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-> Children's Health
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amother
OP
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 Sun, Jan 16 2022, 10:33 pm
hi, does anyone have experience with loratadine oral solution and fluticasone proprionate?
ENT recommended it before surgery?
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amother
Chocolate
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Mon, Jan 17 2022, 10:26 am
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Loratadine is an antihistamine and fluticasone is a steroid. They both function to take down inflammation, which is what’s causing the swelling. But they are not addressing why the swelling happens in the first place. Does your child have obstructive apnea?
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amother
Feverfew
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Tue, Jan 18 2022, 9:22 am
We are on this journey too! I keep on pushing the ENT to look into the cause rather then just remove them both. My DC went for allergy testing, for environmental only NOT food, and all was negative. DC has been on the nasal steroid spray for over a year and it didn't improve. They said DC shouldn't stop taking it or it will get worse. The ENT says the cause isn't so important because even if you remove exposure to it, the tonsils and adenoids may not go back to normal size. DC is now a mouth breather and snores. No sleep study has been done but I do strongly think DC has OSA. Any good suggestions of how to discover the root cause of the issue?
FYI, allergies of all sorts run in both my and my husband's family. It may or may not be related. Eczema, food allergies, hayfever, etc...Both my husband and a sibling of mine have constant nasal congestion, and one of my parents have it seasonally. My 4 year old now has large tonsils too, is a mouth breather and snores. Neither of my kids had any ear infections or strep.
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amother
Chocolate
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Tue, Jan 18 2022, 9:25 am
| amother [ Feverfew ] wrote: | | We are on this journey too! I keep on pushing the ENT to look into the cause rather then just remove them both. My DC went for allergy testing, for environmental only NOT food, and all was negative. DC has been on the nasal steroid spray for over a year and it didn't improve. They said DC shouldn't stop taking it or it will get worse. The ENT says the cause isn't so important because even if you remove exposure to it, the tonsils and adenoids may not go back to normal size. DC is now a mouth breather and snores. No sleep study has been done but I do strongly think DC has OSA. Any good suggestions of how to discover the root cause of the issue? | Does dc get strep a lot? Does dc have a high palate and or tongue tie? What is dc’s diet like?
ENT can’t help you find a cause, they aren’t trained that way. And dr is wrong that tonsils and adenoids won’t shrink if you find and remove the trigger.
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amother
Feverfew
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Tue, Jan 18 2022, 9:47 am
| amother [ Chocolate ] wrote: | Does dc get strep a lot? Does dc have a high palate and or tongue tie? What is dc’s diet like?
ENT can’t help you find a cause, they aren’t trained that way. And dr is wrong that tonsils and adenoids won’t shrink if you find and remove the trigger. |
I just edited my post above to add details. Neither kid of mine has ever had strep or an ear infection. My 4 year old definitely has a high palate and has major teeth crowding and may be tongue tied. One of my other kids was tongue tied and we got it released. If I would have been aware of tongue tie when my 4 yo was a baby I would have gone for an evaluation. I strongly suspect some/all of my kids are as well, but 4 isn't an easy age to deal with post release excersizes so we are waiting, and going to do a pallet expansion as soon as the dentist says he had enough molars. Since I am dealing with at least 3 people in my family that all have tonsil/adnoid, mouth breathing, major congestion (2 others have congestion without the other symptoms), do you know of a place that looks at the bigger picture and deals with all these issues, which are probably interconnected, simultaneously? I would be willing to fly anywhere in the USA to get a diagnose, and if they can do some follow up remotely that would be great.
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amother
Chocolate
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Tue, Jan 18 2022, 9:55 am
| amother [ Feverfew ] wrote: | | I just edited my post above to add details. Neither kid of mine has ever had strep or an ear infection. My 4 year old definitely has a high palate and has major teeth crowding and may be tongue tied. One of my other kids was tongue tied and we got it released. If I would have been aware of tongue tie when my 4 yo was a baby I would have gone for an evaluation. I strongly suspect some/all of my kids are as well, but 4 isn't an easy age to deal with post release excersizes so we are waiting, and going to do a pallet expansion as soon as the dentist says he had enough molars. Since I am dealing with at least 3 people in my family that all have tonsil/adnoid, mouth breathing, major congestion (2 others have congestion without the other symptoms), do you know of a place that looks at the bigger picture and deals with all these issues, which are probably interconnected, simultaneously? I would be willing to fly anywhere in the USA to get a diagnose, and if they can do some follow up remotely that would be great. | Look for an airway informed orthodontist and myofunctional therapist in your area. They often work together, so one can refer you to the other. If you are in NJ I can recommend some good ones. Seems you already know this, but tongue ties and high palates can be a factor in narrowed airway and enlarged tonsils so it’s important to address this first.
Interesting that none of your kids had strep or ear infections. I know it’s typically seen as a sign of good health but sometimes is raises flags for could they have had asymptomatic infections with atypical immune response?
Do your kids have any behavioral concerns?
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amother
Feverfew
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Tue, Jan 18 2022, 10:58 am
| amother [ Chocolate ] wrote: | Look for an airway informed orthodontist and myofunctional therapist in your area. They often work together, so one can refer you to the other. If you are in NJ I can recommend some good ones. Seems you already know this, but tongue ties and high palates can be a factor in narrowed airway and enlarged tonsils so it’s important to address this first.
Interesting that none of your kids had strep or ear infections. I know it’s typically seen as a sign of good health but sometimes is raises flags for could they have had asymptomatic infections with atypical immune response?
Do your kids have any behavioral concerns? |
It may be easier to find a needle in a haystack then either a airway informed orthodontist or myofunctional therapist in my area. I know of a mayo specialist 3 hours away. Is there a website to find local reputable ones?
My 4yo and another child with major nasal discharge have a major sweet tooth. This other kid does have behavior issues specifically impulse control and anger management. But, it maybe something else (ADHD?) cause there are reading issues too.
We try to eat as little processed food as possible except for a treat or two for Shabbos/Yom Tov party, family birthday or special celebration etc. One major addiction in our house now and growing up with my siblings as well, was dairy, specifically cheese and pasta, but also any starch and cheese or mezonos/cereal and milk. I tried taking off my older DC from gluten and dairy for a month, but there was cross contamination from sponges and oven usage, but saw no improvement. DC was also on Claritin and another allergy med before we did the testing, for a few months, over the summer, and again no improvement.
Growing up I had a lot of ear infections. Sometimes even double ear infections. Sometimes the medicine didn't work and I needed to get something stronger prescribed.
I am pretty sure my husband is tongue tied cause he can barely lift it, but surprisingly he doesn't snore. I think I am too, but compensate by lifting the floor of my mouth!
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honey36
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Tue, Jan 18 2022, 11:06 am
Oh my. Yes definitely start with a myofunctional therapist. They should be able to refer you to a good dentist/Ortho who can help you. Not sure what you mean about not being able to do an expansion without molars, but from what I've learned, the earlier you do expansion the better since the bone is soft and more pliable. Get a second opinion about that.
Listen to the untethered Podcast by Hallie bulkin. She claims she can also help find a provider near you. She responds fastest if you private message her Facebook account.
Hatzlacha!
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amother
Chocolate
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Tue, Jan 18 2022, 11:11 am
| amother [ Feverfew ] wrote: | It may be easier to find a needle in a haystack then either a airway informed orthodontist or myofunctional therapist in my area. I know of a mayo specialist 3 hours away. Is there a website to find local reputable ones?
My 4yo and another child with major nasal discharge have a major sweet tooth. This other kid does have behavior issues specifically impulse control and anger management. But, it maybe something else (ADHD?) cause there are reading issues too.
We try to eat as little processed food as possible except for a treat or two for Shabbos/Yom Tov party, family birthday or special celebration etc. One major addiction in our house now and growing up with my siblings as well, was dairy, specifically cheese and pasta, but also any starch and cheese or mezonos/cereal and milk. I tried taking off my older DC from gluten and dairy for a month, but there was cross contamination from sponges and oven usage, but saw no improvement. DC was also on Claritin and another allergy med before we did the testing, for a few months, over the summer, and again no improvement.
Growing up I had a lot of ear infections. Sometimes even double ear infections. Sometimes the medicine didn't work and I needed to get something stronger prescribed.
I am pretty sure my husband is tongue tied cause he can barely lift it, but surprisingly he doesn't snore. I think I am too, but compensate by lifting the floor of my mouth! |
Find a certified myofunctional therapist by location https://aomtinfo.org/find-a-therapist-2/
They should be able to refer you to a holistic dentist or airway informed ortho in your area. Look for practitioners who use myobrace, Alf, biobloc, even though we are going with traditional expansion in the end.
Yikes about the sugar, starch, and dairy addictions. Seems you’d do well off those foods, though believe me, I know how impossibly hard it can be.
Personally, we see the most improvement in tonsil and adenoid size with antimicrobials. I suspect a lot of strep hiding out in there, and maybe also pseudomonas. Even if it’s not showing up on cultures. Which can also explain the behavioral issues (Adhd isn’t a cause, it’s a symptom). We’ve done long term antibiotics, olive leaf extract, oil of oregano, biocidin throat spray. In addition to antihistamines, the myofunctional and orthodontic work. Also doing homeopathy, and hoping to start craniosacral therapy soon.
We may still have to take tonsils out, but aren’t in a rush. But, we don’t have obstructive apnea now. Prior to long term abx and other antimicrobials dc was snoring like a truck and grinding badly. They now sleep quietly.
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amother
Feverfew
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Tue, Jan 18 2022, 11:22 am
| honey36 wrote: | Oh my. Yes definitely start with a myofunctional therapist. They should be able to refer you to a good dentist/Ortho who can help you. Not sure what you mean about not being able to do an expansion without molars, but from what I've learned, the earlier you do expansion the better since the bone is soft and more pliable. Get a second opinion about that.
Listen to the untethered Podcast by Hallie bulkin. She claims she can also help find a provider near you. She responds fastest if you private message her Facebook account.
Hatzlacha! |
Our dentist is old school and doesn't believe in tongue tie. He is a second generation both pediatric dentist and orthodontist! He said younger children don't have enough molars to put the expander on. I think it needs to be placed around the 6 year old molars (like connecting a bridge) and they sometimes come in later then 6.
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amother
Chocolate
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Tue, Jan 18 2022, 11:23 am
| amother [ Feverfew ] wrote: | | Our dentist is old school and doesn't believe in tongue tie. He is a second generation both pediatric dentist and orthodontist! He said younger children don't have enough molars to put the expander on. I think it needs to be placed around the 6 year old molars (like connecting a bridge) and they sometimes come in later then 6. | There are definitely appliances that can be placed on younger kids. Find a better dentist 
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amother
Feverfew
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Tue, Jan 18 2022, 11:42 am
| amother [ Chocolate ] wrote: | Find a certified myofunctional therapist by location https://aomtinfo.org/find-a-therapist-2/
They should be able to refer you to a holistic dentist or airway informed ortho in your area. Look for practitioners who use myobrace, Alf, biobloc, even though we are going with traditional expansion in the end.
Yikes about the sugar, starch, and dairy addictions. Seems you’d do well off those foods, though believe me, I know how impossibly hard it can be.
Personally, we see the most improvement in tonsil and adenoid size with antimicrobials. I suspect a lot of strep hiding out in there, and maybe also pseudomonas. Even if it’s not showing up on cultures. Which can also explain the behavioral issues (Adhd isn’t a cause, it’s a symptom). We’ve done long term antibiotics, olive leaf extract, oil of oregano, biocidin throat spray. In addition to antihistamines, the myofunctional and orthodontic work. Also doing homeopathy, and hoping to start craniosacral therapy soon.
We may still have to take tonsils out, but aren’t in a rush. But, we don’t have obstructive apnea now. Prior to long term abx and other antimicrobials dc was snoring like a truck and grinding badly. They now sleep quietly. |
Long term abx really isn't the route I want to take either because that just trades one issue with another like antibiotic resistance and gut issues and any other issues that would result from that. If it would be for a year, ok, but for life....I don't want to go there. My older DC with the OSA doesn't seem to have pallet issues, but hard to tell about the tongue tie without an evaluation because large tonsils/adnoids restrict tongue movement too.
Though not local at all or even remotely near us, have you heard of
https://www.zaghimd.com/
https://www.thebreatheinstitute.com/
I am looking for top of the line person who can deal with the large picture instead if each individual component. I am a little hesitant of working with someone online since there is nothing like seeing the issue in person and wonder if it would be effective. I would be open to traveling once or twice for a diagnosis, but the day to day work would have to either be with someone local, or someone that can do it well online.
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honey36
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Tue, Jan 18 2022, 11:46 am
| amother [ Feverfew ] wrote: | Long term abx really isn't the route I want to take either because that just trades one issue with another like antibiotic resistance and gut issues and any other issues that would result from that. If it would be for a year, ok, but for life....I don't want to go there. My older DC with the OSA doesn't seem to have pallet issues, but hard to tell about the tongue tie without an evaluation because large tonsils/adnoids restrict tongue movement too.
Though not local at all or even remotely near us, have you heard of
https://www.zaghimd.com/
https://www.thebreatheinstitute.com/
I am looking for top of the line person who can deal with the large picture instead if each individual component. I am a little hesitant of working with someone online since there is nothing like seeing the issue in person and wonder if it would be effective. I would be open to traveling once or twice for a diagnosis, but the day to day work would have to either be with someone local, or someone that can do it well online. |
Yes I've heard of the breath Institute and it's definitely top of the line, but there are plenty of good providers with similar experience/specialization around the US. Where are you located? You can pm me if you want.
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amother
Chocolate
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Tue, Jan 18 2022, 11:49 am
| amother [ Feverfew ] wrote: | Long term abx really isn't the route I want to take either because that just trades one issue with another like antibiotic resistance and gut issues and any other issues that would result from that. If it would be for a year, ok, but for life....I don't want to go there. My older DC with the OSA doesn't seem to have pallet issues, but hard to tell about the tongue tie without an evaluation because large tonsils/adnoids restrict tongue movement too.
Though not local at all or even remotely near us, have you heard of
https://www.zaghimd.com/
https://www.thebreatheinstitute.com/
I am looking for top of the line person who can deal with the large picture instead if each individual component. I am a little hesitant of working with someone online since there is nothing like seeing the issue in person and wonder if it would be effective. I would be open to traveling once or twice for a diagnosis, but the day to day work would have to either be with someone local, or someone that can do it well online. | We did antibiotics for a year and then the herbal antibiotics after that. It’s been 1.5 years after coming off antibiotics and the snoring and grinding hasn’t returned. I’m not thrilled about long term antibiotics, but to me they are still preferable to apnea and tonsillectomy. But we also had a lot of behavioral issues that we needed antibiotics to address so possibly the equation was different for us. When dc went on antibiotics her tonsils were swollen up to her ears, as per her pedi. Strep swab came back negative of course.
I haven’t heard of any of those places, but they look good. I totally get wanting top of the line, but for us we also needed to be realistic about our financial and time resources, so we opted for local providers who may not be top of the line but they are good enough. Good luck with finding someone who can case manage for you lol.
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riks
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Tue, Jan 18 2022, 11:53 am
| amother [ Chocolate ] wrote: | Look for an airway informed orthodontist and myofunctional therapist in your area. They often work together, so one can refer you to the other. If you are in NJ I can recommend some good ones. Seems you already know this, but tongue ties and high palates can be a factor in narrowed airway and enlarged tonsils so it’s important to address this first.
Interesting that none of your kids had strep or ear infections. I know it’s typically seen as a sign of good health but sometimes is raises flags for could they have had asymptomatic infections with atypical immune response?
Do your kids have any behavioral concerns? |
Hi, can you post who you recommended In nj- myofunctional therapist and airway informed orthodontist?
Thank you!
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amother
Feverfew
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Tue, Jan 18 2022, 11:56 am
| honey36 wrote: | | Yes I've heard of the breath Institute and it's definitely top of the line, but there are plenty of good providers with similar experience/specialization around the US. Where are you located? You can pm me if you want. |
I'm in the Midwest.
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amother
Chocolate
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Tue, Jan 18 2022, 11:58 am
| riks wrote: | Hi, can you post who you recommended In nj- myofunctional therapist and airway informed orthodontist?
Thank you! |
Orthodontists: Dr Barry Raphael in Clifton, Dr. Jennifer Morrison in Red Bank, Dr. Naomi Hillel in Edison, she’s a dentist but somewhat airway informed and does the ALF.
Myofunctional therapy: Shira Kirsch in Howell and Jessica Sweeney in red bank
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amother
Feverfew
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Tue, Jan 18 2022, 12:08 pm
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amother
Feverfew
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Tue, Jan 18 2022, 12:09 pm
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Any other way to find someone near me? That other link came up with nothing near me.
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amother
Foxglove
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Tue, Jan 18 2022, 12:14 pm
| amother [ OP ] wrote: | hi, does anyone have experience with loratadine oral solution and fluticasone proprionate?
ENT recommended it before surgery? |
Seems like your original post got hijacked...
To answer your question. Yes. We did Flonase (fluticasone) for one month per ENT recommendation, for my 2 year old. This is because his sleep apnea was labelled "moderate to severe" based on the sleep study. His tonsils are so large, that it did not make a difference. We are planning for surgery. My older daughter had her tonsils and adenoids removed for severe sleep apnea, it was one of the best things we ever did for her. Her sleep and behavior improved drastically following the surgery. My husband had his tonsils removed as a child, and is so grateful for not having them. I have huge tonsils, and unfortunately they cause difficulty breathing especially when I have a cold. My voice is kind of nasal because of them. I snore at night sometimes. I get strep a lot. I wish my parents had gotten my tonsils out as a child, but oh well.
The reason your ENT is ordering those meds is because your child might be a borderline case. Prior to doing surgery, he just wants to check if this will resolve the problem. You did not give a lot of details, but I think usually these meds do not help. It's worth doing the trial as recommended, but do be prepared that your child may need the surgery. And it is probably something you will never regret doing.
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