Monday, February 14, 2011

GI Doc

Today we visited Lalo's GI doc for some insight into his issues with throwing up and weight gain.  This was our first visit to see the GI doc, we liked him and he has come highly recommended by our pediatrician.  He seconded the g-tube without a doubt.  He also took into consideration the pros and cons of the nissen surgery, pros being mainly the reduction in risk of aspirating into the lungs and cons being that it doesn't solve Lalo's issue of "delayed gastric emptying".  He feels strongly that the pulmonary doctors may try to insist on the nissen.  Based on Lalito's history of lung underdevelopment and of lung disease, Lalo puts a lot more at risk each time he refluxes (which is OFTEN!) If any of the reflux were to get into his lungs, he very well could end up with aspiration pnemonia, which of course means very bad things for his health.  Aside from considering the nissen, he wants to agressively manage his reflux.  He made several recommendations...1. Discontinue one of his meds (Bethanechol), 2. Almost double another med (erythromycin), 3. Decrease the volume of food he gets, increase how many calories it is (back to 27 calories/oz) and 4. Switch to continuous feeds.   We are happy to have a game plan and are very hopeful that it will have an impact.  The only part that feels like a step backward is the switch to continuous feeds, but if it helps we are willing to try it and work our way back once the vomiting is less of an issue.  This means that he will now be receiving food constantly throughout the day but at a lot lower volume per hour.  An added benefit of this is that we can work in almost 4 hours chunks of time, which means almost 4 hrs of sleep at a time!

The surgeon wasn't able to get us on the schedule for this week, so we have another week or so of the ng-tube.  We are getting more and more excited to have that off of his face.  The GI doctor was also encouraging that it may relieve some of his symptoms.  Just as we are getting ready to take one thing away, we are adding another.  Tomorrow Lalito gets his helmet, that he will have to wear for the next several months. 

Please pray for our cdh friend D - he is back at Hopkins and developed some new issues.  He and his family can really use any prayers and good thoughts you could send their way.

Happy Valentine's Day!

2 comments:

Nicole said...

Praying for you guys! Hope these issues get resolved soon! Lalito is so handsome and looks like such a happy little boy! Give both boys kisses for me :) Love you guys!

Anonymous said...

Have you started those changes?

Good luck,

Aunt Kirsten