How Do You Know Whether A Reaction to Meds is Herx vs adverse drug reaction?

Hi Lymies,

I've been on amoxicillin 1000 twice a day and Mepron 750 mg twice a day.  I'm also supposed to be on doxycycline 100 mg every day, but when I took it a few times, I had breathing issues which were scary to me so I stopped it.  I had to stop Flagyl for the same reason - because it caused even worse breathing issues - feeling like I might not make it through the night.  My question:  How do I know whether the breathing issues were herxes versus adverse reactions to the medication?  I don't have the breathing issues on amoxicillin and Mepron.  Since being on both of those medications, the persistent  rash on my forehead and cheeks has disappeared which I am very happy about!!

Remembering the dolphin trainer from Orlando on the DVD "Under Our Skin" who stopped breathing and whose fiance called the ambulance, I can't afford to stop breathing at night because I don't have anyone to call 911 for me!  If I stop breathing, it's the end of the road for me!!  That's why I can't take a chance on anything that worsens my nighttime breathing.  I am already on CPAP and oxygen support at night.  It really is possible that I have Lyme/ALS.  I recently had a nerve conduction study done where four points on my calf did not conduct the shock. The neurologist hastily concluded it was merely age-related despite my neuro symptoms.  Frustrating!

Any thoughts on how to distinguish a herx reaction from an adverse drug reaction?

Thanks!

WAF  

[JackieCalifornia]

Hi there

This is a question that is too important and too technical for us not-medically-trained people here to say.  In you it might be a drug reaction, while the same symptom in someone else might instead be a Herx.  

Given that you have other breathing issues and have a CPAP mask, it's really important for you to talk to your doc.  Maybe s/he can vary the meds or the timing of the meds so you're not having difficulty at night, but that's truly your doc's call.

MedHelp is, after all, only a website and nobody here is medically trained.  

Take care, hope you get it figured out.  Let us know what you hear back, hey?  J.

[wonko]

Of course, the advice to consult your doctor is always a good idea in these matters, but for what it's worth I'll share what my LLMD told me about this, as I've asked the same thing to him.

I was told that if you are having an allergic reaction or a side effect to an antibiotic, it will start quickly and persist until you stop using the antibiotic.  On the other hand, a Herx may take days or even weeks to onset, and may continue after you stop the antibiotic.  Herx symptoms may also come and go while you are on the antibiotic.  

Shortness of breath is nothing to scoff at.  You may want to investigate and ask your doctor about "air hunger."  I never really understood this symptom, even though I think I experienced it before.  I think it is most often associated with babesia, but I've always found there to be a lot of overlap between the various co's.  

I hope you feel better soon.

[Weakandfalling]

Thanks for both your responses.  Sounds like my breathing issues were side effects because
they were worse when I was on the antibiotics in question and improved when they were stopped.  Didn't last for days.  I'm not willing to take a chance with nighttime breathing issues (no matter how highly rated the antibiotic is) because there would be no one to rescue me if I did stop breathing at night.

Regarding "air hunger", I do have that at times and have to take a break sometimes mid-afternoon to lie down and have my "Periair" break with CPAP and O2.  Afterward, I feel so much better!

Hope you are both doing well!

Hugs from,

WAF

[JackieCalifornia]

One more thought:  Can you work with your doc to reschedule your medication times so that you are awake for a period of time after you dose, a period of time long enough to get you past any scary reaction possibility?

Rather than take the meds at, say, 9 pm, dial it back to 6 pm?  Just a thought, your doc would be the one to say.

[wonko]

That's a good idea about the timing.  I do that (with my doc's ok) on various meds.

When I start a new med, I try to take it early enough in the day so that I can observe how I react.  If it's a med I'm used to but that gives me a lot of grief, I move it to right before bed in hopes of sleeping through the worst of it.  

Certainly I can understand not wanting to risk having a breathing issue while alone!  Even with someone there, a bad Herx can be scary.  I recall (though I'm trying to forget!) nights when I was scared to go back to sleep, etc., because of how awful I felt.  

Definitely keep your doctor in the loop about the breathing and Herx symptom issues.  My doc always advises me to back off if I can't tolerate a med or a certain dosage.