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PeterPan

Would you go to the ped for yellow jacket stings?

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My ds got into yellow jackets Wednesday and was wearing long sleeves and corduroy pants, all a size too small. (He has autism, so he does weird things with clothes.) We got the clothes off and he had 4 stings that we can count. We gave him tylenol, benadryl, a chamomile tincture, and repeated doses to keep him calm and iced them for swelling. The itching would reappear as the benadryl wore off, and he would tug at his shirt, which was our clue to give him more.

 

Next day I thought he was ok, and we applied a topical cortisone cream.

 

Today, apparently he's been itching them more (no benadryl and can't find the cream), and now he has rashes around them, about 2" in diameter around each sting. So his arm, chest, and back areas each have these rash/welts from the itching. And today his behavior got much worse. He has autism, so instead of just saying he was itching, he becomes very dysregulated, does sensory seeking (wanting to wrestle you, throwing heavy things, etc.). He can't say how he feels and still has wetting incidents, etc.

 

So anyways, I got benadryl and more chamomile tincture into him and he finally calmed down and went to sleep. But now I'm wondering if these rashes are going to clear on their own or whether I need to take him to the ped. I'm not meaning to seem anxious, just saying I'm googling this and realizing I could have been slow on the draw here. 

 

Options?

1) keep giving him benadryl but call the ped office tomorrow and ask for the correct dose for this. Don't die, but all I had was adult benadryl. I've been pouring off half onto a spoon and failed to check to see the correct dose for his age/weight. Actually I never know. With the tylenol for his teeth, the ped gave us a dose. When he has teeth pain, he makes holes in the drywall and doesn't tell us what's wrong. And actually he went to the orthodontist on the same day as he got stung. For real. He screamed and screamed, sigh.

 

2) take him to the pool or dilute some bleach to let that dry them out. I have no clue if it would work, but I had a funky growing reaction like that in middle school that cleared up snappy fast after a day at the water park.

 

3) take him in to the ped in the morning and have them write some kind of scrip for something to nab it. I don't know what that would be, but googlefu is saying an oral corticosteroid.

 

Any opinions on how to know what I should be doing? I'm definitely not winning mother of the year on this one. :(

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It can't hurt to call the pediatrician and ask for their advice. 

 

My ds got stung yesterday. Sigh. More than 4 times, for sure. Ended up with swelling in places he wasn't stung (including his lips/nose), all over rash and itching, and hives. We gave him a double dose of Benedryl and rushed to the ER. Now he, like his sister, will carry an epinephrine pen for a sting allergy.

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PS Benedryl is dosed by weight. Do you know his weight? Also, you can safely give a double dose if needed, but you don't want to do that regularly.

 

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Every time I get stung I get a red, itchy patch all around the sting for a few days; seems to be a normal reaction.

 

If benadryl is keeping him comfortable I would stick with that. If he will tolerate a hot compress for 15-20 second right over and itchy patch that can provide near instantaneous relief--itches like crazy while heat is applied then stops itching when removed and doesn't start again for awhile. I use a warm wet rag heated in the microwave for a few seconds until it is a barely tolerable hot (be careful not to heat too long!)

Edited by maize
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Yes, take him. The stings could be infected, even if he hasn't been scratching. It happened to me a week ago and I am on antibiotics as well as antihistamines.

 

ETA: get a sharpie and dot the outline of the affected areas -- then in a few hours you can see if it has changed for better or worse.

Edited by Vida Winter
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Oh wow, I'm googling this. The benadryl site says one thing and a children's clinic says another. Either way, I could have given him 25mg, and all i gave him was 12.5 (half the 25mg capsule). Sigh. Ok, so I've got a window there.

 

I know it sounds terrible, but I'm just so scared to give it to him. There were stories in the news of a baby that died from benadryl by a babysitter, so I didn't know what dose would hurt him. When your kid is screaming to high heaven, you just do it. And he fights children's chewables, hates the liquids, etc. He's a real bear. I put the nasty capsule powder on a spoon with some sugar and he fought that an hour tonight. I kid you not. 

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I don't know if benadryl is keeping him comfortable. It makes him groggy and sluggish, and he said he doesn't like how he feels on it. So that's why I was trying to decide if dosing him with it will help or if it's just unnecessary side effects and not going to solve it anyway. Remember, he's got the mental piece too with his rigidity. Like right now, he's scared to go outside because it's always on his mind he could get stung, sigh. So anxiety, a really b&w condemnation (I don't like that, I'll nevr take that med again). I'm telling him the rash means he has to have medicine, but I've got to make sure I'm giving him the RIGHT medicine. That window is gonna be short or my credibility will be short.

 

Antibiotics, wow, I would have had no clue! I'll google that. I need to peak more. To me some are the speckled look and the ones on his back near the waist line are more raised.

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Any chance he like chocolate syrup or whipped cream? Those can had powder/liquid meds very well.

 

Any chance he might like the tight squeeze of an ace bandage on the spots? Put some medicine on the spots under the bandage. This helped my DN( also artistic) stop picking his stings. He loved running his hands on the ace bandage.

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A little good news. I checked him now, while he's asleep, to draw lines around the rash and measure change. I think it's going down with the Benadryl. The raised has lowered and I think it is smaller. So I drew lines and will continue to administer.

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Just fyi: when my kids have been stung, the worst seems to be 2-3 days after the sting.  That's when it looks the worst in terms of swelling and redness, and itches the most.  It seems to get steadily better from there.  Hope that ends up being the case for your son. 

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Raising him is more like veterinary medicine than pediatrics. :lol:

Well here's my veterinary medicine story then:

 

My cat was stung by a bee or wasp a few weeks ago, his cheek was all swollen up from it and he scratched so badly with his hind foot that he scratched a big sore clear down to the muscle. It look horrendous.

 

I bought him a cone collar to prevent further scratching and kept antibiotic ointment on the sore for the first few days. Left the cone on for two weeks, though I found I could cut about half of it off so it didn't bother him as much but still prevented the scratching.

 

It all healed beautifully.

 

Not replicable with your boy of course :)

Edited by maize
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If Benadryl is working, I'd continue. Also pick up more cortisone cream/ointment. If you wanted to use a lower dose because of drowsiness, you could use a different type of allergy med with it (like Claritin), to give extra antihistamine effects but not extra drowsiness. The stories about babies dying from Benadryl have to do with difficulty breathing, and sizes of babies. Older kids, and especially adults, do not tend to have those problems because they are much larger. The maximum Benadryl dose is really high so it's unlikely you're overdosing. I'd recommend measuring for the future, though.

 

FYI- reactions from stings can easily last a long time (weeks), but should not be worsening, as infections cas occur.

 

Cool compresses help a lot. Sometimes regular Tylenol helps if there's pain too.

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The last time I had a wasp sting, I had some sort of reaction where my arm/joints ached. My sting was mid-forearm, and I had pain radiating down to my wrist and up to my elbow. Google said it was a type of allergic reaction. I'd been stung before but never had this problem.

 

(I include this off topic anecdote just in case he starts having pain that seems unrelated to the sting site or itching.)

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Oh that's really interesting about the joint pain. I hadn't thought about that, and you're right, he wouldn't say but would just be feeling it. 

 

I think his system is a bit overwhelmed. They're on different parts of the body (chest, back, arm), so the effect is sort of overall overwhelming. 

 

I did find the cortisone cream, hallelujah. 

 

Thanks for explaining the peak can be at 2-3 days. That's definitely fitting with this. The stings were Wednesday, and this was Friday. So we'll see if it stays stable or starts to go down. 

 

I have some Zyrtec, but it makes me a little loopy. I don't have claritin but can get it if this is going to go on. I did find on the dosing that at his age/weight he can now take the full capsule of the adult bendadryl and be fine. Thanks for explaining what was going on with the babies. 

 

Oh dear, the reaction can last weeks? Ugh. 

Edited by OhElizabeth
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A month ago my 14 yo ds was stung.  After 2-3 days, his swelling was not going down.  I took him to the doctor because he was getting ready to go to camp for 10 days.  She told me to give him benedryl or zyrtec and prescribed a steroid cream.  Went to the pharmacy to pick it up and it was going to be $80 after insurance!  There was no way I could do that.  So I called the doctor's office to see if she could prescribe something else and she prescribed a hydrocortisone cream.  It was less than $5!  He got stung again 2 days ago in the stomach and it is swelling up like before.  We are doing the same as the last time.

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If he's fighting off an allergic reaction, they may prescribe steroids. It's worth a call. Yellow jackets are nasty. 4 stings can kill someone allergic to them.

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I would greatly prefer ibuprofen to tylenol.  Tylenol is not anti-inflammatory and is much, much harder on the liver (depletes glutathione in a heartbeat).  (I can't overstate this; some people are even of the opinion that kids with issues should never, ever get tylenol.  I'm definitely not that extreme for my kid with issues - I gave it post-surgery when ibuprofen wasn't an option due to bleeding - but I try to avoid tylenol whenever possible and when I do give it, I try to add in a little liver support.)  Anyway, if there's swelling to go along with the bites, I'd definitely give ibuprofen a try instead, at a decent-sized dose.

 

If you want to try other antihistamines, our doc likes xyzal, which is now available otc.  (Weirdly, my kiddo does poorly on antihistamines - exacerbates something)

Edited by wapiti
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Oh dear, the reaction can last weeks? Ugh. 

 

I got a fire ant bite on my hand once--my hand swelled up and itched like crazy. The swelling went down after a few days and the bite mark cleared up but the itching went on for a month! The time I got stung by a yellow jacket was horrible for a couple days but cleared up faster than the fire ant episode.

 

:grouphug:  I hope your ds feels better soon!

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If zyrtec will work, I'll try that. I already have that. I checked the date, and I need new cortisone cream, oops. 

 

Wapiti, yeah, I put dd on glutathione after her extended tylenol use with her wisdom teeth surgery, ugh. 

 

Well I drew circles last night, and they're no bigger. The puffing went down overnight with the benadryl. I missed the ped office, but I'll keep dosing and creaming.

 

Thanks ladies!!  :)

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I would take him to the Dr.  Insect stings can become cellulitis fairly easily although that isn't likely the case if there is a rash around each sting.  The "rash" makes me think it is a mild allergic reaction which should be documented because reactions often get worse with each subsequent sting.  Also, he may need steroids to alleviate the current reaction.  

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Ok, I missed the ped. It's $100 to be seen at The Little Clinic at Kroger. I think I'm going to get a fresh bottle of the cortisone ointment and keep dosing him. 

 

That cellulitis term is popping me up better articles, thanks. Now I've got an article in the merck manual and it's explaining stuff. Insect Stings - Injuries; Poisoning - Merck Manuals Professional Edition

 

I drew circles around the areas and am watching to make sure it goes down. He's with his aunt right now, so I haven't seen how it looks for a few hours. 

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If you have or can get activated charcoal, I've had really good luck with that for wasp stings. It stops the pain immediately for fresh ones and my kids don't say another word about them after I put it on...even the really dramatic child with sensory issues. You can just make a paste with water or honey and put it on under a bandaid (it will stain though if it gets on clothes or anything).

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I would:

1. Crush a Zyrtec and hide it in pudding. You'll get better, longer control than with Benadryl

2. Try activated charcoal or another black drawing salve if he'll tolerate it.

3. Use triple antibiotic cream to stave off infection because odds are he'll scratch.

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As the parent of a child with autism, I know how dramatically life changes with simple injuries.  Sending you hugs and virtual chocolate.

 

In this case, I wouldn't go to the doctor. I would just stick to the Benadryl routine since you know it keeps him comfortable, (setting a timer to make sure that you stay on schedule) and keep an eye on the wounds.  If he tolerates band-aids, try covering the ones that are easiest to reach.  I would expect to see the covered wounds begin to improve quickly.  If after the weekend they are looking worse rather than better, then it may be time to see the doctor.

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Hope your ds starts feeling better!

 

Hope you killed the nest (if it was on your property). If not on your property, hopefully you let the property owner know about the yellow jackets.

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He took the benadryl with the chocolate syrup much better, score!

Woohoo. Also, really nasty liquid can be mixed with root beer or Dr Pepper. In case you ever need that in your book of tricks. Lol

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