Ronnas

Thank your for the congratulations! We are all doing good and the kids are thrilled with their baby brother and Kurt has been just a wonderful big brother! I have not posted as much in the last year but I just wanted you all to know I read everyone's posts just about every day and my prayers go out to everyone. Four years ago everything was so overwhelming and with the help of the support and information I have received on-line Kurt is doing really well and we are in such a good place. Time really is the best healer of all. I hope everyone has a great summer. We will be away for the summer but Sept will come quickly! Take Care and my best wishes to everyone! Ronna

Interesting discussion and thanks for the great reply Chemar! The topic of whether there is a family history of tics interests me. I will tell you that at one time I would have said...absolutely no way did we have a family history of tics...now I am not so sure. My dad has passed away so there is no way I could ask him as are my grandparents. Really if I try and think back to when I was a child and around my family I would have had no idea if anyone was ticcing whether it was a uncle, aunt, parent, grandparent etc. Another example is that my mom's father died when she was a toddler...how would we ever know if that branch of the family had tics or even if her dad did? My son has PANDAS and if I had never learned anything about PANDAS I would not have realized that I myself had some symptoms of PANDAS as a child which I grew out of as I became a teenager. I never ticced but I think I had some quirky, OCDish kind of stuff. Many of us who post are moms...when you look at family history do you focus on tics or OCD too? From my research it seems that girls show more OCD symptoms (I think this includes anorexia) and boys more tic symptoms. As well I think as parents we are just so much more aware now and what we find alarming may not have even been on the radar of our parents or grandparents. I know if I said to my mom..."I think I was a bit OCDish as a kid"...she'd think I was totally out to lunch. When questioning grandparents etc about tics they may not even know what a tic is...they could see a tic their grandchild has such as head jerking and say "well nope none of my kids did that"...but they might not even think to say..."well he did scrunch his nose alot" because they do not realize the varibility in tics. My husband's cousin has a son that tics and they are nothing like my son's tics but if it were not for the fact that my husband has a close family and they live near us...I don't think we would even know he tics as well. Genes definately play a big role but I think environmental triggers such as strep in my son's case or allergies in my husband's cousins son's case...I think this was the case in past generations as well...but I think our environment is just soooo much worse now in terms of what our kids are exposed to which may be the reason why our kid's tics seems more intense now as opposed to past generations. Well i hope I made some sense!

People with strep throat infections have a red and painful sore throat with white patches on their tonsils (you don't necessarily need to see white patches, though). A person may also have swollen lymph nodes in the neck, run a fever, and have a headache, nausea, vomiting, and abdominal pain can occur but are more common in children than in adults. Once people become infected, they pass the infection to others for up to 2 to 3 weeks even if they don't have any symptoms. After 24 hours of antibiotic treatment, and there is no longer a fever a person will no longer spread the bacteria to others. For more information about strep throat: http://www.niaid.nih.gov/factsheets/strep.htm http://www.emedicine.com/aaem/topic420.htm STREP SCREEN: Throat Swab (Rapid Antigen Test): The doctor or medical assistant wipes the back of the child's throat with a long cotton swab. In the lab, the swab is placed in a test tube with a chemical mixture that extracts part of the strep germ (the antigen) from the swab. This extract is then combined with antibodies to group A strep antigen (these antibodies are protein molecules that attach to the group A strep bacteria's surface antigen). When a third substance that detects the antigen-antibody combination is added to the tube, the liquid changes color if strep germs are present. Culture and Sensitivity: The specimen for a throat culture is taken in the same way, but the fluid from the swab is put into a culture dish in which the bacteria from the specimen must be grown for 2-3 days before strep germs, if present can be identified. Some labs only grow the culture for 24 hours. I always have the doctor write on the requisition to make sure and grow the culture for minimum of 48 hours! The strep screen is about 75-85% accurate. A rapid strep screen can offer results in minutes, whereas the throat culture takes 2-3 days. The symptoms of strep throat usually improve even without treatment in 5 days, but you are contagious for several weeks and there is a risk of developing complications. Lack of treatment or incomplete treatment of strep can lead to various complications. Infectious complications: -the active infection may occur in the throat, skin or in the blood. -skin infections of the skin or soft tissues. -scarlet fever is caused by the toxins released by the strep bacteria. -toxic shock syndrome. ***During the infection, the antibodies (diseases fighting chemicals) are produced. After the organism is cleared, these antibodies can still cause disease in body organs (for example, PANDAS, Sydenham's Chorea etc,). -rheumatic fever -glomerulonephritis About 10-20% of people are carriers of strep, meaning that the bacteria lives in the back of their throat without causing infection. And although the strep is not causing any problems, if you test someone who is a carrier, the test will be positive. The best way to avoide being overtreated with antibiotics when you are a carrier is to avoid being tested when your child does not have classic symptoms of strep throat. Your doctor may also decide to use a stronger antibiotic as treatment so that your child is not a carrier anymore (usually clindamycin). Tonsillectomies used to be done much more than they are now. The current indications for a tonsilectomy for recurrent strep throats is having 5 or more episodes of strep throat in a year, or having 4 episodes each year 2 years in a row. BLOOD TESTS Streptozyme: Detection of multiple antibodies to extracellular antigens of streptococcus. While the streptozyme is of some diagnostic value it should never replace more standard tests such as streptolysin O antibody (ASO) or DNase-B antibody. These antibodies may be detected in patients after streptococcal pharyngitis, rheumatic fever, pyoderma, glomerulonephritis, and other related conditions. In evaluating a patient with suspected acute rheuamtic fever or nephritis, determination of ASO, DNase-B antibody, and streptozyme will likely yeild a postive reult in 92-98% of cases. Streptolysin O Antibody (ASO): The ASO test is used to provide serologic evidence of previous group A streptococcal infection in patients suspected of havinga non-suppurative complications, such as acute glomerulonephritis or acute rheumatic fever. Use of the ASO for diagnosis of an acute group A streptococcal infection is rarely indicated unless the patient has received antibiotics that would render the culture negative. An ASO performed on serum obtained during the presentation of a non-suppurative complication that shows a titer two dilutions above the upper limit of normal is evidence for an antecedent streptococcal infection. It is recommended, however, to use a second test such as the anti-DNAse B to confirm antecedent infections. Elevated serum ASO titers are found in about 85% of individuals with rheumatic fever. When both ASO and anti-DNAse are used, the result is over 95%. Skin infecitons with group A streptococci are often associated with a poor ASO response. Reference Interval: 0-1 year: 0-200 IU/Ml 2-12 years: 0-240 IU/Ml >13 years: 0-330 IU/Ml DNAse-B Antibody: the majority of group A streptococci produce significant quantities of DNAse-B, while most other groups of streptococci do not. High levels of neutralizing antibody to DNAse-B are commonly found in patients following a group A streptococcal infection. Since it persists longer than other streptococcal antibodies (2-3 months), it is the preferred test in patients with chorea suspected due to rheumatic fever. Since it is not influenced by the site of infection, DNAse-B antibody is more reliable than the ASO test in providing evidence for streptococcal infection in patients with post-impetigo glomerularnephritis. Elevated titers are strongly suggestive of recent or current infection with group A streptococci. Fourfold increases in titers between acute and covalescent samples tken approximately 2 weeks apart are confirmatory. Reference Interval: 1-6 years: <1:60 7-17 years: <1:170 18 years and over: <1:85

Hi Daniel, HMMM...tough question. OK when I think in terms of food sensitivities and spring allergies...there is no doubt the food sensitivities are worse in the spring...by how much compared to 4 years ago is tough. You know the years start to mesh together and it is hard to remember exactly what tic happened when and how bad was this year...compared to another year. Overall I would say seasonal allergies make his food allergies about 60% worse. In terms of percentages I would say just removing dairy alone has helped about 80%. As far as number of tics go...well I can't say I have ever really counted or paid that much attention. Overall I just have more of a "feeling" as to how he is doing overall. As I have said before I don't find his tics all that bothersome but it's more of the co-morbid stuff that pops up such as separation anxiety (that is fighting over whether to go to school or not), anger, impatience etc, more bad decisions etc. As far as just spring allergies go I would say he regresses about 50% which is manageable. My son is a PANDAS guy and he had a major exposure to strep last week from his cousin and in the last 2 days he has begun to deteriorate alot so it is back on clindamycin tonight...compared to 4 years ago I would say he is still much, much better in a big way but it is still disconcerting. I attribute this improvement to the diet and supplements but that alone is not enough for his body to handle the exposure to strep. My general feeling is that as he gets older he will handle illnesses better especially strep. During the "waning" times when things are going well my son can be pretty much tic free. With seasonal allergies I guess if I had to put a # on it I would say his tics are in the range of 100 per day...even this is virtually unnoticeable by anyone but me b/c they vary...then with a strep illness or it seems even exposure to it...he can tic TONS...and at that point he will always have a vocal tic...the funny thing is...his motor tics have ALWAYS varied but he has had the same vocal tic for 4 years when it is there...I must say I am quite tired of this tic...it's a HMMM sound... Keep in mind that my son does not seem to notice his tics and really does not mention them...when they were severe and he was hospitalized and went through the biopsies and testing he was age 5 and 6 (he is now 9). He does not seem to remember much of it. He is in grade 2 and no classmates have teased him, and only the people close to him really notice them. To be honest I am not sure if my son even knows what the word "tic" means, he for sure does not know what PANDAS is and only knows that he has some "allergies" to some foods...the easy part for us has been that my son does not feel that his diet is restricted b/c he will literally eat anything I give him...he has never liked "junky" stuff and right from the age of 5 on my first try he could swallow vitamins etc...at this point he can swallow 4 at a time. I would say his biggest challenge by far is that he has a learning disability and finds reading very difficult and he DESPERATELY wants to read chapter books by himself and is not able to. I am not sure if this helps...it's hard to get across in a post how TS/PANDAS has impacted my son...for some it may seem like alot...for others whose children are more severe it may seem like very little...the interpretation of it is all a bit individual.

Hi Allison, Thanks for the kind words. Yeah sometimes I wonder how I got in the "pickle" of 4 kids and a dog Kurt went through TONS of testing for seizures 3 years ago (or is it 4...it's hard to remember in my foggy pregnant state!)...his very first dx was seizures and was even started on meds for this...all of that seems like another lifetime! Kurt never did mind all of the testing...he is a pretty happy go lucky kid. Allison, it is sooo good to hear how well your son is doing. We have many similarities. Kurt still does have waxing periods but I also have to remind myself how far we have come (both him and me!) Take care, Ronna

My son has always been a spring allergie/asthma kid (fall is a tough time also)...although he has grown out of his asthma for the most part I do find that his food sensitivities are worse in the spring and he does tic more in the spring. I have read that food allergies can be worse when combined with environmental allergies. Although Kurt has had a waxing of symptoms this spring they are still the best they have been in 4 years. I think the combination of building his immune system, supplements, diet changes etc have helped over the years in healing his body. TAke Care, Ronna

Daniel, Many of us understand the stress and how overwhelmed you are feeling. I have done as much as I have with my son over the years because his movements and symptoms were quite severe and there were times it interfered with his daily life. It interfered with even his ability to walk and he had ALOT of pain associated with some of his tics with a neck one being the worst and he would BEG me to make it stop. As well he showed alot of regression in behavior. He had alot more going on than tics. My cousin's son is 6 and has tics and my advice to her has been not to intervene because HE does not seem to mind the tics and he is well adjusted in school etc. Remember that in the spring time many kids do tic due to seasonal allergies. You mention that your son has high anxiety. He may be reflecting your own anxiety. At this point counselling for yourself and maybe as a family may be needed before making anymore changes concerning diet etc. Kim gave some great advice and maybe just doing baby steps at this point would be helpful rather than going all the way. It was only once I stopped going full tilt on everything and backed up and introduced changes slwoly that we started to get a grasp on really helping my son. I have said it before and will say again that many, many kids tic and this is ok.

Daniel, I really feel for you...I can remember clearly my own desperation 3-4 years ago. All of the treatments, supplements etc that we did for my son was done under the guidance of our open-minded pediatrician and a naturopath doctor. What works for one child may not work for another...having gudiance of a professional is important. My son had severe tics 3-4 years ago...he was hospitalized many times and was even being investigated for neurodegenerative and metabolic disorders due to the seveirty of his symptoms. Although at times he does have some tics still they are very mild and for the most part I am the only one who notices. Although believe me there were times that my son's tics were VERY upsetting it was more than tics which led me to check out alternative therapies. My son is a PANDAS kid and needed alot of work on building his immune system and because he regressed alot at the age 5 we were very concerned. Changing my son's diet (eliminating dairy being the most important) initially made a huge difference. My family was not initially on board with the dietary changes until we had a bowling night one time and pizza was served...my son changed before our eyes and everyone was a believer. Trying to do a complete food elimination diet does not sound too feasible for you right now...maybe a single food elimination diet would be more helpful. For example just eliminate one thing at a time for a week or two and then re-introduce and see what the reaction is. It is essential to remember that MANY children do tic...it does not mean they have TS. Spring is a particularly bad time for many kids due to environmental allergies. Putting too much attention towards the tics may also make it worse as your son may be aware of the stress in the home. Are the tics bothersome to your son, is he adjusting well in school...it may be time to take a break, find a doctor who can guide you and find a compromise with your wife. Really I never thought I would ever say this but in a way my son's tics are just another part of him...easy to say when they are mild now but with time we have all accepted them and him which has been an important part of our journey.

Daniel, When I read your posts I well remember my initial struggle to find answers for my son 3 years ago. He is doing well now. A book that initially helped me TONS was called... "Unraveling the Mystery of Autism and Pervasive Developmental Disorder: A Mother's Story of Research and Recovery" by karyn Seroussi. It was after reading this book that I really realized that there were many things I could do as a parent that could make a difference for my son. There are many, many other excellent books such as Doris Rapp's..."Is this your child" etc. but the one I listed above was the catalyst in me helping my son through supplements and diet. It would be a good book for both you and your wife to read. Although reading through posts online can be very helpful, it can also be very confusing. There are many good books which can help...don't limit yourself to reading about TS though...there is soooo much to be learned from autism as more research has been done in this area. Take Care, Ronna

My son also does poorly with just omega 3's but does well with a combination product from Natural Factors.

Curr Treat Options Neurol. 2005 May;7(3):183-189. Related Articles, Links Gluten Ataxia and Post-Streptococcal Central Nervous System Syndromes: Emerging Immune-mediated Disorders of the Central Nervous System? Wills A, Dale R, Giovannoni G. Institute of Neurology, Queen Square, London WC1 3BG, United Kingdom. G.Giovannoni@ion.ucl.ac.uk. There is an "emerging concept" that central nervous system dysfunction can be caused by an aberrant immune response triggered by exogenous antigens such as the food allergen gluten or streptococcal infection. The hypothesis of a gluten sensitive ataxia remains unproven, but is worthy of consideration. The data in support of this hypothesis require critical review before any treatment recommendations can be formulated. The idea that anti-gliadin antibody seropositivity per se justifies the term "gluten sensitivity" is important because it offers potential therapeutic possibilities, including simple exclusion diets, for patients with anti-gliadin antibody-associated ataxia. Post-streptococcal basal ganglia dysfunction has various manifestations, all of which fall into a relatively well-defined symptom complex or syndrome. Anti- basal ganglia antibodies that are associated with serologic evidence of recent streptococcal infection are a potential diagnostic marker for this group of disorders, which includes Sydenham's chorea (SC) as the prototype. More recently subjects with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection, Tourette's syndrome, obsessive-compulsive disorder and other movement disorders have been described in association with anti-basal ganglia antibodies. The apparent overlap between the clinical phenotype of SC, pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, Tourette's syndrome, and obsessive- compulsive disorder suggests that they may represent one disease entity. The current working hypothesis is that antibodies induced in response to streptococcal infection cross-react with antigenic determinants in the basal ganglia resulting in basal ganglia dysfunction. Although the experimental evidence is incomplete, there is sufficient evidence to support immune-mediated basal ganglia dysfunction as an emerging clinical entity. This has important implications for the diagnosis and treatment of subjects with these disorders. The latter includes the judicious use of antibiotic prophylaxis and immunomodulatory therapies. Apart from the diagnosis and management of SC, no consensus exists regarding the diagnosis and management of the other clinical entities within this group of disorders.

It is hard to say which supplement may be causing an increase in tics. I think the best thing to do may be to start over and go slower when adding new things. Each child is very individual and what may have caused an increase in tics for my son (ex. fish oils) may be fine for another.

Hi all, I thought I would mention that at some point in the past I read (somewhere?) that seasonal allergies can make food sensitivities more of an issue. Kurt has tolerated the re introduction of eggs, chocolate and corn quite well and milk to a certain extent in terms of cheese etc but as spring comes he has way less tolerance to milk. He has always been a seasonal allergy kid since he was a baby with asthma etc. Anyways, what I am trying to say is that for my son his food sensitivities seem to be much worse in the spring than any other time. Kurt has a cousin that only tics from about March to May which is probably from an allergy to "snow mold". As well Kurt has an aunt that has a sensitivity to eggs in the spring...she only noticed the connection when I mentioned it to her. She generally avoids eggs all year long but does say it seems worse in the spring. Ronna

Interesting that you mention this. My husband and I have always said that our son is a "hottie" at night. He does sweat and just not seem to need or want covers like my other kids. Since a young age he has refused to wear anything but underwear to bed. He hates pj's. My other kids LOVE their pj's and blankies! Ronna

Hi Dara, Yoga is great and having balance is so important...believe me I learned the HARD way! This how I looked at one time...I was on the computer at night tons, and tons after my kids went to sleep...it was not good at all but "sigh" that was in the past and all I can do is learn from my mistakes... I am pregnant with my 4th baby...due in July. Kurt (my son who I post about) is my oldest at almost 9 years old, I have a 6 year old son and a 4 year old daugher and we already know we are having another boy... At present I just had 10 four year olds at my house this afternoon for my daughters birthday party and now that I think about it I again look a little . I think I need to go deep breath...see yoga would be a great idea right now... Take Care, Ronna

Chemar, GREAT words of advice. I well remember how devastating everything was for us 3 years ago. So much has changed since then. Kurt is doing so much better but I would also second that when we relaxed and settled in things became so much easier. We do use supplements and diet restrictions but the best thing we have done is focus on all of Kurt's strengths...he is an awesome kid. He still has tics, he has quite a severe learning disability with auditory processing difficulties being the most difficult and it just doesn't matter as much anymore...we just provide as much support as possible. There was a time that I nearly died of exhaustion looking for answers and the constant worry really took it's toll. Really for awhi,e I was a complete mess. A book that I really liked was "Special children, challenged parents" and it helped alot in understanding the grieving process. I guess I just wanted to advice parents newer to this to take it slow, limit your time on the computer (at one time my husband finally lost it and said he was not looking at the back of my head anymore while I was on the computer), and take any changes slowly. Only do one change at a time, keep a diary, seek out help from professionals such as a supportive pediatrician, naturopath doc, nutritionist etc. Time has a way of healing and when we started this journey Kurt was 5...he's turning 9 now and is such a big boy. He makes me smile everyday...he was heading off to school at lunch today and before going he patted my (pregnant) stomach and with lots of honesty said "boy, is your stomach ever big mom". Ha, Ha...so much for feeling "not so big" this morning and being proud I could still fit my favorite sweats! (((HUGS))) to parents new to this and please know that with time things will get better. Someone gave me the best advice at one time... "Don't worry too much...the things you worry about now probably won't even be a problem later on...and then something you never, ever thought to worry about gives you a curveball"...So true...better to take one day at a time. Take care, Ronna

My son uses Bonnie's vitamins and I really do think it helps him alot. I would say he still does have some mild tics that only I would notice...I think the supplements help TONS in avoiding more waxing and waning. They defineltly help with his behavior and his ability to handle stress, fatigue, school pressure etc. They really just seem to keep him on an even keel. As far as the essential fatty acids go I think they have really helped him with academics in school. He seems to be making good progress at school, his memory seems better and he just seems to be learning easier. Ronna

Kim, I just thought I would mention that my son does really well on Bonnie's vitamins but not on the fish oils that she recommends with her products. They made my son a bit hyper. Once I switched from the fish oils to another essential fatty acid blend he did really well.

Hi Lynn, I am sorry to hear that you are having a difficult time with your daughter. I don't know which antibiotics are best as this needs to be decided with your doctor. I can tell you our experience with antibiotics. My son's story is a long one and his diagnosis is Sydenham's chorea as a complication from rheumatic fever with a secondary diagnosis of PANDAS based mostly on his dramatic improvement with antibiotics...anyways...about 2 years ago he had muscle, nerve and muscle biopsies as the neurologists were looking for neurodegenerative and metabolic disorders b/c my son's tic/abnormal mov'ts and other symptoms were so severe. He developed a post-op infection at the nerve biopsy site and was started on a post-op antibiotic called Keflex...within 3 days we noticed a DRAMATIC improvement in his tics etc and after a long drawn out process we came to the dx of PANDAS. Once my son was done the two weeks of Keflex his symptoms always returned. Our neurologist thought that we should try Pen Vk prophylactically and my son had no response to this antibiotic which we did try several times...again we always returned to Keflex. He was on Keflex for about 6 months and then his tics returned quite abruptly. Our doctor switched to clindamycin to try and erradicate the strep if he was a carrier...he responded well to the clindamycin. He remained on clindamycin prophylactically for about 6 months at which time I did a food elimination diet, added supplements, treated for yeast, and gave probiotics. At this time my son is doing very well...minimal tics that only I would notice. He remains on supplements and all dairy remains a trigger for him so we avoid it. In the last year he has had two sudden PANDAS episodes each of which resided with another round of clindamycin. I certainly have no idea if this is the best way to go but it is what seems to work for my son. The best thing to do is to discuss with your doctor what would be best. Many PANDAS kids are on prophylactic antibiotics. We have chosen to not use prophylactic antibiotics as I am not sold on the idea that it prevents strep infections...but that is just me. My son has a mtiral valve regurg due to the rheumatic fever/sydenham's chorea so we are extra careful to have him swabbed for strep at any sign of illness and we treat him if we think it may be a problem. We have taught our kids very good handwashing and it must be helping because this is the healthiest winter we have ever had (knock on wood). The fact that your daughter has had tics since an early age would suggest to me that she does have the predisposition to a transiet tic disorder or TS and that the strep has exacerbated an already existing condition. You should see improvement on the antibiotics but I would suspect it will not completely eliminate all of her tics. Take Care and (((HUGS))) to you as I know how hard this can be. Ronna

Hi Jason...good luck on your paper. Here's a few links...I hope they help. On the old braintalk I posted quite a bit about strep... http://neuro-mancer.mgh.harvard.edu/ubb/Fo...TML/005700.html At the new braintalk you can always use the "search this forum" feature and type in strep or PANDAS to see what has been posted... http://brain.hastypastry.net/forums/forumd...splay.php?f=253 http://brain.hastypastry.net/forums/forumd...splay.php?f=196 Or you can check these out... http://www.alertpubs.com/pandas.htm http://www.neurotransmitter.net/pandas.html A great web site is... http://www.tourettesyndrome.net/pandas_overview.htm As far as the basics about strep...emedicine is good. Ronna

Hi Dara, I hope all is going well. A few years ago when I was new to all of this I also tried EVERYTHING all at once. I soooo wanted to help my son. He use to beg me to make his neck tics stop as they were so painful by the end of the day. It broke my heart at the time. I have posted in the past about this experience. When I introduced everything too quickly I was not able to tell what was helping and what was making things worse. My best advice for anyone is to start slow and make changes gradually so you can really evaluate what helps. In the end I found that my son reacted poorly to fish oil and any chelated vitamins. With time it all becomes MUCH, MUCH easier. You are doing a great job. I also find that if the TV is on the kids will sit and watch but if I simply don't turn it on they go find other things to do...none of us miss it much but at this point I don't really need to limit it much anymore. I just find it quieter in the house without it on. I was reading with interest a web site last night that really advocates not doing dietary intervention, vitamins etc for tics etc. I guess I was kind of shocked because we have seen such incredible success with removing dairy especially and my son really responds well to essential fatty acids and Bonnie's vitamins and I don't think it is ever a bad thing to cut out TV, PS2 etc. although I know some see it as a cruel thing and can remember debates on-line from years ago that those that chose this were "overzealous" parents who were obsessed with their kids tics. I was watching CNN a few weeks ago about the new "games" coming out at a toy exihibition in Las Vegas and it was talking about the new one for PS2 where kids get to "exercise" while they play and how it was expensive but parents were willing to do "anything" so that their kids got exercise but were concerned about spending so much on a game that their kids might lose interest in. Well I was kind of shocked because mostly I thought...why not sign up for swimming lessons, martial arts, soccer, wall climbing...anything rather than rely on a video game. We have our sons in a mixture of both team and individual sports and they love it. I am so glad spring is coming and we can switch to outdoor sports. Anyways, now I am rambling...Dara...I just wanted to let you know my son was 5 years old when everything started...he is turning 9 next month and is doing very well...we still have little ups and downs but it is NOTHING like it use to be. Take Care, Ronna

We have had good success with seeing a chiropractor along with reflexology. My son really likes both of them. They have a very calming effect on him. We did cranialsacral therapy with the chiropractor. Ronna

The only time my son has a vocal tic which sounds like a "hmmm" sound is when he has anything with milk in it. With the elimination of milk this tic disappeared.

Sorry to hear about the recent strep infection. In my experience with Kurt if we start him on antibiotics at the first sign he does not have a full blown onset of PANDAS. It sounds like your son will be ok if you have not seen an explosion of tics. Best of luck. I guess my only advice is that time will tell. With time and experience the ups and downs of this will get easier to deal with. Although Kurt does remarkably well compared to a few years ago we still do have our tough times. It is getting easier because I have learned with time it will wane. Take Care.

Paige, My son is almost 9 years old. He does have receptive and expressive language delays although the expressive is more pronounced than receptive. He can become quite frustrated when he is not able to express himself as he wants to. I would say this has become easier as he gets older but my son does not have pdd/autism. My son was in speech therapy for years along with occupational therapy. It is my general feeling that with the elimination of milk/casein his speech improved. Ronna