|Cholinergic aka “Exercise Induced” Urticaria|
Greetings! I’ve been down for the count the last couple of days. For the second time in a month, I wound up in the hospital for an allergic problem. This time it was triggered by exercise. I had an attack of “cholinergic uticaria”. Though not qualified to give medical advice, I wanted to relate what happened and share why I now carry a product like Benadryl in the camping first aid kit.
Thursday started out as an ordinary day with an ordinary cardio workout on an “Octane” seated elliptical machine. As I performed a moderate exertion, the scalp and neck started to itch – a sign of an impending allergic reaction. It started spreading. I completed the 30 minute duration anyway but by then was itching pretty badly.
The itch became even more intense after exiting the gym. My lips started to swell until they resembled clay. The entire body broke out in welts that looked like mosquito bites. The left arm looked like one giant hive. My hands swelled until the fingers would barely move. It looked like I had oven mitts on!
Fortunately, I was able to get to the University of Iowa Hospital about thirty miles away. By then, walking and breathing was difficult and I was getting “tunnel vision”. They admitted me immediately and started an IV of diphenhydramine along with IV injections of liquid Pepcid, a stomach medicine which also helps relieve hives. The doctors were discussing putting in a breathing tube but thankfully did not have to.
I was pretty worried but have to admit it was funny when they had trouble finding a vein because everything was puffed up like the Pillsbury dough boy!
The itching and burning improved within about an hour but they admitted me for a day, continuing the antihistamine therapy. It took a second day for the swelling to go down.
This violent and potentially dangerous reaction was sort of a heat rash “gone wild.” Some people say that such a condition is being allergic to your own sweat. Some even call it “exercise induced urticaria” because it often happens during rapid body temperature changes experienced while exercising. If you add in dehydration, the situation can be even more serious. It is very scary.
After things calmed down, one of the doctors and I were discussing Benadryl and how well it had helped. I told him these hives occasionally happen when exposed to heat during exercise and during prolonged sun exposure from camping related activities. He recommended a dose of Benadryl before starting a cardio workout or outdoor activity. Of course, he told me to stay hydrated.
For that reason, I bought a couple of packages of generic diphenhydramine at the Dollar Tree (aka “Everything’s a Dollar”) store. Benadryl was expensive at Walgreens (as was the store equivalent) so the dollar store really helped out! It’s cheap and a welcome addition to the first aid kit. At the first sign of hives, there will be a dose taken.
The allergic reactions to body temperature changes will likely improve in the coming days, according the various internists I spoke with. They feel that with regular, moderate exercise outdoors (and adequate warm-ups) I will adapt and eventually these violent reactions will not occur at all. Having been mostly sedentary for a number of years, it’s no wonder why sudden exertion is perceived incorrectly, triggering such a response.
So now there is diphenhydramine in addition to other helpful over the counter remedies (such as Sudafed) in the van. For the extra dollar or two, the generic “Benadryl clone” offers some peace of mind and perhaps medical relief while camping out in the boonies.
As always, talk to YOUR doctor before taking any medication.
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