Managing Latex and Adhesive Allergies Before Surgeryby Sloane Miller Patient Advocate
This month, I'm going in for an arthroscopic knee procedure. I've had a few day surgeries and outpatient procedures and I always bring up allergies and asthma early on. As in, "I have asthma, keep an eye on my breathing during the procedure please" and, "I have food allergies, so here's the list, just in case, that's related to any medication you're giving me, thank you."
During the surgical consult for my knee, I said, "I have allergies and asthma." We were talking about the anesthesia process, which will be an epidural with some meds to keep me relaxed. The surgeon piped up, "Ok. We definitely don't want to give you too much medication then." Ah good, I thought, he's listening. Then I had a talk with the Physician's Assistant who asked about my allergies. I gave him a list of foods and remembered aloud that I became itchy and blistery the last time I had hospital-grade adhesive on a surgical site. He wrote this on my chart in big bold letters and said, "Thank you, this is important for us to know."
I've written about latex allergies before but only in relation to clothing. Latex allergy is very real and can be quite dangerous.
How many Americans are affected? From the American Latex Allergy Association:
8-17% of health care workers
Up to 68% of children with spina bifida (related to frequent surgeries - anyone who has multiple surgeries is at risk)
Less than 1% of the general population in the U.S. (about 3 million people)
What are the kinds of possible reactions?
Also from the American Latex Allergy Association:
Latex Allergy Definition
Type I (immediate-type) hypersensitivity
Natural Rubber Latex Allergy (NRL) is an IgE-mediated, immediate type hypersensitivity reaction to one or more proteins in natural rubber latex (Hevea brasiliensis). Histamine is release causing symptoms. This reaction is systemic.
Type IV (delayed-type) hypersensitivity is a T cell-mediated, delayed response, and typically occurs 48 to 96 hours after exposure. This is frequently a reaction to the processing chemicals used in manufacturing natural rubber latex (NRL). This reaction is generally localized to the area of contact. This reaction is also referred to as allergic contact dermatitis, T-cell-mediated allergy, or chemical allergy.
Irritant Contact Dermatitis is a non-allergic reaction. Symptoms typically are dry, irritated, and/or fissured lesions.
Food allergies and latex:
If you have food allergies you may be sensitized to latex. From the American Latex Allergy Association:
"Listed below are the allergens reported to be associated (clinically or immunochemically) with natural rubber latex: Banana, Avocado, Chestnut, Kiwi, Apple,
Carrot, Celery, Papaya, Potato, Tomato, Melons. Significant levels of allergenic cross-reactivity have been demonstrated for the allergen groups listed below: Mugwort with Carrot, Celery, Apple, Peanut and Kiwi; Birch with Apple, Pear, Peach, Cherry and Hazelnut; Grasses with Potato; and Ragweed with Banana and Melons." (Please talk with your healthcare professional for a proper and through allergy diagnosis.)
Besides latex allergies, some people may have reactions to the adhesive (sticky stuff) on the tape used in surgery. I don't have a latex allergy; however, the last few times I've had procedures, after which they taped me up with adhesive to keep the bandages dry when bathing, I had a reaction. The site became itchy and blistery Eek. And the last time the nurse gave me very clear instructions: next time you have a procedure tell your doctors that you cannot have adhesive or ask them to find a suitable alternative.
I asked Dr. Clifford Bassett, a NYC allergist about my reaction.
This was his reply: "Dermatitis related to use of adhesive tape and bandages can be from both non-allergic causes of contact dermatitis including irritants which cause skin rash (blisters, etc.) versus allergic contact dermatitis, that is an immune response to a component in the tape adhesive. In the latter, there is usually a very well localized and defined area of redness and local swelling with or without blister formation.
In any event, diagnostic allergy tests need to include allergen patch tests to a variety of standard tests to identify which allergen is causing the reaction, then avoidance and product substitution can take place for optimal care."
So, itchiness, rash and blisters I felt from that medical adhesive may not be caused by an allergy to the adhesive, but if you've experienced anything similar, you should talk to your doctor about testing to be sure.