Last week Luke had a visit with the GI doctor. Thankfully nana was able to watch Cody while we went to the visit, because, well, doctor visits are much easier without a bored four year old!
I immediately liked the doctor, Dr. Peter Lee. As soon as he came into the room it was obvious that he cared. And that, of course, is a big plus. Even better was that Luke was comfortable with him. Luke has been afraid of doctor's offices, even the pediatrician that he has been going to since birth, since his ER visit. He cries, clings to me, tries to get out of the room, and is generally miserable. Dr. Lee let him sit on my lap in a chair away from the examining table throughout the whole visit, and Luke never once cried.
Dr. Lee went over Luke's allergic symptoms, including the ones I had noted since he was two weeks old. Before the visit I typed up a quick time line of the various symptoms I had noticed going back to the beginning. I included it in the stack of papers - growth chart, ER summery, etc - that I gave the nurse. It impressed me that Dr. Lee had taken the time to read it before he came into the room. He asked me about Cody's growth charts (very similar to Luke's - they're both tiny!). Asked me about Luke's reaction to peanut butter. Took a quick look at Luke's hiney to see the scar he has from a bad diaper rash, and the "allergy ring" that he has on his bottom.
Then he asked me what my goal was from being there. I told him that I just want Luke to be comfortable. Luke has always been a happy baby, smiling, laughing, just generally happy. But a child that poops hard pellets more than 5 times a day, has a constant runny nose with major congestion, dark and/or red circles under and around his eyes can't be comfortable. Luke's congestion is equal to if an adult had a cold that lasted for months on end. Just think of how miserable it is to have a cold for a week or two. Now multiply that by a few months. It can't be fun. All of these symptoms have been going on since Luke was just 2 weeks old. His answer was that it was a good reason to be there.
Dr. Lee then addressed Luke's poop issues. First he went into how to make pooping easier for Luke. 1tsp of Miralax to start, mixed with his milk every morning. He explained that it would take a few days to work, since he would still be getting rid of the pellet that were already formed. But once those were gone, the Miralax would add enough water to his poop to make them normal. He said I could reduce the dose if it cause diarrhea, or increase it if it didn't help.
Then he moved on to finding out what is causing the constipation and other allergy symptoms. Because Luke tested positive to so many foods on the patch test (14 of the 19 foods), Dr. Lee wants to do an endoscopy. This wasn't a huge surprise to me. Luke's allergist had mentioned it at his last appointment and I had read about it some on message boards. Dr. Lee explained the endoscopy to me. It's a simple procedure, although Luke will have to be put under. They will give him laughing gas to make him sleep, and then during the endoscopy they will take a couple of small samples of his esophagus. That part will only take a few minutes, and once they're done the gas will be turned off and Luke will wake up slowly. We'll be able to go home the same day, and Luke should have no pain or recovery from it.
Once that is done, they will use the samples to determine if there is any inflammation of the esophagus. If there is, we will have to eliminate some foods from Luke's diet for a certain time period and then go back for another endoscopy. If that endoscopy shows that the inflammation is gone, we'll know that one of those foods is triggering the inflammation. If it's not gone, we'll have to eliminate more, have another endoscopy, and hope that it shows inflammation is gone. It'll keep going like that until they find what is causing it. If we have to eliminate too many foods, he may have to go on a special formula to ensure that he is receiving all of the nutrients that he needs.
Inflammation of the esophagus is referred to as eosinophilic esophagitis. Although I hope to find what's causing his symptoms, I am praying that he does not have this.