It has been a hive-filled week at our house. Jersey #5 had an allergic reaction to the antibiotics he was given for his sinus infection. He started a series of Amoxicillin last Wednesday. When I gave him his morning dose on Saturday, within 20 minutes, he looked like this.....
I knew it was hives right away. What I did not know is that it was an allergic reaction. Sure, the thought crossed my mind. But, I quickly ruled it out for a few reasons. First, he has taken Amoxicillin at least once (possibly twice) before, with no problems. Plus, no one in our immediate family has any food or medicine allergies, so this is not a common issue for us. Considering he has been sick for nearly 3 weeks, and considering he had been running a fever for the better part of the past 3 days, I really thought he was just having a skin issue from all the illness.
So, I gave him his mid-day dose on schedule.
We then loaded up in the car and spent the day at basketball functions. I watched a new set of hives appear and merge with the older set all throughout the afternoon. He was certainly allergic to Amoxicillin, no doubt about it!
This is what his hives looked like at bedtime. He even had some on his forehead. Most were on his torso and legs.
So, I gave him his mid-day dose on schedule.
We then loaded up in the car and spent the day at basketball functions. I watched a new set of hives appear and merge with the older set all throughout the afternoon. He was certainly allergic to Amoxicillin, no doubt about it!
This is what his hives looked like at bedtime. He even had some on his forehead. Most were on his torso and legs.
I knew he was having an allergic reaction. I knew that any more exposure to the allergen would cause an even bigger reaction. So, I knew we had to immediately stop giving him the medication. I did not know if or when he needed to see a doctor to verify and document this medication allergy. I called a friend who has children with allergies, to get some wisdom from her experiences. I then called the nurse hotline to inquire about when to see the doctor, and also to get the correct dose of Benedryl for his weight.
The nurse who answered was very friendly. She took down all of his information and the details of his hive situation. She entered all that I told her into a medical database and out popped a recommendation.
To my shock, the recommendation was to continue giving him the medicine until he could be seen by a doctor. The suggested timeline was to see a doctor within 24 hours.
I could not contain my shock, and actually blurted out, "You've got to be kidding me!" Even the nurse seemed a bit surprised. She carefully read every word on her computer screen, which said that because his hives did not itch, it should be assumed that the rash he has is actually a non-allergic Amoxicillin rash that 5-10% of children get. I argued that he did not have a rash, but indeed had hives. She argued that hives itch, so it must not be hives. She also told me to not give him Benedryl, since it was not an allergic reaction. I could not contain my disbelief. To add comfort, she assured me that a doctor may later tell me it was an allergic reaction, but until then, I should assume it was not.
Before becoming a stay-at-home-Mom, I worked for 4 years in biomedical research.....in an immunology laboratory! I understood the basics of an allergic response. More exposure to an allergen yields a larger allergic response! I attempted to explain to the nurse that if my son was allergic to the medication, then giving him more doses will cause a larger reaction in him, which could even be fatal. She agreed with me, and suggested that I watch him closely for signs of swelling and trouble breathing.....and if that happened to rush him to the Emergency room!
I was nearly speechless, so I quickly thanked her and got off the phone. I then attempted to process this horrible advice. On a Saturday night, when there were no doctor clinics available, I was advised to continue giving my son a potential allergen, and watch for signs of emergency. And the only reason I was told to do this is because a nurse did not believe I could identify hives, and a computer database states that hives must itch.
I marveled at the stupidity of it all. I decided that there was no reason to err on the side of creating an emergency. Instead, I halted the medication, looked up the benedryl dose on a pediatric site on the internet, and resolved to wait until Monday to try to get an appointment with our family doctor. If the hives were gone by Monday, and a doctor needed to see them in order to verify an allergy, then that experiment would have to be done during business hours at a medical facility.
This is what the hives looked like on Sunday morning. Many had grown together in large blotches, and were warm to the touch.
The nurse who answered was very friendly. She took down all of his information and the details of his hive situation. She entered all that I told her into a medical database and out popped a recommendation.
To my shock, the recommendation was to continue giving him the medicine until he could be seen by a doctor. The suggested timeline was to see a doctor within 24 hours.
I could not contain my shock, and actually blurted out, "You've got to be kidding me!" Even the nurse seemed a bit surprised. She carefully read every word on her computer screen, which said that because his hives did not itch, it should be assumed that the rash he has is actually a non-allergic Amoxicillin rash that 5-10% of children get. I argued that he did not have a rash, but indeed had hives. She argued that hives itch, so it must not be hives. She also told me to not give him Benedryl, since it was not an allergic reaction. I could not contain my disbelief. To add comfort, she assured me that a doctor may later tell me it was an allergic reaction, but until then, I should assume it was not.
Before becoming a stay-at-home-Mom, I worked for 4 years in biomedical research.....in an immunology laboratory! I understood the basics of an allergic response. More exposure to an allergen yields a larger allergic response! I attempted to explain to the nurse that if my son was allergic to the medication, then giving him more doses will cause a larger reaction in him, which could even be fatal. She agreed with me, and suggested that I watch him closely for signs of swelling and trouble breathing.....and if that happened to rush him to the Emergency room!
I was nearly speechless, so I quickly thanked her and got off the phone. I then attempted to process this horrible advice. On a Saturday night, when there were no doctor clinics available, I was advised to continue giving my son a potential allergen, and watch for signs of emergency. And the only reason I was told to do this is because a nurse did not believe I could identify hives, and a computer database states that hives must itch.
I marveled at the stupidity of it all. I decided that there was no reason to err on the side of creating an emergency. Instead, I halted the medication, looked up the benedryl dose on a pediatric site on the internet, and resolved to wait until Monday to try to get an appointment with our family doctor. If the hives were gone by Monday, and a doctor needed to see them in order to verify an allergy, then that experiment would have to be done during business hours at a medical facility.
This is what the hives looked like on Sunday morning. Many had grown together in large blotches, and were warm to the touch.
By Monday morning, the hives were disappearing rather nicely. They were much lighter in color, and much smaller in size.
I managed to get an appointment with our family doctor for the early afternoon. I decided to email the earlier pictures to him in advance, so that he could see how things looked during the weekend, for comparison.He did not have a chance to check his email before our visit. He walked into the room, looked at Jersey #5 sitting on the exam table in a diaper, and exclaimed, "Boy! Look at those hives!"
Well, that settles it. I really do know what hives are! I was all prepared to defend my case, and there was no reason to do so. I gave Dr. S the brief run-down of events that lead up to our clinic visit that day. He chuckled at my initial disbelief about the allergic response and giving a 2nd dose. He nodded about the hives getting worse due to that 2nd dose. He gasped at the advice I was given from the nurse hotline. After I told him what I chose to do instead, he very seriously said, "You did the right thing." Then, he shook his head as he processed it all. He told me that hives are pretty distinguished so there was no reason to assume I could not identify them. He said they do not always itch. He said the medical database that the nurse line uses must have an algorithm that declares hives must itch in order for them to give such illogical advice. He then examined Jersey #5 and discovered that in addition to his sinus infection that started this whole adventure, he also has an ear infection and bronchiolitis (which was causing wheezing in his upper chest).
Dr. S explained that Jersey #5 can no longer have Amoxicillin. And, since we will tell everyone that he is allergic to Amoxicillin, odds are high that no provider will give him Penicillin either. But, rest assured, there are many antibiotics available, so all should be well. He prescribed a new antibiotic that was not from the Penicillin family.
Jersey #5 woke up with hives the very next morning following that first dose of the new antibiotic.....
So, it is back to the drawing board we go...
Poor Jersey #5. I am in shock at the advice given to continue the medication and NOT give benadryl. A toddler isn't going to be able to verbalize whether or not those hives itch, so it seems to me that you should assume that they do and halt the potential allergen, rather than keep giving it and potentially cause an anaphylactic emergency.
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