sting

On Wednesday Owen got stung by either a wasp or hornet while at camp. He was near a piece of playground equipment where a hive was so he's lucky he didn't get stung more. It's the only the second time he's been stung and I didn't think more of it after he showed me his pinky and couldn't even point out where he had been stung. Then he woke me up at 3 in the morning crying saying his hand hurt. I was annoyed and about ready to tell him to just go back to bed but when I turned on the light I noticed his pinky finger was swollen. He stayed home from camp and my mom took him to the doctor's and they didn't seem terribly concerned, said it was a large local reaction and recommended Benadryl, elevation and ice to help with the swelling (the triage nurse recommended Benadryl when I had called in the wee hours of the morning but I didn't have any, having bought bottle a bottle years ago as a precaution for the kids, which I never used it and promptly threw it out and never replaced when it expired). I got home from Western Psych (my clinical rotation), got the report from my Mom and brought Owen with me (he had a dose of Benadryl in him) to get Oona from camp and then we had to stop at a mechanic's. All the while swelling continued with his hand (to continue with the Harry Potter theme his pinky resembled Dudley's Aunt Marge when Harry inadvertently blows her up while angry). His pinky was ready to pop. So I called the doctor's office again and went back over. I became more concerned when Owen started telling me his throat felt scratchy. They put a pulse ox on him that measured his O2 sats at 92% and it didn't go up- just for reference, the monitor limits (vital signs) at Children's Hospital are set to alarm when they go below 93% because children can desat much quicker than adults. So another doctor looked at the hand, was similarly nonplussed by the rash or for that matter Owen's O2 sats, but wrote a scrip for a steroid which he recommended on top of the steroid to help alleviate the swelling. This picture isn't the best because the flash wiped out the redness but can you see that the swelling went up to his wrist and across to the middle finger and that portion of his hand. I have never seen a twelve hour delayed reaction to a bee sting, let alone a reaction like this. The other picture shows a profile of how fat his hand got because he's pretty skinny so you can usually see the bones in in his without a problem, like how you can notice them in the right hand in the first picture. Now I don't know if I should have him tested for allergies to beestings or not. Most literature says people with large local reactions will be fine but they do mention that a percentage of those who have large local reactions can go on to develop anaphylactic reactions and if the large local reaction goes beyond 10 centimeters (almost 4 inches) that increases the risk. I'd hate for him to have a reaction like this if he got stung on the neck and call me crazy but I'd rather have an epi pen on me if he suddenly developed a systemic allergic reaction. Thankfully the steroids and Benadryl combo have made the swelling go down significantly. His pinky is still a bit red and swollen but nothing like it was.