From the Bee-Log of an Api-phobe
“Time to address the pink elephant in the room (aka bee stings)”
Barbara Thompson, Pualani Bee Farm
November 6, 2020
[Sting of a honeybee. The barbed stinger is torn off and remains in the skin. Muscles at the stinger continue to pump venom into the wound. Photograph: Waugsberg, 1 September 2007. This file is licensed under the Creative Commons Attribution-Share Alike 2.5 Generic, 2.0 Generic and 1.0 Generic license.]
FROM BEE-PHOBE TO BEEKEEPER
One might ask of an api-phobe (aka bee-phobe): why become a beekeeper? I would love to wax and wane about the virtues of courageously facing my fears, like the time I went scuba diving among sharks in the Indian Ocean off the coast of Kenya. However, it was different with beekeeping. My journey into beekeeping was not a deliberate, self-inflicted intervention against an excessive and irrational fear reaction. It was a much more subtle process born of my experiences as a “foster parent” to eighteen needy bee colonies after the 2018 volcano eruption in lower Puna, which took out the neighboring beekeeping communities in and around Kapoho, now buried under 20 feet of a hardened shell of still steaming lava.
Indeed, the genesis of my desire to become a beekeeper was driven from my daily encounters with our host bees: watching them go about their business in and around the hives; enjoying the fruits of their labor in pollinating our fruit trees and veggies; and frolicking together in the gardens on our farm, each of us tending to our individual garden chores and living quite peacefully in harmony. During this time of hive hosting, the bees reminded me only twice—via stings—not to get too close to the colonies while mowing or weed whacking, which they really hate! My growing love, admiration, and fascination for our host bees quickly superseded my bee-phobia and developed into the desire to officially become a beek (beekeeper), which I finally did, a little over 6 months ago by acquiring our own hives this past spring.
Since then, I have taken great strides in overcoming my phobic responses to bees, particularly to hundreds of them buzzing around me but also to the pain of the occasional bee sting, which in time became little more than a brief annoyance. On one particular occasion, while weeding in the bee garden near the hives (which they also hate!), I had a memorable encounter with a particularly irate bee who stung me on my back. To her credit, she had warned me numerous times before doing so but I was determined to get the weedy garden under control, so I persisted to ignore her. My mistake!
In the bee’s post-sting panic, she ended up getting caught in my hair. In my post-sting panic, I ended up running back up to the house all the while gyrating backwards, forwards, and sideways, flailing my hands around my head, trying to get the bee out of my hair as she frenetically buzzed around and deeper into my hair creating an ever greater entanglement. Equally as panicked as the bee was, my own bee-phobia was in full throttle at the point as I imagined thousands of her vengeful sisters chasing me. With the pool closer than the house, I desperately jumped in, fully clothed, pursuing what I perceived was the only way out of this mutually unpleasant predicament. I felt horribly bad for the dying bee, wishing she could have a quick and less painful demise and not this frightening death by hair strangulation. Hence, the pool solution worked out for both of us—calming my terrified self and quickly ending this dying bee’s life. It was not until later that day, while washing my hair in the shower, that poor, little dead bee loosened from a tangled lock of my hair and circled down the drain. A sad, sad picture! To my great relief, there was no one around that day to witness (or film) this “America’s Funniest Video” moment, which is now burned into the folds of my brain.
Despite this and a handful of other stings, I continued to collect bee pollen from the hives every day wearing my shorts and a tank top or on really balmy summer evenings in my bathing suit—all without a single bee sting mishap! While inspecting the hives over the course of the summer honey harvesting season, I felt ever more relaxed and confident with my hands and face up close and personal with the bees, admittedly, this confidence was made possible by wearing my bee suit. “THERE IS NO SHAME IN SUITING UP!” I would exclaim to myself over and over. The bees greatly appreciated my increased self-confidence, apparent by their ever-calmer demeanor toward me as I became less clumsy, less fearful, and certainly more agile in handling the interior workings of their home.
Eventually, I was ready to take off the “kid” gloves—the very protective but clumsy leather beekeeping gloves—and graduate to wearing only nitrile gloves during hive inspections. What an amazing experience that was: to feel their little feet crawling onto and over my hands and to sense the increase of wind and vibration of their wings when they were agitated (as in when I was about to crush one!). It was as though their body language, perceptible through the nitrile gloves, was saying, “hey lady, slow down, take a breath, pay attention! We are trying to work here too!” Or when I got drips of honey on the gloves, I could feel the bees’ enthusiasm as they quickly gathered around the droplets to slurp up my mess. And most surprising: they did not sting me! Moreover, the agility I gained from wearing these super-thin gloves while maneuvering the hives was ten-fold. I could not wait to gain enough confidence to discard the nitrile gloves all together, thus becoming a “real” beek by working bare-handed (though still in a bee suit).
And then the unexpected happened! Sometime in September, I was only about half-way toward obtaining the requisite “dozen or so stings a season,” which some beekeepers say is the key to gaining immunity from the pain. Indeed, I had noticed a drastic decrease in pain and swelling with each successive sting but then, one fine autumn evening, minding my own business while walking up the driveway (nowhere near the hives, I should add), a bee stung me on the ankle. I swore this had to be a bee from a neighbor’s apiary, certainly not my bees, who know me and would never sting me for no apparent reason!
First, the ankle swelled up, then the whole foot, and finally the lower leg all the way up to the knee. The excessive swelling, redness, itchiness, and burning lasted for five days—resistant to various home remedies applied. “Maybe the sting hit a nerve,” my mentor, Scott Nelson explained. “Yes, that must be it, not much flesh, fat, or muscle on the ankle,” I thought, “It’s just a one-off experience. All will return to normal next time I get stung and I can continue to strive toward gloveless beekeeping.” Four weeks later, I got another sting (while weeding in the garden; the bees really hate that too)! This time it was on my wrist, which—like the previous sting episode—developed into massive swelling, inflammation, and itching all the way up my arm, lasting more than a week plus an excruciatingly itchy skin rash that contined for over two weeks! “Ok, time to see the doctor,” I finally admitted to myself.
The doctor confirmed that I was developing an allergic reaction to bee stings. Say what?!?!? “But I’m a beekeeper now! And I have been getting stung my whole life (hence the cause of my api-phobia) and I have never had an allergic reaction!” In that moment, it seemed my beek days were over. Thankfully, the doctor confirmed that the allergic reaction was not (yet) the life-threatening anaphylactic kind and that there was only a slim chance that it could develop into the severe reaction. But… given the “large localized reaction,” (the medical term for this kind of allergic response) of these past few stings to my extremities, the doctor warned that a sting to the shoulders, neck, or head and the subsequent swelling to that larger area could cause breathing difficulties. Hence, she prescribed an Epi-pen nearby to keep on hand at all times and advised to continue with beekeeping using great caution. What a relief!
Since then, I did get stung once more on my upper arm, leading to the same allergic reaction as the last few stings but luckily no need for the Epi-Pen. Instead, over the next two days, I alternately wrapped my arm in a thick layer of honey and beeswax/propolis salve. Happily, the allergic reaction resolved itself in only two days.[1] Progress!
WHAT DOES THE SCIENCE SAY?
After the doctor’s diagnosis and the bees’ seemingly increased appetite to sting me lately (what is that about???), I was a bit perturbed by what I had read about becoming “immune” to the pain of stings by getting stung throughout the season, which, when I think of it, sounds more like a professional method of hazing than actual fact.
In my usual researcher mode, I decided to dig deeper into the science to get to the bottom of this. I found that although this precept about building immunity to the pain through bee stings at the hive can be true, it depends on various factors. In actuality, the occurrence of allergic reactions, such as large localized responses, severe systemic responses, and anaphylactic shock is surprisingly high among beekeepers. According to Müller (2005), “major risk factors for allergic sting reactions in beekeepers are: fewer than 10 annual stings [that was me in this case!!], an atopic [meaning generally allergic] constitution and symptoms of upper respiratory allergy during work in the beehive.” Annilla et al (1996), further found that systemic allergic reactions were present in 26% of their study population of beekeepers whereas large localized reactions were found in 38%. Other studies claim the former numbers of systemic reactions amongst beekeepers can range between 14-32%. Given the beek’s high potential for exposure to stings, their risk of allergic reaction is decidedly higher thank non-beekeeping populations. Oddly enough, the risk percentages change according to the beekeeper’s locations (certain countries are much higher whereas others are lower) as well as previous history with allergies in general (see Ediger et al 2018).
Moreover, it seems that there is a higher risk of systemic reactions in the early years of beekeeping among those who have fewer than 25 stings per year [that would be me!!]. Such cases account for 45% of the severe reactions compared to beekeepers who receive over 200 stings per year, which, according to the science, inversely renders these beekeepers nearly totally protected from a severe reaction.[2] Drawing from academic, medical, and government sources and other cited resources, Ellen Wright from the Southern Oregon Beekeepers Association, notes that, “[e]ven though the fear of deadly allergy to a bee sting is not warranted by the data, the fear is still real and needs to be addressed respectfully.”[3] There are some important points from Wright’s summary to consider:
Insect stings cause 3 kinds of reactions:
- Transient local inflammation: short-lived pain, itching, swelling, and/or rash at the sting site are normal responses that occur in the majority of cases.
- Large localized reactions: severe swelling (8 – 10 inches in diameter), burning, and itching that lasts 2 – 7 days occurs in a minority of cases.
- Systemic reactions: a severe response, of which there are several kinds, within the systems of the body, which are the most rare forms of allergic reaction. A systemic reaction can involve swelling of the throat, lips, or tongue; difficulty in breathing; rapid heart rate; dizziness, nausea, and the development of hives.
Life threatening reactions, such as anaphylactic shock[4] is the most severe form of systemic reaction and are extremely rare. Only 3% of adults and 1% of children are at risk of a systemic allergic reaction to insect stings (bees, wasps, hornets, fire ants etc.). Deaths from severe reactions are even more rare: 40 fatalities in a population of 316,500,000 people in the US occurred in 2013. Most life-threatening reactions do not occur with the first sting, rather they happen after repeated stings [with beekeepers being at the highest risk!]
WHAT TO DO WHEN STUNG
Unlike other bees or wasps, honeybees generally leave the stinger embedded in the skin after stinging. Immediately remove the stinger by scraping it off with a fingernail or knife blade, being careful to not crush or pinch the venom sac, since some additional venom may be pumped into the sting site.
Wash the sting site with soap and water or with an antiseptic to prevent possible infection. Cooling lotions, ice compresses, hydrocortisone cream, calamine lotion, and oral or topical antihistamines help relieve the small-scale localized pain and swelling, which will gradually disappear within a few hours. Various other materials applied to the sting site may also reduce pain, such as crushed aspirin, a paste of baking soda and water, and meat tenderizer (and even urine!) being among those that have been suggested although little scientific evidence is available on the efficacy of these home-grown methods of reducing swelling and itching. Finally, watch for signs of a serious reaction and seek immediate medical attention from a physician should any such symptoms occur.[5]
Many beekeeping blogs as well as medical discussions note that the sudden emergence of large localized reactions to bee stings rarely lead to the end of a beekeeper’s practices, as allergy desensitization treatments, such as venom immunotherapy (medically controlled and administered and doses of de-sensitizing bee venom) and the use of adrenaline auto-injector devices, such as the EpiPen, are very effective in treating severe reactions. While developing an allergy to bee stings can certainly be regarded as a beekeeper’s occupational hazard, it is a manageable risk especially when given the proper attention and care. To my relief, I am in good company with many other devoted and stalwart beekeepers, now armed with an Epi-pen, and ready to stay calm and carry on with my bees.[6]
When my friends, neighbors, and fellow beeks heard about my budding allergy to stings, they asked with concern, “so, are you giving up the bees?” My quick and clear answer. “No way!” Given this fact, I think it is safe to say that I am finally cured of my life-long bee phobia. However, these most recent allergy developments have left me more cautious about getting stung—not just for the kamikaze bee’s sake but for my own. I am much less inclined now to aspire toward getting “seasoned with immunity” by a multitude of bee stings at the hive (a horrific idea when thinking about all those dead bees associated with this home-brewed method of immunotherapy!). If at any point I decide to seek immunotherapy, it would be under medical supervision using controlled methods that preferably do not call for the death of bees.
So, I am back to wearing leather gloves and fully reliant on a bee suit—except when I am just collecting pollen, which I continue to do very carefully in everyday clothing just after dusk, when most foraging bees are back in their hives and probably fast asleep from a hard day’s work. For new and unexpected reasons, I have learned that there really is NO SHAME in wearing protective gear when opening the hives, as it will allow me to continue with my passion of beekeeping, despite the new allergy. I will also keep consuming honey, bee pollen, and propolis, in hopes that one day these wonderfully therapeutic hive products might even reverse this odd allergic trend. One can only hope!
[1] See the various blogs about the health benefits of honey, bee pollen, propolis, and beeswax on the Raw Hawaiian Honey Company Bee-log.
[2] See https://www.researchgate.net/publication/7757770_Bee_venom_allergy_in_beekeepers_and_their_family_members
[3] She also notes that since wasp stings are often reported as bee stings, most data cited in the various studies include stings for all insects in the wasp/bee family.
[4] Mayo Clinic defines anaphylaxis as being caused by the immune system releasing a flood of chemicals that can cause a person to go into shock — with blood pressure suddenly dropping and airways narrowing, thus blocking breathing. Signs and symptoms include a rapid, weak pulse; a skin rash; and nausea and vomiting.
[5] See also https://www.samhealth.org/about-samaritan/news-search/2019/08/13/ease-the-pain-of-bee-stings
[6] See also https://www.bee-craft.com/news/honey-bee-stings-and-anaphylaxis#:~:text=The%20more%20severe%20end%20of,0.48%2F1%2C000%2C000%20inhabitants%2Fyear.