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Struggling with whether to start 5 year old son on allergy shots
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christine0125 posted:
My son went through allergy testing a couple weeks ago as he has struggled with seasonal allergies since he was 2 and getting worse each year. He was previously on Zyrtec and Zaditor eye drops and that didn't seem to help at all. One day he spent a couple hours outside and his eyes swelled up and he ended up with a rash on his face. He's also had several sinus infections. Based on the testing the doctor is strongly encouraging that we start allergy shots. She also switched him to allegra 2x day, bepreve eye drops and veramyst nasal spray as well as doing nasal irrigation up to twice a day. This combination of treatments has helped tremendously. I hate that he's so dependant on these medications but I'm also wondering if starting him on shots at age 5 is just too much to put him through since the allergies appear to be fairly controlled right now.

Any words of wisdom from those with similar situations?
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coughy16 responded:
Well, I'm a little older than 5, but I can say that shots have helped me tremendously. You didn't mention what he is allergic to. He does sound like he is on a lot of medication, and there is the possibility that once the shots start to help, he could get off some medication. Is he allergic to things that he can avoid? If so than that could help too, but if he is avoiding what he can & still has so many symptoms, it might be worth a try. The shots are given with a very thin needle right under the skin, so they are pretty much painless, although they can cause some redness, swelling & itching at the injection site which can be annoying.
 
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Aqua14 responded:
This would be a tough decision for any mom to make. I have some thoughts, as a mom of a teenager with mild allergies/asthma, and as an allergy/asthma patient who's been on allergy shots for 5 years.

Allergy shots will take between 3-5 years to reach full effect. If he's strongly allergic, it could take longer because the doctor may have to back down the dosage if your son has strong reactions to the shots. But as the shots take effect, likely he won't have to take as many medications as he does now, or perhaps he won't need any.

Plus, there's been research in children indicating that allergy shots help prevent development of new allergies and development of asthma.

On the other hand, most kids REALLY hate shots. Allergy shots aren't all that painful, and some allergists treat the skin with a topical anesthetic before giving the shot, but you have to consider the freak-out factor. Under the tongue allergy drops are still in research studies in America, but possibly in the next couple of years they'll be FDA approved -- something for you to consider.

The other thing to consider (and this is possibly anecdotal) is that boys sometimes "outgrow" their allergies as they get older. This was something my son's allergist told me, but I'm not sure whether it was just in her experience or whether there was actual research out there supporting this. In my son's case, his allergies/asthma have improved as he went into his teenage years.

So those are some of the pros and cons that I see with allergy shots for children. For me, shots have been wonderful and have gotten me back to an (almost) normal life and I'm glad I made the decision. If my son's allergies were bad enough that shots were a consideration, I think I'd have a tough time too deciding.

Hopefully these thoughts help you out, and I hope that one of the medical experts on the board will chime in with his experience. Take care & good luck. Judy
It's never too late to be what you might have been. ~ George Eliot. A journey of a thousand miles begins with a single step.
 
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christine0125 replied to Aqua14's response:
Thanks for the replies. He's very allergic to trees and grasses and also cats (don't have any) and mild allergy to dogs (have 1). I'm leaning towards starting the shots this summer in hopes by next Spring he is seeing some relief and would require less meds.
 
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sgbl88 replied to christine0125's response:
I don't blame you for being hesitant to start shots. However, shots are mild doses of the allergen. They are natural. As you said in you last post, next spring, he could take fewer meds and be comfortable if he took them.

Find a GOOD pediatriac allergist (one who has studied in a pediatric hospital). He/she and their nurses would have more experience working with children and make the experience less traumatic. My allergist treats tons of children. There is a cream that can be applied about 20 - 30 minutes before getting the shot so that it doesn't hurt at all. There is minimal pain without the cream.

I am sure that you will make the correct decission for you son.

Take care and God bless.
Sonya
Jeremiah 29:11 For I know the thoughts that I think toward you, saith the LORD, thoughts of peace, and not of evil, to give you an expected end... Ye shall seek me, and find [me]
 
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DDan1967 responded:
Hello Christine,

As a 43 year old adult with allergys to trees, grasses, leaf molds, and just about anything that flowers. I was first diagosed when I was about 10 years old and have been on just about every new emerging over the counter and perscription allergy treatment through the years.

As a generaly rule most allergy meds were only effective for me for 1 to 2 years before thier protection started to wain and I had to supliment them with OTC's such as benadryl and sudaphedrin. (Which pushed my blood pressure to critically high levels, I didn't know that many decongestants increase BP too.)

I started the allergy shots a few years ago, was on them until leaving for my last deployment and have restarted them since I returned last January. All I can say is that they have changed my life for the better. To not be dependent on the many things such as your son is presently doing has given me a new life.

Believe me your son will be thankful and so will you that he doesn't need a medicine cabnet to make it thru the day.

As for the shots hurting, they generally don't much. They usually use a insolen syringe which has about the smallest needle there is and like someone else mentioned, there are topical ointments that can minimize any pain.

The regiment varies, but is is generally shots once a week until you reach the maintenace dose. Then perhaps every two weeks, finally to once a month.

Where as the medications attempt to surpress the bodys responce and the nasal irrigation helps to mittigate the bodys responce to allergens. Allergy immunotheropy shots retrain the immune system to view allergens as a normal part of life, which they are. Hence, illiminating or at significantly reducing the need for medications.

From the current regiment that your son is one it is obvious that his allergic reaction is already pretty sever. From my personal experience and what I have been learning in Nursing school, I can only imagine that without the shots, his allergies will only get worse with time.

Believe me living with sever allergies is no way to live, it limits your life more than you can imagine. The things I can enjoy now and activities I can participate in have given me a new appreciation for life.

I wish you and your son luck with his treatments and Hope you both have a wonderful Memorial Day.

Doug
 
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DUKE MEDICINE
Michael H Land, MD responded:
Dear Christine,

Your question is a very good one and always a difficult decision to make. With your son's age group, some kids are very open to getting shots if they have some pain-free "cream" or a numbing device (like a handheld massager) to prevent sensation of the injection, while other children will start to hyperventilate if they know they're going to the doctor's office and the entire experience each week is a nightmare from a panic-like attack. Depending on what kind of child your son is, it may not be worth the added stress in your life if it's going to be a weekly anxiety-filled visit, tantrum, etc. If things are going well, why change? I would say "just because you can do it, should yo do it?"

I always ask parents to weigh the pros and cons. It is a time consuming (3-5 year) therapy, and each visit requires a 30 minute observation period after the shot. It has a great potential to reduce his sensitivity and he could possibly not require the medications (or as much) in the future.

Firstly, if medical therapy controls his symptoms very well, and he tolerates taking the medicines without too much trouble, you could maintain him on treatment for a few more years (seasonally). The decision could be deferred. Is he an indoor kid (crafts, games, reading, etc.) or an outdoor kid (sports, bikes, running around)?

If he's a child who may not have that much exposure to the triggers, he might do just fine on medical therapy.

On the other hand, if he is always outside, always exposed to the triggers, or the medications aren't as effective, then it may make a big difference in his quality of life. I have patients who are soccer players, football players, and their sports performance suffers from their allergies and asthma, even on medication.

I give every family different advice depending on their unique circumstances: How the child feels about shots (will it make your life worse?), if he is a kid with high exposure, if the medications are effective or not, and other factors like if they have Asthma or other conditions they might suffer from. Also, if you plan on moving anytime soon (to another country, or to a different region of the US (assuming you are in the US)), it will make a difference on if the shots are necessary or not.

I would have a good discussion with your allergist and perhaps get a second opinion if you're still not sure. If you decide to go for it, I would encourage you to get the shots done by a Board Certified Allergist who has done a 2-3 year fellowship in Allergy/Immunology. This type of doctor has trained in either pediatrics or internal medicine for 3 years before doing their specialty training. The difference between this type of physician and doctors in general practice (i.e. Family medicine) or Ear, Nose Throat surgeons is the training in allergen vaccine dosing and regimens.

Good Luck!


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