Most days are just like any other day. Last Sunday (July 17, 2016) was like most days, an ordinary day filled with people doing what they ordinarily did. I was just finishing up a photo shoot, one of my favorite kinds – we were making powerful images that addressed social issues, it was a shoot I had been looking forward to for quite a while – I was working with two of my favorite people, we were in the beautiful Black Hills, the sun was shining, it was a good day. I was literally snapping the last few pictures when that perfect, ordinary day suddenly turned extraordinary.

I was photographing one of my favorite couples, Pam and Brett, and we were shooting on our friend Fiona’s land in Custer, South Dakota. We were just finishing up when something stung me on my left arm. I stopped shooting to take a look, I think I swore and dismissed it as a pesky bee sting that would annoy me for a few days and nothing more.

A few minutes later as I sat in the shade to look at the pictures we had just taken, my heart started pounding really, really fast and I felt like I couldn’t take a deep breath. I told Pam and Brett that something was wrong, that I didn’t feel right and I tried to stand up and walk. I think Pam or Brett said something about taking me to a hospital, and I don’t know if I could talk but I remember thinking in my head  ‘This is crazy, I don’t need to go to a hospital, I’ve been stung by bees and wasps many times before.’  I felt dizzy and my arms and legs felt heavy and I kind of fell over and passed out.

At this point I began drifting in and out of consciousness and I don’t remember much of what happened over the next several minutes but have pieced it together based on what people have told me and the doctor’s notes.

Once I passed out, Brett ran down the hill we were shooting on to Fiona’s house and they called 911 while Pam stayed with me and tried to keep me awake and alert by pouring water on me and talking to me. She said she had to hold my head at one point because I was jerking around a lot and frothing at the mouth. A few minutes later Brett and Fiona were back at the top of the hill and Fiona’s husband Dan had driven a 4-wheeler up to get me. Brett told me later that day that when they got back to the top of the hill my feet were starting to turn blue. I remember people lifting me onto the back of the four-wheeler and kind of slumping forward onto Dan. I remember thinking “I do not want to fall off this” and I tried to interlock my fingers so my arms wouldn’t come undone from around his waist.

The next thing I remember is being back down at the bottom of the hill by Fiona’s house and people helping me into the backseat of a maroon SUV. I heard the ambulance sirens but saw it wasn’t there yet, so I understood that we weren’t waiting for the ambulance and that they were going to drive me to the hospital. That scared me. I think that’s the moment I realized I might be in real trouble. It seemed like an awful dream, just a few minutes earlier we were all having a perfect day and now everything was unfolding so quickly. I was scared.

I remember snippets of the car ride to the ER; someone asking me questions – “what’s your name, what’s your birthday, what’s your daughter’s name” and I remember having a very hard time breathing and feeling like I was suffocating. As terrifying as that was, what scared me more was how fast my heart was beating; I remember thinking in the backseat of that SUV that I was going to have a heart attack. I’m 39 years old, slightly overweight, and I smoke a pack a day. On my best days I’m a candidate for a cardiac episode, so I was convinced that whatever had caused this reaction was going to kill me in the form of a heart attack.

The next thing I remember is sitting up in the backseat of the SUV, the door was open and I saw a lot of people standing in what looked like a long hallway. I felt something on my leg and looked down and saw a little red drop of blood coming up through my jeans. I remember wondering why that was happening – I didn’t realize we were at the hospital and the ER doctor (Dr. Heith Waddell) had just given me an EpiPen shot in my thigh. They put me in a wheelchair and took me into the ER. Once I was inside they gave me a second EpiPen shot. I remember hearing a lot of people talking but not really what they were saying, and I remember feeling them cutting my clothes off me. (Later I asked one of the nurses if they had by chance been able to salvage my Bernie Sanders t-shirt, sadly the answer was no.)

At this point I was still having a really hard time breathing and they were putting an oxygen mask over my nose and mouth. I was cognizant enough to realize I was in the hospital and they were trying to help me, and I was aware that I had been stung by something and that was why I couldn’t breathe, but I still felt like I was suffocating and I remember trying to take the oxygen mask off my face. I don’t know how loudly or effectively I could speak because I still couldn’t breathe, but in my head I was screaming at them to take the mask off my face.

I remember the nurses asking me if they should call my mom, and I think I initially told them not to because I didn’t want to scare her, but they did call her a few minutes later. I apparently even spoke to my mom on the phone but that I don’t remember.

The first few hours in the hospital are kind of a blur, I remember my friends coming in to see me and talking to them and a constant stream of nurses checking my IV’s and stats. I don’t remember really seeing any of this, I think they had put a cold washcloth over my head because I think I was really hot; the nurses had to change the sheets I was lying on a few times because they would keep getting soaked with my sweat. I don’t really remember being hot or sweating profusely, I actually remember being really cold; I kept asking for more blankets and I remember each time they brought me a new one it was warm, like it had just come out of a dryer. Later I was sitting in the room with my mom and I peeled back all the layers of blankets – I think there were 15.

As the day went on and I improved my friends and the hospital staff filled in some blanks for me. The maroon SUV that sped me to the hospital belongs to a friend of Fioan’s who was just down the road from us, and who also happens to be a doctor. Dr. Joy Falkenburg was off work that day, visiting a friend not far from us. After Fiona called 911 she called Dr. Joy who got to me before the ambulance. Dr. Joy called ahead to the ER to let them know we were coming and she drove almost 90mph through town to get me there. The Sheriff was also called and gave us an escort to the hospital. 

Throughout the day, as different friends or nurses would come into my room, when they first saw me they all said the same thing “Wow! You look so much better!” I started wondering how bad I had looked and just how close to death I had actually come. As Dr. Waddell talked with me before I left that day, he kept telling me I was very lucky. His exact words were “The stars truly aligned for you today.” A few days after I was discharged I went back to the Custer ER to get copies of his notes. As I read over the notes it began to hit me just how close I did come to dying. Dr. Waddell wrote in his notes “she would have been in complete respiratory failure had she waited 1 or 2 minutes.” One or two minutes…..120 seconds between life and death. 

It has taken me a few days to process the events of Sunday and to understand how many people reacted so quickly to save my life. If Brett and Pam hadn’t gotten immediate help for me, if Dan hadn’t had a four-wheeler, if Dr. Joy hadn’t been visiting a friend, if the Sheriff hadn’t gotten there so quickly, if the hospital staff hadn’t been prepared for me…all these “if’s”…all these people who were going about their normal lives one minute, and the next they were thrust into a life or death situation. It’s a very strange feeling to know that people you never met helped save your life, strangers. I never got to meet Dan, or Fiona’s daughter who made the second 911 call to tell them we couldn’t wait for the ambulance, or Dr. Joy, or the officer who escorted us, or the EMS workers. I haven’t gotten to meet these people yet, but I know they will be part of my life forever, for without them I wouldn’t have this life anymore. Dr. Waddell told me the stars aligned for me on Sunday, those stars were a few of my friends and a lot of strangers. My stars, my heroes.

2018 Update:  I had two EpiPens that I had to use last year after I got stung by another bee in Lusk, Wyoming. It happened at the end of the summer so I decided to wait until the following spring to get more EpiPens. Well, spring this year came and turned into summer and I kept putting it off because the cost is so high. Finally I had no choice – I had plans to go out of town for an outdoor concert and I had to have EpiPens with me. So I called around Rapid City to first find a doctor who could see me and write me a prescription (my prescription had expired). Once I found a doctor to see, I started calling pharmacies to see if they had the generic EpiPens available. Since Mylan has steadily raised the price of EpiPens over the last ten years, including a huge price spike a few years ago, a two pack that cost less than $100 in 2007 now costs more than $600 today. The first few pharmacies I called said they were out of EpiPens, I kept calling around and it turns out ALL of the pharmacies in western South Dakota are out. There is a national back-order. None had generic alternatives and only one could even get the vials of epinephrine, but that would take several days. (EpiPens are wonderful because they are so easy to use – but that is not the only way people can get the life-saving medicine they need. If your doctor is willing to teach you how, you can ask for a prescription for a vial of epinephrine. Vials are much less expensive than the auto-injectors, but that method is much more complicated and a doctor should advise you on that.)

In my desperation to find an EpiPen, I called the Custer hospital where I was seen in 2016. Dr. Waddell was no longer there, but was working not too far away in Sundance, Wyoming. (The Custer pharmacy was also out of all forms of epinephrine.) By this time of the day, it was already after 5pm, getting close to 6pm, and I didn’t think anyone would answer but I called the Crook County clinic where Dr. Waddell works and his nurse did answer! She was extremely helpful and said she would talk to Dr. Waddell and call me back to see if they could get me in. She called back quick, and said that I could schedule an appointment the following morning.

Driving to my appointment, it really hit me that I was going to see the doctor that saved my life. Just thinking back to that day makes me cry, not because I’m sad I almost died, but because of all the amazing people who helped me. I got emotional again in the exam room when he came in, and as he told me more about that day I couldn’t stop the tears from sliding down my cheeks. I am heavily tattooed, and most of my tattoos are all black ink, but Dr. Waddell told me that my skin was so discolored from the Anaphylaxis that he didn’t even know I had tattoos when I was brought into his ER that day in 2016. He also told me he was seconds away from doing a Cricothyrotomy, but heard my lungs starting to clear. He reminded me how fast and severe my reaction to the sting was and told me I should never go anywhere without epinephrine. I asked him about using the vials instead of the auto-injectors, but because my reaction is so fast and severe he didn’t think I would have time to mess with a syringe and a vial, even if I was able to. He miraculously tracked down the last two-pack of EpiPens for me in Sundance and had the pharmacist hold them for me. When my appointment was done, I hugged him and thanked him again, though that seems utterly inadequate. How do you thank someone for saving your life?

– – –

I have to talk for a few minutes about the Custer Regional Hospital and the staff that helped me that day. I have to talk about them, but I fear I lack the vocabulary to properly convey the torrent of emotions and gratitude I feel for these people. Though my memory of that day is blurry, the constant from that day I do remember was how caring, and patient, the hospital staff was. I know that as doctors and nurses they help people every single day, it’s their job. But damn, what an amazing job. What an amazing thing they do for people they don’t even know. Saving a life may be part of their everyday lives, but Sunday it was my life they saved and so to me what they did was nothing short of a miracle. Thank you to Dr. Joy Falkenburg, Dr. Heith Waddell, Nurse Pam, Barb, Jessie, Katie, Mary, Kate and Kyle – you are my heroes!

– – –

This is the last photo I took that day. If it weren’t for the two people in this photo, it would be the last photo I took – ever.

I look at this picture now and so many thoughts and feelings go through my mind. These two people, my friends, have no idea what is about to happen. They have no idea that in a matter of minutes they would be saving my life. Brett talked about his experience that day in a recent podcast and he put into words what I have been unable to thus far. He talks about the people in our lives, the connections we make and how, without even knowing it sometimes, we shape the lives of others by just being us.

I walked up that hill that morning with two people who were my friends, but we all left Custer that day with a much bigger family.

You can listen to Brett’s podcast here: www.spreaker.com/user/mynameisbrettray/embodied-grace-stories-stories-stories

– – –

What did I learn from this extraordinary experience? I learned that it’s actually not extraordinary. People die every day. We are all going to die. From the time we are capable of critical thinking, that is the one fact we all know for sure – as humans, we will not live forever. One day, each and every one of us will perish. We all know this, yet we go through most of our days trying to deny it, to forget that fact. Experiencing what I did reminded me that no matter what we may think we have planned for our lives, our plans can be canceled without notice. It reminded me that the last time you talk to your mom, a friend, or your child could be the last time you ever talk to them. So choose your words carefully, help others whenever you can and love others freely.

– – –

About EpiPens & When to Use Them

I’m sure we all know what an EpiPen is, and we probably all know people that have to carry them, but I wanted to provide a little information about how to use an EpiPen and how to look for symptoms in someone who might need help.

As a photographer, I spend much of my time outdoors and I have been stung by bees, wasps, ants, mosquitoes…pretty much anything that’s out there. I’ve never had a severe allergic reaction before Sunday, and I certainly had never experienced Anaphylaxis before. I thought that because I have been stung before and experienced nothing worse than an itchy bump that it could never happen to me. But that’s not the case, not for me, not for anyone. Apparently even if you have been stung by bees or wasps etc. in the past with no severe reaction, you can still go into Anaphylactic Shock, which is what happened to me. I was so confident I would never experience that, in fact, I even told Pam and Brett after I got stung that I would be fine, I wasn’t allergic. I even went out of my way a few weeks ago to get some photos of various kinds of bees who were pollinating a field of flowers while I was on a walk with my mom. She told me to be careful and not get stung, and my exact words to her were “Well if I get stung, it will suck, it will hurt, but it won’t kill me.”

What is Anaphylaxis?
Anaphylaxis is a severe, potentially life-threatening allergic reaction. It can occur within seconds or minutes of exposure to something you’re allergic to, such as a peanut or the venom from a bee sting.

The flood of chemicals released by your immune system during anaphylaxis can cause you to go into shock; your blood pressure drops suddenly and your airways narrow, blocking normal breathing. Signs and symptoms of anaphylaxis include a rapid, weak pulse, a skin rash, and nausea and vomiting. Common triggers of anaphylaxis include certain foods, some medications, insect venom and latex.

Anaphylaxis requires an immediate trip to the emergency department and an injection of epinephrine. If anaphylaxis isn’t treated right away, it can lead to unconsciousness or even death.

Symptoms of Anaphylaxis
Anaphylaxis symptoms usually occur within minutes of exposure to an allergen. Sometimes, however, anaphylaxis can occur a half-hour or longer after exposure.

Anaphylaxis symptoms include:
-Skin reactions, including hives along with itching, and flushed or pale skin (almost always present with anaphylaxis)
-A feeling of warmth
-The sensation of a lump in your throat
-Constriction of the airways and a swollen tongue or throat, which can cause wheezing and trouble breathing
-A weak and rapid pulse
-Nausea, vomiting or diarrhea
-Dizziness or fainting

When to see a doctor:
Seek emergency medical help if you, your child or someone else you’re with has a severe allergic reaction.

If the person having the attack carries an epinephrine autoinjector (such as an EpiPen or EpiPen Jr), give him or her a shot right away. Even if symptoms improve after an emergency epinephrine injection, a visit to the emergency department is still necessary to make sure symptoms don’t return.[/tab]

Your immune system produces antibodies that defend against foreign substances. This is good when a foreign substance is harmful (such as certain bacteria or viruses). But some people’s immune systems overreact to substances that shouldn’t cause an allergic reaction. When this occurs, the immune system sets off a chemical chain reaction, leading to allergy symptoms. Normally, allergy symptoms aren’t life-threatening. But some people have a severe allergic reaction that can lead to anaphylaxis. Even if you or your child has had only a mild anaphylactic reaction in the past, there’s still a risk of more severe anaphylaxis.

A number of allergens can trigger anaphylaxis, depending on what you’re allergic to.
Common anaphylaxis triggers include:
-Certain medications, especially penicillin
-Foods, such as peanuts, tree nuts (walnuts, pecans, almonds, cashews), wheat (in children), fish, shellfish, milk and eggs
-Insect stings from bees, yellow jackets, wasps, hornets and fire ants

Less common causes of anaphylaxis include:
-Latex
-Medications used in anesthesia
-Exercise

Anaphylaxis symptoms are sometimes caused by aspirin and other drugs — such as ibuprofen (Advil, Motrin, others) and naproxen (Aleve, Midol Extended Relief) — and the intravenous (IV) contrast used in some X-ray imaging tests. Although similar to allergy-induced anaphylaxis, this type of reaction isn’t triggered by allergy antibodies.

Anaphylaxis triggered by exercise is not common and varies from person to person. In some people, aerobic activity, such as jogging, triggers anaphylaxis. In others, less intense physical activity, such as walking, can trigger a reaction. Eating certain foods before exercise or exercising when the weather is hot, cold or humid also has been linked to anaphylaxis in some people. Talk with your doctor about any precautions you should take when exercising.

If you don’t know what triggers your allergy attack, your doctor may do tests to try to identify the offending allergen. In some cases, the cause of anaphylaxis is never identified. This is known as idiopathic anaphylaxis.

Risk Factors
There aren’t many known risk factors for anaphylaxis, but some things that may increase your risk include:

-A personal history of anaphylaxis. If you’ve experienced anaphylaxis once, your risk of having this serious reaction increases. Future reactions may be more severe than the first reaction.
-Allergies or asthma. People who have either condition are at increased risk of having anaphylaxis.
-A family history. If you have family members who’ve experienced exercise-induced anaphylaxis, your risk of developing this type of anaphylaxis is higher than it is for someone without a family history.

How To Use an EpiPen

If you are with someone who goes into Anaphylactic Shock and they have an EpiPen, here’s what you do:
(If they do not have an EpiPen call 911 immediately)

 

2018 Update about EpiPens: There has been a national shortage of EpiPens for months. Ask your doctor or pharmacist about any alternatives to the standard auto-injectors that might be available.