gale

A lot of people are misinformed or confused about how they work. With the rise of food allergies and the existence of other allergies (bee sting, medication) it's likely that you'll encounter someone who carries one and you never know when they'll need to use one. Avoiding their allergen and never using them is the best thing.

1. They are very expensive and have to be replaced often. Our last twin pack cost about $300 and our insurance doesn't cover that. There are coupons sometimes but it only helps a little. We buy 2 twin packs per year. They usually expire in a year so they have to be replaced at that time. They also have to be kept in a controlled temperature (not too hot, not too cold). Last year my husband took my daughter fishing on a day that was about 75. Since the epi needs to be kept between 67 and 86, he didn't worry about it. She has a small thermometer she keeps with it. He left it in the truck with the windows open and the thermometer showed it got over 90 degrees. It's never easy to monitor the temp constantly in the summer or winter, especially doing outdoor activities. If it gets too hot or too cold, it has to be replaced.

2. They are only a band-aid. If a person uses an epi pen, they have about 15 minutes before the reaction starts again. It's never as simple as using one and that's the end of it. They have to get to an emergency room within 15 minutes or use a 2nd pen. This is why they're sold in twin packs. A lot of people don't live or have activities within 20-30 minutes of a hospital equipped to handle anaphylaxis.

3. Of course this means an emergency room visit charge. If you have a deductible or your insurance only covers 60, 70, 80 percent of costs, this could get expensive. Once would be bad. Over and over could bankrupt you.

4. Epi pens don't always work. There was a recent news story of a girl that bit into a food that contained her allergen. She knew immediately and spit it out. Her parents, at least one a doctor, gave her benadryl and monitored her closely and she had no symptoms. At first. 20 minutes later she started going downhill. Her father administered THREE doses of epi (not all at once but one after another after the first didn't stem the reaction). She died anyway. Turns out that she was having symptoms during that 20 minutes, only they weren't visible on the outside. Most people's action plan involves giving epi pens at certain signs of a reaction. This did not help this child. Many have changed their action plans.

I read arguments all the time about how people with allergies should just suck it up and not worry about nuts (obviously not eating them but not worrying about cross contamination or allergy-bullying or shared tables in schools, or eating in classrooms, etc) because they can just carry an epi pen (that would need to be replaced with every use ($$$)). It's not that simple.

eta: did you know that a lot of people use walnut shells in their pincushions? This could be very dangerous for a person allergic to walnuts. And expensive.