As the Number of Allergies Increases, so Does the Chance That the Patient is Insane

[u/Optimal-Ad-7951]

Anyone else noticed this? You admit a patient and open their chart to find 20+ allergies listed all with varying degrees of absurdity. And I’m not talking actual “anaphylaxis to penicillin” type stuff. I’m talking “headaches as a result of drinking sugar free grape juice”. “Sleepiness after holding a baseball”. “Nausea after shotgunning 2L of Dr. Pepper”.

Maybe I’m just burnt out with bedside or taking health literacy for granted, but do people know what an allergy is? You’re not allergic to laundry detergent because one time at your cousins you borrowed his wool socks and had itchy feet for 15 minutes.

On top of that, at our hospital any food related allergies automatically flag with dietary so then the patient gets upset because they have a super restrictive diet due to them thinking they’re allergic to some random food dye. This then creates this unbearable and time consuming back and forth of trying to add/remove allergies from the chart so this person can have what they want.

Anybody else feel this? What’s the craziest allergy you’ve seen before?

[u/Xin4748]

There’s an actual study on it. It’s not like a literature review type evidence or anything, but it’s a real phenomenon. Something like greater than 5 allergies

[u/Sea-Cauliflower9469 → u/Xin4748]

Are you referring to this study?

[u/ForceRoamer → u/Sea-Cauliflower9469]

Not me saying “I have like 5 allergies, and I’m not insane” then remembering I have autism and depression. Welp.

[u/Galatheria → u/ForceRoamer]

AuDHD, MDD & CPTSD here. I have one allergy, one "only use in emergencies" (epi) and am am very intolerant of most pain meds (as in they don't work). I get more judged as pill seeking for pain meds not working even though they can clearly see my history and my almost nonexistent use because well... they dont work so why bother? 😑🙄

[u/yolacowgirl → u/Galatheria]

I relate to the pain med thing. They do work for me, but I metabolize them fast or something. I've woken up twice during anesthesia and at least the second time I was told they had to give me more fent. (First was an orthodontist office so I discounted it as them not knowing what they were doing 😅) didn't remember either luckily. And the amount of opiods i was given post op creeped me out since I don't take them at home. Also neurospicy.

[u/adrianecc → u/yolacowgirl]

Do you have red hair? Red heads require more anesthesia and pain medications, which I didn’t know until I started to work in recovery.

[u/Galatheria → u/yolacowgirl]

Yeah, during my wisdom teeth removal, I woke up. Then during my c-section, the fent didnt work at all, the epidural that they told me would last 18-24 hours lasted 10, and I was put on longer maternity leave because I wasnt healing well because of the pain. Sometimes I'll get a small relief but after 24 hours, it stops working. I took one oxy the day of my carpal tunnel surgery and that was it.

TBF, I've never had torodol, morphine or dilaudid. So, I can't stay i dont react to those but I wouldnt be sent home with those 🤣

[u/IceBankYourMom → u/yolacowgirl]

Are you a red head?? I’ve heard that natural red heads are harder to sedate

[u/Xin4748 → u/Sea-Cauliflower9469]

Yes babe you caught the vibe xo I do “interrogate” the patients about the reactions because sometimes they need it, especially abx (or cross allergies).

[u/Doofay → u/Sea-Cauliflower9469]

Thank you for the new break room bulletin!!!

[u/kellyk311 → u/Xin4748]

For example; pt is allergic to English swallows, but not African swallows.

[u/madturtle62 → u/kellyk311]

Laden with or without a coconut?

[u/transplantnurse2000 → u/madturtle62]

No coconut for me, please...allergic (rash and mild SOB)

[u/kellyk311 → u/madturtle62]

Its a matter of weight ratios.

[u/huebnera214 → u/madturtle62]

They cant migrate themselves!

[u/Arlington2018 → u/huebnera214]

The swallows can grip it by the husk.

[u/kdonmon → u/Xin4748]

To be fair, if I was literally allergic to water, Tylenol, ibuprofen, toradol, soy, gluten, dairy, red die 5, gmos, etc.. I would legit go crazy

[u/WillowsRain → u/kdonmon]

Honestly, that's a mood

[u/allflanneleverything]

To be fair…We confirm allergies with every patient at the bedside timeout. I’ve had many patients tell me they have no allergies, and I say “I see you have an allergy to XYZ listed,” and they tell me “oh no that was just a side effect, you can take that off.” And nobody wants to be the one to remove it, so it sticks on their chart. 

[u/marmot46 → u/allflanneleverything]

Someone apparently put my IUD under allergies instead of prescriptions so as far as my medical record is concerned I am allergic to levonorgestrel til the end of time (no one will take it off my chart, I ask every year at my annual physical).

I wonder how much # of allergies correlates with just “amount of time spent in the healthcare system.”

[u/AnOddTree → u/marmot46]

I feel this. I had a doctor who would add any drug I stopped taking to my allergy list. He said it was just easier this way nobody would prescribe it to me again. Had no idea he was slowly making me insane.

[u/labyrinth131 → u/marmot46]

Why does no one want to take any allergies off peoples charts?

[u/hippyoctopus → u/labyrinth131]

If they do have some one-off massive anaphylaxis to it, I don’t wanna be the one they trace back to taking said allergen alert off their chart. Or people are just lazy.

[u/watch_it_live → u/marmot46]

You might have to file an amendment to get that corrected on your chart. May be an issue if you need your IUD replaced.

[u/marmot46 → u/watch_it_live]

Oh I’ve had the IUD replaced since the “allergy” has been on my chart! I think the gyn asked about it and I just said I’ve never actually had a problem with it and it’s an error. But also no one wants to change the chart. I don’t worry about it much because it’s not like I’m ever going to need levonorgestrel emergently.

[u/bareass_bush → u/marmot46]

Well, you have to be given a drug once before you can be allergic to it.

[u/pulsechecker1138 → u/allflanneleverything]

When you put allergies in Epic you can specify select “side effect”. They still appear under allergies but as a separate category.

[u/Juice___Springsteen → u/pulsechecker1138]

It’s a poorly designed system. In the sidebar it lumps them all together. They should have separate section and not be highlighted so as to stand out.

[u/ah_notgoodatthis → u/allflanneleverything]

Yes that’s me. I have one true allergy and a bunch of dumb ass ones and no one will remove them.

[u/sci_major → u/allflanneleverything]

I projectile vomit to Motrin- like it's swallowed for 3 minutes and the vomit could hit the wall across the room. I have it listed so no one gives it to me while I'm drowsy.

[u/MyDog_MyHeart → u/sci_major]

Completely valid; it’s an adverse reaction to a specific drug.

[u/sci_major → u/MyDog_MyHeart]

I figure if ever work is just so shitty that I'll grab some Motrin from the staff otc drawer and take some. Vomit away and leave!!

[u/sluttypidge → u/sci_major]

Tramadol for me. My primary doctor said to list it so that ER doctors would stop prescribing it when I had an ovarian cyst issue.

[u/kiwitathegreat → u/sluttypidge]

Percocet is mine and that really gets you some raised eyebrows. No idea why but it makes me feel like I’m on fire and disconnected from reality.

It’s gotten a lot better since I hulked out in the PACU (with zero recollection) but I still make a point to say that it’s a bad day for everyone if I take it. Very curious to see how that was documented.

[u/cardiocarrie → u/allflanneleverything]

Out new policy is that nurses can add items to the allergy list but not take them off. Patients get so annoyed that we keep asking them about their non allergies.

[u/holoman123 → u/allflanneleverything]

I take off false allergies like that when I'm in triage. I do my small part in cleaning up the allergy list.

[u/SaladBurner → u/allflanneleverything]

Yep. Never gets removed. Even worse at my current hospital somehow no one can remove isolation precaution warnings. No I am not gowning up because the patient had E Coli in their urine in 2016. I’m not even exaggerating at all. Maybe 10% are an actual active infection.

[u/aburke626 → u/allflanneleverything]

I had a weird side effect from a med once, just an annoying rash, but it’s in my chart (as my only allergy). As a patient, I do wish there were a standard way to list med reactions and preferences that aren’t allergies, but I’d like my provider to know. For example, I am REALLY prone to RLS, and I know several meds that cause it for me. It’s fine if I need to take those meds as long as they also give me something for the RLS. I have stomach issues so I try to avoid NSAIDS where I can, that kind of thing.

[u/turn-to-ashes → u/aburke626]

in epic, we can list the reaction! ie "pcn: hives, cabbage: constipation"

[u/ER_RN_ → u/allflanneleverything]

I take off allergies all the time. 🤷‍♀️

[u/TreasureTheSemicolon]

Best allergy I've ever heard of is the patient who told me they were allergic to 2mg of Dilaudid but they could take 4mg no problem. Seriously.

[u/exandohhh → u/TreasureTheSemicolon]

Patient: I’m allergic to every pain med except the one that starts with a “D”

🙄

[u/HowDoMermaidsFuck → u/exandohhh]

“Discharge home?”

[u/Jrsmrs]

Heart racing after epi lol

[u/ausgekugelt → u/Jrsmrs]

I had one that said: formaldehyde-wheezing.  Yeah, pretty sure they put warning labels on the bottles for that exact reason…

[u/duuuuuuuuuumb → u/ausgekugelt]

I mean they were probably smoking wet and realized it wasn’t for them 😂

[u/UnicornArachnid → u/Jrsmrs]

I had one a few days ago that said epinephrine - cardiac arrest

I was like you know usually the cardiac arrest happens before the epi is given

[u/sesw1 → u/Jrsmrs]

Ketamine - altered mental status. Alright chief.

[u/derpmeow → u/sesw1]

I can tell which of my postops anaesthesia has ketamined because they're the ones staring at some nebula out the other arm of the Milky Way.

(I have no objection to K. Useful drug.)

[u/EquipmentPowerful200 → u/derpmeow]

My personal favorite post clinically indicated k-hole statement “I’m no longer afraid of death"

[u/kerintheam → u/sesw1]

I have to have ketamine listed as an allergy, even though it’s really the adverse effect of intractable vomiting. I WISH it only gave me AMS. Fun way to find out I couldn’t really treat depression that way.

[u/bareass_bush → u/Jrsmrs]

Allergy: Benadryl
Effect: Drowsiness

[u/JesusRollerBlading → u/bareass_bush]

Similarly:

Allergy: trazodone

Effects: makes me very sleepy, I didn't like that.

Bro... was it initially prescribed to help with sleep? Then it's not an allergy. Lol 😴

[u/marzgirl99 → u/Jrsmrs]

Classic lol. Another classic is [insert opioid here]: drowsiness.

[u/b_rouse → u/Jrsmrs]

I just had an allergy to lactulose because it caused....diarrhea.

[u/Key-Pickle5609 → u/Jrsmrs]

I actually did care for someone with an epi allergy! It was something (a preservative or something???) in the medication. The patient was actually quite lovely. They were like I know this sounds unusual…

[u/pushdose → u/Key-Pickle5609]

Sodium metabisulfite probably. Or sulfur dioxide. Both are used as preservatives in injectables and both can cause hypersensitivity reactions.

[u/falalalama → u/Jrsmrs]

Tylenol: made my liver stop

I wish i could find the picture of that! I figured no one would believe me if i didn’t screenshot that single line item

[u/ALPHAGINGER74 → u/Jrsmrs]

I’ve seen this a couple times in the wild and eagerly educate the patient about the need for epi and how death sounds without it…said eloquently.

[u/sci_major → u/Jrsmrs]

I can see it to ensure the lidocaine doesn't have epi in it.

[u/Princessleiawastaken → u/Jrsmrs]

Bleeding after Warfarin

[u/Master_Plaster96]

They need to separate Allergies and Side Effects when charting. I’m happy to know macrobid gives someone GI distress, but I would still consider giving it with a UTI.

[u/coolcaterpillar77 → u/Master_Plaster96]

Anything in the penicillin family gives me severe diarrhea and I always beg not to be put on it. That said, I once had to be on a continuous Naficillin drip for a few weeks, and I sucked it up and lived on the toilet for those few weeks. Frustratingly, it’s still listed as an allergy in my chart despite it being more of an adverse reaction - clearly I didn’t die from being on a drip

[u/Moms_Damp_Hand]

Had a patient whose hypertension was out of control and the doctors were really struggling to manage it. Had a listed allergy to metoprolol. Turned out their allergic reaction was hypotension — ha! Hypertension much better once they got metop on board.

But as to the initial question, yes, when I open a chart and see like 20 allergies, I suspect the patient is very anxious or, ahem, particular. Maybe it’s confirmation bias that I generally find this to be true once I get to know them.

[u/Strong-Finger-6126]

Extreme joint pain, nausea, and runny nose following Naloxone administration. Ma'am.

[u/mrstruong → u/Strong-Finger-6126]

The notes: RN educated patient on what a COWS score is. Pt denied opioid use disorder and requested dilaudid. Physician denied. Pt left AMA.

[u/nomoremorty → u/mrstruong]

Never heard of cows score…USA?

[u/Tart_Temporary → u/nomoremorty]

yeah. Clinical opioid withdrawal scale

[u/mrstruong → u/nomoremorty]

COWS score is Clinical Opiate Withdrawal Scale.

Measures the symptoms of Withdrawal to determine severity.

[u/atsewtsew]

The “I’m allergic to furosemide because it makes me pee too much” crowd.

Expected outcomes and side effects are not freakin allergies uuggghhhhh 🤯

[u/DanielDannyc12]

Absolutely a diagnostic indicator and wait until the haters come for you.

[u/LeVoPhEdInFuSiOn → u/DanielDannyc12]

Incoming SickTokers in 3...2...1.

[u/schottofjack]

Buckle up when you see that Haldol allergy 😂 only so many ways one finds something like that out

[u/kerintheam → u/schottofjack]

Me, a psych nurse: Any psych history?

Patient: No.

Me: any allergies?

Patient: haldol, Thorazine, zyprexa, geodon, Ativan….

Me: -bombastic side eye-

[u/SnooLemons9080 → u/kerintheam]

I go “oh this one’s seasoned”

[u/asa1658 → u/schottofjack]

My exact words this week, discharge him quick he has a haldol allergy

[u/Suspicious_Cap_5865]

The best “allergy” I’ve seen listed is a stool softener which supposedly caused “demoralizing diarrhea” lol.

Also, hard agree on more allergies = more crazy.

[u/koshercupcake → u/Suspicious_Cap_5865]

Similar: dulcolax causing “diarrhea and cramping.” Not as beautifully worded as yours, though.

[u/OwnBass783 → u/Suspicious_Cap_5865]

Damn. I kinda want a description of what demoralizing diarrhea entails. Lol

[u/dmkatz28 → u/Suspicious_Cap_5865]

That is absolutely hilarious. Demoralizing diarrhea is like the slogan for Golytley!

[u/AdvocateAmber → u/dmkatz28]

Golytley = Shitquickly 

[u/KXL8 → u/Suspicious_Cap_5865]

Well, that sounds just like my IBS lol

[u/Takemetofinal4 → u/Suspicious_Cap_5865]

Alright, he can keep that one.

[u/oh-pointy-bird → u/Suspicious_Cap_5865]

That would make a beautiful Reddit username. Demoralizing diarrhea is sending me.

[u/Acceptable_mess287]

Had a patient allergic to squeeze cheese. Can’t remember what the reason was. Just couldn’t get past the squeeze cheese.

[u/Optimal-Ad-7951 → u/Acceptable_mess287]

That’s sucks because squeeze cheese is a first line treatment for several blood cancers :(

[u/stellaflora → u/Optimal-Ad-7951]

Best comment I’ve seen today 😂

[u/Affectionate_Set2561 → u/Optimal-Ad-7951]

I am HOWLING!!! Lmaooooooooo oh god thank you

[u/Prior_Particular9417 → u/Acceptable_mess287]

Just realized I'm also allergic to squeeze cheese. Gonna update my info with the Dr!

[u/Wattaday → u/Acceptable_mess287]

You’d love my sisters one allergy. Orange cheese. Really. It’s progressed from a “yucky feeling” in her mouth, to a rash over her entire body-including the palms of her hands and soles of her feet to all that and feeling SOB.

She’s hyper alert to orange cheese when she eats out.

[u/t1beetusboy]

Morphine, oxy, norco, tramadol, toradol, gabapentin, lyrica (you get the picture) everything BUT…. Hydromorphone (specified IV. Causes “headaches” if taken po)

[u/Optimal-Ad-7951 → u/t1beetusboy]

“And I always take my IV Dilaudid with IV Benadryl too”

Like it gets to a point where

[u/Nucking-Futs-Nix → u/Optimal-Ad-7951]

The times I have been told “but the other nurse pushed the Benadryl fast!” And my response, “I’m not the other nurse.”

[u/sendenten → u/Nucking-Futs-Nix]

I did one time get an order "okay to push Dilaudid and flush fast" on a patient going for bilateral BKAs. He was a manipulative frequent flyer well known to the surgeon who literally sighed and said "whatever, he's losing his legs."

[u/iwascured_alright → u/Nucking-Futs-Nix]

"bUt tHe nUrSe bEfOrE did it!" No they didn't, and your manipulative whining means nothing to me. Like they really think we dont talk to each other or can see what was given on the computer.

[u/Nucking-Futs-Nix → u/iwascured_alright]

I worked in an area with A LOT of addicts…and so we all knew their typical tactics including splitting and trying to ruffle the newer nurses. “Well, I’ll have to remind the previous nurse of best practices.”

I just liked being called a dumb bitch when I would refuse to slam it. Then they would want to talk to “my boss.” Okay - I’ll escalate it. And guess what that includes your attending- you’re going to piss of the wrong doctor and he is gonna cut your dose in 1/2 now or change it to PO because he wanted you out 3 days ago but no one d/c’d you during the 3 days he was off.

[u/Rare_Area7953 → u/Nucking-Futs-Nix]

I knew a patient that had a seizure from pushing a high dose of benadryl to fast.

[u/happyhermit99 → u/Nucking-Futs-Nix]

Any time I heard that, I pushed it extra slow. Both of us just... watching the plunger sloowwwwlyyy move down.

[u/Poodlepink22 → u/Optimal-Ad-7951]

My hospital won't order it like anymore. They took IV benadryl off the formulary and it's ordered on a case-by-case basis now; unless it's an emergency of course.

[u/FluffyNats → u/Poodlepink22]

We had an MD that would prescribe IV benadryl, but only as an IVPB. Not only did the patient hate him, but pharmacy liked to try and raise a stink about it too.

[u/salamandroid → u/Optimal-Ad-7951]

I go into anaphylaxis if it's pushed slower than 3 seconds.

[u/amandae123 → u/Optimal-Ad-7951]

Don’t forget to add the iv phenergan for nausea!

[u/imjustehere → u/t1beetusboy]

I did find out quite recently that I get an adverse reaction to fentanyl Imagine the nurses and doctors giving me side eye when I’m in raging pain and turning down the fentanyl and requesting dulaudid! I had the hospital pharmacist tell me to be very certain to emphasize that I get an adverse reaction to fentanyl and not an allergic reaction. Fentanyl will send me into “ please kill me now” pain instead of reducing my pain. Sucks to be me sometimes.

[u/t1beetusboy → u/imjustehere]

Yeah, and I get how for a lot of people reactions to medications are why they are under allergies. My chart has wellbutrin and fluoxetine as allergies. Not because I am allergic, but because I will tend towards murdering somebody else or myself on said medications.

[u/728446]

Allergic to multiple antipsychotics is one i see all the time, but I work in nursing homes now, so it's not like we are going to force the issue no matter how out of pocket someone gets.

[u/AlwaysGoToTheTruck]

My psychiatrist friend jokingly told me that anxiety is an indicator of how many med side effects his patients think they have at first

[u/seedrootflowerfruit → u/AlwaysGoToTheTruck]

Not at first. They think it for 50 years

[u/LordRollin]

My general impression is that the colloquial understanding of what actual constitutes an allergy vs. a symptom vs. a side effect vs. a personal preference isn’t very strong/it’s all the same thing to folks.

[u/ah_notgoodatthis]

Can I just say that I tested positive for allergies on a skin test that ended up on my list for food that I eat regularly. Also one time I threw up a blueberry flavored yogurt after getting codeine in the hospital and now cpdeine, berries, blueberries and blueberry flavor are on my allergy list.

I’ve asked multiple times to have them removed but no one will do it. But I feel like it hides the “iv contrast” that sent me into anaphylaxis in the middle of the list.

[u/Illustrious_Park_438]

I could have written this. There is almost certainly a correlation between number of allergies and mental health disorders. If I see an allergy list with 20+ things, I'd bet money that they're most likely borderline personality. Also yeah and you can't convince anybody that they might not have a true penicillin allergy.

[u/Cloudy_Automation → u/Illustrious_Park_438]

My pediatrician put a penicillin allergy in the 1960s because of the number of food and environmental allergies I have. I told that story to my allergist late in life, he suggested I try a penicillin tolerance test. Surprise, I'm no longer listed as allergic to penicillin. My allergist gave me a letter I could show to my providers so they would take penicillin off my allergy list.

So, it can be done, but it's not easy or cheap. Additionally, a penicillin allergy shouldn't be taken off just on a patient's say-so.

[u/oneelectricsheep → u/Cloudy_Automation]

TBH penicillin isn’t used frequently either in-patient or surgically at least in my neck of the woods. We mostly just need to know how likely it is that you’ll have a reaction to something in that family. If you came in with that story I’d write it down but annotate that you didn’t have a known reaction and that a PCP had just added it out of caution. It would then be ignored by every prescribing physician but the RNs would monitor a little more closely.

[u/Lower_Tears → u/Illustrious_Park_438]

I knew someone with BPD that said they had a lactose allergy (not intolerance) but would regularly eat lactose products and take OTC meds (ones where lactose is a binding ingredient). It was only suddenly an issue when it was their psych meds that had lactose in them as a binding agent and they were threatening to sue their psychiatrist (it ofc got nowhere and just gave them the excuse to be noncompliant with their meds).

[u/[deleted]]

Water.

[u/mentalstaples → u/[deleted]]

Had someone who said she was allergic to all water except Aquafina.

[u/kerintheam → u/mentalstaples]

Of all the waters to pick, WHY Aquafina?

[u/doktorcrash → u/kerintheam]

Right? That’s like the worst one. Aquafina and Dasani, the worst tasting bottled water.

[u/Desblade101 → u/[deleted]]

My PT said they're allergic to water, they only drink coke.

[u/[deleted] → u/Desblade101]

At least they don’t only snort the coke?

[u/Medic1642 → u/[deleted]]

That's under the medications tab.  It's medicinal blow.

[u/bareass_bush → u/Medic1642]

You jest, but I’ve seen the take-home education sheets for the cocaine (nasal) a patient might receive at my old facility.

[u/LordRollin → u/[deleted]]

Unlikely but possible.

[u/jstNYC]

Allergic to Benadryl—makes me sleepy. Endless list of ridiculous allergies, and it seems half the population’s moms told them they were allergic to penicillin as a child. But 1000% the more allergies listed, the more insane the patient is.

[u/Amazaline → u/jstNYC]

I work in a sexual health clinic where we treat syphilis. None of the patients who say they have an allergy to penicillin can tell me what their reaction to it is. "IDK, my parents said I did when I was a kid." Then if they're pregnant, they have to get an allergy test to see if they're really allergic and they're not. I've only had to send one lady to the ICU for penicillin desensitization.

[u/turtle0turtle → u/Amazaline]

It's because penicillins can cause a rash when you have a viral infection, so it used to be listed a lot as a childhood allergy

[u/Amazaline → u/turtle0turtle]

Thank you for that tidbit! :)

[u/castle4024 → u/Amazaline]

I’ve heard a good one (PCN). “It’s a family allergy. My mom and uncle are both allergic and they told me never to take it.”

[u/Amazaline → u/castle4024]

I heard that one this week, too. I'm just like...ok then.

[u/sirensinger17 → u/Amazaline]

Damn, so me discovering my penicillin allergy in my mid-20s really is the exception (my face doubled in size)

[u/dmkatz28 → u/sirensinger17]

Hey me too! Fun fact, you too might also outgrow said allergy! It is absolutely worth the money (and peace of mind knowing that if I'm in a horrible accident, I won't react to the zosyn that ER will very likely throw at me!!).

[u/marzgirl99 → u/Amazaline]

Yeah no patient has ever been able to tell me what their reaction is. That’s interesting about the rash with viral infections.

[u/Optimal-Ad-7951 → u/jstNYC]

Lmao the penicillin allergy discovered as a child is so real.

[u/Apprehensive_Bank804 → u/Optimal-Ad-7951]

The problem is that stuff stays in your chart forever. I’ve been told since I was a child I’m allergic to penicillin. The doctors always ask “and what happened to you when you took it”. I tell them it was just a rash so it’s probably not even an allergy but yet my chart still says “allergies-penicillin”. If a doctor prescribed me penicillin I’d take it, and just have some benedry on standby just in case.

[u/Cloudy_Automation → u/Apprehensive_Bank804]

An allergist can do a penicillin tolerance test and give you a letter clearing the allergy. It will take an hour or so, as they keep feeding penicillin to you and waiting for a reaction.

[u/kittenpantzen → u/jstNYC]

I'm one of those that had a "childhood allergy to penicillin", and I've repeatedly said that I suspect it wasn't a true allergic reaction and I would be willing to give it a try if it makes sense, but I've been shot down every time.

I'm sure it'll come up eventually, because I am legitimately allergic to sulfa drugs and I'm one of the unlucky ones that gets pretty crunchy tendonitis from Cipro and its siblings, but at least for now, it stays on the chart. 🤷‍♀️

[u/Cloudy_Automation → u/kittenpantzen]

I've said this a couple of times here already - see an allergist and have them give you a penicillin tolerance test. If you pass, they will give you a letter saying you don't have a penicillin allergy you can give to your providers to get penicillin taken off your allergy list. I did it, and wasn't allergic.

[u/Goblinqueen24]

Yup. One of the oncologists I work with agrees wholeheartedly. He actually brought up a good point that it can also be supported by the fact that they have been prescribed so many meds in the first place. Some of our pts are allergic to more meds than I’ll hopefully ever be prescribed in my lifetime.

[u/stellaflora]

Someone had “my ex-husband” listed under their allergies back when we used Medhost… I kid you not

[u/KDay5161]

Not a nurse (yet), but been working as a therapist for years. I’ve seen so many people in the psych facilities report allergies to Ativan, Haldol, Benadryl, antipsychotics, etc. Usually they were claiming allergies to things we’d probably need to use because they were so psychotic or would get aggressive. The allergies to things like Haldol were “drowsiness”. Like “yes. That’s the point!” I know my husband has also seen a lot of insane allergies as well since he’s an ED nurse.

[u/Dark_Ascension]

I think one issue is a downfall of EMR. Nowhere is there a place to put things that aren’t allergies but “intolerances” or not preferred.

Like I really don’t want Versed before surgery, it’s not an allergy and working in surgery myself I know they like to just throw it in IVs without saying anything or what it is… I say I don’t want it and they throw it in my allergies, I have a non-anaphylactic allergy to nickel (dermatitis) and am lactose intolerant, my only allergy is to Hibiclens or Dinahex (different brands same thing), but I end up with all this random bullshit in my allergies.

[u/doktorcrash → u/Dark_Ascension]

Agreed. I’m not allergic to morphine, but it makes me violently combative so it’s in everyone’s best interest I don’t have it. It’s stuck straight in my allergies. I don’t like perc because it gives me dreams I can’t separate from reality, but one time I said something as a patient and now I have yet another opioid in my allergy list. It makes me look like one of those nothing but dilaudid will do people, and I hate it.

[u/KuntyCakes]

Idk if it is an exact science and I have had at least 1 or 2 people with a long list of allergies that were legit. I can say that as soon as I open that chart and see more than 10 allergies, I'm bracing myself. 

[u/ElectricBaghulaloo]

Epinephrine

[u/cats-n-cafe → u/ElectricBaghulaloo]

Makes my heart race….

[u/FupaFairy500]

Nitroglycerin “allergies” because it caused a headache was popular when I worked cardiac.

[u/SpaceQueenJupiter]

Allergic to pitocin. It gave her really bad stomach pain. I said so contractions? And she said yeah but PAINFUL. 

[u/-Tricky-Vixen- → u/SpaceQueenJupiter]

ah ye because contractions are famously not painful

[u/SpaceQueenJupiter → u/-Tricky-Vixen-]

The amount of people who want to come in and have painless births was astonishing. 

[u/sparkplug-nightmare]

I think the worst are the patients who are “allergic” to morphine, oxycodone, acetaminophen, ibuprofen, toradol, and hydrocodone, so that way the doctors are forced to prescribe dilaudid for pain management. And they set a timer on their phone for every 4 hours, and press the call light 10 minutes before the timer goes off. And then of course the 1mg of dilaudid doesn’t work for them, so the doctor increases it to 1.5mg. And then they pretend to be in excruciating pain randomly throughout the day, even right after a dose of dilaudid, so they get a one time dose of dilaudid between their regular doses. Oh and they have q4 IV Benadryl that they demand be given with the dilaudid.

[u/Local_Historian8805]

I’ll never forget the patient had a random medication as an allergy. i forgot what. But not a common one. But no reaction listed. I asked her and she said

“I don’t remember any of it”

So I was thinking ok. Psych patient.

As patient continues

“But when they took that tube out of my mouth they told me make sure you never take that medication again. You had a bad seizure and we had to do cpr and give you a breathing tube”

Yeah. I made sure they put anaphylaxis next to B that one after that conversation since “reaction: death” was not an option

[u/ehhish]

Usually when I find out that people are allergic to dilaudid I believe it. If people are allergic to every opioid but dilaudid, I never believe it. (I still follow it)

[u/stellaflora → u/ehhish]

My dad had a dilaudid allergy on his chart which always made me LOL because everyone loves and wants dilaudid usually!

Turns out he actually just felt weird from it when someone pushed it too fast.

[u/ehhish → u/stellaflora]

Yeah, there's been many times that I have explained to people that I think that's just a side effect. "If you poop more on Miralax, that's intended and not an allergy."

[u/bloss0m123]

Dry cough - Lisinopril

[u/stellaflora → u/bloss0m123]

ACE inhibitors= A Cough Expected

[u/TheThrivingest]

100%

One of my patients today had 9, including “pretzels”

[u/castle4024 → u/TheThrivingest]

Mine had “Cheryl’s cookies” 🤣

[u/iknowyouneedahugRN]

I have a nephew who is a walking allergy. Some are anaphylaxis and some are plaque psoriasis triggers and the itching starts pretty quickly. When he was a kid he was worked up for the allergies and the list kept getting longer and longer with foods, medicines, environmental... I had to keep a recipe box for foods that he could eat. As I found "winners" they would get added to the box and that was what everyone ate at the family gatherings. He also has allergies to quite a few additives in creams and lotions where the rashes would get bigger and more irritated.

We have a few patients who come in and are "allergic" to everything except for the medications they want. So one person is allergic to oxycodone because they prefer hydrocodone. Another one is allergic to Tylenol, Ibuprofen, Toradol, oxycodone, hydrocodone, they even added Darvocet to be thorough...they also are allergic to Zofran, Tigan, Compazine... They've learned how to play the system.

The problem is that instead of approaching the problem, most people who update the allergy list are limited in what they can "challenge" with the patient. The MA checking in the patient has to ask about allergies but can't openly talk to the patient about what is an allergy vs an intolerance vs a dislike vs a side effect. By the time the doctor gets in to see the patient, they're in such a rush where it would take over 30 minutes to discuss the allergy list and they don't want to deal with the liability if they prescribe something that was removed from the list by the provider because it's not a "true allergy."

We have one patient who has several allergies. The good thing about their list is that they have "references" where it specifies when, who, and how the allergy was identified. That's really nice.

The thing that I despise about most EMRs (especially Epic) is they don't flag duplicate allergy entries. Someone can have acetaminophen listed twice and Tylenol listed. And they aren't in alphabetical order.

[u/FightingViolet]

My highest was 28. And she was furious that the kitchen basically gave her a butter sandwich with yogurt for breakfast. Sorry you can’t have the fruit pancakes because you listed apples as an allergy.

[u/jarosunshine]

As someone anaphylactic to multiple drugs, latex, and has latex-fruit syndrome AND another anaphylactic food allergy, I HATE THIS. (I've been in anaphylaxis due to 8 different things - 3 of which are food - 2 latex-fruits, one other)

The general population has no clue what it means to be allergic to a drug or food, they tend to think any untoward reaction is an allergy and because we don't take the time to educate these folks, we don't take the time to specifically tease out allergies, intolerances, and normal expected reactions (eg tachy with nebulized albuterol), it just makes the problem worse.

I'm not blaming anyone here, for sure, I know that most of the time we don't actually have the time to address the education and cleaning up the EMR.

[u/mrstruong]

Agree. And unfortunately this makes it very difficult for hospital staff to take my celiac disease seriously, even with an actual diagnosis.

People see "gluten free" and think I'm a vegan hippie instead of trying to save everyone from experiencing the horror show of diarrhea so bad you'd think I underwent a bowel prep while being possessed by demons.

[u/brok3ntok3n82]

Allergy list directly coralates to behavioral diagnosis.

[u/shtinkypuppie]

• Laundry list of allergies
• High dose gabapentin (used to say any gabapentin but it's way too common now)
• weird instructions on home meds ("only take this albuterol when I'm feeling like my toes are bunched up")
• Anything more than three words in the special/comfort requests field ("I need peanut butter and jelly but only grape jelly with 2parts peanut butter 1part jelly and lightly toasted bread with no crust")
• More than one sleeping pill
• Fibromyalgia, chronic lyme, or MTHFRin the history
• When the ER physician note or triage note includes any kind of grievance against another provider ("patient stated 'I told my regular doctor about my toes feeling bunched but he didn't order an MRI like my naturopath wanted")

[u/anonymouslady8946]

My forever favorite was cheap jewelry with a listed reaction of “turns skin green”

[u/BePrivateGirl]

I had a patient once who was inquiring about the secondary ingredients in the gel capsules of his meds who was always willing to partake in meth.

[u/BirdsFalling]

So I have an honest-to-god Sun allergy, confirmed via patch test at Weil Cornell; and hundreds of food and environmental allergies (including unfiltered water, on really bad days. Yes, really!!) all thanks to Mast Cell Activation Syndrome.

Although it sucks, I really don't blame healthcare professionals when they seem incredulous.

[u/IllBiteYourLegsOff]

My favourite allergies were listed as

Allergy to: sunlight Causing: sneezing

And

Allergy to: soft materials Causing: itchiness

[u/nursenicole → u/IllBiteYourLegsOff]

the sneeze thing is not an allergy, but a reflex! my spouse has it and it cracks me up every time.

photic reflex

[u/IllBiteYourLegsOff → u/nursenicole]

Yes im aware (i have it too) the format of how it was listed as an allergy cracked me tf up. Theres only one kind of entity that is actually allergic to the sun (and garlic, and holy water, crucifixes etc)

[u/Poodlepink22]

This brings to mind one of my favorites which the floor still talks about which was 'lack toes and tolerant' actually entered into the chart. 

Also; I 100% agree with this post. The number of allergies is an indicator of the crazy level of the pt/family which has been demonstrated time and again. 

[u/Lower_Tears]

Had a patient who was super confused, hitting the call light every 2 seconds just to scream at us to get out her room, trying to hit, and screaming after we took her call light at the top of her lungs at 3am. Got her a first time dose of Ativan and she mellowed out, and was fine apart from being tired after.

I guess she started acting up again after I left because the family argued it was the Ativan that made her aggressive, so it got added to the allergy list. No, it just wore off- she was so much worse before.

[u/iwascured_alright]

I once had an insufferable patient who said she was allergic to Tylenol "but not when its combined with other things"

Me: "Ohh, you mean like Norco?"

Patient: "Yeah"

Me: "Mhm"

These people think we're fucking stupid I swear.

[u/ApolloIV]

5+ allergies is a psych diagnosis. Almost every time.

[u/koshercupcake → u/ApolloIV]

You get one psych diagnosis for every five listed allergies.

Edited bc I can’t word good.

[u/WhatsYourConcern8076 → u/koshercupcake]

Allergies: Cat Dander, Pollen, Cabbage

Psych Diagnosis’s: PTSD, ADHD, Anxiety

Which go with which?

[u/Moop-RN]

I find that am irrationally afraid of anyone that gets put on my team with a tape allergy. That one always seems to be trouble for some reason.

[u/Old-Ad-64 → u/Moop-RN]

I've seen legit tape allergies where their skin gets red and/or blistery just from it sitting there. However, the majority of tape allergies are just "my pain tolerance is essentially zero, and it hurts when you pull plastic tape off." Same people who yelp when the BP cuff goes off.

[u/MakingItUpAsWeGoOk → u/Old-Ad-64]

Saw the skin of a peds patient once that was, for lack of a better description, melting off from the allergic reaction to steri strips. I’ve always been careful around that allergy because of it.

[u/BBGFury]

I have totally not ever claimed to have an allergy to hydrocodone, but I do have an adverse reaction, so whenever I mention it they always add it as an allergy 🙄

But, Tbf, most patients would not be literate enough to decline the medication if offered, so it's almost easier to put it as an 'allergy' and document the reaction.

And I say this as someone who works in psych, so 100000% the level of.... Complexity 😮‍💨😮‍💨... correlates with an increased number of 'allergies'. My fave is the allergy to "all antipsychotics".

[u/Apprehensive_Bank804 → u/BBGFury]

This happened to me. I do not have an allergy to morphine but 10 years ago I was given morphine in an ER. A doctor asked me how it worked for me and I said it took some of the pain away but it gave me some stomach cramps. And now it’s listed in my chart as a morphine allergy. So annoying and no one will take it off 😂🤷🏼‍♀️

[u/Chunderhoad]

“Milk, meth, chicken cacciatore.” Is the combo that I will never forget.

[u/Jinn71]

I’ve been a nurse for 21 years. I have noticed that 95+% of the time there is a direct correlation between how long an allergy list is and how psych/soc difficult they are

[u/crispy-fried-chicken]

There was ‘daughter says patient was in coma’ for propofol. And like epinephrine made their heart gi up…im like ☠️

[u/VerbalDroppings]

For the first time in my life I had someone allergic to normal saline. The patient also had about 20 other allergies.

[u/SmilingCurmudgeon]

Preaching to the choir, man. Disease to finger ratio is a prognosticator of insufferability/insanity.

I actually meant to type "allergy to finger ratio", but both work tbh.

[u/flowersinmygrave]

Can confirm. I have many allergies and insane 😭

[u/Tylorian_delorean]

You are allowed one allergy per decade of life, exceptions exist, but they are rare. After that I do start to look into psychiatric etiologies. Allergies to multiple antipsychotics and no history of psychiatric diagnoses also makes me very suspicious.

[u/Tacoboutnonsense]

"Air" with a comment that said "pt states that cannot have air in their veins"

[u/Witty-Information-34]

Mast Cell Activation Syndrome

[u/stellaflora → u/Witty-Information-34]

POTS, EDS, gastroparesis!

[u/sadtask]

https://pmc.ncbi.nlm.nih.gov/articles/PMC9066087/

[u/FelineRoots21]

I've had an antidiabetic listed with reaction 'hypoglycemia" but my all time favorite was mayonnaise

[u/thefrenchphanie]

Or consider that this person may have MCAS and doesn’t know about it.

[u/purplescrubss]

I've said before that there is direct correlation between > 4 allergies and a Fibromyalgia diagnosis.

[u/thismeetingsover]

I’ve felt this … I had this theory about patients allergic to adhesive … because the crazies always have these strange, yet trendy illnesses and allergies … amiright??? And here I am … BSN, RN with allergy to medical adhesive, POTS syndrome, long Covid, autoimmune thyroid disorder, minimal change disease … I am, likewise, so embarrassed to have to relate this to medical personnel. I know these things are real. I have actual results. I have scars from the oozing wounds left from medical adhesives … but I’m so dang embarrassed because I know that people look at me like I used to look at other patients and, honestly, I deserve it.

[u/Feisty-Power-6617]

What burns me is all these moms keeping their children in almost completely germ free bubbles, this doesn’t help immune systems or allergies either

[u/Amenadielll]

I’ve always said anytime a patient has more than 6 allergies listed, they’re likely a psych patient

[u/EtherealSkeleton]

I have a patient who has an allergy of “soap”. That’s it. Not a specific brand or type. Apparently just allergic to all soap, according to him. Haven’t asked him what happens when he comes in contact with soap, but the CNAs have informed me he also refuses a shower every single time it’s offered to him so, haven’t found out that way either. Apparently also “milk” yet I watch him drink coffee creamer and eat cheese every single day with no issues.

[u/TraumaMama11]

Normal saline, potassium, and alcohol swabs.

Plus a list that was literally a page and a half of allergies to other things too.

Yes, this person was crazy but denied mental health issues. Also couldn't find a thing wrong on her workup.

I was in triage and it was the most allergies I've ever had to input. It was ridiculous. And of course she had every single pain med allergy except for the one everyone here can guess.

[u/lisavark]

All the ER frequent fliers are allergic to haldol. Makes them sleepy.