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[quote=Anonymous]PP if your DS came down with OCD after strep when he was 9, there is even greater chance to suppose the ED is OCD driven and strep may be the culprit.  An OCD like ED is frequently associated with PANDAS, often in the form of of an aversion to, say, certain textures of food.  There is some evidence that PANDAS outbreaks in teenagers more often take the form of an ED like disorder.

This is what I would do:  Get a strep culture for your DS and also have the ASO and anti-DNASE B titers done.  If one of these is positive, see if you can get antibiotics prescribed for your DS to see if that helps.  Steroid sometimes help as well.

Call someone like Charles Mansueto at the Behavior Therapy Center and explain the situation to him and see if they can help with CBT.  Make an appointment now with Dr. Beth Latimer in Georgetown.  She is the go to PANDAS person in this area.  There is a long waiting list but many come from out of town to see her, so frequently there are cancellations.  Ask to be put on the cancellation list, but don't rely on that.  Call up every week to see if there are cancellations.

If this is PANDAS OCD behavior, it often can be more treatable than a pure ED.  Further, the usual ED treatments often aren't that effective if it is actually PANDAS.  I would also suggest that you go to Latitudes.org and register on the PANDAS forum.  There are some very knowledgeable people on there, many in this area, who could give you some good advice on how to get treatment.

As for the OCD never entirely going away after your DS was 9.  I had a DS in this position.  He was treated very late for PANDAS as not much was available at the time. He did get SSRIs for OCD, but they did not help and for him caused side effects we could not live with.  He was diagnosed at the NIH but not accepted into their trial because he was deemed too chronic, which was definitely the case.  CBT at BTC (a year and a half!--ugh) basically took care of it until he got strep again as a college freshman.  The manifestations that time were quite different from what they were when he was a child.  It took a long course of antibiotics to bring the OCD to acceptable levels.[/quote]

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