I Almost Forgot - Allergies!

V1 Rash
I look sad because this particular
rash appeared after just 2 sips
of a Blue Moon.
"Not Blue Moon!", I cried. 😆🍺

Since I know that there are other Myositis and immune suppressed people that read this blog as well as friends in the medical field, I feel like it’s important to share my recent allergy information.
Others can skip this, since it’s a long, boring story about allergies. Not very exciting.

Many of my friends know that I have been experiencing some kind of food allergy reaction over the past 2 years that I hadn’t been able to determine the cause.
First, I thought that it was tree nuts. Then, perhaps some kind of alcohol. It happened every time I ate something at a hotel restaurant in AZ, so perhaps some kind of preservative or cooking spray? All of these theories, to no avail.

The reaction was a red “beard” on my face (or sometimes a “goatee”) that I could feel (but didn't itch or burn) that appeared within about 10 minutes of eating or drinking something. No shortness of breath other than a couple of panic attacks the few times it happened.

Let us first travel along my journey to this newfound information:

• ·   10 years ago

I have complete allergy testing done and learn that the only thing that I’m allergic to is dogs. Knife to the heart. Allergy medication it is, for life!

• ·   Two years ago

After having a blistering skin reaction when using a variety of skin and hair products, I have extensive skin allergy testing done. It's determined that I am not only allergic to nickel (as I always have been), but extremely allergic to lanolin, propylene glycol, and two other things that I have never even seen listed in any ingredients.
Avoiding these ingredients has been a major lifesaver for me, although they’re in f#*king everything, so that’s been fun.

• ·   One year ago

I met with an Allergist who told me that due to being on immune-suppressants for as long as I have been, I can’t have any allergies. He told me to take a 24 hour Zyrtec twice a day and one immediately after any rash.
I left feeling pissed off and completely confused by doctor speak, which I try REALLY hard to understand as it pertains to me and my health.

• ·   A couple months after that appointment

I asked my Rheumatologist if I had no allergies due to my immune-suppressants and she looked at me like the Allergist that I saw was on drugs and told me that I can certainly have allergies. Wtf.

• ·   6 months ago 

I was at my Dermatologist’s office and showed her the photo of my “beard rash” (above) in an attempt to determine what the hell it was and she gave me an EPI pen on the spot and told me how to use it. I freaked out.  

Per my Dermatologist’s advice, I made an appointment with a new Allergist for a second opinion.

• ·   Two weeks ago! 

After having to reschedule twice due to cracking because of allergies while off my Zyrtec (you have to be off of any allergy medications for one week before any allergy testing). I made it. Barely.

Here’s what I learn: 

1. Methotrexate and Azathioprine kill off the cells that allow allergies to show up on skin tests.

2. Rituxan kills allergy cells (or something).
If at some point, I stop getting the Rituxan infusions, in 6 months to a year, I will get a whole new immune system. So, I’m not actually allergic to dogs (anymore).

“Your reactions are unlikely to be due to a true IgE medicated reaction, but that is not to say that you are not reacting through a different mechanism.” – Allergy Dr.

3. Allergy cells can “fire” for fun. 

So, even if you don’t have "allergies", the allergy cells can put out the message for the reaction of that nature.
Apparently, my allergy cells are having a great time, because for whatever reason, they fire constantly.

4. Because the Rituxan kills the allergies, the chances of any reaction progressing to anaphylaxis is very unlikely (so I can ditch the dog-walking fanny pack that carries the epi pen).

5. The “Beard Rash” is called a V1 Reaction. FYI.

So, the first Allergist and my Rheumatologist were apparently explaining things right past each other, as both were [somehow] correct.

Medications
I’m told by new Allergy Dr. to continue using Zyrtec twice a day and to add Montelukast (aka Singulair) and Ranitidine (Zantac – apparently increases the effectiveness of Zyrtec) to the pill tray to cover additional allergens. I was actually already taking Zantac twice daily, but that is another blog post...

I’m given Azalastine (Astelin - an allergy nose spray) to use if a V1 rash appears. It responds faster than Zyrtec in those situations.

So, I’m good?
I went home and as an "F U" to the past 2 years, ate a macadamia nut cookie that I had been staring longingly at in the cupboard for a month and was completely fine. It was delicious.


I’m okay with all of the information above, but I leave with questions that I know I asked at least 3 times in the appointment, because all of the B cell, E cell info was so confusing to me.

• If I don’t have allergies, why do I have such severe skin allergies?
• Why do I still have to avoid the foods that I thought that I was allergic to?
• Why are my allergy cells having so much fun in there?
• Why is all of this happening only in the past 2 years, which is also how long I have been getting Rituxan infusions? 
• If I don’t have allergies, why do I have “breakthrough” in the fall and spring?      
• Does taking immune-suppressants make you more sensitive to… everything?

While the last appointment was more informative, I am not super pumped about more medication and the fact that I can expect the rash to continue. 

Nice that it won’t likely be harmful, but it’s a little alarming when it happens, and isn’t the best look for me 😉 It also takes about 30 minutes to an hour to go away after taking the response medication.

I wanted to share my experience with others taking immune-suppressants for shared knowledge. I’m also curious if any friends/readers have additional information to share in the comments for us all?

This blog has been viewed nearly 55,000 times and by readers in 10 different countries since its creation in 2010 – so I know that it has been helpful to people like me and their families.

Thank you to those who have taken the time to read this and for sharing any information that can be helpful, especially if it’s in Laymen’s Terms, since clearly decoding medical speak in this subject has not been successful for me!

Best,
M