Not the Bees Knees… When a Sting Goes Bad on the Bike

We’ve all experienced it while riding – innocent grasshoppers slamming into our shins, massive horseflies colliding with our shoulders, and yes, the occasional bee in our bonnet.

I am not a doctor. I have no allergies. But I learned first-hand this weekend how to handle an unexpected reaction to a bee sting while riding.

If you have a known allergy to bees, you have been instructed by your doctor on preventative and treatment measures. However, in my case, I’ve been stung plenty of times over the years, have no known allergy, yet had a severe enough reaction to this particular sting to end up in an ambulance on the way to the ER… Here’s what I learned.
1.  Expect the Unexpected

So it’s a gorgeous Colorado almost-end-of-summer day, and the Venus de Miles ride is off to a flying start…

And then. Flying down a hill just 30 minutes into the ride, going about 25mph, it feels like I’m struck in the lower lip by a stone. A stone that hangs on. And then PAIN. I realize I’m stung and immediately bat at my mouth to brush it away. NOTE: I’m so grateful for the bike handling skills I’ve learned in mountain biking – I did not swerve all over the road or slam on my brakes. If you read up on cycling bee stings, you’ll see that most danger is usually the panicked reaction that causes a rider to go down.

2. Try to remain calm, and carefully remove the stinger and venom sac

I knew right away I had something still stuck in my lower lip – the stinger – and I needed to find help to remove it carefully. You see, the venom sac has a muscle that continues to pump poison even after removed from the bee. You need to get that process stopped.

That’s when I spotted a couple gals on the side of the road fixing a flat. I coasted over and asked for help… Betsy Mertens took charge, asking first – and foremost – if I was allergic. Nope, I have no allergies at all. I’ve been stung plenty of times – no allergy. Turns out her husband is allergic and I’d found the right person. Folks with allergies always – always, always, always – carry antihistamine (Benadryl), Epi Pen, and allergy I.D.

I asked if she could see a stinger in my bottom lip… “Oh my,” she said. “It’s hard to miss!”  It was quite large. “Must have been a massive bee…” She removed the stinger, showed it to me, and then held me by the shoulders and said, “And now we’re going to work on your breathing.”

3.  Take some minutes to assess the sting, and the body’s reaction

Betsy enfolded me in her arms and instructed me to breathe with her. I accepted her hug and took a couple breaths, and then went to pull away. “Not yet,” she said. “Just because you haven’t been allergic before doesn’t mean you won’t have a reaction now.” Really? Yes. The Mayo Clinic says,

“Bee stings can produce different reactions, ranging from temporary pain and discomfort to a severe allergic reaction. Having one type of reaction doesn’t mean you’ll always have the same reaction every time you’re stung.”

And, the Cleveland Clinic says,

“Insect sting allergy can develop at any age and usually manifests after several uneventful stings… Approximately one half of deaths occur in victims with no history of a prior sting reaction. Most fatalities (80%) occur in adults older than 40 years…”

A massive comforting hug, and we breathed together, in and out. And again. And again. Not only was she being incredibly kind and recognizing my rather freaked-out state, but she was assessing my heart rate. Simple kindness like this from a stranger goes such a long way! We agreed my heartrate and breathing were fine. I had no hives or itchiness. Just a pouty lower lip. Now I was feeling rather silly, eager to get on with my ride, and self-conscious about the delaying these ladies’ ride.

4. Apply ice if available, and continue assessing.

My lip was already swelling so I pulled an ice cube from my water bottle and climbed back on my bike, heading down the road. The ice helped, but I could tell the swelling was worsening. But I was FINE. I’d just keep going and it would settle down soon. This was Venus de Miles! I wanted to hurry up and catch my friends and get on with the day.

As I pulled up to a stop light I recognized 303 ambassador Marty Rosenthal. He noticed my swollen mouth (hard to miss) and at the same time Karli Gronholm, founder of Venus de Miles came alongside. She herself is allergic to bees.

She took one look at me and said, “You need antihistamine.”

5. Take Antihistamine and continue to assess

At the side of the road Karli pulled out her arsenal of first aid, giving me a Benadryl, and offering an Epi pen. An Epi pen? I’m not allergic! No, I don’t need that. I’m FINE. This is just initial swelling. Let’s get on with the day!

Karli told me it can take up to 45 minutes for the antihistamine to work, so I decided to just put my head down and ride, and wait for things to get better.

I hung on to Karli’s wheel like a lost puppy, trying to convince myself this was a silly insect bite and I needed to quit being a baby.

As we rode we chatted, and it became increasing difficult to talk…

6. If worsening, seek medical attention

About two miles from the aid station I told Karli I could feel the swelling spreading into my chin and neck. I’m not sure she could understand me. I couldn’t close my mouth and I was drooling. It was a good look. I realized I couldn’t drink from my water bottle. It had been 45 minutes since I took the Benadryl, so that clearly was not fixing my situation.

As I pulled in to the aid station and racked my bike, it wasn’t long before folks were staring and an aid volunteer noticed me and ushered me to a seat in the shade.

Then things began to move quickly.

The course EMT was summoned, and volunteer Wendy (a former EMT) held my hand. Wendy told me more about how not having prior allergies didn’t guarantee I wasn’t having a severe reaction now.

I argued a little – I’m not allergic to bees! And I still needed to get back out on the ride. Maybe another Benadryl? But that could make me sleepy, which would be unsafe. She also pointed out that I couldn’t eat or drink…

She expressed concern that the swelling was approaching my airway as my chin and upper neck were visibly swollen, and she noticed I’d developed a slight rash on my face.

7. Epinephrine

Once the first EMT arrived, my situation was sinking in. Though my breathing and heart rate were still fine, I was starting to feel anxious with all this talk about my airway. He suggested – strongly – using the Epi pen, as the swelling just wasn’t stopping. Wendy nodded her strong agreement.

But that would mean following protocol, which meant a mandatory ambulance and trip to the ER.

I said, “OK, as long as you don’t use the lights or sirens!” It came out “oh ay ath thon ath oo own ooz thith ah thiwez,” with lots of drool.

I was stabbed with the Epi pen and we could hear the sirens across the hills as everyone at the aid station looked to see what the emergency was. Just me and my balloon face!

I was asked my name, address and other identifying information repeatedly, and was glad to have my driver’s license to show, since I couldn’t speak well.

The ambulance ride was pretty calm and short. But man, I was really feeling the effects of the Epinephrine. I kept trying to talk to the medic next to me, feeling chatty, trying to explain I was a journalist and why I was taking pictures. And darned if it didn’t feel like some of the pressure in my chin was letting up.

Once at the hospital I was admitted, again grateful for my I.D., and told I’d have to be monitored for at least an hour while the Epi wore off, to see if my symptoms reoccurred.

I could tell the swelling had at leased stopped, and I was feeling much less scared.

8. Steroids

I was then given an injection of Prednisone, a steroid to further reduce swelling.

That really did the trick. After about 30 minutes my lip was half the size.

9. Discuss your condition with your doctor, develop a plan for future, allow your body to rest and recover

I was feeling much better, and now wondering if I’d over-reacted. I even wondered if I could still jump in on the end of the ride… The doc said no. I was sent home with my son and encouraged to rest. I had prescriptions for prednisone and EpiPen, and instructions to continue taking antihistamines for the next few days and also continue to watch for any worsening.

A smoothie hit the spot, and I had canine comfort all afternoon. 

By dinner I was mostly back to normal, other than a big headache.

The doc advised me to take Benadryl on rides. She said she wouldn’t necessarily classify me as allergic to bees, since my breathing was never affected, but she also cautioned the next bee sting could bring on a more severe reaction.

10. Close your mouth & zip your jersey

One final tip: during my research I read repeatedly of incidents where cyclists had been descending with mouth agape, and were stung INSIDE their mouths. Yikes! Similar stories of bees becoming trapped inside unzipped jerseys.