Questions about non-food allergies

[kdnc5716]

Just for background info, our 4.5 year old son has not been formally diagnosed with anything yet. The pediatrician has only confirmed that he is having tics. I don't know if he has a transient tic disorder or is heading toward some kind of more specific PANDAS or TS diagnosis.

 

Anyway, we had him allergy tested yesterday with a traditional scratch and intradermal test. He didn't have any tics while we were there, but his face did turn red during testing. He tested positive to 17 items, all of which were non-food. He tested moderately to highly allergic to 10 types of indoor and outdoor mold, grass pollen, ragweed, and cockroaches (yuck). He tested highly allergic to dust mites, dogs, and cats. They also said that he has mild/intermittent asthma, based on a breathing test they administered and the fact that he's had at least three episodes of wheezing.

 

The allergist recommended that we start three medicines daily: Zyrtec, Singulair, and Nasonex. The Zyrtec can then be removed after a couple weeks. I'm hesitant about the Singulair, because the doctor admitted that it can have behavioral side effects. Any thoughts about any of these meds? My son has never been on a daily medicine (aside from antibiotics when sick and multivitamins), so I'm nervous! Might any of these things exacerbate his tics?

 

Also, my son's tics have been waning the last couple weeks, and then today they flared back up again (facial grimacing, clucking, humming). Could this be from the allergy testing yesterday? It's weird to me that he didn't tic during the test, but he did tic starting first thing this morning. I guess he still has the welts on his arms though.

 

Oh, and this leads me to my final question: what do you all think about allergy shots? The doctor highly recommended them, so we can try to contain his asthma symptoms and eventually have him on less or no allergy meds. It's a big commitment though, and I was wondering whether they will cause his tics to worsen? Does anyone know about this?

 

Thanks so much for the help. I really appreciate it!

Edited August 12, 2011 by kdnc5716

[911RN]

The allergist recommended that we start three medicines daily: Zyrtec, Singulair, and Nasonex. The Zyrtec can then be removed after a couple weeks. I'm hesitant about the Singulair, because the doctor admitted that it can have behavioral side effects. Any thoughts about any of these meds? My son has never been on a daily medicine (aside from antibiotics when sick and multivitamins), so I'm nervous! Might any of these things exacerbate his tics?

 

Also, my son's tics have been waning the last couple weeks, and then today they flared back up again (facial grimacing, clucking, humming). Could this be from the allergy testing yesterday? It's weird to me that he didn't tic during the test, but he did tic starting first thing this morning. I guess he still has the welts on his arms though.

 

Oh, and this leads me to my final question: what do you all think about allergy shots? The doctor highly recommended them, so we can try to contain his asthma symptoms and eventually have him on less or no allergy meds. It's a big commitment though, and I was wondering whether they will cause his tics to worsen? Does anyone know about this?

 

 

My older son did allergy shots for 5 years. It was the best thing we ever did. Yes, it is a big commitment but the results are worth the investment. He seldom, if ever, gets sick, now and does not suffer from allergies, anymore. He suffered from chronic sinus infections prior to shots. Especially, if your child is asthmatic- it will make a positive impact, IMO. My children were not asthmatic, just severe allergies.My son had moderate to severe allergic reactions to nearly every indoor and outdoor allergen tested (much like your son, it seems:( Both my children have taken Zyrtec and Nasonex next over the years with no increase in tic behaviors noted. Great combo for allergy symptom relief. Our allergist who is one of the smartest women/docs I know states she has never recommended Singulair. Lots of side effects for very little benefit in her opinion.

 

I would say yes, the allergy testing flared his tics. The intradermal and scratch testing causes a big allergic reaction/histamine release. The shots should not do that. Start out with small,minimal amounts of meds and build up slowly. Immunotherapy that makes them desensitized to the allergens.Serums change and increase over time. You have to be committed and stay on schedule for best results.

 

Allergists don't typically highy encourage shots unless they are really needed. They will try med managment first unless you have a child like yours that is highly alllergic to so many thing and asthmatic to boot. Med management failed on my older son but works on my younger son- he was not nearly as allergic as my older one.

 

Word to the wise- we are getting into ragweed season- if child has ragweed allergy- they will likely react neagativley to any lopes and melons (cantelopes, honeydew and watermelon). They are in the ragweed family- believe it or not!! Best to avoid these foods even if they don't test positive to them. My sons tested negative but always threw up after eating cantelope when they were younger- never figured it out until they tested so sensitive to ragweed:)

 

Good luck in your decisions- I would not fret Zyrtec or Nasonex. I'm a avid fan of allergy shots and how my son improved. PITA for scheduling but worth every shot (for us). My son had to do shots for 5 years, whereas, allergist states she usually only has to do it for 3 years...he was so allergic to so many things she knew he would take longer.

[kdnc5716]

 

My older son did allergy shots for 5 years. It was the best thing we ever did. Yes, it is a big commitment but the results are worth the investment. He seldom, if ever, gets sick, now and does not suffer from allergies, anymore. He suffered from chronic sinus infections prior to shots. Especially, if your child is asthmatic- it will make a positive impact, IMO. My children were not asthmatic, just severe allergies.My son had moderate to severe allergic reactions to nearly every indoor and outdoor allergen tested (much like your son, it seems:( Both my children have taken Zyrtec and Nasonex next over the years with no increase in tic behaviors noted. Great combo for allergy symptom relief. Our allergist who is one of the smartest women/docs I know states she has never recommended Singulair. Lots of side effects for very little benefit in her opinion.

 

I would say yes, the allergy testing flared his tics. The intradermal and scratch testing causes a big allergic reaction/histamine release. The shots should not do that. Start out with small,minimal amounts of meds and build up slowly. Immunotherapy that makes them desensitized to the allergens.Serums change and increase over time. You have to be committed and stay on schedule for best results.

 

Allergists don't typically highy encourage shots unless they are really needed. They will try med managment first unless you have a child like yours that is highly alllergic to so many thing and asthmatic to boot. Med management failed on my older son but works on my younger son- he was not nearly as allergic as my older one.

 

Word to the wise- we are getting into ragweed season- if child has ragweed allergy- they will likely react neagativley to any lopes and melons (cantelopes, honeydew and watermelon). They are in the ragweed family- believe it or not!! Best to avoid these foods even if they don't test positive to them. My sons tested negative but always threw up after eating cantelope when they were younger- never figured it out until they tested so sensitive to ragweed:)

 

Good luck in your decisions- I would not fret Zyrtec or Nasonex. I'm a avid fan of allergy shots and how my son improved. PITA for scheduling but worth every shot (for us). My son had to do shots for 5 years, whereas, allergist states she usually only has to do it for 3 years...he was so allergic to so many things she knew he would take longer.

 

 

This was really, really helpful. Thank you so much for typing all this out for me. It makes me feel better about the treatment plan the allergist outlined (minus the Singulair). I have been overwhelmed since yesterday trying to sort out everything I just learned. Thanks again!

Edited August 13, 2011 by kdnc5716

[Clare]

The allergist recommended that we start three medicines daily: Zyrtec, Singulair, and Nasonex. The Zyrtec can then be removed after a couple weeks. I'm hesitant about the Singulair, because the doctor admitted that it can have behavioral side effects. Any thoughts about any of these meds? My son has never been on a daily medicine (aside from antibiotics when sick and multivitamins), so I'm nervous! Might any of these things exacerbate his tics?

 

Also, my son's tics have been waning the last couple weeks, and then today they flared back up again (facial grimacing, clucking, humming). Could this be from the allergy testing yesterday? It's weird to me that he didn't tic during the test, but he did tic starting first thing this morning. I guess he still has the welts on his arms though.

 

Oh, and this leads me to my final question: what do you all think about allergy shots? The doctor highly recommended them, so we can try to contain his asthma symptoms and eventually have him on less or no allergy meds. It's a big commitment though, and I was wondering whether they will cause his tics to worsen? Does anyone know about this?

 

 

My older son did allergy shots for 5 years. It was the best thing we ever did. Yes, it is a big commitment but the results are worth the investment. He seldom, if ever, gets sick, now and does not suffer from allergies, anymore. He suffered from chronic sinus infections prior to shots. Especially, if your child is asthmatic- it will make a positive impact, IMO. My children were not asthmatic, just severe allergies.My son had moderate to severe allergic reactions to nearly every indoor and outdoor allergen tested (much like your son, it seems:( Both my children have taken Zyrtec and Nasonex next over the years with no increase in tic behaviors noted. Great combo for allergy symptom relief. Our allergist who is one of the smartest women/docs I know states she has never recommended Singulair. Lots of side effects for very little benefit in her opinion.

 

I would say yes, the allergy testing flared his tics. The intradermal and scratch testing causes a big allergic reaction/histamine release. The shots should not do that. Start out with small,minimal amounts of meds and build up slowly. Immunotherapy that makes them desensitized to the allergens.Serums change and increase over time. You have to be committed and stay on schedule for best results.

 

Allergists don't typically highy encourage shots unless they are really needed. They will try med managment first unless you have a child like yours that is highly alllergic to so many thing and asthmatic to boot. Med management failed on my older son but works on my younger son- he was not nearly as allergic as my older one.

 

Word to the wise- we are getting into ragweed season- if child has ragweed allergy- they will likely react neagativley to any lopes and melons (cantelopes, honeydew and watermelon). They are in the ragweed family- believe it or not!! Best to avoid these foods even if they don't test positive to them. My sons tested negative but always threw up after eating cantelope when they were younger- never figured it out until they tested so sensitive to ragweed:)

 

Good luck in your decisions- I would not fret Zyrtec or Nasonex. I'm a avid fan of allergy shots and how my son improved. PITA for scheduling but worth every shot (for us). My son had to do shots for 5 years, whereas, allergist states she usually only has to do it for 3 years...he was so allergic to so many things she knew he would take longer.

 

 

This was really, really helpful. Thank you so much for typing all this out for me. It makes me feel better about the treatment plan the allergist outlined (minus the Singulair). I have been overwhelmed since yesterday trying to sort out everything I just learned. Thanks again!

[kdnc5716]

Clare, I can't see your reply for some reason, only the posts you quoted. I would love to hear your thoughts! :-)

[Clare]

Sorry...don't know why my reply didn't "post"... this may be too much info...but here's our story...

 

On Thursday, March 3, 2011, my previously healthy DS11 came home from school saying he didn't feel well and that his history teacher had even commented that he looked extremely pale and asked if he was feeling okay. I kept him home from school the next day because he still looked very pale (not hard since he is very fair...red hair/blue eyes). He was no better on Saturday, March 4, 2011, my DH took him to the pediatrician...no diagnosis other than "a virus". From there it went downhill, fast.

 

On Monday, March 7, he started coughing and for two months he did not stop coughing...every 10-20 seconds all day long. Of course, he couldn't go to school not only because he couldn't control it but his body ached from the constant coughing...he couldn't reach for anything or lift anything heavy because his ribs hurt so much. Then he developed reflux as a result of the coughing. Then, one of the doctors suggested breathing techniques to combat the cough, the result was that he starting swallowing air and his cough turned into burping....all day long. That was in late April/early May.

 

Anyway, our pediatrician seemed to think I was suffering from Münchausen syndrome by proxy or hysteria since I insisted on taking him to one specialist after another. Our pediatrician was definitely frustrated-- during one visit, she ignored my presence and told my DS to "just stop coughing", prescribed muscle relaxers and suggested that "mom might benefit from these, too." Finally, after my DS had been out of school for 3 weeks, I asked our pediatrician to sign off on a homebound education plan. She spoke with the school guidance counselor who then canvassed my son's teachers. The conclusion was that because he was such a good student that he would be able to catch up. Plus, the pediatrician said that she didn't want to see my DS further isolated from his friends and the sooner he got back in the routine of going to school, the better. So, she would not sign off on the homebound education plan which meant we had to wing it. (Fortunately, my son's teachers were a great help during this time.) The pediatrician also told me that I should "get used to the coughing and that it is now a new way of life for my DS". I couldn't believe what I was hearing. I told her that i absolutely refused to believe it. I was shocked, upset, defeated, furious, disappointed, stunned...need I say more. The upshot was my DS was designated as a "truant" from school. So, I worked closely with the school to get his attendance record updated with "excused" days for doctor's visits but when I asked our pediatrician to sign off on other days (e.g. out of school on a Friday but saw the doctor on Saturday), she wouldn't.

 

By early May, I had hammered away at the pediatrician enough to convince her that my ds cough/burp could be a tic and that he might have PANDAS. At the same time, I went to a new allergist who, thankfully, didn't rule out the idea of PANDAS when I suggested it. He also found that along with seasonal allergies, my son is highly allergic to dust mites. He thinks that my son's allergies might have triggered his immune system to have a PANDAS "response" and recommended that we seriously consider immunotherapy. (We are still on the fence about that and will start his allergy meds...zyrtec, nasonex, nasal rinse... before the fall allergies get into full swing.) So, in late April, my ds began taking Keflex (cephalexin), singulair, nasonex, and clonidine (for the tic). After being on Singulair for two weeks, I was convinced that he was suffering from the side effects...he was angrier than ever, seemed to be getting more depressed, sleepwalking a ton...so he stopped taking singulair. By the second week in May, my ds was able to go back to school...no cough!!!! I should add that in late May, my ds was diagnosed with a raging ear infection in both ears. Since he had already been on a hefty dose of antibiotics, he received a daily shot, for three days, of Rocephin( Ceftriaxone).

 

The good news is that my son finished the year out with all A's and was promoted. The day school ended, we switched to a "pandas-friendly" pediatrician!

 

By the end of June, my son was off all meds. So far, so good. He still has some residual anxieties and I was finally able to get him into our local child/family psychiatric group in late July. While they were reluctant to agree about the PANDAS diagnosis, they agreed that he demonstrated borderline OCDish behavior and had some anxiety issues. The md felt my ds may see some benefit from an SSRI and CBT. We are due to go back next week to discuss.

 

My son's PANDAS symptoms were:

• sudden onset of tic...coughing all day long, stopped the moment he went to sleep and started the moment he woke up. (His cough became so bad that he developed reflux. The m.d. tried to show him some breathing techniques, but, the result was he learned to swallow air and his cough morphed in burping, aka aerophagia.)
• crazy nightmares/sleepwalking/sleeptalking (I was up with him sometimes 5-7/night)
• had a need to "stomp" while taking a shower
• silently repeats sentences without realizing it
• extremely sensitive to light & sudden/loud noises
• quick to anger
• afraid to be alone on another floor of our house
• freaking out over dog hair (we have a big, yellow lab that sheds everywhere)

So, basically, I spent two months ruling things...my son was scoped, xrayed, asthma/allergy tested, upper GI, pulmonary function, the list goes on. He was prescribed steroids, inhalers, cough suppressants (made his cough worse), antibiotics (azith, augmentin, amoxicillin, keflex, rocephin)...you name it. He was seen by three ent's, an er visit, a ped gi, three asthma/allergists, a speech language pathologist, two different psychologists, and a ped psychiatrist. His strep titers were only slightly elevated, he never tested positive for strep even though I had him in the ped's office many times in the 6-8 months prior to March. Whooping cough test came back negative. Although, the one thing he has still not been tested for is Lyme. How did I miss that one? The only diagnosis was "vocal cord paresis" (observed in early March; has since healed; related to all this?) and allergies (seasonal & dust mites). Of course, I am very nervous about the fall allergy season. I am also wondering about Lyme and may get him tested, if it's not too late given all the antibiotics he has taken. Plus, I am very suspicious of the role of the DTap booster and flu mist he received last fall. Maybe the vaccines, seasonal & dust mite allergies, and exposure to strep all contributed to his PANDAS episode. If his PANDAS flares up again this fall, even while taking Zyrtec and Nasonex, we may start the shots rather than try Singulair again. (By the way, I should have mentioned my son is a twin. His twin sister is rarely sick...she had the same vaccines, at the same time and she does not have any allergies.)

 

So, this has been a long way of answering your post. I believe that my son, almost from the get-go, suffered the side effects of Singulair. I am glad we stopped the Singulair and continued with the Zyrtec and Nasonex along with the Clonidine and antibiotics. I think that is what stopped his tic.

[911RN]

On Monday, March 7, he started coughing and for two months he did not stop coughing...every 10-20 seconds all day long. .

 

By early May, I had hammered away at the pediatrician enough to convince her that my ds cough/burp could be a tic and that he might have PANDAS. At the same time, I went to a new allergist who, thankfully, didn't rule out the idea of PANDAS when I suggested it. He also found that along with seasonal allergies, my son is highly allergic to dust mites. He thinks that my son's allergies might have triggered his immune system to have a PANDAS "response" and recommended that we seriously consider immunotherapy. (We are still on the fence about that and will start his allergy meds...zyrtec, nasonex, nasal rinse... before the fall allergies get into full swing.) .After being on Singulair for two weeks, I was convinced that he was suffering from the side effects...he was angrier than ever, seemed to be getting more depressed, sleepwalking a ton...so he stopped taking singulair. [/b]By the second week in May, my ds was able to go back to school...no cough!!!! I should add that in late May, my ds was diagnosed with a raging ear infection in both ears. Since he had already been on a hefty dose of antibiotics, he received a daily shot, for three days, of Rocephin( Ceftriaxone).

 

By the end of June, my son was off all meds. So far, so good. He still has some residual anxieties and I was finally able to get him into our local child/family psychiatric group in late July. While they were reluctant to agree about the PANDAS diagnosis, they agreed that he demonstrated borderline OCDish behavior and had some anxiety issues. The md felt my ds may see some benefit from an SSRI and CBT. We are due to go back next week to discuss.

 

The only diagnosis was "vocal cord paresis" (observed in early March; has since healed; related to all this?) and allergies (seasonal & dust mites). Of course, I am very nervous about the fall allergy season. Maybe the vaccines, seasonal & dust mite allergies, and exposure to strep all contributed to his PANDAS episode. If his PANDAS flares up again this fall, even while taking Zyrtec and Nasonex, we may start the shots rather than try Singulair again.

 

So, this has been a long way of answering your post. I believe that my son, almost from the get-go, suffered the side effects of Singulair. I am glad we stopped the Singulair and continued with the Zyrtec and Nasonex along with the Clonidine and antibiotics. I think that is what stopped his tic.

 

Clare,

My son also developed cough tic following Strep in the Spring- it was the one thing that got my Peds on board that PANDAS was a possibility?? That and he had so many sudden onset motor tics it made Peds crazy just to be in the same room with him!! He took 90 days of high dose Azithro and the cough ticccing and other motor stopped within days! Ever changing, non debilitating OCD behaviors persist but improving on SSRI. Has been on Prozac for 10 weeks, now. Tolerating well with improvments. Only side effects has been night time teeth grinding.

 

We have never done Singulair- for reason stated in last post- Allergist doesn't like it nor recommends it. He only takes Nasonex and Zyrtec as needed which he tolerates fine.

 

If your child suffers dust mite allergies- make sure you have dust mite resistant pillow and mattress covers, no stuffed animals in room and wet dust room weekly. It will make a big difference in their allergy smptoms. Also, open windows in house are a no, no. My allergist told me we are not going to be the open the windows for fresh air type family. Go directly from heat to air and vice versa.If we open windows- we pay the price- not worth it. If we try- my entire household is sniffing and snorky in the morning. All reaching for the Zyrtec

 

Sounds like you went through a similar he!@ that we did last Spring- glad your son is doing better. Although, I had a supportive Peds that "took a leap of faith" with me. That, in itself, was a life saver as your story points out! As stated in last post- if your son is highly allergic to multiple things- allergy shots are the bomb. If not, kids can usually be med managed. Especially, if it is mainly dust mites- environmental changes can have a strong impact on that.

[Clare]

On Monday, March 7, he started coughing and for two months he did not stop coughing...every 10-20 seconds all day long. .

 

By early May, I had hammered away at the pediatrician enough to convince her that my ds cough/burp could be a tic and that he might have PANDAS. At the same time, I went to a new allergist who, thankfully, didn't rule out the idea of PANDAS when I suggested it. He also found that along with seasonal allergies, my son is highly allergic to dust mites. He thinks that my son's allergies might have triggered his immune system to have a PANDAS "response" and recommended that we seriously consider immunotherapy. (We are still on the fence about that and will start his allergy meds...zyrtec, nasonex, nasal rinse... before the fall allergies get into full swing.) .After being on Singulair for two weeks, I was convinced that he was suffering from the side effects...he was angrier than ever, seemed to be getting more depressed, sleepwalking a ton...so he stopped taking singulair. [/b]By the second week in May, my ds was able to go back to school...no cough!!!! I should add that in late May, my ds was diagnosed with a raging ear infection in both ears. Since he had already been on a hefty dose of antibiotics, he received a daily shot, for three days, of Rocephin( Ceftriaxone).

 

By the end of June, my son was off all meds. So far, so good. He still has some residual anxieties and I was finally able to get him into our local child/family psychiatric group in late July. While they were reluctant to agree about the PANDAS diagnosis, they agreed that he demonstrated borderline OCDish behavior and had some anxiety issues. The md felt my ds may see some benefit from an SSRI and CBT. We are due to go back next week to discuss.

 

The only diagnosis was "vocal cord paresis" (observed in early March; has since healed; related to all this?) and allergies (seasonal & dust mites). Of course, I am very nervous about the fall allergy season. Maybe the vaccines, seasonal & dust mite allergies, and exposure to strep all contributed to his PANDAS episode. If his PANDAS flares up again this fall, even while taking Zyrtec and Nasonex, we may start the shots rather than try Singulair again.

 

So, this has been a long way of answering your post. I believe that my son, almost from the get-go, suffered the side effects of Singulair. I am glad we stopped the Singulair and continued with the Zyrtec and Nasonex along with the Clonidine and antibiotics. I think that is what stopped his tic.

 

Clare,

My son also developed cough tic following Strep in the Spring- it was the one thing that got my Peds on board that PANDAS was a possibility?? That and he had so many sudden onset motor tics it made Peds crazy just to be in the same room with him!! He took 90 days of high dose Azithro and the cough ticccing and other motor stopped within days! Ever changing, non debilitating OCD behaviors persist but improving on SSRI. Has been on Prozac for 10 weeks, now. Tolerating well with improvments. Only side effects has been night time teeth grinding.

 

We have never done Singulair- for reason stated in last post- Allergist doesn't like it nor recommends it. He only takes Nasonex and Zyrtec as needed which he tolerates fine.

 

If your child suffers dust mite allergies- make sure you have dust mite resistant pillow and mattress covers, no stuffed animals in room and wet dust room weekly. It will make a big difference in their allergy smptoms. Also, open windows in house are a no, no. My allergist told me we are not going to be the open the windows for fresh air type family. Go directly from heat to air and vice versa.If we open windows- we pay the price- not worth it. If we try- my entire household is sniffing and snorky in the morning. All reaching for the Zyrtec

 

Sounds like you went through a similar he!@ that we did last Spring- glad your son is doing better. Although, I had a supportive Peds that "took a leap of faith" with me. That, in itself, was a life saver as your story points out! As stated in last post- if your son is highly allergic to multiple things- allergy shots are the bomb. If not, kids can usually be med managed. Especially, if it is mainly dust mites- environmental changes can have a strong impact on that.

[Clare]

We got the dust mite resistant casings for all of us! Plus, we have a humidity monitor in my son's room. We do keep our windows closed all year long, although it drives my husband crazy. We have been renting our house since we moved here two years ago and my son's bedroom has carpeting. We recently decided to buy this house so one of the first things we are going to do is tear up the carpeting. Thanks for the words of wisdom. It does take a village.

[kdnc5716]

Thank you so much for typing out your story, Clare!! I really appreciate it. It's so helpful to hear what worked and what didn't. (Glad you found a new pediatrician, by the way. I can't believe the way she treated you. It made me so frustrated just reading about it!) I'm pretty confident now that I want to stay away from Singulair if I can. I started him on the Zyrtec, and I'm waiting for insurance to get sorted out with the Nasonex. I talked with my husband and I think we are going to go ahead and start the immunotherapy, too. I bought allergy reducing pillows, and I'm looking for a decent mattress encaser. We are going to replace the window in his room (it's broken and lets in outside air). We want to buy a HEPA filter for his room, too. (I'd love recoommendations if you have one!) I'm really hoping that getting his allergies under control will help his tics a bit!

 

Again, I genuinely appreciate both of your responses. I love the support I've found here! :-)