someone with more extensive personal experience with allergies than me

[alexseanchai]

(because I have never in my life had an allergy shot, you see, unless we're counting the dozens of little testing needles)

Suppose an environmental shift such that an allergy trigger abruptly gets a lot more prevalent. (Not seasonal-related.) I am assuming the response in this particular person's case is to start on allergy shots.

WebMD tells me the shots start out once or twice a week for several months, then once they're at maintenance dose level, it drops to every two to four weeks for a few months. I'm not sure when exactly I'm setting this bit relative to the environmental shift in question, but six, eight, maybe ten months later sounds reasonable?

Thing I'm trying to figure out is, how often would this person be getting his allergy shot? How badly would he expect it to go, on a personal health level, if he skipped one shot and didn't reschedule it for ASAP? Would he reasonably think, slash would it be reasonable generally to expect, that he could take over-the-counter antihistamines to bridge the gap to the next scheduled shot without his family noticing?

…no, I'm not trying to figure out how to make an identity reveal via "Adrien misses an allergy shot because Chat Noir has an akuma to beat → M. Pigeon N+1 has Chat Noir sneezing his head off" make realistic sense, why do you ask? in other news, gullwhacker, sometimes I overthink shit…

(this still isn't even important, or not terribly important to the fic I want to write here, or anyway it shouldn't be, as they have already learned each other's identities and by the time the story opens the dust from the emotion explosion has mostly settled)

Comments

[orcofnewyork]

It varies a lot depending on age, health, environment, but once you're on maintenance shots a typical late teen/young adult would take a daily antihistamine and get a shot once every two weeks. If they have complications due to asthma their maintenance shot could be every week in addition to the antihistamines. A more robust person could go a month between shots and more or may not take the daily antihistamines.

Basically, the severity is a sliding scale - you have a lot of wiggle room and would still fall within the realm of realism.

[alexseanchai]

oh excellent, that means I can figure out what'll work best story-wise and declare the facts to suit

thanks!

[azurelunatic]

In Steph's case, missing some 🐝🍶 meant rearranging the subsequent shot schedule so it took longer than it might have to knock the allergy down to acceptable levels.

[alexseanchai]

thx 😺

[anaraine]

Seconding that there's a lot of wiggle room for allergy shots, but in terms of like, severe allergies, I had four shots every week for, oh, idk, four years? Five years? (Until they said that shots probably weren't doing anything more for me, and we could revisit it in ten years. And then I immediately felt the lack of no shots the next month and it sucked.) And every time a new nurse was in I had to go through the rigamarole of, "you have to take that many shots?!" Most of the people in the waiting room were only getting 1 or 2 shots, and they were either getting them per week, every other week, or per month. For those of us who had to take shots every week, if you missed a week you missed a week. There was no point getting it rescheduled, just come in the next time. (I imagine that if they were only getting them once a month they might have gotten it rescheduled, tho.)

Also seconding that if you're taking allergy shots, you're probably taking antihistamines on the regular. Possibly multiple antihistamines. And they could definitely bridge the gap between the next scheduled shot. Like, it wouldn't be fun if you walked through a cloud of allergens, but you could hack it. (Hot showers might also feature regularly.)

It's the sneezing his head off thing that strikes me as weird, tbh; like, I get that sneezing is a symptom, I have it too! But that's not what tells me that I'm having an allergic reaction. It's everything else that tells me allergens have landed: tight throat, itchy eyes, clogged sinuses, general miserableness, and a migraine if I'm really lucky.

[alexseanchai]

sneezing is the symptom that is visibly onscreen in canon. point taken, though. also it's gonna be more fun if she notices the connection between his personas because she's paying attention to less visible details than if both his personas startle her by sneezing anyway. 😸

[anaraine]

Oh yeah, do what you need to do re: fic, I figured I'd just provide some anecdata. <3

[alexseanchai]

am v appreciative!

…canon y u do this to me

[anaraine]

Hrm, I'd guess he's allergic to bird dander, not dust mites? So it's not the feathers he's allergic to, specifically.

I know that you can get tested for being allergic to birds, though I'm not sure it's on the normal slate of generic testing. (I had to ask for it because I was in close contact with cockatiels and wanted to rule them in/out; they didn't have that, though they did have parrot, and thankfully I wasn't allergic to that.)

[alexseanchai]

that makes so much more sense!

[worlds_of_smoke]

I've been on allergy shots for 5 years, but I had SEVERE allergies. I was badly allergic to every fucking plant my allergist tested for and he flat out said "Well, all we can do is hope that we get you to the point where you don't have to take antihistamines every day."

We started out every week for a couple years, and then went down to every other week until last year, when we went to once a month. I get tested again in April and I should be able to stop the regular allergy shots then. My allergist said that some people continue the maintenance dose after they technically don't need it, but I probably won't because it's kind of a pain in the ass to get downtown ATM because of my back.

My main allergy symptoms were fatigue and watery eyes. If I miss a shot due to like weather or something, I just go in a week later and adjust my schedule accordingly.

[alexseanchai]

not sure severity of the character in question's allergies—clearly doesn't incapacitate him to be around the allergen, anyway, though I have zero idea how much meds he might have taken before or during that episode.

thank you lots!

[jenett]

It depends a lot on the allergist's protocol.

I started allergy shots in May 2018. My allergist does two shots each time you get one (they do the right arm is indoor allergens, and the left is outdoor allergens) with a serum based on the result of your testing. (I am allergic to approximately everything.)

Her rapid start protocol is that you go weekly for a period of time (at least three months, could be 5-6) and get one set of shots, wait 30 minutes to make sure there's no scary reaction, get another set of shots, wait another 30 minutes, and then you can go away again.

During the initial period, you're titrating up from an extremely diluted version of the serum to a non-diluted version, in carefully planned steps - that's so that you don't go into anaphylactic shock or have some other not-good reaction. (They colour code the vials, and basically you get a larger amount of the serum as you step up in each vial, then move up a vial, until you get to the maintenance dose.)

How long that takes depends on your reactions (I had no bad reactions, and it was exactly 3 months for me: my allergist said most people need to step back once or twice, where you go back to a dose that didn't cause you more than mild problems, and build up from there again.)

(Mild reactions are little bumps/itchiness/etc. that go away after a couple of hours.)

While I was on the buildup protocol, I also had to take a daily antihistimine, and there were multiple breathing tests after each round of shots.

Once I hit maintenance dose, it's a single set of shots (one in each arm). It takes about 6 months of maintenance dose to get a full sense of how they're working for you, and obviously, since a lot of allergens have some sort of seasonal/weather component, it can take some time beyond that to figure out how effective they are. They ask me before the shots about allergy symptom levels and reactions to the previous shots.

At my allergist's office, you can go anywhere for maintenance shots between every 2 weeks and every 4 weeks, depending on symptoms (if you start having more symptoms, come in more often.) But if you have more than 4 weeks (even a day over!) you have to step back two steps back onto the build up chart, come in weekly for a few weeks, and then go back to the 2-4 week cycle. Because of that, I aim for every 3 weeks, to give me leeway if something comes up.

(You also go back a couple of steps on the ramp up chart when they make you new serum, about once a year, since there's a chance you'll react slightly differently to the allergens in the serum - it'll be the same species of tree or whatever, but not the same exact tree.)

One thing that is an issue on scheduling is that I have to go when the office is open (logical, right?) but that means I have to take off from work an hour or two early every 3 weeks to go over there. My allergist doesn't do fixed appointments for shots, you just show up and sign in, but you need to be there about an hour before the office closes to make sure you've got enough time, and their office is swamped after school with teenagers. (So I leave work around 2, get there around 2:30, and am mostly done by the time school age kids get there.)

It's the first time I've had a job where that kind of regular appointment scheduling (and getting to the actual office) was reasonably feasible, because my other jobs have had significant at-service-desk hours involved (especially the high school library job)

My allergist does allow people to do shots at their local doctor's office, which in my case would have easier hours.

Other stuff of possible use: the itching can be annoying. The shots are usually on the fleshy part of the upper arm, with sites moving so you don't get scar tissue. You're not supposed to do significant exercise or exertion for a couple of hours before or after the shot, because that will spread the allergens more, and increase the risk of a severe reaction.

I don't take a daily antihistamine most of the time, but I do take one as needed, and I take a long acting asthma inhaler for a couple of weeks if my lungs are more than usually cranky. (I have historical issues with being on them long-term, so I have been given permission to take them for two weeks, take a two week break, repeat as needed, which is working pretty well.)

Building up tolerance to antihistamines is a thing, so my allergist encouraged me to rotate periodically, especially when I was taking them daily.

Long term: my allergist does the regular shots for 3-5 years, then evaluates whether you go off them or not (via testing and discussion.)

[alexseanchai]

*takes notes*

the flexible scheduling thing in particular is really good to know is at least an option, given what this character's schedule canonically looks like. (a mess nobody plotted out properly, is what it looks like, but in the process of discarding the bits of canon I don't like in order to get something coherent, it's very good to know about this thing!)

re the daily/as-needed antihistamine: so the environmental shift is, The Villain, having lost at the end of season two the advantage of nobody knowing he is capable of turning any particular someone into a monster-of-the-week more than once, changed strategies. as of most of the way through season three, the pigeon MotW has been back a couple dozen times; the canonical timeline is contradictory and unclear, but how I usually work it out, that's about four months. So Our Heroes are dealing with M. Pigeon every three to seven days now, and Our Hero with the (apparently RL-nonexistent) feather allergy would like to not be even a little bit incapacitated every time, thanks. so I'm guessing he's taking a daily antihistamine whether he needs it or not, because there's like one in five odds he's going to need it?

(for bonus S2-premiere-spoilery dramatic irony, The Villain, I figure, made a point of having his son up the allergy meds right after the second or third M. Pigeon attack, at the earliest moment it became believable that he could know this was going to be a recurring thing without risking letting on to Our Heroes thereby that he had advance knowledge of this. guess who his son secretly is!)

[jenett]

Just to throw something else itno the mix, do you know about Bird Fancier's Lung? (Wikipedia) - I mostly know about it because my mother has Farmer's Lung, long story.)

Short version: reaction to particular stuff involving birds is possible, even if actual feather allergies are very rare (and this would be diagnosed differently, even if the allergens could also cause allergic reactions.)

[alexseanchai]

now I do! Wiki doesn't say sneezing is a symptom, though, and that is the one symptom Our Hero unambiguously canonically has. so.

anaraine guesses bird dander, and poking at that further, WebMD suggests bird dander or mites (which may or may not be the same type that one would find in down feather bedding, I haven't poked that yet); I suspect bird dander is the route I'm taking.

thanks!

[fred_mouse]

For me the allergy treatment ran 2 or 3 years -- I think this was also the case for eldest. For a very short period of time it was weekly, as the dosages ramped up, then monthly for the rest of the time. The exception was when I had an unexpected level of reaction, and had to go weekly for a month. In that time period I skipped one and had no additional reaction.

However, it wasn't until quite late in that that my allergy symptoms abated to the level they are now (about five years post treatment). And I would have been using over the counter anti-histamines the whole time. For the first six months I was using them at double the standard dose (daily tablets twice daily) because the shots were addressing one issue my immune system was having, while the anti-histamines were addressing a separate one.

It may strongly depend on what the allergy is.