Wednesday, June 10, 2009

Gastroenterology

That's a mouthful, huh? And why is it called GI for short? Where's the I?! I'm assuming it's for intestinal? Anyway...

The doctor was great. Carver actually spit up a little in the office and I was able to show him before I wiped him clean. Just the classic white curdles. I felt like the doctor took us seriously, considered the implications of SPD and make an accurate diagnosis.

It's not what I wanted to hear.

It's called "rumination" and it's a VOLUNTARY regurgitation, a habit or nervous twitch in the stomach that forces food back up. I've googled it and it fits Carver perfectly. It's more common in infants and children with developmental delays/disorders, it's (sadly) often linked with a lack of attachment or the absence of a mother. But we're not going to dwell on that part because it's not our situation, right?

Carver's tendency to eat quickly and not chew well lets the food sit in his stomach longer, making it easy to regurgitate. We'll work on those as best we can.

Another recommendation was to use bio feedback, which is more a psychology technique that builds association with the habit until you can use that association to control and eliminate the habit. For example, singing the ABC song is something other families have done with each regurgitation. I'd be singing it continuously sometimes. He suggested a toy that makes noise, essentially a distraction that will take attention from the behavior and eventually replace it. I get the concept, I'm just not sure how we're going to do that exactly. He recommended a child psychologist for more help. Sometimes anxiety/anti depressants help, but he doesn't recommend that. Thank goodness!

Speaking of medication, he'll stay on his Zantac indefinitely. It doesn't help the rumination, but it will control the acid and prevent damage to his esophagus, teeth, etc... Carver doesn't mind taking it, it doesn't have negative side effects. The dose was right, so we'll be refilling that somewhere cheaper than Bartell's and trying harder not to forget.

The doctor also said that there was a 5% chance there was something else involved and said we could elect to do an endoscopy (en-DAH-scuh-pee). I still have to repeat it in my head a couple times to say it right. Anyway, it's the procedure where they send a camera inside, take pictures, biopsies and rule out any other medical, physical problem. Allergies, hernias, ulcers, etc... It's done with general anesthesia at the Children's Hospital in Seattle. We've been there with ear tubes and it's a very similar experience. It'll be half a day at the hospital for a 10 minute procedure. He couldn't recommend it necessarily and left it totally up to us. His nurse told me after he left that he's very straight forward and would've said one way or the other if it mattered to him. I liked knowing that, but I still wished he'd just decide. Then I thought about my last post and how much I believe in mothers knowing what's best for their children. And I suppose I'm grateful to be involved and respected in Carver's healthcare.

I worried and thought and second guessed all the way home. And I prayed - a LOT. I've been fasting and praying to know what to do, to get answers and to be able to help Carver. I worry a little about the anesthesia because I can't help it. But in the end, I really feel like it is a good idea to go ahead and do the endoscopy. We might not find anything, but that alone would give me the energy and focus to move forward on the rumination with no question in my mind that there might be more to it. I'm pretty sure I don't WANT to find anything else. That would just make everything more complicated.

The endoscopy is Monday morning, bright and early. I haven't gotten all the instructions yet, but I know for sure that he's not eating anything after 7 pm the night before. And I think he's on a smoothie diet the 12 hours before that. It's a good thing he likes that sort of thing, but I still anticipate a rather grumpy day.

I think we'll know some results right away, but the biopsy results will take longer and will be discussed in another office visit. I feel tired thinking of another long-term condition to overcome, but I am so grateful to KNOW. It's where everything has to start. Now I just need to focus on HOPE in the future and the courage to keep heading that direction.

5 comments:

Ebony said...

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Kari George (AKA Mom) said...

WOW...rumination? Who would have guessed? I've never heard of that, but you are right...sounds like the gi doc knows what he is doing. Isn't that a nice feeling to feel confident that the doc knows what he is doing? LOVE IT! (BTW GI stands for GastroIntestinal).

Interesting that rumination is associated with a nervous, self induced state. It really goes to show you how our SPD kidos are having a difficult time (anxiety) and they are dealing with it the best they know how (as a result...Carver does rumination). YOU now get to learn about rumination and turn this around for Carver...YOU get to teach him the appropriate (non self destructive, socially accceptable) ways of dealing with his anxiety. Make this a positive spin for yourself, instead of a negative one. YOU CAN DO THIS! Take a deep breath (smell the roses...and blow out the candles) and learn yourself...then teach Carver!

BTW...I would also have done the endoscopy if it were my child. So in my opinion, I think you did the RIGHT thing! I know this is all scary and is probably causing you some anxiety, but YOU can do it! Carver will feed off of your energy (positive or negative), so make this a positive experience for all! In the end you will KNOW FOR SURE if there is something else going on!...and then you can move on!

Take care of yourself in this process...and always remember to just love Carver just as he is!

Now...off of my soap box! Have a good one! I'm thinking GOOD thoughts for you and Carver!

Kari

donna said...

Wow! Just think how far you all have come! We're praying as always and I'm grateful for a doctor who listened and cared. You are right to have the endoscopy. No point coming this far and not checking that out.

Kari is right, YOU can do it. Hopefully, we can help sometimes.

Alice Wills Gold said...

I love smart doctors with accurate diagnosis.

It is really amazing what the body and mind can do. I have never heard of this disorder, but I have full confidence that if any mother was built to overcome it, it's you.

God bless you and Carver in this new journey.

I hope you will be encouraged with the hope for a better spit free future instead of discouraged with another label/condition.

You can totally do this and Carver will totally overcome it.

Kent and Leisy said...

kent learned all about rumination this past year in school. It's not too crazy actually- and some people do it as adults (not that that is necessarily encouraging!). My neighbor had a roommate who did it in college! anyway- metta got an esophagogastroduodenoscopy not too long ago- I'm assuming that's the type of endoscopy carver will get?! She said the experience wasn't too bad. Her pictures of it all are actually on my blog! you can just search my blog for "scope" and it will pop up.
I'm glad to hear that you guys are making such progress. You are an inspirational mother!