If this were a multiple choice question, the answer would be “All of the above.’ Hives are miserable, awful, heart-breaking and cruel. It was a terrible experience, made even worse by the fact that there are no answers. Were they from a drug allergy? Was it a food that caused them? Could it have been something in our environment? Maybe the hives were from an illness or a virus? At this point, we may never know, especially given the doctor’s “solution” to finding the cause… but we’ll get into that later.
It all started several weeks ago on Thursday, January 27th. Gavin woke up with a very snotty nose and some congestion. We dealt with it in the normal manor - bulb syringe, Vick's and steam showers. Gavin’s cold seemed to be lingering on and on over the next few weeks, but he didn't have any other symptoms of illness and the drainage was clear.
Thursday, February 17, Jacob had a 24 hour bug and came home from school sick and throwing up with a low grade fever. The next day, TD seemed to have come down with something similar to what Jacob had the day before. He was suffering from body aches and vomited once. Brie was coughing and didn't feel great either. That Friday night, the 18th, Gavin had a low grade fever. His “little cold” was going on for three weeks at this point, but he was cutting all four of his two-year molars and we thought that it was mostly attributable to the teeth. I assumed the fever was from the cold, molars or maybe the virus Jacob brought home. Gavin started coughing that Saturday, and on Sunday afternoon woke up from his nap complaining that his ears hurt. I took him to CHP's Urgent Care and saw a doctor there. The urgent care doctor informed us that Gavin had an ear infection in both ears, but it was mild. The doctor said even though Gavin was coughing, his lungs sounded clear. He prescribed amoxicillion, 7 ml, twice a day for the next ten days, and Motrin for the pain. Over the next few days, Gavin's cough seemed to clear up some, but he remained very grumpy and wasn't sleeping well. The weekend was here again and we had a quiet Saturday and Sunday. TD and I still felt like Gavin must be having a hard time cutting of his two year molars and that was why he wasn't himself. On Sunday night, February 27th Gavin had a 100.6 fever. Again, I blamed the teething. He had been on amoxicillin for seven days, so there was no way he was still reacting to an illness. It was a terrible night. Gavin got up every hour crying and trying to get comfortable. I gave him some Motrin around 4:30 am so he and I could both get some rest. The next day was going to be a big day for all of us.
Our family got up that Monday morning, February 28th, and headed to Shands for Jacob's port placement surgery. Gavin felt a little warm, but slept most of the way to Gainesville. I was thinking the entire time, "Why does teething have to be so painful?" Gavin ate his breakfast, had some trail mix, drank his juice and we gave him his amoxicillin and Motrin (for teething pain) around 11:00 am. By 1:45 pm that afternoon he had a rash starting on his elbows and knees. TD and I were baffled at what it was from. After talking to Gavin's doctor in Tallahassee, we took Gavin to the urgent care in the same building as the surgical center Jacob was having his surgery in. By the time we got Gavin into a room to see a doctor at the walk in ER (our wait wasn't very long) the rash was looking more like hives and had spread to his legs and feet. It was extremely upsetting. Not only was my little two year old in the ER two hours away from home with an unknown rash, but my precious fourteen year old was in surgery! The nurse and doctor were very nice and said the hives were either from a food allergy, an allergic reaction to something he touched or to the amoxicillin. I thought, "Really? Thanks for clearing that up for us!" The ER doctor also looked at Gavin's ears and said his ear infections were still very bad, that they had obviously gotten worse since the “mild” verdict from the urgent care doc. She also said to stop the amoxicillin immediately. Gavin was prescribed Benadryl, Zithromax and a steroid if needed. I went to bed Monday night exhausted from traveling, worrying and doing my best to take care of my boys. (Thank you Brie for being (mostly) well at this time!! Brie had tested positive for flu the weekend before, had been miserable, but was getting better.)
Gavin was up and down all Monday night and woke up at 5:30 am Tuesday morning shaking, crying in pain with full blown hives on most of his body and a fever of 99.7. He was still congested. TD called into work to make sure Brie got to school and Jacob was well taken care of while I took Gavin to see our family doctor here in Tallahassee. I needed to find out what she thought was going on and what was the best plan of attack with all of this medicine. Even though I had given Gavin Motrin, his fever had still gone up a bit to 100.8 by 7:45 am. I called Dr. Kelch's office as soon as they opened at 8:00 am and had Gavin there by 8:30 am. Gavin was crying, screaming "Ow" over and over and wouldn't walk. He didn't want to be touched or moved. It was scary and heart-breaking all at the same time.
Dr. Kelch said she couldn't be positive what was causing the hives. She said, as of that morning, the breakout didn't look like an amoxicillin reaction, but because he was taking it when he broke out, it was definitely a maybe. She said it could be food, but that food-borne reactions usually get better within the first 24 hours. And Gavin was getting worse. She said she thought it was probably hives brought on from a reaction to an illness, like a virus or the flu. She did have the nurses prick his toe to get a sample of blood to check to see if his white blood count was elevated. Dr. Kelch said his lungs didn't sound great and if his white blood count was up he would need to go for an x ray to rule out pneumonia. She did find that his ears didn't look too bad, a difference in opinion from the other doctor the day before. She said she could see the fluid build-up, but overall she thought they were healing. Gavin's white blood count came back normal so we were sent home to wait it out. So I left our doctors with a schedule for Prednisone, Benadryl, Zithromax and the ok to give Motrin and or Tylenol with them. And a helpless feeling. And a notepad to track the madness. We still had no idea what was causing the horrible hives.
Wednesday morning came and Gavin was still covered in hives. And much more miserable than the previous day. By that afternoon he hadn't walked in almost 48 hours. After a Benadryl and Motrin cocktail, we made him get out of bed and walk around. It was heart-breaking. He looked like he was learning to walk all over again. With every slow step he cried and shook. We held his hands and cheered him on. Jacob and I took him outside and encourage him to move around. Holding Jacob's hand, Gavin crossed the yard and stopped and picked a flower. His little field trip lasted about 30 minutes and Gavin was crying to go back inside to lay down. The hives had spread to his face.
Another night of crying, 4:00 am oatmeal baths, tossing and turning passed. I was exhausted and emotionally sick over what Gavin was going through. He was on day four of hives, pain and congestion, with no signs of getting better. His hives had left horrible bruising and the hives that had moved to his face were swelling up his eyes. That night, before bed, his eyes looked like they could have swelled shut and were matting a bit. The only thing that relieved the itching for a few minutes was covering Gavin from head to toe in calamine lotion. That morning I called Dr. Kelch's office in tears and insisted on them seeing Gavin again. My laptop loaded with multiple photos of Gavin's hives from the previous days, I took Gavin back to the doctor. It was the third trip that week. Dr. Kelch looked very disappointed that Gavin was still so sick. She viewed all the photos I had on my laptop and said that some of the hives in the pictures did look like a penicillin allergic reaction, but she said Gavin's fever didn't make sense. His temperature Thursday morning was 102.5, and that was after his morning dose of Tylenol. (We stopped the Motrin and switched to Tylenol that day in case it was an allergic reaction to the Motrin. At this point, I would’ve tried anything, and I was thinking that he was allergic to EVERYTHING). She looked at Gavin and did a flu swab. She said the results would be back in a few days. She also added Claritin to the list of drugs Gavin was taking. Evidently, up to five antihistamines can be taken at once. I prayed it wasn't going to come to that. Dr. Kelch, still puzzled with what was causing Gavin's hives and still believing they were from an illness, sent Gavin to the lab have blood drawn.
I took Gavin to the Lab Corp on Tim Gamble first and they were slammed packed as usual. After signing in and sitting for a brief time with Gavin crying and about to burst into tears myself, I asked the attendant at the window how long the wait was going to be. She said a long time. She said there were six people in front of us just to have their paper work done, not counting all the people who were waiting that were already checked in. Gavin had been madly itching since the dose of Prednisone I had given him when we left the doctors office and was covered head to toe with glowing red, huge and horrible hives. You would of thought the lab techs would have made an exception and taken Gavin right back. This situation reminded me of one of my daily devotions I had read this year. It is about finding your joy. One way to feel true joy is to give something away each day, not talking about material things. A few examples are giving encouragement, an extra pair of hands, your seat, forgiveness, and giving a sick baby your place at the blood lab!! I will remember what a difference this could have made for us at the time. Unable to hold back my tears any longer, I asked her, crying, if there was another lab I could take him to. She said our HMO had their own Lab Corp at it's urgent care facility. This was good news. CHP Urgent Care was very close by and I had been to their lab once before. I sure wish I had known you could go there for simple blood work. I thought it was a speciality lab. Turns out it isn’t, so we went there. The attendant was very nice, but she made me take Gavin across the hall to have him weighed. With young children, there are rules based on their weight as to how much blood can be taken at once. Dr. Kelch had ordered a parvo (Fifths disease) test, mono, white blood count, cbc, and a blood culture.Getting Gavin's weight was a pain because Gavin was screaming, itching and crying. The doctor who had prescribed Gavin the amoxicillin almost two weeks before let me back into the clinic, watched me weigh Gavin and then held the door for us to leave. He didn't say a word and I wondered if he even recognized us. Even though Gavin wasn't next in line they took Gavin right back. This is how it should have been and I was very grateful. Sitting in the chair was horrible. I tried holding Gavin still, but he is so strong and determined. The tech was able to get one vile of blood drawn and because Gavin moved too much she "blew" his vein and had to tape that arm up. I was so happy to see TD come in. As happy as I could be at that moment. I could see his heart breaking looking at Gavin and me. What totals wrecks we were at that point. The first tech got another tech and TD and I recognized him from the Lab Corp right next to our house that had closed. We knew he was good at his job. I'm sure that is why she went and got him. TD sat in the chair and held Gavin for the second blood draw, from Gavin's hand. They took five tubes of blood. I was very relieved our trip to the blood lab was over and we could go home. TD had brought the Claritin I asked for and I gave it to Gavin. We went home and Gavin took a good nap. The Claritin seemed to help some.
Friday we continued the Benadryl every four hours, Prednisone in the morning and Claritin once in the morning and once at night. Tylenol for pain and fever and Friday was Gavin's last does of Zithromax. This is entirely too much medicine to have to give a little one.
Gavin looked a bit better on Friday. He seemed to be feeling a bit better too. He was still red and itching, but his fever was gone. Gavin's legs and hands looked better and the swelling had gone down some. His face was still broken out, but not as swollen. I talked to Anna at Dr. Kelch's office and she said Gavin's white blood count came back slightly elevated and he was negative for mono. She said the other blood tests would be back the following week. I told her that Gavin was feeling a bit better, moving around and eating some. We talked about the fact that it usually takes five to seven days for penicillin to leave the body after the last dose. Gavin was almost on day five since his last dose and he was getting better. I say getting better lightly. He was moving and his attitude and demeanor were returning. He looked better to us, but anyone who hadn’t seen him probably wouldn’t have said, “He looks great!” At that point, anything would’ve been better than the past days.
Saturday was another good day of healing.
Sunday was a very good day. Our baby was coming back! Gavin had been fever-free since Thursday night and the hives were now red blotches. He played outside and ate well. We cut back on all the medicines and only gave him one dose of Benadryl and Claritin.
Monday I spoke with Anna and gave her the good news. Gavin was getting better and better a little each day! She informed me that Gavin was negative for parvo (Fifths disease), flu, mono and his blood culture had grown normal. With these results, it was appearing like penicillin very well could have been the culprit. “The “solution” to determining whether or not Gavin is allergic to penicillin is simple: The next time we give him amoxicillin for an infection, if he breaks out in hives, penicillin is the allergen.” A laughable remark, but apparently, the only way we will know for sure is to give it to him again. I learned that allergies can take several exposures to present themselves, but once they do come out they always come out. Gavin has had amoxicillin once before in October of last year with no reaction. TD and I talked about what we will do in the future and we decided that we will ask for the alternative to penicillin and until Gavin is older we will assume he is extremely allergic to penicillin. We don't want him to ever go through another reaction like he had just experienced.
What else I learned:
Allergies to egg, milk, soy, wheat, peanuts and tree nuts represent 90% of all food allergies in children.
Penicillin allergy is one of the most common drug allergies.
I also learned there is a difference between peanuts and tree nuts. Nuts in the tree nut family are almonds, Brazil nuts, cashews, chestnuts, filbert/hazelnut, macadamia nuts, pecans, pine nuts, pistachios and walnuts. It makes sense, but I had just not thought about it before. We researched it because Gavin had cashews and almonds for the first time on the day his hives started. Also, persons with tree nut allergies are known to have coconut allergies.
An allergy is an overreaction of the immune system. The body's immune system treats the substance (called an allergen) as an invader and reacts inappropriately, resulting in symptoms that can be anywhere from annoying to possibly harmful to the person. In an attempt to protect the body, the immune system of the allergic person produces antibodies called immunoglobulin E (IgE). Those antibodies then cause mast cells and basophils (allergy cells in the body) to release chemicals, including histamine, into the bloodstream to defend against the allergen "invader." It's the release of these chemicals that causes allergic reactions, affecting a person's eyes, nose, throat, lungs, skin, or gastrointestinal tract as the body attempts to rid itself of the invading allergen. Future exposure to that same allergen (things like nuts or pollen that you can be allergic to) will trigger this allergic response again. This means every time the person eats that particular food or is exposed to that particular allergen, he or she will have an allergic reaction.
I learned that Gavin's great grandfather is allergic to penicillin, but TD and his dad are not. The tendency to develop allergies is often hereditary. However, just because a parent or one of your children might have allergies doesn't mean that all of your kids will definitely get them, too. And someone usually doesn't inherit a particular allergy, just the likelihood of having allergies.
I hope to never see a case of hives again!!!