Monday, December 6, 2010

Gastro visit

This morning I took the kids to school for the Parent Discussion group. We were a tad early, although I felt like we were running super late. The kids were the first ones in the classroom. I came in to help them take their coats off. Nikko wasn't frazzled this time around. In fact, he was eager to dump his coat and start playing. I took my cue and left the room quickly after that. It was nice to be in the company of adults without any kids pulling at me, and the hour went by too fast.

Mom came at 2pm to watch Ronin and Audrey so I could take Nikko to the gastro. It was on the far side of the Glen. Good thing I called them this morning to confirm their address, otherwise I'd be wandering Glenview North Shore Hospital with no one knowing which doctor I was looking for. We arrived, filled out the paperwork, and got height (41") and weight (44 lbs) by 3:15p. When Dr. Nelson came in, Nikko was munching on his umpteenth lollipop. He wouldn't sit on the exam table, and since she was going to feel his tummy I had to put him in my lap while she held onto his legs. He struggled mightily, whining and crying. It's a good thing he didn't have a more intensive exam because we would need more people to hold him down. I told her about everything I've done with him since the summer, about our bouts of miralax, about how he has soft poops but difficulty pushing them out so there's a blockage. She was kind and listened. I asked her if she had worked with other kids with autism and she said that she had. Dr. Nelson said constipation was common with ASD kids, but I already knew that. She told me that the colon stretches out and the blockages just pile up, so she recommends upping the dosage of miralax to 3/4 capful to clean him out. THEN, we'll work on building fiber back in. And sometimes, some kids end up staying on miralax for a long time. However, they can outgrow it. She said that the colon is pretty long, so the blockages might not only be at the end. That's why she wants to clean him out completely. A week on the higher dosage, then a phone call update to see if tweaking is needed, and then keep him regular for a month. THEN the rebuilding. She said not to use Benefiber or the MoPo at this time, because the psyllum fiber is a bulking agent and that's contributing to the blockages, it cancels out the work the miralax is doing. Ok, fine. I think Dr. Nelson could hear my anxiety in my voice about not understanding why Nikko is the way he is, so she said that she doesn't have a crystal ball to see what will happen, but we'll take it in steps and the first step will be to clear out his system. She also mentioned that he should be tested for celiac disease to rule it out, that it's not common in ASD kids, but constipation is a symptom of it, thusly leading to a gluten-free diet. On Saturday I think we will take all three kids to Northwest Community Hospital for a triple blood draw, since the younger two need a draw for their RAST test from the allergist.

Heavy sigh.

But I felt good about the visit. The doctor didn't tell me I wasn't doing the right things, she seemed to want to guide us with first steps. The miralax will help clear Nikko out, I hope, within a week at the higher dosage. We'll see.

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