Boatloads of Augmentin

[purple66p]

DS13 has had an earache since the weekend that just wasn't getting better, so off to the family doc today. (We saw her last week to get her up-to-speed on PANDAS and she was very receptive to reading the pile of literature I laid on her.) It turns out he had a pretty yucky ear and, based on what we discussed last week, she started him on Augmentin, 2000 mg am and 2000 mg pm. However, she prescribed the standard 10 days. I'm hoping that he will improve and I can go back to her for a longer treatment if it does help. My question: can we hope to see any improvement in PANDAS symptoms in that length of time?

 

We're off to the neurologist tomorrow--we'll see if he considers a PANDAS diagnosis or finds something else. Poor kid is sick of doctor appointments!

[EAMom]

DS13 has had an earache since the weekend that just wasn't getting better, so off to the family doc today. (We saw her last week to get her up-to-speed on PANDAS and she was very receptive to reading the pile of literature I laid on her.) It turns out he had a pretty yucky ear and, based on what we discussed last week, she started him on Augmentin, 2000 mg am and 2000 mg pm. However, she prescribed the standard 10 days. I'm hoping that he will improve and I can go back to her for a longer treatment if it does help. My question: can we hope to see any improvement in PANDAS symptoms in that length of time?

 

We're off to the neurologist tomorrow--we'll see if he considers a PANDAS diagnosis or finds something else. Poor kid is sick of doctor appointments!

 

How big is your son? "Saving Sammy" was about 100 pounds and took 1000mg of Aug. XR 2x daily...you could kind of "cheat" and give 1000mg 2x daily...so your pills would last 20 days instead of 10.

 

I don't know what would happen to the yucky ear infection though, on the lower dose.

 

The other approach is to give as rx'd ...and then (hopefully) you'll notice an improvement in his PANDAS symptoms. At that point you say, "could I have a refill to see if the symptoms *continue* to improve...?" and go from there.

 

Or, if she denies you initially, you could say, "wow, his PANDAS symptoms started to improve while on antibiotics, but got worse again once he was off. I think it would be reasonable to try another (longer) course of antibiotics to make sure this isn't a coincidence..." or something like that.

Edited September 30, 2010 by EAMom

[nevergiveup]

Lowering dose, sounds risky if he has a "pretty bad" ear infection. Augmentin is given at this dose for adult size individuals with persistent infection. (4000 mg per day). I would see if it helps the panda symptoms, I am sure just getting rid of the bad ear infection will help the panda symptoms some. If u think it helped go see a pandas expert or have a phone consult and get more abx.

[purple66p]

So here's a (long winded) update:

1. We saw the neurologist. He agreed that it was possibly Pandas but stated that "the treatment is the same [as for other OCD.]" I'm going to try to educate him a little better and also continue educating our family doc. I want to stay with this neurologist, for now, as we reduce and eliminate the bipolar meds since he has a lot of experience there.

2. We're at day 8 of the Augmentin for the ear infection. The ear is much better and I *think* the tics are better. He's had a few fits--not to the point of the rages we've seen in the past--but somehow they seem habitual. He started to go into total obsessive mode this morning before school, but then he just let what he was obsessing about go until after school and we got to school on time. I need to journal better to really track the ups and downs!

3. We got the CaM Kinase II results back today: 177, which puts him well within the upper half of the Pandas group. I was feeling squishy about whether we were dealing with Pandas after so many years of calling his problems "bipolar" and "ocd," but I'm now comfortably in the Pandas camp! I'm going to share the Cunningham results with the family doc and ask to extend the Augmentin and FIGHT THIS DISEASE WITH ALL MY MIGHT!

 

Thanks to everyone on this board for your support and encouragement. I'm so glad I found you guys!

[momaine]

Best of luck to you. So glad to read your update.

[EAMom]

I finally listened to this today http://www.voiceamerica.com/voiceamerica/vepisode.aspx?aid=44414 with Dr. Latimer and LLM. It would be great to get your neurologist and family doc to listen to that, b/c they make it clear that you don't treat PANDAS like any other case of OCD/tics. You address the infection (and source whether it's vaginal, skin, tonsils, sinuses), prevent future infections, and address the inappropriate immune response (with steroids, or IVIG to "re-set" the immune system, or plasmapheresis). All in all, I thought it was a pretty good intro to PANDAS.

 

(I listened to the Dr. K. podcast a while back, haven't done Dr. T. yet).

[purple66p]

Thanks for the reminder. I listened to all three when I first learned about Pandas a few months ago and even took a lot of notes but I didn't think to reccomend it.