B.J.

B.J. is a nine-year old boy who was initially evaluated on November 10, 1997. His parents' chief concerns focused on mood swings and a decreased attention span.

During infancy, B.J. was "always active and on the move, demonstrated an increased temper and a poor sleeping pattern. Despite an articulation problem, his speech was normal and with the exception of sloppy handwriting, so was his coordination. B.J. excels in mechanical skills and is proficient with a computer. He has had only several sinus and ear infections his entire life.

Nasal symptoms have been increased since age three and have gradually progressed. The nasal symptoms are perennial, but appear worse in the spring and fall. Over the counter medications result in hyperactivity-type behavior. There was a positive history including the allergic salute and a croaking throat sound. For some time, B. J. has dark circles under his eyes, increased eye itching and lid puffiness that is only prevalent in the spring. He has tinnitus at night, significant post-nasal drip that provokes sore throats and chronic hoarseness. His cough is thought to be secondary to post-nasal drip and is although perennial is worse in the spring and fall.

B.J.'s behavior includes a diminished attention span and concentration, forgetfulness, hyperactivity, fatigue at times and difficulty following directions. As of November 1997, B.J. was also "aggressive, loud, temperamental if upset and easily frustrated." According to his mother, he never settles down and "is always into something." At age three, a day care provider suggested B.J. suffered from Attention Deficit Hyperactivity Disorder (ADHD), and by kindergarten he was described as not listening or following directions and was suspended.

B.J.'s parents were already aware that he was affected by certain foods including hot dogs, apples, candy and dyes. He was described as being "hyper and mean" after the ingestion of artificial dyes. Prior to visiting our office, he was on the Feingold Diet for approximately one year. The diet helped with B.J.'s his impulsivity, aggressiveness, and self-control.

B.J. was assessed and diagnosed with ADHD as well as "Oppositional Defiance Disorder" traits. His other problems included Central Auditory Processing Disorder and Graphomotor Disorder. A recommended trial of Ritalin resulted in no benefit and caused nightmares and stomach pain. Above a low-dose of 5 mg. he was described as being a "zombie." Sensory Integration Dysfunction was obvious in the B.J. has a history of being sensitive to loud sounds and prefers loose clothing. He is also a hypersensitive child who is aware of aromas, sensitive to medications and dislikes the smell of lawn spraying in the spring and summer.

When I initially saw B.J., his diet included drinking milking, approximately two gallons per week, as well as ingesting many other dairy products. Physical examination was normal for the allergic shiners and the allergic appearance to the nasal turbinates. I recommend extensive allergy testing and restricting all dairy products for two weeks to see the effect.

At the follow-up visit mid March 1998, B.J.'s response was dramatic. He was being treated for allergies to 27 foods in his diet, 25 molds and 8 inhalants. His largest reactions were to dust, mites, cheese, chicken and beef.

From December 1997 to March 1998, B.J. did not experience any hoarseness or a cough and did very well in school. A review of medical symptoms included a significant improvement in ear, nose, throat, and eye conditions, decreased hoarseness, decreased cough and improved energy. His attention span and behavioral concerns were also significantly improved. According to B.J., I feel like I can concentrate better in school." His mother commented that "for the first time in his life, B.J. was able to sit and read."

In conclusion, B.J. represents a child whose diagnosis of ADHD was primarily allergy-induced and complicated by his sensory issues and learning disabilities. Stimulant medication was not necessary for this child.

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