Tag: medical

Hemolytic Anemia & G6PD Deficiency: How I survived intravenous corn derivatives.

If you’ve ever read my posts on ER Safety, Hospital Safety, or the Hidden Corn- Medical Supplies post, you probably know that blood transfusions contain corn derivatives. I’ve known this a while and made plans for eventually having to have an emergency treatment that would require corn exposure in order to save my life. But I had always hoped it just wouldn’t happen to me. But of course it did, last July.

Continue reading “Hemolytic Anemia & G6PD Deficiency: How I survived intravenous corn derivatives.” →

Hospital and Medical Safety With a Corn Allergy

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Updated 2/21/2017bl

I’ve written a bit about how to stay safe in emergency situations, but not about longer hospital stays and planned surgeries. There’s no possible way for me to cover every possibility, so the best way to stay safe in a medical context is to familiarize yourself with where corn hides in medical supplies, in food, and in medications, and familiarize yourself with the list of ingredients commonly derived from corn and if possible train a family member or loved one on these things so that they can help advocate for you.

Here are just a few suggestions for staying safe in a hospital setting. This document is very much work-in-progress, but I feel it’s important to share as much as I can think of  as soon as I have time to rather than continue waiting until I have time to be complete.

Create an Advance Healthcare Directive

If you are an adult, and you are conscious and of sound mind, you legally should always (to my knowledge) have control of your medical care (or the medical care of your dependent child). However if you are unconscious, or are deemed not to be of sound mind, someone else can (and will) make decisions regarding your care for you (or your dependent). Claiming to have adverse reactions to such commonplace ingredients such as citric acid and dextrose, or displaying fear of just about any and every medication, can seem like paranoia to physicians. It unfortunately HAS happened that those with corn allergies have been treated with psych medication instead of antihistamines, or been given medication that they had severe reactions to while they were unconscious or unable to advocate for themselves.

There is no way to guarantee that this won’t happen, but creating an advance healthcare directive, or living will, can help. Here’s more info on how to do that. What you put in that advance directive will be individual. Please do this as soon as you are able and well ahead of any planned procedures, and work with your team of medical professionals as well as your trusted corn allergy resources on the correct content.

Wear A Mask

If you are airborne reactive this is a must. If you are not usually airborne reactive, have a mask anyway, because it is likely you will be so bombarded with allergens in the hospital that you may become airborne reactive where you usually aren’t. You can find out what masks I use on my product list page.

Negotiate Safe Meds

Get the NDC # for any medication they want to use. This is found on the package insert. The paper package insert has the inactive ingredients somewhere on it, but it is hard to find in all that tiny print. Rather than scouring the inserts, look the NDC # up on DailyMed and skip to the last section, “Ingredients and Appearance.” There should be a section on inactive ingredients which you can cross reference with the corn derivatives list. 

I’ve also made a google doc spreadsheet available containing some of my findings on medications. This list was using for open heart surgery for someone, so it isn’t exhaustive of every possible med you would ever want to use. It also was done basically in one night on an emergency basis, so it is really just my off-the-cuff response after eyeballing the ingredients list. However it is a better starting place than nowhere.

When negotiating safe medications, consider not discussing corn. Explain that you have a history of allergic reactions to “excipients and preservatives” in medications, and that you really need your meds to be preservative free for your safety.

This includes premade saline flushes for iv lines. I found that out the hard way when I was recently admitted to the hospital.

When You Can’t Negotiate 100% Safe Meds, Pre-Medicate

I recently had to have blood transfusions, and not only is there  corn in blood bags as well as plasma, but reactions to blood transfusions are common even in those without allergy problems. This was scary, but I didn’t have a choice. I needed blood. The hospital admitted me even though transfusions are typically an outpatient procedure, and we agreed on a premedication protocol before proceeding with any transfusions.

If you need to receive blood transfusions, plasma, or any other procedure that may cause you to react, or if you need to take a medication for which you cannot find a corn free form, you just have to take medication to help prevent severe reactions, and remain under observation so that any reactions can be treated.

You will want to consult with your doctor on the right premedication protocol for you. I use a version of what The Mastocytosis Society recommends. I do have MCAS, however those who have “just” allergies and not mast cell disease can follow mast cell protocols with quite a bit of success.  That protocol is:

  • Corticosteroids, either intravenous 2 hours beforehand (if  this needs to be done right away), or orally starting 2 days beforehand (if you have time to plan).
    • If you receive an injection of steroids before a procedure, you need a taper of steroids to begin after the injection wears off to account for biphasic reaction or further irritation from the medication or procedure.
    • The length of the taper will depend on the procedure and your particular reactivity. Consult with your doctor.
    • For me personally, my preferred steroid injection is solu-medrol (methylpredisolone sodium succinate powder for injection- mixed in water only, no ethanol). I find it to be far more effective than prednisone. Dexamethasone might be a good option, but I am unable to take it due to my g6pd deficiency.
  • Intravenous or intramuscular benadryl  25-50 mg 1 hour before and 25-50mg IV, IM, or orally every 4-6 hours after  until chance of reaction is passed. (This may be several days depending on the procedure or medication.)
    • This needs to be intravenous or intramuscular if at all possible because it is much more effective than oral.
    • Hospira brand is safest for me diphenhydramine hcl for injection is safest for me.
    • If you are concerned about having a reaction to the benadryl or an ingredient in it, wait until the steroids have kicked in, and choose intramuscular over intravenous as it will “mute” the reaction somewhat.
    • You may be able to use another strong H1 antihistamine such as hydroxyzine if you cannot use benadryl. Consult with your doctor.
  • Oral, intravenous, or intramusculer H2 antihistamine (pepcid 40mg or zantac 150mg) 1 hour before and every 4-6 hours after until chance of reaction has passed.
    • This increases the effectiveness of the benadryl (or other h1 antihistamine).
    • This is less of a big deal to do IV or IM, and can be oral. Meaning if you can’t find a safe injectable version, ask the hospital staff to allow you to take your own H2 if you have one.

All meds should of course be prervative free and corn free.

Cook Ahead

If you have a corn allergy, it’s highly unlikely that you will be able to eat any hospital food, even if they swear they can cook you something corn-free. Most people, not even medical staff, just cannot understand what “corn free” is to the degree that we have to avoid it. If you know you are going to have be inpatient, cook yourself enough meals in advance to cover your planned stay and then some, and keep it in the freezer. If you don’t have a lot of freezer space, consider investing in a separate freezer. Even in an apartment it’s likely you can make room for at least a small freezer. You can likely create some vertical storage shelving above it to reclaim some of that space. (I originally said you can store stuff on top of it, and then found a TON of manufacturer advice not to do that because it interferes with venting!)  If money is a concern, you should be able to find used freezers on craigslist, although you’ll possibly need to do some work to decontaminate it since it may have had unsafe food in it. (I realize that *any* money is still money that many of us don’t have, and I totally understand and sympathize- I’m just making my ideal-world recommendations.)

As far as what to cook ahead, that depends on your preferences and safe foods. I honestly haven’t found too many things that I eat that don’t freeze and reheat well, maybe cooked eggs (which I personally am allergic to) and some types of dairy products such as cream and un-melted cheeses may get gross. When cooking for hospital visits, probably go with things that are easy to chew and somewhat bland as if you aren’t feeling well you may not enjoy chewing or spicy items, and even consider freezing or canning (more on corn-free canning here) some plain bone or meat broth in case you’re feeling too ill to tolerate anything else. I try to keep bland soups, baby-food style meat purees, broth, and fruit purees on hand for illness or a possible hospitalization.

You will need to get permission from the hospital to bring your own food. Be polite but firm about this- it’s not optional. You will also need to arrange for a place to keep frozen food and a way to reheat it.

Pack Ahead

Create a “hospital bag” (or in my case a suitcase) that contains everything you need for a hospital stay. The exact contents will depend very much on your sensitivity and needs, but I would err on the side of over-preparing, as you may find that in a hospital context, your reactivity and sensitivity ratchets up quite a bit.

Here is what is in my hospital bag:

  • 3x Twin Sheet Sets (I will react to the laundry detergents used by the hospital so need to bring my own clean bedding)
  • 3x spare twin fitted sheets (You may sweat, bleed, or otherwise soil the sheets in a hospital context, so bring spares!)
  • 2x Vog n99 Carbon Filter mask *with* head strap accessory.
  • 2x Extra mask filters (I use I Can Breathe  removable filters inside my vog mask to “double up” and help protect from airborne reactions better.)
  • 1x 3M Half Facepiece Respirator with  the  3M 60926 Multi Gas Filter Cartridges.
  • 4x hospital gowns (washed in my safe detergent)
  • 4x hospital socks (“hospital socks” refers to the kind with the treads on the bottom so you can’t slip)
  • 2x allergen pillow cover
  • 2x blanket
  • 3x panties (probably I could stand to have more, who knows how long I’ll be in there)
  • 6x cloth menstrual pad
  • 3x cotton lined waterproof mattress pads (mostly for sweat, I hope, but who knows!)
  • Towels, washcloths
  • body soap/dish soap
  • baking soda (For brushing teeth, washing hands, cleaning “whatever” – I use Karlin’s Finest)
  • shea butter (dry skin or lips, NOW brand is safe for me)
  • jojoba oil (dry skin or lips, NOW brand is safe for me)
  • hand soap in pump bottle (this is largely for setting in the room for nurses and visitors to use instead of the corny stuff)
  • phone charger (with a nice long cord so you can use it from bed while still plugged in)
  • coban tape
  • t-shirt sleeve for under pressure cuff (many react to the sanitizers used on the cuffs between patients)
  • Safe plate, bowl, spoon
  • HEPA filter (run in your room constantly and request the door be kept closed)
  • plastic tub to use as a dish washbasin
  • Safe water filter or safe bottled water (many corn allergics react to tap water or certain brands of bottled water such as Dasani)
  • safe sippy cup  with straw (if you’re sick you’ll spill- heck, I spill when not sick. I use a mason jar with a silicone koozie, a plastic sippy lid, and silicone straws)
  • 3 days worth of all daily & rescue medications.  (The hospital will not want to allow you to take your own medications but if you use the instructions above to check for corn in the medications they want to administer, and cannot identify a corn-free option, they may allow you to take your own if you calmly and rationally explain to them that you are likely to react to the excipients and preservatives in the medications they have on hand.) 

Laminated Signs

At shift changes, nurses don’t always carefully read every patients’ chart, and may mix up and forget individual patients’ needs. Hang signs anywhere there is a hazard for you to help reduce the chance of them doing something that will make you react. I have a home laminator and have pre-printed laminated signs in my bag. You can certainly use neatly hand-written signs though. But better to come up with what you need in advance than scramble while sick/injured.

  • No HAND sanitizer sign for front door
  • Keep Door Closed sign for door
  • Mop Floors with Water Only sign (consider getting translated into some commonly spoken local languages in case the cleaning staff do not read english well)
  • small do not use signs for hand soap & sanitizer
  • NO DEXTROSE NO GLUCOSE NO CITRIC ACID NO LACTIC ACID sign for iv pole

More Resources/Links

ER Safety with a Corn Allergy

ER Protocol for Mobile Devices

List of Commonly Corn Derived Ingredients (Corn Allergens List)

Hidden Corn – Medical Supplies

Hidden Corn – Food

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Where’s the Corn in Medical Supplies and Equipment?

Last updated: December 2022

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.

I know it is difficult to prioritize something that has not happened yet when you’re trying to find safe food to eat, but PLEASE do your research and try to assemble a care plan BEFORE you have an emergency. Figuring this stuff out when you’re actually in the ER is really difficult and it’s easy to miss things.

Hospital And Medical Safety with a Corn Allergy

Emergency Room Safety with a Corn Allergy

Spreadsheet With Brief Research On Specific Drugs for Surgery

ADHESIVES: Corn starch is frequently used in adhesives. Many 3m brand medical dressings seem to work best for both latex and corn allergy people, but this is likely to come down to individual sensitivity.

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.

FLUIDOTHERAPY / HAND THERAPY:  The cellulose used in Fluidotherapy machines used by some hand therapists is made from ground corn cobs. 

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!

Get a copy of the inactive ingredients and compare any IV or oral med you take to the corn derivative list. 

INTRAVENOUS IMMUNOGLOBULIN (IVIG):

Here is the list of IVIG meds I was able to get:
  • IBivigam
  • Carimune
  • Flebogamma
  • Gammagard S/D [low IgA]
  • Gammagard Liquid
  • Gammaked
  • Gammaplex
  • Gamunex
  • Octagam and Privigen
Of these, I found several forms that contained dextrose, maltose, or sorbitol all of which are corn derivatives. These were the Gammagard S/D, IBivigam, Gammaplex, and Octagam.
There are several that look like they may not have corny inactive ingredients  if their DailyMed pages are accurate. Note that I did already find that one (Octagam) had maltose (def a corn sugar) that was not listed on DailyMed so I would double check all of these.
Ingredients I found in these “safer” looking IVIG products:
  • glycine which is synthesized either by amination of chloroacetic acid with ammonia or reaction of an aldehyde with ammonium chloride in the presence of potassium cyanide (Strecker synthesis). Note that chloroacetic acid *is* made with acetic acid which will be from corn. This would be something that some people might tolerate since it is very processed away from the original source, and others might not. It may also be possible that there are acetic acid sources which are not from corn depending on the supplier.
  •  proline which is synthesized from diethyl malonate and acrylonitrile
  • sucrose which is a sugar from beets or cane.

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.

PLASMA: Plasma is diluted with 1 part citrate phosphate dextrose (CPD) anticoagulant to 4 parts plasma on collection. The CPD is corny due to the citrate (from citric acid) and the dextrose (corn sugar).

PLASTER CASTS: Plaster casts are made from muslin that have dextrose (corn sugar) and “starch” (likely corn starch) added. Opt for fiberglass or air casts instead.

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

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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.

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Finding Inactive Ingredients of Medications

There are a few different ways to find inactive ingredients of a medication. My absolute favorite by far only works for pills, but I always check it first. It’s a brand new search engine from the NIH called Pillbox. In fact, it’s so new it’s still in beta stages.

This search engine is intended for identifying “mystery” pills, but I’ve been using it to get a quick list of every manufacturer of a particular drug and the inactive ingredients.

Here’s a brief tour:

pillbox_0

Go to http://pillbox.nlm.nih.gov/ and click on Advanced Search (picture on the right).

pillbox_1

In “Drug Name,” enter the name of the drug you’re looking for. In this case, I’ve entered cephalexin, the generic name of Keflex. This will give me both the brand-name drug and all generic variants.  Click Search.

cephalexin_2The search results will give you a listing of all known manufacturers and dosages of the drug, with the inactive ingredients listed right on the page. You can click hide/show next to “Inactive Ingredients” to see the full listing.

If I can’t find what I’m looking for on this search engine, or need more details, my next go-to search engine is NIH’s DailyMed database, which is an archive of package inserts for all kinds of medication and medical supplies.

For each med listed on DailyMed, there should be an “ingredients and appearance” section on the bottom.

dailymed1

The inactive ingredients should be listed in this section.

dailymed2

 

Instructions for a Dental Filling

This is what I brought in to my dentist and it is tailored for my needs/level of sensitivity. You will need to modify it, but it’s a good place to start. 

Allergy Info for ______________

 

Products to use/not use:

– Please use only powder-free gloves.

– No topical anesthetic please, it contains a corn derivative.

– I need to provide my own cup and water for rinsing. 

– I have brought my own unwaxed floss and toothpaste. Please only use those.

– Please, no mouthwash/mouth rinse, only water!

– Please don’t apply anything to my lips using q-tips. I have my own “safe” lip balm that I can apply myself, no q-tip,  if needed.

– Injected anesthetic: Please use only Carbocaine.

Additional Information

– I have reacted before to highly processed corn derivatives such as sorbitol and citric acid, as well as to plastic and waxed paper cups. My first point of reaction is always my mouth and throat: tongue swelling, difficulty swallowing, sometimes lip swelling. In extreme cases I will have an asthma attack.  Since my mouth will be numbed, I may need your help to watch out for swelling if we’ve missed anything about the ingredients or products used. (Beth has been very thorough, I hope we will be fine.)

 

– I have taken 25mg of Benadryl to head off any possible reactions. I will likely be a bit sleepy but not completely out of commision.  My boyfriend will pick me up when the appointment is over.


– If there is a swelling reaction, I have an additional 25mg benadryl pill that I can take- prefer not to take it though, as it *will* put me to sleep. If my airway  begins close off, I will need to use my epi-pen and then go to the emergency room.

Dental Cleaning Instructions

This is what I brought in to my dentist and it is tailored for my needs/level of sensitivity. You will need to modify it, but it’s a good place to start. 

Dental Cleaning Instructions for ________________

Products Okay To Use:

  • powder-free nitrile gloves

  • white cosmetic (kaolin) clay (provided by patient)

  • cup for rinsing provided by patient

  • Desert Essence Tea Tree Dental Tape

Avoid:

  • No paper/disposable cups.

  • No q-tips

  • No mouth rinses/mouth wash.

  • When I rinse, I need to use my own water from home. 

  • Topical anesthetics, disinfectants, or any other products in the mouth or on lips that were not discussed ahead of time.

X rays: I react to the plastic sheath you use for the digital receiver. I need to use my own sandwich bags for this.

Safety

-My first point of reaction is always my mouth:  tongue swelling, difficulty swallowing, sometimes lip swelling. In extreme cases I will have an asthma attack.  I may need your help to watch out for swelling if we’ve missed anything about the ingredients or products used.

 

– If there is a swelling reaction, I have a benadryl pill that I can take.

 

– If my airway  begins close off, I will need to use my epi-pen and then go to the emergency room.