Strep while recovering from t and a surgery

[thereishope]

It seems like a lot of our kids got strep shortly after t and a surgery. I'm curious how many. My son tested + one month after. As usual, no classic symptoms, just behavioral.

[nojo]

It seems like a lot of our kids got strep shortly after t and a surgery. I'm curious how many. My son tested + one month after. As usual, no classic symptoms, just behavioral.

 

We we positive, probably during the surgery. She definitely had it during the recovery, and was very sick.

[P_Mom]

no strep during recovery here.

[bronxmom2]

No strep (I don't think), but VERRY difficult recovery (three full weeks of acute pain)... which I've heard is not unusual for PANDAS kids or kids with very enlarged/encrypted tonsils.

[peglem]

Mine did get strep during recovery, but I don't think the surgery had anything to do with it- she ALWAYS had strep. The only thing is, once the course of abx was finished after surgery, it was assumed that she wouldn't get strep much anymore, so no prophylaxis was prescribed and, since her throat was still sore from surgery, nobody wanted to swab it and possibly knock open a scab. After a few months, she was the worst she's ever been!

[thereishope]

That's what I'm trying to figure out. I don't think the surgery is the reason he got strep so fast, but I've wondered if he had a small amount of strep in his tonsil area still then once they did surgery, it was exposed then multiplied. What totally throws off that reasoning for me is that he was 100% back to being himself presurgery. So if strep was still hiding out, he shoudln't have gone back to 100%. Maybe I'm just trying to find reason where there is no reason. I tend to do that. I'm a big overthinker.

 

I know one PANDAS teenager who says when she had her tonsils out, she continued to get + strep tests for months. Maybe she even said a year. Then, suddenly it went away and she hasn't had strep in a couple years. Obviously that's what I'm hoping for. He'll just stop getting it.

[Suzan]

I'm pretty sure that after my dd's t&a, this is when she stopped getting strep in her throat. She has not had it again since the surgery, but of course she still gets strep, just other places.

 

This did make me remember that after her ear tubes, she did continue to get ear infections but at least I knew when she got them and could treat them right away. I know totally unrelated to what you are asking about though.

 

Susan

[dcmom]

I didn't have dd tested after T&A because we did antibiotics regardless, but

 

she was about 99% better before T&A (for a month and a half),

 

and then exacly one week after surgery she woke up in a full blown episode.

 

So something happened- I think she was probably exposed during surgery.

 

I would still do it again- I am glad the tonsils are out

[colleenrn]

My daughter was strep free/PANDAS symptom free for exactly 1 1/2 glorious years after her T & A. It was so wonderful, until she woke up one morning with her symptoms back again.

 

My son was less clear to me when he started getting strep after his T & A. His symptoms were and are still harder to figure out than his sister's b/c his are much more ADHD/emotional/behavioral stuff, so it is harder to figure out. With my daughtrer it was much easier to figure out b/c she would immediately begin with tics and repeating the same phrases over and over and over again.

 

I did not do this with either of my children pre and post T & A, but really wish I had and would do it this way if my other kids needed them removed. I would have them on antibiotics ( a full treatment dose of Zithromax) 2 weeks before and two weeks after surgery. They usually cannot remove 100% of the tonsils/adenoids. The more skilled the surgeon, the better chance you have, but if any strep is anywhere in the body, it can just recolonize. That may be what has happened with some of these children.

Colleen

[peglem]

My daughter was on full strength omnicef for 21 days prior to surgery and on amoxicillan for 14 days after...then the strep came raging back.

[dcmom]

Colleen-

 

My daughter was on daily zithromax 10 days before, and 5 days after T&A. Possibly that was holding the strep at bay, and when we went to prophylactic dose- a few days later a pandas episode. Unfortunately for the next month and a half, I only had twice per week zith (both doctors were not available), so we just dealt with the episode, until she did steroids and 10 days of zithromax.

 

Collen- what dose are your kids on (my daughter is about 36lbs)? Right now my dd is on 200mg, 2x week. She is doing okay, but we are just not getting to 100%. We are pursuing pex, but I am thinking of upping her abx until then, to see if it helps. What and how long would a treatment dose be, and what type of maintenance dose are you kiddos on? Does this squash all of their symptoms? If you back off, do the symptoms return? (I guess I am thinking of Saving Sammy here, and what helped him...)

 

thanks,

 

Eileen

[colleenrn]

My three oldest children are on Zithromax 250mg/day and have been now for exactly one year (as of 2 days ago). The times I have cut back to 125mg/day I have seen symptoms creeping back. My kids on Zith are 6, 8, and 13. The 6 yo weighs 46 lb.

 

Treatment dose is usually given at 250mg/day for 5 days, BUT I have posted a few times about this. My sister's very conservative pediatrican says that new research shows when treating strep you need to take Zithromax 500mg/day for 5 days. I can't find that research anywhere- have spent hours trying to find it. I am trying to get my sister to ask her doc for more info on that new research.

 

Eileen-

The 500mg/day would be too much for your 36 lb. child. A treatment dose (12mg/kg/day) would be 196mg/day, so 200mg/day. B/c 200mg/day is a treatment sized dose for your child, you could see about giving 200 daily for 10 days and see if there is an improvement. I know some people are dosing only 2x/week, but my gut tells me that is just not enough. What about every other day?

 

Colleen

[dcmom]

Colleen- thanks.

 

When her pandas remitted from zithromax, it was at the dosage you said 200mg/day, it took 30 days. I think I may start that now.

 

When you say every other day, are you thinking 200mg. I guess it is trial and error. If I go up to 200mg/day and see improvement, stay there a while? then start to very slowly pull back?

 

What is your gut feeling on this- why is the daily zith what your kids need? Do you think they have an ongoing strep infection? Or is it the immune modulation properties of the zith with the prophylactic that helps them not contract strep?

 

We are working on getting her pex. If there is no ongoing infection, and we can prevent further infection, theoretically it should work. But, is there an underlying infection that we are not clearing?

 

Tired of questions Want answers

[colleenrn]

Yes, every other day at 200mg. Yes, if you see an improvement on 200/day, I would stick with that for a while, and then slowly decrease. It really is trial and error at this point. You could do 100mg/day everyday. You could try 200mg every other day. I am not sure. If it were me, I think I would do 200mg/day for 3-4 weeks, then decrease to 200mg every other day.

Colleen