If your HS student has significant allergies

Parent Cafe
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<p>Spring has arrived in our neighborhood, with fresh grass, and beautiful flowers, and blooming trees, all conspiring to make my 8th grader miserable. His allergist says that puberty can make allergies better, or it can make them worse. My poor eighth grader is definitely in the latter category. Despite taking a pharmacy full of drugs, he’s missed 3 days of school since Easter because of uncontrollable nosebleeds or a cough so loud that I know the nurse will just send him back home. </p>

<p>He’s a kid who loves sports, and sunshine, and being outside, and every year I struggle with deciding how much I restrict him from outdoor activities. His first absence was the Monday after he volunteered to help with a stream clean up at a local zoo. His second and third came after he caddied 21 holes of golf. Even activities that don’t seem like “outdoor” activities can lead to asthma and allergies if he needs to walk there or wait at an outdoor bus shelter for a public bus. I know that if I stopped him from doing these things, his attendance would go up, but I also think his happiness would go down, and that’s important too. Up until this year, I’ve definitely picked happiness over school, but I feel like 9th grade “counts” in a way that middle school doesn’t and I worry about the impact on his grades of so many absences. His allergist is definitely on the “let him be a kid” side, but she’s not the one getting letters from the school about him having more than 20 absences. </p>

<p>Anyway, sorry to ramble. I’m just wondering if others have faced this issue, and if so how you made choices about what to prioritize.</p>

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<p>Has the allergist tried desensitizing him?
That sounds miserable.</p>

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<p>We started allergy shots last spring after a really brutal year of allergies. He missed 23 days of 7th grade. But we ended up stopping them in February. Every week we were struggling to make difficult choices – does he skip football practice to go get this week’s shot, or does he miss play rehearsal? I felt as though the issue was just going to get worse, trying to juggle the shots with more homework, more practices etc . . . in high school and that we’d never reach therapeutic dose. Since then things have definitely gotten better. He’s found a combination of meds that have eliminated summer and winter symptoms, and made fall much more manageable. I was hoping spring would be better too, but I don’t think it is. Until Easter he’d only missed 3 days of school due to asthma this year. Of course he also caught the stomach flu, and was out most of a week with a snowboarding concussion.</p>

4

<p>Son who is a freshman in college had similar spring - seasonal allergy issues. Definitely affected his HS performance, including wondering if he was going to be ok to take his AP exams. </p>

<p>We opted to keep him inside as much as possible for the worst 2 - 3 weeks of spring, keep all windows closed at home and treat him with prescription eye drops, nasal spray and oral medications.</p>

<p>It was a relatively short window of time and he wasn’t happy about it but we felt it was necessary academically.</p>

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<p>For the future, college was a surprisingly easy time for desensitization. No car trips, just stop at the Health Center and get the shot weekly. It was all set up beforehand with our local allergist. Getting the stuff there was a bit of a hassle, as it has to be kept refrigerated. But once there, she was good for the year.</p>

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<p>That’s great to hear about desensitization and college.</p>

<p>Az, I wish it was a couple of weeks, unfortunately he’s quite allergic to grass pollen as well as tree, so he often has symptoms until at least mid June, and then starts again with ragweed in August.</p>

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<p>I feel for your S. D has has asthma since she was small and we spent many a night in urgent care but she seems to have come out on the side of it getting better with puberty. We did keep her from applying for the rainforest trip this summer though, since pollen and grasses are her worst triggers. Since she’s on “as needed” albuterol only now, we really didn’t think it would work with her being in the middle of nowhere and having a major attack. We didn’t want to have to keep her from doing something she wanted like that but maybe another year will be enough for her system to handle it.</p>

<p>Sounds like your S has a much worse time though. Her main athletic activity is dance, which is indoors. If we had to stop her from doing THAT, her happiness would indeed go down. It would be like tying her up and putting on her favorite dance music. If it came to that, I’d probably keep looking for a med combo that would minimize the attacks but allow her to dance.</p>

8

<p>I have allergies as well, but as I have grown older, the kitty one eclipses the stuff outside. The best I can suggest beyond the meds is for him to keep his hair super short (shaved?) and then to shower and completely change his clothes as soon as he gets in for the day. At least that should help to rid him of the worst symptoms assuming you keep your windows shut.</p>

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<p>Find a more convenient clinic for the shots. Is it really a question of missing football practice so he doesn’t miss 30 days of school, which also means missing 30 days of practice? One of the urgent care centers here will does allergy shots after normal clinic hours. Maybe check around and see if you have something like that too. I would also have his allergy/asthma doctor test him for asthma if he/she has not.</p>

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<p>I’m sure this lands me solidly in helicopter mom land, but given the possibility of a life threatening allergic reaction to shots, I’m only willing to try with a provider I know and trust. An urgent care is outside my “safe” zone.</p>

<p>If we started allergy shots this summer it would likely be the middle of sophomore year before we saw a reduction in symptoms. So for the next while it’s a choice between missing 20+ days or missing 20+days plus part of a day each week.</p>

<p>He’s got an asthma diagnosis plus significant asthma meds.</p>

11

<p>Steve, I think I misread your question. I think that if I pulled him out of any EC’s that involved going outside either as part of the activity (e.g. football, his caddie job, his environmental service group, soccer refereeing) or that involved walking outside to get there (the school play) we would see some.improvement in his symptoms. However, it’s not a day by day thing. That is, he’d need to skip all of preseason practice, which likely means he wouldn’t have a slot on the roster once ragweed dies in mid Sept.</p>

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<p>D2 is a competitive swimmer and has pretty severe environmental allergies plus exercise induced asthma. She can go for months being fine and then all hell will break loose. She is currently having a really bad week. I took her to the pediatrician and he loaded her up with meds - prednisone, antibiotic, mucinex plus her usual as needed albuterol and twice a day symbicort. I HATE giving her all this medicine. </p>

<p>Thankfully I made a follow up appointment many months ago for the allergist. We are going today and and I am going to have him start immunotherapy. We have just one more month of school so I thought summer would be a good time to start.</p>

<p>I use a hepa filter in my bedroom and just got one for my daughter. I had horrible allergies for years and the filter plus the shots really helped. I was in my 30’s before I finally started the shots and had suffered for years. I wish I would have started much sooner.</p>

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<p>CuriousJane - Once you get through the first few months of having shots the risk of reaction is minimal. I would have your son start shots with the less convenient allergist during the summer. Once he’s done with the first vials, I would find someplace more convenient.</p>

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<p>Some of us never can get through the first few months of shots. Our S had wheezing and other rather dramatic reactions from every shot. The pediatric allergist decided his reaction to the shot was worse than his reaction to his environmental allergens and after several attempts, we all agreed to stop.</p>

<p>Fortunately, now that he’s 25, his allergies have significantly improved. He has become a GREAT housekeeper and uses a robotic vacuum cleaner to keep dust to a minimum in his apartment. For him, urban environments seem a bit better with perhaps fewer pollens than other places. He decided he prefers urban over rural in any case and is happily living in Arlington.</p>

<p>Water sports like swimming and diving and canoeing and kayaking and water polo can be excellent for kids to otherwise have allergy problems to pollens. Our poor D was allergic to pool chemicals so she was fine in salt water but nothing around chlorine. Neither of my kids like the beach or much water. ;(</p>

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<p>Sounds a lot like my teen years. Seasonal allergies hit me full force at 14. I once missed half of the days in one quarter and got no grades at all. Some things that seemed to work for me:

  1. Allergy shots twice per week. Yes, we had to wait around for 20 minutes in the office within reach of epinephrine. We carried them around during vacations so I wouldn’t miss a shot.
  2. I had to stop taking steroid inhalers and switch to oral asthma meds because of the coughing. I tried every one of them that was available at the time (late 70s).
  3. Antihistamines. I spent 1 1/2 years practically in a coma before someone mentioned that I could break the pills in half and see if that was enough. It was, and most of the nosebleeds stopped. The new non-drowsy ones have helped a lot of people.
  4. Cortisone nasal sprays. I found Nasonex to be the best for avoiding nosebleeds. Other ones seemed to be more drying. This is the only thing I am still taking.
  5. Water. Staying hydrated seemed to help. Getting enough sleep really helped.</p>

<p>We treated it a bit like a science experiment, tracking diet, medications, activities, and correlated it to how I felt, all written in a training calendar. </p>

<p>Getting older helped. My last hospitalization was at age 19, last allergy shot around 22. My last asthma attack was age 26. For most, it gets better.</p>

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<p>CuriousJane–your allergist sends over the shot components to the clinic or urgent care, it’s no different then going to your dr for the shots, and depending on your urgent care center, maybe safer because they have more medical equipment to handle emergencies. The clinic we go to is in a multi-specialty clinic. I still don’t understand why football is more important than school or his health.</p>

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<p>^^Same suggestion. Last time I did shots I used Dr. Care near me since doc is across town. If S’s allergies last that long I would try them again. At least for me, after a certain point I only had to get shots once a month, once a week when went up to new vial. Also thought is was easy to get shots at student health in college…in fact college was the second time I went through shots…something on that campus:)</p>

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<p>For what it’s worth, I went to National Jewish Health and had a series of many allergy shots in a very short period of time under close medical supervision (about 20 shots total in less than a week). This was the only way for me to safely get to my maintenance dose so I could stop going in for allergy shots twice a week to build up. We never got anywhere after over two years of twice weekly shots. </p>

<p>This accelerated program is known as RUSH Immunotherapy and needs to be carefully monitored and administered by a qualified specialist. It was covered by my insurer. It is something to consider with the doc. Once I got to my maintenance dose, we could drop back to one shot/month. </p>

<p>It worked wonders for me and I was able to stop allergy meds and nasal steroids.</p>

19

<p>Well, he was bleeding at the bus stop again, so I let him stay home and took him to a midday Dr.'s appointment. We couldn’t get in to see his regular allergist, but saw someone else in the office. She agreed that he should go back on shots, but also had some good news too. She printed out his current PFTs and compared them to a visit we made at the same time last year before we played with his meds. His efficiency in his small airways has gone from 49% of expected levels to 88%, which is enormous improvement. So, what we’re seeing is all in his head (not his mind, but in his sinuses and nasal passages, plus coughing due to post nasal drip), which is far better than it being in his lungs. She gave him a prescription for a cream to put inside his nose to see if that helps with the bleeding. If we can get that under control, it will be a huge improvement.</p>

<p>Steve, I’m comfortable with what I’m comfortable with. It’s not just about the contents of the shot, it’s about knowing and trusting the person pulling up the dose, and the person watching him for symptoms. He had two scary issues with drug reactions as a baby/toddler, one of which will have lifelong impact on his health. So, I’m probably more skittish than most people. If we do allergy shots again, we’ll do them in his allergist’s office.</p>

<p>As far as your comment about football, I’m not sure why you’re pulling out one activity from the many I talked about. Obviously, I’m torn about whether or not to restrict activities, but it’s not as easy as his health vs. football. There are huge benefits to kids’ physical and mental health to being active. In his case, I think these are magnified by the asthma. Regular physical exercise has made a huge difference in his lung capacity. As a single working mom, I’m also aware that kids at home, unstructured, for hours after school are at risk for lots of things, and that regular supervised activities with a strong adult presence cuts that risk dramatically. </p>

<p>Finally, to be clear, he doesn’t have exercise induced symptoms. The issue is things that happen outdoors. So spending time outside reffing a soccer game, or pulling weeds with the service group, has the same impact as walking home from a play practice that runs too late for the school bus. Yes, swimming indoors would be better than football, except that in order for him to swim when I’m not home he’d need to walk to the subway and from subway to the pool.</p>