r/emergencymedicine • u/Asleep-Palpitation43 Nurse Practiciner • Feb 02 '25

Advice Allergy Olympics

Is it wrong that if I see a patient has more than 10 allergies I IMMEDIATELY assume she's (bc it's always a she) a psych case?

In 24 years I've never been wrong.

You'll never read this in a textbook but add it to your practice today and thank me later👍

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u/Spare_Progress_6093 Feb 02 '25

No there actually is something to this. High Sympathetic tone can make people more sensitive to physical changes. So someone saying they’re “allergic” to something and the reaction. Is dizziness for example, the dizzy spell may have been so minute that no one else would have noticed but this person was hyper aware of bodily sensations and it felt intolerable.

Borderline is a good example of this. Untreated/undiagnosed anxiety.

Can also be a reason that I would have to titrate psych meds slowly in autistic patients, their sensory processing is dysregulated and anything that feels different can cause distress.

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u/Asleep-Palpitation43 Nurse Practiciner Feb 03 '25

"I'm not crazy, I'm just feeling the things that 99.99% of the population can't feel🤪"

8

u/YouMatter_4 Feb 02 '25

Hey hey now, this thread is for shitting on those patients, not understanding them!

2

u/Asleep-Palpitation43 Nurse Practiciner Feb 03 '25

Ahhh the old "high sympathetic tone", diagnosed easily via the modern technology of allergy lists🙃