Monday, April 28, 2008

Test Results


Results came in today. First of all Abby's blood work came out normal! Yeah! It doesn't look like she has any sort of infection (CRP level) and her hypothalamus is "probably" not the cause of her wacky temps. I suppose we can chock her low grade fevers into the "Fever of Unknown Origin" box and leave them there. Honestly we haven't been paying too much attention to her temps lately because other issues have taken precedence. Yesterday it was 99.8, which 'technically' isn't considered a fever. Hopefully this issue will eventually resolve itself... but in the meanwhile, we will turn our energy towards other things.

Reflux.

The GI office called with her Gastroscopy and pH study results. Despite efforts to prevent/decrease Abby's reflux over the past 6 months (increased Nexium, and J-feedings), her esophageal biopsies showed reflux. Although this is discouraging, we aren't surprised.

Official report: "The pH probe study didn't show a lot of reflux but what did come up is very irritating to her tissue".

This report didn't seem very quantifiable or comprehensive, so I pushed for more details. Unfortunately the doc doesn't make these calls himself, so the nurse who is just reading from a brief summary can't usually answer our questions. As I tried very hard to be patient and friendly I still wanted more info. She was able to tell me that the test showed a total of 17 episodes in the 24 hr period. This didn't sound too bad to me initially, remembering that Abby's first pH probe (6 months old and 5 lbs) showed over 500 episodes! But then realizing that she is not getting any feedings into her stomach and is only secreting gastric juices that are still backing out of the stomach into her esophagus seems concerning. She wasn't able to tell me how long the episodes lasted and if they correlated with the diary we kept during the test.

The doc ordered an increase in her Nexium to 3 times a day, and encouraged us to try Carafate (a liquid coating). This should be interesting as Abby will have to swallow 2.5cc of liquid. Might not seem like much but you'd be surprised what a challenge this can be in kids with dysphagia and oral motor dysfunction... not to mention a kid who just plain Hates to swallow! We'll see how this goes. We are supposed to give it 2 weeks before we consider more aggressive measures.

I'm guessing we will go back in to speak face to face with the doc about the results and obtain more detailed information and hopefully form some type of plan.

Abby had feeding therapy today. Her OT has noticed a sharp decline in her oral skills and swallowing since last fall. Abby no longer tolerates the hour long session like she did before. There are no signs of swallowing at all, rather big sloppy messes in the bib. We still plug along trying to give her a fun oral experience with hopes of feeding improvements to come.

Josiah has started potty training! Yikes. I don't know how committed he is to his new potty chair yet, but I guarantee he will have plenty of opportunity to become very familiar with it. We bought him some super cute Big Boy "undies"! He likes wearing them.

Useful Potty Training tips are welcome!

5 comments:

Anonymous said...

P(SQUARED)

Maybe if you tried feeding Abby some tots, she might get the hang of it.

Uncle Rico

Superdave said...

Patrick and Patty,

Somebody should tell Uncle Rico to shut up and stop ruining your lives!

Gracie and I will continue to pray for God's intervention (that He will be your Intervener :) for Abby.

Love you guys,
David

The Caldwells said...

Ok. Potty training for boys. That's a world of it's own. Nate likes to stand to pee (then again there wasn't much choice--daddy said so. haha). During the summer we let him run around with his "big boy" undies and in the privacy of our backyard and many, many trees (the Filipino in me coming out)... you get the picture. The first couple of months when the interest wasn't very strong we gave match-box cars as a reward since they were his favorite (you can buy a 'sleeve' of them for a couple dollars). When we were giving away a car a day instead of a car a week or longer we had to get another plan. So the next was a big, blue poster board and as I wrote "Good job! YEA! We're so proud of you! etc.. all over it he used his crayons and then we hung in on the bathroom wall with ticky tac and every time he went potty he got a sticker (which he picked out weekly at the store) LOTS of Lightening McQueen ;) I was worried he'd never go without a reward... but one day he said he didn't need them anymore bec. he was a big boy. haha! Another friend put cheerios for her son to 'aim' at. This was long, sorry. But I don't have your email. Have fun! Krista (Wiese) Caldwell

just me said...

Hey Pats... I've potty trained 2 boys and a girl so far (one boy left but he's not quite a year so i've got another year to go til then.. ha ha). I SUGGEST sitting! it's SO much cleaner!! :) we started with the small potty chair. with noah - we bribed with candy - it lasted a while... then it went from a jellybean everytime he pottied to just a jellybean everytime he went "#2". and at some point we just quit them all together. big boy undies are huge. pull ups (in my opinion) prolong the process. with micah we only used pull ups at night. undies hard core and didn't look back (until he completely regressed with our move etc .. but he's now fully "re" trained...). set the timer. make a big deal out of "trying" and "going" ... do a potty dance when he's successful... with carissa we did stickers everytime she went. that was enough for her. she was trained in a week and hasn't had a night time accident EVER! (she trained at 27 mo)

anyway... happy training. i truly think it's more about training the MOM than the child... and if the kid is ready it happens fairly easily - we pushed, i think with noah and it was a much longer process....

hope SOME of that helps...

lots of love!
Charity

BusyLizzyMom said...

Reflux is the root of the problem for so many of our kids. Hopefully with the meds their will be an improvement.
As for potty training, Elizabeth still liks the candy reinforcers and the PEZ dispensers are great. I do agree at first it is potty training mom, I blame myself for her accidents.
Good luck.