Up to $100 off on EpiPens 2-Packs!

Mylan is offering a “copay card” that can get you $100 off of the copay your EpiPen 2-Pack or EpiPen Jr. 2-Pack prescription. The cash price for each 2-pack is generally in the range of $200-$250, so this is a *significant* savings. The  offer is valid for up to three 2-packs per prescription.

To apply for the card, go to the Copay Card Activation Site,  fill out the form as instructed, and download and print your card. You can then begin using it right away. The card should have instructions for your pharmacist, and a number to call with questions.

Terms and Conditions of the program. 

The press release from Mylan on the program.

The offer expires December 31, 2013!

Where’s the Corn in Medical Supplies and Equipment?

Last updated:February 2017

This research was originally done by the creator of the blog called Hidden Corn. This blog is no longer maintained as the author  was no longer keeping up on the newest developments. I wanted it to remain available for people, so I took the data over and am soliciting help from a trusted friend to keep it up to date. We are making changes and additions as we note missing or outdated information.  Please comment or email me at cornallergygirl@gmail.com  if you see anything that is incorrect, or any broken links.

Do your legwork, people! Do it BEFORE you need medical care. And do your darndest to ensure you have someone who will advocate for you in those medical situations in which you are unable to advocate for yourself — this should be someone who is not timid about questioning medical care providers and who knows (for example) you need a saline IV rather than a glucose or dextrose IV and so forth.

ADHESIVES: Many corn allergics react to adhesives. I’m missing a source on why this is, but it’s been reported many times. If you need to avoid adhesives don’t claim it’s due to corn allergy, simply say that you have an adverse reaction to many adhesives.

ANTIBIOTICS: Corn is almost always the growth medium. There isn’t any avoiding this. If you need antibiotics, you’ll have to simply medicate to avoid a severe reaction.  Typical pre-medication would be an H1 antihistamine such as benadryl, an H2 antihistamine such as zantac or pepcid, and perhaps a prophylactic steroid. (Make sure you have corn free versions of all these!)  When taking any medication, you need to determine what the inactive ingredients are and from what they’re derived to choose something that is as corn-free as possible.  If you have time, it may be best to have your medications compounded to be as corn free as possible. Another option may be to use the intravenous version and that has a corn free ingredients list. Cross reference with the corn derivatives list  Keep in mind that even if the ingredients “look safe” you may still react to consider asking to trial a small amount of the medication before doing a full dose.

BODY BAGS: Can be made from corn. (source: Corn-Free Lifestyle)

BLOOD BAGS/BLOOD TRANSFUSIONS: Contain corn-based anticoagulants, specifically dextrose and citric acid. (2) If you need a blood transfusion, you need to medicate with a steroid, an h1 antihistamine such as benadryl, and an h2 anithistamine such as zantac or pepcid.  More info on premedication in my Hospital Safety post.

BLOOD PRESSURE CUFFS: Some folks report skin reactions due to the sanitizers used on these between patients. Bring the sleeve of an old t-shirt to put between you and the cuff if you have the presence of mind or have them take your BP over your shirt if you have sleeves on.

CT SCAN CONTRAST: The contrast solution, if flavored, will probably contain corn derivatives. Look for a contrast with the least amount of ingredients possible (will probably be unflavored), to be mixed in plain water. Ingredients should also be checked for IV contrasts. Note: reactions to CT contrast are common even in people without allergies, so radiologists may be more likely to understand concerns about reactions and have a protocol should you react.

DENTAL VISITS:  Pretty much all of the products used at a dental visit can be corny, from the medications and products themselves to the paper and gloves used for sanitation. Dental health is very important though, and many many corn allergics have managed safe dental care.  More on corn free dental care: Corn Allergy Safety at the Dentist.

HAND SANITIZER: Almost all hand sanitizer contains ethanol from corn, and even not very sensitive people will have airborne reactions to corn-derived ethanol. Hand sanitizers also frequently contain scents which can be a concern for corn or chemical sensitivity. They will also contain inactive ingredients  that are often from corn such as glycerin that may cause a contact reaction if someone touches you after using it.  If staff insists on using hand sanitizer near you ask them to wear (powder free) gloves afterwards.

HAND SOAP: Almost all liquid hand soaps contain glycerin which may be from corn as well as citric acid and other ingredients commonly derived from corn. If you are skin-reactive, you may have a contact reaction to someone touching you who has used these soaps, or if you are highly airborne reactive you may have issues breathing near someone who has used them. Here is one example ingredients list from an antimicrobial soap used in surgical settings.

GLOVES: Powdered surgical and exam gloves are often powdered with corn starch. Effective Jan 19, 2017 the US FDA has banned the sale and use of powdered surgical and exam gloves, so that’s good news for us corn allergy sufferers. It make take some time for full compliance, and non-medical settings may still make use of them.

INTRAVENOUS SOLUTIONS: Lactated Ringers’ solution contains sodium lactate, which is made from lactic acid. Lactic acid isn’t *always* fermented on corn sugar but several of the major distributors of the product do use corn sugar. Given the volume of production of sodium lactate for medical purposes I doubt there’d be a way to know for sure which supplier the lactic acid came from. Additionally dextrose/glucose is often added to intravenous solutions and injectables. Ask for a saline IV fluid.  If you are inpatient, consider making signs to hang on the IV stand stating no lactated ringers and no dextrose as nurses will not always check your charts at shift change or will mix you up with other patients. Realize that the nurses may still not read the IV stand and remind them. Train an advocate such as a family member or close friend before you need one to help remind them!

NON-MEDICINAL INGREDIENTS aka Preservatives and Excipients: Go HERE to read an excellent article about corn derivatives used in non-medicinal ingredients. The article was in the College of Pharmacists of British Columbia’s May/June 2007 newsletter; it may be an older newsletter, but the information is still extremely applicable!

MEDICATIONS: Inactive ingredients of pills, injections, and topical products may contain corn. Get package inserts and compare the active and inactive ingredients with the corn derivative list. Finding the Inactive Ingredients of Medications.  In many cases you may need to have a medication custom made to be corn free. This is called “compounding.” Getting Medications Compounded. Finding a Compounding Pharmacy.

PREFILLED SALINE FLUSHES for IV lines and catheters contain a preservative. Staff needs to get a vial of plain saline and draw it into a syringe and use that to flush your line.

SANITIZERS: I don’t have a source on why anti-microbial floor and surface cleaners in hospitals seem to be a concern for people who are airborne reactive to corn, but reports from the corn allergy community, and my personal experience show that they are. Some contain ethanol from corn, some don’t. It may be that corn allergics are often also chemically sensitive. All I know is that even when I can’t smell any cleaners in hospitals, I react the entire time I’m inside on just from breathing the air, and many other airborne-reactive corn allergics experience the same. I wear a carbon filter mask, and if in-patient, ask for them to only mop the floor in my room with water. I also bring in a HEPA filter for my room and run that and put a sign on the door to keep the door closed at all times, even if just coming in for a second.

SUTURES: Absorbable sutures may be made from PLA or polylactic acid, which is frequently made from corn.  I am told some non-dissolvable sutures may be dusted with corn starch, although I have no source to prove this. I have also heard reports of those with corn allergies reacting to sutures that should be corn-free, so exercise caution.

SYNTHETIC INGREDIENTS: If you are attempting to determine the source of an ingredient and are told it’s “synthetic,” don’t let that be the end of the line in your questioning or you will be taking a risk that your medication might contain a corny ingredient. See if you can find out which raw ingredients are used in the chemical process that creates the synthetic ingredient.

TUBING FOR OXYGEN MASKS: You may react, I don’t know if this is  corn starch dusting or what. Ask to have them wiped or rinsed with water.

TONGUE DEPRESSORS: Can be made from corn. (source: Corn-Free Lifestyle)

ER Safety: Emergency Medical Treatment With a Corn Allergy

Updated 2/21/2017

Emergency Medical Instructions – For Mobile

Emergency Medical Instructions – Letter size (designed for front and back)

Corn products are in many  medical supplies. In particular, dextrose and glycerin (both usually from corn) seem to be in a number of injected drugs, and those two have in the past caused me severe–even anaphylactic– reactions when they come in contact with a mucus membrane. The last time I allowed a glycerin-based gel to touch my lip, everywhere it touched swelled immediately, and my tongue swelled on that side of my face, all the way into my throat. It was terrifying.

Injections aren’t the only danger, either. Disinfectants, lubricants, preservatives, and disposable  paper products also contain enough corn to give me at least a small problem, if not a dangerous reaction. Even the sugar used to treat dehydration and restore electrolyte balance is corn-based.

Even those without such severe and immediate reactions can and have experienced significant discomfort as a result of corn in medical products. GI reactions, migraines, or rashes may not block off your airway, but they are definitely unpleasant and can still be dangerous.

The idea that someone could kill me while trying to save me keeps me up at night, so I’ve been asking a lot of questions trying to figure out how a medical responder can avoid killing me when trying to save me. I don’t have all of the answers, but I have a plan, and I hope it works.

  1. Wear some kind of medical alert bracelet. I have a MedicAlert brand bracelet, the largest size available, to fit as much as possible, which still isn’t enough. The text reads: TREAT WITH IV SALINE. ANAPHYLAXIS TO LACTATED RINGERS, GLUCOSE,DEXTROSE, SUCROSE, PCN.  (PCN is short for penicillin.) I have a membership so that I can use MedicAlert’s online medical history service but there are definitely other services out there that do similar, and plenty of other jewelry-only type vendors.
  2. Keep a thorough but succinct treatment plan in several places on your person. The document below is my best attempt at this. It is formatted to fit on a letter-sized sheet of paper, front and back. I also want to make small laminated cards to keep in my wallet and a version on an In Case of Emergency app on my mobile phone.
  3. Keep a more detailed medical history on your person and/or an online repository. There are also USB medical bracelets that you can buy and wear.
  4. Consider putting together a hospital bag ahead of time for inpatient stays that contain necessities.

I don’t know how well this will work, but I really hope it will at least keep me alive in a medical emergency.

And, of course, I am sharing what I have so far. The following is a publicly available Google Doc that you can copy to your own google doc and alter as you like. My doc includes notes on what you should change to customize for yourself. And of course it only covers a corn allergy, so if you have other allergies, such as penicillin, that need to be mentioned, it is only a starting point. Here it is:

Corn Allergy Emergency Medical Instructions – Letter size (designed for front and back)

Corn Allergy Emergency Medical Instructions – formatted for mobile

I’ll update here as I get more formats set up for wallet cards and mobile apps.  Different ICE apps have different features, but they all usually provide a widget so that the info can be accessed from the lock screen without unlocking the phone. This is important to me since I have all of my email and social networking accounts hooked up to my phone. While I’m not particularly concerned that an EMT would stop trying to safe me to try to hack into my stuff, I think that my phone could end up in ANYONE’s hands if I were incapacitated.

Note that the document is only meant to cover emergency room procedures- not routine medical care, nor longer term or inpatient procedures. I now have a post about longer hospital visits that is very much work-in-progress.

Dealing with Skeptics

Something that comes up often in any medical situation is skepticism that corn can be the root cause of all the reactions to various chemical derivatives. Rather than argue this in an emergency situation, the following tactics have worked in the past:

  • Claim chemical sensitivity: Say that you react to “preservatives,” “dyes,” and “additives.” People are for some reason more likely to believe that one can have a non-specific sensitivity to these things than that one can be reacting to the corn source of them.
  • Claim multiple sensitivities: For some reason people are more willing to believe that you are separately allergic to citric acid, potassium benzoate, polyethylene glycol, glycerine, and a dozen other ingredients than that you are only allergic to them when they are derived from corn.
  • Use the term “sensitivitiy” or “adverse reaction” rather than “allergy” unless you have a positive IgE test result to show. “Allergy” means something specific in the medical world, so if your adverse reactions are not proven to have IgE as a mediator, it’s only going to hurt your case to insist that you have an allergy. Adverse reactions can still be severe, so make sure that you stress that you have had severe adverse reactions to corn derivatives, preservatives, and excipients in medications.
  • Remain calm and be as logical as possible. If you seem emotional, you will not be taken seriously. I realize that the fear and the coursing adrenaline in emergent situations make this difficult. Try to breathe. If they are insisting that there is no choice other than a product or medication you fear you will react to, ask if they can try a small amount or do a skin test to make sure it’s safe. Also ask what their protocol is for severe reactions or anaphylaxis. This is both so that you understand what will be done if you react, and to remind them that anaphylaxis is a possibility.