort.

[yes2matt]

...The best result was application of an anti-histamine cream immediately (unfortunately these are no longer permitted in Australia - but I make my own) ...

Any recipes for us there, Wombat? When I get stung on my hands they swell like crazy and it's a couple of days of major discomfort.

Ditto that request, and I think I'll  add some liquid Benadryl to my workbox. This venom talk gets me nervous.

[GSF]

My first year keeping bees I had swelling and itching. Now almost nothing. Go to Wal Mart and get some "Prid". Comes in a little round (about the size of a quarter) container. When you get stung rub it on there. It supposedly draws out the venom. I say it does good.

[bwallace23350]

I will get some thanks.

[KeyLargoBees]

I took 14 stings to my right hand on Sunday.....trying to beat a thunderstorm and get a swarm out of a tree....big chunk missed the bucket pole as I shook it and since I was in a hurry I hadn't  gloveed up and a huge glob landed on my right hand....I guess Im a beekeeper now because it hurt and swelled a little but I kept going and was all better on Monday. Suits and veils are all well and good but they don't combat carelessness, stupidity, or getting in a hurry.....just saying 

[tjc1]

Suits and veils are all well and good but they don't combat carelessness, stupidity, or getting in a hurry.....just saying 

Well... they don't if you don't put them on! 

[cao]

I know this thread is about Benedryl, but as far as the immediate pain of the sting I crush some leaves from english plantain and rub it on the area stung.  It stops the pain and I think it helps reduce the swelling too.

[Wombat2]

...The best result was application of an anti-histamine cream immediately (unfortunately these are no longer permitted in Australia - but I make my own) ...

Any recipes for us there, Wombat? When I get stung on my hands they swell like crazy and it's a couple of days of major discomfort.

Message me offline

[GSF]

Cao, will any plantain do?

[Playapixie]

I'm an emergency flight RN and EMT and take care of anaphylaxis patients...

Benadryl doesn't mask the symptoms of anaphylaxis, it might actually PREVENT anaphylaxis. Whoever gave you that advice doesn't understand anaphylaxis or antihistamines.  Benadryl is one of two first-line meds for allergic anaphylactic reactions. The other is epinephrine. The sooner you take the Benadryl, the better. The idea is to stop the histamine response and hopefully halt the progression or limit severity of the allergic reaction.

That said, if you're not allergic, you might choose not to take Benadryl. Benadryl is highly sedating and the sedation is long lasting. When I take it the only thing I want to do for the next 8-12 hours is sleep. I usually just take a newer generation antihistamine like Allegra (fexofenidine) for the itching, maybe ice it a bit, and get on with my day.

A normal bee sting reaction is localized to the area of the sting. It may be red, swollen & firm, hot, painful, and itchy. That reaction probably extends several inches in all directions from the sting and can seem pretty impressive (I'm always amazed how hot that are feels for a couple of days.) This is a normal response to bee venom and isn't an allergic response.  They key is that the response is localized to the area of the sting.

Signs to worry you: any Difficulty breathing, tightness in throat, tingling or swelling or itching of mouth or throat, dizziness or lightheadedness, hives or rash on other parts of your body besides the site of the sting,  possibly nausea/vomiting, or any symptom that concerns you that is not at the immediate area of the sting. For those symptoms you want to take bandryl right away, use an epi pen if you have one AND call for emergency help. Epinephrine doesn't last as long as anaphylaxis, so multiple doses and further treatment may be necessary.

Most people aren't allergic to bee stings. Most people could take nothing and just have some itching and a little pain at the site to put up with. But most of us don't enjoy itching, so an antihistamine pill or lotion, some ice, and some Tylenol are plenty to ease the symptoms.

[bwallace23350]

itching of mouth or throat........... That is a typical reaction to my seasonal allergies it would have to be very severe for me to worry about that. Thanks for the information. I will take the Benadryl as it does not really make me tired. I only took it for the shot to the face I had and I still went to bed at normal time so I will just make it a part of my normal sting treatment.

[flyboy]

I'm an emergency flight RN and EMT and take care of anaphylaxis patients...

?...

Signs to worry you: any Difficulty breathing, tightness in throat, tingling or swelling or itching of mouth or throat, dizziness or lightheadedness, hives or rash on other parts of your body besides the site of the sting,  possibly nausea/vomiting, or any symptom that concerns you that is not at the immediate area of the sting. For those symptoms you want to take bandryl right away, use an epi pen if you have one AND call for emergency help. Epinephrine doesn't last as long as anaphylaxis, so multiple doses and further treatment may be necessary.

Most people aren't allergic to bee stings. Most people could take nothing and just have some itching and a little pain at the site to put up with. But most of us don't enjoy itching, so an antihistamine pill or lotion, some ice, and some Tylenol are plenty to ease the symptoms.

An epipen is a double edged sword. It is not something to be taken lightly. Firstly you need a prescription in Canada to get one and the prescription would presumably have to be renewed periodically. Secondly an epipen contains Epinephrine which is produced by the adrenaline gland.

The body naturally produces a natural version which is automatic when we are traumatized and it speeds up the heart, cuts off blood to the intestines etc. so you can run like the devil away from a raging tiger.

So if you have heart trouble, or are older, or have any issues with your whole cardiovascular system, maybe had a rough night last night, or any of a number of stressors, then it might cause a heart attack, stroke, etc, etc. because in effect the heart would just 'explode' for want of a different way to explain.

After a sting you have a bit of time (maybe 20 minutes) before the allergy sets in and incapacitates you, so best to call 911 or call up a responsible adult, who can get you physically into and out of a vehicle (to get you to a medical pro, before the epipen, because you may not bee able to afterwards. This is one time when the cure is as bad or worse than the problem. In other words, if you have a heart attack you won't bee able to call anybody.

If I was with someone and I knew there was a problem I would get them into the car lickity-split (tech term) and get them to a medical pro before trying anything.

Bottom line to me and the teacher who was teaching me about apiatherapy, and my wife who was a nurse, is that if you really are the 1 in 5000 who are seriously allergic, maybe you should just consider changing your carreer/hobby. Beeking is not 4 U.

You can gradually reduce your allergic reaction or possibly check to see if you are allergic by using a bee venom cream on your skin. It is commercially available (around 30 or 35 CanDollars) and you can make your own https://www.youtube.com/watch?v=SGQso0dWwy8

We have been practicing using the cream (the students from the course) and it just causes the skin to get red and a bit itchy, but not anywhere near what a bee sting causes. It is actually quite benficial as it artificially induces blood flow to the area in the same way that an acupuncture needle does.

Something interesting that I observed at our last bee sting practice session was that I had an incredible strong initial reaction to the actual stings. (I was fine afterwards)

The four or five stings and probably a dozen or a dozen and a half micro-stings were on my lower back, (lumbar area) medially along the spine, and about two inches laterally and up and down probably around Tzuiao acupuncture point. Man they were painful.

I could not understand because previous sessions were not painful at all. Then it occurred to me that the day before I had done some very serious physical work, working close to exhaustion in the hot sun, which probably weakened the area which is historically not that strong anyhow.

[flyboy]

If you are allergic it may be helpful to apply a tounaquet between the sting and the heart to slow down the flow of the venom.

"Any port in a storm"...

[cao]

GSF
Yes any will help but I have noticed a slight difference between the different varieties.  That's just my experience though.  I have been thinking of making a poultice with some so I don't have to walk around the yard trying to find it every time I get stung.

Playapixie
Good information. Thanks.

[iddee]

Playapixie, good info.

Flyboy, although what you say can't be denied, the danger from the epi-pen would be about equal to the Adrenalin rush you would get from walking up on a large snake unexpectedly.

[flyboy]

Playapixie, good info.

Flyboy, although what you say can't be denied, the danger from the epi-pen would be about equal to the Adrenalin rush you would get from walking up on a large snake unexpectedly.

Tell that to the dead folks

[iddee]

You mean the ones who had heart attacks and died while out for an evening stroll?

The US Army issues an epi-pen to every soldier, with maybe 5 minutes instruction. It is part of the standard field pack. I don't think they would if there was a great danger.

[PhilK]

I would agree with iddee on this one - Epipens are extremely useful to have. Anaphylaxis can set in and kill you much faster than 20 minutes, so I'll take the chance with an Epipen and calling 000 rather than having my friend drive me to the doctor to see if we should use the pen. I'd be interested if you have any data of Epipen deaths to back up your post, flyboy?

Applying a tourniquet isn't likely to do anything. The histamine release is the issue, not the 'venom blood flow'. You're thinking of a snake bite, and tourniquets are contraindicated for snake bites now as well.

[tjc1]

Yeah, I tried the tourniquet once for a bee sting I caught on my forehead - not so good...

[divemaster1963]

My cardiologist prescribed my epipens. I have had  3 heart attacks and one stroke in my 50 plus years. My cardiologist stated that if a antifalatic episode was to happen  that pen would get me to the ER where meds could be introduced to slow the heart rate. Better to make it to a er than to the morge ( his own words).

John

[Wombat2]

Some conditions can make epinephrine fatal. I have an over active Vagus Nerve which causes a number of effects in the body most notable is a slow heart rate (54-58 BPM) To diagnose it they do a "Tilt Table Test". It involves strapping you to a bed like device and measure your vital signs the raise the "table" from horizontal to vertical and monitor your response. They then give you a shot of adrenaline(epinephrine) that gets the heart racing and repeat the test. The Vagus then attempts to slow the heart. If it is over active it will go too far and stop the heart - I have a printout showing I flat lined for just over 30 seconds before they started it again. Interestingly I could hear everything going on during the test. I respond the same way to nitrates they use for angina.

So what I am saying is DON'T use an Epipen unless advised by a Medical Practioner who has checked you out first and knows your medical history.

[PhilK]

So what I am saying is DON'T use an Epipen unless advised by a Medical Practioner who has checked you out first and knows your medical history.

In an episode of anaphylaxis your options are generally use an Epipen or die from anaphylaxis (unless the ambos get to you very quickly)... Obviously with specific conditions such as yours their use is contraindicated, but if I'm going to die from anaphylaxis anyway you'd better believe I'd give the Epipen a go!

[Wombat2]

So what I am saying is DON'T use an Epipen unless advised by a Medical Practioner who has checked you out first and knows your medical history.

In an episode of anaphylaxis your options are generally use an Epipen or die from anaphylaxis (unless the ambos get to you very quickly)... Obviously with specific conditions such as yours their use is contraindicated, but if I'm going to die from anaphylaxis anyway you'd better believe I'd give the Epipen a go!

If you Doctor does their job properly and you ask  they will be able to test you to see if you are an anaphylactic risk. Besides it is rare to have a fatal anaphylactic episode straight up without a couple of "serious" responses on previous occasions. Haphazard use of an Epipen  can have more serious consequences if used when not necessary.

[flyboy]

You mean the ones who had heart attacks and died while out for an evening stroll?

The US Army issues an epi-pen to every soldier, with maybe 5 minutes instruction. It is part of the standard field pack. I don't think they would if there was a great danger.

Maybe I did not say it clearly, but my intention was to suggest that if you were to use the Epipen first, then, there would be no one to take you to the Dr. if it was a fatal item for you. At least if someone was notified, you might stand a chance of being revived. If all went well with the Epipen, then no problem.

Reference the military, there is a huge difference between a 20 year old 'fit as a fiddle' guy who might need to be in a remote part of the world where it might be useful, compared to an old fart beek? (like me) and plenty of others in my boat, who know nothing and this is the first they read about an Epipen.

Not sure how old you are, but there are a lot of PPL who do have a heart attack/stroke, in fact years ago a very healthy 45 YO friend had a myocardial infarction at the start of a mountain bike race. Another friend, a very fit ex-mil. pilot, shovelled the driveway and dropped dead.

So what I am saying is DON'T use an Epipen unless advised by a Medical Practioner who has checked you out first and knows your medical history.

In an episode of anaphylaxis your options are generally use an Epipen or die from anaphylaxis (unless the ambos get to you very quickly)... Obviously with specific conditions such as yours their use is contraindicated, but if I'm going to die from anaphylaxis anyway you'd better believe I'd give the Epipen a go!

In Canada, you are not given the opportunity to commit suicide, you have to have a prescription from a medical pro.

I would agree with iddee on this one - Epipens are extremely useful to have. Anaphylaxis can set in and kill you much faster than 20 minutes, so I'll take the chance with an Epipen and calling 000 rather than having my friend drive me to the doctor to see if we should use the pen. I'd be interested if you have any data of Epipen deaths to back up your post, flyboy?
Applying a tourniquet isn't likely to do anything. The histamine release is the issue, not the 'venom blood flow'. You're thinking of a snake bite, and tourniquets are contraindicated for snake bites now as well.

Re: deaths, just do a Google.

Re: venom, my wife said that she saved someone's life after an allergenic reaction to a drug injection with a tourniquet. This article looks more like snake oil than real science.: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700615/

Here is a quote from a CBC article that is interesting and germane to this conversation.

"If you've used the EpiPen, you must be seen in an emergency room or by somebody who's competent. And the reason is the venom is still in your system," he said, explaining that the epinephrine will wear off, potentially allowing a rebound reaction hours later, which can be even more serious than the original attack" http://www.cbc.ca/news/canada/hamilton/news/death-by-bee-sting-rare-mcmaster-allergist-says-1.2715351

I am not saying don't use an Epipen, I'm saying that it should be taken seriously.

My youngest daughter went into AS after being stung my a wasp when she was maybe 1 YO +/-. I was not even remotely aware that it happened, but my wife was going ballistic that we had to see a DR. After that, we got an Epipen, but she apparently got stronger as she grew and it is no longer an issue. It is apparently not that unusual with infants.
A neighbour told me one of her sons was allergic to bee stings. When I got her to expand on allergic, I found out that he would get red around the sting?.. hmmmmmm allergic eh?.

[PhilK]

Re: deaths, just do a Google.

I'm sure I could Google 'Epipen causes deaths' and get plenty of results, but I wouldn't trust them.. you can Google anything and get the information you're looking for, but most of the time it isn't worth anything.

Re: venom, my wife said that she saved someone's life after an allergenic reaction to a drug injection with a tourniquet. This article looks more like snake oil than real science.: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2700615/

Was the drug injected intravenously? A tourniquet would make some sense in that scenario. The article you've linked also suggests that tourniquets for snake bites are not recommended and have been shown to be ineffective and even harmful - I would suggest the same is true for bee stings and tourniquets. Pressure bandaging (like you would a sprained joint) is far more effective!

I am not saying don't use an Epipen, I'm saying that it should be taken seriously.

We can agree on that! I just would hate for someone to read this thread and avoid using an Epipen when having an anaphylactic reaction (even though that is very unlikely) because they're worried it may harm them, when it is far more likely to save their lives.

[Kathyp]

Playapixies post is excellent.  I keep the liquid benadryl on hand.  I have large reactions which consist of huge swelling to the point the skin weeps so taking something is a no brainer for me.  I also have epi-pens because one never knows when a systemic reaction will occurs, especially for one who is pretty sensitive to the stings.  epinephrine is short acting so you really want to have 2 and if you use them go to the doc right away because the epi will wear off before the toxin. 

The liquid benadryl has the advantage of being fast acting and you don't have to worry to much about dose if you take a swig.  I will take loratadine before if I know I am going into a situation where I will probably be stung.  It does not cause as much sedation. 

Having the stuff and not needing it is better than not having it.  I get the liquid benadryl at the dollar store   

[Playapixie]

Epinephrine is sound medical practice for  anaphylaxis. In my state EMT Basics used to only be able to give it to those with prescriptions, but now the laws have changed so they can give it to anyone with symptoms of anaphylaxis. There are NO contraindications to epi for anaphylaxis (except an allergy to it, or possibly some rare other medical condition, both which are exceedingly unlikely.) That's because anaphylaxis is rapidly deadly! The risk of epinephrine is remote. Certainly no one should take it without signs of anaphylaxis (Which were described in my original reply,) but in the presence of those symptoms, it is absolutely a life saver.

Yes, epinephrine increases the work of the heart. However, in anaphylaxis, your blood vessels dilate and your blood pressure drops dangerously.  You NEED that extra work from your heart to deliver blood supply to your brain and heart!

Telling people not to use epi in the presence of anaphylactic symptoms is deadly advice.

But yes, it's best to have a prescription when possible.

Anyhow, my point was that most people aren't allergic, and that a localized reaction isn't an allergic reaction, and most of the time, most people do not need epinephrine. They mostly don't need Benadryl, either, but they may want it to limit itching and swelling.

[bwallace23350]

So seeing this gave me a shot of adrenline like and epi pen. I was holding my 8 month old when I saw it. Just a rat snake so I let it live.

[BeeMaster2]

Good for you Bwallace. The only snakes that I kill are the water moccasins that I cannot catch and move off our property. They are too fast and to dangerous to catch.
My wife's cat used to bring snakes into the house all the time. It never brought in a poisonous snake. Luckily for them, my wife also doesn't have any problems removing them as long as she can recognize which type it is.
Jim

[bwallace23350]

She is one of two rat snakes we have in our yard. The other one is much bigger than that one but we have no rats in the yard.

[iddee]

Beautiful animal. Thank You for letting it live there. It will pay you well for it's stay.

PS. It will also eat venomous snakes.

[flyboy]

just curious, how are snakes around bees? Are they a problem?

We only have garter snakes on our island.

[bwallace23350]

I have no clue. I don't live near my bees.

[iddee]

No problem. Snakes don't bother bees, and bees don't bother snakes.

[cao]

I seen at least four different snakes on my property this year.  Luckily it is very very rare to find a poisonous one in my neck of the woods.  So I say live and let live.  I'd rather have snakes then rats and mice.