From: sjk@strl.labs.tek.com (Steven King)
Newsgroups: misc.kids
Subject: Re: Preventive Antibiotics (Long)
Date: 4 Jan 93 17:55:48 GMT
Reply-To: sjk@strl.labs.tek.com (Steven King)
Followup-To: misc.kids
Distribution: na
Organization: Software Technology Research Lab, Tektronix, Inc.

In article <29059@oasys.dt.navy.mil>, dsegelho@oasys.dt.navy.mil (Diane Segelhorst) writes:

|> Well, Carrie has her fourth (or is it the fifth) ear infection of the
|> winter.  When her previous one was diagnosed, the pediatrician mentioned
|> the possibility of preventive antibiotics for the rest of the winter
|> if she got another one.  The urgent care doctor diagnosed this latest
|> one the day after Christmas, so he really wasn't prepared to discuss
|> preventive antibiotics.  I'm preparing myself to bring up the subject
|> when she goes back in two weeks for her followup, and her six month
|> checkup.  (Almost a month late because of the back to back infections.)

I'll share our experience with you.  Our son suffered from ear infections
for over six months.  In that time, he was put on Ceclor (developed an
allergy & broke out in hives all over his body), Augmentin (caused his
bottom to bleed from the yeast infection, also set off some food intolerances),
and Gantracin (seems tolerable for his system).  We discovered several
interesting things about ear infections, food allergies, yeast infections
and pediatricians in that time!

Our ex-pediatician is one of the most celebrated in Portland.  He has written
several books, appears on TV talk shows, etc.  He was very arrogant, and 
treated us like we couldn't possibly understand medical science.  His
solution to every problem caused by the antibiotics was yogurt and Caldescene.
He didn't know much about the practical side of child rearing, to be sure.

First off, we discovered that long-term heavy-duty antibiotic usage set off
Patrick's food allergies.  Whenever he ate foods high in carbohydrates (both
simple and complex) his bottom would get sore.  He was cranky whenever he
was on antibiotics.  Before the antibiotics he was a very happy little boy.
The Ceclor (after only three days worth) caused a case of hives that lasted
one month, even with the constant use of bendadryl.  To cure the bleeding
buttocks, we did the following:

o Visited a applied-kinesiologist for food allergy testing.  If we followed
  the recommended diet AND did the following activities, then his bottom
  would clear up within 12 hours of the first sign of redness.  We would
  have preferred an M.D. allergist who performs P/N testing, but couldn't
  find any in the PDX area.  The recommendations of the kinesiologist did
  make a difference, in any case.

o Supplemented his diet with Calcium.

o Supplemented his diet with Acidopholis and Bifidus.  I purchased these in
  powder form at the local Natures Fresh NW grocery store.  We found that
  the yogurt or kiefer drink with Acidopholis didn't help (which is what
  the Ped. recommended).  The Bifidus is the prevelant bacteria in a childs
  gut.  The ratio starts to change at about 2yo to a higher percentage of
  Acidopholis.

o Dry his bottom with a warm hair dryer.  This was recommended by a ped.
  nurse friend (who is also a mother of a 4yo and 2yo).  This helps to
  dry the lower layers of the skin, inhibiting the growth of yeast.

o The combination of over-the-counter yeast medicine (Monistat) and
  cornstarch powder worked the best for Patrick.  Caldescene did nothing.
  Vaseline made things worse.  (Many people recommmended the Vaseline, so
  you might try it once you dry your daughters bottom.  The Ped. simply
  recommended Caldescene - what a bozo!)

o Settled on Gantracin as the med. of choice.  This caused the least
  irritation to his system (although he would still have yeast infections
  if we didn't modify his diet AND use the Monistat/Corn starch/hair dryer
  combination.

We read a couple of books on childhood allergies.  These were very helpful
and gave us hope (since the Ped. didn't exactly make us feel confident).
We kept a journal of what we tried and when we tried it.  By tracking his
progress we were able to pinpoint some causal relationships between
treatment and reaction.  (I HIGHLY recommend you do this.  It helped us
to control the side-effects of the antibiotics within a months time.)
The books we read are: "Childhood Ear Infections", Micheal Schmidt M.D.,
North Atlantic Books and "Is This Your Child?", Doris Rapp M.D.

While we hoped that the diet modifications, which were extremely limiting,
would help clear up the infections, they did not.  They did help him with
his attitude and his yeast infections, however.
 
|> What have people's experiences been with preventive antibiotics?  Brad
|> was on them for a month or so, but it was near the end of the winter.
|> He didn't get any more ear infections, but with cold season really over
|> by then, he might not have gotten any in any case.  The antibiotics
|> gave him TERRIBLE diaper rash, so that he would cry whenever he had
|> a dirty diaper.  I almost think the preventive medicine was worse than
|> getting another ear infection would have been.

We didn't want Patrick on long-term antibiotics, but the Ped. seemed very
reluctant to refer us to an ENT (our insurance works on primary-care
physician referral only).  After six months of various "breakthoughs"
while on antibiotics, and the constant prodding of Katherine, he relented
and gave us the referral.  He did write a note in Patrick's chart about us
being overly-concerned parents - we found out from the ENT.

At first the Ped. used the rule of "having an ear infection immediately
after antibiotic therapy".  After Patrick passed this test he moved to the
rule of "one ear having fluid at the end of antibiotic therapy".  Once this
requirement was satisfied he tried "having an infection while on prophylactic
antibiotic therapy (one ear)".  Patrick passed this, so he switched to
"having both ears infected while on phophylactic antibiotics".  He never
passed this one.  This constant switching of the rules led us to believe that
his ego was getting in the way and he didn't want to refer us to the ENT.
The note on the chart was further evidence to us that he wanted to avoid
a referral no matter what the health of the patient indicated.

Once we saw the ENT he read Patrick's history and immediately scheduled
surgery for tubes.  This was based upon the fact that: 1) He had broken
through the prophylatic antibiotic and 2) had fluid in the ears at the
end of antibiotic therapy.   To me, this was a better alternative to the
long-term antibiotics (which he would break through anyway).  Katherine was
hoping that the diet alone would solve his problems completely, but that
only seemed to help with his attitude and yeast infections.  BTW: The ENT
told us that we were there for a reason, and given the note about overly
concerned parents he recommended that we switch pediatricians.  We did.

The surgery was a breeze.  We read him a couple of books, including the
Berenstain Bears book on hospital visits.  The anestesiologist used a bright
red balloon for the general anestestic, which Patrick really liked and still
remembers!  They also took him into surgery on a Radio Flyer wagon.  Patrick
really like that touch.

He had the surgery nine months ago, and hasn't had a single ear infection
since.  This was quite a relief from the constant six months of ear
infections.  After about six months of a restricted diet, we found that
some occasional wheat, milk or fruit products wouldn't set off yeast infections
anymore.  While he still cannot tolerate a totally "normal" diet, we can
take him to McDonald's (MaConals in 3yo talk) every once in a while.

He still suffers from some environmental allergies.  They are controlled
with an in-room air filter (Amway brand) and a hudifier heat register.  If
we discontinue either of these Patrick with cough all night and have bags
under his eyes in the morning.  Thank God we can control them!
 
|> On a happier note, Carrie pulled herself up to standing on Christmas
|> day!  I'll bet I've got another early walker.

Yeah!

Learn all you can about ear infections.  Try different methods for curing
the yeast infections.  Hang in there and you'll do just great!

Steven (sjk@strl.labs.tek.com)

"Sometimes if you have a cappuccino and then try again it will work OK."
(Dr. Brian Reid)  "Sometimes one cappuccino isn't enough." (Marcus Ranum)
"A double vanilla latte always works."  (Me)