Please help with next steps - breastfeeding at major risk - Page 31
I'm just so glad he's more clued in to little Ellie's issues - at least to the point of wanting to do a scope. How do you feel about that? I never felt comfortable with it but it was never seriously on the table for us. And Neocate "fixed" the issue for the most part. How are you feeling that he was open to talking nursing?
And way to time it, Ellie. Not that the odds are high she'd have a "great" moment at the appt, but the actual in-his-face evidence of her problems must have been helpful for everyone. Poor baby.
As far as nursing...I can tell he'd prefer I let it go. He is not a full on advocate. What he did say is that nursing w/ allergies, esp given my past failures w/ TEDs, introduces many variables. And right now Ellie is miserable and we have to get her to a baseline, first and foremost.so he just said that if I want to keep pumping, and we can get her to a baseline, we can discuss the reintroduction then. (Yeah, he used those words, lol). But he does raise a valid point. He mainly was stuck on that after watching her reflux and seeing how bad it is. His medical concern is that she has esophagitis and messing w/ eliminatin diets and variables that may continue that slide, is not good. So he just wants her stable first. Which I think is fair.
He would like to scope her in the next couple weeks. I'm really nervous about that procedure. DH and I agreed that we'll do a couple days off eryth, take inventory, start the Nutramigen AA, give is a week, take inventory again. If she isn't Substantially better, we'll proceed w/ the endoscopy. If she seems much improved, we'll ask for a couple week delay to revisit.
I don't Love the Dr. I do feel like I now understand his position, he listened to me and explained and discussed. I feel like we're able to get on the same team. He could tell I was so desperately exhausted.
And on a personal note..I put DD2 (be 3yo in 2 wks) on a waitinglist for a preschool program at our local Arts Center. Hoping she could @ age 4. They called today and have an opening for T/TH from just 9:30 till 12pm. I love the program...play based, super crunchy, my oldest went there. I decided, given the chaos @ home w/ Ellie and the lack of attention I feel like I can give everyone, that I'm going to go ahead and try her out 2 mornings a week. She is totally excited and independant and will do great. I feel some relief that she'll get to go have a blast there a few hrs a week. Will be a nice break for her.
I'm glad to hear that he brought up concerns about side effects from the drugs, and not wanting to medicate just to medicate. . It sounds like he wants to get to the bottom of this now. Way, way better!
Dd1 never had a scope - the esophagitis concern sounds legit to me - Most of the people who'd talked about the scopes said they weren't as bad as they thought they'd be, FWIW.
What did he say about the DGE suspicions?
Maybe he just has a standard brush-off approach with the first appointment and then if things persist takes you seriously? I know some Peds refer for any reflux med (weird as that may seem), so if he spends a lot of time just writing scripts for PPIs or Zantac because the Ped wasn't comfortable diagnosing it -- that might explain his dismissive attitude (not that it matters anyway since he's listening now).
ETA: Hurray on the Preschool, I'm sure that will be helpful for your 3 year old! And for you and Ellie, too.
He said with DGE he would recommend that feeding pattern too.
She was up exactly 1 lb as well. (Note: 12 of the 16 oz came during my BFing)
This experience has me left with a massive admiration and respect for parents of children with long term special needs. The chances that Ellie grows out of most of this in the next couple years is high. I can't imagine having a little one that for whatever reason, requires this level of care, around the clock need, etc...with no real breaks.
Mama's and daddy's of special needs kiddos truly have to be some of the most incredibly strong people on the planet.
And I'm thankful that your doctor is finally coming around. ...and that Ellie's gained some weight.
Just popping in to update the last couple weeks. We are currently on a Neocate, Prevacid, Zantac regimine, with Levbid as needed. She is about 85% better. She is happy much of the time, but fighting bad reflux, poor poor sleeping, and some gas. I would just say she is a kinda high needs reflux baby now, but smiles, kicks around, etc. She is also eating about 3-5oz at a time. She is pudgin up well. :) This is a doable way to live and the best baseline, by far, we have had. Her reflux is still pretty "severe" and on Monday we are going to go ahead with the endoscopy. She is chronically hoarse and the reflux is still bad. The GI dr says too much reflux meds can cause side effect in babies (headaches, etc) that many Drs dont always think about. He doesnt want to up any meds, etc without assessing the damage first. 3 weeks ago we quit the erythromycin and sure enough, a few days later she got nailed with NASTY trush. We tried days and days of probiotics and gentian violet and it didnt even touch it. She ended up with her entire tongue, cheeks, lips, throat and esophagus covered. Her "voice" was nearly gone. We went on Nystatin and 8 days later it was even worse. FINALLY we switch to Diflucan 3 days ago. Gave her a dose at 4pm and the next day by 2pm it was nearly gone. One more dose adn the next day there was not even a white spot. We gave her two more doses and are done. We are getting lots of probiotics down her now.
All in all, this is the longest happy baby stretch we have had. She is starting to play catch up, developmentally, and I think will be fine. I still sometimes find myself analyzing everything...she frequently does this head cocking to the left....she sometimes does this hand shaking thing...and stuff that I would never notice if there was not a history. But right now, she is within normal in everything, she has a couple chins, she smiles, laughs, is starting to roll over, and our family life is so much better. Things are feeling like we have found a new normal. Insurance denied our request for coverage for Neocate, despite 3 letters of medical necessity from Drs. With her increased eating we are spending about $1000 in Neocate, medicine and dr visit copays. Hoping some appeals with insurance will be accepted, but who knows. So that is a hit. She is SO interested in our food, and I feel bad that I can't let her taste some tidbits.
I am pumping just a couple times a day. I am not sure if I will give that a go again. I have pumped about 2-3 months worth of "clean" milk since this all started. When she is a few months older, I may try to get that into her.
All in all, life is good, she is significantly more happy, family is functional, and Ellie likes balls, her sisters, and to sleep on my chest. :) I will update again after the endoscopy.
And down the road we continue.....
Endoscopy showed she is all healed up and everything looks good. Now that we have narrowed down somethings, I am trying to make sense of this all. If anyone here has any brain power left for this, I am happy to hear thoughts. :)
So Ellie is 6 months now. The Neocate, Prev and Zantac combo has healed things up and she now no long has excessively bothersome gas and the all day crying. Now that we have knocked some of that out, there are still bits we are trying to figure out. (Note: Dr is just kind of back to 'sounds like it is under control because her endoscopy looked good and she is gaining weight' opinion).
-She still spits excessively, often out her nose, is chronically congested from it, wakes many times gasping from spitting in her sleep, still doesn't sleep laying down and not for any stretch of time.
-She still gets very uncomfortable when she eats more than 3oz. She WANTS more and will eat more, but then the spit up gets out of control and makes her miserable.
-Dr gave us the all clear to try a rice cereal. I got Happy Bellies kind so it is clear of any additional ingrediants that "may" bother her. I gave her a tablespoon of it and she spend the next day or two Significantly more uncomfortable and spitting, crying....was a bad scene. So do I stay away from solids? Or try the Happy Bellies oatmeal?
She is still far far from normal. I am just not sure what is normal for a reflux baby and should just be dealt with, and what needs flagged. My DD2 who was a severe but happy spitter was Never like this.
Honestly, with her I would *not* do rice cereal or any grains for a while. There is simply no need for them and grains are very hard on digestion. What about trying a nice bone broth? Lots of minerals.
The sleep stuff sounds an awful lot like sleep apnea which can be caused by enlarged adenoids. It's possible due to her issues that her adenoids and/or tonsils are enlarged from all the spitting up. If that is the case, her sleeping will not improve until that situation is cleared up. the only way to know for sure would be to take her to an ENT who would stick a scope up her nose & look at the adenoids.
Not sure about the spitting up or eating things. Has she ever had any structural work? Maybe she has something mechanical going on that can be helped by that.
Still so very rough. Still no answers. She is almost 9 months. We tried and failed now 11 foods. We have tried several BF-ing attempts, all failed and made her sick. She has rotated through various meds. No magic bullets. She is a little happier being mobile...moving and being distracted has been good for her. Bu the minute she is not distracted, it's really rough. We are meeting with an OT for a few developmental things, but nothing alarming and all deemed a result of just a rocky start....nothing they think is neuro based or anything. She wakes every 20 min to 2 hours all night every night. I'm so tired. Drs have discussed possible eosinophilic disorders so we are consulting with Cincinnati Children's. Our GI here sucks...said to give her anti-spasmotics and move her to another room to CIO. This is for sure the most difficult time I have had to cowboy up for. I feel pretty beaten most of the time. But we will get there. She is nice a plump, loves her sisters, and is happiest when moving and shaking.
and thanks for asking. I feel very alone in this...partly because no one IRL understands the angles like not nursing and the emotional stuff that is so important...or the difficulty in failed TEDs, etc, etc. I really appreciate the people here that spent so much time and effort working through this with me.