Dd strep pos. today: nurse swabbed differently

[thenmama]

The bad news is dd, who has had some PANDAS uptick this weekend and woke today complaining of a sore throat, tested positive for strep this afternoon. The good news is that we actually got the positive and confirmed it for a change! My kiddos NEVER come up positive-- even when dh had confirmed strep and they had sore throats and were totally PANDAS-tweaked (the docs treated them anyway, of course, and they both responded). Both of them have overactive gag reflexes and don't do well with the swab-- they always pull away (instinctually, I mean, they do try to cooperate). Dd mentioned that to the nurse before her swab today and the nurse suggested they try it lying down, so she wouldn't pull away b/c her head would be resting on the table and maybe they could get it right the first time. I can't imagine how we've never tried this before; it seems so obvious. It was a much easier and faster process this way. I was expecting the doctor to come back as usual and say it was negative and probably viral (especially since she's on Augmentin). But to my surprise--she came in and told us it was positive! It made us wonder if it wasn't just a coincidence that she tried lying down for her swab for the first time today. Dd said this feels just like all of the other sore throats she gets. The ped flagged her chart with instructions to make sure they swab her this way every time.

 

Anyway, just thought I'd share in case it might help someone else whose kiddo has difficulty being swabbed.

[EAMom]

The bad news is dd, who has had some PANDAS uptick this weekend and woke today complaining of a sore throat, tested positive for strep this afternoon. The good news is that we actually got the positive and confirmed it for a change! My kiddos NEVER come up positive-- even when dh had confirmed strep and they had sore throats and were totally PANDAS-tweaked (the docs treated them anyway, of course, and they both responded). Both of them have overactive gag reflexes and don't do well with the swab-- they always pull away (instinctually, I mean, they do try to cooperate). Dd mentioned that to the nurse before her swab today and the nurse suggested they try it lying down, so she wouldn't pull away b/c her head would be resting on the table and maybe they could get it right the first time. I can't imagine how we've never tried this before; it seems so obvious. It was a much easier and faster process this way. I was expecting the doctor to come back as usual and say it was negative and probably viral (especially since she's on Augmentin). But to my surprise--she came in and told us it was positive! It made us wonder if it wasn't just a coincidence that she tried lying down for her swab for the first time today. Dd said this feels just like all of the other sore throats she gets. The ped flagged her chart with instructions to make sure they swab her this way every time.

 

Anyway, just thought I'd share in case it might help someone else whose kiddo has difficulty being swabbed.

 

good suggestion!

 

 

but yikes on the positive swab, despite being on abs! What dose of Augmentin is she on (and how much does she weigh)? Is she getting the augmentin 2x daily? What ab did they put her on?

does she have her tonsils?

[dcmom]

I have heard- maybe on here- that laying down is less "painful". We haven't tried it.

 

But to EAmom- I had one daughter get strep while on a treatment dose of zith, plus a treatment dose (2x day) of Augmentin. The other daughter was on treatment dose zith plus rifampin at the same time, and got strep.

Neither had their tonsils.

 

This was the point that we kinda gave up on the antibiotics

[thenmama]

She's about 100 lbs and taking 500 mg Augmentin twice a day. She does have tonsils. We're known to have a particularly evasive or virulent strain of strep in these parts. I suppose it could be the particular strep strain around here and/or our particular kiddos' immune systems. Both have some deficiencies. Dd's IgG is low, but not crazy low or absent-- it's been falling in the 500s (the low end cutoff for the lab's ref range is 760). It's her subclass 1 that's low if that is meaningful. She has failing strep pneumo titers but we won't do the vax challenge b/c vax have sent her into exacerbation in the past. She's at the low normal limits for IgA. Her IgM was also low/out of range. We just got her immune testing done this spring-- after our ds was found to have deficiencies and she'd been getting sick about once a month.

 

Anyway, the ped we saw today, who is our pinch hitter when we can't get in to see our primary, put dd on a course of Clinda, so she's got something to take for this while we catch up with the rest of our doc squad...

 

 

Really appreciate our great nurse today, though. The one time it's good for a PANDAS kid to test positive for strep is when she has strep.

[EAMom]

We're known to have a particularly evasive or virulent strain of strep in these parts. I suppose it could be the particular strep strain around here and/or our particular kiddos' immune systems.

 

yeah, that is the big question! is it the nasty strains of strep (pehaps worse than 30 years ago, and it sounds like your area/ DC is esp. bad)...or the fact that PANDAS kids have bad immune systems against strep.

 

And is the "bad immune system against strep" something that causes the PANDAS in the first place ("bad immune system against strep" causes more strep infections, and more strep infections lead to PANDAS)? or is it that the unlucky kid gets the wrong strain of strep, and once the wheels of PANDAS are set in motion (autoimmunity, the immune system attacking the basal ganglia instead of the strep), these kids develop a vunerability to future strep infections/lose the ability to "fight" strep in a normal and productive manner? In other words, is the "bad immune system against strep" the cause (or one of the causes), or the result of PANDAS?

Edited June 4, 2012 by EAMom

[ptcgirl]

I will use this technique with my dd the next time she needs to be checked. although, our drs locally don't really ever want to check her anyway. "She's on abx.... She couldn't possibly have...." I'm so tired of crappy doctors. If I ask them to check, they should check!